Association Between Psychological Flexibility and Eating Disorder Symptoms Among College Students

Objective: Research suggests an association between emotion regulation difficulties and eating disorders. Less is known about the association between psychological flexibility (a related construct) and eating disorders, particularly among college students. Therefore, this study aimed to estimate the association between psychological flexibility and eating disorder symptoms among a national sample of U.S. college students. Method: Participants in the 2018-2019 Healthy Minds Study (N = 25,086) completed the Acceptance and Action Questionnaire-II (AAQ-II) and the SCOFF questionnaire. I conducted unadjusted and adjusted analyses to determine the association between AAQ score and a positive eating disorder screen (SCOFF). Results: Analyses revealed significant associations between psychological flexibility and a positive eating disorder screen. Participants who screened positive for an eating disorder had higher mean scores on the AAQ (p < .001), indicating greater psychological inflexibility compared to those who screened negative. Logistic regression analysis revealed that greater psychological inflexibility was significantly associated with higher odds of a positive eating disorder screen (adjusted OR 1.05, 95% confidence interval [1.04, 1.05]), while adjusting for covariates. Conclusions: Social workers and eating disorder prevention efforts can incorporate specific interventions to help college students develop greater psychological flexibility, which may reduce eating disorder symptoms.