L’alexithymie pourrait expliquer la relation entre les traits autistiques et la psychopathologie des troubles alimentaires
Titre original en anglais : Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology
Vuillier, L., Carter, Z., Teixeira, A., & Moseley, R. (2020). Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology. Molecular Autism, 11(1), 63-63. https://doi.org/10.1186/s13229-020-00364-z
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Résumé
CONTEXTE : Les personnes autistes sont disproportionnellement vulnérables à l’anorexie mentale et à d’autres troubles alimentaires (TA), et, au sein de la population générale, les traits autistiques sont corrélés à la psychopathologie des TA. Un mécanisme supposé pouvant sous-tendre ce risque accru est l’alexithymie, une difficulté à identifier et à décrire les états émotionnels, observée à la fois dans l’autisme et dans les TA. Dans deux expériences menées auprès d’échantillons non cliniques indépendants, nous avons examiné si l’alexithymie pouvait médiatiser le risque accru de psychopathologie alimentaire chez les personnes présentant des niveaux élevés de traits autistiques. MÉTHODES : Notre première expérience a utilisé la macro PROCESS pour SPSS afin d’examiner les relations entre l’alexithymie (mesurée par la Toronto Alexithymia Scale (TAS-20)), les traits autistiques (autism quotient (AQ)) et la psychopathologie alimentaire (Eating Attitudes Test (EAT-26)) chez 121 participants. Notre deuxième expérience (n = 300) a répliqué et approfondi cette analyse en examinant les effets modérateurs du sexe et en contrôlant l’anxiété et la dépression comme covariables. Nous avons également inclus une mesure supplémentaire de l’alexithymie fondée sur la performance, la Levels of Emotional Awareness Scale (LEAS). RÉSULTATS : L’étude 1 a suggéré que les scores à la TAS-20 médiatisaient la relation entre des traits autistiques élevés et la psychopathologie alimentaire. La réplication et l’examen plus approfondi de ce résultat, dans l’étude 2, ont révélé que cet effet de médiation était partiel et spécifique aux participantes de cet échantillon. L’effet de médiation semblait être porté par la sous-échelle de difficulté à identifier les sentiments de la TAS-20, même après contrôle de la dépression et de l’anxiété. Toutefois, les scores à la LEAS n’étaient pas significativement liés aux traits autistiques ni à la psychopathologie alimentaire. LIMITES : Les données transversales empêchent toute conclusion concernant la direction et la causalité des relations entre l’alexithymie, les traits autistiques et la psychopathologie alimentaire (ainsi que la dépression et l’anxiété), ce qui nécessite des recherches longitudinales. Notre échantillon non clinique était principalement composé d’étudiants universitaires caucasiens ; il reste donc à déterminer si ces résultats seraient extrapolables à des échantillons cliniques et/ou autistes. La divergence entre la TAS-20 et la LEAS soulève des questions cruciales concernant la validité conceptuelle de ces mesures. CONCLUSIONS : Nos résultats concernant les traits autistiques suggèrent que l’alexithymie pourrait expliquer partiellement la prévalence des TA chez les personnes autistes et pourrait ainsi constituer un élément important à prendre en compte dans la pathogenèse et le traitement des TA chez les personnes autistes comme non autistes. Des recherches supplémentaires auprès d’échantillons cliniques sont essentielles pour explorer ces idées. Les différences entre les hommes et les femmes soulignent en outre l’importance de rechercher des facteurs de risque spécifiques au sexe ainsi que des facteurs génériques chez les hommes et les femmes autistes et non autistes.
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