The Mediating Role of Emotional Distress in The Relationship Between Differentiation of Self and The Risk of Eating Disorders Among Young Adults

Abstract

Background: The prevalence of eating disorders (EDs) is on the rise among male and female young adults. Given that most studies have focused on adolescents, and that there is a lack of research regarding EDs among young adults, the current study aimed to examine this age group. In addition, based on findings indicating that emotional distress may increase the risk of EDs, and that it is associated with differentiation of self (DoS), the main goal of the current study was to investigate whether emotional distress mediates the relationship between DoS (emotional reactivity, I-position, emotional cut-off, fusion with others) and the risk of EDs. Methods: A sample of 421 non-clinical participants was recruited to fill-out questionnaires. Preliminary analyses examined differences between males and females using t-tests. In addition, Pearson correlations were run to examine the association between background variables and the study metrics among both males and females. Due to a gender moderation effect, two mediation models were examined, one for women and one for men, using path analysis. Results: Young adult women reported higher levels of risk for developing EDs than young adult men. Among women, emotional distress mediated the relationship between three metrics of DoS (emotional reactivity, I-position, fusion with others) and three metrics of EDs (drive for thinness, bulimic tendencies, and body dissatisfaction). Among men, similar associations were found, except for fusion with others which was not found to be associated with emotional distress. Conclusions: It is concluded that DoS may increase the risk of EDs through the mediation of emotional distress. It appears that people with a high risk of EDs have difficulties maintaining intimate relationships. When they feel overwhelmed, they rarely share their feelings and stick to their thoughts. The results are consistent with Kerr and Bowen’s Family Systems Theory that suggests that DoS dimensions rooted in early family experiences impact one's mental and physical health.Trial registration: Retrospectively registered.

Personality and Family Risk Factors for Poor Mental Well-Being

“…Empirically, low DoS has been found to reinforce the false self, increase anxiety [5], correlate with physiological symptoms [6], and impact physical health [6,7]. It has also been shown to hinder the individual's ability to deal positively with important tasks and stressful events and to regulate emotions [8,9].…”

Adolescents at risk of eating disorders: The mediating role of emotional distress in the relationship between differentiation of self and eating disorders

“…), whereas, for boys, it is likely that mainly emotional distress increases preoccupation with eating behaviors. The importance of this finding among adolescents emerged in light of a recent study conducted among young adults, which revealed that of the indices, perfectionism was the only one that was not found to be related to EDs or DoS ( Peleg et al, 2022 ). Adolescents likely turn to perfectionism because they are in the process of shaping and strengthening self-identity and self-confidence.…”

“…Hence, it is essential to examine its mediating role between the two variables of DoS and the risk of EDs. Thus, for example, in a recent study conducted among young adults ( Peleg et al, 2022 ), emotional distress was found to mediate the relationship between DoS and the risk of EDs and specifically, between I-position and the risk of EDs, showing that a low level of I-position indicates a tendency to avoid direct communication in interpersonal relationships. This leads to increased psychological distress, which may, in turn, increase predisposition to EDs.…”

“…Indeed, it was demonstrated that low levels of DoS are associated with high levels of anxiety in adolescents ( Peleg et al, 2015 ), depression ( Choi and Murdock, 2017 ), problematic coping styles, stress, physical health problems ( Hooper and Doehler, 2011 ) and EDs ( Peleg et al, 2022 ). Thus, for example, Doba et al (2018) found in a sample of adolescents that low DoS may lead to distortions in self-perception, channel emotions into excessive eating or extreme weight gain, and increase pathologies aimed at improving body image.…”

“…It has been suggested that emotional distress may increase the risk of EDs, but this depends on certain family indices (e.g., Peleg et al, 2022 ). Hence, it is essential to examine its mediating role between the two variables of DoS and the risk of EDs.…”