Higher and Lower Endorsement of Eating Disorder Symptoms Among Adolescents and Their Caregivers

Low symptom endorsement among adolescents with eating disorders (EDs) may pose challenges for the accurate assessment of symptoms. To better understand low symptom endorsement, the current study examined demographic and clinical characteristics associated with lower symptom endorsement among adolescents with EDs, and compared patterns of endorsement between adolescents and their caregivers.

Treatment-seeking adolescents (N = 629) completed measures of ED psychopathology (Eating Disorder Examination-Questionnaire; EDE-Q), depression, and anxiety at admission, and caregivers completed the Parent EDE-Q. Patients were categorised as 'higher endorsers' or 'lower endorsers' based on their EDE-Q Global score.

Patients with anorexia nervosa-restricting subtype (AN-R) were more likely to be low symptom endorsers than those with AN-binge/purge subtype (AN-BP). Lower endorsers had a shorter length of stay, lower anxiety and depression symptoms at admission, and lower percent of expected body weight at admission and discharge than higher endorsers. Adolescents with AN-R exhibited more discrepancy between their report of ED symptoms and their caregivers' report than adolescents with AN-BP.

The current study supports the importance of including multiple informants when assessing adolescents with EDs.