Body image as a mediator in the relationship between psychotic experiences and later disordered eating: A 12-month longitudinal study in high school adolescents

Abstract

Introduction Psychotic experiences (PE) and disordered eating (DE) are frequently observed among the general population, especially in childhood and adolescence. However, the relationship between the two groups of disorders is still unclear. Objectives To explore the hypothesis that the pathways from PEs to DE are mediated by body-image disturbances in a sample of adolescents Methods We conducted a 12-month longitudinal study on high school students from four different high schools from the Ariana governorate, from April 2022 to April 2023. Participants were evaluated at baseline then every 6 months with a target length of follow-up of 1 year. The questionnaire contained Questions about socio demographic variables The Eating Attitude Test (EAT-26) The Multidimensionnal Body Self-Relations Questionnaire Appearance Scale (MBSRQ-AS) The Community Assesment of Psychic Experiences (CAPE-42) Results 1) Sample characteristics Sample was constituted of 510 individuals. Of those, 312 (61.2%) were females. Mean age was of 16.05 (SD=1.01) years. The majority of the students resided in urban areas, accounting for 97.8% of the total. When it comes to family income, 4.1% of the students’ families had an income of less than 1000 Tunisian Dinars (TD), 25.9% had an income between 1000 and 2000 TD, 32.2% had an income ranging from 2000 to 3000 TD, and the remaining 37.8% had a family income of over 3000 TD. The EAT-26, MBSRQ-AS and CAPE-42 scores are shown in table 1. Table 1. The longitudinal evolution of study variables Baseline T 6 months T 12 months p Partial Eta Squared η2 Disordered eating (EAT-26) 11.9 ± 9.4 11.9 ± 9.7 12.6 ± 10.2 .080 .006 Self-classified weight (Body image) 6.0 ± 1.7 5.9 ± 1.6 6.0 ± 1.6 .946 .001 Body areas satisfaction 30.9 ± 6.4 31.8 ± 6.4 31.4 ± 6.8 .025 .010 Overweight preoccupation 9.3 ± 3.6 9.2 ± 3.7 9.2 ± 3.7 .545 .001 Appearance Orientation 41.0 ± 5.4 41.6 ± 5.4 41.6 ± 5.5 .007 .014 CAPE positive dimension (total) 39.6 ± 8.7 39.1 ± 9.1 39.7 ± 9.5 .756 .001 Body Mass index 21.6 ± 3.4 21.5 ± 3.2 21.7 ± 3.2 .034 .009 2) Findings of the mediating analysis Disordered Eating scores had no significant effect in subjects across time. However, the effect of the interaction between baseline Overweight Preoccupation with Disordered Eating across time was statistically significant (p=0.036). Overweight Preoccupation (Z=85.095, p<0.001), Body Area Satisfaction (Z=25.053, p<0.001), and CAPE positive dimension (Z=59.931, p<0.001) scores had significant main effects between subjects. (figure 1 and figure 2) Image: Image 2: Conclusions Findings showed that body image disturbances mediated the prospective association between PEs and DE. Adolescents with increased PEs were more likely to experience body image disturbances and, in turn, DE symptoms. These findings offer promising new avenues for prevention and early intervention. Disclosure of Interest None Declared