Radha Kothari

Gender differences in the relationship between social communication and emotion recognition.

Objective To investigate the association between autistic traits and emotion recognition in a large community sample of children using facial and social motion cues, additionally stratifying by gender. Method A general population sample of 3,666 children from the Avon Longitudinal Study of Parents and Children (ALSPAC) were assessed on their ability to correctly recognize emotions using the faces subtest of the Diagnostic Analysis of Non-Verbal Accuracy, and the Emotional Triangles Task, a novel test assessing recognition of emotion from social motion cues. Children with autistic-like social communication difficulties, as assessed by the Social Communication Disorders Checklist, were compared with children without such difficulties. Results Autistic-like social communication difficulties were associated with poorer recognition of emotion from social motion cues in both genders, but were associated with poorer facial emotion recognition in boys only (odds ratio = 1.9, 95% CI = 1.4, 2.6, p = .0001). This finding must be considered in light of lower power to detect differences in girls. Conclusions In this community sample of children, greater deficits in social communication skills are associated with poorer discrimination of emotions, implying there may be an underlying continuum of liability to the association between these characteristics. As a similar degree of association was observed in both genders on a novel test of social motion cues, the relatively good performance of girls on the more familiar task of facial emotion discrimination may be due to compensatory mechanisms. Our study might indicate the existence of a cognitive process by which girls with underlying autistic traits can compensate for their covert deficits in emotion recognition, although this would require further investigation.

Eating Disorder Psychopathology, Brain Structure, Neuropsychological Correlates and Risk Mechanisms in Very Preterm Young Adults

This study investigates the prevalence of eating disorder (ED) psychopathology, neuropsychological function, structural brain correlates and risk mechanisms in a prospective cohort of very preterm (VPT) young adults. We assessed ED psychopathology and neuropsychological correlates in 143 cohort individuals born at <33 weeks of gestation. Structural brain correlates and risk factors at birth, in childhood and adolescence, were investigated using prospectively collected data throughout childhood/adolescence. VPT-born individuals had high levels of ED psychopathology at age 21 years. Executive function did not correlate with ED symptomatology. VPT adults presenting with ED psychopathology had smaller grey matter volume at age 14/15 years in the left posterior cerebellum and smaller white matter volume in the fusiform gyrus bilaterally, compared with VPT adults with no ED psychopathology. Caesarean delivery predicted engaging in compensatory behaviours, and severe eating difficulty at age 14 years predicted ED symptomatology in young adulthood. VPT individuals are at risk for ED symptomatology, with evidence of associated structural alterations in posterior brain regions. Further prospective studies are needed to clarify the pathways that lead from perinatal/obstetric complications to ED and relevant neurobiological mechanisms.

The Early Cognitive Development of Children at High Risk of Developing an Eating Disorder

Diagnosis of an eating disorder (ED) has been associated with differences in cognition. Recent evidence suggests that differences may be present prior to onset. Children at familial high risk for ED show cognitive differences at ages 8–10 years. Research is required to investigate differences in cognitive development at various time points. This is the first study to investigate cognitive development in children at high risk at 18 months (Griffiths Mental Development Scale; n = 982) and 4 years old (Wechsler Preschool and Primary Scale of Intelligence—Revised; n = 582), in comparison with children not at risk, using a general population sample, the Avon Longitudinal Study of Parents and Children. Children of women with lifetime anorexia nervosa revealed difficulties in social understanding, visual-motor function, planning and abstract reasoning. Cognitive differences observed here have also been observed in clinical groups. This suggests difficulties may be present prior to onset, potentially affecting risk status for development of ED. Findings contribute to an understanding of aetiology, and design of prevention/intervention strategies.

2D:4D ratio in children at familial high-risk for eating disorders: The role of prenatal testosterone exposure.

Markers of prenatal hormone exposure have been associated with the development of eating disorder (ED) behaviors. Our aim was to determine whether 2D:4D ratio, a marker for in utero testosterone exposure, is associated with risk for ED in a large population‐based cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). Methods: This is the first study to investigate prenatal testosterone exposure in children at high‐risk for ED, using 2D:4D as a marker. We compared children whose mothers reported a lifetime ED (anorexia, bulimia, or both; N = 446) to children whose mothers did not (n = 5,367). Results: Daughters of women with lifetime bulimia nervosa (BN) had lower 2D:4D ratio (B: −0.01, 95% CI: −0.02 to −0.002, P = 0.02), indicating higher prenatal testosterone exposure, than daughters of mothers unaffected by ED. No differences were observed in the male children of women with an ED. Conclusions: Findings suggest that children at high‐risk for BN may be exposed to higher levels of testosterone in utero. Fetal exposure to androgen excess is thought to be causal in the development of polycystic ovary syndrome (PCOS), a disorder which is highly comorbid with binge eating and BN. Future research should investigate the potential role of testosterone exposure in utero as a risk factor for BN and binge eating. Am. J. Hum. Biol. 26:176–182, 2014.

