title: Social cognition in children at familial high-risk of developing an eating disorder.
abstract: OBJECTIVE
  Diagnosis of an eating disorder (ED) has been associated with differences in social cognition. To date research investigating social cognition and ED has mainly employed patient and recovered samples. It is therefore unclear whether differences in social cognition are present prior to onset of ED, potentially contributing to development, or whether differences observed are a consequence of the disorder. We aimed to further explore whether individuals at high-risk for ED present social cognition characteristics previously found in ED groups.
  
  
  METHODS
  Our sample was drawn from a population-based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Data on maternal ED behaviors over the lifetime were collected through in-depth clinical interviews (n = 1128) conducted using the Structured Clinical Interview for DSM disorders (SCID), and were used to categorize mothers according to ED behaviors over the lifetime: Restricting and Excessive Exercising (n = 58), Purging (n = 70), Binge-eating (n = 72), Binging and Purging (n = 66), no ED (n = 862). High-risk status of children was determined using these maternal lifetime behavioral phenotypes. Children at high-risk (maternal ED exposure) were compared to children at low-risk (born to mothers with no ED) on three measures of social cognition: the Social Communication Disorders Checklist (SCDC) (n = 922), the faces subtest of the Diagnostic Analysis of Non-Verbal Accuracy (DANVA) (n = 722), and the Emotional Triangles Task (n = 750).
  
  
  RESULTS
  Children at high-risk for ED showed poorer performance on measures of social cognition compared to children at low-risk. Maternal lifetime binge-eating, and maternal lifetime binging and purging were associated with poorer social communication in children (OR: 2.4, 95% CI: 1.0, 5.7, p = 0.05; and OR: 2.7, 95% CI: 1.1, 6.5, p = 0.03 respectively). Maternal binging and purging was also found to be associated with differential facial emotion processing and poorer recognition of fear from social motion cues (B: -0.7, 95% CI: -1.1, -0.2, p = 0.004).
  
  
  CONCLUSIONS
  Children at high-risk for ED showed slight differences in some areas of social cognition when compared to children at low-risk. Characteristic patterns in social cognition are present in children at high-risk for ED, particularly among children whose mothers have binge-eating and purging behaviors over the lifetime. Our findings support the hypothesis that these differences may be part of an intermediate phenotype for ED: perhaps contributing to development, or perhaps indexing a shared liability with psychiatric disorders characterized by abnormal social cognition.
authors: Behavioural and Brain Sciences, Institute of Child Health, University College London London, UK ; Division of Psychology and Language Sciences, University College London London, UK.
authors: Radha
authors: R
authors: Kothari
authors: Behavioural and Brain Sciences, Institute of Child Health, University College London London, UK.
authors: Manuela
authors: M
authors: Barona
authors: Psychological Medicine, King's College London Institute of Psychiatry London, UK.
authors: Janet
authors: J
authors: Treasure
authors: Behavioural and Brain Sciences, Institute of Child Health, University College London London, UK ; Department of Psychiatry, Icahn Medical School at Mount Sinai New York, NY, USA ; Mindich Child health and Development Institute, Icahn Medical School at Mount Sinai New York, NY, USA.
authors: Nadia
authors: N
authors: Micali
keywords: ALSPAC; DANVA; SCDC; eating disorder; emotion recognition; high-risk; phenotype; social cognition