Shared and Idiosyncratic Symptom Associations with the Urge to Restrict

Individuals with eating disorders present with heterogenous cognitive-affective symptom profiles, whereas behavioral symptoms tend to be more homogenous. For example, dietary restriction is a common behavioral symptom across the eating disorders; however, the cognitive-affective factors that predict restriction may vary among persons. The aim of this study was to examine which variables are associated with dietary restriction in group-level models of eating disorder pathology and describe how these symptoms compare to the associations evidenced in person-specific models. We collected time-intensive longitudinal data from 26 participants with eating disorders. Participants provided a mean of 355.92 observations across a 90-day period. We estimated group-level models using group iterative multiple model estimation including nodes with the six highest means for the sample. We estimated idiographic (N=1) models by using regularized graphical vector autoregressive models including nodes with the six highest means for each participant. Nodes included in the group-level model were anxiety, feeling fat, fear of weight gain, overevaluation of weight and shape, drive for thinness, and the urge to restrict. In the group-level model, aside from the autoregressive relationship, fear of weight gain was the only variable associated with the urge to restrict. In idiographic models, the urge to body check was the most common variable associated with the urge to restrict, followed by anxiety and feeling fat. Findings from the group-level model were rarely maintained at the individual level. Idiographic models may provide more tailored conceptualizations of eating disorder symptom dynamics related to dietary restriction relative to group-based models.Keywords: eating disorders, dietary restriction, idiographic, network analysis, anorexia nervosa, bulimia nervosa, OSFED