The Interaction Between Mentalizing, Empathy and Symptoms in People with Eating Disorders: A Network Analysis Integrating Experimentally Induced and Self-report Measures

Background: The role of mentalizing and empathy in the socio-emotional processing deficits of Eating Disorder (ED) patients has been under investigated. We aimed to assess these psychological processes and their interplay with ED symptoms by means of the network analysis approach. Methods: Seventy-seven women with EDs completed self-report questionnaires assessing ED, anxious and depressive symptoms, and underwent two computerized tasks; the Movie for the Assessment of Social Cognition (MASC), assessing emotional and non-emotional mental state inferences, and the Empathic Accuracy Task-Revised (EAT-R), measuring accuracy in identifying others’ emotions and the extent to which those emotions are shared. A partial correlation network and bridge function analyses were computed. Results: In the partial correlation network inference of cognitive mental states and shape concern were the nodes with the highest strength centrality. Inference of emotional mental states was the node with the highest bridge strength in the cluster of social cognition functions. Empathic and mentalizing abilities were directly connected with each other and with ED symptoms. Conclusions: This is the first network analysis study which integrates self-reported symptoms and objective socio-cognitive performance in people with EDs. Results highlight the importance of mentalizing abilities in that they contribute to maintenance of ED psychopathology and to empathic ability.