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Sequencing of symptom emergence in anorexia nervosa, bulimia nervosa, binge eating disorder, and purging disorder in adolescent girls and relations of prodromal symptoms to future onset of these eating disorders

Published online by Cambridge University Press:  02 June 2022

Yuko Yamamiya Open the ORCID record for Yuko Yamamiya [Opens in a new window] ,
Christopher David Desjardins  and
Eric Stice
Yuko Yamamiya*
Affiliation:
Temple University, Japan Campus, Tokyo, Japan
Christopher David Desjardins
Affiliation:
Department of Mathematics and Statistics, Saint Michael's College, Colchester, US
Eric Stice
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, US
*
Author for correspondence: Yuko Yamamiya, E-mail: yuko.yamamiya@tuj.temple.edu
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Abstract

Background

To advance knowledge regarding the etiology of eating disorders, we characterized the sequencing of eating disorder symptom emergence for adolescent girls who subsequently developed anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) for community-recruited adolescents and tested whether prodromal symptoms increased risk for future onset of each eating disorder.

Methods

Data collected from adolescent girls (N = 496; M age = 13.02, s.d. = 0.73) who completed a diagnostic interview annually over an 8-year period were used to address these aims.

Results

For all four eating disorders, compensatory weight-control behaviors were the first behavioral symptom to emerge and weight/shape overvaluation was the first cognitive symptom to emerge. Moreover, lower-than-expected BMI predicted future AN onset, binge eating and all cognitive symptoms predicted future BN onset, weight/shape overvaluation predicted future BED onset, and compensatory behavior and all cognitive symptoms predicted future PD onset. These predictive effects were small-to-large in magnitude. Collectively, prodromal symptoms predicted an eating disorder onset with 83–87% accuracy.

Conclusions

Results suggest that compensatory weight-control behaviors and weight/shape overvaluation typically emerge before other prodromal symptoms in all eating disorders during adolescence. Moreover, different prodromal symptoms seem to predict future onset of different eating disorders. Screening adolescent girls for these prodromal symptoms and implementing indicated prevention programs designed to reduce these symptoms may prove effective in preventing future onset of eating disorders.

Keywords

Anorexia nervosabinge eating disorderbulimia nervosaprodromal symptomsprospectivepurging disordersymptom emergence
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 10 , July 2023 , pp. 4657 - 4665
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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