Are Central Eating Disorder Network Symptoms Sensitive to Item Selection and Sample? Implications for Conceptualization of Eating Disorder Psychopathology from a Network Perspective

Item selection is a critical decision in modeling psychological networks. The current pre-registered two-study research used random selections of 1,000 symptom networks to examine which eating disorder (ED) and co-occurring symptoms are most central in longitudinal networks among individuals with EDs (N = 71, total observations = 6,060) and tested whether centrality changed based on which items were included in the network. Participants completed two weeks of ecological momentary assessment (EMA; 5 surveys/day). In Study 1, we obtained initial strength centrality values by estimating an a-priori network using eight items with the highest means. We then estimated 1,000 networks and their centrality from a random selection of unique 8-item symptom combinations. We compared the strength centrality from the a-priori network to the distribution of strength centrality estimates from the random-item networks. In Study 2, we repeated this procedure in an independent longitudinal dataset (N=41, total observations=4,575) to determine if our results generalized across samples. Shame, guilt, worry, and fear of losing control were consistently central across networks, regardless of items included in the network or sample. Results suggest that these symptoms may be important to the structure of ED psychopathology and have implications for how we understand the structure of ED psychopathology. Existing methods for item inclusion in psychological networks may distort the structure of ED symptom networks by either under- or overestimating strength centrality, or by omitting consistently central symptoms that are non-traditional ED symptoms. Future research should consider including these symptoms in models of ED psychopathology.