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Seeing the bigger picture of anorexia
THIS WEEK
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autistic traits like poorer social skills, and greater attention to detail (British Journal of Clinical Psychology, DOI: 10.1348/ 014466507x272475). Simon Baron-Cohen of the Autism Research Centre in associated with extreme Cambridge, UK, is also measuring attention to detail and a rigid, whether adolescents with anorexia inflexible style of thinking – score higher on autistic traits than traits also associated with ASD. healthy people, as he suspects To investigate further, her team that some of them may actually used neuropsychological tests have undiagnosed Asperger’s to measure central coherence, syndrome. “We have always or the ability to see the big picture known that Asperger’s syndrome as well as the finer details, in was diagnosed more often in 42 women with anorexia and males,” he says. “The new question “Anorexia and autism are 42 without it. Women with is whether it takes a different obviously not the same anorexia had weaker central form in females, and can account thing, but they have some coherence, with a bias towards for at least a subgroup of those things in common” local, rather than global who are diagnosed with anorexia.” processing (International Journal If it does, this could have of Eating Disorders, vol 41, p 143). spectrum in 22 women with important implications for the In a separate study, Treasure anorexia and 45 without it. They way that anorexia is treated. “As and her colleagues found that 45 found that although those with well as treating the ‘eating per cent of people with anorexia the eating disorder didn’t differ disorder’ the clinician and the or bulimia have problems from healthy women in terms of patient might [also] focus on “set-shifting”, or modifying empathising or systemising, they social skills,” says Baron-Cohen, their behaviour in response to did show elevated scores on other although he adds that weight gain would remain a key target. Tchanturia is already conducting a study in around 30 people with anorexia, who are having cognitive remediation therapy (CRT) to encourage flexible and bigger-picture thinking. For example, patients are given an exercise in which they have to summarise several pages of text, to practice seeing the gist rather than the details. “We’re putting the focus on how people think, rather than what people think,” says Tchanturia. The technique has already had some success – in a pilot study of 19 patients with anorexia, 17 patients said they felt it helped them to think more flexibly – although it’s too early to say whether it will help their anorexia in the long-term. “They found the treatment helpful in reducing their perfectionist tendencies and it helped them to see things more holistically,” Tchanturia says (International Journal of Eating Disorders, DOI: –Don’t fixate on weight – 10.1002/eat.20536). ■
Brain training can help in anorexia A GROWING appreciation of the links between anorexia and autism spectrum disorders has uncovered new opportunities for treating the eating disorder. Mental health professionals are now attempting to train the brains of people with anorexia to be more flexible and to see the big picture as well as fine details. In doing so, they hope patients will be less inclined to obsess about body weight and calories and be better equipped to overcome their eating disorder in the long term, as well as gaining weight more immediately. Last month, the international Academy for Eating Disorders published a paper calling for eating disorders (EDs) such as anorexia and bulimia to receive the same degree of healthcare as other biologically based mental illnesses such as schizophrenia, bipolar disorder and obsessive compulsive disorder (OCD) (International Journal of Eating Disorders, DOI: 10.1002/ eat.20589). Other groups are even calling for anorexia to be placed in the same diagnostic category as autism spectrum disorders (ASD). The main reason for this change is a growing understanding of the biological basis of EDs. Twin studies suggest that between 50 and 83 per cent of EDs have a genetic basis. Now, evidence suggests that people with anorexia have cognitive traits associated with ASD. “Eating disorders and autism spectrum disorders are obviously not the same thing, but they do have some things in common,” says Janet Treasure of the Institute of Psychiatry in London. Treasure had already discovered that anorexia was 12 | NewScientist | 25 April 2009
MAXPPP/BARCROFT MEDIA
Linda Geddes
changing goals, compared to just 10 per cent of healthy people. This type of focused thinking can be a beneficial skill, but when thinking becomes obsessive, for example, it can be destructive, says Treasure, who presented her results at a meeting of the British Psychological Society in Brighton, earlier this month. In another series of studies, Treasure’s team, together with Kate Tchanturia, also of the Institute of Psychiatry, assessed empathy, systemising ability, and other traits on the autistic
