Mentalizing ability in acute and remitted anorexia nervosa

Mentalizing refers to an individual's capacity for inferring intentions, thoughts, and emotions from verbal and nonverbal cues. Impairments in mentalizing are well established in anorexia nervosa (AN). It is unclear, however, whether these deficits only occur in the acute phases of AN (state-like), or if deficits remain once remission has been achieved (trait-like). The current study aimed to determine the predictive value of the severity of AN in determining the severity of mentalizing deficits and whether mentalizing differs in acute and recovered stages of AN. The final sample comprised of 161 participants aged 18-30. Participants were allocated to the acute-AN group (BMI under 17, n = 15), remission-AN group (BMI over 17 with previous history of AN, n = 64) or the general population control group (no history of AN, n = 82). Participants provided demographic information and completed a battery of online tests and surveys. No significant differences were found on mentalizing between the acute and remission groups. The control group demonstrated significantly better mentalizing than the remission-AN group. Severity of AN (measured by BMI) was a significant predictor of mentalizing when measured objectively but not subjectively. The findings suggest no categorical improvement in mentalizing following remission and demonstrated mentalizing improvements as BMI increased, suggesting mentalizing deficits may be trait-based and observable in AN regardless of stage of illness.