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. 2021 Aug;26(6):2065-2070.
doi: 10.1007/s40519-020-01050-y. Epub 2020 Oct 26.

Social appearance anxiety moderates the relationship between thin-ideal internalization and eating disorder symptoms cross-sectionally and prospectively in adolescent girls

Caroline Brooke Christian  1 , Betty K Ngo  1 , Leigh C Brosof  1 , Cheri A Levinson  2
Affiliations

Social appearance anxiety moderates the relationship between thin-ideal internalization and eating disorder symptoms cross-sectionally and prospectively in adolescent girls

Caroline Brooke Christian et al. Eat Weight Disord. 2021 Aug.

Abstract

Purpose: The sociocultural theory of eating disorders (EDs) posits that thin-ideal internalization may interact with social risk factors to influence ED development. Social appearance anxiety (SAA) is a potential social risk factor for EDs that may influence the relationship between thin-ideal internalization and EDs.

Methods: The current study (N = 525 adolescent females) examined whether SAA moderated the relationship between thin-ideal internalization and ED symptoms cross-sectionally and prospectively across one month.

Results: The interaction between thin-ideal internalization and SAA on ED symptoms was significant in both models, such that when SAA was higher, there was a significantly stronger relationship between thin-ideal internalization and ED symptoms. We also found that SAA uniquely, prospectively predicted ED symptoms.

Conclusion: These results suggest that adolescents with high SAA and high thin-ideal internalization are more likely to exhibit higher ED symptoms. SAA both prospectively predicts ED symptoms and may amplify the relationship between thin-ideal internalization and EDs. This research highlights SAA as a social risk factor for ED development in adolescents. Interventions focused on SAA may optimize ED prevention in this population.

Level of evidence: Level IV, evidence obtained from multiple time series with or without the intervention.

Keywords: Adolescents; Eating disorders; Moderation; Social appearance anxiety; Thin-ideal internalization.

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