Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study
Highlights
► Classification tree analysis identifies distinct pathways for eating disorders. ► We determine cut-points for identifying adolescents at risk for eating disorders. ► Body dissatisfaction pathway to eating disorder onset emerged. ► Risk increased with depressive symptoms. ► Self-reported dieting is primary risk factor for second pathway.
Section snippets
Participants and procedures
Participants were 496 middle school girls (M age = 13.5, SD = 0.7) recruited from four public schools from the Austin Independent School District (n = 409) and four smaller private schools (n = 87) in Austin Texas. The sample was composed of 2% Asian/Pacific Islanders, 7% African Americans, 68% Caucasians, 18% Hispanics, 1% Native Americans, and 4% other/mixed and average parental education was 29% high school graduate or less, 23% some college, 33% college graduate, and 15% graduate degree, which was
Results
With respect to attrition, the percentages of participants missing self-report and diagnostic interview data from were 0% (N = 496), 1% (N = 491), 3% (N = 481), 3% (N = 481), 2% (N = 486), 3% (N = 481), 4% (N = 476), and 6% (N = 466) for each of the eight annual assessments. It should be noted that we were sometimes able to collect data from participants who did not provide data at an earlier assessment. Attrition was not significantly correlated with any of the variables examined herein.
Variables that showed
Discussion
The objective was to use CTA to determine empirically derived cut-points for identifying adolescent girls at risk for future onset of threshold, subthreshold, and partial eating disorders and test for interactions between risk factors suggestive of qualitatively distinct risk pathways, with the hope that this would allow clinicians to identify youth at greatest risk for eating pathology, which can be a challenge because of the low incidence of these conditions, and to design prevention programs
Acknowledgments
The authors of this manuscript have no conflicts of interest, including financial interests relevant to the subject of this manuscript.
Eric Stice was responsible for study design and contributed to data analysis and manuscript writing and revisions. Nathan Marti contributed to data analysis and manuscript writing and revisions. Shelley Durant contributed to manuscript writing and revisions.
This study was supported by a career award (MH01708) and a research grant (MH/DK61957) from the National
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