PEACE Publications

Westwood H, Mandy W, Tchanturia K (2017)

The association between autistic symptoms and neuropsychological performance in females with Anorexia Nervosa

This study recruited women from inpatient and day-patient eating disorder services to assess the relationship between autism spectrum condition (ASC) symptoms and performances on neuropsychological tests (i.e. tests measuring rigidity in thinking and ‘bigger picture’ thinking). It was found that individuals who had higher levels of ASC symptoms also reported higher levels of cognitive rigidity and made more errors on the set-shifting test compared to those with lower levels of ASC symptoms.

Psychiatry Research

Kerr-Gaffney J, Hall D, Harrison A, Tchanturia K (2020)

Exploring Relationships Between Autism Spectrum Disorder Symptoms and Eating Disorder Symptoms in Adults With Anorexia Nervosa: A Network Approach

It is suggested that patients with more severe eating disorders tend to have higher autistic traits. This study examines a network of symptoms seen in patients with a lifetime history of anorexia nervosa (AN), with a focus on the relationships between their eating disorder and autism spectrum condition (ASC) symptoms. The core symptoms identified in the network are difficulties in social communication and isolation (over and above conventional symptoms such as weight and shape concern), whereas the symptoms that link eating disorder pathology to ASC are low self-confidence and social anxiety worries. The results suggest that social confusion and difficulties may be important in explaining comorbidity between AN and ASC.

Frontiers in Psychiatry

Tchanturia, K., Smith, K., Glennon, D., & Burhouse, A. (2020)

Towards an Improved Understanding of the Anorexia Nervosa and Autism Spectrum Comorbidity: PEACE Pathway Implementation

How was the PEACE pathway developed? How did we implement it? How were we able to tailor treatment adaptations for autism and eating disorder comorbidity? You can find detailed answers in this paper.

Frontiers in psychiatry

Kinnaird E, Norton C, Pimblett C, Stewart C, Tchanturia K (2019)

Eating as an autistic adult: an exploratory qualitative study

The investigator interviews 12 autistic adults about their eating habits, looking at common traits such as avoiding certain foods, eating similar foods repeatedly, and sensory sensitivity. Overall, the participants reported that autism did continue to impact their eating into adulthood: they tend to be more sensitive to taste and smell; some may have gastrointestinal problems or allergies which affected their eating; some find food shopping and preparation extremely stressful because they have to come up with a “satisfactory plan”; and some follow rigid routines when it comes to food. All generally described becoming more flexible around food as they became older, but for some this requires conscious effort and specific changes, including making an effort to try new foods, support from their family who used routines to help introduce new foods in a boundaried, safe way, and self-education as an adult around diet and nutrition.

Plos one

Brede J, Babb C, Jones C, Elliott M, Zanker C, Tchanturia K, Serpell L, Fox J, Mandy W (2020)

“For me the anorexia is just a symptom and the cause is autism”

The study showed that anorexia nervosa (AN) in autistic individuals seems to relate to sensory sensitivities, difficulties with social interaction and relationships, sense of self and identity, difficulties with emotions, autistic thinking styles and a need for control and predictability. It was reported by parents that their autistic daughters had more difficulty reflecting on triggering factors of their AN. Healthcare professionals were able to identify common patterns of behaviour from having worked with multiple autistic women, while also comparing them to their non-autistic patients.

J Autism Dev Disord

Smith, K. A., & Tchanturia, K. (2020)

Are Huddles the Missing PEACE of the Puzzle in Implementing Clinical Innovation for the Eating Disorder and Autism Comorbidity?

Introduces the huddle - time-limited, focused meetings to help organise and support clinical teams in the PEACE pathway. This paper evaluated the weekly PEACE huddles across a 12-month period, regularly attended by the multidisciplinary team. Benefits of the huddles included: keeping the teams updated on the pathway's progress, fostering collaborations and team discussions, and improving education.

