Intact social cognitive processes in outpatients with anorexia nervosa: a pilot study.

Katarzyna Kucharska,Reza Mafi,Julia Jeschke

doi:10.1186/s12991-016-0108-0

Katarzyna Kucharska, Reza Mafi + Show 1 more

Open Access

https://doi.org/10.1186/s12991-016-0108-0

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Abstract

ObjectiveThe aim of the study was to assess social cognition in community patients suffering from anorexia nervosa (AN) compared to healthy controls.Methods25 women diagnosed with AN and 25 women matched for education level and age were involved in the study. Both subject groups were assessed using a set of validated experimental tasks, such as the facial expression recognition test, short recognition memory test for faces, ‘Reading the mind in the eyes’ test. Patients were assessed for symptoms of: eating disorder (the eating attitudes test—EAT-26), OCD (the Yale–Brown obsessive compulsive scale—Y-BOCS) and depression (Beck depression inventory—BDI). The research hypothesis indicated that patients suffering from anorexia represent no significant difference in social cognitive functioning in comparison to the healthy controls. These assessment scales were used to identify whether there are any problems according to social cognitive functioning especially emotion recognition and theory of mind (ToM). The primary outcome assessment was to identify social cognitive deficits in anorexic outpatients and secondary outcome was to verify whether these problems in emotional functioning found in women in acute phase of AN are state or trait effects.ResultsAnorexic patients showed significantly higher scores on EAT-26, BDI and Y-BOCS. No significant differences were found in performance of social cognitive tests and facial perception test.DiscussionNo marked alterations were found in social cognitive functioning in community patients with average body mass index (BMI) of 17.6. This may indicate that social cognition is a very complex construct to be reliably measured in anorexia nervosa considering relatively limited psychometric data for many social cognitive tasks. Further longitudinal studies are needed to untangle ongoing controversy whether social cognitive deficits in AN could be state or trait related.

Highlights

Anorexia nervosa (AN) is a severe mental disorder characterised by persistent restriction of food intake leading to significantly low body weight, intense fear of gaining weight or becoming fat or persistent behaviour that interferes with weight gain, and disturbance in the way in which one’s body weight or shape is experienced (DSM-5).Adolphs [1] described social cognition as “the ability to construct representations of the relation between oneself and others and to use those representations flexibly to guide social behaviour”.Social cognition has been defined as the mental operations underlying social interactions, and is thought to represent a specialised domain of cognition, which captures affect perception, social cue perception, “theory of mind”, empathy, and attribution style [18]
There have been suggestions that difficulties in socioemotional aspects of anorexia nervosa presentation may be related to autistic type traits [13], and this leads to a hypothesis that impairments in theory of mind/mentalising might be seen [29]
The effect of clinical and demographic variables on task performance Pearson correlations were performed between mean accuracy scores and clinical variables (e.g. Yale–Brown and Beck depression inventory (BDI), the eating attitudes test (EAT-26), years of education, illness duration and current body mass index (BMI))

Summary

Introduction

Anorexia nervosa (AN) is a severe mental disorder characterised by persistent restriction of food intake leading to significantly low body weight, intense fear of gaining weight or becoming fat or persistent behaviour that interferes with weight gain, and disturbance in the way in which one’s body weight or shape is experienced (DSM-5).Adolphs [1] described social cognition as “the ability to construct representations of the relation between oneself and others and to use those representations flexibly to guide social behaviour”.Social cognition has been defined as the mental operations underlying social interactions, and is thought to represent a specialised domain of cognition, which captures affect perception, social cue perception, “theory of mind”, empathy, and attribution style [18]. Previous research has found that individuals with eating disorders exhibit lower emotional awareness compared to normal controls, impaired processes of theory of mind/mentalising, and empathy [2, 17, 20, 33]. Mentalisation plays crucial role in social cognition research and can be seen as a form of mental ability which allows to perceive and interpret human behaviour in terms of intentional mental states [10]. There have been suggestions that difficulties in socioemotional aspects of anorexia nervosa presentation may be related to autistic type traits [13], and this leads to a hypothesis that impairments in theory of mind/mentalising might be seen [29]. For that reason participant groups were assessed on the ‘Reading the mind in the eyes’ task, which asked participants to identify a person’s mental state from photographs of people’s eyes

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