Using the Autism-Spectrum Quotient to Measure Autistic Traits in Anorexia Nervosa: A Systematic Review and Meta-Analysis

Heather Westwood, Ivan Eisler, William Mandy, Jenni Leppanen, Janet Treasure, Kate Tchanturia, Heather Westwood, Ivan Eisler, William Mandy, Jenni Leppanen, Janet Treasure, Kate Tchanturia

Abstract

Interest in the link between Autism Spectrum Disorder (ASD) and Anorexia Nervosa (AN) has led to estimates of the prevalence of autistic traits in AN. This systematic review and meta-analysis assessed the use of the Autism-Spectrum Quotient (AQ) or abbreviated version (AQ-10) to examine whether patients with AN have elevated levels of autistic traits. Seven studies were identified and subsequent meta-analysis indicated that those with AN appear to have significant difficulties of a manner characteristic of ASD, relative to controls. Whilst this analysis supports previous indications of higher prevalence of ASD in AN, the aetiology of these traits remains unclear. Studies using more robust clinical measures of ASD within AN are needed to confirm what self-report measures appear to show.

Keywords: Anorexia Nervosa; Autism; Autism-Spectrum Quotient; Female; Meta-analysis; Systematic review.

Figures

Fig. 1
Fig. 1
Systematic review search process in accordance with the PRISMA statement
Fig. 2
Fig. 2
Funnel plot of studies included in the meta-analysis to assess for publication bias. Each dot represents a study included in the meta-analysis, with the Y axis representing the size of each study and the X axis, each study’s result
Fig. 3
Fig. 3
Forest plot for mean total Autism-Spectrum Quotient (AQ) and short Autism-Spectrum Quotient (AQ-10), with standardised mean effect sizes for difference between Anorexia Nervosa (AN) and Healthy Controls (HC). The Y axis shows each included study and the X axis represents the magnitude of difference between the AN and HC groups. The overall effect sizes for adult and child studies and the mean summary measure are depicted by the black diamonds
Fig. 4
Fig. 4
Mean and standard deviations sub-scale scores and forest plots for Autism-Spectrum Quotient with effect sizes for difference between Anorexia Nervosa (AN) and Healthy Controls (HC). The Y axis shows each individual study and the X axis represents the magnitude of difference between the AN and HC groups on the AQ sub-scales. The overall effect sizes for each sub-scale score are depicted by the black diamonds

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