Exploring autistic traits in anorexia: a clinical study (original) (raw)

Levels of autistic traits in anorexia nervosa: a comparative psychometric study

BMC Psychiatry, 2013

Background: A number of characteristics associated with Autism Spectrum Disorders (ASD) are over-represented among patients with Anorexia Nervosa (AN) as well as among relatives of these patients. Yet the co-occurrence of autistic traits in AN has not been fully explored and no previous study has directly compared self-reported evaluations of cognitive and socio-affective skills in AN and ASD. Methods: We aimed to determine the degree of overlap between AN and ASD from scores on questionnaires classically used to measure ASD impairments. Fifteen AN participants, 15 ASD participants and two groups of matched controls completed a battery of self-reports measuring: autistic traits (Autism-Spectrum Quotient), empathy (Empathy Quotient-short and Interpersonal Reactivity Index), systemizing (Systemizing Quotient-short) and alexithymia (Bermond-Vorst Alexithymia Questionnaire-B). Univariate comparisons of mean totalled scores were performed on each measure (patients vs. controls, and AN vs. ASD), and a Principal Component Analysis was used to study subject proximities in a reduced-factor space constructed from AQ, BVAQ-B and IRI subscales.

An investigation into the relationship between eating disorder psychopathology and autistic symptomatology in a non-clinical sample

British Journal of Clinical Psychology, 2011

Objective. Female adults with a diagnosis of anorexia nervosa (AN) have been found to score higher than healthy controls on a questionnaire that measures characteristics associated with Autism Spectrum Disorders (ASD). This research investigated the relationship between eating disorder (ED) and ASD symptomatology in a non-clinical sample, with an additional focus on prenatal testosterone (pT) levels. Design. A cross-sectional research design was used. The selected age group of both males and females allowed for a focus on early onset of ED symptomatology in both sexes. Methods. Self-reported questionnaire data from the Eating Attitudes Test (EAT-26) and the Autism Spectrum Quotient (AQ) were collected from 132 schoolchildren (61 boys, 71 girls) aged 11 to 14, with no recorded psychiatric diagnoses. Digit ratio (2D:4D) measures to index levels of pT exposure were also obtained. Results. A significant relationship between levels of ED symptomatology and ASD symptomatology was identified. Particularly strong relationships were identified between the EAT-26 and the attention to detail and communication subscales of the AQ. Few relationships were found for digit ratios. Conclusion. The results extend previous research from a sample with a diagnosis of AN to a non-clinical population. Those registering higher levels of ED symptomatology also reported higher levels of attention to detail and communication difficulties associated with ASD.

The impact of internalizing symptoms on autistic traits in adolescents with restrictive anorexia nervosa

Neuropsychiatric Disease and Treatment, 2015

Background: Although previous studies indicated a positive association between restrictive anorexia-nervosa (AN-R) and autistic traits, the potential interference of psychiatric internalizing comorbidity on this association is not yet fully investigated. Materials and methods: The aim of this study was to explore autistic traits and internalizing psychopathology in adolescents (age range: 11.7-17.2 years) with AN-R. Twenty-five patients referred to two tertiary-care hospitals were compared to a large control group (N=170) with no differences in age and sex. AN-R patients and controls filled out instruments assessing autistic traits (autism spectrum quotient [AQ]), psychopathology (youth self-report [YSR] 11-18), and eating patterns (eating attitude test [EAT]). In order to disentangle the possible mediating role of internalizing symptoms on autistic traits, two separate control groups (called True and False healthy control, both composed of 25 eating-problem-free participants) were derived from the whole control group on the basis of the presence or absence of internalizing problems in the YSR. Results: AN-R patients scored significantly higher on AQ compared to the whole control group and to controls without internalizing problems (True HC), but these differences disappeared when only controls with internalizing problems (False HC) were considered. Conclusion: Autistic traits in AN-R individuals may have been overestimated and may partly be due to comorbid internalizing symptoms in investigated patients.

RESEARCH ARTICLE Open Access Levels of autistic traits in anorexia nervosa: a comparative psychometric study

2015

Background: A number of characteristics associated with Autism Spectrum Disorders (ASD) are over-represented among patients with Anorexia Nervosa (AN) as well as among relatives of these patients. Yet the co-occurrence of autistic traits in AN has not been fully explored and no previous study has directly compared self-reported evaluations of cognitive and socio-affective skills in AN and ASD. Methods: We aimed to determine the degree of overlap between AN and ASD from scores on questionnaires classically used to measure ASD impairments. Fifteen AN participants, 15 ASD participants and two groups of matched controls completed a battery of self-reports measuring: autistic traits (Autism-Spectrum Quotient), empathy (Empathy Quotient-short and Interpersonal Reactivity Index), systemizing (Systemizing Quotient-short) and alexithymia (Bermond-Vorst Alexithymia Questionnaire-B). Univariate comparisons of mean totalled scores were performed on each measure (patients vs. controls, and AN vs...

