Identifying disordered eating behaviours in adolescents: how do parent and adolescent reports differ by sex and age?

Abstract

This study investigated the prevalence of disordered eating cognitions and behaviours across mid-adolescence in a large European sample, and explored the extent to which prevalence ratings were affected by informant (parent/adolescent), or the sex or age of the adolescent. The Development and Well-Being Assessment was completed by parent–adolescent dyads at age 14 (n = 2225) and again at age 16 (n = 1607) to explore the prevalence of 7 eating disorder symptoms (binge eating, purging, fear of weight gain, distress over shape/weight, avoidance of fattening foods, food restriction, and exercise for weight loss). Informant agreement was assessed using kappa coefficients. Generalised estimating equations were performed to explore the impact of age, sex and informant on symptom prevalence. Slight to fair agreement was observed between parent and adolescent reports (kappa estimates between 0.045 and 0.318); however, this was largely driven by agreement on the absence of behaviours. Disordered eating behaviours were more consistently endorsed amongst girls compared to boys (odds ratios: 2.96–5.90) and by adolescents compared to their parents (odds ratios: 2.71–9.05). Our data are consistent with previous findings in epidemiological studies. The findings suggest that sex-related differences in the prevalence of disordered eating behaviour are established by mid-adolescence. The greater prevalence rates obtained from adolescent compared to parent reports may be due to the secretive nature of the behaviours and/or lack of awareness by parents. If adolescent reports are overlooked, the disordered behaviour may have a greater opportunity to become more entrenched.

Neural Correlates of Failed Inhibitory Control as an Early Marker of Disordered Eating in Adolescents

“…Firstly, presence/absence of DEBs were determined by self-report. There is a debate surrounding the optimal method of assessing DEBs in children and adolescents, however, we found participants were forthcoming about their behaviors, with a greater prevalence of DEBs emerging from adolescent compared to parental reports (53). Secondly, participant groups were not random.…”

Contemporary screen time modalities among children 9–10 years old and binge‐eating disorder at one‐year follow‐up: A prospective cohort study

“…Screen time use and incidence of binge‐eating disorder may rise after ages 9–11; thus, studies following the ABCD cohort into later adolescence will be an important area of future research. Although parent and child reports of binge eating tend to have low concordance (Bartholdy et al, 2017; Tanofsky‐Kraff, Yanovski, & Yanovski, 2005), parents are particularly important reporters for eating disorders in this age range (Barch et al, 2018) since young children may have less insight regarding their eating behaviors (Braet et al, 2007). The binge‐eating questions came from a reliable and validated tool (KSADS‐5) that was based on DSM‐5 diagnostic criteria.…”

Duration of untreated eating disorder and relationship to outcomes: A systematic review of the literature

“…Second, studies of younger participants tend to mainly include AN, which is a highly visible disorder, whereas studies of adults often include a mixture of AN and those with bulimic EDs, which are more hidden. For example, parents are often unaware of bulimic symptoms in their adolescent children (Bartholdy et al, 2017). Third, it may also matter who reports on DUED.…”