An internalizing and externalizing model to explain the psychopathology onset of the eating disorders at adolescence

The etiology of eating disorders (ED) is complex, and multiple models have attempted to conceptualize it. The objective of this study was to determine whether internalizing and externalizing behaviors are general proximal risk factors for psychopathology or specific for ED, and which symptomatic components of ED are related to these behaviors. Hence, a cross-case-control design was used to compare eating disorders at onset (n= 50) with three control groups: a group with psychiatric pathologies (depressive disorders [DD], n= 40), a group with psychosomatic pathology (asthma, n= 40), and a control group without pathologies (n= 50). The entire sample is made up of 180 adolescent women aged 12-18 years and their families matched by age and socioeconomic status. The results obtained indicate that internalization is a general risk factor for the psychopathology of ED and mood disorders, and that in ED it is specifically associated with a drive for thinness, ineffectiveness, interoceptive awareness, depression, trait-anxiety and obsessive-compulsive symptomatology. Thus, the high comorbidity of ED is associated mainly with other internalizing behaviors.