# Autobiographical memory and episodic future thinking in anorexia nervosa: a three-year follow-up

## TL;DR

People with anorexia nervosa struggle to recall specific life events, and this issue remains over time, even if they don't recover fully.

## Contribution

This study is the first to examine the long-term stability of autobiographical memory issues in anorexia nervosa over three years.

## Key findings

- Participants with anorexia nervosa showed stable difficulties in recalling specific autobiographical memories over three years.
- Baseline memory specificity was not linked to BMI, eating disorder symptoms, or identity functioning at follow-up.
- Memory issues did not worsen despite ongoing illness and high psychiatric comorbidity.

## Abstract

People with anorexia nervosa (AN) show deficiencies with recalling specific details of autobiographical memories (AM). This may interfere with wider processes of self-narrative construction and identity building, which are a fundamental part of the recovery process. However, no studies have examined the temporal stability of AM deficiencies over time or their prognostic value in this population.

This study followed up adults with mostly longstanding AN that participated in a previous study examining AM and episodic future thinking (EFT) abilities after 3 years. A total of 20 participants with AN responded (44% of the original sample) and repeated a remotely administered written version of the Autobiographical Memory Test (AMT) and Episodic Future Thinking Task (EFT-T) and a series of questionnaires. The word lists used were identical to the previous study, but were alternated for the present study (i.e., participants viewing list A for the AMT previously saw list B in the follow-up). Task outcomes included AM and EFT specificity, vividness, difficulty to remember/imagine, positivity, realisticness and detailedness.

Respondents had persistently high eating disorder psychopathology and comorbid psychiatric symptoms at follow-up. Body mass index (BMI) increased in most participants (n = 15), albeit the group average was 17.2 kg/m2. There was comparable performance on the AMT and EFT-T at both baseline and at follow-up. Analyses interrogating prognosis were not possible due to the homogeneity in ED-related outcomes, although baseline AM specificity was not related to BMI, ED symptoms, depressive symptoms or measures of identity functioning (i.e., consolidated identity, disturbed identity, or lack of identity), at follow-up.

Problems with retrieving specific details of AMs show temporal stability over time in people with longstanding AN. The prognostic value of AM specificity on ED outcomes remains unknown, which future well-controlled prospective longitudinal studies could address.

The online version contains supplementary material available at 10.1186/s40337-025-01280-4.

People with anorexia nervosa (AN) often show difficulties with recalling events from their personal life and may show overgeneralisations in their memory recall, as well as biases in how they think about the future. It is unknown however whether these difficulties persist over time, get better when people recover, or perhaps even worsen when people remain unwell for long periods of time. In this study, people with AN that took part in a previous study looking at autobiographical memory recall and thinking about the future were followed up three years later, where they completed the same tasks. People that took part in this follow-up were largely unrecovered, meaning that it was not possible to examine whether memory abilities were related to poor or good outcomes over time, although memory abilities were not related to the follow-up BMI, eating disorder symptoms or depression symptoms. Participants still showed deficiencies in recalling specific details of personal memories at this time-point, suggesting that their memory may not worsen even with persisting illness.

The online version contains supplementary material available at 10.1186/s40337-025-01280-4.