Archives of Women's Mental Health

, Volume 20, Issue 6, pp 721–731 | Cite as

Risk and maintenance factors for young women’s DSM-5 eating disorders

  • Antonios DakanalisEmail author
  • Massimo Clerici
  • Francesco Bartoli
  • Manuela Caslini
  • Cristina Crocamo
  • Giuseppe Riva
  • Giuseppe Carrà
Original Article


Recent research with young women attending colleges, who are at the average age of eating disorder (ED) onset, established that the ED symptoms are not only prevalent but also relatively stable over the college period. Nonetheless, our knowledge regarding the course and modifiable factors associated with both the onset and maintenance of diagnosable (DSM-5) EDs in this population is limited. The objective of this report was to address these key research gaps. Data were examined from 2713 women who completed assessments of potential vulnerability factors and EDs in the autumn semester of the first (baseline) and fourth (follow-up) college years. A total of 13.1% of the sample met DSM-5 criteria for an ED diagnosis at baseline. At 4-year follow-up, 7.6% of the sample met DSM-5 criteria for an ED, with 67.5% of these cases representing women who had maintained an ED diagnosis from baseline, and 32.5% representing new onset EDs. Elevated appearance-ideal internalization, body dissatisfaction, self-objectification, dieting, and negative affectivity at baseline as well as changes in these factors between assessments all predicted onset and maintenance of DSM-5 EDs at 4-year follow-up. Self-objectification (thinking about and monitoring the body’s appearance from an external observer’s perspective) was the largest contributor to both ED onset and maintenance. In addition to enhancing our knowledge about the course of young women’s (DSM-5) EDs during college, this work highlights potentially similar psychological foci for prevention and treatment efforts. Implications for improving existing preventive and treatment approaches are outlined.


Eating disorders Onset Maintenance Longitudinal study DSM-5 


Compliance with ethical standards

As mentioned in the methods and materials section, informed consent was obtained from all individual participants included in the study. All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards, and the study protocol was approved by the ethics review board (ID No: 2927/LG/010) of the co-ordinating body of the project (University of Pavia).

Conflict of interest

The authors declare that they have no conflicts of interest.

Financial support

This research received no specific grant from any funding agency, commercial or not for-profit sectors.


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Copyright information

© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  1. 1.Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
  2. 2.Department of Medicine and SurgeryUniversity of Milano BicoccaMonzaItaly
  3. 3.Department of PsychologyCatholic UniversityMilanItaly
  4. 4.Applied Technology for Neuro-Psychology LaboratoryIstituto Auxologico ItalianoMilanItaly
  5. 5.Division of Psychiatry, Faculty of Brain SciencesUniversity College of LondonLondonUK

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