First Department of Psychiatry, National & Kapodistrian University of Athens, Eginition Hospital , Athens, Greece.
Department of Psychosis Studies, Institute of Psychiatry, King's College , London, UK.
Soc Neurosci. 2020 Aug;15(4):477-488. doi: 10.1080/17470919.2020.1760131. Epub 2020 May 13.
The existing evidence on the specific profile and the determinants of empathic and mentalizing abilities in anorexia nervosa (AN) and bulimia nervosa (BN) is not conclusive. Moreover, it is not clear whether patients with eating disorders also exhibit diminished ability to accurately appraise their own empathic skills. We examine in AN and BN: (a) the impairments in various aspects of empathy and theory of mind (ToM), while accounting for the effect of other cognitive functions and (b) the accuracy of self-appraisal of empathy. Self-reported and performance-based empathy, ToM, and cognitive functions were assessed in 46 patients with AN, 30 patients with BN, and 42 healthy controls (HC). Both AN and BN patients reported diminished overall empathic abilities, whereas only BN patients reported reduced cognitive empathy compared to HC. Deficits in performance-based empathy were found in both patient groups. Cognitive ToM was impaired only in AN. Significant correlations between self-reported and performance-based empathy were found in BN and HC but not in AN. Cognitive deficits negatively affected the self-appraisal of empathy in AN but not empathic skills per se. Our findings highlight a double deficit related to empathic responding in AN: diminished performance and inaccurate self-appraisal of empathic abilities, indicating dysfunctional self-reflection.
目前关于神经性厌食症（AN）和神经性贪食症（BN）患者共情和心理理论（ToM）能力的特定特征和决定因素的证据尚无定论。此外，尚不清楚饮食障碍患者是否也表现出共情技能评估能力下降。我们在 AN 和 BN 中检查了：（a）共情和心理理论各个方面的障碍，同时考虑到其他认知功能的影响，以及（b）共情自我评估的准确性。在 46 名 AN 患者、30 名 BN 患者和 42 名健康对照组（HC）中评估了自我报告和基于表现的共情、ToM 和认知功能。与 HC 相比，AN 和 BN 患者均报告整体共情能力下降，而仅 BN 患者报告认知共情下降。在两个患者组中均发现基于表现的共情能力下降。仅在 AN 中存在认知 ToM 受损。在 BN 和 HC 中发现自我报告和基于表现的共情之间存在显著相关性，但在 AN 中则没有。认知缺陷会对 AN 患者的共情自我评估产生负面影响，但不会影响共情技能本身。我们的研究结果突出了与 AN 中共情反应相关的双重缺陷：表现下降和共情能力的自我评估不准确，表明自我反思功能障碍。
