Psychosocial Predictors of Disordered Eating in Adolescents with Celiac Disease: Body Image Dissatisfaction, Anxiety, Depression, and Family Eating Environment

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Degree type
Doctor of Social Work (DSW)
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Discipline
Social Work
Subject
Celiac Disease
Disordered Eating
Diet and Health Related Conditions
Adolescents
Medical Social Work
Social Work Practice
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Copyright date
2025-03-18
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Author
Rowen, Kaitlin
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Abstract

Purpose/Objective: Research suggests a high prevalence of disordered eating in adolescents with celiac disease, however research on vulnerability factors is limited. To address this gap, this study tested the hypothesis that a higher level of body image dissatisfaction, greater severity of anxiety symptoms, greater severity of depression symptoms, and poorer quality of family eating environment predicts greater disordered eating behaviors, attitudes, and feelings in U.S. adolescents with celiac disease. Methods: A correlational design with a nonprobability convenience sample of N = 187 was used. Participants were U.S. adolescents, 13 to 18 years old, with celiac disease. Data was collected via a one-time, online survey. Measures included Celiac Dietary Adherence Test, Eating Attitudes Test-26, Appearance and Weight subscales of the Body Esteem Scale for Adolescents and Adults, Depression and Anxiety subscales of the Revised Child Anxiety and Depression Scale-25, and Family Eating Habits survey. Multiple and logistic regression analyses were used to test hypotheses. Results: Findings partially supported the hypothesis, indicating a higher level of body image dissatisfaction (measured as weight dissatisfaction), greater severity of depression symptoms, and poorer quality of the family eating environment (measured as atmosphere) predicted greater disordered eating behaviors, attitudes, and feelings when measured as 1. dieting; 2. bulimia and food preoccupation; and 3. composite of behaviors, attitudes, and feelings about dieting, bulimia and food preoccupation, and oral control. No differences in disordered eating were found among groups defined by race, body mass index, or co-occurring diet and health related conditions. Post-hoc analysis indicated that transgender males scored significantly higher than cisgender males on disordered eating behaviors, attitudes, and feelings regarding dieting. However, no other gender group differences were significant under Bonferroni cutoff. Conclusions: Filling a research critical gap, results enhanced understanding of potential psychosocial vulnerabilities for disordered eating in adolescents with celiac disease. Clinical recommendations are made for targeted assessments and individual and family-based interventions that allow for early detection, treatment, and prevention of disordered eating in this high-risk population.

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Solomon, Phyllis
Date of degree
2025-05-19
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