Fear of negative evaluation among eating disorders: examining the association with weight/shape concerns in adolescence

Objective: Fear of negative evaluation has been proposed as a transdiagnostic factor associated with the development of eating disorders and has been shown to relate to disorders of body image, especially those with weight/shape concerns such as eating disorders and muscle dysmorphia. The current study aimed to investigate whether fear of negative evaluation was a transdiagnostic factor of disorders diagnostically characterized by weight/shape concerns. The study examined whether fear of negative evaluation was associated with higher odds for meeting criteria for an eating disorder and/or muscle dysmorphia, especially those disorders diagnostically characterized by weight/shape concerns.

Method: Data were used from a subgroup of the first wave of the EveryBODY study, a longitudinal investigation of eating disorders and body image concerns among Australian adolescents (N = 4,030). Participants completed measures on demographics, weight/shape concerns, disordered eating, psychological distress, muscularity concerns, and fear of negative evaluation.

Results: Findings revealed that fear of negative evaluation was associated with higher odds of meeting criteria for any eating disorder but significantly more so for those characterized by weight/shape concerns diagnostically, as well as binge-eating disorder. Similar results were found for muscle dysmorphia.

Discussion: The findings suggest that fear of negative evaluation constitutes a transdiagnostic feature for developing and/or maintaining an eating disorder.