Autistic traits and experience and attitude toward the body: an investigation in a sample of Italian female patients with eating disorders

Objectives: the present study aims to explore possible associations between autistic traits and the experience and attitude toward the body in female patients affected by eating disorders. Methods: Participants with diagnosis of EDs as defined by the DSM-5TR were recruited between January and June 2023. Adult Autism Subthreshold (ADAS) Spectrum and Body Attitudes Test (BAT) were used to explore the presence of autistic traits and the alteration in body attitude. Results: 44 female patients have been included in the study. The most represented ADAS Spectrum domains were “Empathy” and “Hyper–and hyporeactivity to sensory input”. Forward stepwise regression analysis indicated that BAT “Negative appreciation of body size” factor was predicted (R2 = .311; R-squared adjusted = .277; F = 9.241; p < .0001) by ADAS Spectrum “Inflexibility” (p = .006) and “Verbal communication” (p = .038) domains, BAT “Lack of familiarity with one's own body” factor was predicted (R2 = .587; R-squared adjusted = .566; F = 29.092; p < .0001) by ADAS Spectrum “Non-Verbal communication” (p < .0001) and “Hyper– and hyporeactivity to sensory input” (p = .001) domains, and BAT “General body dissatisfaction” factor was predicted (R2 = .290; R-squared adjusted = .273; F = 17.181; p < .0001) by ADAS Spectrum “Non-Verbal communication” (p < .0001) domain. Conclusions: the current work highlights that several core autistic traits, as assessed by the ADAS Spectrum, may be predictive of alterations in body image, knowledge, and satisfaction. The observed association between subthreshold autism and eating disorders supports the hypothesis that EDs could be one of the possible psychopathological trajectories of a neurodevelopmental disorder rooted in autism spectrum.