{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:00:34Z","timestamp":1787029234996,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>Background: Anorexia Nervosa (AN) is a severe Feeding and Eating Disorder (FED) that is more prevalent in females, often manifesting during adolescence. Recent research highlights an elevated presence of comorbid Autism Spectrum Disorder (ASD) traits among individuals with AN, with specific expressions in females accounting for sensorial and interoceptive experiences. This study retrospectively explores the association between ASD traits, eating symptomatology, and interoceptive deficits in Italian female adolescents with AN. Methods: A retrospective evaluation of female AN\/Atypical AN patients (n = 52) aged 13\u201317 years was conducted at two university pediatric hospitals in Italy. The participants underwent neuropsychiatric assessments, including the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), and measurement of ASD traits with the Autism-spectrum quotient (AQ), camouflaging ASD traits Questionnaire (CAT-Q), Toronto Alexithymia Scale (TAS-20), and FED-symptomatology-related measures. Results: Overall, 9.6% of the participants exhibited an ADOS-2 clinical impression consistent with ASD. Higher scores in AQ and CAT-Q revealed ASD traits and camouflaging strategies. The interoceptive deficits positively correlated with the ASD traits, alexithymia, and camouflage, and TAS\u2014Difficulty Identifying Feelings emerged as the sole predictor for interoceptive deficits. Discussion: This Italian study preliminarily underscores the importance of recognizing ASD traits in the AN population, emphasizing early intervention strategies. The intersection of alexithymia and interoceptive deficits emerges as a crucial nexus between ASD and AN, with potential therapeutic implications.<\/jats:p>","DOI":"10.3390\/pediatric16040092","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T08:33:51Z","timestamp":1733387631000},"page":"1077-1088","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Autism Spectrum Disorder Traits Predict Interoceptive Deficits and Eating Disorder Symptomatology in Children and Adolescents with Anorexia Nervosa\u2014A Cross-Sectional Analysis: Italian Preliminary Data"],"prefix":"10.3390","volume":"16","author":[{"given":"Maria","family":"Califano","sequence":"first","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell\u2019Et\u00e0 Pediatrica, Centro Regionale per i Disturbi della Nutrizione e dell\u2019Alimentazione in et\u00e0 evolutiva, 40139 Bologna, Italy"},{"name":"Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7540-0776","authenticated-orcid":false,"given":"Jacopo","family":"Pruccoli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell\u2019Et\u00e0 Pediatrica, Centro Regionale per i Disturbi della Nutrizione e dell\u2019Alimentazione in et\u00e0 evolutiva, 40139 Bologna, Italy"},{"name":"Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melania","family":"Martucci","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Visconti","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell\u2019Et\u00e0 Pediatrica, Centro Regionale per i Disturbi della Nutrizione e dell\u2019Alimentazione in et\u00e0 evolutiva, 40139 Bologna, Italy"},{"name":"Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Barasciutti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0589-7614","authenticated-orcid":false,"given":"Carla","family":"Sogos","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Parmeggiani","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell\u2019Et\u00e0 Pediatrica, Centro Regionale per i Disturbi della Nutrizione e dell\u2019Alimentazione in et\u00e0 evolutiva, 40139 Bologna, Italy"},{"name":"Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/YCO.0000000000000818","article-title":"Worldwide prevalence of DSM-5 eating disorders among young people","volume":"35","year":"2022","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1002\/aur.2696","article-title":"Global prevalence of autism: A systematic review update","volume":"15","author":"Zeidan","year":"2022","journal-title":"Autism Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1001\/archgenpsychiatry.2011.38","article-title":"Epidemiology of Autism Spectrum Disorders in Adults in the Community in England","volume":"68","author":"Brugha","year":"2011","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.psychres.2017.09.005","article-title":"The association between symptoms of autism and neuropsychological performance in females with Anorexia Nervosa","volume":"258","author":"Westwood","year":"2017","journal-title":"Psychiatry Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s10802-017-0301-x","article-title":"Assessing ASD in Adolescent Females with Anorexia Nervosa using Clinical and Developmental Measures: A Preliminary Investigation","volume":"46","author":"Westwood","year":"2018","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"94","DOI":"10.2174\/1745017901915010094","article-title":"Autistic traits and illness trajectories","volume":"15","author":"Lorenzi","year":"2019","journal-title":"Clin. Pract. Epidemiol. Ment. Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1017\/S1092852919001615","article-title":"The broad autism phenotype in real-life: Clinical and functional correlates of autism spectrum symptoms and rumination among parents of patients with autism spectrum disorder","volume":"25","author":"Carpita","year":"2019","journal-title":"CNS Spectr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1001\/archgenpsychiatry.2009.34","article-title":"Neuropsychological profile of autism and the broad autism phenotype","volume":"66","author":"Losh","year":"2009","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1007\/s11065-011-9183-9","article-title":"Autistic traits below the clinical threshold: Re-examining the broader autism phenotype in the 21st century","volume":"21","author":"Sucksmith","year":"2011","journal-title":"Neuropsychol. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/1362361311421776","article-title":"Quantitative autism traits in first degree relatives: Evidence for the broader autism phenotype in fathers, but not in mothers and siblings","volume":"16","author":"Noens","year":"2012","journal-title":"Autism"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.psychres.2013.05.014","article-title":"Investigating emotional impairments in adults with autism spectrum disorders and the broader autism phenotype","volume":"208","author":"Berthoz","year":"2013","journal-title":"Psychiatry Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.neuropsychologia.2012.11.013","article-title":"Empathy and emotion recognition in people with autism, first-degree relatives, and controls","volume":"51","author":"Sucksmith","year":"2013","journal-title":"Neuropsychologia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.jaac.2013.12.020","article-title":"The broader autism phenotype in infancy: When does it emerge?","volume":"53","author":"Ozonoff","year":"2014","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Billeci, L., Calderoni, S., and Conti, E. (2016). The broad autism (endo)phenotype:neurostructural and neurofunctional correlates in parents of individuals with autism spectrum disorders. Front. Neurosci., 10.","DOI":"10.3389\/fnins.2016.00346"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.comppsych.2019.03.004","article-title":"Mood symptoms and suicidality across the autism spectrum","volume":"91","author":"Carpita","year":"2019","journal-title":"Compr. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1037\/0033-2909.133.6.976","article-title":"Anorexia nervosa and autism spectrum disorders: Guided investigation of social cognitive endophenotypes","volume":"133","author":"Zucker","year":"2007","journal-title":"Psychol. Bull."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1017\/S1092852920002011","article-title":"Eating disorders and autism spectrum: Links and risks","volume":"27","author":"Carpita","year":"2022","journal-title":"CNS Spectr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1080\/09540261.2018.1531831","article-title":"Same behaviours, different reasons: What do patients with co-occurring anorexia and autism want from treatment?","volume":"31","author":"Kinnaird","year":"2019","journal-title":"Int. Rev. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4280","DOI":"10.1007\/s10803-020-04479-3","article-title":"For Me, the Anorexia is Just a Symptom, and the Cause is the Autism\u201d: Investigating Restrictive Eating Disorders in Autistic Women","volume":"50","author":"Brede","year":"2020","journal-title":"J. Autism Dev. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.brainres.2006.07.045","article-title":"Hunger and satiety in anorexia nervosa: fMRI during cognitive processing of food pictures","volume":"1114","author":"Santel","year":"2006","journal-title":"Brain Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1097\/00006842-197810000-00004","article-title":"Body awareness in anorexia nervosa: Disturbances in \u2018body image\u2019 and \u2018satiety\u2019","volume":"40","author":"Garfinkel","year":"1978","journal-title":"Psychosom. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"150664","DOI":"10.1098\/rsos.150664","article-title":"Alexithymia: A general deficit of interoception","volume":"3","author":"Brewer","year":"2016","journal-title":"R. Soc. Open Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2147\/PRBM.S120584","article-title":"Interpersonal psychotherapy for eating disorders: Current perspectives","volume":"11","author":"Miniati","year":"2018","journal-title":"Psychol. Res. Behav. Manag."