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Cognitive and Affective Empathy in Eating Disorders: A Systematic Review and Meta-Analysis

Kerr-Gaffney, J; Harrison, A; Tchanturia, K; (2019) Cognitive and Affective Empathy in Eating Disorders: A Systematic Review and Meta-Analysis. Frontiers in Psychiatry , 10 , Article 102. 10.3389/fpsyt.2019.00102. Green open access

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Abstract

BACKGROUND: Recent models of eating disorders (EDs) have proposed social and emotional difficulties as key factors in the development and maintenance of the illness. While a number of studies have demonstrated difficulties in theory of mind and emotion recognition, little is known about empathic abilities in those with EDs. Further, few studies have examined the cognitive-affective empathy profile in EDs. The aim of this systematic review and meta-analysis was to provide a synthesis of empathy studies in EDs, and examine whether those with EDs differ from healthy controls (HC) on self-reported total, cognitive, and affective empathy. // METHODS: Electronic databases were systematically searched for studies using self-report measures of empathy in ED populations. In total, 17 studies were identified, 14 of which could be included in the total empathy meta-analysis. Eight of the 14 studies were included in the cognitive and affective empathy meta-analyses. // RESULTS: Meta-analyses showed that while total empathy and affective empathy scores did not differ between those with anorexia nervosa (AN) and HC, those with AN had significantly lower cognitive empathy scores compared to HCs (small effect size). Meta-analyses of Interpersonal Reactivity Index sub-scores revealed that AN had significantly lower Fantasy scores than HC (small effect size), indicating that those with AN have more difficulty in identifying themselves with fictional characters. Only 3 studies examined empathy in those with bulimia nervosa (BN) or binge eating disorder (BED). // CONCLUSIONS: The lowered cognitive empathy and intact affective empathy profile found in AN is similar to that found in other psychiatric and neurodevelopmental conditions, such as autism spectrum disorder (ASD). These findings add to the literature characterizing the socio-emotional phenotype in EDs. Future research should examine the influence of comorbid psychopathology on empathy in EDs.

Type: Article
Title: Cognitive and Affective Empathy in Eating Disorders: A Systematic Review and Meta-Analysis
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fpsyt.2019.00102
Publisher version: https://doi.org/10.3389/fpsyt.2019.00102
Language: English
Additional information: © 2019 Kerr-Gaffney, Harrison and Tchanturia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. http://creativecommons.org/licenses/by/4.0/
Keywords: empathy, eating disorders, anorexia nervosa, autism, self-report, insight
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Psychology and Human Development
URI: https://discovery.ucl.ac.uk/id/eprint/10070481
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