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Eating disorder and social anxiety symptoms in Iranian preadolescents: a network analysis

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

Network studies of eating disorder (ED) symptoms have identified central and bridge symptoms in Western samples, yet few network models of ED symptoms have been tested in non-Western samples, especially among preadolescents. The current study tested a network model of ED symptoms in Iranian preadolescents (ages 9 to 13), as well as a model of co-occurring social anxiety disorder (SAD) and ED symptoms.

Method

Preadolescent boys (n = 405) and girls (n = 325) completed the Children Eating Attitudes Test-20 and Social Anxiety Scale for Children. We estimated two network models (ED and ED/SAD networks) and identified central and bridge symptoms, as well as tested if these models differed by sex.

Results

We found that discomfort eating sweets were the most central symptoms in ED networks. Concern over being judged was central in networks including both ED and SAD symptoms. Additionally, concern over being judged was the strongest bridge symptoms. Networks did not differ by sex.

Conclusion

Future research is needed to test if interventions focused on bridge symptoms (i.e., concern over being judged) as primary intervention points target comorbid ED-SAD pathology in preadolescents at risk for ED and SAD.

Level of evidence

Level III; Evidence obtained from well-designed observational study, including case–control design for relevant aspects of the study.

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Data availability

The data that support the findings of this study are available on request from the first author.

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Acknowledgements

We thank the preadolescents who participated in the study, the teachers and principals of the schools.

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Authors and Affiliations

  1. Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran

    Reza N. Sahlan

  2. Department of Psychological and Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA

    Ani C. Keshishian, Caroline Christian & Cheri A. Levinson

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  1. Reza N. Sahlan
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  2. Ani C. Keshishian
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  3. Caroline Christian
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  4. Cheri A. Levinson
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Correspondence to Cheri A. Levinson.

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This study attained Institutional Review Board approval and complied with all ethical guidelines by the Iran University of Medical Sciences.

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Informed consent was obtained from all individual participants included in the study.

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All procedures performed in studies 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.

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Sahlan, R.N., Keshishian, A.C., Christian, C. et al. Eating disorder and social anxiety symptoms in Iranian preadolescents: a network analysis. Eat Weight Disord 27, 1855–1867 (2022). https://doi.org/10.1007/s40519-021-01329-8

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  • DOI: https://doi.org/10.1007/s40519-021-01329-8

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