Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Education




Stewart, Shannon


School and Applied Child Psychology Program


This study explored various psychosocial factors associated with disordered eating in adolescents accessing mental health services across Ontario, Canada. Data were collected using the interRAI Child and Youth Mental Health (ChYMH) assessment tool and participants were categorized into three groups: individuals with diagnosed eating disorders (ED, n=207), disordered eating without a formal ED diagnosis (sub-ED, n=888), and other treatment-seeking youth (non-ED, n=3285). The ED and sub-ED groups did not differ in many ways, presenting with a similarly greater prevalence of mental health issues, and dysfunctional family and peer relationships, in comparison to non-ED youth. However, the ED group was more likely to have other psychiatric diagnoses (i.e., mood, anxiety, and sleep disorders) than the sub-ED or non-ED groups. These findings highlight a potentially underserved population of treatment-seeking youth in Canada, facing significant psychosocial challenges related to disordered eating, yet lacking access to proper diagnostic services.

Summary for Lay Audience

This study investigated various psychosocial factors contributing to the development of disordered eating behaviours in a group of young individuals seeking mental health treatment across Ontario, Canada. The researchers focused on adolescents who exhibited disordered eating patterns (e.g., binge eating/purging, fasting/major restriction of diet, body image concerns) but had not been formally diagnosed with an eating disorder (ED). These participants were compared to two other groups: one with diagnosed EDs and another with mental health disorders but without any eating issues. The results revealed that those with undiagnosed disordered eating behaviours displayed similar psychosocial characteristics to those with diagnosed EDs. Both groups were primarily composed of females and older adolescents. In comparison to the non-ED comparison group, disordered eating participants (ED and sub-ED) had a greater prevalence of participants struggling with high levels of internalizing symptoms, depression, anxiety, and risk of suicide and self-harm, as well as self-reported physical and mental health issues. Both groups also presented with greater family dysfunction and peer bullying compared to the non-ED comparison group. Although both groups presented with similar levels of psychosocial impairment, the main distinction between ED-diagnosed and undiagnosed participants with disordered eating was the number of other formal diagnoses received, with ED individuals diagnosed with more comorbid anxiety, mood, and sleep disorders than the other two groups. Secondary analyses revealed that parents of participants in the ED group presented with especially high levels of caregiver distress and parental distress, in comparison to the non-ED group. The sub-ED group included the most participants with externalizing symptoms, peer conflict, and diagnoses of substance-related and adjustment disorders. These findings highlight the importance of identifying and treating EDs among young Canadians, particularly those who seek mental health treatment but lack access to formal ED diagnoses (sub-ED youth). By identifying the psychosocial characteristics of this underserved population, findings may inform efforts aimed at identifying and addressing disordered eating behaviours in youth across Ontario.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.