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Risk factors that predict future onset of each DSM-5 eating disorder: Predictive specificity in high-risk adolescent females
Open accessAbstract
Because no single report has examined risk factors that predict future onset each type of eating disorder and core symptom dimensions that crosscut disorders, we addressed these aims to advance knowledge regarding risk factor specificity. Data from 3 prevention trials that targeted young women with body dissatisfaction (N = 1,272; Mage = 18.5, SD = 4.2) and collected annual diagnostic interview data over 3-year follow-up were combined to identify predictors of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Negative affect and functional impairment predicted onset of all eating disorders. Thin-ideal internalization, body dissatisfaction, dieting, overeating, and mental health care predicted onset of subthreshold/threshold BN, BED, and PD; positive thinness expectations, denial of cost of pursuing the thin ideal, and fasting predicted onset of 2 of these 3 disorders. Similar risk factors predicted core eating disorder symptom onset. Low BMI and dieting specifically predicted onset of subthreshold/threshold AN or low BMI. Only a subset of factors showed unique predictive effects in multivariate models, likely due to moderate correlations between the risk factors (M r = .14). Results provide support for the theory that pursuit of the thin ideal and the resulting body dissatisfaction, dieting, and unhealthy weight control behaviors increase risk for binge/purge spectrum eating disorders, but suggest that youth who are inherently lean, rather than purposely pursuing the thin ideal, are at risk for AN. Impaired interpersonal functioning and negative affect are transdiagnostic risk factors, suggesting these factors should be targeted in prevention programs. (PsycINFO Database Record
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“A previous report using data from this high-risk sample focused on the main effects of risk factors that predicted onset of AN, BN, BED, and PD (Stice et al., 2017), but did not test for interactions between risk factors.”
From Interactions between risk factors in the prediction of onset of eating disorders: Exploratory hypothesis generating analyses (2018) · cites this paper as Stice et al., 2017
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Metadata
- Authors
- Stice, E., Gau, J. M., Rohde, P., & Shaw, H.
- Affiliations
- Oregon Research Institute (US)
- Venue
- Journal of Abnormal Psychology
- Published
- 2017-01
- Volume
- 126
- Issue
- 1
- Pages
- 38-51
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- PMC
- PMC5215960
- OpenAlex
- W2529662426
- Cited by
- 558
- References
- 64
- Citations by year
- 2026: 54 · 2025: 59 · 2024: 61 · 2023: 79 · 2022: 66 · 2021: 77 · 2020: 57 · 2019: 50 · 2018: 36 · 2017: 16
- FWCI
- 45.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Abnormal Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (MH/DK061957, MH070699, and MH086582)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- eating disorders, risk factors, anorexia nervosa, bulimia nervosa, binge eating disorder, purging disorder, body dissatisfaction, thin-ideal internalization, dieting, negative affect, functional disability, transdiagnostic risk factors, adolescent girls, eating disorder prevention, low body mass index, interpersonal functioning
- MeSH terms
- Adolescent, Anorexia Nervosa, Feeding and Eating Disorders, Female, Follow-Up Studies, Humans, Risk Factors, Sensitivity and Specificity, Diagnostic and Statistical Manual of Mental Disorders, Bulimia Nervosa, Binge-Eating Disorder
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