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Cognitive Therapy and Research

Gepubliceerd in:

01-06-2008 | Original Article

The Role of Anxiety Sensitivity in Eating Pathology

Auteurs: Michael D. Anestis, Jill M. Holm-Denoma, Kathryn H. Gordon, Norman B. Schmidt, Thomas E. Joiner

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2008

Abstract

Background

In past research, anxiety sensitivity (AS) has been identified as a risk factor for anxiety, mood, and alcohol problems. Little work, however, has examined the relationship between AS and eating pathology. We predicted that individuals high in AS would have elevated rates of eating disorder symptoms as measured by the Eating Disorder Inventory (EDI).

Methods

Participants in two studies—one undergraduate sample (N = 88) and one clinical sample (N = 96)—were assessed for anxiety sensitivity and eating disorder symptoms.

Results

In both samples, AS was significantly related to EDI-Bulimia scores, controlling for depressive symptoms, trait anxiety symptoms, and impulsivity. In the clinical sample, AS was also significantly related to EDI-Drive for Thinness, controlling for the same covariates. A follow-up analysis suggested that the relationship between AS and EDI eating disorder symptoms was mediated by EDI-Interoceptive Awareness.

Limitations

Both studies were cross-sectional, which prohibits causal interpretations. The follow-up mediational analysis must be interpreted with caution due to overlap between the measures of AS and interoceptive awareness. Because of a small sample size and significant comorbidity, the exploratory results analyzing diagnostic categories in Study 2 must be interpreted with caution.

Conclusions

AS has a statistically significant relationship to certain eating disorder symptoms measured by the EDI. Future research should investigate whether high AS individuals utilize certain eating behaviors in an effort to regulate somatic symptoms of anxiety.

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When no covariates were used in the regression analyses, ASI scores significantly predicted EDI-bulimia (P < .001) and EDI-body dissatisfaction (P < .05) scores. However, ASI scores only significantly predicted EDI-drive for thinness scores at a trend level (P = .06).

refers to the unstandardized beta weight.

Due to concerns about the high correlation between AS and EDI-Interoceptive Awareness, an alternative approach towards the mediational analysis was also utilized. Items on both the ASI and the EDI-Interoceptive Awareness scale that rationally appeared to overlap across constructs were deleted from each measure (items 33, 40, 47, and 64 on the EDI-IA; items 5 and 16 on the ASI). The correlation between the two scales decreased from .54 to .44. After this step, the mediational analyses were run again. The results were identical to those found with the original versions of the scale, with interoceptive awareness mediating the relationship between AS and eating disordered symptoms as measured by the EDI. This increases our confidence that this mediational relationship is worthy of further exploration in future studies, but nonetheless, caution should be used in interpreting the results.

When ASI scores were used to predict EDI-bulimia, EDI-interoceptive awareness, EDI-drive for thinness, and EDI-body dissatisfaction scores with no covariates, all of the analyses were significant (i.e., ASI significantly predicted each EDI subscale score; all P’s < .001).

Due to the low number of patients with eating disorder diagnoses (n = 5) and the large amount of comorbidity within this sample, analyses examining the role of anxiety sensitivity in diagnosis were essentially impossible. However, the patients included in this sample exhibited elevated eating disorder symptoms as indicated by mean scores on the EDI subscales (bulimia, drive for thinness, and body dissatisfaction). In a purely exploratory regression analysis, we found that ED diagnosis was, in fact, significantly related to AS scores. Future studies with larger samples of eating disorder diagnoses would help to further elucidate the nature of our findings.

Due to concerns about the high correlation between AS and EDI-Interoceptive Awareness, the same alternative approach towards the mediational analysis utilized in Study 1 was also utilized in Study 2 and the correlation between the two scales was thus decreased from .67 to .65. Given this small decrease (i.e. the observation that the correlation did not significantly decrease in magnitude), subsequent mediational analyses were not conducted.

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Titel: The Role of Anxiety Sensitivity in Eating Pathology
Auteurs: Michael D. Anestis
Jill M. Holm-Denoma
Kathryn H. Gordon
Norman B. Schmidt
Thomas E. Joiner
Publicatiedatum: 01-06-2008
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 3/2008
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-006-9085-y

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Abstract

Background

Methods

Results

Limitations

Conclusions

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