Clinical evaluation of autistic symptoms in women with anorexia nervosa.
Heather Westwood, William Mandy, Kate Tchanturia
PMID 28331571WHAT IT FOUND
Twenty-three percent of women hospitalized for anorexia nervosa scored above the autism cutoff on direct observation.
Their symptoms involved social difficulties and speech oddities, but rarely repetitive behaviors. These traits linked to anxiety and emotional processing issues, not starvation or eating disorder severity.
Key findings
01Of the 60 women assessed, 14 (23.3%) scored above the clinical cutoff for autism symptoms using the revised ADOS-2 algorithm.
02Among the women who scored above the cutoff, only eight displayed repetitive and restricted behaviors, with speech abnormalities being the most common.
03Elevated autism symptoms were significantly associated with higher scores for alexithymia and obsessive-compulsive behaviors, but not with eating disorder severity or BMI.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used a cross-sectional design, so it cannot determine if the autism traits caused the eating disorder, resulted from it, or if they simply co-occur. All participants were hospitalized or in day-patient care, meaning they had severe anorexia. These findings may not apply to people with milder eating disorders. The ADOS-2 is an observational tool and does not include developmental history. The authors note that repetitive behaviors are hard to spot in a short assessment, so some women may have had them but were missed. The study did not account for whether the observed social difficulties were actually symptoms of anxiety or depression rather than autism.
Declared interests
The research was supported by non-U.S. government funding. No specific commercial conflicts of interest were declared in the text.
The easy way to misread this
Do not diagnose autism based solely on this study's findings. The women in this sample had severe anorexia, and their social difficulties or speech patterns could be secondary to anxiety, depression, or the eating disorder itself, rather than indicating a primary developmental condition.