Peer-reviewed article
Mentalization in developmental age’s eating disorders: Comparison between anorexia nervosa and avoidant/restrictive food intake disorder (ARFID)
Gigliotti F, Basile C, Colaiori M, Terrinoni A, Ardizzone I et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compares how children and adolescents with two different eating disorders—anorexia nervosa and avoidant/restrictive food intake disorder (ARFID)—differ in their ability to understand and recognize emotions in themselves and others. The researchers tested 30 young people (aged 6–18 years) using several questionnaires and tests measuring emotional awareness, empathy, and theory of mind. They found that children with ARFID had lower emotional empathy but less difficulty recognizing emotions in themselves, while those with anorexia nervosa showed higher emotional difficulty but more empathy-related challenges. The findings suggest that different eating disorders involve different patterns of emotional understanding difficulties.
Key points
- Two groups of 15 patients each (AN and ARFID) aged 6–18 years were compared on mentalizing abilities
- ARFID patients showed lower affective empathy scores compared to AN patients
- AN patients had higher alexithymia (difficulty identifying emotions) than ARFID patients
- Mentalization impairment appears to be present across both eating disorders but in different patterns
- The study suggests tailored clinical interventions addressing specific emotional regulation deficits for each disorder
Limitations
The study is preliminary with small sample sizes (15 per group) and does not specify the country of origin, limiting generalizability. The document does not describe whether there was a control group of children without eating disorders or report statistical significance testing.
Abstract
Introduction Anorexia Nervosa (AN) and Avoidant/Restrictive Food Intake Disorder (ARFID) are two primary restrictive eating disorders described in DSM-5, characterized both of them by insufficient food intake. This behavior In ARFID is not driven by weight and shape concerns that tipify AN. While there are several studies that highlight the presence of mentalizing difficulties in AN, there are still no data about mentalizing profile in ARFID. Objectives The aim of this study was to better characterize the mentalizing profile of AN and ARFID children and adolescent. Methods Two groups of AN or ARFID outpatients (15+15), aged 6 to 18 years, were assessed by Alexythimia Questionnaire for Children (AQC) and Toronto Alexythimia Scale-20 (TAS-20) to evaluate alexythimia; by Interpersonal Reactivity Index (IRI) and Basic Empathy Scale (BES) to assess empathy; by NEPSY-II social perception subtests to evaluate Theory of Mind and Emotion recognition. Exclusion criteria were the presence of intellectual disability, pervasive developmental disorders and binge eating behavior (eating disorder other than AN or ARFID). Results Preliminary results showed different mentalizing profiles between ARFID and AN patients, with differences in the score for affective empathy, lower in ARFID than in AN patients while the score for alexythimia traits resulted higher in AN population. Conclusions By our results, mentalization impairment appeared trans-diagnostic across several eating disorders. This first result should be further improved to better analyze this construct in order to develop effective clinical intervention to improve the subject’s affective regulation. Disclosure No significant relationships.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Assessment and comparison of mentalizing abilities using standardized questionnaires and cognitive tests (AQC, TAS-20, IRI, BES, and NEPSY-II subtests)
- Population
- Outpatients aged 6–18 years with anorexia nervosa (n=15) or ARFID (n=15); excluded those with intellectual disability, pervasive developmental disorders, or binge eating
Key finding
ARFID patients had lower affective empathy scores than AN patients