ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Psychopathology
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1641020
Cognitive and Emotional Processing in Brothers of Individuals with Anorexia Nervosa: Exploring Familial Cognitive Vulnerability
Provisionally accepted
- 1University of Padua, Padua, Italy
- 2Azienda ULSS 8 Berica, Vicenza, Italy
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Background: Anorexia nervosa (AN) is associated with altered cognitive and emotional traits, including deficits in empathy, theory of mind (ToM), and increased alexithymia. While these traits are well-documented in affected individuals, little is known about their presence in unaffected male siblings, who share genetic and environmental risk factors. This study investigates whether male siblings of women with AN (bAN) exhibit intermediate cognitive-emotional traits compared to both their affected sisters and general population (GP) controls. Methods: We assessed 31 bAN, 31 GP, and 31 affected sisters. Participants completed self-report questionnaires (Empathy Quotient, Toronto Alexithymia Scale, Eating Disorder Examination Questionnaire) and two computerized tasks evaluating theory of mind (Story-based Empathy Task (SET), Reading the Mind in the Eyes Task). Between-group differences were assessed using non-parametric tests due to the non-normality of the data. A binary logistic regression was then conducted to evaluate whether specific socio-cognitive variables predicted group membership. Results: bAN showed significantly lower scores than the GP on measures of cognitive empathy and theory of mind, particularly Causal Inference (SET-CI; r = 0.594, p < 0.001), Emotional Attribution (SET-EA; r = 0.520, p < 0.001), and Intention Attribution (SET-IA; r = 0.463, p = 0.001). Logistic regression identified SET-CI as the strongest predictor of bAN status. Other empathy and alexithymia measures showed no significant group differences. Conclusion: These findings suggest that domain-general inferential difficulties—particularly in causal reasoning—may be associated with familial vulnerability to anorexia nervosa in male siblings. Further research is needed to clarify the role of such cognitive traits in the broader context of risk and to inform early identification and intervention strategies.
Keywords: Anorexia Nervosa, Empathy, Emotions, Sibilings, alexithymia, Theory of Mind
Received: 04 Jun 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Meneguzzo, Ceccato, Sala and Santonastaso. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Paolo Meneguzzo, University of Padua, Padua, Italy
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