King's College London, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Psychological Medicine Clinical Academic Group, South London and Maudsley NHS Trust, London, UK.
Mol Autism. 2013 Nov 12;4(1):44. doi: 10.1186/2040-2392-4-44.
The objectives of this study were to explore associations between autistic traits and self-reported clinical symptoms in a population with anorexia nervosa (AN). Experimental and self-report evidence reveals similarities between AN and autism spectrum condition (ASC) populations in socio-emotional and cognitive domains; this includes difficulties with empathy, set-shifting and global processing. Focusing on these similarities may lead to better tailored interventions for both conditions.
A cross-sectional independent-groups design was employed. Participants with AN (n = 66) and typical controls (n = 66) completed self-report questionnaires including the Short (10-Item) Version Autism Spectrum Quotient (AQ-10) questionnaire (the first time this has been implemented in this population), the Eating Disorder Examination Questionnaire, the Hospital Anxiety and Depression Scale and the Work and Social Adjustment Scale. Group differences and the relationship between autistic traits and other questionnaire measures were investigated.
The AN group had a significantly higher AQ-10 total score and a greater proportion scored above the clinical cut-off than the control group. Seven out of ten AQ-10 items significantly discriminated between groups. In the AN group, levels of autistic traits correlated with a greater self-reported anxiety and depression and a lower ability to maintain close relationships; however, eating disorder symptoms were not associated with autistic traits.
Women with anorexia possess a greater number of autistic traits than typical women. AQ-10 items that discriminated between groups related to 'bigger picture' (global) thinking, inflexibility of thinking and problems with social interactions, suggesting that autistic traits may exacerbate factors that maintain the eating disorder rather than cause the eating disorder directly. Using screening instruments may improve understanding of patients' problems, leading to better tailoring of intervention. We conclude that further investigation of autistic traits in AN could inform new intervention approaches based on joint working between ASC and eating disorder services.
本研究旨在探讨厌食症（AN）患者的自闭症特征与自我报告的临床症状之间的关联。实验和自我报告证据表明，AN 人群和自闭症谱系障碍（ASC）人群在社会情感和认知领域存在相似之处，包括同理心、思维转换和全局处理方面的困难。关注这些相似之处可能会为两种疾病提供更好的针对性干预措施。
采用横断面独立组设计。共纳入 66 名 AN 患者和 66 名典型对照组参与者，完成了包括自闭症谱系商数短卷 10 项版（AQ-10）问卷（这是该问卷首次在该人群中实施）、饮食障碍检查问卷、医院焦虑抑郁量表和工作和社会调整量表在内的自我报告问卷。调查了两组间的差异以及自闭症特征与其他问卷测量指标之间的关系。
AN 组的 AQ-10 总分显著较高，且有更大比例的人得分高于临床临界值。AQ-10 的 10 个项目中有 7 个能显著区分两组。在 AN 组中，自闭症特征水平与更高的自我报告焦虑和抑郁以及维持亲密关系的能力降低相关；然而，饮食障碍症状与自闭症特征无关。
患有厌食症的女性比典型女性具有更多的自闭症特征。能区分两组的 AQ-10 项目与“全局”思维、思维僵化和社交互动问题有关，这表明自闭症特征可能会加剧维持饮食障碍的因素，而不是直接导致饮食障碍。使用筛查工具可能会提高对患者问题的理解，从而更好地针对干预措施进行调整。我们的结论是，进一步研究 AN 中的自闭症特征可能会为基于 ASC 和饮食障碍服务的联合工作的新干预方法提供信息。
