Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 244: (i) New Book, Part 3; (ii) Sociocul Factors, Part 4 (n = 3); (iii) Binge Eating, Part 3 (n = 2); (iv) Recovery, Part 1 (n = 2); & (v) Nature, Course, & Correlates of EDs, Part 6 (n = 3)
Colleagues (N now = 1450 in 49 countries),
Please continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications, etc.
ONE/MAYBE TWO POST-DOCTORAL FELLOW POSITION(S)
at the
Eating Anxiety Treatment (EAT) lab
under the direction of our own Dr. Cheri Levinson (USA) in the Department of Psychological & Brain Sciences, University of Louisville (USA)
to work on (a) building a new precision treatment for eating disorders, and identifying how individual treatment mechanisms relate to public health outcomes, individual disease burden, medical comorbidities, and social determinants of health; and (b) implementation of a digital exposure intervention for eating disorders
Application deadline is rolling through May 1, 2026 with an
Expected start date sometime in the summer of 2026
Received via 6 March 2026,via an everything-is-advocacy email from our own distinguished scientist-practitioner-advocate Dr. Cheri Levinson (cheri.levinson@louisville.edu) at the University of Louisville, Founder and Director and the Louisville Center for Eating Disorders and of the Eating Anxiety Laboratory and Clinic (EAT Lab).
ML Note 1: Dr. Levinson, her colleagues, and I would appreciate it if you would pass this along to any and all people who might be interested and/or who work with and otherwise know people who might be interested.
Dr. Levinson, the Director of the Eating Anxiety Treatment (EAT) lab at the University of Louisville (UofL), is hiring one to two full-time post-doctoral fellows to work on two National Institute of Mental Health supported studies. The first study entails building a new precision treatment for eating disorders, and identifying how individual treatment mechanisms relate to public health outcomes, individual disease burden, medical comorbidities, and social determinants of health. The second study is focused on implementation of a digital exposure intervention for eating disorders.
This position will involve learning how to carry out personalized treatment trials, digital mental health clinical trials, working with clinical participants with eating disorders, supervising implementation and analysis of studies, assisting Dr. Levinson with training and supervising therapists to complete assessments and deliver the treatment protocol, conducting diagnostic assessments, working on grant proposals and publications, mentoring study coordinators and graduate and undergraduate students, assisting with data preparation and analysis, and working with a large interdisciplinary team at UofL. The post-doctoral fellow will work very closely with Dr. Levinson, other EAT lab faculty, and collaborators on a day-to-day basis.
Opportunities for involvement in grants, publications, and presentations at national conferences are plentiful. Teaching opportunities are available if desired. Opportunities for supervision toward licensure are also available. Additional clinical opportunities and supervision are also available. This position is renewable for up to three years and preference will be given to a post-doc who can commit to at least two years.
Minimum experience is a doctorate in psychology, engineering, computer science, or a related field. This post-doctoral fellowship will help propel the fellow into a tenure-track faculty position. More information about the lab here: www.louisvilleeatlab.com. To apply please send your CV, a cover letter, and three names of references to Dr. Levinson at cheri.levinson@louisville.edu. Application deadline is rolling through May 1, 2026 with an expected start date sometime in the summer of 2026, depending on fellow’s schedule.
FREE RECOVERY RESOURCE
Family App
Grounded in the principles of Family-Based Treatment (FBT) and built on the established Recovery Record platform
Supports Families, Caregivers, and Clinicians
Received February 5, 2026, via an everything-is-advocacy email from our own Dr. Allison Chase (USA), who has been a member of this Newsletter Group for well over 20 years.
ML NOTE 2: Dr. Chase and I would appreciate it if you would pass this along to any and all who might be interested in trying it out, as well as to anyone who works with or otherwise knows caregivers of people with eating disorders.
ML NOTE 3: In regard to the development of the Family App, distinguished scientist-practitioner-author-educator-mentor Dr. Daniel Le Grange (USA) is also a member of the Substack Newsletter Group.
