Dr Kylie Ball: Disordered eating, psychological stress and coping in young women.

While disordered eating among young women is generally believed to be multifactorially determined, two factors frequently implicated for their hypothesized etiological importance are psychological stress, and a reliance on maladaptive coping strategies. A review of empirical evidence indicated strong support for the concept that stress and inadequate coping strategies were major precursors of disordered eating, but also identified a number of conceptual and methodological limitations. Most significantly, prior research was characterized by a reliance on cross-sectional methodologies, from which no conclusions regarding causal relationships can be made.

A series of interconnected research studies was therefore designed to address these issues and investigate in detail the relationships between stress, coping and disordered eating in young Australian women. Firstly, the relationships between these variables were assessed cross-sectionally in two community surveys. 

Results of these quantitative surveys were supplemented with those of several qualitative studies, assessing young women's perceptions of relationships among stress, coping and disordered eating. Finally, a longitudinal study, targeting women with reported eating pathology, was conducted, with multiple regression and structural equation modelling used to investigate causal relationships between the study variables.

Overall, the cross-sectional data indicated strong relationships between stress, coping and disordered eating; this was supported by qualitative findings suggesting a strong perception among young women that stress triggered subsequent eating pathology. However, results of longitudinal analyses, demonstrating only tenuous relationships between the study variables, did not support the hypothesis that stress and coping strategies predict disordered eating over time. These findings, while contrary to general opinion in the eating disorders literature, are consistent with those of the few previous longitudinal studies reported, and suggest that stress, coping and disordered eating may be closely intertwined, occurring concurrently among young women. 

Future studies replicating and extending these results could help to further clarify our knowledge of the mechanisms underlying these relationships, and, ultimately, to increase our understanding of the complex etiology of disordered eating.