Abstract
Objective: Body checking (BC) and avoidance (BA) form the behavioral component of body image disturbance. High levels of BC/BA have often been documented to hold a positive and potentially reinforcing relationship with eating pathology. While some researchers hypothesize, that patients engage in BC/BA to prevent or reduce levels of anxiety, little is known about the mediating factors. Considering the great comorbidity between eating disorders (ED) and in particular social anxieties, the present study investigated whether socially relevant types of anxiety mediate the relationship between eating pathology and BC/BA.Methods: 83 participants reporting an eating disorder and 323 healthy participants (14–25 years) took part in an online survey. Eating pathology was measured with the Eating Disorder Examination Questionnaire and Body Checking and Avoidance Questionnaire. Trait and social anxiety were assessed by means of the State Trait Anxiety Inventory (STAI-T), the Fear of Negative Evaluation (FNE) and the Social Appearance and Anxiety Scale (SAAS). Separate mediation analyses were carried out with eating pathology as independent variable, BC/BA as dependent variable and STAI, FNE, and SAAS as mediating variables.Results: Anxieties correlated highly positive with eating pathology in both groups. SAAS mediated the relationship between ED pathology and BC/BA in participants with ED and mediated the relationship between ED pathology and BA in healthy participants. FNE mediated the relationship between eating pathology and BA for participants with eating pathology.Discussion: SAAS mediated the relationship between eating pathology and BC/BA. Being afraid of bodily evaluations may represent a particular relevant fear that triggers safety behaviors.
Highlights
Anxiety disorders often co-exist with eating disorders (ED) and are more prevalent in this patient group than in community samples (Swinbourne and Touyz, 2007)
The present study strived to elucidate in what way social appearance anxieties (SAA), fear of negative evaluation (FNE), and STAI-T mediate the relationship between ED pathology and the need to engage in body checking (BC) or body avoidance (BA)
SAA was found to be a consistent mediator for the relationship between ED pathology and the behavioral component of body image disturbances (BID) measured by BC and BA in participants reporting an ED
Summary
Anxiety disorders often co-exist with eating disorders (ED) and are more prevalent in this patient group than in community samples (Swinbourne and Touyz, 2007). Anxiety and Body Image Disturbance as safety behavior (Pallister and Waller, 2008; Waller, 2008). This might imply the execution of body checking (BC) or avoidance (BA) as safety behaviors in order to deal with the experience or fear of bodily evaluations. No study has investigated whether social anxieties mediate the relationship between eating psychopathology and BC/BA. To date, it is unclear whether BC/BA share a similar functionality or not. The present study will shed light on potential factors contributing to the vicious cycle between ED psychopathology and BC/BA and may offer support for the anxiolytic function of BC and BA
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