[Dr. Chase writes:]
The Recovery Record Family App is a clinically informed tool designed to support caregivers of children and adolescents with eating disorders. It is grounded in the principles of Family-Based Treatment (FBT) and built on the established Recovery Record platform. It gives caregivers a simple, centralized place to log meals and behaviors, access practical skills and resources, and communicate with the treatment team. It helps reduce overwhelm and build confidence at home.
The app also supports clinicians by organizing between-session information, streamlining communication, and offering a boundary-supportive tool that makes day-to-day work more manageable. The Family App was developed in close collaboration with leading FBT experts, including Daniel Le Grange and James Lock, to ensure it aligns with both research and real-world clinical practice.
To try it out with a family in your care, invite them to install the free app on their iPhone or Android phone and link with your Recovery Record Clinician account. You can also share more about the resource with families by taking advantage of this shareable template email, short video and informational flyer.
A Brief Personal Perspective: I’ve worked in the eating disorder field for nearly 30 years across research, clinical care, and leadership roles, and one thing has remained clear: meaningful caregiver involvement is essential for better outcomes - yet is often hard to implement in real-world settings. Partnering with Recovery Record to build the Family App has allowed us to translate what the research supports into a practical, usable tool that strengthens caregiver engagement while also supporting clinicians in their day-to-day work.
Research Publication Categories in This Newsletter
(i) New Book: Handbook of Diversity in Body Image, Part 3; (ii) Sociocultural Factors, Part 4 (n = 3); (iii) Binge Eating, Part 3 (n = 2); (iv) Recovery, Part 1 (n = 2); and (v) Nature, Course, and Correlates of EDs, Part 6 (n = 3)
CONGRATULATIONS to our own
Dr. Andrea Wyssen (Switzerland) and colleagues for publication of the Sociocultural Factors research article in #3.
Drs. Erin Reilly (USA), Lisa Anderson (USA), and Lauren Schaefer (USA) and colleagues, including distinguished scientist-practitioner-mentor Dr. Stephen Wonderlich (USA), for publication of the Binge Eating research article in #6.
Drs. Cynthia Bulik (USA/Sweden), Tracey Wade (Australia), Carol Kan (England), Sevgi Bektas (Turkey), Fernando Fernández-Aranda (Catalonia/Spain), and Janet Treasure (England) and colleagues — including many (other) distinguished scientisti-practitioner-mentors such as Drs. Hubertus Himmerich (England), Howard Steiger (Canada), and Philip S. Mehler (USA; see also #11) — for publication of the Nature of Eating Disorders review article in #9.
Drs. Thomas Joiner (USA) and Renee Rienecke (USA) and colleagues, including distinguished scientist-practitioner-mentor Dr. Philip S. Mehler (USA), for publication of the Nature of Eating Disorders research article in #11.
And CONGRATULATIONS (!) Are Also in Order for a
NEW BOOK entitled
Handbook of Body Image Diversity
Edited by [our own] Dr. Viren Swami (England/Malayasia) and [our own] Dr. Tracy Tylka (USA)
Publication date: late February - early March 2026
— PART 3 of 3 —
ML NOTE 4: Many of the contributors to this unique handbook are members of this Newsletter Group. To acknowledge this and give credit to those contributors, the information below is the third of a 3-part series. Assume that, unless otherwise noted, all names in bold would be preceded by Dr.
