Exploring The Relationship Between Mentalizing, Psychiatric Comorbidities and Eating Disorders Severity: A Cross- Sectional Study

Abstract

Abstract Background and Aims: Mentalizing, the ability to understand mental states of the self and others, has been found to be impaired in individuals with eating disorders (EDs) and other psychiatric comorbidities. The current study aims to evaluate the relationship between mentalizing, psychiatric comorbidities and ED severity in adults with EDs. Methods: 26 adults with ED and 24 healthy controls (HCs) completed the eating disorders examination questionnaire (EDE-Q), Reflective Functioning Questionnaire (RFQ), The Social Functioning Questionnaire (SFQ), Reading the Mind in the Eyes Test (RMET), Depression Anxiety Stress Scales (DASS-21), The Ritvo Autism Asperger’s Diagnostic Scale-Revised (RAADS-R), Adult ADHD Self-Report Scale (ASRS-v1.1) and Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD). ANCOVA analysis was used to compare the two groups, Pearson correlation was used to determine the associations between mentalizing, psychiatric comorbidity and eating psychopathology. Regression analysis was employed to explore the association between mentalizing, psychiatric comorbidity and eating disorders severity. Key Words: Eating Disorders, Mentalizing, Reflective Functioning, Reading the Mind in the Eyes Test, Autism, ADHD, Borderline Personality Disorder, Psychiatric Comorbidities. Results: After controlling for age, mentalizing measures were not significantly different in EDs versus HCs. SFQ was significantly different (F= 9.31, p = .004). RFQ-Uncertainty was significantly correlated with RAADS, RFQ-Certainty was negatively correlated with DASS and EDE-Q global. Moreover, psychological distress (DASS total) was the best predictor of EDs severity in the regression model (β = 0.464, p = .008). Conclusion: Although it did not differ between EDs and HCs, mentalizing was correlated to EDs psychopathology and autistic traits in EDs. Psychological distress was important predictor of EDs severity.