We identified public eating and drinking as bridge symptoms between EDs and SAD. Future research is needed to test if interventions focused on public eating and drinking might decrease symptoms of both EDs and SAD. Researchers can use this study (code provided) as an exemplar for how to use network analysis, as well as to use network analysis to conceptualize ED comorbidity and compare network structure and density across samples.

D-cycloserine is associated with a small augmentation effect on exposure-based therapy. This effect is not moderated by the concurrent use of antidepressants. Further research is needed to identify patient and/or therapy characteristics associated with DCS response.

Eating disorders (EDs) and post-traumatic stress disorder (PTSD) are highly comorbid. However, specific mechanisms by which PTSD-ED comorbidity is maintained are unknown. The current study constructed two PTSD-ED comorbidity networks (25 EDs and 17 PTSD symptoms) in two samples: a clinical (N = 158 individuals with an ED diagnosis) and a nonclinical sample (N = 300 college students). Glasso networks were constructed to identify (1) pathways between disorders (bridge symptoms) and (2) core symptoms. Three illness pathways emerged: between binge eating and irritability, between desire for a flat stomach and disturbing dreams, and between concentration problems and weight and shape-related concentration problems. Our findings suggest that pathways between binge eating and irritability, body dissatisfaction and trauma reminders, and concentration difficulties may be the mechanisms by which comorbidity is maintained. Interventions disrupting these pathways and targeting core and bridge symptoms may be more efficient than traditional treatment approaches.

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Interoceptive awareness (IA), or the awareness of internal body states, is known to be impaired in individuals with eating disorders (EDs); however, little is understood about how IA and ED symptoms are connected. Network analysis is a statistical approach useful for examining how symptoms interrelate and how comorbidities may be maintained. The present study used network analysis to (1) test central symptoms within an IA–ED network, (2) identify symptoms that may bridge the association between IA and ED symptoms, and (3) explore whether central and bridge symptoms predict ED remission at discharge from intensive treatment. A regularized partial correlation network was estimated in a sample of 428 adolescent (n = 187) and adult (n = 241) ED patients in a partial hospital program. IA was assessed using items from the Multidimensional Assessment of Interoceptive Awareness, and ED symptoms were assessed using items from the Eating Disorder Examination–Questionnaire. Central symptoms within the network were strong desire to lose weight, feeling guilty, and listening for information from the body about emotional state. The most central symptom bridging IA and ED symptoms was (not) feeling safe in one’s body. Of the central symptoms, greater desire to lose weight predicted lower likelihood of remission at treatment discharge. Bridge symptoms did not significantly predict remission. Body mistrust may be a mechanism by which associations between IA and EDs are maintained. Findings suggest targeting central and bridge symptoms may be helpful to improve IA and ED symptoms.

Eating disorders (EDs) often develop during adolescence and early adulthood but may persist, arise, or reemerge across the life span. Research and treatment efforts primarily focus on adolescent and young adult populations, leaving large knowledge gaps regarding ED symptoms across the entire developmental spectrum. The current study uses network analysis to compare central symptoms (i.e., symptoms that are highly connected to other symptoms) and symptom pathways (i.e., relations among symptoms) across five developmental stages (early adolescence, late adolescence, young adulthood, early-middle adulthood, middle-late adulthood) in a large sample of individuals with EDs (N = 29,902; N = 32,219) in two network models. Several symptoms related to overeating, food avoidance, feeling full, and overvaluation of weight and shape emerged as central in most or all developmental stages, suggesting that some core symptoms remain central across development. Despite similarities in central symptoms, significant differences in network structure (i.e., how symptom pathways are connected) emerged across age groups. These differences suggest that symptom interconnectivity (but not symptom severity) might increase across development. Future research should continue to investigate developmental symptom differences in order to inform treatment for individuals with EDs of all ages.

It is well established that social anxiety (SA) has a positive relationship with neuroticism and a negative relationship with extraversion. However, findings on the relationships between SA and agreeableness, conscientiousness, and openness to experience are mixed. In regard to facet-level personality traits, SA is negatively correlated with trust (a facet of agreeableness) and self-efficacy (a facet of conscientiousness). No research has examined interactions among the Big Five personality traits (e.g., extraversion) and facet levels of personality in relation to SA. In two studies using undergraduate samples (N = 502; N = 698), we examined the relationships between trust, self-efficacy, the Big Five, and SA. SA correlated positively with neuroticism, negatively with extraversion, and had weaker relationships with agreeableness, openness, and trust. In linear regression predicting SA, there was a significant interaction between trust and openness over and above gender. In addition to supporting previous research on SA and the Big Five, we found that openness is related to SA for individuals low in trust. Our results suggest that high openness may protect against the higher SA levels associated with low trust.

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