Adolescent–Adult discrepancies on the eating disorder examination: A function of developmental stage or severity of illness?

Abstract

Objective Across studies, adolescents score lower on measures of eating disorder pathology than adults, but it is unclear whether such findings reflect discrepancies inherent to site/study or true developmental differences. The aim of this study was to determine whether age predicts subscale and diagnostic scores of the Eating Disorder Examination (EDE) in adolescents and adults with anorexia nervosa (AN) admitted to a single research center within the same period of time. Method The sample consisted of 16 adolescent and 20 adult consecutive admissions to parallel, age-specific, research-based AN treatment programs. Participants completed a baseline evaluation at admission that included the EDE, depression measures, and global assessment of functioning scales. Results Age significantly predicted EDE scores in univariate regression analyses. However, in multivariate models that included severity indices of general and specific psychopathology as covariates, age was no longer a significant predictor of severity of eating disorder symptoms. Discussion This study adds to the growing body of data showing lower scores on the EDE for adolescents with AN relative to their adult counterparts, while eliminating potential site confounds. Results indicate that the higher adult scores may be carried in part by a more overall severe and chronic general clinical profile.

Comparative study of children and adolescents referred for eating disorder treatment at a specialist tertiary setting

“…When compared with adolescents, children reported lower scores on measures of ED cognitions, consistent with previous studies comparing premenarcheal and postmenarcheal females with AN and adolescents and adults with AN and mixed EDs . There are several interpretive possibilities.…”

Parent–child concordance in reporting of child eating disorder pathology as assessed by the eating disorder examination

“…Adolescents as a cohort score lower on the EDE relative to adult counterparts . Adolescents have been found to have greater levels of denial and lower levels of desire for help than adults diagnosed with eating disorders, potentially leading to poor parent–youth concordance on eating disorder cognitions and behaviors.…”

“…Adolescents as a cohort score lower on the EDE relative to adult counterparts. 22 Adolescents have been found to have greater levels of denial and lower levels of desire for help than adults diagnosed with eating disorders, 23 potentially leading to poor parent-youth concordance on eating disorder cognitions and behaviors. The amplified nature of egosyntonicity and the impact of minimization may yield lower scores among youthinformants, as might clinical presentations with complete absence of weight and shape-based disturbance, whereas the parent may superimpose these concerns as part of their explanatory model for the symptoms.…”

Assessment of anorexia nervosa: an overview of universal issues and contextual challenges

“…However, empirically supported definitions of severity are largely lacking. Clinicians commonly default to one or more symptom markers or treatment intensity markers such as BMI [ 64 ] or multiple severity indices based on different symptoms (not all of which are AN symptoms [ 65 ]), hospitalisation [ 66 ] or length of illness [ 67 ]. In an attempt to address problems with all of the above strategies, a more recent approach has been the development of empirically derived tools to stage AN severity [ 36 , 68 ].…”