Binge eating and purging were seen in both male and female adolescents, according to study results published in Psychological Medicine. Features of borderline personality and depressive symptoms predicted eating disorder behaviors in both sexes.
Investigators used data from 5812 participants included in the Avon Longitudinal Study of Parents and Children (55% female), which measured temperament, borderline personality features, sensation seeking, “big 5” personality factors, and depressive symptoms at 5 time points from early childhood to adolescence. Univariate analyses assessed these predictors of binge eating and purging at 14 and 16 years for the sex-stratified samples. Structural equation modeling fit the data to a path analysis model of hypothesized associations.
By age 16 years, 12.54% of participants engaged in binge eating and 7.05% engaged in purging. Prevalence increased considerably from 14 to 16 years among female participants. For both sexes, an eating disorder was predicted by features of borderline personality, depressive symptoms, and lower emotional stability. Sensation-seeking conscientiousness was a significant predictor of an eating disorder for female participants. For this group, modeling identified emotional instability as a risk pathway to an eating disorder from early childhood into adolescence.
The study was limited by its sample of mainly white participants in southwest England, which may affect the generalizability of the findings. In addition, the study relied on self-reporting and did not include other ED behaviors such as restrictive eating, compulsive exercise, or body image disturbance.
Overall, binge eating and purging are common among adolescents and seen at a higher rate in female adolescents. Early temperament and personality factors related to difficulty regulating emotions predicted later adolescent ED behaviors. The researchers stated, “Our results have significant clinical implications, including ED prevention programs, increased identification, and temperament based and emotion regulation interventions for all at-risk youth.”
Brown M, Hochman A, Micali N. Emotional instability as a trait risk factor for eating disorder behaviors in adolescents: sex differences in a large-scale prospective study [published online August 5, 2019]. Psychol Med. doi:10.1017/S0033291719001818