Eating Disorder Symptomatology and Self-Concept in Late Childhood and Early Adolescence: A Cross-Lagged Longitudinal Approach

Abstract

The present study examined the longitudinal associations and directionality of effects between self-concept and eating disorder symptoms in late childhood and early adolescence. A total of 380 participants (Time 1: 52.2% female; M_age = 9.97 years, SD = 0.84, range = 8–12 years) completed self-report questionnaires annually for 3 years. Cross-lagged panel models were used to examine the associations over time between global and domain-specific self-concept (i.e., physical appearance, scholastic competence, athletic competence, social acceptance and behavioral conduct) and eating disorder symptoms. The findings revealed that lower global self-concept and appearance-related self-concept predicted higher eating disorder symptoms over time, and vice versa. Eating disorder symptoms also negatively predicted scholastic competence and behavioral conduct over time. These results underscore the developmental interplay between self-concept and eating disorder symptoms, highlighting the importance of early self-concept interventions to prevent eating disorder symptomatology in children transitioning to adolescence.

Keywords

self-concept eating disorder symptoms longitudinal cross-lagged

Get full access to this article

View all access options for this article.

References

Altay

Törüner

E. K.

Akgün-Çıtak

(2020). Determine the BMI levels, self-concept and healthy life behaviours of children during a school based obesity training programme. AIMS Public Health, 7(3), 535–547. https://doi.org/10.3934/publichealth.2020043

Bardone-Cone

A. M.

Schaefer

L. M.

Maldonado

C. R.

Fitzsimmons

E. E.

Harney

M. B.

Lawson

M. A.

Robinson

D. P.

Tosh

Smith

(2010). Aspects of self-concept and eating disorder recovery: What does the sense of self look like when an individual recovers from an eating disorder? Journal of Social and Clinical Psychology, 29(7), 821–846. https://doi.org/10.1521/jscp.2010.29.7.821

Batista

Antić

L. Ž.

Žaja

Jakovina

Begovac

(2018). Predictors of eating disorder risk in anorexia nervosa adolescents. Acta Clinica Croatica, 57(3), 399–410. https://doi.org/10.20471/acc.2018.57.03.01

Beckers

Burk

W. J.

Larsen

J. K.

Cillessen

A. H.

(2024). The bidirectional associations between self‐esteem and problematic eating behaviors in adolescents. International Journal of Eating Disorders, 57(1), 104–115. https://doi.org/10.1002/eat.24083

Benninger

Savahl

(2017). A systematic review of children’s construction of the self: Implications for children’s subjective well-being. Child Indicators Research, 10(2), 545–569. https://doi.org/10.1007/s12187-016-9382-2

Blakemore

S.-J.

(2008). Development of the social brain during adolescence. Quarterly Journal of Experimental Psychology, 61(1), 40–49. https://doi.org/10.1080/17470210701508715

Brechan

Kvalem

I. L.

(2015). Relationship between body dissatisfaction and disordered eating: Mediating role of self-esteem and depression. Eating Behaviors, 17, 49–58. https://doi.org/10.1016/j.eatbeh.2014.12.008

Brown

G. L.

Mangelsdorf

S. C.

Neff

Schoppe-Sullivan

S. J.

Frosch

C. A.

(2009). Young children’s self-concepts: Associations with child temperament, mothers’ and fathers’ parenting, and triadic family interaction. Merrill-Palmer Quarterly, 55(2), 184–216. https://doi.org/10.1353/mpq.0.0019

Brown

T. A.

(2015). Confirmatory factor analysis for applied research. Guilford Publications.

10.

Buelens

Luyckx

Gandhi

Kiekens

Claes

(2019). Non-suicidal self-injury in adolescence: Longitudinal associations with psychological distress and rumination. Journal of Abnormal Child Psychology, 47(9), 1569–1581. https://doi.org/10.1007/s10802-019-00531-8

11.

Campbell

J. D.

Assanand

Paula

A. D.

(2003). The structure of the self‐concept and its relation to psychological adjustment. Journal of Personality, 71(1), 115–140. https://doi.org/10.1111/1467-6494.t01-1-00002

12.

