Auditory Sensory Attenuation in Anorexia Nervosa (UdSA_AN)

The Sensory Attenuation Paradigm in Auditory Modality in Anorexia Nervosa

The goal of this observational cross-sectional study is to test the sensory attenuation effect with auditory stimuli comparing women affected by anorexia nervosa and healthy-weight women. Specifically, the study aims to test whether the sensory attenuation effect (i.e., the perceived loudness of a self-generated sound is weaker than when another person produces the same sound):

i) is observed in anorexia nervosa ii) it can be modulated in interactive action contexts, as was previously observed in healthy participants.

Participants will compare the loudness of target sound with a comparison tone, which can be prompt by the participant by pressing a button on their own will (i.e., individual context) or upon the experimenter's signal (i.e., interactive context); externally-generated sounds are produced in the opposite way.

Study Overview

• Status: Completed
• Conditions: Anorexia Nervosa

Detailed Description

The perceived loudness of a self-generated sound is generally weaker than when another person produces the same sound. This effect is known as sensory attenuation, and it is considered a proof of sense of agency (i.e., it relies on the anticipation of the sensory-motor effects of one's intentional action). Recently, it was suggested that this effect is enhanced in interactive action contexts in healthy individuals, meaning that sounds are produced as a consequence of cooperation between individuals.

Participants will compare the loudness of target sound with a comparison tone, which could be generated in 4 different conditions:

i) participants press a button ii) the experimenter press the button iii) participants press the button upon the experimenter's signal (i.e., who touch the participants' arm) iv) the experimenter presses the button upon the participants' signal (i.e., who touch the experimenter's arm).

However, it is not clear whether the same effect of cooperation can be observed also when individuals experience difficulties in social interactions and relationships.

To this purpose, the study compared the sensory attenuation effect for auditory stimuli in a traditional (i.e., individual) and interactive context, comparing women affected by anorexia nervosa with healthy-weight women.

Indeed, relational difficulties and social withdrawal characterized this clinical condition.

• Study Type: Observational
• Enrollment (Actual): 31

Contacts and Locations

Study Locations

• Italy
  • VCO
    • Piancavallo, VCO, Italy, 28824
      • IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

women affected by anorexia nervosa will be recruited at the IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, VB, Italia (eating and nutritional disorders ward).

women with healthy weight will be recruited in the local community and among the researchers contacts

Description

Inclusion Criteria:

• diagnosis of anorexia nervosa according to the DSM-V classification (experimental group)
• BMI ranged between 19 - 25 kg/m2 (controls)
• handedness: right

Exclusion Criteria:

• history of eating disorders (controls)
• major psychiatric conditions (e.g., psychosis, personality disorders)
• developmental disorders (e.g., autism spectrum disorders)
• neurological or brain injuries disorders
• motor impairments

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
women with anorexia nervosa; DSM-V criteria for anorexia nervosa must be satisfied
healthy weight women; BMI range: 19-29 kg/m2

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
point of subjective equality (PSE)	individual PSE in each experimental condition is obtained by fitting observed judgements of loudness, relative to seven possible comparison tones. The PSE represents the tone loudness that participants perceive as loud as the target sound (i.e., the sound intensity which records only 50% of correct judgments "which sounds was louder?")	day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
cognitive empathy	Interpersonal Reactivity Index - IRI: 28-item self-report questionnaire on a 5-point Likert scale (from 1 -does not describe me well to 5 - describes me very well). Four components of cognitive empathy are measured: i) perspective taking (IRI-PT); ii) fantasy (IRI-F); iii) empathic concern (IRI-EC); iv) personal distress (IRI-PD); each subscale includes 7 items (total scores range from 1 to 35): the higher the score, the higher the expression of cognitive empathy described in each subscale.	day 1
interpersonal pleasure	Anticipatory and Consummatory Interpersonal Pleasure Scale - ACIPS: 17-item self-reported questionnaire scored on 6-point Likert scale (from 1 - very false for me to 6-very true for me). ACIPS total score ranges from 1 to 102: higher scores indicate higher anticipatory and consummatory interpersonal pleasure.	day 1

Collaborators and Investigators

• Sponsor: Istituto Auxologico Italiano

Publications and helpful links

General Publications

• Colle L, Hilviu D, Boggio M, Toso A, Longo P, Abbate-Daga G, Garbarini F, Fossataro C. Abnormal sense of agency in eating disorders. Sci Rep. 2023 Aug 30;13(1):14176. doi: 10.1038/s41598-023-41345-5.
• Weiss C, Herwig A, Schutz-Bosbach S. The self in social interactions: sensory attenuation of auditory action effects is stronger in interactions with others. PLoS One. 2011;6(7):e22723. doi: 10.1371/journal.pone.0022723. Epub 2011 Jul 27.

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2023
• Primary Completion (Actual): February 29, 2024
• Study Completion (Actual): June 30, 2025

Study Registration Dates

• First Submitted: March 1, 2024
• First Submitted That Met QC Criteria: March 1, 2024
• First Posted (Actual): March 7, 2024

Study Record Updates

• Last Update Posted (Estimated): September 8, 2025
• Last Update Submitted That Met QC Criteria: September 5, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: anorexia nervosa; anhedonia; cognitive empathy; sensory attenuation; interpersonal difficulties
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Mental Disorders; Neurobehavioral Manifestations; Feeding and Eating Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Anhedonia; Anorexia Nervosa
• Other Study ID Numbers: 21C307

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: upload of anonymized raw experimental data on public repository (i.e., Zotero)
• IPD Sharing Access Criteria: Experimental data will be provided upon reasonable request to the Authors. Requests can be send through the repository platform (log-in on the platform is required)
• IPD Sharing Supporting Information Type: CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No