Conducting ethical, co-produced research with autistic individuals with an eating disorder: best practice guidelines.

There is a notable overlap between autism and eating disorders (EDs), and autistic individuals may experience poorer ED treatment outcomes than non-autistic peers. To make meaningful change in this field, it is imperative that we actively engage in co-production of research, however there are currently no guidelines to support co-production with autistic people with eating disorders. This paper reports on best practice guidelines that were co-produced across a series of workshops bringing together autistic people with EDs, researchers, clinicians, third-sector organisations, and parents/carers.

The Sensory Landscape and Embodied Experiences in Anorexia Nervosa Treatment: An Inpatient Sensory Ethnography.

: Anorexia nervosa (AN) is a complex eating disorder that often requires inpatient care, where treatment experiences are influenced by both the illness and the surrounding environment. Sensory issues in AN are increasingly acknowledged for their impact on treatment engagement and outcomes. Despite this, the ways in which the sensory landscape of inpatient settings shapes patients' lived experiences and meaning-making processes remain underexplored.

A Mixed Method Systematic Review Into the Impact of ED Treatment in Autistic People and Those With High Autistic Traits.

Objective: Our understanding of the impact of eating disorders (ED) treatment in Autistic people remains elusive. Research has begun to explore ED treatment outcomes and experiences in this population, however current understandings are poorly integrated. The current review therefore sought to explore the impact of ED treatment on Autistic people and those with higher Autistic traits.

Treatment escalation for people with anorexia nervosa: setting, therapies and nutritional interventions.

Purpose Of Review: Adult patients with severe anorexia nervosa often receive the same unsuccessful treatment without changes regarding the setting, the therapies, or nutritional interventions.

Recent Findings: Settings where people with anorexia nervosa are treated include their general practitioner, an independent psychiatric practice, a community mental health team (CMHT), a specialized eating disorder outpatient service, eating disorder early intervention services, a highly intensive eating disorder outpatient or home treatment programme, eating disorder daycare, an inpatient eating disorder service, a general hospital or a general psychiatric hospital, or residential treatment. At a specialized eating disorder service, patients should be offered evidence-based psychotherapy for anorexia nervosa, dietary advice and physical health monitoring as a first step.

Eating Disorder and Autism Collaborative project outline: promoting eating disorder research embedded in a neurodiversity-affirming culture.

EDAC (Eating Disorders and Autism Collaborative) is an innovative project aiming to increase research capacity by supporting collaboration in the fields of eating disorders and autism. EDAC comprises four integrated workstreams to co-produce interdisciplinary research, directed by Autistic individuals with lived experience of eating disorders. Workstream 1 will outline best collaborative practices, informing the research network.

"Don't talk to me like I am an illness": exploring patients' needs using the communication passport in an eating disorder service.

Purpose: Social challenges are common in patients with eating disorders (ED). The presence of autistic characteristics often exacerbates social difficulties within this group, potentially affecting treatment outcomes. This study investigates the communication preferences, challenges, dislikes, and support needs of patients with ED, both with and without autistic traits, using a communication passport in a national inpatient ED service.

The potential value of brief waitlist interventions in enhancing treatment retention and outcomes: a randomised controlled trial.

People with eating disorders are often placed on lengthy waitlists for treatment. This is problematic, as increased time spent on waitlists has been shown to predict dropout. We examined whether providing brief interventions to people on a waitlist improved retention or outcomes in treatment.

A qualitative evaluation of the pathway for eating disorders and autism developed from clinical experience (PEACE): clinicians' perspective.

Introduction: The Pathway for Eating disorders and Autism developed from Clinical Experience (PEACE pathway) is a clinical pathway of adapted treatment for individuals with eating disorders and autism in the UK. This study aims to investigate multidisciplinary clinicians' views of the strengths and challenges of PEACE pathway adaptations, while identifying areas where further improvement is needed.

Method: Semi-structured interviews were conducted with 16 clinicians who worked on the PEACE pathway.

Introducing a Smart Toy in Eating Disorder Treatment: A Pilot Study.