Association among Autistic Traits, Treatment Intensity and Outcomes in Adolescents with Anorexia Nervosa: Preliminary Results

Journal of Clinical Medicine

The present study investigates the impact of Autism Spectrum Disorder (ASD) traits on the treatment intensity and outcomes (psychopathology and weight) of 22 adolescent inpatients with Anorexia Nervosa (AN), who were selected on the basis of suspected ASD traits. ASD traits were measured at admission (T0) using the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and the Autism-Spectrum Quotient (AQ). Psychopathology was measured with Eating Disorder Inventory-3 (EDI-3) and Self-Administered Psychiatric Scales for Children and Adolescents (SAFA) at admission and discharge (T0, T1). Percentage BMI was assessed at admission, discharge, first follow-up (T2, 7–22 days) and second follow-up (T3, 22–45 days). Results were controlled for age and EDI-3 global psychological maladjustment. When compared with other patients with AN, AN individuals with ADOS-2 and AQ diagnostic scores for ASD showed overlapping types of treatments, as well as psychopathological and weight outcomes...

Autistic Traits and Social Responsiveness: The Relationship Between Autistic Traits and Comorbid Psychiatric Symptoms in Adolescents with Anorexia Nervosa

Archives of Neuropsychiatry, 2021

Introduction: It is known that patients with anorexia nervosa (AN) display social difficulties like social responsiveness and high levels of autistic behaviors such as rigidity, narrow interests of food and weight; however it is not clear whether they have comorbid Autism Spectrum Disorders (ASD) or it is about acute phase of illness. In this study it is aimed to investigate autistic traits and social responsiveness in adolescents with AN. Methods: Study group was consisted of 39 female AN patients aged between 12-18 years. Control group was consisted of 34 female adolescents who did not have any psychiatric disorder. K-SADS-PL was applied to all participants in order to detect the psychiatric disorders. Autism traits and social responsiveness were evaluated using Social Responsiveness Scale. All adolescents of the study were administered The Eating Attitude Test, Beck Depression Inventory, Screen for Child Anxiety and Related Disorders, Maudsley Obsesive Compulsive Inventory. Resul...

Characteristics of autism spectrum disorder in anorexia nervosa: A naturalistic study in an inpatient treatment programme

Autism

Previous research has demonstrated links between anorexia nervosa and autism spectrum disorder however, few studies have examined the possible impact of symptoms of autism spectrum disorder on clinical outcomes in anorexia nervosa. The aim of this study was to examine the association between symptoms of autism spectrum disorder and eating disorders, and other psychopathology during the course of inpatient treatment in individuals with anorexia nervosa. Participants with anorexia nervosa (n = 171) completed questionnaires exploring eating disorder psychopathology, symptoms of depression and anxiety, and everyday functioning at both admission and discharge. Characteristics associated with autism spectrum disorder were assessed using the Autism Spectrum Quotient, short version. Autism spectrum disorder symptoms were significantly positively correlated with eating disorder psychopathology, work and social functioning, and symptoms of depression and anxiety, but not with body mass index....

Using the Autism-Spectrum Quotient to Measure Autistic Traits in Anorexia Nervosa: A Systematic Review and Meta-Analysis

Journal of autism and developmental disorders, 2015

Interest in the link between Autism Spectrum Disorder (ASD) and Anorexia Nervosa (AN) has led to estimates of the prevalence of autistic traits in AN. This systematic review and meta-analysis assessed the use of the Autism-Spectrum Quotient (AQ) or abbreviated version (AQ-10) to examine whether patients with AN have elevated levels of autistic traits. Seven studies were identified and subsequent meta-analysis indicated that those with AN appear to have significant difficulties of a manner characteristic of ASD, relative to controls. Whilst this analysis supports previous indications of higher prevalence of ASD in AN, the aetiology of these traits remains unclear. Studies using more robust clinical measures of ASD within AN are needed to confirm what self-report measures appear to show.

Do girls with anorexia nervosa have elevated autistic traits

Background: Patients with anorexia may have elevated autistic traits. In this study, we tested test whether patients with anorexia nervosa (anorexia) have an elevated score on a dimensional measure of autistic traits, the Autism Spectrum Quotient (AQ), as well as on trait measures relevant to the autism spectrum: the Empathy Quotient (EQ), and the Systemizing Quotient (SQ).

Anorexia nervosa and autism: a prospective twin cohort study

Journal of Child Psychology and Psychiatry, 2020

Background: Anorexia nervosa (AN) and autism spectrum disorder (ASD) may be phenotypically and etiologically linked. However, due to the absence of prospective studies, it remains unclear whether the elevation of autistic traits in AN is evident in early childhood. Here, we prospectively investigated autistic traits before and after the first diagnosis of AN. Methods: In a population-based sample of 5,987 individuals (52.4% female) from the Child and Adolescent Twin Study in Sweden, parents reported autistic traits at ages 9 and 18. AN and ASD diagnoses were retrieved from the Swedish National Patient Register. In addition, AN diagnoses were ascertained by parent-reported treatment for AN. We compared whether individuals with and without AN differed in autistic traits before the first diagnosis of AN (age 9) and after the first diagnosis of AN (age 18). Results: We did not find evidence for elevated autistic traits in 9-year-old children later diagnosed with AN. At age 18, however, there was a marked elevation in restricted/repetitive behavior and interests, but only in the subgroup of individuals with acute AN. A less pronounced elevation was observed for social communication problems. Conclusions: Coping strategies in individuals with ASD and the somewhat different female ASD phenotype may explain why we did not find elevated autistic traits in children who later developed AN. Alternatively, it is possible that elevated autistic traits were not present prior to the onset of AN, thus questioning the previously reported elevated prevalence of ASD in AN. Future studies should use tailored measurements in order to investigate whether autistic traits in individuals with AN are best conceptualized as an epiphenomenon of the acute AN phase or whether these symptoms indeed represent ASD as a clinically verifiable neurodevelopmental disorder.