Exploring the role of subthreshold autistic traits on body image uneasiness: a study among Italian female with eating disorders

Objective: The present study evaluate the presence of subthreshold autistic traits, assess the level of body image dissatisfaction, and explore their potential association in female patients with eating disorders. Method: The study used the Adult Autism Subthreshold Spectrum–AdAS and the Body Uneasiness Test–BUT to identify autistic traits that predict body image distress, applying linear and stepwise regression. Results: The sample consisted of 49 female patients with eating disorders with a mean duration of illness of 4 years. Regression analysis indicated that BUT ‘Weight Phobia’ factor was positively associated with AdAS ‘Non-Verbal communication’ and ‘Inflexibility and adherence to routine’ domains, BUT ‘Body Image Concerns’ factor was associated with AdAS ‘Non-Verbal communication’ and ‘Inflexibility and adherence to routine’ domains. BUT ‘Compulsive Self-Monitoring’ factor was associated with AdAS ‘Inflexibility and adherence to routine’ domain and, finally BUT ‘Depersonalization’ factor was positively associated with AdAS ‘Hyper– and hypo reactivity to sensory input’. The average AdAS score is 73.8 (± SD 22.8). Conclusions: The study highlights that subthreshold autistic traits may play a role in altering body image in patients with eating disorders, possibly due to altered sensory perception. Further research is needed to explore causes and therapies.