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Socio-cognitive processing in people with eating disorders: Computerized tests of mentalizing, empathy and imitation skills

Research output: Contribution to journalArticlepeer-review

Elisa Corsi, Valentina Cardi, Sophie Sowden, Michel Pierre Coll, Giammarco Cascino, Valdo Ricca, Janet Treasure, Geoffrey Bird, Alessio Maria Monteleone

Original languageEnglish
Pages (from-to)1509-1518
Number of pages10
JournalInternational Journal of Eating Disorders
Issue number8
Accepted/In press2021
PublishedAug 2021

Bibliographical note

Funding Information: M.P.C. is funded by a fellowship from the Canadian Institutes of Health Research. This work was supported by the Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London (Valentina Cardi and Janet Treasure). Valentina Cardi is supported by a grant from MIUR (Dipartimenti di Eccellenza DM 11/05/2017 n. 262) to the Department of General Psychology. Publisher Copyright: © 2021 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Objective: Eating disorders are psychiatric illnesses characterized by extreme eating behaviors, such as sustained food restriction or loss of control over eating. Symptoms are thought to be maintained by a variety of mechanisms, one of which may be the socio-cognitive impairments associated with eating disorders. While some previous work has addressed socio-cognitive impairments in eating disorders, this work has relied mostly on self-report data. Method: Here we employed computerized tests of (a) mentalizing (ability to infer the mental states of others); (b) empathy (the degree to which the emotional states of others can be identified and the degree to which the states of others impact one's own emotional state); and (c) imitation (the degree to which observation of another's actions prompts the performance of those actions); in a group of 78 women with an eating disorder and a matched control group of 66 healthy women. Results: People with eating disorders showed both hyper- and hypo-mentalizing and reduced accuracy of emotional and cognitive mental state inference. They displayed less imitation of observed actions, but no differences in empathy compared to healthy controls. Although anxiety and depressive symptoms had significant effects on mentalizing, most of the observed inter-group differences persisted. Discussion: Women with eating disorders have difficulties mentalizing and imitating observed actions despite intact non-social automatic imitation, compared to healthy controls. These findings provide an indication that intervention modules to strengthen specific areas of social cognition might be helpful to improve patients' social skills.

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