Category: Child / Adolescent - Anxiety
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).
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 Storch– Professor, College Of Medicine Pediatrics, University of South Florida; Rogers Behavioral Health – Tampa; Johns Hopkins All Children’s Hospital, St. Petersburg, Florida
Clinical Psycholog Ph.D Candidate
University of Central Florida