Autistic Traits in Patients With Anorexia Nervosa Treated With Intensive Enhanced Cognitive Behavior Therapy (CBT-E): A Prospective Cohort Study.

OBJECTIVE: This study examined the role of autistic traits in patients with anorexia nervosa receiving an intensive, focused form of enhanced cognitive behavior therapy (CBT-E). The aim was to assess changes in these traits during treatment and their predictive value for outcomes. METHOD: In this prospective cohort study, 81 patients aged 16-65 years were admitted for intensive CBT-E. Body mass index (BMI), eating disorder psychopathology, general psychopathology, and functional impairment were assessed at baseline, end of intensive treatment (EOIT), and 20-week follow-up. Autistic traits were evaluated using the Autism Spectrum Quotient (AQ) at baseline and EOIT. RESULTS: Sixty-nine patients (85.2%) completed treatment, and 59 among completers (85.5%) attended follow-up. AQ scores decreased significantly from baseline to EOIT, although the magnitude of the change was small. The AQ global score did not predict dropout. In both intention-to-treat and completers' analyses, the AQ global score measured at baseline and at EOIT did not predict eating disorder psychopathology and BMI at EOIT and at follow-up, respectively. CONCLUSIONS: In this prospective cohort study, AQ scores decreased significantly over the course of intensive CBT-E, and autistic traits did not predict treatment outcomes. These findings suggest that intensive CBT-E produces significant improvements across the main clinical outcomes of anorexia nervosa without requiring systematic adaptations for autistic traits.