Abstract
Theory of Mind (ToM) is the ability to understand and represent mental states of others, a skill that plays a key role in how we interact with people around us. Difficulties with ToM have been posited as an underlying mechanism for autism and implicated in difficulties faced by those with anorexia nervosa (AN). This study examined, both quantitatively and qualitatively, the responses of women between the ages of 14 and 25 years on the Frith-Happé Triangle Animations, a well-validated test of ToM. Participants were split into healthy controls (HCs), AN patients (AN), and AN patients with high levels of autistic features (AN+ASF). We found no significant quantitative differences between groups in performance on the task. Qualitatively, there were differences between groups such that AN patients, especially those in the AN+ASF group, were more focused on describing the videos than creating narratives, were more negative in their interpretations, and were much more anxious about their performance. These qualitative differences have clinical implications, including that not all AN patients with autistic features should be assumed to have difficulties with ToM.
Highlights
Theory of Mind (ToM) is the ability to represent mental states, such as beliefs and intentions, in order to predict and explain people’s behavior [1, 2]
Post hoc t-tests revealed that both anorexia nervosa (AN) and AN+ASF groups scored significantly higher than healthy controls (HCs) participants on the EDE-Q Global score, HADS Anxiety, and HADS Depression
Clinical Measures and Theory of Mind We explored whether levels of eating disorder behaviors, anxiety and depression, autistic features, and body mass index (BMI) had an impact on either accuracy or on number of mental state terms, negative, and positive terms participants used in their narrations
Summary
Theory of Mind (ToM) is the ability to represent mental states, such as beliefs and intentions, in order to predict and explain people’s behavior [1, 2]. Large numbers of studies, using a range of ToM tasks, have consistently found that autistic people score lower than neurotypical counterparts in terms of their ability to extrapolate the mental states of characters [e.g., Refs. A steady accumulation of evidence has shown that people with anorexia nervosa (AN) show similarities in cognitive profile to autistic individuals [7,8,9]. Cognitive features such as poor flexibility and detail-focus (or weak “central coherence”) have been documented in both AN and autistic groups relative to healthy controls (HCs) [9, 10]. A recent review of the literature comparing autistic people and those with AN [12] reported a number of
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