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. 2018 Feb;127(2):251-264.
doi: 10.1037/abn0000327.

Network Analysis of Pediatric Eating Disorder Symptoms in a Treatment-Seeking, Transdiagnostic Sample

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Free PMC article

Network Analysis of Pediatric Eating Disorder Symptoms in a Treatment-Seeking, Transdiagnostic Sample

Andrea B Goldschmidt et al. J Abnorm Psychol. .
Free PMC article

Abstract

Classifying eating disorders in youth is challenging in light of developmental considerations and high rates of diagnostic migration. Understanding the transactional relationships among eating disorder symptoms, both across the transdiagnostic spectrum and within specific diagnostic categories, may clarify which core eating disorder symptoms contribute to, and maintain, eating-related psychopathology in youth. We utilized network analysis to investigate interrelationships among eating disorder symptoms in 636 treatment-seeking children and adolescents (90.3% female) ages 6-18 years (M age = 15.4 ± 2.2). An undirected, weighted network of eating disorder symptoms was created using behavioral and attitudinal items from the Eating Disorder Examination. Across diagnostic groups, symptoms reflecting appearance-related concerns (e.g., dissatisfaction with shape and weight) and dietary restraint (e.g., a desire to have an empty stomach) were most strongly associated with other eating disorder symptoms in the network. Binge eating and compensatory behaviors (e.g., self-induced vomiting) were strongly connected to one another but not to other symptoms in the network. Network connectivity was similar across anorexia nervosa, bulimia nervosa, and otherwise specified feeding or eating disorder subgroups. Among treatment-seeking children and adolescents, dietary restraint and shape- and weight-related concerns appear to play key roles in the psychopathology of eating disorders, supporting cognitive-behavioral theories of onset and maintenance. Similarities across diagnostic categories provide support for a transdiagnostic classification scheme. Clinical interventions should seek to disrupt these symptoms early in treatment to achieve maximal outcomes. (PsycINFO Database Record

Figures

Figure 1
Figure 1
Eating disorder symptom network in a transdiagnostic sample. Note: Each node represents an item on the Eating Disorder Examination,1 and each link represents the zero-order correlation between each pair of items. Solid links indicate positive correlations, and dashed links indicate negative correlations. The thickness of a link represents the magnitude of the correlation.
Figure 2
Figure 2
Centrality measures for eating disorder psychopathology network in the full sample Note: See Footnote 1 for Eating Disorder Examination item (i.e., node) abbreviations.
Figure 3
Figure 3
Average correlations between centrality indices of networks sampled with persons dropped and the original sample. Note: Lines indicate the means and areas indicate the range from the 2.5th quantile to the 97.5th quantile.
Figure 4
Figure 4
Eating disorder symptom network within individuals with anorexia nervosa. Note: Each node represents an item on the Eating Disorder Examination,1 and each link represents the zero-order correlation between each pair of items. The thickness of a link represents the magnitude of the correlation.
Figure 5
Figure 5
Centrality measures for eating disorder psychopathology network in participants with anorexia nervosa Note: See Footnote 1 for Eating Disorder Examination item (i.e., node) abbreviations.
Figure 6
Figure 6
Eating disorder symptom network within individuals with bulimia nervosa. Note: Each node represents an item on the Eating Disorder Examination,1 and each link represents the zero-order correlation between each pair of items. Solid links indicate positive correlations, and dashed links indicate negative correlations. The thickness of a link represents the magnitude of the correlation.
Figure 7
Figure 7
Centrality measures for eating disorder psychopathology network in participants with bulimia nervosa Note: See Footnote 1 for Eating Disorder Examination item (i.e., node) abbreviations.
Figure 8
Figure 8
Eating disorder symptom network within individuals with otherwise specified feeding or eating disorder. Note: Each node represents an item on the Eating Disorder Examination (EDE),1 and each link represents the zero-order correlation between each pair of items. The thickness of a link represents the magnitude of the correlation.
Figure 9
Figure 9
Centrality measures for eating disorder psychopathology network in participants with otherwise specified feeding or eating disorder Note: See Footnote 1 for Eating Disorder Examination item (i.e., node) abbreviations.

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