Social cognition in anorexia nervosa: Specific difficulties in decoding emotional but not nonemotional mental states.
Building on recent models of anorexia nervosa (AN) that emphasize the importance of impaired social cognition in the development and maintenance of the disorder, the present study aimed at examining whether women with AN have more difficulties with inferring other people's emotional and nonemotional mental states than healthy women.



Social cognition was assessed in 25 adult women with AN and 25 age-matched healthy women. To overcome limitations of previous research on social cognition in AN, the processing of social information was examined in a more complex and ecologically valid manner. The Movie for the Assessment of Social Cognition (MASC) reflects complex real-life social interaction and allows for disentangling emotional and non-emotional mental state inference as well as different types of errors in mentalizing.



Women with AN showed poorer emotional mental state inference, whereas non-emotional mental state inference was largely intact. Groups did not differ in undermentalizing (overly simplistic theory of mind) and overmentalizing (overly complex or over-interpretative mental state reasoning). Performance in the MASC was independent of levels of eating disorder psychopathology and symptoms of depression and anxiety.



The findings suggest that AN is associated with specific difficulties in emotional mental state inference despite largely intact nonemotional mental state inference. Upon replication in larger samples, these findings advocate a stronger emphasis on socio-emotional processing in AN treatment. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:883-890).
Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Center for Psychosocial Medicine, Heidelberg, Germany. timo.brockmeyer@kcl.ac.uk.|Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. timo.brockmeyer@kcl.ac.uk.
Timo
T
Brockmeyer
Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Center for Psychosocial Medicine, Heidelberg, Germany.
Judith
J
Pellegrino
Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Center for Psychosocial Medicine, Heidelberg, Germany.
Hannah
H
Münch
Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Center for Psychosocial Medicine, Heidelberg, Germany.
Wolfgang
W
Herzog
Berlin School of Mind and Brain and Institute of Psychology, Humboldt-University, Berlin, Germany.
Isabell
I
Dziobek
Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Center for Psychosocial Medicine, Heidelberg, Germany.|Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
Hans-Christoph
HC
Friederich
D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000523:psychology; D003863:Depression / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D056345:Theory of Mind / Q000502:physiology; D013850:Thinking / Q000502:physiology; D055815:Young Adult
eating disorders; empathy; mentalization; mindreading; socio-emotional processing; theory of mind