Disordered eating, self-esteem, and depression symptoms in Iranian adolescents and young adults: A network analysis

Abstract

Objective: The network theory of psychopathology examines networks of interconnections across symptoms. Several network studies of disordered eating have identified central and bridge symptoms in Western samples, yet network models of disordered eating have not been tested in non-Western samples. The current study tested a network model of disordered eating in Iranian adolescents and college students, as well as models of co-occurring depression and self-esteem.

Method: Participants were Iranian college students (n= 637) and adolescents (n = 1,111) who completed the Eating Disorder Examination-Questionnaire (EDE-Q), Rosenberg Self-Esteem Scale (RSES) and Beck Depression Inventory, Second Edition (BDI-II). We computed six Glasso networks and identified central and bridge symptoms.

Results: Central disordered eating nodes in most models were a desire to lose weight and discomfort when seeing one's own body. Central self-esteem and depression nodes were feeling useless and self-dislike, respectively. Feeling like a failure was the most common bridge symptom between disordered eating and depression symptoms. With exception of a few differences in some edges, networks did not significantly differ in structure.

Discussion: Desire to lose weight was the most central node in the networks, which is consistent with sociocultural theories of disordered eating development, as well as prior network models from Western-culture samples. Feeling like a failure was the most central bridge symptom between depression and disordered eating, suggesting that very low self-esteem may be a shared correlate or risk factor for disordered eating and depression in Iranian adolescents and young adults.

Keywords: depression; disordered eating; network analysis; self-esteem.

Figure 1.. Model 1 network and centrality plot.

Notes: See Table 2 for a list of all node names and their corresponding symptoms/measure items. Larger dots on the centrality graph (right) denote the most central symptoms.

Figure 2.. Model 2 network and centrality plot.

Notes: Orange items = EDE-Q items; purple items = RSES items; green items = BDI-II items. Larger dots on the centrality graph (right) denote the most central symptoms. Model 2 is made up of the full sample (N = 1,748). See Table 2 for a list of all node names and their corresponding symptoms/measure items.

Figure 3.. Models 3–6 networks.

Notes: Orange items = EDE-Q items; purple items = RSES items; green items = BDI-II items. Model 3 is made up of a college sample (n = 637). Model 4 is made up of an adolescent sample (n = 1,111). Model 5 is made up of a male sample (n = 757). Model 6 is made up of a female sample (n = 991). See Table 2 for a list of all node names and their corresponding symptoms/measure items.

Figure 4.. Models 3–6 centrality plots.

Notes: Orange items = EDE-Q items; purple items = RSES items; green items = BDI-II items. Larger dots denote the most central symptoms. Model 3 is made up of a college sample (n = 637). Model 4 is made up of an adolescent sample (n = 1,111). Model 5 is made up of a male sample (n = 757). Model 6 is made up of a female sample (n = 991). See Table 2 for a list of all node names and their corresponding symptoms/measure items.