Date on Senior Honors Thesis

5-2021

Document Type

Senior Honors Thesis

Degree Name

B.A.

Department

Psychological and Brain Sciences

Degree Program

College of Arts and Sciences

Author's Keywords

eating disorders; prevention; adolescents; risk factors; network analysis

Abstract

Eating disorders (EDs) are psychological disorders characterized by disturbances in eating that commonly develop during adolescence and may be influenced by risk factors, both ED-specific (i.e., factors linked to future ED symptoms) and transdiagnostic (i.e., factors underlying multiple psychological disorders). Network analysis allows for the study of the connections between ED symptoms and risk factors by identifying central symptoms (i.e., the most interconnected symptoms) and bridge symptoms (i.e., symptoms which strongly connect across the symptom and risk factor clusters). Examining networks of ED symptoms and risk factors in adolescence can inform how risk factors influence ED development, as well as how this can be disrupted by prevention programs. The current study (N=301 adolescents) used network analysis to estimate the unique connections across ED symptoms, ED-specific risk factors (feared concerns about eating, food avoidance behaviors, eating anxiety, thinness and restricting expectancies, and exercise dependence), and transdiagnostic risk factors (emotion dysregulation, maladaptive perfectionism, social appearance anxiety, and negative urgency) in adolescent girls before and after an ED prevention program. The most central symptom in both networks was feared concerns about eating. The most central bridge symptoms in the pre-network were thinness/restricting expectancies and feared concerns about eating. The most central bridge symptom in the post-network was thinness/restricting expectancies. A network comparison test revealed twenty significantly different edges. These findings suggest that prevention programs targeting central risk factors (e.g., feared concerns about eating) and bridge risk factors (e.g., thinness/restricting expectancies) may limit the escalation of risk factors to full-threshold EDs in adolescents. Understanding ED risk factors specific to adolescents can result in better prevention programs optimized to reduce incidence and address the heterogeneity of EDs.

Lay Summary

Eating disorders (EDs) are psychological disorders that present with disordered eating behaviors, including binge eating, restricting, and purging, and cognitive dysfunction, such as distorted thoughts about food and body image. EDs can lead to poor health and social outcomes, suicidal ideation, and in the most severe circumstances, death. EDs often emerge during adolescence. Research has identified certain risk factors that may contribute to the development of EDs during this critical period. Such risk factors can be specific to EDs, in that they underlie ED development, or transdiagnostic, in that they underlie many psychological disorders, like depression and anxiety, as well as EDs. Due to the high rate of EDs among adolescents, prevention programs like the Body Project have been developed to reduce ED occurrence. The current study aimed to compare ED symptoms and risk factors before and after the Body Project using network analysis. Network analysis is a statistical technique that identifies the most interconnected symptoms (i.e., symptoms that are strongly connected and drive the relationship between one another) and the symptoms that are most highly connected across risk factors and ED symptoms. Our results found that thinness/restricting expectancies (i.e., expecting that thinness or food restriction will make oneself better) and feared concerns about eating (i.e., fears about the consequences of eating) were the most highly interconnected symptoms across risk factors and ED symptoms. This may suggest that that these risk factors are especially important in the development of EDs in adolescents. Targeting thinness/restricting expectancies and feared concerns about eating may improve prevention programs for EDs. Improved prevention programs targeting symptoms that are driving ED development will reduce the incidence of EDs and result in better outcomes.

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