Frontiers in psychiatry

Tchanturia, K, Dandil, Y, Li, Z, Smith, K, Leslie, M, Byford, S. (2020)

A novel approach for autism spectrum condition patients with eating disorders: Analysis of treatment cost‐savings

In this paper we describe the impact of PEACE pathway on the length and (therefore) cost of hospital admissions. The treatment innovations brought by PEACE have led to shorter admission for patients with the comorbidity, and the estimated cost‐savings were approximately £22,837 per patient and approximately £275,000 per year for the service as a whole.

European Eating Disorders Review

Leppanen J, Tosunlar L; Blackburn R; Williams S; Tchanturia K; Sedgewick S (2021)

Critical incidents in anorexia nervosa: perspectives of those with a lived experience

In this study, young adults with current or past anorexia nervosa described the positive and difficult critical events in an online survey. The findings suggest that although anorexia may be largely characterised by negative emotions and loneliness, this is not the full picture. Many participants described living rich lives with both difficult and positive experiences and were open to have their negative expectations challenged with positive actions.

Journal of Eating Disorders

Babb C, Brede J, Jones C, Elliott M, Zanker C, Tchanturia, K, Serpell L, Mandy W, Fox J (2021)

“It’s not that they don’t want to access the support… it’s the impact of the autism”: The Experience of Eating Disorder Services From the Perspective of Autistic Women, Parents and Healthcare Professionals

Autism: International Journal of Research and Practice

Kinnaird E, Oakley M, Lawrence V, Shergill S, Tchanturia K (2021)

A peer interview qualitative study exploring support for carers of people with comorbid autism and eating disorders

Journal of Eating Disorders

Dandil Y, Smith K, Adamson J, Tchanturia K (2020)

Individual Cognitive Remediation Therapy Benefits for patients with Anorexia Nervosa and High Autistic features

This paper assesses the benefits of Cognitive Remediation Therapy (CRT; a treatment which targets cognitive inflexibility/rigidity and encourages bigger picture thinking) for anorexia nervosa (AN) patients with or without high levels of autistic features. The results show that CRT effectively improves cognitive flexibility for both groups.

European Eating Disorder Review

Dandil Y, Baillie C, Tchanturia K (2019)

Dandil Y, Baillie C, Tchanturia K (2019) Cognitive Remediation Therapy as a Feasible Treatment for a Young Person With Anorexia Nervosa and Autism Spectrum Disorder Comorbidity: A Case Study

This is a case study of a 21-year-old female patient (“Milly”) with anorexia nervosa (AN) and autism spectrum condition (ASC) comorbidity who had cognitive remediation therapy (CRT). The study provided detailed description of Milly’s autistic traits, eating difficulties and other complications and potential risk factors such as early childhood stressful events. In treatment, she was given CRT which helps patients increase flexibility, bigger picture thinking, and spontaneity. The case study shows that CRT is a feasible and effective treatment before proceeding to more complex individual psychological work, such as cognitive behavioural therapy (CBT).

Clinical Case Studies

Li, Z., Dandil, Y., Toloza, C., Carr, A., Oyeleye, O., Kinnaird, E., & Tchanturia, K. (2020)

Measuring Clinical Efficacy Through the Lens of Audit Data in Different Adult Eating Disorder Treatment Programmes

We explored treatment outcomes for patients with anorexia and high/low autistic traits in different treatment programmes. It was shown that inpatient treatment with individualized and structured routine care may be effective for patients with high autistic traits, leading to weight restoration and improvement in eating disorder systems.

Frontiers in psychiatry

Tchanturia K, Baillie C, Biggs C, Carr A, Harrison A, Li Z, McFie C, Oyeleye O, Toloza C (2021)

Sensory wellbeing workshops for inpatient and day-care patients with anorexia nervosa

In this article we review the sensory wellbeing workshop, a group intended for those with and without autistic characteristics with a focus on sensory wellbeing. Findings suggest that the workshop has seen positive progress in participants' confidence and awareness of sensory wellbeing. You can also find the protocol for in-person and online sensory workshops in this article.

