Neurodevelopmental Processes of Social Cognition in Anorexia Nervosa and Autism

描述（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，标准化死亡率比表明自杀死亡风险是年龄匹配队列的57倍。这些令人震惊的统计数据说明了AN的丧失能力，令人困惑和孤立的性质，AN是一种严重的精神疾病，对受影响的个人及其家庭的生物，情感和心理社会功能产生负面影响。纵向研究表明，社会功能受损会增加致命结局的风险。即使在康复后，社会障碍仍然存在，影响生活质量。尽管这些知识，很少有人知道在AN的社会信息处理。对AN中的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，共情受损和缺乏安全附件。孤独症谱系障碍（ASD）的症状，特别是在影响社会认知的认知领域，在慢性AN患者中比例过高，并在恢复后持续存在。相比之下，ASD中的饮食失调被广泛承认，但很少成为系统调查的主题。相对于AN，ASD中的社会信息处理被很好地表征，并且可能有助于告知AN中这些域的表征。本研究的目的是：1）提供有助于AN社会信息处理的行为、视觉和神经认知过程的详细特征; 2）通过描述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）比较与高功能自闭症女性相关的社会认知神经回路;（4）发展一种新的范式来评估父母和孩子在情感平衡条件下互动过程中的社会信息处理。我们将使用一系列神经心理学和社会认知测量来实现这些目标，在观看动态面部情感刺激时使用fMRI，在观看社会信息处理任务时使用眼动追踪。复杂的方法，其特征的认知过程，社会信息处理缺陷和映射到功能神经回路的基础上，可以大大提高我们的知识的病理生理学的AN，并可能开辟新的途径，有效的治疗开发。

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.