Psychological and behavioral risk profiles as they relate to eating disorder diagnoses and symptomatology among a school-based sample of youth

Abstract

Objective: Examine substance use, depression, self-esteem, and suicidality by eating disorder (ED) classifications among nonclinical youth.

Method: A school-based sample of 4,746 youth completed anthropometric measures and Project EAT survey items matched to DSM-IV ED criteria. Logistic regression analyses and general linear models compared three threshold (AN, BN, or BED), two subthreshold (binge-eating and/or compensatory behaviors not meeting ED diagnosis, or body image disturbance without disordered eating) and one asymptomatic ED classifications.

Results: Subthreshold and threshold classifications reported lower self-esteem and greater substance use, depression, suicidal ideation/attempts than asymptomatic youth. The BED group had higher depressive mood, and BED and BN had lower self-esteem, than the subthreshold groups. Odds ratios for suicidality were highest among the BN group and lowest among the body image disturbance group.

Discussion: Subthreshold and threshold classifications are associated with compromised health, suggesting the importance of addressing the continuum of weight/shape concerns and disordered eating behaviors within prevention and treatment interventions.