Relationship Between Dysregulation of Oxytocin and Deficits in Social Emotional Functioning in Active and Partially Recovered Anorexia Nervosa

Abstract

Objective: Anorexia nervosa (AN) is associated with social-emotional functioning deficits; however, whether these deficits are secondary to low weight is unclear. Further, the roles of disease severity and abnormal secretion of the social neurohormone oxytocin in social-emotional functioning impairment have not been fully elucidated. Method: We performed a cross-sectional study of 148 women ages 18-45 [46 AN, 48 AN in partial recovery (ANPR), and 54 healthy controls (HC)] between December 2008 and March 2014. We administered the Eating Disorder Examination – Questionnaire (EDE-Q), Leibowitz Social Adjustment Scale – Self Report (LSAS-SR), Dimensional Assessment of Personality Pathology – Basic Questionnaire (DAPP-BQ) (suspiciousness and insecure attachment subscales), and the Toronto Alexithymia Scale (TAS-20). In a subset of 79 subjects, we analyzed fasting oxytocin levels. Results: Social fear, public fear, social avoidance, and difficulty describing feelings were increased in ANPR compared to HC (p≤0.034), but not to the extent of AN (p≤0.0498). Suspiciousness, insecure attachment, difficulty identifying feelings, and overall alexithymia score were also increased in ANPR (p≤0.043) at a level similar to AN. Public avoidance did not differ between ANPR and HC. Current body mass index (BMI), EDE-Q global score, and lowest adult BMI correlated with several measures of social-emotional functioning (p≤0.04). Oxytocin levels were low in ANPR compared to HC (p=0.0004) and negatively associated with difficulty identifying feelings (r=-0.45, p=0.007) and overall alexithymia score (r=-0.35, p=0.04). Conclusion: We conclude that women with AN in partial recovery have persistently abnormal social-emotional functioning and speculate that oxytocin dysregulation and disease severity are contributors.