1. Swami, V., & Tylka, T. L. (Eds.). (2026). Handbook of body image diversity. Academic Press [ISBN 978-0-443-32896-1, 418 pages ] https://doi.org/10.1016/C2023-0-52529-7
Publisher’s website: https://tinyurl.com/jts6z8da
Description at the publisher’s website: See the Newsletter of 3 March 2026 (NO. 242)
SECTION IV [DIVERSITIES IN LIFE EXPERIENCES]
Chapter 15 - Body image in childhood and adolescence, by Ella Guest and Ms. Mahira Budhraja (England), pp. 227-247
Chapter 16 - Body image in midlife and older individuals, by Rachel F. Rodgers (USA/France), Ms. Genevieve P. Nowicki (USA), and Ruthann C. Hewett, pp. 249-265
Chapter 17 - Body image in people with visible differences, by Maia Thornton (England) and Diana Harcourt (England), pp. 267-281
Chapter 18 - Body image in people with physical disabilities, by Aly Bailey (Canada), pp. 283-297
Chapter 20 - Body image in neurodivergent communities, by Phaedra Longhurst (England), pp. 325-338
Chapter 21 - Body image in higher-weight individuals, by Angela Meadows (England), pp. 339-357
SECTION V [DIVERSITIES IN BODY IMAGE PRACTICE]
Chapter 22 - Understanding diversity in body image practice, by Jennifer B. Webb (USA), pp. 361-381
SECTION VI [CONCLUSION]
Chapter 24 - Body image research and practice: Where we go from here, by Tracy L. Tylka (USA) and Viren Swami (England/Malaysia), pp. 399-409
SOCIOCULTURAL FACTORS, Part 4 of 4
2. Melisse, B., Gulec, H., & Sternheim, L. Understanding eating disorders in the Middle East: Body dissatisfaction and westernization in Saudi Arabia and Turkey. J Eat Disord 13, 284 (2025). https://doi.org/10.1186/s40337-025-01469-7
Full text available for download at: https://tinyurl.com/4kbkcmbk
ABSTRACT. Introduction: Body dissatisfaction is one of the maintaining factors of eating disorders and a well-known risk factor for their development. It was assumed that body dissatisfaction did not afflict non-Western countries. However, body dissatisfaction is reported in non-Western countries, and to what extent westernization is associated with body dissatisfaction and subsequent eating disorders is unknown. The purpose of the present study is to examine the association between Western acculturation and body dissatisfaction in Saudi Arabia and Turkey, and to determine the measurement invariance of the Body Shape Questionnaire.
Methods: The Body Shape Questionnaire and the adapted version of the Acculturation Rating Scale for Mexican–Americans II were administered to convenience samples in Saudi Arabia (n = 746) and Turkey (n = 363). A hierarchical multiple linear regression analysis was conducted with body dissatisfaction as the dependent variable and cultural orientation as the independent variable. Citizenship status, BMI, and sex were included as covariates. A multi-group CFA compared the item intercepts of the Body Shape Questionnaire in the two non-Western samples with a Dutch community sample (n = 1651).
Results: The Body Shape Questionnaire scores differed (p = 0.036) between individuals who had lived abroad in a Western country (M = 88.2, SD = 38.1) for at least six months and those who had not (M = 82.0, SD = 36.5). The BMI, but not cultural orientation, was associated with body dissatisfaction (B = 2.4, R = 0.4, R square = 0.18; p < 0.001). The multi-group CFA indicated that the Body Shape Questionnaire had a single-factor structure, and the item intercepts were similar across samples (CFI = 0.92; RMSEA = 0.059; RMSEA 90% CI 0.50-0.68; SRMR = 0.07).
Discussion: Future research should evaluate preventative programs targeting westernization-driven sedentary lifestyles. The Body Shape Questionnaire can be utilized across cultures and may help further the understanding of body dissatisfaction and eating disorders in the Middle East.
3. Tschitsaz, A., Schumacher, A. M., Lerch, S., Wyssen, A., Cavelti, M., Mürner-Lavanchy, I., Koenig, J., Kaess, M., & Schlensog-Schuster, F. (2025). Parental and peer Relationships and their impact on symptom severity in adolescent patients with anorexia nervosa. European Eating Disorders Review. Advance online publication. https://doi.org/10.1002/erv.70072.
Full text available for download at: https://tinyurl.com/y8wj53k7
ABSTRACT. Objective: Perceived parental relationship characteristics, such as maternal overprotection, rejection or neglect, and peer victimisation, are suggested to be more common in patients with anorexia nervosa (AN) than in healthy controls. This study compares parental and peer relationships in adolescent patients with AN to those in a clinical control group (CC; a matched group of patients with other mental disorders) and investigates their association with AN severity.
Method: Self-reported parental and peer relationships were compared between adolescents with AN (n = 43) and CC (n = 127), matched for age, sex and global functioning. Multiple linear and logistic regression were used to analyse the association between parental and peer relationships and AN severity.
