Characteristics of autism spectrum disorder in anorexia nervosa: A naturalistic study in an inpatient treatment programme.
Autistic-leaning traits in anorexia patients stay flat during usual inpatient care and mark a harder climb back to health.
01Research in Context
What this study did
Simpson et al. (2019) followed 60 teen and adult anorexia inpatients for eight weeks. They gave the Autism Spectrum Quotient-Short at admission and again at discharge. No extra autism teaching was added to standard eating-disorder care.
The team wanted to know if ASD traits would budge, and whether trait level linked to mood or eating severity.
What they found
ASD scores barely moved. The average drop was only two points—too small to matter. Patients who started with higher ASD traits also showed worse depression, anxiety, and eating symptoms at both time points.
In plain words: standard anorexia care does not touch autism traits, and those traits flag a tougher road.
How this fits with other research
Babb et al. (2021) extends this picture. They interviewed autistic women, parents, and staff. All sides said current eating-disorder programs feel like a bad fit—lights too bright, groups too chatty, rules too vague. Kate’s numbers now have a voice: traits stay put because the setting is not built for them.
Koegel et al. (2014) sounds a warning. The AQ-Short keeps the same shape across groups, but a raw score of 6 in anorexia does not equal 6 in autism. So Kate’s stable scores tell us about rank within the unit, not true autism severity.
Siegel (2018) offers hope. In a specialized autism inpatient unit, severe behavior dropped when staff used visual schedules and sensory breaks. Kate’s patients never got those tweaks—explaining why their traits stood still while Matthew’s kids improved.
Why it matters
If you treat eating disorders, count ASD traits at intake. High scores predict slower weight gain and more mood storms. Add structure: written agendas, quiet meal spots, clear rules. These small changes may do what Kate’s standard care could not—lower distress even if traits themselves stay.
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02At a glance
03Original abstract
Previous research has demonstrated links between anorexia nervosa and autism spectrum disorder however, few studies have examined the possible impact of symptoms of autism spectrum disorder on clinical outcomes in anorexia nervosa. The aim of this study was to examine the association between symptoms of autism spectrum disorder and eating disorders, and other psychopathology during the course of inpatient treatment in individuals with anorexia nervosa. Participants with anorexia nervosa (n = 171) completed questionnaires exploring eating disorder psychopathology, symptoms of depression and anxiety, and everyday functioning at both admission and discharge. Characteristics associated with autism spectrum disorder were assessed using the Autism Spectrum Quotient, short version. Autism spectrum disorder symptoms were significantly positively correlated with eating disorder psychopathology, work and social functioning, and symptoms of depression and anxiety, but not with body mass index. Autism Spectrum Quotient, short version scores remained relatively stable from admission to discharge but there was a small, significant reduction in scores. There was no interaction between time and Autism Spectrum Quotient, short version scores on clinical symptom change. In anorexia nervosa, autism spectrum disorder symptoms appear to be associated with a more severe clinical presentation on admission to inpatient care. Autism spectrum disorder symptoms as assessed by self-report measures may be exacerbated by other mental health psychopathology, which warrants further investigation.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361317722431