For daily news stories, visit www.NewScientist.com/news
autistic traits like poorer social skills, and greater attention to detail (British Journal of Clinical Psychology, DOI: 10.1348/ 014466507x272475). Simon Baron-Cohen of the Autism Research Centre in associated with extreme Cambridge, UK, is also measuring attention to detail and a rigid, whether adolescents with anorexia inflexible style of thinking – score higher on autistic traits than traits also associated with ASD. healthy people, as he suspects To investigate further, her team that some of them may actually used neuropsychological tests have undiagnosed Asperger’s to measure central coherence, syndrome. “We have always or the ability to see the big picture known that Asperger’s syndrome as well as the finer details, in was diagnosed more often in 42 women with anorexia and males,” he says. “The new question “Anorexia and autism are 42 without it. Women with is whether it takes a different obviously not the same anorexia had weaker central form in females, and can account thing, but they have some coherence, with a bias towards for at least a subgroup of those things in common” local, rather than global who are diagnosed with anorexia.” processing (International Journal If it does, this could have of Eating Disorders, vol 41, p 143). spectrum in 22 women with important implications for the In a separate study, Treasure anorexia and 45 without it. They way that anorexia is treated. “As and her colleagues found that 45 found that although those with well as treating the ‘eating per cent of people with anorexia the eating disorder didn’t differ disorder’ the clinician and the or bulimia have problems from healthy women in terms of patient might [also] focus on “set-shifting”, or modifying empathising or systemising, they social skills,” says Baron-Cohen, their behaviour in response to did show elevated scores on other although he adds that weight gain would remain a key target. Tchanturia is already conducting a study in around 30 people with anorexia, who are having cognitive remediation therapy (CRT) to encourage flexible and bigger-picture thinking. For example, patients are given an exercise in which they have to summarise several pages of text, to practice seeing the gist rather than the details. “We’re putting the focus on how people think, rather than what people think,” says Tchanturia. The technique has already had some success – in a pilot study of 19 patients with anorexia, 17 patients said they felt it helped them to think more flexibly – although it’s too early to say whether it will help their anorexia in the long-term. “They found the treatment helpful in reducing their perfectionist tendencies and it helped them to see things more holistically,” Tchanturia says (International Journal of Eating Disorders, DOI: –Don’t fixate on weight – 10.1002/eat.20536). ■
Brain training can help in anorexia A GROWING appreciation of the links between anorexia and autism spectrum disorders has uncovered new opportunities for treating the eating disorder. Mental health professionals are now attempting to train the brains of people with anorexia to be more flexible and to see the big picture as well as fine details. In doing so, they hope patients will be less inclined to obsess about body weight and calories and be better equipped to overcome their eating disorder in the long term, as well as gaining weight more immediately. Last month, the international Academy for Eating Disorders published a paper calling for eating disorders (EDs) such as anorexia and bulimia to receive the same degree of healthcare as other biologically based mental illnesses such as schizophrenia, bipolar disorder and obsessive compulsive disorder (OCD) (International Journal of Eating Disorders, DOI: 10.1002/ eat.20589). Other groups are even calling for anorexia to be placed in the same diagnostic category as autism spectrum disorders (ASD). The main reason for this change is a growing understanding of the biological basis of EDs. Twin studies suggest that between 50 and 83 per cent of EDs have a genetic basis. Now, evidence suggests that people with anorexia have cognitive traits associated with ASD. “Eating disorders and autism spectrum disorders are obviously not the same thing, but they do have some things in common,” says Janet Treasure of the Institute of Psychiatry in London. Treasure had already discovered that anorexia was 12 | NewScientist | 25 April 2009
MAXPPP/BARCROFT MEDIA
Linda Geddes
changing goals, compared to just 10 per cent of healthy people. This type of focused thinking can be a beneficial skill, but when thinking becomes obsessive, for example, it can be destructive, says Treasure, who presented her results at a meeting of the British Psychological Society in Brighton, earlier this month. In another series of studies, Treasure’s team, together with Kate Tchanturia, also of the Institute of Psychiatry, assessed empathy, systemising ability, and other traits on the autistic