Eating Disorder Symptomatology and Identity Formation in Adolescence: A Cross-Lagged Longitudinal Approach

Abstract

Introduction: Eating disorder symptomatology, comprising both psychological and behavioral aspects of subclinical eating concerns, constitutes a clear precursor of developing eating disorders. It is crucial to investigate its antecedents and correlates to subsequently inform eating disorder prevention programs. The present study focused on identity formation, a core developmental task in adolescence, that has increasingly been linked to eating disorder development. Our main aim was to examine the temporal sequence between eating disorder symptomatology and identity formation.Methods: Data on eating disorder symptomatology and identity formation were collected in 530 high school students (at Time 1: mean age = 15 years; SD = 1.84; range: 12–18 years; 50.6% females) using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modeling was performed to examine the directionality of effects.Results: Results indicated bidirectional effects between eating disorder symptomatology and identity formation. Identity confusion seemed to increase vulnerability to body dissatisfaction and bulimia symptoms, whereas identity synthesis seemed to protect against their development. Additionally, identity synthesis seemed to protect against the development of drive for thinness as well. At the same time, body dissatisfaction and bulimia symptoms positively predicted identity confusion and negatively predicted identity synthesis over time.Conclusion: The present study adds to the growing body of literature on identity and eating disorders by focusing on their temporal interplay in a community sample of adolescents. As bidirectional effects emerged, a greater emphasis on identity formation in eating disorder prevention programs is advocated.

Behavioral functions underlying NSSI and eating disorder behaviors

“…The body of literature demonstrating that gaining a sense of control and asserting one's independence from others underlie ED behaviors (e.g., Froreich et al, ) is congruent with the interpersonal boundaries function (e.g., “demonstrating I am separate from other people”) being rated as more salient to ED. Similarly, research suggests that individuals with ED often struggle with forming a cohesive sense of self and experience identity confusion (Verschueren et al, ). An ED diagnosis may provide the person with a sense of identity that distinguishes one from others; thus, reinforcing the autonomy function of the behavior.…”

Identity and Psychopathology: Bridging Developmental and Clinical Research

“…To examine such a bidirectional relationship, we conducted a 2-year, three-wave longitudinal study with a community sample of adolescents and emerging adults (Verschueren et al, 2018). Cross-lagged analyses indicated that identity confusion appeared to increase one's vulnerability to experience body dissatisfaction and display bulimia symptoms over time relative to the rest of the sample, whereas identity synthesis seemed to protect against the emergence of both.…”

“I’m truly free from my eating disorder”: Emerging adults’ experiences of FREED, an early intervention service model and care pathway for eating disorders

“…relationships; vocation; ideology) [ 50 ]. Furthermore, burgeoning research has identified the important interplay between ED aetiology /treatment response and ongoing developmental context, with concurrent identity development identified as particularly relevant [ 9 , 10 , 37 , 51 , 52 ].…”