Social appearance anxiety moderates the relationship between thin-ideal internalization and eating disorder symptoms cro
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BRIEF REPORT
Social appearance anxiety moderates the relationship between thin‑ideal internalization and eating disorder symptoms cross‑sectionally and prospectively in adolescent girls Caroline Brooke Christian1 · Betty K. Ngo1 · Leigh C. Brosof1 · Cheri A. Levinson1 Received: 24 August 2020 / Accepted: 9 October 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose The sociocultural theory of eating disorders (EDs) posits that thin-ideal internalization may interact with social risk factors to influence ED development. Social appearance anxiety (SAA) is a potential social risk factor for EDs that may influence the relationship between thin-ideal internalization and EDs. Methods The current study (N = 525 adolescent females) examined whether SAA moderated the relationship between thinideal internalization and ED symptoms cross-sectionally and prospectively across one month. Results The interaction between thin-ideal internalization and SAA on ED symptoms was significant in both models, such that when SAA was higher, there was a significantly stronger relationship between thin-ideal internalization and ED symptoms. We also found that SAA uniquely, prospectively predicted ED symptoms. Conclusion These results suggest that adolescents with high SAA and high thin-ideal internalization are more likely to exhibit higher ED symptoms. SAA both prospectively predicts ED symptoms and may amplify the relationship between thin-ideal internalization and EDs. This research highlights SAA as a social risk factor for ED development in adolescents. Interventions focused on SAA may optimize ED prevention in this population. Level of evidence Level IV, evidence obtained from multiple time series with or without the intervention. Keywords Social appearance anxiety · Moderation · Thin-ideal internalization · Eating disorders · Adolescents
Introduction Eating disorders (EDs) are serious psychiatric illnesses carrying many negative outcomes, such as high chronicity, social functioning impairment, and increased risk of medical complications and death [1]. EDs frequently emerge and are highly prevalent in adolescence [2], representing an important population for studying developmental risk factors for EDs. Although many risk and maintenance factors for EDs during adolescence have been identified, including thin-ideal internalization (i.e., the extent to which an individual accepts societally constructed appearance ideals), other potential risk factors for the development of EDs * Cheri A. Levinson [email protected] 1
Department of Psychological and Brain Sciences, University of Louisville, 317 Life Sciences Building, Louisville, KY, USA
remain understudied [3, 4]. Additionally, fewer studies have investigated how such risk factors operate in concert with one another to amplify risk for EDs [3]. Models including multiple risk factors may elucidate the cumulative risk of these factors on ED development and maintenance, informing prevention and treatment efforts. One prominent theory that may aid in the iden
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