Empathy, mentalizing, and cognitive functioning in anorexia nervosa and bulimia nervosa

Area of Science:

• Psychology
• Neuroscience
• Psychiatry

Background:

• Evidence on empathy and mentalizing in eating disorders like anorexia nervosa (AN) and bulimia nervosa (BN) is inconclusive.
• The accuracy of self-appraisal of empathic skills in these patients remains unclear.

Purpose of the Study:

• To investigate impairments in empathy and theory of mind (ToM) in AN and BN patients.
• To assess the accuracy of self-appraisal of empathy in these patient groups.
• To examine the influence of cognitive functions on empathy and self-appraisal.

Main Methods:

• Assessed self-reported and performance-based empathy, ToM, and cognitive functions in 46 AN patients, 30 BN patients, and 42 healthy controls (HC).
• Utilized a mixed-methods approach combining subjective reports and objective performance measures.

Main Results:

• Both AN and BN patients reported lower overall empathy; BN patients specifically reported reduced cognitive empathy compared to HC.
• Performance-based empathy deficits were observed in both AN and BN groups.
• Cognitive ToM was impaired only in AN patients. Self-appraisal accuracy differed, with AN patients showing deficits linked to cognitive impairments.

Conclusions:

• AN and BN patients exhibit distinct empathy and ToM profiles.
• AN patients demonstrate a double deficit: impaired empathic performance and inaccurate self-appraisal, suggesting self-reflection issues.
• Findings underscore the complexity of social cognition in eating disorders and the need for tailored interventions.