(PS6-B44) A Comparison of Demographic and Clinical Characteristics for Individuals with Traditional and Non-traditional Core Eating Disorder Symptoms

Eating disorders (EDs) are dangerous psychiatric illnesses with high mortality rates and societal cost (Deloitte Access Economics, 2020). Despite these devastating effects, current gold standard ED treatment only works in about 50% of cases (Steinhausen, 2009). While gold-standard ED treatment primarily focuses on traditional ED symptoms (i.e. weight and shape concerns; Fairburn et al., 2003), EDs are also commonly maintained by what may be thought of as non-traditional ED symptoms (i.e. guilt/shame, feelings of ineffectiveness, comorbid conditions; Levinson et al., 2022). At present, little is known about which individuals may present with primarily traditional ED symptoms and which may present with non-traditional maintaining pathology. The present study attempts to identify demographic and clinical characteristics that may differentiate individuals with traditional vs non-traditional primary symptoms. Participants (N=71) were adults with a current diagnosis of any ED.
 

Participants completed ecological momentary assessment (EMA) surveys 4 times a day for 15 days. Idiographic (i.e., one person) network analysis was used to determine the participant’s two most central symptoms and classify participants into traditional (n=34) vs non-traditional (n=37) groups based on primary symptoms. Chi-squared analyses and Fisher’s exact tests were performed to compare the two groups on categorical demographics and clinical characteristics. Independent samples t-tests were performed to compare the two groups on continuous demographics and clinical characteristics. Participants in the traditional symptom group were more likely to report an income above $55,000 a year (Χ2 = 5.824, p < .05) and report an ED relapse in the past year (p < .05). Participants in the non-traditional group had significantly higher scores on the checking subscale of the Obsessive Compulsive Inventory (OCI; t(64.9)= -2.04, p < .05).
 

There were no other differences in gender, sexual orientation, ED diagnosis, employment, family characteristics, smoking, religion, ethnicity, other comorbid disorders, age, body mass index, or feelings about recovery between groups. This study begins to characterize if there are differences in participants with traditional maintaining ED symptoms versus non-traditional core pathology. These findings suggest that there are some minor differences in terms of income, relapse rates, and OCD pathology. Considering the high percentage of participants who presented with only non-traditional central symptoms, this study also sheds light on the need for transdiagnostic, personalized treatments for EDs that consider both traditional and non-traditional symptoms.
 

The ability to identify who might need tailored outcomes based on core pathology could lead to more precise and individually tailored treatments.