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Designing cognitive behavioural therapy for anorexia nervosa in people with co-occurring autism

Cardiff School of Psychology

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Prof John Fox , Dr Joanne Williams , Dr C Jones No more applications being accepted Competition Funded PhD Project (Students Worldwide)

About the Project

The PhD project will develop and adapt cognitive behavioral therapy (CBT) for people with anorexia nervosa who are also autistic or have a high degree of autistic traits.

Anorexia is a psychiatric condition characterised by significantly low body weight and distorted views and behaviours around weight gain. In contrast, autism spectrum disorder is a neurodevelopmental disorder that centres around difficulties with social communication and the presence of restricted and repetitive behaviours. Despite their apparent differences, the co-occurrence of anorexia and autism is well-established, with estimates of 20-30% of women in treatment for AN meeting the diagnostic criteria for autism (Westwood & Tchanturia, 2017). More generally, autistic traits are generally elevated in anorexic populations compared to those without anorexia (Westwood et al., 2016).

Our previous research has explored how autistic traits may be related to the development and persistence of anorexia in some women (Brede et al., 2020). We have also explored the challenges that autistic people with anorexia experience when receiving treatment for their eating disorder (Babb et al., in press). We identified a lack of understanding in eating disorders services about autism, and found that needs relating to autism were often not recognised or met. Our research also uncovered changes that could be made to therapies and services to improve the treatment that autistic women with anorexia receive. This included adapting both communication styles and the treatment environment.

Optimising treatment for people with anorexia is critical as it has one of the highest mortality rates of all psychiatric disorders (Chesney, Goodwin & Fazel, 2014). Further, over 50% of people with anorexia will not fully recover nine years after its onset, with a significant proportion developing a severe and enduring presentation of the disorder (Steinhausen, 2002). Against this background, our aim is to build on the knowledge within our research and clinical team to develop a therapy that is optimised for use with anorexic people with either autism or a high degree of autistic traits.

The successful candidate will work closely with the supervision team to investigate the needs of autistic people with anorexia when in treatment for their eating disorder. The specific design of the project will be developed during the PhD but is likely to include qualitative interviews, surveys, and co-production with relevant stakeholders. A key output of the PhD will be the development of a CBT programme for anorexia that has been adapted for individuals with co-occurring autism or a high degree of autistic traits.

The PhD project will be based in the School of Psychology at Cardiff University in the Wales Autism Research Centre, which is part of the Cardiff University Centre for Human Developmental Science. The student will be supervised by an interdisciplinary team with expertise in developmental psychology (Jones), clinical psychology (Fox) and cognitive behavioural therapy (Williams), alongside shared expertise in autism (Jones) and anorexia (Fox). We are looking for an enthusiastic and motivated individual with an excellent degree in psychology or a related discipline.

Any questions about the project can be directed to Professor John Fox [Email Address Removed]

The studentship will commence in October 2021 and will cover your tuition fees (at UK level) as well as a maintenance grant. In 2020-21 the maintenance grant for full-time students was £15,285 per annum. As well as tuition fees and a maintenance grant, all School of Psychology students receive access to courses offered by the University’s Doctoral Academy and become members of the University Doctoral Academy.

As only one studentship is available and a very high standard of applications is typically received, the successful applicant is likely to have a very good first degree (a First or Upper Second class BSc Honours or equivalent) and/or be distinguished by having relevant research experience

Applicants should apply to the Doctor of Philosophy in Psychology with a start date of October 2021

In the research proposal section of your application, please specify the project title and supervisors of this project and copy the project description in the text box provided.

In the funding section, please select 'I will be applying for a scholarship/grant' and specify that you are applying for advertised funding from Designing cognitive behavioural therapy for anorexia nervosa in people with co-occurring autism 

Funding Notes

This studentship is open to Home, EU or international students. The award offered will cover Home fees and maintenance stipend. International/EU candidates are welcomed but may need to self-fund the difference between Home and International fees.

However, there are a limited number of studentships available for international/EU applicants that can cover full or partial fees


Babb, C., Brede, J., Jones, C.R.G., Elliott, M., Zanker, C., Tchanturia, K., Sepell, L., Mandy, W., Fox, J. (in press). “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
Brede, J., Babb, C., Jones, C.R.G., Elliott, M., Zanker, C., Tchanturia, K., Sepell, L., Fox, J., Mandy, W. (2020). “For me, the anorexia is just a symptom, and the cause is the autism” – Investigating restrictive eating disorders in autistic women. Journal of Autism & Developmental Disorders. 50, 4280-4296
Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all‐cause and suicide mortality in mental disorders: a meta‐review. World psychiatry, 13(2), 153-160.
Steinhausen, H.-C. (2002). The outcome of anorexia nervosa in the 20th century. American Journal of Psychiatry, 159(8), 1284-1293.
Westwood, H., Eisler, I., Mandy, W., Leppanen, J., Treasure, J., & Tchanturia, K. (2016). Using the Autism-Spectrum Quotient to Measure Autistic Traits in Anorexia Nervosa: A Systematic Review and Meta-Analysis. Journal of Autism and Developmental Disorders, 46(3), 964-977.
Westwood, H., & Tchanturia, K. (2017). Autism spectrum disorder in anorexia nervosa: an updated literature review. Current Psychiatry Reports, 19(7), 41.

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