Neurodevelopmental Processes of Social Cognition in Anorexia Nervosa and Autism

描述（由申请人提供）：神经性厌食症（AN）患者中自杀死亡的比例不成比例，标准化死亡率表明，相对于年龄匹配的队列，自杀死亡的风险高出57倍。这些令人震惊的统计数据表明，AN是一种严重的精神疾病，会对患者及其家人的生理、情感和社会心理功能产生负面影响，它使人丧失能力、令人困惑和孤立。纵向研究表明，社会功能受损会增加死亡风险。即使在康复后，社会障碍仍然存在并影响生活质量。尽管有这些知识，但对AN中的社会信息处理知之甚少。对AN患者社会认知的仔细研究可以阐明可能影响结果和治疗效果的受损过程：难以形成治疗联盟、身体形象障碍、移情受损和缺乏安全依恋。自闭症谱系障碍（ASD）的症状，特别是在影响社会认知的认知领域，在慢性AN患者中被过度代表，并且在康复后持续存在。相比之下，ASD的饮食障碍得到了广泛的承认，但很少有系统调查的话题。相对于AN， ASD中的社会信息处理得到了很好的表征，可能有助于了解AN中这些领域的特征。本研究的目的是：1)提供行为、视觉和神经认知过程的详细特征，这些过程支持AN的社会信息处理；2)通过表征疾病过程中的变化来区分低体重状态对这些缺陷的贡献；3)比较高功能自闭症女性患者的社会认知神经回路；4)建立一种新的评估父母和儿童在情感平衡条件下互动过程中社会信息加工的范式。我们将使用一系列的神经心理学和社会认知测量，在观看动态面部情感刺激时使用功能磁共振成像，以及在观看社会信息处理任务时使用眼动追踪来实现这些目标。复杂的方法表征了社会信息处理缺陷背后的认知过程，并映射到功能性神经回路，这可能极大地增强我们对AN的病理生理学的认识，并可能为有效的治疗开发开辟新的途径。

DESCRIPTION (provided by applicant): Death by suicide occurs in a disproportionate percentage of individuals with anorexia nervosa (AN), with a standardized mortality ratio indicating a 57 fold greater risk of death from suicide relative to an age-matched cohort. These shocking statistics speak to the incapacitating, perplexing, and isolating nature of AN, a severe psychiatric illness that negatively impacts the biological, emotional, and psychosocial functioning of both the affected individual and her or his family. Longitudinal studies indicate impaired social functioning increases risk for fatal outcomes. Social impairment persists and affects quality of life even after recovery. Despite this knowledge, very little is known about social information processing in AN. Careful study of social cognition in AN may elucidate impaired processes that may influence outcome and therapeutic efficacy: difficulty forming therapeutic alliances, disturbances in body image, impaired empathy, and dearth of secure attachments. Symptoms of autistic spectrum disorders (ASD), particularly in cognitive domains that impact social cognition, are overrepresented in individuals with chronic AN and persist after recovery. In contrast, eating disturbances in ASD are widely acknowledged, but are seldom the topic of systematic inquiry. Relative to AN, social information processing in ASD is well characterized and may help to inform the characterization of these domains in AN. The goals of this investigation are: 1) to provide a detailed characterization of the behavioral, visual, and neurocognitive processes that subserve social information processing in AN; 2) to differentiate the contribution of low weight status on these deficits by characterizing changes over the course of illness, 3) to compare the neurocircuitry of social cognition in relation to females with high functioning autism; and 4) to develop a new paradigm for assessing social information processing during parent and child interactions across emotionally valanced conditions. We will achieve these goals using a battery of neuropsychological and social cognitive measures, fMRI while viewing dynamic facial affective stimuli, and eye-tracking while viewing social information processing tasks. Sophisticated methodologies that characterize the cognitive processes that underlie social information processing deficits and map onto functional neurocircuits may greatly enhance our knowledge of the pathophysiology of AN and may open new avenues for effective treatment development.