Chen

F. F.

(2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14(3), 464–504. https://doi.org/10.1080/10705510701301834

13.

Claes

Simons

Vandereycken

(2009). Self-concept disturbances in eating-disordered female students compared to normal controls. In Ayres

(Ed.), Anxiety in college students (pp. 1–11). Nova Science Publishers.

14.

Colmsee

I.-S. O.

Hank

Bošnjak

(2021). Low self-esteem as a risk factor for eating disorders. Zeitschrift für Psychologie, 229(1), 48–69. https://doi.org/10.1027/2151-2604/a000433

15.

Crone

E. A.

van Drunen

(2024). Development of self-concept in childhood and adolescence: How neuroscience can inform theory and vice versa. Human Development, 68(5-6), 255–271. https://doi.org/10.1159/000539844

16.

Dalle Grave

Sartirana

Calugi

(2021). Enhanced Cognitive Behaviour Therapy for Eating Disorders. In Complex Cases and Comorbidity in Eating Disorders (pp. 29–46). Springer International Publishing. https://doi.org/10.1007/978-3-030-69341-1_3

17.

Dapp

L. C.

Roebers

(2018). Self-concept in kindergarten and first grade children: A longitudinal study on structure, development, and relation to achievement. Psychology, 9(7), 1605–1629. https://doi.org/10.4236/psych.2018.97097

18.

Decaluwé

Braet

(1999). Child eating disorder examination-questionnaire. Dutch translation and adaptation of the eating disorder examination-questionnaire, authored by CG Fairburn & SJ Beglin (Unpublished manuscript). Faculty of Psychology and Educational Sciences, Ghent University.

19.

Enders

C. K.

Bandalos

D. L.

(2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling: A Multidisciplinary Journal, 8(3), 430–457. https://doi.org/10.1207/s15328007sem0803_5

20.

Fairburn

C. G.

Cooper

Shafran

(2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509–528. https://doi.org/10.1016/S0005-7967(02)00088-8

21.

Favaro

Caregaro

Tenconi

Bosello

Santonastaso

(2009). Time trends in age at onset of anorexia nervosa and bulimia nervosa. The Journal of Clinical Psychiatry, 70(12), 21711–21721. https://doi.org/10.4088/JCP.09m05176blu

22.

Galmiche

Déchelotte

Lambert

Tavolacci

M. P.

(2019). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402–1413. https://doi.org/10.1093/ajcn/nqy342

23.

Gelman

Hill

(2006). Data analysis using regression and multilevel/hierarchical models. Cambridge University Press.

24.

Goossens

Braet

(2010). Screening for eating pathology in the pediatric field. International Journal of Pediatric Obesity, 5(6), 483–490. https://doi.org/10.3109/17477160903571995

25.

Goossens

Van Durme

Naeye

Verbeken

Bosmans

(2019). Insecure attachment moderates the association between thin internalization and girls’ eating concerns. Journal of Child and Family Studies, 28(11), 3183–3192. https://doi.org/10.1007/s10826-019-01494-6

26.

Grau

Magallón-Neri

Faus

Feixas

(2019). Cognitive impairment in eating disorder patients of short and long-term duration: A case–control study. Neuropsychiatric Disease and Treatment, 15, 1329–1341. https://doi.org/10.2147/NDT.S199927

27.

Grilo

C. M.

Udo

(2021). Examining the significance of age of onset in persons with lifetime anorexia nervosa: Comparing child, adolescent, and emerging adult onsets in nationally representative US study. International Journal of Eating Disorders, 54(9), 1632–1640. https://doi.org/10.1002/eat.23580

28.

Harter

(2008). The developing self.

29.

Harter

(2012). Emerging self-processes during childhood and adolescence. In Tangney

M. R. L. J. P.

(Ed.), Handbook of self and identity (2nd ed., pp. 680–715). Guilford Publications.

30.

Ibrahim

J. G.

Molenberghs

(2009). Missing data methods in longitudinal studies: A review. Test, 18(1), 1–43. https://doi.org/10.1007/s11749-009-0138-x

31.