Social cognition in children at familial high-risk of developing an eating disorder

Objective: Diagnosis of an eating disorder (ED) has been associated with differences in social cognition. To date research investigating social cognition and ED has mainly employed patient and recovered samples. It is therefore unclear whether differences in social cognition are present prior to onset of ED, potentially contributing to development, or whether differences observed are a consequence of the disorder. We aimed to further explore whether individuals at high-risk for ED present social cognition characteristics previously found in ED groups. Methods: Our sample was drawn from a population-based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Data on maternal ED behaviors over the lifetime were collected through in-depth clinical interviews (n = 1128) conducted using the Structured Clinical Interview for DSM disorders (SCID), and were used to categorize mothers according to ED behaviors over the lifetime: Restricting and Excessive Exercising (n = 58), Purging (n = 70), Binge-eating (n = 72), Binging and Purging (n = 66), no ED (n = 862). High-risk status of children was determined using these maternal lifetime behavioral phenotypes. Children at high-risk (maternal ED exposure) were compared to children at low-risk (born to mothers with no ED) on three measures of social cognition: the Social Communication Disorders Checklist (SCDC) (n = 922), the faces subtest of the Diagnostic Analysis of Non-Verbal Accuracy (DANVA) (n = 722), and the Emotional Triangles Task (n = 750). Results: Children at high-risk for ED showed poorer performance on measures of social cognition compared to children at low-risk. Maternal lifetime binge-eating, and maternal lifetime binging and purging were associated with poorer social communication in children (OR: 2.4, 95% CI: 1.0, 5.7, p = 0.05; and OR: 2.7, 95% CI: 1.1, 6.5, p = 0.03 respectively). Maternal binging and purging was also found to be associated with differential facial emotion processing and poorer recognition of fear from social motion cues (B: −0.7, 95% CI: −1.1, −0.2, p = 0.004). Discussion: Children at high-risk for ED showed slight differences in some areas of social cognition when compared to children at low-risk. Characteristic patterns in social cognition are present in children at high-risk for ED, particularly among children whose mothers have binge-eating and purging behaviors over the lifetime. Our findings support the hypothesis that these differences may be part of an intermediate phenotype for ED: perhaps contributing to development, or perhaps indexing a shared liability with psychiatric disorders characterized by abnormal social cognition.

Intimate partner violence among women with eating disorders during the perinatal period

ABSTRACT Objective  Prevalence of intimate partner violence (IPV) during pregnancy is estimated to be 4%–8%. Women with mental health difficulties are at increased risk for IPV during the perinatal period. Prevalence of IPV is high among women with eating disorders (ED); however, prevalence of IPV during the perinatal period among women with ED is unknown. Method  We studied women from a population‐based cohort, the Avon Longitudinal Study of Parents and Children. Prevalence and odds of physical and emotional IPV during and after the perinatal period was investigated among women with lifetime ED, with (n = 174) or without pregnancy shape and weight concern and/or purging behaviors (n = 189), and women with no ED (n = 8723). Results  Women with lifetime ED showed higher prevalence of IPV during and after the perinatal period (physical = 9.6%–14.3% and emotional = 24.1%–28.1%). Lifetime ED was associated with higher odds of physical IPV during the perinatal period (odds ratio: 2.34, 95% confidence interval: 1.11–4.93, p = .03). Lifetime ED with and without pregnancy shape and weight concerns and/or purging was associated with higher odds of IPV after the perinatal period, and higher odds of reporting emotional IPV at all time points. Associations were moderated by partners response to pregnancy and maternal experience of childhood sexual abuse. Discussion  Mothers with ED and their children may be vulnerable to negative effects due to maternal ED and IPV combined, both of which have been associated with severe and long‐lasting harmful consequences. Partners response to pregnancy and maternal experience of childhood sexual abuse might contribute to the association between ED and IPV perinatally.