Individuals with eating disorders (EDs) often encounter challenges related to body image, emotional, and sensory difficulties during nutritional rehabilitation. To address these challenges, a novel technology-enabled smart toy, Purrble, designed for immediate assistance in emotion regulation, is being explored. A mixed-method approach involving workshops, diaries, and focus groups was employed to examine the feasibility of Purrble as a therapeutic tool and its impact on participants' daily routines, sensory experiences, and emotional states.

Longitudinal exploration of biopsychosocial profiles in individuals with anorexia nervosa.

Background: Previous work in individuals with Anorexia Nervosa (AN) has demonstrated a range of psycho-social difficulties such as increased anxiety, depression, obsessive-compulsive symptoms, as well as difficulties in work and with interpersonal interactions. However, making inferences regarding the stability of these psycho-social difficulties from previous studies is challenging, due to lack of a control group and known frequentist statistical issues.

Methods: 134 participants, 40 healthy controls (HC) and 94 participants with AN, completed self-reported measures designed to explore eating disorder concerns, body mass index, mood symptoms, work and social functioning as well as traits associated with autism at two time points, two years apart.

Positive communication workshops: are they useful for treatment programmes for anorexia nervosa?

Background: Social isolation, loneliness and difficulties in relationships are often described as a core feature of eating disorders. Based on the experimental research, we have designed one-off workshops for patients in inpatients and day care services and evaluated its acceptability and effectiveness using feedback questionnaires.

Methods: This naturalistic project is an evaluation of multiple positive communication workshops.

In-person and online sensory wellbeing workshop for eating disorders: updated case series.

Background: A one-off sensory wellbeing workshop has been developed to help patients with eating disorders (ED) manage sensory sensitivities. The aim of this study was to evaluate and compare the outcomes of the workshop in online versus face-to-face (F2F) formats among a sample of patients with ED.

Methods: Cumulative link models were applied to the outcome measures (awareness of sensory wellbeing, awareness of strategies to enhance sensory wellbeing, and confidence in managing sensory wellbeing) to test the differences between online and F2F workshops.

Analysis of symptom clusters amongst adults with anorexia nervosa: Key severity indicators.

This study used cluster analysis to explore clinically relevant subgroups of adult patients with anorexia nervosa (AN). Patients were clustered based on their body mass index (BMI), eating disorder symptomatology, anxiety and depression symptoms and autistic characteristics. The difference between clusters in work and social functioning, duration of illness, bingeing and purging behaviour, previous hospitalisations and number of comorbidities was also investigated.

Improving programme-led and focused interventions for eating disorders: An experts' consensus statement-A UK perspective.

Objective: Eating disorders are associated with significant illness burden and costs, yet access to evidence-based care is limited. Greater use of programme-led and focused interventions that are less resource-intensive might be part of the solution to this demand-capacity mismatch.

Method: In October 2022, a group of predominantly UK-based clinical and academic researchers, charity representatives and people with lived experience convened to consider ways to improve access to, and efficacy of, programme-led and focused interventions for eating disorders in an attempt to bridge the demand-capacity gap.

"Your mind doesn't have room for anything else": a qualitative study of perceptions of cognitive functioning during and after recovery from anorexia nervosa.

Background: Past research has indicated the presence of cognitive difficulties in individuals with anorexia nervosa (AN), although it is unclear how these are experienced in real life. Moreover, it is unclear how and whether the experience of cognitive difficulties changes in nature and intensity over the course of the illness and following recovery.

Methods: Twenty-one female participants (AN = 11; recovered AN = 10) participated in online semi-structured interviews, utilising open-ended questions and exploring topics relating to their experiences of their cognitive function, changes over time and their perspectives on the future.

How to support adults with anorexia nervosa and autism: Qualitative study of clinical pathway case series.

Introduction: Previous research has explored the overlapping presentation between autism and eating disorders (ED). This study aims to summarize the clinical challenges associated with co-occurring autism and anorexia nervosa (AN) based on clinicians' case notes and minutes from case discussions, to understand how to better support people with the comorbidity.

