Family History of Eating Disorder and the Broad Autism Phenotype in Autism.
Mothers of autistic children who have had eating disorders show sharply higher rigid traits—so add a brief ED history check to parent interviews.
01Research in Context
What this study did
Mulder et al. (2020) asked mothers of autistic children about past eating disorders. They then gave the moms the BAP-Q, a short survey that measures autism-like traits in adults.
The team split moms into two groups: those with an ED history and those without. They compared the BAP-Q scores to see if eating-disorder history lined up with higher rigid or socially aloof traits.
What they found
Mothers who had experienced an eating disorder scored much higher on the Rigid domain of the BAP-Q. Their scores on Aloof and Pragmatic Language domains were also elevated, but rigidity showed the biggest gap.
In plain words, moms of autistic kids with a past ED looked noticeably more inflexible and rule-bound than other moms.
How this fits with other research
Neville-Jones et al. (2025) extends this picture. They tested neurocognitive skills in parents of autistic kids and parents of kids with anorexia. Both groups showed weaker imagination and cognitive flexibility, hinting that the autism-ED overlap runs deeper than questionnaires.
Gurbuz Ozgur et al. (2025) move from traits to feeding problems. They found that moms with orthorexia—an obsessive focus on “healthy” eating—had autistic children with more severe ARFID symptoms. Together with A et al., this builds a chain: maternal eating psychopathology → maternal rigidity → child feeding issues.
Dudley et al. (2019) seems to clash at first. They reported that rigid BAP traits in moms reduced reappraisal use but did not mention eating disorders. The gap is methodological: they never asked about ED history, so the rigid subgroup in their sample may have quietly overlapped with the ED-history moms seen here.
Why it matters
If you assess autism in a child and mom seems highly rule-bound or anxious around food, ask one extra question: “Have you ever had an eating disorder?” A quick screen can explain rigid parent behavior and flag families who may need added feeding support. Share the BAP-Q with the medical team; elevated rigidity just became another data point for the family’s intervention plan.
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02At a glance
03Original abstract
Autism features occur frequently among individuals with eating disorders (ED). This co-occurrence is not well understood but there is speculation that select traits (e.g., rigidity) are common to both autism and ED. To explore the co-occurrence of autistic traits and ED features, we used the Simons Simplex Collection (SSC; N = 2,623 families) to test whether first-degree relatives of individuals with autism with a history of ED features had more autism traits, as measured by the Broad Autism Phenotype Questionnaire (BAP-Q), compared to relatives with no history of ED. The frequency of individuals with ED features was 2.2% (N = 57) among mothers, <1% in siblings, and not present in fathers. We restricted our analyses to mothers. Compared to mothers with no history of ED, those with a history of ED had significantly higher scores on the BAP-Q Total Score and each of the three BAP-Q domains. More importantly, when the BAP-Q was used as a classification tool, we found that when compared to mothers with no history of ED, those with a history of ED were most likely to fall into the clinically significant range on the BAP-Q Rigid domain. Our results suggest that a history of ED features among mothers of individuals with autism is associated with the presence of autistic traits. This extends previous work showing a relationship between autism and ED and expands the range of neuropsychiatric traits that have relevance to the BAP among family members of individuals with autism. LAY SUMMARY: Using information from the Simons Simplex Collection we tested whether mothers of individuals with autism with a history of eating disorder had more autism traits (i.e., similar to those in autism but milder) compared to mothers with no history of eating disorder. The most striking difference between the groups was the presence of rigidity in mothers with a history of eating disorder. This extends previous work showing a relationship between autism and eating disorders and suggests the utility of studying eating disorders in future family studies of autism. Autism Res 2020, 13: 1573-1581. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2020 · doi:10.1002/aur.2378