Social appearance anxiety moderates the relationship between thin-ideal internalization and eating disorder symptoms cross-sectionally and prospectively in adolescent girls

Abstract

The sociocultural theory of eating disorders (EDs) posits that thin-ideal internalization may interact with social risk factors to influence ED development. Social appearance anxiety (SAA) is a potential social risk factor for EDs that may influence the relationship between thin-ideal internalization and EDs. The current study (N = 525 adolescent females) examined whether SAA moderated the relationship between thin-ideal internalization and ED symptoms cross-sectionally and prospectively across onemonth. The interaction between thin-ideal internalization and SAA on ED symptoms was significant in both models, such that when SAA was higher, there was a significantly stronger relationship between thin-ideal internalization and ED symptoms. We also found that SAA uniquely, prospectively predicted ED symptoms. These results suggest that adolescents with high SAA and high thin-ideal internalization are more likely to exhibit higher ED symptoms. SAA both prospectively predicts ED symptoms and may amplify the relationship between thin-ideal internalization and EDs. This research highlights SAA as a social risk factor for ED development in adolescents. Interventions focused on SAA may optimize ED prevention in this population. Level IV, evidence obtained from multiple time series with or without the intervention.