The role of stress in the association between low self-esteem, perfectionism, and worry, and eating disorders

Int J Eat Disord. 2005 Mar;37(2):135-41. doi: 10.1002/eat.20079.


Objective: Several theorists have hypothesized that stressful situations may trigger abnormal eating and even eating disorders in predisposed people. The purpose of the current study was to assess whether a stressful situation would reveal an association between perfectionism, low self-esteem, worry, and body mass index (BMI) and measures of eating disorder symptoms in female high school students.

Method: A sample of 145 female high school students completed the Eating Disorder Inventory, the Multidimensional Perfectionism Scale, the Penn State Worry Questionnaire, and the Self Liking and Competence Scale three times--on an average school day, on the day of an examination, and on the day the subjects received the results of that examination. Linear regression analysis was performed to verify whether the dimensions of perfectionism were associated with the measures of eating disorders.

Results: Low self-esteem, worry, and parental criticism (a dimension of perfectionism) were associated with the measures of eating disorders only during the stressful situation, whereas concern over mistakes (another dimension of perfectionism) was associated in both stressful and nonstressful situations.

Discussion: The results suggest that in nonclinical female individuals, stress might bring out a previously absent association between some psychological predisposing factors for eating disorders and an actual desire or plan to lose weight. Such a finding suggests that stress may stimulate behaviors related to eating disorders in a predisposed personality.

MeSH terms

  • Body Mass Index
  • Feeding and Eating Disorders / diagnosis
  • Feeding and Eating Disorders / epidemiology*
  • Feeding and Eating Disorders / psychology*
  • Female
  • Humans
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology*
  • Personality Disorders / psychology*
  • Personality Inventory
  • Self Concept*
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / epidemiology
  • Stress, Psychological / diagnosis
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires