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Peer-reviewedCC BY 4.0Frontiers in Psychiatry

Conceptualisation of restrictive repetitive behaviours across autism and orthorexia nervosa

  • Jane Edge1
  • Jac Airdrie1,2
  • Maddy Greville-Harris3
  • Samuel J.R.A. Chawner1,4
4 affiliations
  1. 1Wolfson Centre for Young People’s Mental Health, Department of Psychological Medicine and Clinical Neuroscience, Cardiff University
  2. 2School of Psychology, Cardiff University
  3. 3Psychology Department, University of Exeter, Washington Singer Building
  4. 4Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine and Clinical Neurosciences, Cardiff University
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Abstract

Orthorexia Nervosa (ON) is widely regarded as an emerging eating disorder although it is not currently recognised as a formal diagnosis. It is characterised by a strict adherence to “pure” eating which becomes excessive and can lead to nutritional deficiencies, psychological distress, and impaired daily functioning. Restrictive eating behaviour in ON shows overlap with Restricted Repetitive Behaviours (RRBs) observed in autism. However, the conceptual relationship between ON and autism remains underexplored. This perspective article synthesises existing literature to explore potential overlapping and diverging mechanisms of RRBs across ON and autism. Intolerance for Uncertainty is highlighted as a possible shared mechanism that may contribute to RRBs observed in both ON and autism, whereas Cognitive Inflexibility and Perfectionism may mechanistically differentiate the conditions. We consider that autistic RRBs reflect neurodevelopmental divergence, whereas orthorexic RRBs may be influenced by evaluative belief-centred cognitions. We propose a conceptual model outlining how cognitive, affective and functional factors may interact to produce and maintain RRBs. Clarifying these distinctions is important in supporting clinicians to appropriately consider the drivers and mechanisms underlying RRBs across ON and autism, therefore supporting accurate diagnosis, formulation and treatment.

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Cite

BibTeXRIS
BibTeX
@article{edge2026conceptualisation,
  title = {{Conceptualisation of restrictive repetitive behaviours across autism and orthorexia nervosa}},
  author = {Jane Edge and Jac Airdrie and Maddy Greville-Harris and Samuel J.R.A. Chawner},
  journal = {Frontiers in Psychiatry},
  year = {2026},
  month = oct,
  doi = {10.3389/fpsyt.2026.1936477},
  url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1936477/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Conceptualisation of restrictive repetitive behaviours across autism and orthorexia nervosa
AU  - Jane Edge
AU  - Jac Airdrie
AU  - Maddy Greville-Harris
AU  - Samuel J.R.A. Chawner
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Psychiatry
DO  - 10.3389/fpsyt.2026.1936477
UR  - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1936477/full
AB  - Orthorexia Nervosa (ON) is widely regarded as an emerging eating disorder although it is not currently recognised as a formal diagnosis. It is characterised by a strict adherence to “pure” eating which becomes excessive and can lead to nutritional deficiencies, psychological distress, and impaired daily functioning. Restrictive eating behaviour in ON shows overlap with Restricted Repetitive Behaviours (RRBs) observed in autism. However, the conceptual relationship between ON and autism remains underexplored. This perspective article synthesises existing literature to explore potential overlapping and diverging mechanisms of RRBs across ON and autism. Intolerance for Uncertainty is highlighted as a possible shared mechanism that may contribute to RRBs observed in both ON and autism, whereas Cognitive Inflexibility and Perfectionism may mechanistically differentiate the conditions. We consider that autistic RRBs reflect neurodevelopmental divergence, whereas orthorexic RRBs may be influenced by evaluative belief-centred cognitions. We propose a conceptual model outlining how cognitive, affective and functional factors may interact to produce and maintain RRBs. Clarifying these distinctions is important in supporting clinicians to appropriately consider the drivers and mechanisms underlying RRBs across ON and autism, therefore supporting accurate diagnosis, formulation and treatment.
SN  - 1664-0640
ER  -