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Cited by 40Eating Disorders and BehaviorsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNutrition, Health and Food Behavior

Mediating role of experiential avoidance in the relationship between anxiety sensitivity and eating disorder psychopathology: A clinical replication

Espel-Huynh, Hallie M., Muratore, Alexandra F., Virzi, Nicole, Brooks, Gayle, Zandberg, Laurie J.·2019·Eating Behaviors
DOI 10.1016/j.eatbeh.2019.101308
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Abstract

Objective This study sought to examine whether anxiety sensitivity was associated with eating disorder (ED) symptom severity among patients with severe EDs, and to determine whether this relationship was mediated by experiential avoidance.Method Adolescent and adult females (N = 625) seeking residential ED treatment completed self-report measures of anxiety sensitivity, experiential avoidance, and ED psychopathology. Linear regression evaluated the cross-sectional association between ED symptom severity and three dimensions of anxiety sensitivity (social, physical, and cognitive). Regression-based mediation analysis with bootstrapping tested the associations among the three dimensions of anxiety sensitivity and ED symptom severity through experiential avoidance.Results The social dimension of anxiety sensitivity was positively associated with severity of ED psychopathology. Experiential avoidance mediated this association.Discussion ED symptoms in this sample were more severe among patients who endorsed greater concern about appearing nervous or anxious to others. The current results indicate that this relationship was driven by a tendency to avoid experiences that evoke emotional discomfort. If replicated, these findings suggest that targeting both social anxiety sensitivity and experiential avoidance may improve ED treatment outcomes. Further study of the mechanistic relationships among social anxiety sensitivity, experiential avoidance, and ED psychopathology, is warranted.

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  • The relationship between anxiety sensitivity and eating disorder symptoms is mediated by experiential avoidance or by interoceptive awareness.

    “In these studies, the relationship between AS and ED symptoms was mediated by experiential avoidance (the tendency to avoid situations causing discomfort; Espel-Huynh et al., 2019; Fulton et al., 2012), or by interoceptive awareness, (the general sense of the body’s sensations; Anestis et al., 2008).”

    From Early reduction in anxiety sensitivity predicts greater reduction in disordered eating and trait anxiety during treatment for bulimia nervosa. (2024) · cites this paper as Espel-Huynh et al., 2019

  • Anxiety sensitivity is cross-sectionally associated with eating disorder symptoms, including bulimia symptoms, in undergraduates, adult mental health outpatients, and adolescents and adults receiving residential eating disorder treatment.

    “Recent work links ED pathology and AS cross-sectionally. Among undergraduates, AS is associated with ED symptoms (Fulton et al., 2012) and bulimia symptoms specifically (Anestis et al., 2008). It is also associated with bulimia symptoms and drive for thinness in adult mental health outpatients (Anestis et al., 2008), and with ED symptoms in adolescents and adults receiving residential ED treatment”

    From Early reduction in anxiety sensitivity predicts greater reduction in disordered eating and trait anxiety during treatment for bulimia nervosa. (2024) · cites this paper as Espel-Huynh et al., 2019

  • Indirect evidence suggests that fears of negative evaluation, physical sensations, or uncertainty may predict EA in the context of other disorders, such as symptoms of eating disorders and generalized anxiety disorder.

    “However, indirect evidence suggests that each may predict EA in the context of the other disorders, such as symptoms of eating disorders (Espel-Huynh et al., 2019) and generalized anxiety disorder (Akbari & Khanipour, 2018).”

    From Evaluating Mechanisms: Mapping Weekly Dynamics between Experiential Avoidance and SAD Symptoms (2021) · cites this paper as Espel-Huynh et al., 2019

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Authors
Espel-Huynh, H. M., Muratore, A. F., Virzi, N., Brooks, G., & Zandberg, L. J.
Affiliations
  • Drexel University (US)
  • University of Pennsylvania (US)
ORCID
Venue
Eating Behaviors
Publisher
Elsevier BV
Published
2019-08
Volume
34
Pages
101308
ISSN
1471-0153 (ISSN-L)
DOI
10.1016/j.eatbeh.2019.101308
OpenAlex
W2954042816
Cited by
40
References
72
Citations by year
2026: 4 · 2025: 6 · 2024: 11 · 2023: 6 · 2022: 8 · 2021: 4 · 2020: 1
FWCI
3.79
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Eating Behaviors (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
anxiety sensitivity, experiential avoidance, eating disorders, eating disorder psychopathology, mediation, adolescents and adults
MeSH terms
Adolescent, Adult, Aged, Anxiety, Anxiety Disorders, Feeding and Eating Disorders, Avoidance Learning, Cross-Sectional Studies, Emotions, Female, Humans, Male, Middle Aged, Psychopathology, Young Adult, Self Report

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