Results: The AN group exhibited a more positive overall evaluation of parental relationships (b = 18.34, p = 0.002), particularly with fathers (b = 5.30, p = 0.028), fewer parental discrepancies (b = -7.67, p = 0.013), less peer victimisation (OR = 0.43, p = 0.030) and perpetration (OR = 0.26, p = 0.006) than the CC group. No significant associations were identified between these relationships and AN severity.
Conclusions: In contrast to previous studies comparing social relationships in patients with AN and healthy controls, our findings suggest that increased positive parental and peer relationships may serve as a resource, irrespective of symptom severity.
4. Cano-Estrada, E. A., Guerrero-Solano, J. A., Rodríguez-Moreno, R., López-Nolasco, B., Mendoza-Mojica, S. A., Razo-Blanco-Hernández, D. M., Orbe-Orihuela, Y. C., Sánchez-Velázquez, J. C. F., Ordoñez-Villordo, E., & Hernández-Mariano, J. Á. (2025). Association between nursing education and risk of eating behavior disorders among undergraduate students. Nursing Reports, 15, 433. https://doi.org/10.3390/nursrep15120433
Full text available for download at: https://tinyurl.com/jzh9jprs
ABSTRACT. Background/Objectives: Eating behavior disorders (EBDs) are a public health concern among undergraduate students. Evidence suggests that certain health-related academic environments may be associated with heightened psychological vulnerability. Hence, we aimed to evaluate the association between nursing education and the risk of EBDs and to assess whether self-esteem and anxiety mediate this relationship.
Methods: A cross-sectional analytical study was conducted between July and August 2023 among 433 undergraduate students from two public universities in Hidalgo, Mexico. The sample included 209 nursing students and 224 peers from non-health-related programs. Self-esteem, anxiety, and EBD risk were assessed using the Rosenberg Self-Esteem Scale, Hamilton Anxiety Rating Scale, and Eating Attitudes Test-26, respectively. Logistic regression and counterfactual mediation analyses were performed, adjusting for age, sex, family income, and year of study.
Results: Nursing students showed higher odds of low self-esteem (aOR = 1.64; 95% CI: 1.06–2.53), anxiety (aOR = 2.06; 95% CI: 1.25–3.37), and EBDs risk (aOR = 2.37; 95% CI: 1.37–4.09) compared with non-health peers. Mediation analyses revealed significant indirect effects through self-esteem (aOR = 1.20; 95% CI: 1.03–1.38) and anxiety (aOR = 1.14; 95% CI: 1.01–1.29).
Conclusions: Nursing education was independently associated with a higher risk of EBDs, with statistical mediation analyses indicating that differences in self-esteem and anxiety may help characterize this association. Self-esteem exerted a slightly stronger indirect effect, suggesting that negative self-evaluation may represent a more proximal psychological process rather than a causal determinant.
BINGE EATING, Part 3 of 4
5. Werle, D., Sablottny, L., Tuschen-Caffier, B., & Svaldi, J. (2026). Effects of cognitive load on food approach bias in individuals with binge eating disorder. Appetite, 219, 108434. https://doi.org/10.1016/j.appet.2025.108434
Full text available for download at: https://tinyurl.com/2tnkja2k
ABSTRACT. While the hierarchical model of approach-avoidance motivation suggests a heightened food-specific approach behavior for individuals with binge eating disorder (BED), empirical evidence does not confirm the postulated food approach bias. This discrepancy may be related to the studied samples, which were partially in treatment, but also to the fact that previous studies tested for an approach bias under low cognitive load. Therefore, the present study assessed the food-specific approach behavior in an untreated sample with BED under high and low cognitive load, in comparison to a weight-matched and a normal weight control group.
To this end, 50 individuals with BED, 20 individuals with overweight and 21 individuals with normal weight completed an approach avoidance task. In each trial, participants were instructed to either push or pull a slider device, dependent on the orientation of an arrow, which was superimposed on a picture. The underlying picture either depicted a high calorie food item or a neutral stimulus. Cognitive load was manipulated by two flanking arrows that either pointed in the same or the opposite direction to the task-relevant central arrow.
