Transdiagnostic vulnerability factors in eating disorders: A network analysis

Eur Eat Disord Rev. 2021 Jan;29(1):86-100. doi: 10.1002/erv.2805. Epub 2020 Nov 6.

Abstract

Objective: Eating disorder (ED) symptoms and transdiagnostic vulnerability characteristics play a crucial role in the aetiology and maintenance of EDs. Over the last decade, researchers have started to model complex interrelations between symptoms using network models, but the literature is limited in that it has focused solely on symptoms and investigated-specific disorders while ignoring transdiagnostic aspects of mental health.

Method: This study tackles these challenges by investigating network relations among core ED symptoms, comorbid clinical symptoms (depression and anxiety) and empirically supported vulnerability and protective mechanisms (personality traits, maladaptive cognitive schemata, perfectionism and resilience) in a sample of 2302 treatment-seeking ED patients. We estimated a regularized partial correlation network to obtain conditional dependence relations among all variables. We estimated node centrality (interconnectivity) and node predictability (the overall magnitude of symptom inter-relationships).

Results: The findings indicate a central role of overvigilance, excessive focus on inhibiting emotions and feelings, interoceptive awareness and perfectionism.

Conclusions: These results suggest that excessive control of bodily aspects by dietary restraint (possibly through inhibition) and interoceptive awareness may be important constructs that warrant future research in understanding vulnerability in EDs. We provide all code and data via the Open Science Framework.

Keywords: eating disorders; inhibition; interoceptive awareness; network analysis; perfectionism.

MeSH terms

  • Anxiety
  • Anxiety Disorders
  • Emotions
  • Feeding and Eating Disorders* / diagnosis
  • Feeding and Eating Disorders* / epidemiology
  • Humans
  • Perfectionism*