Emotion Recognition Abilities in Adults with Anorexia Nervosa are Associated with Autistic Traits.

Jess Kerr-Gaffney,Luke Mason,Emily Jones,Eva Loth,Jumana Ahmad,Hannah Hayward,Declan Murphy,Kate Tchanturia,Amy Harrison

doi:10.3390/jcm9041057

Abstract

Difficulties in socio-emotional functioning are proposed to contribute to the development and maintenance of anorexia nervosa (AN). This study aimed to examine emotion recognition abilities in individuals in the acute and recovered stages of AN compared to healthy controls (HCs). A second aim was to examine whether attention to faces and comorbid psychopathology predicted emotion recognition abilities. The films expressions task was administered to 148 participants (46 AN, 51 recovered AN, 51 HC) to assess emotion recognition, during which attention to faces was recorded using eye-tracking. Comorbid psychopathology was assessed using self-report questionnaires and the Autism Diagnostic Observation Schedule–2nd edition (ADOS-2). No significant differences in emotion recognition abilities or attention to faces were found between groups. However, individuals with a lifetime history of AN who scored above the clinical cut-off on the ADOS-2 displayed poorer emotion recognition performance than those scoring below cut-off and HCs. ADOS-2 scores significantly predicted emotion recognition abilities while controlling for group membership and intelligence. Difficulties in emotion recognition appear to be associated with high autism spectrum disorder (ASD) traits, rather than a feature of AN. Whether individuals with AN and high ASD traits may require different treatment strategies or adaptations is a question for future research.

Highlights

Anorexia nervosa (AN) is a severe psychiatric disorder characterised by an intense fear of weight gain, persistent behaviour to restrict energy intake, and a disturbance in the way one’s body weight or shape are experienced [1]
The current study aimed to examine emotion recognition abilities in those with acute AN, REC, and healthy controls (HCs)
Our prediction that emotion recognition abilities would be associated with attention to faces, as well as alexithymia and autism spectrum disorder (ASD) traits, was partially supported

Summary

Introduction

Anorexia nervosa (AN) is a severe psychiatric disorder characterised by an intense fear of weight gain, persistent behaviour to restrict energy intake, and a disturbance in the way one’s body weight or shape are experienced [1]. Findings from studies in individuals with AN are mixed, with some reporting those with AN are significantly less accurate at inferring emotions from faces than HCs [19,20,21,22], and others reporting no differences [23,24,25,26]. While some report performance similar to that of HCs [28], others have reported poorer emotion recognition abilities, similar to those who are acutely unwell [20,29]. It is not known whether potential differences in emotion recognition abilities are a result of the ill state in AN. One study found that emotion recognition difficulties were present in unaffected twins of those with AN, suggesting that difficulties in this domain might represent an endophenotype for the disorder [30]

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