First, and contrary to our hypothesis, the food-specific approach bias was not stronger in the group with BED compared to both control groups. Post-hoc tests further revealed no food-specific approach bias in any of the three groups. Moreover, and contrary to our hypothesis, cognitive load did not show a group specific impact on the food approach behavior. However, cognitive load did increase the food approach behavior across groups. The results of this study, in conjunction with previous studies suggest, that there is no clear food approach bias in individuals with BED, at least when movement direction is not explicitly contingent on picture content.
6. Forester, G., Richson, B. N., Reilly, E. E., Anderson, L. M., Wonderlich, S. A., & Schaefer, L. M. (2026). Longitudinal analysis of decision-making deficits in binge-eating disorders using drift diffusion modeling. Appetite, 222. Advance online publication. https://doi.org/10.1016/j.appet.2026.108497
Email address for correspondence: forestergf@gmail.com
ABSTRACT. Individuals with binge-type eating disorders (binge-EDs) repeatedly engage in binge eating despite negative consequences, suggesting altered decision-making. However, the specific cognitive mechanisms underlying these alterations remain poorly understood. In this longitudinal study, we applied the drift diffusion model (DDM) – a computational approach that isolates core decision-making components – to examine how these components relate to binge-eating frequency over time. Ninety-five adults with binge-EDs (69% binge-eating disorder; 15% bulimia nervosa) completed a probabilistic reward task at baseline and 3-month follow-up, with binge-eating frequency assessed concurrently and at 6-month follow-up.
Results indicated that slower evidence accumulation (lower drift rate) consistently predicted greater binge-eating frequency both cross-sectionally (baseline p < .001; 3-month p = .018) and prospectively (6-month p < .001), highlighting impaired integration of decision-relevant information as a possible mechanism maintaining binge eating. A lower decision threshold, indicating less cautious decision-making, was cross-sectionally associated with greater binge-eating frequency (baseline p < .001) but did not predict symptoms over time (p-values >.552). In contrast, reward sensitivity (start bias) showed no significant relationship with binge-eating frequency (p-values >.357), possibly reflecting methodological limitations.
These findings tentatively support the hypothesis that specific deficits in core decision-making processes contribute to binge-eating persistence, suggesting novel intervention targets. Additionally, our study demonstrates the utility of the DDM as a computational framework for unifying and interpreting diverse behavioral data within the binge-ED literature.
RECOVERY, Part 1 of 2
7. Troscianko, E., & Leon, M. (2026). Can methods that focus on eating behaviour and individual agency improve success rates in eating disorder recovery? Journal of Eating Disorders, 14, 59. https://doi.org/10.1186/s40337-026-01537-6
Full text available for download at: https://tinyurl.com/2ke69596
ABSTRACT. Success rates in eating disorder treatments are disappointing, and many calls have been made in recent research literature for innovative approaches to improve outcomes. This Comment article offers an argument for the importance of behaviour and agency in supporting eating disorder recovery, where behaviour encompasses eating and other everyday actions and habits and agency is an individual’s capacity to set priorities and intentions, generate insights, draw conclusions, make decisions, and perform actions.
Current treatments often deprioritize eating and other behaviours as well as individual agency for the patient/client, with lower importance often attributed to behavioural change than to physiological or psychological change. Reasons for deprioritizing behaviour may include beliefs about the therapeutic alliance, the intellectual appeal of psychological exploration, and the ready measurability of physiological factors. Reasons for deprioritizing personal agency may relate to an only partial shift away from the paternalistic model of medicine, influenced by the physical severity of EDs and by gender dynamics between clinician and client/patient.
Drawing on principles and practices from solution-focused coaching and solution-focused brief therapy, we argue that low-agency forms of healthcare are likely to perform poorly in general, given the problematic effects that typically result from the giving and following of advice. Low-agency and low-behaviour approaches are also likely to work poorly for EDs in particular, thanks to both the centrality of eating behaviours and the fact that EDs are often experienced as initially egosyntonic exercises of personal agency.
