Social cognition in women with eating disorders: Differences between the restrictive and purgative profiles

Difficulties in interpersonal interactions have been related to Social Cognition (SC) impairments in eating disorders (EDs). However, results do not account for differences between restrictive (rED) and purgative (pED) profiles and are just based on decoding tasks. This study assessed SC by Theory of Mind (ToM) abilities in ToM decoding and inference tasks between rED and pED patients and healthy women and its relationship with clinical variables.

37 rED patients, 42 pED patients and 34 controls were evaluated using the Movie for the Assessment of Social Cognition (MASC) -ToM inference abilities- and the Reading the Mind in the Eyes revised version (RMET-R) - ToM decoding abilities-. Age, body mass index (BMI) and disorder's duration were considered as clinical variables. ANCOVA analyses were carried out to analyse differences between groups, controlling for impulsivity as a covariate. Group relationships between ToM and clinical variables were analysed through linear regression models.

pED showed lower correct MASC responses (p < .01) and more overmentalising errors (p < .05) than controls, and for rED, differences overmentalising errors were close to significance (p = .051). For RMET-R, differences were related to impulsivity. Age (p < .01) and BMI p < .05) were related with correct MASC responses.

Patients with EDs show difficulties in ToM inference abilities, especially those with a purgative profile, with poorer performance related to clinical severity indices such as weight and age. Differences in ToM decoding appear to be related to impulsivity rather than clinical diagnosis.