About CONNECTED
CONNECTED is a series of four separate research studies being run by Imperial College:
These studies address the extent and type of social problems that many adolescents with eating disorders face. We are working towards a clinical trial of a hormone called oxytocin, which may improve social difficulties experienced by these individuals, and may also have a beneficial effect on the eating disorders they experience.
soCial cOgNition iN adolEsCents wiTh Eating Disorders
What is the CONNECTED project - An overview
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Eating disorders affect over 13% of adolescents, with a cost to the UK economy of £15 billion/year. According to BEAT (the UK eating disorders charity), eating disorders prevalence has increased 7% year on year since 2009 and hospital admissions for eating disorders have risen by 37% in the last two years, exacerbated by the isolation and social changes brought about by COVID19 living restrictions. Despite the prevalence of eating disorders, our understanding and treatment repertoire is still limited and funding for eating disorders research remains inadequate.
Social behaviours and the quality of adolescent relationships predict the development of disordered eating and eating disorders, and their course and outcome. We know that the more successful an individual is in social situations the less likely they are to eating disorder symptoms.
Adolescents often present at eating disorders clinics with a range of problems with social behaviour that can appear autistic-like in nature. Some research suggests that up to 37% of adults with anorexia nervosa—the most common diagnosis in eating disorders services—also have autism spectrum disorder or autism spectrum disorder traits.
Estimates for the presence of autism spectrum disorder and eating disorders in adolescent populations are lower, however. This might be because autism spectrum disorder traits are accentuated by age and by prolonged illness. Or it could be that social communication deficits are difficult to recognise during adolescent development because social behaviours are still developing during puberty. For some, social difficulties are manifestations of potentially treatable problems, such as social anxiety, or fears of rejection, or interpersonal difficulties arising from bullying. For others, social difficulties reflect ingrained social communication difficulties that have only become manifest because of the complex social demands of adolescence. Peers surpass parents during adolescence as the primary source of social support and having good friends is a known protective buffer reducing the likelihood of mental health issues developing. and social anxiety interferes with healthy peer relations, which are known to have a protective effect against mental ill health.
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Adolescence, which is characterised by changes in brain structure, plasticity, and function, has gained traction in the scientific literature as a sensitive developmental period during which mental health interventions may have particular success. The ontogenetic transition of adolescence is a critical window for changes in social cognition and stress susceptibility, particularly social stress. Social brain networks (especially medial prefrontal cortex and the posterior superior temporal sulcus) change during adolescence, resulting in heightened self-consciousness, increased peer-directed social interactions and complexity of peer relationships. The early adolescent period is distinct, particularly in terms of social stress and maturation of abstract reasoning.
This project sets out to address that shortcoming in current knowledge by the categorisation of social deficits and linkage of these to outcomes.  This is a key piece of research that has not yet been carried out, and relates, for the first time, the broad range of autism-spectrum disorder symptoms to eating disorder symptoms.