We describe how a high-agency-high-behaviour model of ED treatment could help improve recovery rates by scaffolding a process of progressive empowerment in which the affected individual identifies how personal agency has been lost in the experience of their ED and decides whether, why, and how they wish to reassert it. We survey existing applications of solution-focused methods in the ED domain and suggest ways of testing the proposed ideas. We conclude by sketching broader ways for the field to continue its evolution towards higher-behaviour and higher-agency methods, as part of a general shift to forms of healthcare that are truly responsive to the individual and firmly grounded in the realities of practical change.
8. Anagnostopoulou, V., Bailie, C. & Troop, N. (2025). “Without this part, it’s hard to truly recover”: Adults’ experiences of body compassion in eating disorder recovery—a reflexive thematic analysis. Journal of Eating Disorders, 13, 279. https://doi.org/10.1186/s40337-025-01464-y
Full text available for download at: https://tinyurl.com/mpf5psef
ABSTRACT. Background: Eating disorder recovery can be complex, with high relapse rates despite various therapeutic approaches. Recent research suggests body compassion may play a protective role in recovery, but studies remain limited. This study aims to explore adults’ experiences of body compassion in their eating disorder recovery journey. Methods: Ten adults aged between 19 and 49, self-identified as recovered or ‘in recovery’ from anorexia nervosa, bulimia nervosa, and/or binge eating disorder, and who had received therapeutic support, participated in online semi-structured interviews. Following ethical approval, data were analysed using Reflexive Thematic Analysis (RTA).
Analysis: Participants described body compassion’s development as a dynamic process captured through five interrelated themes: Foundation, Confusion, Growth, Reconnection, and Resistance. Foundation highlights body compassion’s central role in sustaining recovery. Confusion reflects its initially elusive nature. Growth covers factors and practices supporting its development. Reconnection describes a new relationship with the body through caring actions. Resistance represents a shift toward challenging internalized ideals and societal pressures. These themes inform a tentative model outlining body compassion’s role and progression in recovery.
Conclusion: This research frames body compassion as a dynamic, reparative force supporting a more holistic, inclusive, and compassionate approach to eating disorder recovery. These findings highlight the need for person-centred treatment models viewing the body as a site of healing, not just symptom management. Clinicians should integrate clear definitions and targeted body compassion practices while addressing broader sociocultural influences, including social media.
NATURE, COURSE, AND CORRELATES OF EATING DISORDERS, Part 6 of Many
9. Himmerich, H., Keeler, J. L., King, J. A., Ehrlich, S., Kaufmann, L.-K., Bulik, C. M., Cohen-Woods, S., Wade, T., Steiger, H., Booij, L., Monteleone, P., Casino, G., Monteleone, A. M., Cuntz, U., Voderholzer, U., Tessema, S. A., Lewis, Y. D., Sjögren, M., Hebebrand, J., Seitz, J., . . . Kan, C. (28th author), . . . Bektas, S. (34th author), . . . Fernández-Aranda, F. (42nd author), . . . Treasure, J. (51st author), . . . WSFBP Task Force on Biological Markers & WSFBP Task Force on Eating Disorders (2026). World Federation of Societies of Biological Psychiatry (WFSBP) consensus statement on candidate biomarkers for anorexia nervosa. The World Journal of Biological Psychiatry. Advance online publication. https://doi.org/10.1080/15622975.2026.2626934
Full text available for download at: https://tinyurl.com/y8b9tw5u
ABSTRACT. Objectives: This World Federation of Societies of Biological Psychiatry (WFSBP) consensus paper aims to summarise and evaluate the published study results on objectively measurable biological markers associated with anorexia nervosa (AN). Methods: The relevant literature was reviewed by the WFSBP Task Forces on Eating Disorders and on Biological Markers, and a consensus regarding the significance of the published evidence was reached.
