Resilience and Disordered Eating Among Japanese Adolescents: A Population-Based Cohort Study

The relationship between resilience and eating disorder psychopathology among adolescents has been understudied. This study assessed prospective associations between baseline resilience and subsequent eating disorder psychopathology in a nationally representative longitudinal cohort of Japanese adolescents.

We conducted a prospective cohort study with participants in grades 5-9 (10-15 years; n = 987) drawn from the Japan Adolescent and Youth longitudinal study. In 2021, resilience was measured using the Rasch-validated version of the Child and Youth Resilience Measure, while eating disorder psychopathology was assessed at the 2022 follow-up using the Eating Disorder Examination-Questionnaire adapted for children. Both instruments were child-reported. Linear regression examined relationships between resilience scores and eating disorder psychopathology, adjusting for grade and maternal education.

Higher overall resilience (β = -0.116; 95% confidence interval [CI]: -0.198, -0.034), personal resilience (-0.113; 95% CI: -0.196, -0.031), and caregiver resilience (-0.109; 95% CI: -0.192, -0.026) were each significantly associated with lower eating disorder psychopathology scores. Higher caregiver resilience was significantly associated with lower levels of restraint over eating (-0.093; 95% CI: -0.179, -0.006), while higher personal resilience was significantly associated with lower levels of guilt about eating (-0.103; 95% CI: -0.200, -0.005).

Higher resilience was associated with fewer eating disorder symptoms among adolescents. Personal resilience was observed to be more salient for some symptoms, while caregiver resilience was more salient for others. These findings highlight the multifaceted role of resilience and suggest that interventions may benefit from strengthening both adolescents' individual coping resources and the supportive capacities of caregivers.