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Abstract
Heightened detail-processing and low levels of central coherence are common in individuals with anorexia nervosa (AN) and predict poorer prognosis. However, it is unclear whether these processing styles predate the disorder or, rather, emerge during later stages of AN. The current study aimed to address this question by investigating central coherence, and the neural correlates of central coherence, in a sample of young women with AN with shorter duration of illness than previous studies recruiting adult samples. We recruited 186 participants, including: 73 young women with AN, 45 young women weight-recovered from AN, and 68 age-matched controls. Participants completed the Embedded Figures Task during an fMRI scan. There were no significant differences between the participant groups in performance accuracy or reaction time. There were no other between-groups differences in neural response to the Embedded Figures Task. These findings contrast with evidence from older adults demonstrating differences in the neural underpinning of central coherence amongst participants with AN versus control participants. The current study adds to an increasing literature base demonstrating the resilience of neuropsychological traits and associated brain systems in the early stages of AN.
Highlights
INTRODUCTION AND AIMSAnorexia nervosa (AN) is a severe psychiatric disorder characterised by restricted eating and other weight‐loss behaviours leading to excessively low body weight, intense fear of gaining weight or becoming fat, and disturbances in the perception of body weight and shape or disturbances in the perception of the seriousness of the individual’s low weight (American Psychiatric Association, 2013)
We divided the sample into two groups, such that the group with low autistic traits was defined by an Autism Quotient‐10 item version (AQ10) score ≤ 3, while the group with high autistic traits was defined by an AQ10 score > 3
The current study aimed to investigate differences in the neural correlates of central coherence in young women with, versus without, AN on the Embedded Figures Task (EFT)
Summary
INTRODUCTION AND AIMSAnorexia nervosa (AN) is a severe psychiatric disorder characterised by restricted eating and other weight‐loss behaviours leading to excessively low body weight, intense fear of gaining weight or becoming fat, and disturbances in the perception of body weight and shape or disturbances in the perception of the seriousness of the individual’s low weight (American Psychiatric Association, 2013). One factor that has been suggested to contribute to the development and maintenance of AN are autistic traits. Autism‐spectrum disorders are over‐ represented in populations with AN versus the general population (Westwood et al, 2017) and autistic traits have been found to correlate with greater levels of disordered eating even in non‐clinical young adult populations (Carton et al, 2014). A neuropsychological phenotype characterised by a rigid and detail‐focused cognitive processing style, characteristic of autism spectrum disorders (ASD) (Cribb et al, 2016), has been posited to contribute to the maintenance of restrictive eating behaviour in AN (Treasure & Schmidt, 2013). Evidence suggests that the obsessionality associated with a rigid and detail‐focused processing style impedes response to treatment‐as‐usual and is associated with a poorer prognosis in AN (Lo Sauro et al, 2013). The extent to which these traits reflect an inherited endophenotype, versus state‐ related consequences of starvation, is currently unclear
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