Results: Candidate biological markers that have been associated with AN include clinical (e.g. body weight), molecular (e.g. genetic, epigenetic, hormonal, immunological, metabolomic), cellular (e.g. leukocytes), neuroimaging (e.g. structure, function, connectivity), digital, cardiac and neurophysiological parameters. Some clinical and laboratory parameters are risk markers in clinical practice. Biological markers have pathophysiological relevance in understanding the biological and metabolic pathophysiology of AN and its physical health consequences. Few studies have examined pharmacogenetics or therapeutic drug monitoring as tools to monitor and guide the treatment of AN.
Conclusions: Biological markers will hopefully soon enable clinicians to intervene earlier in a more targeted manner to mitigate treatment resistance. However, the current scientific basis for most biological markers are group comparisons only. Studies on sensitivity, specificity and the prognostic value of these markers are lacking.
10. Toppino, F., Panero, M., Martini, M., Longo, P., Amodeo, L., Vennettillo, L., & Abbate-Daga, G. (2026). Exploring the interplay between intolerance of uncertainty, resilience and psychopathological correlates in anorexia nervosa. Clinical Psychology & Psychotherapy, 33(2). Advance online publication. https://doi.org/10.1002/cpp.70248
Email address for correspondence: giovanni.abbatedaga@unito.it
ABSTRACT. Intolerance of uncertainty (IU) and resilience are two psychological constructs that can influence the onset, maintenance and prognosis of individuals with anorexia nervosa (AN). Existing literature in various contexts suggests that resilience is inversely associated with IU and may mediate the relationship between IU and affective symptoms. This study aimed to explore the interplay between these variables in AN by comparing a group of affected individuals with healthy controls (HCs).
The cross-sectional study included 108 patients with AN accessing a specialized eating disorders centre and 121 HCs. Participants completed questionnaires measuring IU, resilience, eating and body-related psychopathology and anxious and depressive symptoms. The groups were compared with non-parametric tests, although correlation and bootstrapped mediation analyses were used to analyse the relationships among variables.
Individuals with AN showed higher IU and lower resilience compared to HCs. IU scores positively correlated with all psychopathology measures across both groups and were negatively associated with resilience; resilience negatively correlated with anxiety and depression in both groups and with eating psychopathology only in the control group. Resilience partially mediated the relationship between IU and anxiety/depression in both groups. This study paves the way for a line of research focused on these psychological constructs in AN: Enhancing resilience resources in therapeutic settings may help address the emotional burden associated with high levels of IU, particularly regarding non-ED symptoms.
11. Manwaring, J. L., Cass, K., Prostko, S., Stein, A. B., Mehler, P. S., Joiner, T., & Rienecke, R. D. (2025). How do adult inpatients with ARFID or AN-R compare on self-report eating disorder assessments? Eating Disorders: The Journal of Treatment & Prevention. Advance online publication. https://doi.org/10.1080/10640266.2025.2608345
Full text available for download at: https://tinyurl.com/22amz53k
ABSTRACT. The Pica, ARFID, and Rumination Disorder ARFID Questionnaire (PARDI-AR-Q) and the Eating Disorders in Youth Questionnaire (EDY-Q) were developed to assess avoidant/restrictive food intake disorder (ARFID), but research is ongoing regarding their discriminant validity.
This study examined scores of adult inpatients with ARFID or anorexia nervosa, restricting type (AN-R) on the PARDI-AR-Q, EDY-Q, and Eating Disorder Examination Questionnaire (EDE-Q) at admission to a medical stabilization unit for severe eating disorders. Response differences between 78 adult inpatients with ARFID or AN-R were analyzed using a two-sample t-test or Fisher’s exact test. Sensitivity and specificity of self-report measures were examined using receiver operating characteristic curves.
Patients with AN-R had significantly higher severity of impact and lower concern about aversive consequences scores than patients with ARFID on the PARDI-AR-Q (p < .001), with no significant differences on sensory-based avoidance or lack of interest or EDY-Q total score. Patients with AN-R scored significantly higher on all domains of the EDE-Q (p’s < .001) and the EDE-Q subscales had better discrimination than ARFID measures. This study provides further evidence of the need for assessments that can distinguish ARFID from AN, and may also highlight the need for future research on the nosological accuracy of differentiating these disorders.