Comparing executive functions profiles in anorexia nervosa and autism spectrum disorder in adolescence

Executive functions (EFs) inefficiencies in anorexia nervosa (AN), especially in set-shifting and central coherence, suggest a link between AN and autism spectrum disorders (ASDs). This study aimed at comparing EF profiles in AN and ASD, and investigating clinical variables associated with the identified EF difficulties.

One hundred and sixty-two adolescents with AN or ASD completed self-report questionnaires assessing depression, anxiety and autism symptoms. Parents completed the behaviour rating of executive functions parent-form (BRIEF-P). Besides comparing EFs in AN and ASD, we also analysed clinical variables scoring below and above the mean age score across the all sample. We additionally examined the relationship between clinical variables and the BRIEF-P indexes in AN.

Participants with ASD had greater EF difficulties than participants with AN on all BRIEF-P scales. In the whole sample, higher autistic features were related to poorer EF. In AN, lower body mass index and particularly higher autism-spectrum quotient (BRI: Beta = 0.55; p < 0.001 and GEC: Beta = 0.50; p < 0.001) were most strongly associated with poorer EF.

Although participants with ASD showed greater difficulties, autistic traits were related to alter EFs in AN. Exploring further this dimension can undeniably allow better adaptive cognitive remediation programs.