Brede, Janina Lisa; (2021) Towards a Better Understanding of Restrictive Eating Disorders in Autistic Women. Doctoral thesis (Ph.D), UCL (University College London).

Preview

Text Brede_10141194_Thesis_id_removed.pdf Download (4MB) | Preview

Abstract

Autistic women are overrepresented among individuals with restrictive eating disorders (REDs), such as Anorexia Nervosa, and commonly available eating disorder treatments tend to lack efficacy in this client group. This PhD employed a mixed-method approach with the aim of contributing evidence that can inform the improvement of eating disorder service provision for autistic women. Specifically, this thesis sought to generate a better understanding of (1) women’s experiences of REDs, (2) the mechanisms that might link autism and REDs in women, and (3) the ways in which mental health services function for their autistic clients. Three studies were undertaken. In Study 1 we conducted semi-structured interviews with autistic women with experience of Anorexia Nervosa, parents, and healthcare professionals (N=45) to identify potential causal and maintaining factors of Anorexia Nervosa in autistic women. Based on these findings, we developed a theoretical model of restrictive eating difficulties in autistic individuals. Study 2 further examined the clinical presentation of autistic women with REDs and tested elements of the model developed in Study 1. Study 2 compared the presentation of autistic traits, disordered eating-related symptoms and sensory sensitivities, measured using self-report questionnaires, in autistic women with and without REDs and non-autistic women with REDs (N=210). Autistic women with REDs presented with similar levels of autistic traits and sensory sensitivities to autistic women without REDs. They presented with: (i) significantly lower levels of traditional disordered eating symptoms, traditionally associated with Anorexia Nervosa, than non-autistic women with REDs, although these were still evident compared to autistic women without REDs, and (ii) significantly higher levels of autism-specific unusual eating behaviours than both other groups. These findings suggest that while core autism characteristics and sensory sensitivities are unlikely to directly contribute to REDs in autistic women, there might be other autism-related difficulties that make some autistic women more vulnerable to developing REDs than others. Study 2 also identified a subset of women with REDs who did not have an autism diagnosis, but had very high autistic traits (n=36). These presented similarly to formally diagnosed autistic women with REDs on measures of autistic traits, autism-specific unusual eating behaviours and sensory sensitivities, suggesting a significant proportion could be undiagnosed autistic women. Study 3 was systematic review and meta-synthesis of qualitative research on autistic adults’ experience of accessing and receiving support for mental health difficulties. This study elucidated perceived barriers for autistic adults in mental health services and ways to overcome them. The current thesis increases our understanding of the clinical presentation for autistic women with REDs and can help eating disorder services to become more autism friendly, by informing treatment adaptations to better meet their needs. In the long-term, the current thesis may contribute to the development of new autism-informed eating disorder treatments and interventions to prevent of development of restrictive eating disorders in autistic individuals.

Download activity - last month

Export as JSONCSVXML

Download activity - last 12 months

Export as XMLCSVJSON

Downloads by country - last 12 months

Export as JSONCSVXML

Archive Staff Only

View Item