},{"key":"ref_25","first-page":"137","article-title":"Is Alexithymia the Link Between Anorexia and Autism Spectrum Disorders?","volume":"19","author":"Miniati","year":"2022","journal-title":"Clin. Neuropsychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s13052-021-01006-7","article-title":"Autism spectrum disorder and anorexia nervosa: An Italian prospective study","volume":"47","author":"Pruccoli","year":"2021","journal-title":"Ital. J. Pediatr."},{"key":"ref_27","unstructured":"Lord, C., Rutter, M., Dilavore, P.C., Risi, S., Gotham, K., and Bishop, S.L. (2012). (ADOS-2) manual (Part 1) modules 1\u20134. Autism Diagnostic Observation Schedule, Western Psychological Services. [2nd ed.]."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1005653411471","article-title":"The autism-spectrum quotient (AQ): Evidence from Asperger syndrome\/high-functioning autism, males and females, scientists and mathematicians","volume":"31","author":"Wheelwright","year":"2001","journal-title":"J. Autism Dev. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s10803-018-3792-6","article-title":"Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q","volume":"49","author":"Hull","year":"2019","journal-title":"J. Autism Dev. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Patel, V., Preedy, V., and Martin, C. (2014). Diagnosing Autism with Checklist for Autism Spectrum Disorder (CASD). Comprehensive Guide to Autism, Springer.","DOI":"10.1007\/978-1-4614-4788-7"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/0022-3999(94)90005-1","article-title":"The twenty-item Toronto Alexithymia Scale\u2013I. Item selection and cross-validation of the factor structure","volume":"38","author":"Bagby","year":"1994","journal-title":"J. Psychosom. Res."},{"key":"ref_32","unstructured":"Garner, D.M. (2004). The Eating Disorder Inventory-3, Psychological Assessment Resources Inc.. Professional Manual."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1080\/08039488.2016.1271452","article-title":"Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA): Clinical norms and functional impairment in male and female adults with eating disorders","volume":"71","author":"Dahlgren","year":"2017","journal-title":"Nord. J. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/jcpp.13255","article-title":"Trajectories of autistic social traits in childhood and adolescence and disordered eating behaviours at age 14 years: A UK general population cohort study","volume":"62","author":"Solmi","year":"2021","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"114271","DOI":"10.1016\/j.psychres.2021.114271","article-title":"Anorexia Nervosa and Autism Spectrum Disorder: A Systematic Review","volume":"306","author":"Boltri","year":"2021","journal-title":"Psychiatry Res."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"(2015). Lai M-C, Baron-Cohen S Identifying the lost generation of adults with autism spectrum conditions. Lancet Psychiatry, 2, 1013\u20131027.","DOI":"10.1016\/S2215-0366(15)00277-1"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jaac.2014.10.003","article-title":"Sex\/gender differences and autism: Setting the scene for future research","volume":"54","author":"Lai","year":"2015","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/NMD.0000000000001458","article-title":"Interoceptive Awareness and Anorexia Nervosa: When Emotions Influence the Perception of Physiological Sensations","volume":"210","author":"Wollast","year":"2022","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1007\/s40519-022-01510-7","article-title":"Anorexia nervosa as a disorder of the subcortical-corticalinteroceptive-self","volume":"27","author":"Innocenti","year":"2022","journal-title":"Eat. Weight Disord."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1177\/1362361317738392","article-title":"Autism spectrum disorder and interoception: Abnormalities in global integration?","volume":"23","author":"Hatfield","year":"2019","journal-title":"Autism"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Gaggero, G., Dellantonio, S., Pastore, L., Sng, K.H.L., and Esposito, G. (2022). Shared and unique interoceptive deficits in high alexithymia and neuroticism. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0273922"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Aaron, R.V., Blain, S.D., Snodgress, M.A., and Park, S. (2020). Quadratic Relationship Between Alexithymia and Interoceptive Accuracy, and Results From a Pilot Mindfulness Intervention. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.00132"}],"container-title":["Pediatric Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7503\/16\/4\/92\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:47:21Z","timestamp":1760114841000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7503\/16\/4\/92"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,5]]},"references-count":42,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["pediatric16040092"],"URL":"https:\/\/doi.org\/10.3390\/pediatric16040092","relation":{},"ISSN":["2036-7503"],"issn-type":[{"value":"2036-7503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,5]]}}}