Date of Award:


Document Type:


Degree Name:

Doctor of Philosophy (PhD)



Committee Chair(s)

David M. Stein


David M. Stein


Mary Doty


Georgia Lauritzen


Ken Merrell


Lani Van Dusen


The goal of the present study was to verify whether four purported risk factors predate the development of eating disorder symptoms, particularly bulimia nervosa. The four major purported risk factors for developing bulimia nervosa (and eating disorders in general) among female adolescents include: (a) over internalization of culture’s value of thinness in women, (b) inordinate dissatisfaction with body form, (c) depression, and (d) irrational beliefs and cognitions about thinness and the benefits of dieting. The present study involved a 5-year follow-up of adolescent girls initially identified as being either at high or low risk for developing an eating disorder, particularly bulimia nervosa. Subjects completed the risk factor inventories, and eating disorder diagnoses were based upon a structured Diagnostic and Statistical Manual of Mental Disorders clinical interview.

Results indicated that: (a) two bulimic cases were found in the high-risk group, with an overall prevalence rate of 3.5% (2/57); (b) the total 6-month incidence rate (for any eating disorder) was 6.5% in the high-risk group, and 0.0% in the low-risk group; (c) younger at-risk girls tended to generally acknowledge more eating disorder symptoms; (d) z-score means of the low and high risk group are dramatically different at both Time #1 and 5 years later at Time l#2, with the high-risk group exhibiting more severe and quite stable symptomatology relative to the low-risk group; and (e) change in scores over time, in all four risk factor measures, was related to bulimia, binge-related symptoms, and overall (total) symptoms. The study confirmed the importance of these risk factors in the etiology of eating disorder symptoms, as well as the significance of tracking girls in early adolescence in longitudinal studies.



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