The association between symptoms of autism and neuropsychological performance in females with Anorexia Nervosa

The aim of this study was to investigate the relationship between symptoms of autism spectrum disorder (ASD) and performance on measures of set-shifting and central coherence in a sample of females with anorexia nervosa (AN). Ninety-nine females aged 12-47, recruited from inpatient and day patient eating disorder services, were assessed with the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2), as well as the Wechsler Abbreviated Scale of Intelligence, 2nd edition (WASI-II); Wisconsin Card Sorting Test (WCST); Rey-Osterrieth Complex Figure Test (ROCFT) and self-report questionnaires assessing eating disorder pathology, depression, cognitive rigidity and attention to detail. Individuals scoring above clinical cut-off on the ADOS-2 (N = 35) reported significantly higher levels of cognitive rigidity than those with lower levels of ASD symptoms but there was no difference between groups on self-reported attention to detail. There group with high levels of ASD symptoms also made significantly more perseverative errors on the WCST but there was no association between ASD symptoms and performance on the ROCFT. The group who scored above cut-off on the ADOS-2 were significantly younger than the sub-clinical groups. The presence of symptoms associated with ASD appears to be related to increased cognitive rigidity in females with AN.