Method: Thematic analysis was conducted on de-identified notes on 20 cases with AN and autistic characteristics and minutes from case discussions.

Difficulties in retrieving specific details of autobiographical memories and imagining positive future events in individuals with acute but not remitted anorexia nervosa.

Introduction: The factors that contribute to the maintenance of anorexia nervosa (AN) are not fully understood, although it is generally accepted that depression is a core feature and contributes to poor prognosis. Individuals with depression tend to have difficulties in producing specific details of autobiographical memories and future episodes. Our aim was to investigate autobiographical memory and episodic future thinking (EFT) in individuals with AN (n = 46), people recovered from AN (recAN; n = 40), and non-affected controls (n = 35).

Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes.

Background: Recently, elevated levels of autistic features and autism diagnoses have been reported among people with anorexia nervosa (AN). In clinical settings high levels of autistic features have been linked to more complex, highly comorbid illness presentation and poorer treatment outcome. This study aimed to examine whether autistic features predict AN symptom profile in long term.

Pilot study of facial and bodily feedback.

Background: The modulation hypothesis of facial feedback has not adequately examined how combining facial expressions and bodily postures might influence our experience of emotional stimuli. This pilot study examined a new method for manipulating both face and body together, which is important in furthering our understanding of how face and body interact to influence emotional experiences in the real world.

Methods: Using a within-subjects design, 30 participants viewed positive film clips under four conditions: (1) positive face with positive body (PP), (2) positive face with neutral body (PN), (3) neutral face with positive body (NP) and (4) neutral face with neutral body (NN).

What we can do about Autism and Eating Disorder comorbidity.

Objective: We are pleased to introduce this special issue about Autism and Feeding and Eating Disorders, representing reflections on this complex comorbidity.

Method: Contributions focussed on several main themes: (1) the definition and assessment of autism and eating disorder (ED) comorbidity; (2) the brain imaging findings of similarities and differences between autism and EDs; (3) sensory systems and interoception; (4) comorbidity across the age spectrum and (5) improving treatment outcomes in ED and autism comorbidity.

Results: The papers in this issue highlight the importance of research, screening and practical adaptations in the field of ED and autism comorbidity.

Group cognitive remediation therapy for children and adolescents in intensive day-patient treatment for anorexia nervosa: a feasibility study.

Background: Cognitive Remediation Therapy (CRT) is an adjunct treatment targeting set-shifting (SS) and weak central coherence (CC) thought to play a role in maintaining anorexia nervosa (AN). This study aimed to test the feasibility of brief group CRT for young people with AN in a day-patient setting using neuropsychological assessment of SS and CC. It also explored the benefit for young people with Autism Spectrum Disorder (ASD) features.

Examining the relationship between autistic spectrum disorder characteristics and structural brain differences seen in anorexia nervosa.

Cortical differences have been reported in Anorexia Nervosa (AN) compared with healthy controls (HC); however, it is unclear if Autism Spectrum Disorder (ASD) characteristics are related to these cortical differences. The aim of this study was to examine if structural measures were correlated to ASD traits in AN. In total 184 female participants participated in the study; 57 acutely underweight AN participants (AAN), 59 weight-restored participants (WR) and 68 HC.

The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach.

Background: Previous theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and clinical populations. The aim of this review was to build on this previous work by conducting a network meta-analysis to explore associations between adaptive and maladaptive emotion regulation strategies and ED psychopathology trans-diagnostically across the ED spectrum to identify areas of emotion dysregulation that have the strongest association with symptomatology.

Methodology: A total of 104 studies were included in the meta-analysis and correlation coefficient representing the associations between specific emotion regulation strategies and ED symptomatology were extracted.

Young people and parents' views towards individual cognitive remediation therapy-qualitative findings from a feasibility randomised controlled trial.

Purpose: Cognitive Remediation Therapy (CRT) has been used mostly in adults. Randomised Controlled Trials (RCTs) in anorexia nervosa (AN) have shown that CRT enhances cognitive flexibility, abstract thinking and is associated with quality-of-life improvement. More research is needed in younger populations.

Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study.

Background: The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable.

Aims: (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography.