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Eating disorders (EDs) are serious mental illnesses that often develop in adolescence and persist in adulthood. Social appearance anxiety (SAA; fear of appearance-based judgment) is a risk factor for EDs and related to ED symptoms. SAA is more prevalent in non-clinical adolescents than non-clinical adults, yet no research has investigated the relationship between SAA and ED symptoms across age. The present study tested if age moderated the relationship between SAA and drive for thinness (DT), bulimic symptoms, and body dissatisfaction in a clinical ED sample (N=952, 28.5%), a nonclinical sample (N=1,693; 51.7%), and the full sample (N = 3,273). In the clinical ED sample, there was a significant interaction between age and SAA on DT, such that SAA and DT were more strongly related in older participants (b=.43, p<.001), compared to younger participants (b=.25, p<.001). Age did not moderate the relationship between SAA and ED symptoms in the overall sample or nonclinical sample (p>.05), and results indicate SAA is strongly related to all three domains of ED symptoms regardless of age (bs=.25-.62, ps<.001). These results support SAA as a core factor in EDs across all age groups. Interventions focused on SAA may be used with people of all ages and levels of ED symptoms to improve outcomes. Future studies should examine the associations between SAA and ED symptoms across all developmental stages and duration of illness. Future research should test the influence of social media and technology on the relationship between SAA and ED symptoms across different age groups.

Publication Date

Spring 4-2020


eating disorders; social appearance anxiety


Clinical Psychology

Social Appearance Anxiety is Strongly Related to Eating Disorder Symptoms regardless of Age in both Clinical Eating Disorder and Nonclinical Cases