Social functioning and its association with accompanying psychiatric symptoms in adolescents with anorexia nervosa

Abstract

OBJECTIVE: This study aimed to investigate social functioning and its relation to associated psychiatric symptoms and disorders in adolescent girls with anorexia nervosa. METHODS: Thirty-two adolescent girls with anorexia nervosa aged between 12 and 18 years were compared to a control group of 30 adolescent girls without any psychiatric disorder. The Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version (K-SADS-PL) was applied to determine comorbid psychiatric disorders in the anorexia nervosa group and to rule out any psychiatric disorder in the control group. Submissive Acts Scale, Shyness Scale and Social Comparison Scale were used to assess social functioning. RESULTS: Submissive behaviours and negative social comparisons were significantly higher in adolescents with anorexia nervosa and were more associated with the comorbid depression and anxiety symptoms, rather than the severity of anorexia nervosa symptoms. CONCLUSION: The results of this study would guide us to develop more effective treatment strategies for adolescents with anorexia nervosa who have comorbid psychiatric symptoms. Treatment strategies in this age group should consider social functioning and its relation to accompanying psychiatric symptoms and aim to improve social communication and coping skills.

Cognitive bias modification training of attention and interpretation to reduce expectations of social rejection in adolescents with eating disorders: A small efficacy randomized controlled trial

“…Adolescents with anorexia nervosa report submissive behaviors, unfavorable social comparison, sensitivity to rejection and poorer quality of social relationships to a greater extent than their healthy peers (Cardi et al, 2019 ; Kalaycı et al, 2019 ; Rowlands et al, 2021 ). Some of these problems, for example greater alienation perceived within family and peer relationships (Pelletier Brochu et al, 2018 ) and heightened interpersonal sensitivity (Rowlands et al, 2021 ), have been associated with a greater severity of self‐reported eating disorder psychopathology.…”

A systematic review of social rank perception and contribution to eating disorder psychopathology in individuals with eating disorders

“…The majority of the included studies employed a cross‐sectional design ( N = 13; 76.47%) (Ambwani et al, 2016; Blomquist et al, 2012; Brugnera, Coco, Salerno, et al, 2018; Brugnera, Coco, Tasca, et al, 2018; Cardi et al, 2014; Cardi et al, 2018; Connan et al, 2007; De Paoli et al, 2017; Duarte et al, 2016; Kalayci et al, 2019; Pinto‐Gouveia et al, 2014; Troop et al, 2003, 2014). Three studies (17.64%) utilized a prospective cohort study design (Brugnera et al, 2019; Carter et al, 2012; Hartmann et al, 2010), whereas one study (6.25%) (Ma & Kelly, 2020) employed ecological momentary assessment (EMA), which assessed participants repeatedly in their natural environment in real time.…”

“…For the prospective cohort studies, two did not report the length of time between baseline data collection and follow‐up, but only described it as pre‐ and posttreatment (Carter et al, 2012; Hartmann et al, 2010), whereas in the other study (Brugnera et al, 2019), the length of time between baseline data collection and follow‐up was 12 months. The majority of studies ( N = 12; 70.58%) included a control group of healthy participants (i.e., not having a diagnosis of ED) (Ambwani et al, 2016; Brugnera, Coco, Salerno, et al, 2018; Brugnera, Coco, Tasca, et al, 2018; Brugnera et al, 2019; Cardi et al, 2014; Carter et al, 2012; Connan et al, 2007; De Paoli et al, 2017; Hartmann et al, 2010; Kalayci et al, 2019; Pinto‐Gouveia et al, 2014; Troop et al, 2003).…”

“…In addition, some studies used the Submissive Behavior Scale (SBS; Allan & Gilbert, 1997), a self-report measure where participants rate how they act and feel about social situations (N = 4; 23.52%) (Cardi et al, 2014;Kalaycı et al, 2019;Troop et al, 2003Troop et al, , 2014. It consists of 16 examples of submissive behavior (e.g., "I agree that I am wrong even though I know I'm not"), which people rate as a behavioral frequency (from 0 = Never to 4 = Always); higher scores indicate a higher level of submissive behavior.…”

“…Studies that examined the association between perception of social rank and ED symptomatology (Blomquist et al, 2012;Brugnera, Coco, Salerno, et al, 2018;Cardi et al, 2014Cardi et al, , 2018Carter et al, 2012;Duarte et al, 2016;Kalaycı et al, 2019;Ma & Kelly, 2020;Pinto-Gouveia et al, 2014;Troop et al, 2003Troop et al, , 2014 (Troop et al, 2003(Troop et al, , 2014. Especially in AN, individuals are highly concerned with their weight and shape and engage in severe eating restriction or compensatory behaviors as a possible mechanism to gain or maintain high social rank (Pinto-Gouveia et al, 2014;Troop et al, 2003Troop et al, , 2014.…”