Perception of emotion and bilateral advantage in women with eating disorders, their healthy sisters, and nonrelated healthy controls

Background: Eating disorders (EDs) are characterized not only by disordered eating, but also by other psychopathology. In this exploratory study, we examined the ability of women with different diagnoses of EDs, their unaffected sisters, and healthy unrelated controls to recognize their own and other's emotions. We also looked at interhemispheric integration of emotion recognition and its relationship with depression. Method: Five groups of women participated: 1. anorexia nervosa restricting (AN-R) and 2. (AN-B/B) binge/purge, 3. bulimia nervosa binge/purge, (BN-B/P), 4. healthy sisters of women with ED, and 5. unrelated healthy controls. We used two questionnaires measuring alexithymia and depression, and two lateralized experimental tasks requiring recognition of facial emotion. Unilateral versus bilateral presentation allow the indexing of interhemispheric integration. Results: Alexithymia: All the ED groups were found to be more alexithymic and depressed on the self report scales compared to the two healthy groups. Depression completely mediated alexithymia in the AN-R group but not in the AN-B/P and BN-B/P patients. Sisters of ED women were more alexithymic than unrelated controls. Lateralized facial emotion recognition: ED women showed no deficits in recognizing basic emotions. However, the clinical groups did not show a bilateral advantage whereas the two healthy groups did so. Conclusions: We present three conclusions: we show, for the first time, evidence for a deficit in hemispheric integration in EDs. This implies that EDs may be a disconnection syndrome; alexithymia characterizes women with EDs and members of their family; depression is manifested differently in AN-R, than in women who binge/purge.