An evaluation of autism spectrum disorder traits and the social and emotional cognition of adolescents with anorexia nervosa

The purpose of the present dissertation is to investigate Autism Spectrum Disorder (ASD) traits and aspects social and emotional functioning consistent with ASD among young people with Anorexia Nervosa (AN). This dissertation is made up of four sections; (1) Literature review: The literature review will consider the aetiology of AN and ASD, their clinical presentation, overlap between the disorders and the theories underlying the aetiology of both conditions. Literature relating specifically to ASD and associated traits with respect to social and emotional functioning in AN will be examined. This will be followed by the theoretical positions proposed to explain the presence of traits consistent with ASD in AN which frame the research questions. (2) Systematic review and meta-analysis: Title: Using the Autism-Spectrum Quotient to Measure Autistic Traits in Adolescents and Young People with Anorexia Nervosa: A Systematic Review and Meta-Analysis The principal focus of the systematic review and meta-analysis is to understand the prevalence of ASD traits as measured by one of the most commonly used screening measures of Autism traits in AN, the Autism Quotient (AQ) and AQ short version, the AQ10. The systematic review and meta-analysis was limited to studies conducted with adolescents and young people under the age of 25 with AN to assess the prevalence of ASD traits prior to prolonged periods of nutritional deprivation. This is presented through a specific journal article format. (3) Empirical research written in specific journal article format: Title: An Evaluation of Autism Spectrum Disorder Traits and the Social and Emotional Cognition of Adolescents with Anorexia Nervosa The empirical research is presented in two parts, the first of which is in a journal article form tailored to the format of a specific academic journal. This incorporates the most relevant aspects of the literature review in addition to the methodology, results and discussion of the present empirical research study. The second part presents the empirical research through a supplementary methodology, results and discussion section which follow sequentially from the literature review (Section 4). The original empirical research section of the dissertation seeks to investigate traits consistent with ASD and related aspects of social and emotional cognition among young people with AN. ASD is proposed to exist on a spectrum where more pronounced ASD traits are often associated with functional impairment in social functioning, language, communication and restricted/repetitive interests. At the less pronounced end of the spectrum ASD traits are considered more subtle and not generally associated with functional impairment. Research with AN groups has indicated that a considerable percentage of these research samples meet the criteria for ASD. Prior research has also indicated that among those individuals with AN not meeting the full criteria for an ASD diagnosis commonly have increased levels of ASD traits as compared to control populations. The purpose of the present research is to understanding if commonly reported ASD traits and difficulties with social and emotional cognition with ASD are present in the early stages of AN prior to prolonged nutritional deprivation. Within previous literature, traits associated with ASD have been studied individually among groups with AN. This study is the first to examine ASD traits, theory of mind, alexithymia and empathy simultaneously in an adolescent group with AN. The study assumes a cross-sectional design where participants consist of two adolescent groups; individuals with AN attending a specialist eating disorder service and a healthy control group recruited from the community through secondary schools. The study collected participant demographic, clinical symptoms and illness-related variables in addition to self-reported ASD traits, a theory of mind task, and measures of alexithymia and empathy. Data were analysed by comparing group means across dependent variables. AN group-specific analyses were conducted using correlational analyses to examine relationships between dependant variables. Findings are presented in the context of prior literature. (4) Empirical research study supplementary chapters: The supplementary chapters present the empirical research through supplementary methodology, results and discussion sections