Prospective Pathways to Depressive Symptoms and Disordered Eating in Adolescence: A 7-Year Longitudinal Cohort Study
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EMPIRICAL RESEARCH
Prospective Pathways to Depressive Symptoms and Disordered Eating in Adolescence: A 7-Year Longitudinal Cohort Study Helena Lewis-Smith
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Isabelle Bray1 Debra Salmon2 Amy Slater1 ●
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Received: 24 March 2020 / Accepted: 9 July 2020 © The Author(s) 2020
Abstract Eating pathology and depressive symptoms increase during adolescence, yet predictive pathways remain predominantly unexplored, despite their implications for prevention. The present study aimed to identify shared risk factors for eating pathology and depressive symptoms by evaluating an adapted Dual-Pathway Model of disordered eating, which postulated that higher BMI would predict disordered eating and depressive symptoms via pathways between body dissatisfaction, later BMI, depressive symptoms, and visible indicators of puberty (breast development for girls, height for boys). The participants were 8915 children (49% girls) from the Avon Longitudinal Study of Parents and Children, a population-based cohort study of British children, who were assessed at different intervals between the age of 7 to 14 years. Path analyses revealed that, for girls, childhood BMI exerted indirect effects on disordered eating via body dissatisfaction, depressive symptoms, and more advanced breast development, with indirect pathways identified to depressive symptoms via earlier depressive symptoms and more advanced breast development. For boys, childhood BMI had indirect effects on disordered eating via later BMI and body dissatisfaction, while only earlier depressive symptoms were found to have an independent and direct effect on adolescent depressive symptoms. This study reveals shared and independent risk factors for eating pathology and depressive symptoms in adolescence and suggests targets for preventative interventions, including higher BMI, body dissatisfaction, and depressive symptoms, in addition to advanced breast development, for girls. Keywords
Disordered eating Depression BMI Body image Puberty Adolescence ●
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Introduction Research indicates that eating pathology and depressive symptoms increase during adolescence (Goldschmidt et al. 2016). Both are associated with harmful effects upon physical and psychological health in adulthood, including full threshold eating disorders, anxiety, mood disorders, personality disorders, self-harm, and substance abuse (Bornioli et al. 2019; Johnson et al. 2009). Disordered eating and depressive symptoms often co-occur in adolescence (Goldschmidt et al. 2016), which suggests the likelihood of common underlying causes. Indeed, researchers have called for the examination of how independently studied risk factors interrelate with one another to foster eating
* Helena Lewis-Smith [email protected] 1
University of the West of England, Bristol, UK
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City University London, London, UK
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pathology and depressive symptoms (Ferreiro et al. 2012), and have recommended targeting shared risk factors for these outcomes in public health interventions (Becker et al
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