1. Age Moderates the Relationship Between Fear of Food and Eating Disorder Symptoms Lisa P. Michelson, M.A., Leigh C. Brosof, B.A., and Cheri A. Levinson, Ph.D.
University of Louisville
**Deleted from Results: Multiracial or biracial (n = 3, 1.8%), Hispanic (n = 3; 1.8%), Black (n = 1, 0.6%), Japanese American (n = 1, 0.6%)
Median days since discharge = 140d (Range: 1 – 868d)
Median time in treatment = 2hrs (SD = 42.26) a week.
Results
Introduction
Fear of food are associated with ED symptoms (Levinson & Byrne, 2014)
Food Avoidance
Assess behaviors that are indicative of avoidance related to anxiety over food
Feared Concerns
Assess the core fears or maladaptive thoughts underlying anxiety about eating
Anxiety about eating
Assess trait levels of fear and anxiety surrounding food and eating
Treatment of eating disorders (ED) symptoms may vary by age (Peat et al., 2008)
No research on how age affects relation between fear of food and ED symptoms
We investigated if age moderated the relationship between fear of food and ED symptoms
Age moderated the relationship between:
Age did not moderate relationship between:
Anxiety about Eating
Food Avoidance
Feared Concerns
ps ≤ .002
ps ≤ .007
ps ≤ .001
Shape Concerns (Fig. 1)
Shape Concerns (Fig. 4)
Shape Concerns (Fig. 6)
Eating concerns and fears of food
(ps ≤ 0.36)
Weight Concerns (Fig. 2)
Weight Concerns (Fig. 5)
Weight Concerns (Fig. 7)
Restraint and:
Food Avoidance (p = .14)
Restraint (Fig. 3)
Feared Concern (p = .23)
Fig. 1-7: Age Moderated Relationships Between FOF and ED Symptoms
Younger Age Older Age
Participants
Participants
n = 168
Age range
14-59
M = 26
SD = 9.44
Sex
Female
n = 159
94.60%
Ethnicity
European American
n = 156
92.9%
Diagnosis
Anorexia Nervosa
n = 34
14.7%
Atypical Anorexia Nervosa
n = 104
61.9%
Purging disorder
n = 16
9.55
Bulimia Nervosa
n = 13
7.7%
Binge eating disorder
n = 1
0.6%
Treatment
Outpatient
n = 96
57.1%
Intensive outpatient
9.5%
Partial Hospitalization
n = 5
3.03%
Impatiant or Residential
n = 8
4.7%
Time in treatment
M = 2 hrs/ week
SD = 42.26
Measures
Eating Disorder Questionnaire (EDE-Q) (Fairburn, Cooper, & O’Connor, 2014)
Four subscales used:
Weight Concerns
Have you had a strong desire to lose weight?
Shape Concerns
Have you been dissatisfied with your overall shape (your figure)?
Eating concerns
On what proportion of the times that you have eaten have you felt guilty?
Restraint
Have you wanted your stomach to be empty?
Good discriminant validity and internal consistency
Fear of Food Measure (FOFM) (Levinson & Byrne, 2014)
Three subscales used:
Anxiety About Eating
I worry about eating
Food Avoidance
I have rules about what I eat
Feared Concerns
I don’t like to eat in social situations
Fig. 3
Discussion
Fear of food impacted ED symptoms differentially by age
Higher fear of food is associated with higher ED symptoms more so in younger rather than older individuals
ED interventions should be personalized based on age
Fear of food is not as salient for older individuals
Other fears may contributed to ED symptoms
E.g., fear of negative evaluation
Targeting fear of food may be especially important in ED treatment for younger individuals
E.g., Exposure therapy to feared foods