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Anorexia nervosa and its relation to depression, anxiety, alexithymia and emotional processing deficits

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Abstract

Purpose

Psychopathological changes and dysfunction in emotion processing have been described for anorexia nervosa (AN). Yet, findings are applicable to adult patients only. Furthermore, potential for discriminative power in clinical practice in relation to clinical parameters has to be discussed. The aim of this study was to investigate psychopathology and emotional face processing in adolescent female patients with AN.

Methods

In a sample of 15 adolescent female patients with AN (16.2 years, SD ± 1.26) and 15 age and sex matched controls we assessed alexithymia, depression, anxiety and empathy in addition to emotion labelling and social information processing.

Results

AN patients had significantly higher alexithymia, higher levels of depression, and state and trait anxiety compared to controls. There was a trend for a lower ability to recognize disgust. Happiness as a positive emotion was recognized better. All facial expressions were recognized significantly faster by AN patients. Associations of pathological eating behaviour and trait anxiety were seen.

Conclusion

In accordance with the stress reduction hypothesis, typical psychopathology of alexithymia, anxiety and depression is prevalent in female adolescent AN patients. It is present detached from physical stability. Pathogenesis of AN is multifactorial and already fully present in adolescence. An additional reinforcement process can be discussed. For clinical practice, those parameters might have a better potential for early prognostic factors related to AN than physical parameters and possible implication for intervention is given.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstrasse 5, 89075, Ulm, Germany

    Ulrike M. E. Schulze, Kathrin Bauer & Sabine Müller

  2. Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany

    Dorothée Lulé, Friederike Schöll & Ingo Uttner

  3. Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075, Ulm, Germany

    Anne-Katharina Fladung

Authors
  1. Dorothée Lulé
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  2. Ulrike M. E. Schulze
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  3. Kathrin Bauer
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  5. Sabine Müller
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  7. Ingo Uttner
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Correspondence to Ulrike M. E. Schulze.

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Lulé, D., Schulze, U.M.E., Bauer, K. et al. Anorexia nervosa and its relation to depression, anxiety, alexithymia and emotional processing deficits. Eat Weight Disord 19, 209–216 (2014). https://doi.org/10.1007/s40519-014-0101-z

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  • DOI: https://doi.org/10.1007/s40519-014-0101-z

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