Identifying disordered eating behaviours in adolescents: how do parent and adolescent reports differ by sex and age?

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Abstract
This study investigated the prevalence of disordered eating cognitions and behaviours across mid-adolescence in a large European sample, and explored the extent to which prevalence ratings were affected by informant (parent/adolescent), or the sex or age of the adolescent. The Development and Well-Being Assessment was completed by parent–adolescent dyads at age 14 (n = 2225) and again at age 16 (n = 1607) to explore the prevalence of 7 eating disorder symptoms (binge eating, purging, fear of weight gain, distress over shape/weight, avoidance of fattening foods, food restriction, and exercise for weight loss). Informant agreement was assessed using kappa coefficients. Generalised estimating equations were performed to explore the impact of age, sex and informant on symptom prevalence. Slight to fair agreement was observed between parent and adolescent reports (kappa estimates between 0.045 and 0.318); however, this was largely driven by agreement on the absence of behaviours. Disordered eating behaviours were more consistently endorsed amongst girls compared to boys (odds ratios: 2.96–5.90) and by adolescents compared to their parents (odds ratios: 2.71–9.05). Our data are consistent with previous findings in epidemiological studies. The findings suggest that sex-related differences in the prevalence of disordered eating behaviour are established by mid-adolescence. The greater prevalence rates obtained from adolescent compared to parent reports may be due to the secretive nature of the behaviours and/or lack of awareness by parents. If adolescent reports are overlooked, the disordered behaviour may have a greater opportunity to become more entrenched.
Funding Information
  • Sixth Framework Programme (LSHM-CT- 2007-037286 (IMAGEN))
  • Seventh Framework Programme (602450 (IMAGEMEND), 602805 (AGGRESSOTYPE), 603016 (MATRICS), 115300-2 (EU-AIMS))
  • Medical Research Council (93558 ("Developmental pathways into adolescent substance abuse"), MR/N000390/1 (c-VEDA))
  • VR
  • Forskningsrådet för hälsa, arbetsliv och välfärd
  • Svenska Forskningsrådet Formas
  • National Institute for Health and Care Research (Infrastructure grant for the Wellcome Trust/KCL Clinical Research Facility)
  • National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London
  • Bundesministerium für Forschung, Technologie und Raumfahrt (01GS08152, 01EV0711, eMED SysAlc 01ZX1311A, Forschungsnetz AERIAL)
  • Deutsche Forschungsgemeinschaft (SM 80/7-1, SM 80/7-2, SFB 940/1)
  • Euranet-Neuron (AF12-NEUR0008-01 - WM2NA)
  • Agence Nationale de la Recherche (ANR-12-SAMA-0004)
  • Fondation de France
  • Fondation pour la Recherche Médicale
  • Mission Interministerielle de Lutte-contr-les-Drogues-et-les-Conduites-Addictives
  • Assistance Publique - Hôpitaux de Paris
  • INSERM, Paris Sud University
  • National Institutes of Health (Axon, Testosterone and Mental Health during Adolescence, RO1 MH085772-01A1, Consortium grant U54 EB020403)

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