EMOTIONAL PROCESSING IN ADULT VS ADOLESCENT PATIENTS WITH EATING BEHAVIOR DISORDERS; EMOTIONAL RECOGNIZING AND THE MENTAL THEORY

Objective and methods: Current research has focused on the impact of difficulties in emotional recognition and regulation and deficits in social cognition (ToM) in the predisposition and maintenance of eating disorders EDs. Though most studies have assessed adult patients, few studies have examined these characteristics in adolescent patients. This study assessed difficulties in emotional recognition and ToM in 48 adult and adolescent patients (39 Anorexia Nervosa patients, and 9 Bulimia Nervosa patients) of varying degrees of severity, who were compared with a group of healthy controls using the TAS-20, and the RME. Results: The results substantiate the initial working hypothesis that difficulties in emotional recognition would be greater in both AN and BN patients as compared to controls. Moreover, these difficulties were modulated by age and the severity of the disorder i.e., severely affected adult patients had more difficulties in emotional recognition than less severely affected adolescent patients. No differences were observed according to diagnosis or BMI. Contrary to expectation in terms of the functioning of social cognition (theory of mind), both adult and adolescent AN and BN patients maintained their ability to infer the mental state of others, and performance in mentalizing task was similar to controls. Performance was slightly lower, but not statistically significant, in long-term previously treated patients than in controls. No relationship with low BMI or eating symptoms was observed. Conclusion: Since all of the ED patients exhibited emotional difficulties, techniques designed to enhance emotional recognition are vital for successful treatment. As difficulties become more acute as the disorder progresses, the treatment of adolescent patients must entail early therapeutic interventions designed to arrest further deterioration. In terms of ToM, the results suggest difficulties in social cognition can neither be generalized to all AN patients nor to those suffering from severe malnutrition. In long-term patients mentalization was slightly low and apparently poorly associated to difficulties in therapeutic link. These results do not lend support to the hypothesis that AN patients share the characteristics of patients affected by autistic spectrum disorders, at least not in terms of all the dimensions of ToM. These, and other controversial fmdings in the social cognition of EDs suggest that difficulties in mentalization cannot be generalized to all ED patients, which underscores the need for further research on the differential characteristics of AN patients with ToM disorders that goes beyond the emotional difficulties observed.