Prospective examination of the transdiagnostic cognitive behavioural model of eating disorders among adolescent boys and girls: A latent structural equation modeling (SEM) approach.

Introduction: The Transdiagnostic Model (TM) of eating disorders (EDs) was developed in order to a) recognize the common features of all EDs and b) expand the explanatory power of the previous cognitive behavioural conceptualization of EDs by including four additional mechanisms (i.e., clinical perfectionism, low self-esteem, mood intolerance and interpersonal difficulties), that may contribute to develop and/or maintain ED symptoms. This study aimed at examining for the first time a) the validity of the TM amongst adolescents, using perspective data and b) potential gender differences between the four additional variables (Baseline/Time1), concerns about shape/ weight (Time2), and ED symptomatology (Time 3). Methods: Participants were 322 Italian adolescents (Mage at T1= 14.6; 46 % boys), examined through semi-structured clinical interviews and self-reported measures annually over a 2-year period. BMI and previous levels of the Time2 and Time3 variables under investigation were examined within SEM analyses. Results: Both the measurement and the structural model fitted the data well. As no differences in the structural path coefficients between boys and girls were observed, the results of the entire sample are described. Interpersonal difficulties were directly linked to core low self-esteem. Clinical perfectionism, low self-esteem, and interpersonal difficulties indirectly impacted restriction through concerns about shape and weight, whereas mood intolerance was the only variable directly linked to binge eating and compensatory behaviours. Surprisingly, there was no direct relationship between restriction and binge eating. Conclusions: The prospective validity of the TM is partially supported. In line with previous studies, our findings suggest that a) males and females are more similar than dissimilar in terms of core eating disordered behaviours, b) factors other than dietary restriction may play a critical role in the development of binge eating and c) binge eating may serve an emotion regulation function.