Kelly

P. J.

(2022). Examining mediators of the relation between self-concept clarity and body dissatisfaction and disordered eating, (Undergraduate honors thesis, The University of North Carolina at Chapel Hill).

32.

Keski-Rahkonen

Mustelin

(2016). Epidemiology of eating disorders in Europe: Prevalence, incidence, comorbidity, course, consequences, and risk factors. Current Opinion in Psychiatry, 29(6), 340–345. https://doi.org/10.1097/YCO.0000000000000278

33.

Kline

R. B.

(2015). Principles and practice of structural equation modeling. Guilford Publications.

34.

Lantz Lesser

Smith

K. E.

Strauman

T. J.

Crosby

R. D.

Engel

S. G.

Crow

S. J.

Peterson

C. B.

Wonderlich

S. A.

(2021). Relationships between nonappearance self-discrepancy, weight discrepancy, and binge eating disorder symptoms. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 26(5), 1571–1580. https://doi.org/10.1007/s40519-020-00975-8

35.

Lavender

J. M.

Wonderlich

S. A.

Engel

S. G.

Gordon

K. H.

Kaye

W. H.

Mitchell

J. E.

(2015). Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clinical Psychology Review, 40, 111–122. https://doi.org/10.1016/j.cpr.2015.05.010

36.

Little

R. J.

(1988). A test of missing completely at random for multivariate data with missing values. Journal of the American statistical Association, 83(404), 1198–1202.

37.

López-Gil

J. F.

García-Hermoso

Smith

Firth

Trott

Mesas

A. E.

Jiménez-López

Gutiérrez-Espinoza

Tárraga-López

P. J.

Victoria-Montesinos

(2023). Global proportion of disordered eating in children and adolescents: A systematic review and meta-analysis. JAMA Pediatrics, 177(4), 363–372. https://doi.org/10.1001/jamapediatrics.2022.5848

38.

McLean

S. A.

Wertheim

E. H.

Masters

Paxton

S. J.

(2017). A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders. International Journal of Eating Disorders, 50(7), 847–851. https://doi.org/10.1002/eat.22708

39.

Morales

Rodríguez‐Menchón

Espada

J. P.

Orgilés

(2023). Examining academic self‐concept as a mediator of the relationship between anxiety and depression: A longitudinal study. Child and Adolescent Mental Health, 28(3), 354–362. https://doi.org/10.1111/camh.12577

40.

Moreira

Saraiva

(2018). Self-concept and disturbed eating behavior in a clinical population of adolescents with eating disorders. Nascer e Crescer-Birth and Growth Medical Journal, 27(2), 93–97. https://doi.org/10.25753/BirthGrowthMJ.v27.i2.13170

41.

Muris

Meesters

Fijen

(2003). The self-perception profile for children: Further evidence for its factor structure, reliability, and validity. Personality and Individual Differences, 35(8), 1791–1802. https://doi.org/10.1016/S0191-8869(03)00004-7

42.

Neumark-Sztainer

Wall

Guo

Story

Haines

Eisenberg

(2006). Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: How do dieters fare 5 years later? Journal of the American Dietetic Association, 106(4), 559–568. https://doi.org/10.1016/j.jada.2006.01.003

43.

Pennesi

J.-L.

Wade

T. D.

(2016). A systematic review of the existing models of disordered eating: Do they inform the development of effective interventions? Clinical Psychology Review, 43, 175–192. https://doi.org/10.1016/j.cpr.2015.12.004

44.

Pfeifer

J. H.

Peake

S. J.

(2012). Self-development: Integrating cognitive, socioemotional, and neuroimaging perspectives. Developmental Cognitive Neuroscience, 2(1), 55–69. https://doi.org/10.1016/j.dcn.2011.07.012

45.

Raemen

Claes

Buelens

Vankerckhoven

Van Oudenhove

Luyckx

(2023). Personal identity, somatic symptoms, and symptom-related thoughts, feelings, and behaviors in adolescence: Examining between-and within-person associations and the role of depressive symptoms. Journal of Youth and Adolescence, 52(9), 1–17. https://doi.org/10.1007/s10964-023-01811-9

46.

