Meneguzzo Paolo, Ceccato Enrico, Sala Alessandra, Santonastaso Paolo
Department of Neuroscience, University of Padova, Padova, Italy.
Padova Neuroscience Center, University of Padova, Padova, Italy.
Front Psychiatry. 2025 Aug 29;16:1641020. doi: 10.3389/fpsyt.2025.1641020. eCollection 2025.
Anorexia nervosa (AN) is associated with altered cognitive and emotional traits, including deficits in empathy, theory of mind (ToM), and increased alexithymia. While these traits are well-documented in affected individuals, little is known about their presence in unaffected male siblings, who share genetic and environmental risk factors. This study investigates whether male siblings of women with AN (bAN) exhibit intermediate cognitive-emotional traits compared to both their affected sisters and general population (GP) controls.
We assessed 31 bAN, 31 GP, and 31 affected sisters. Participants completed self-report questionnaires (Empathy Quotient, Toronto Alexithymia Scale, Eating Disorder Examination Questionnaire) and two computerized tasks evaluating theory of mind (Story-based Empathy Task (SET), Reading the Mind in the Eyes Task). Between-group differences were assessed using non-parametric tests due to the non-normality of the data. A binary logistic regression was then conducted to evaluate whether specific socio-cognitive variables predicted group membership.
bAN showed significantly lower scores than the GP on measures of cognitive empathy and theory of mind, particularly Causal Inference (SET-CI; r = 0.594, p < 0.001), Emotional Attribution (SET-EA; r = 0.520, p < 0.001), and Intention Attribution (SET-IA; r = 0.463, p = 0.001). Logistic regression identified SET-CI as the strongest predictor of bAN status. Other empathy and alexithymia measures showed no significant group differences.
These findings suggest that domain-general inferential difficulties-particularly in causal reasoning-may be associated with familial vulnerability to anorexia nervosa in male siblings. Further research is needed to clarify the role of such cognitive traits in the broader context of risk and to inform early identification and intervention strategies.
神经性厌食症（AN）与认知和情绪特征改变有关，包括共情缺陷、心理理论（ToM）以及述情障碍增加。虽然这些特征在受影响个体中已有充分记录，但对于共享遗传和环境风险因素的未受影响的男性同胞中这些特征的存在情况知之甚少。本研究调查与患有AN的女性的男性同胞（bAN）相比，她们受影响的姐妹和一般人群（GP）对照组是否表现出中间认知-情绪特征。
我们评估了31名bAN、31名GP和31名受影响的姐妹。参与者完成了自我报告问卷（共情商数、多伦多述情障碍量表、饮食失调检查问卷）以及两项评估心理理论的计算机任务（基于故事的共情任务（SET）、读心术任务）。由于数据不呈正态分布，使用非参数检验评估组间差异。然后进行二元逻辑回归以评估特定的社会认知变量是否能预测组成员身份。
在认知共情和心理理论测量方面，bAN的得分显著低于GP，特别是因果推理（SET-CI；r = 0.594，p < 0.001）、情绪归因（SET-EA；r = 0.520，p < 0.001）和意图归因（SET-IA；r = 0.463，p = 0.001）。逻辑回归确定SET-CI是bAN状态的最强预测因子。其他共情和述情障碍测量未显示出显著的组间差异。
这些发现表明，领域通用的推理困难——特别是因果推理方面——可能与男性同胞中神经性厌食症的家族易感性有关。需要进一步研究以阐明此类认知特征在更广泛的风险背景中的作用，并为早期识别和干预策略提供信息。
