Abstract

BackgroundPatients 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).MethodsTwo groups were tested: (1) female adolescents with anorexia: n = 66, aged 12 to 18 years; and (2) female adolescents without anorexia: n =1,609, aged 12 to 18 years. Both groups were tested using the AQ, EQ, and SQ, via the parent-report adolescent versions for patients aged 12 to 15 years old, and the self-report adult versions for patients aged over 16 years.ResultsAs predicted, the patients with anorexia had a higher AQ and SQ. Their EQ score was reduced, but only for the parent-report version in the younger age group. Using EQ-SQ scores to calculate ‘cognitive types’, patients with anorexia were more likely to show the Type S profile (systemizing (S) better than empathy (E)), compared with typical females.ConclusionsFemales with anorexia have elevated autistic traits. Clinicians should consider if a focus on autistic traits might be helpful in the assessment and treatment of anorexia. Future research needs to establish if these results reflect traits or states associated with anorexia.

Highlights

  • Patients with anorexia may have elevated autistic traits

  • We investigated whether there is any link between anorexia and autistic traits, despite the fact that superficially these seem very different

  • Because self-reported weight data can be unreliable, body mass index (BMI) was not analyzed as a variable of interest, but the data confirmed that all patients with anorexia had a BMI significantly below the average range

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Summary

Introduction

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). A preoccupation with the self can present as a failure to empathize, for example, with the stress their behavior causes their family, and this resembles the social difficulties in autism Both autism and anorexia show social anhedonia [14,15], deficits in ‘emotional intelligence’ [16,17], difficulties on ‘advanced’ theory of mind tests (such as the ‘Reading the Mind in the Eyes’ test) [18,19,20,21,22,23,24,25], and alexithymia (difficulty in reflecting on one’s own emotion). Both autism and anorexia show atypical structure and function in ‘social brain’ regions, including in the superior temporal sulcus, fusiform face area, amygdala, and orbitofrontal cortex [35]

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