Category: Child / Adolescent - Anxiety

PS11- #B47 - Social Anxiety as a Predictor of Disordered Eating Symptom Severity

Saturday, Nov 18
12:15 PM – 1:15 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Child Anxiety | Comorbidity | Eating Disorders

Background: Extant studies support conceptual overlap between nosological aspects of Social Anxiety Disorder (SAD) and Eating Disorders (ED) potentially due to cognitive and behavioral links between them (Fang & Hofmann, 2010). More specifically, levels of social anxiety (SA) are elevated in patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) as concerns regarding an individual’s physical appearance correlates to symptoms of SAD (Fang & Hofmann, 2010). While comorbidity of SAD with other mental disorders is associated with poorer functional outcomes (Dalrymple & Zimmerman, 2007), the complexity of the associations among SAD and EDs have yet to be investigated. Thus, this study examines the role of SA when accompanying EDs and examines if compounded presence indicates increased symptom severity and decreased quality of life.



Methods:
This study included 69 treatment seeking children and adolescents (µ=14.6), who endorsed symptoms of AN or BN. ED symptoms were assessed using the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS), Eating Disorder Examination Questionnaire (EDE-Q), and Body Checking Questionnaire (BC-Q). SA was assessed using the Liebowitz Social Anxiety Scale (LSAS), and was examined as a predictor for increased ED severity and overall quality of life using the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (P-QLES).



Results:
Linear regressions were calculated to predict ED severity based on LSAS severity. Results revealed a significant regression for the EDE-Q (F(1,89)=33.44, p<.00; β=.53), BC-Q (F(1,90)=34.96, p<.00; β=.53), YBC-EDS-P (F(1,71)=20.16, p<.00; β=.47), and YBC-EDS-R (F(1,71)=31.81, p<.00; β=.56). When comparing the predictive strength of LSAS severity onto AN and BN independently, results revealed LSAS severity as a significant predictor of severity on the EDE-Q (F(1,45)=25.46, p<.00; β=.53), BC-Q (F(1,45)=26.76, p < .00; β=.62), and YBC-EDS P (F(1,35)=12.31, p=.001; β=.52) for patients with AN but not for those with BN. Lastly, results of a linear regression revealed that presence of an ED and meeting clinical cutoff on the LSAS (≥30) was significant in predicting lower P-QLES (R2Adj=.174; F(1,58)=13.25, p=.001; β=-.43).



Conclusion:
This study extends current research in that compounded presence of ED and clinical levels of SA indicate lower quality of life. However, this study contributes a unique perspective on the significant predictive ability of SA on AN, but not BN severity. Clinically, it is worthy to consider SA as a potential barrier to treatment for those with AN and to adjust treatment plans accordingly. Furthermore, these data have implications for the examination of nosological differences between AN and BN and how compounded presence of SA may exacerbate symptom severity.

Thien-An Le

Clinical Psycholog Ph.D Candidate
University of Central Florida
Orlando, Florida

Brian Kay

Rogers Behavioral Health

Joshua Nadeau

Rogers Behavioral Health

Eric A. Storch

Professor, College Of Medicine Pediatrics
University of South Florida; Rogers Behavioral Health – Tampa; Johns Hopkins All Children’s Hospital
St. Petersburg, Florida