Neuropsychiatry

Kerr-Gaffney J, Harrison A, Tchanturia K (2020)

The Social Responsiveness Scale is an efficient screening tool for autism spectrum disorder traits in adults with anorexia nervosa

The social responsiveness scale adult self-report version (SRS-2) is a self-rated 65-item questionnaire. The original SRS is often used in children and adolescents with autism spectrum condition (ASC) in order to give a comprehensive diagnostic assessment of ASC. This study suggests that the SRS-2 may be a useful tool in screening for ASC traits in adults with anorexia nervosa (AN) as its scores significantly predict ADOS-2 classification. Additionally, scores were found to be higher in those with AN and those who had recovered when compared to healthy controls. This suggests that autistic traits are still present in patients recovered from AN even when their BMI appeared normal.

European Eating Disorder Review

Kinnaird E, Dandil Y, Li Z, Smith K, Pimblett C, Rafiu A, Stewart C Tchanturia K (2020)

Pragmatic sensory screening in anorexia nervosa and associations with autistic traits

Researcher in the PEACE team has developed a brief sensory screening tool based on the five basic senses: vision, hearing, smell, taste and touch. Patients can choose on a scale from 0 to 10 whether they are very sensitive or not sensitive at all to each sensory modality. This study finds out that people with anorexia nervosa (AN) and high autistic traits had higher scores (overall more sensitive) compared to those with low autistic traits, especially in the area of smell. Results suggest that this screening tool can be a quick and easy way for clinicians and dieticians to make treatment more tailored to individual needs and personalise treatment strategies.

Journal of Clinical Medicine

Kate Williams (2021)

PEACE Conference 2021: Adapting Food Service to Support Treatment and Recovery

Kate Williams (Dietetic adviser to the PEACE project) presents on: Adapting Food Service to Support Treatment and Recovery

Professor Kate Tchanturia (2021)

PEACE Conference 2021: Welcome – Link between Autism and Eating disorders, why it matters? –

Professor Kate Tchanturia (Consultant Clinical Psychologist/ Principal Investigator of PEACE Pathway – King’s College London): Welcome – Link between Autism and Eating disorders, why it matters? –

Oyenike Oyeleye (2021)

PEACE Conference 2021: Practical, environmental and communication adaptations to becoming a more autism friendly service

Oyenike Oyeleye (Assistant Psychologist at inpatient national ED service SLAM) presents on: Practical, environmental and communication adaptations to becoming a more autism friendly service

Zhuo Li (2021)

PEACE Conference 2021: Existing literature on case studies of ED and autism treatment: 1980-2018

Jo Zhuo Li (PhD candidate/PEACE researcher) presents on: Existing literature on case studies of ED and autism treatment: 1980-2018

Anna Carr; Camilla Biggs (2021)

PEACE Conference 2021: Sensory workshops developed by the PEACE pathway

Camilla Biggs and Anna Carr (Assistant Psychologists, national ED service SLAM) present on: Sensory workshops developed by the PEACE pathway

Dr Claire Baillie (2021)

PEACE Conference 2021: Sensory Workshops: An intervention which could help demystify the body?

Dr Claire Baillie (Senior Chartered Counselling Psychologist at SLaM) presents on: Sensory Workshops: An intervention which could help demystify the body?

Madeleine Oakley (2021)

PEACE Conference 2021: Carers need support: Let’s Collaborate

Madeleine Oakley (PEACE Carers Champion/Psychotherapist) presents on: Carers need support: Let’s Collaborate

Cindy Toloza; Danilen Nursigadoo (2021)

PEACE Conference 2021: Exploring identity in a group context

Danilen Nursigadoo (Family Therapist) and Cindy Toloza (Assistant Psychologist) presents on: Exploring identity in a group context