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Despite their apparent dissimilarity, Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD) share many features, especially in terms of social and emotional difficulties. In recent years, empathic abilities in AN have been frequently assessed using self-report measures. Otherwise, the director task (DT) has been used to investigate the ability to take the visual perspective of another individual in a communicative context, using eye-tracking technology. The aim of the current study was to test the presence of autism-relevant features in AN, through: (i) comparing self-reported autistic traits and empathic abilities in a group of young inpatients with AN and age/gender matched healthy controls (HC); (ii) comparing performance on the director paradigm. The participants were females in the age-range between 11 and 18 years: 24 with AN and 23 HC. Autistic traits, empathic abilities, and severity of the eating disorder were respectively measured using: the Autism Quotient (AQ), the Interpersonal Reactivity Index (IRI), and the Eating Disorder Inventory-3 (EDI-3). Both groups performed a computerized task in which a director instructed them to move objects placed on a set of shelves using a mouse, while their eye gaze was tracked. A total of 36 shelf configurations, divided into three categories (with dimensional distractor – with spatial distractor – control), were created. Subjects with AN showed higher autistic traits than HC. Eye-tracking data revealed that subjects with AN took longer to decide which object to select and where to move it, both in distractor-trials and in control-trials. In the AN group, we found a significant negative correlation between the total score of the AQ and the number of fixations to the irrelevant object in the dimensional control condition -in which the subjects were asked to focus on dimensional aspects of the object (large-small)-. Autistic traits were over-represented in a group of young inpatients with AN. Through the use of eye-tracking technology, this exploratory study documented some differences between AN inpatients and HC in their online processes during the perspective taking tasks, which could be considered a target of tailored intervention. A larger sample of patients is needed to confirm these preliminary findings. Anorexia nervosa (AN) and Autism Spectrum Disorders share a number of common features, including social and emotional difficulties. In this framework, previous investigations have analyzed autistic traits and empathic abilities of AN patients with mixed results. In the current study, we assess in AN adolescents compared to healthy control peers: (i) autistic traits and empathic abilities using self-report measures; (ii) perspective-taking ability (a process related to cognitive empathy, i.e. the capacity to understand the emotional/mental experiences of others) using an eye-tracking metric from the 'director task'.Results indicated that autistic traits were over-represented in the group of adolescents with AN. The eye-tracking based measure of perspective-taking ability showed longer response latencies in AN subjects compared to the control sample, which may be an expression of the need for more time to "put themselves in the shoes of others". If confirmed, these findings suggest that tailored interventions focusing on perspective taking's abilities may be implemented in AN subjects.
Fantozzi et al. (Wed,) studied this question.