Characterization of parent and youth-reported eating disorder symptoms and premorbid factors in the Adolescent Brain Cognitive Development Study

PurposeEating Disorders (EDs) often start in adolescence, though ED-related concerns in diverse youth samples remain understudied. We leveraged data from the Adolescent Brain Cognitive Development{square}(ABCD) Study to identify the prevalence of parent- and youth-reported ED symptoms and their sociodemographic characteristics. MethodsData were drawn from baseline (ages 9-11 years, n=11,868) and 2-year follow-up (ages 11-14 years; n=10,908) from the ABCD Study. A tetrachoric factor analysis summarized clusters of ED symptoms, which were compared between parent and youth reports and across sociodemographic variables. ResultsThree factors emerged reflecting "weight distress", "weight control", and "binge eating" (prevalence range: 1.5-7.3%). Symptoms loaded onto similar factors between reporters. Rates of symptom endorsement were similar between sexes, with disproportionately higher endorsement rates for youth who self-identified as sexual minority, Hispanic, Black, or Mixed race participants, and those from a disadvantaged socioeconomic background, compared to the reference ABCD sample. Youth and parent reports at 2-year showed [~]12% overlap. ConclusionsED-related concerns among historically understudied racial and sexual minority groups call for greater attention to the detection and treatment of these symptoms in these groups. Applying a transdiagnostic approach to ED symptoms can inform effective detection and intervention efforts. Public health statementOur work depicts the sociodemographic breadth of disordered eating behaviors in a large diverse sample of American youth, and underscores the importance of including multiple reporters when assessing ED symptoms in community samples of children and adolescents. Taking into consideration the diverse sociodemographic landscape of disordered eating behaviors is imperative to ensure access to care is equitable across the sexes, and racial, ethnic and socioeconomic groups.