Mécanismes spécifiques au sexe du risque de troubles du comportement alimentaire chez les hommes et les femmes présentant des traits autistiques : le rôle de l'alexithymie

Titre original en anglais : Sex-specific mechanisms for eating disorder risk in men and women with autistic traits: the role of alexithymia

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Moseley, R., Atkinson, C., Surman, R., Greville-Harris, M., May, L., & Vuillier, L. (2023). Sex-specific mechanisms for eating disorder risk in men and women with autistic traits: the role of alexithymia. Journal of Eating Disorders, 11(1), 18-18. https://doi.org/10.1186/s40337-023-00746-7

Date de publication: 10/02/2023 Ajout dans AutiHub: 06/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
6
Auteur·ices de la publication identifié·es comme autistes
1 / 6 (16,7 %)
  1. Rachel Moseley *
  2. Carlie Atkinson
  3. R. Surman
  1. Maddy Greville-Harris
  2. L. May
  3. Laura Vuillier

Résumé

CONTEXTE : Il existe une relation mal comprise entre les troubles du comportement alimentaire (ED) et les conditions du spectre autistique (ASC : ci-après « autisme »). Les ED sont plus prévalents chez les personnes autistes et les personnes présentant des traits autistiques élevés, et les caractéristiques autistiques sont pronostiques d'une maladie plus longue. Dans le but de comprendre ce qui augmente le risque d'ED en relation avec l'autisme et les traits autistiques, des recherches antérieures ont impliqué l'alexithymie comme mécanisme causal dans cette relation. Ces études n'ont toutefois pas pu démêler si l'alexithymie explique la relation entre la pathologie des ED et les traits autistiques directement ou par son impact sur les symptômes anxieux/dépressifs, qui entraînent à leur tour une symptomatologie d'ED plus élevée. De plus, malgré des preuves de différences entre les sexes dans l'étiologie des ED, peu de recherches ont examiné l'impact du sexe sur ces relations. MÉTHODES : En nous concentrant sur l'association entre les traits autistiques et la psychopathologie des ED, nous avons examiné les effets médiateurs indépendants de l'alexithymie et des symptômes anxieux/dépressifs, ainsi que les effets de médiation séquentielle dans lesquels l'alexithymie affecte la psychopathologie des ED par son impact sur les symptômes anxieux/dépressifs. Les participants étaient 198 hommes et 265 femmes ayant reçu un diagnostic formel d'ED ou chez qui un ED était suspecté, qui ont rempli une enquête en ligne comprenant des échelles standardisées. RÉSULTATS : Chez les hommes, des traits autistiques plus élevés étaient associés à la psychopathologie des ED de manière séquentielle, par le biais d'une alexithymie plus importante et, par son intermédiaire, de symptômes dépressifs/anxieux plus importants. Chez les femmes, l'alexithymie a médiatisé la relation entre les traits autistiques et la psychopathologie des ED à la fois directement et séquentiellement par son impact sur les symptômes anxieux/dépressifs. Fait intéressant, les symptômes dépressifs/anxieux ont également médiatisé cette relation indépendamment de l'alexithymie. CONCLUSIONS : Bien que transversaux, ces résultats suggèrent que la relation entre les traits autistiques et la symptomatologie des ED est médiatisée par d'autres variables. En soutien à son rôle proposé dans l'étiologie des ED, l'alexithymie était directement associée aux symptômes d'ED chez les femmes. Elle a également affecté indirectement les symptômes d'ED, chez tous les participants, par son effet sur les symptômes dépressifs/anxieux. Les interventions se concentrant sur l'alexithymie peuvent faciliter le rétablissement non seulement par leur effet sur les ED, mais aussi par leur effet sur d'autres formes de psychopathologie de l'état qui contribuent au maintien et au développement des ED. Les différences entre les sexes reflètent toutefois que des cibles thérapeutiques alternatives pour les hommes et les femmes peuvent être bénéfiques.

BACKGROUND: A poorly understood relationship exists between eating disorders (ED) and autism spectrum conditions (ASC: henceforth 'autism'). ED are more prevalent in autistic people and people with high autistic traits, and autistic features are prognostic of longer illness. Aiming to understand what increases the risk of ED in relation to autism and autistic traits, previous research has implicated alexithymia as a causal mechanism in this relationship. These studies could not, however, disentangle whether alexithymia explains the relationship between ED pathology and autistic traits directly or through its impact on anxious/depressive symptoms, which in turn result in higher ED symptomatology. Moreover, despite evidence for sex differences in the aetiology of ED, little research has examined the impact of sex on these relationships. METHODS: Focusing on the association between autistic traits and ED psychopathology, we examined independent mediating effects of alexithymia and anxious/depressive symptoms, as well as sequential mediation effects where alexithymia affects ED psychopathology via its impact on anxious/depressive symptoms. Participants were 198 men and 265 women with formally diagnosed and suspected ED, who completed an online survey of standardised scales. RESULTS: In men, higher autistic traits were associated with ED psychopathology sequentially via greater alexithymia and through that, greater depressive/anxious symptoms. In women, alexithymia mediated the relationship between autistic traits and ED psychopathology both directly and sequentially through its impact on anxious/depressive symptoms. Interestingly, depressive/anxious symptoms also mediated that relationship independently from alexithymia. CONCLUSIONS: While cross-sectional, these findings suggest that the relationship between autistic traits and ED symptomatology is mediated by other variables. In support of its proposed role in the aetiology of ED, alexithymia was directly associated with ED symptoms in women. It also affected ED symptoms indirectly, in all participants, via its effect on depressive/anxious symptoms. Interventions focusing on alexithymia may facilitate recovery not only via their effect on ED, but via their effect on other forms of state psychopathology which contribute to the maintenance and development of ED. Sex differences, however, reflect that alternative therapeutic targets for men and women may be beneficial.

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Références citées
74
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
3 / 74 (4,1 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
3 / 329 (0,9 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 3 / 63 (4,8 %). Auteurices cité·es distinct·es identifié·es comme autistes : 1 / 292 (0,3 %).
Occurrences citées rattachées à la base AutiHub
63 / 329 (19,1 %)
Auteurices cité·es distinct·es rattaché·es : 44 / 292 (15,1 %)
Occurrences rattachées, non identifiées comme autistes
60 / 63 (95,2 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 60 / 329 (18,2 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 43 / 44 (97,7 %).
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