About this trial
Masking is a behaviour or strategy used by many Autistic people to appear non-Autistic and blend in with a neurotypical society. The goal of this observational study is to understand the relationship between masking, anorexia nervosa symptoms and brain structure in Autistic people. The main questions this study aims to answer are:
* Do Autistic individuals with anorexia nervosa show differences in structure or function of the brain relation to Autistic individuals without anorexia nervosa? * Do Autistic individuals with anorexia nervosa display higher levels of masking than Autistic individuals without anorexia nervosa? * Are there indeed relationships between levels of masking, anorexia nervosa symptoms and brain structure in Autistic people?
Researchers will compare Autistic people without anorexia nervosa to Autistic people with anorexia nervosa to see if there are differences between groups. Participants will:
* Complete a series of questionnaires focused on eating disorder symptoms, autistic traits, autistic masking and psychological well-being * Undergo an MRI scan at the Aberdeen Royal Infirmary
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Be aged 25-45 years
Be Autistic (clinically diagnosed and/or have an Autism Quotient (AQ-10) score of ≥6)
Be able to provide informed consent for the study
Be able to read, understand and respond to questionnaires in English
Disqualifiers
Are aged <25 or >45 years
Are not Autistic or not clinically diagnosed as Autistic and have an AQ-10 score of <6
Are diagnosed with an eating disorder other than anorexia nervosa
Have a history of brain injury (e.g., stroke)
Trial population
The population for this study consists of Autistic individuals who both present or do not present with acute anorexia nervosa. Study population will be recruited from Scotland, primarily the NHS Grampian region.
Trial design
Case-control
Prospective
Treatments tested in this trial
Single Research Visit 3T MRI Research Scan
Other interventionSingle research visit scan performed with a 3T magnetic resonance imaging scanner.
Demographic and Behavioural Questionnaires
Other interventionA series of demographic and behavioural questionnaires to be completed by participants, either online or during the single study visit. Questionnaires include the Eating Disorder Examination Questionnaire, Autism Spectrum Quotient, Monotropism Questionnaire, Camouflaging Autistic Traits Questionnaire, Hospital Anxiety and Depression Scale, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Work and Social Adjustment Scale, International Trauma Questionnaire and Leibowitz Social Anxiety Scale. These questionnaires will also include a demographic questionnaire to acquire measures such as age, BMI, co-occurring conditions, etc.
Treatment groups
Trial outcomes
Primary outcomes
Structural and Functional Brain Differences
To examine whether Autistic individuals with anorexia nervosa exhibit differences in brain structure or function relative to Autistic individuals without anorexia nervosa via 2-sample t-tests. Brain structure will be measured using surface and subcortical parcellations (in mm\^3) acquired from Freesurfer. Brain functional connectivity at resting state will be measured using bivariate correlations of mean BOLD signal across pairs of regions of interest, converted to normally distributed scores using Fisher's transformation.
Levels of Masking
To determine whether Autistic individuals with anorexia nervosa exhibit higher masking behaviour than Autistic individuals without anorexia nervosa via 2-sample t-tests on total and subscale scores on the Camouflaging Autistic Traits Questionnaire. The Camouflaging Autistic Traits Questionnaire contains 25 statements relating to three subcategories of camouflaging (9 statements for the compensation subscale; 8 statements for the masking subscale; 8 statements for the assimilation subscale). All statements are scored on a scale of 1-7, and the scoring range on this measurement ranges from 25 to 175. Higher scores reflect greater camouflaging, with a threshold score of high camouflaging consisting of a score of 100 or greater.
Associations Between Masking, Anorexic Symptoms and Brain Structure
To determine if there are associations between the levels of masking, eating disorder symptomatology and brain structure in Autistic individuals via multiple 3-path mediation analysis established using generalised linear models. Levels of masking will comprise of total and scores on the Camouflaging Autistic Traits Questionnaire, which contains 25 statements. All statements are scored on a scale of 1-7, with a scoring range of 25-175. Higher scores reflect greater camouflaging, with a threshold score of consisting of 100 or greater. Levels of eating disorder symptomatology will comprise of the Eating Disorder Examination Questionnaire, which contains 28 statements. Total scores range from 0-6, with a clinical cut-off score of 2.8 for women, and 1.68 for men. Brain structure will be measured using surface and subcortical parcellations (in mm\^3) acquired from Freesurfer.
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
University of Aberdeen
Lead sponsor
NHS Grampian
Collaborator