Premium
Not all body image constructs are created equal: Predicting eating disorder outcomes from preoccupation, dissatisfaction, and overvaluation
Author(s) -
Askew Autumn J.,
Peterson Carol B.,
Crow Scott J.,
Mitchell James E.,
Halmi Katherine A.,
Agras W. Stewart,
Haynos Ann F.
Publication year - 2020
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.23277
Subject(s) - binge eating , eating disorders , binge eating disorder , disordered eating , psychology , bulimia nervosa , clinical psychology , psychiatry , dsm 5
Objective Diverse terminology has been used to operationalize body image disturbance in eating disorders. However, the differential validity of these terms and their underlying constructs to predict outcomes among heterogeneous eating disorders is unknown. This study evaluated the validity of body image constructs to predict eating disorder and negative psychological symptoms concurrently and prospectively over 2 years in a transdiagnostic clinical sample. Methods Women with heterogeneous eating disorder diagnoses ( n = 448) completed assessments at baseline, 12‐month, and 24‐month follow‐up. Cross‐sectional and cross‐lagged generalized linear models examined effects of three body image constructs (i.e., weight and shape preoccupation, overvaluation, and dissatisfaction) on concurrent and subsequent outcomes (i.e., global eating disorder symptoms, binge eating, purging, fasting, self‐esteem, and depression). Results In concurrent analyses, preoccupation was significantly associated with all outcomes ( p s = .01 to <.001), overvaluation with all outcomes ( p s = .01 to <.001) except binge eating ( p = .06), and dissatisfaction with all outcomes ( p s < .001) except purging ( p = .38). In prospective analyses, preoccupation predicted Eating Disorder Examination global ( p = .003) and fasting ( p < .001), overvaluation predicted binge eating ( p = .01), and body dissatisfaction did not predict any outcomes. Discussion Preoccupation, overvaluation, and dissatisfaction are differentially related to eating disorder and psychiatric outcomes, indicating that no one body image construct can capture clinical risk in eating disorders. Preoccupation was the most consistent concurrent and longitudinal predictor; this construct may warrant further attention in assessment and diagnosis. Further investigation of these constructs in diverse samples is encouraged.