Ram

J. R.

Shelke

S. B.

(2023). Understanding eating disorders in children and adolescent population. Journal of Indian Association for Child and Adolescent Mental Health, 19(1), 60–69. https://doi.org/10.1177/09731342231179267

47.

Rosseel

(2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. https://doi.org/10.18637/jss.v048.i02

48.

Serpell

Troop

(2003). Psychological factors. In Handbook of eating disorders (pp. 151–167). John Wiley & Sons.

49.

Sesker

A. A.

Strickhouser

J. E.

Luchetti

Lee

J. H.

Aschwanden

Terracciano

Sutin

A. R.

(2021). Cognition and the development of temperament from late childhood to early adolescence. Journal of Research in Personality, 95, Article 104163. https://doi.org/10.1016/j.jrp.2021.104163

50.

Sharpe

Griffiths

Choo

T. H.

Eisenberg

M. E.

Mitchison

Wall

Neumark‐Sztainer

(2018). The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. International Journal of Eating Disorders, 51(10), 1168–1175. https://doi.org/10.1002/eat.22936

51.

Simone

Telke

Anderson

L. M.

Eisenberg

Neumark-Sztainer

(2022). Ethnic/racial and gender differences in disordered eating behavior prevalence trajectories among women and men from adolescence into adulthood. Social Science & Medicine, 294, Article 114720. https://doi.org/10.1016/j.socscimed.2022.114720

52.

Smith

K. E.

Mason

T. B.

Juarascio

Schaefer

L. M.

Crosby

R. D.

Engel

S. G.

Wonderlich

S. A.

(2019). Moving beyond self‐report data collection in the natural environment: A review of the past and future directions for ambulatory assessment in eating disorders. International Journal of Eating Disorders, 52(10), 1157–1175. https://doi.org/10.1002/eat.23124

53.

Stice

Marti

C. N.

Rohde

(2013). Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. Journal of Abnormal Psychology, 122(2), 445–457. https://doi.org/10.1037/a0030679

54.

Tang

Brummelman

Novin

Assink

Thomaes

(2023). Children’s domain-specific self-evaluations and global self-worth: A preregistered cross-cultural meta-analysis. International Journal of Behavioral Development, 47(6), 521–539. https://doi.org/10.1177/01650254231190926

55.

van der Cruijsen

Blankenstein

N. E.

Spaans

J. P.

Peters

Crone

E. A.

(2023). Longitudinal self-concept development in adolescence. Social Cognitive and Affective Neuroscience, 18(1), Article nsac062. https://doi.org/10.1093/scan/nsac062

56.

Van Durme

Braet

Goossens

(2015). Insecure attachment and eating pathology in early adolescence: Role of emotion regulation. The Journal of Early Adolescence, 35(1), 54–78. https://doi.org/10.1177/0272431614523130

57.

Vartanian

L. R.

Froreich

F. V.

Smyth

J. M.

(2016). A serial mediation model testing early adversity, self-concept clarity, and thin-ideal internalization as predictors of body dissatisfaction. Body Image, 19, 98–103. https://doi.org/10.1016/j.bodyim.2016.08.013

58.

Veerman

J. W.

Straathof

M. A. E.

Treffers

P. D. A.

Van den Bergh

B. R. H.

Ten Brink

L. T.

(1997). Competentiebelevingsschaal voor kinderen (CBSK). Swets en Zeitlinger.

59.

Verschueren

Claes

Palmeroni

Raemen

Moons

Bruckers

Molenberghs

Dierckx

Schoevaerts

Luyckx

(2024). Identity functioning in patients with an eating disorder: Developmental trajectories throughout treatment. Nutrients, 16(5), Article 591. https://doi.org/10.3390/nu16050591

60.

Watson

H. J.

Joyce

French

Willan

Kane

R. T.

Tanner‐Smith

E. E.

McCormack

Dawkins

Hoiles

K. J.

Egan

S. J.

(2016). Prevention of eating disorders: A systematic review of randomized, controlled trials. International Journal of Eating Disorders, 49(9), 833–862. https://doi.org/10.1002/eat.22577