The findings of this study support the hypothesis of a positive relationship between Eating Disorders, AN and ASD. People are more likely to have AN if they are autistic. (Westwood & Tchanturia 2017). This investigation provides important information about the consistency of the AQ questionnaire score where there was a greater variation in the AN than the Non-Eating Disorder AN group. These results agree with Westwood & Tchanturia's (2017) findings that there is a definite link between the two conditions. However, this disagrees with Hambrook et al. (2008) where the authors assert their results were inconclusive. Tchanturia (King’s College London, 2022) has conducted extensive research in the field of AN and ASD in females, and to the extent, she helped develop a specialist National Health website called the PEACE, {Pathway for Eating Disorders and Autism developed from Clinical Experience} (2020).
An additional written practice guidebook has been newly published for those with autistic individuals with Eating Disorders including Anorexia, (Tchanturia, 2021). As the Lead Investigator of the PEACE Pathway, Tchanturia has firmly established a link between the two conditions which is an extremely helpful resource for health professionals/members of the public, service users, and carer/family members, (PEACE Pathway, 2020).
However, to note in this study there were limitations, and all study participants were under the age of 51 years. Having investigated the dramatic increase in ASD diagnoses people are four times more likely to be diagnosed with ASD now than they were historically according to academic clinical neurologist Steven Novella, (The Increase in Autism Diagnoses 2008). In addition, this is the same in late diagnoses with AN. DSM III stated that diagnosis of AN would not be possible over the age of 30 years, (Mulchandani et al. 2021). This was the historic view that was prevalent at that time and reaffirms Dr. Novella ‘s statement, (The Increase in Autism Diagnoses 2008). Tchanturia et al. (2019) also used a similar age group for their study which may have reinforced the lack of diagnoses for over the age 30 plus with AN and ASD. This could be the evident reason why both conditions may generally not be picked in late middle age plus due to the possibility of having no diagnose within these older age groups.
The study also excludes those under 18 years of age possibly due to ethical considerations. This eliminates many young individuals with AN (Halmi et al., 1979). These authors also discovered the age of onset for AN has two peaks, one at 14 1/2 and another at 18 years old. This means the potential younger participants have been discounted from this research analysis. This also could be another limitation and may leave the study more underrepresented for under 18 years and over 51 years old.
In addition, no distinction was made between the results for gender as the study aimed to focus on the overall association with AN and having ASD (Westwood & Tchanturia 2017). This could have contributed to some bias and it would have been interesting to see if Westwood et al., (2017) findings would have supported the argument of having more females with AN and ASD should gender have been included as part of this study analyses.
Also due to the nature of the study participants completed the online tasks which would exclude those who do not have a reasonable level of Literacy and IT skills. The Autism-Spectrum Quotient Test (AQ50 questionnaire) has been used for the purposes of pre-screening. This has been widely used to measure the expression of Autism spectrum traits and assess if further ASD diagnoses are needed. Baron-Cohen et al., (2001) assert that any score above 32 points should be put forward for further investigation for a full Autism diagnosis. Although the AQ50 questionnaire has reasonable validity it is not a definitive diagnosis of Autism.
To conclude the results should be understood in the context of methodological limitations. Evidence suggested that there were higher incidents of ASD amongst those who had AN, (Dattaro, 2020; European Society for Child and Adolescent Psychiatry (ESCAP), 2013; Huke et al., 2013; Karjalainen et al., 2019). Further research would be needed to assess whether gender would cause any significant difference to these results. It would also be interesting to see whether research could be extended to include younger and older generations to have identified if these results would be consistent particularly with a more varied and diverse age range group.