Same or different? Eating disturbances across demographics and identities in adolescents
Xu, Yang
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Permalink
https://hdl.handle.net/2142/129645
Description
Title
Same or different? Eating disturbances across demographics and identities in adolescents
Author(s)
Xu, Yang
Issue Date
2025-05-09
Director of Research (if dissertation) or Advisor (if thesis)
Briley, D. A.
Department of Study
Psychology
Discipline
Psychology
Degree Granting Institution
University of Illinois Urbana-Champaign
Degree Name
M.S.
Degree Level
Thesis
Keyword(s)
adolescent eating disorder
identities
differential item functioning
Abstract
Disordered eating can emerge for various reasons among adolescents. Clinical evidence has persistently documented differences in adolescent eating disorder across demographics and identities. However, much of this research has overlooked the potential for differential item functioning (DIF), which suggests that eating-related items may not be understood or relevant equally across different identity groups. This measurement issue may lead to biased conclusions about group differences and diagnostic biases at the individual level. I formally tested the measurement properties of eating-related items (worry about weight gain, weight control, self-worth related to weight, and binge eating) using data from the Adolescent Brain Cognitive Development (ABCD) study (N = 9, 914 participants, yielding 33,913 cases across waves and informants, ages 10–14) across identities and demographics (i.e., children’s age, race/ethnicity, gender, sexual orientation, time since baseline, family socioeconomic status, ΔBMIp95, and rater). Using moderated nonlinear factor analysis, I identified sources of differential item functioning and conducted valid group comparisons with bias-corrected scores. Adolescents responded to body image items differently as a function of their identity and demographics leading to DIF. Most group differences (i.e., age, gender, race/ethnicity, sexual orientation) were underestimated due to measurement biases, except for rater differences being exaggerated. Bias-corrected group comparison revealed substantial heterogeneity across identities and demographics, with marginalized individuals reporting higher disordered eating (e.g., girl, transgender and gender nonbinary, nonheterosexuality, or Hispanic youth). Gender nonconforming or Black youth showed lower eating disturbance. Consistent with prior research, older age and ΔBMIp95 (deviation from the 95th percentile BMI for age and sex) were associated with more severe eating disturbances. Our results thus highlight the urgent need for more inclusive and culturally sensitive research approaches.
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