Disordered eating in a community sample of Swedish adolescent girls

Abstract: Previous research has described that disordered eating (DE) is common in adolescents, especially in girls. DE is defined as maladaptive behaviours (e.g., vomiting) and negative attitudes toward eating and one’s body shape, appearance, and weight. The present thesis had several aims. First, to validate a Swedish version of a Danish 8-item screening inventory, Risk Behaviour for Eating Disorders/RiBED-8, for the detection of DE/risk behaviours for eating disorders (EDs) in a community sample of over 900 Swedish high school students. Second, to describe the occurrence of DE in this sample, especially in girls. Third, to prospectively study DE and its associations with risk factors for EDs and other psychological variables. Fourth, to advance the knowledge on DE by using cluster analysis with the further aim to find patterns of DE and its prospective associations with other psychological variables. Three studies with a longitudinal design (one-year interval) with two measurement points were conducted. Study 1 found that DE is common among adolescents, especially in girls of which about 30 % presented DE. Study 1 also found that the RiBED-8 demonstrated good psychometric properties among girls, although not among boys. Study 2 found that DE, body esteem and psychological difficulties displayed a high degree of stability in girls over a one-year period. Furthermore, general psychological difficulties and lower levels of body esteem at T1 predicted DE at follow-up one year later (T2). Additionally, reciprocal associations between DE and psychological difficulties were found. Study 3, a cluster analysis, found six DE clusters at T1 that were replicated at T2 and that severe forms of DE clusters (multiple eating problems including/without purging) were associated with higher levels of psychological difficulties and lower levels of body esteem. Moreover, girls who reported purging as part of the multi-problems cluster also reported being engaged in nonsuicidal self-injury to a larger extent. The main conclusions of the thesis was that RiBED-8 is a useful tool for screening DE in girls, that DE is a common and stable phenomenon among adolescent girls and also associated with other psychological problems, and furthermore, that the results could contribute to the knowledge of DE and possibly the prevention of further development of more severe forms of DE in adolescent girls.

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