Neural Correlates of Theory of Mind Are Preserved in Young Women With Anorexia Nervosa.

Monica Leslie,Hannah Hayward,Jenni Leppanen,Felicity Sedgewick,Mima Simic,Steven Williams,Declan Murphy,Kate Tchanturia,Daniel Halls,Dasha Nicholls,Katie Lang,William Mandy,Leon Fonville,Katherine Smith

doi:10.3389/fpsyg.2020.568073

Abstract

People with anorexia nervosa (AN) commonly exhibit social difficulties, which may be related to problems with understanding the perspectives of others, commonly known as Theory of Mind (ToM) processing. However, there is a dearth of literature investigating the neural basis of these differences in ToM and at what age they emerge. This study aimed to test for differences in the neural correlates of ToM processes in young women with AN, and young women weight-restored (WR) from AN, as compared to healthy control participants (HC). Based on previous findings in AN, we hypothesized that young women with current or prior AN, as compared to HCs, would exhibit a reduced neural response in the medial prefrontal cortex (mPFC), the inferior frontal gyrus, and the temporo-parietal junction (TPJ) whilst completing a ToM task. We recruited 73 young women with AN, 45 WR young women, and 70 young women without a history of AN to take part in the current study. Whilst undergoing a functional magnetic resonance imaging (fMRI) scan, participants completed the Frith-Happé task, which is a commonly used measure of ToM with demonstrated reliability and validity in adult populations. In this task, participants viewed the movements of triangles, which depicted either action movements, simple interactions, or complex social interactions. Viewing trials with more complex social interactions in the Frith-Happé task was associated with increased brain activation in regions including the right TPJ, the bilateral mPFC, the cerebellum, and the dorsolateral prefrontal cortex. There were no group differences in neural activation in response to the ToM contrast. Overall, these results suggest that the neural basis of spontaneous mentalizing is preserved in most young women with AN.

Highlights

Specialty section: This article was submitted to Eating Behavior, a section of the journal Frontiers in Psychology
Based on previous findings in anorexia nervosa (AN), we hypothesized that young women with current or prior AN, as compared to healthy control participants (HC), would exhibit a reduced neural response in the medial prefrontal cortex, the inferior frontal gyrus, and the temporo-parietal junction (TPJ) whilst completing a Theory of Mind (ToM) task
The analysis initially identified differences in the level of social language used for the random and ToM trials, such that HC participants tended to use greater levels of social language to describe random trials than participants with acute AN (AAN) and WR participants tended to use greater levels of social language to describe ToM trials than participants with

Summary

Introduction

Specialty section: This article was submitted to Eating Behavior, a section of the journal Frontiers in Psychology. It is possible that ToM processes may hinder individuals’ response to talking therapies, such as by contributing to poor self-insight, and may impact affected individuals’ ability to access and utilize social support networks in the recovery process (Bora and Köse, 2016). It is, pertinent to better characterize the nature of ToM difficulties in AN and its underlying biological mechanisms in order to better understand the development of AN and possible social-cognitive targets for treatment intervention (Russell et al, 2009)

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