Eating Disorders Across Genders, Generations, and Adult Developmental Stages - Very little is known about how the prevalence of eating disorders (EDs) has changed across generations or the trajectory of EDs over the course of adult development. This study offers a unique opportunity to 1) examine ED point prevalence and mean scores on dimensional ED measures across 5 cohorts of college students randomly sampled from the same university population in 1982, 1992, 2002, 2012, and 2022, 2) examine the longitudinal course of eating pathology from late adolescence to midlife (18 to 62+ years), and 3) identify predictors of course focusing on factors unique to adulthood. This project will offer new insights into how generation impacts gender differences in EDs and how both gender and generation impact longitudinal trajectory. This project builds on a study initiated in 1982 and replicated with the addition of new cohorts and extended with follow-up of well-characterized, established cohorts every 10 years since its inception. In the spring of 2022, 1600 undergraduates (800 women and 800 men) will be randomly sampled to complete surveys of weight, height, body image disturbance, dieting, disordered eating behaviors, and EDs. In addition, participants who completed these assessments in college will be sought for 10-, 20-, 30-, and 40-year follow- up. We project collecting 20-year follow-up data in over 1,700 adults (>70% retention), including nearly 500 men and over 400 participants from ethnic/racial minority groups. These data will allow us to examine generation X age effects to determine whether course of eating pathology differs across Baby Boomers (1982 cohort), Generation X (1992 cohort), and Millennials (2002 cohort). The investigation will be conducted in two stages: a survey phase and an interview phase. The survey phase will replicate methods employed for data collection in all prior waves to ensure comparability of data. Surveys include detailed items about demographic background; height and weight; dieting, body image, and exercise; 5 scales of the Eating Disorders Inventory (Bulimia, Drive for Thinness, Maturity Fears, Perfectionism, and Interpersonal Distrust); and symptoms of anorexia nervosa, bulimia nervosa, binge-eating disorder, and permit DSM-5 ED diagnosis and diagnoses of their partial and subthreshold variants. In addition, beginning in the 3rd wave, surveys included the Eating Disorder Diagnostic Scale which is included as a core ED assessment for the NIMH. On the basis of self-report survey data, all subjects diagnosed with an ED and controls matched to these subjects on age, sex, race, and ethnicity will be recruited for participation in the interview phase of the study. Interviews will establish the validity of survey assessments, as well as provide data on psychosocial function, suicidality, comorbidity, and treatment history for a nonclinical sample, similar to their use in the 3rd wave, 20 years ago. The long-term objectives of this project are to evaluate whether we are making progress in reducing the public health burden associated with EDs, determine the adult developmental course of EDs, and identify predictors of ED trajectory that can be translated into targets for intervention, including what to modify, in whom, and when.
