title: Anxiety and depression mediate the role of low self-esteem and low self-directedness in the development of eating disorders.
abstract: OBJECTIVE
  Low self-esteem and low self-directedness (SD) are considered a risk factor for the development of eating disorders (EDs). The aim of this study was to test the hypothesis that low self-esteem and low SD lead to a higher risk for EDs through the mediation of anxiety and depression.
  
  
  METHODS
  Seventy-seven female teenagers answered the Eating Disorder Inventory 3 (EDI-3), the Intolerance of Uncertainty Scale (IUS), the Temperament and Character Inventory-Revised (TCI-R), the Rosenberg Self-Esteem Scale (RSES), and the State and Trait Anxiety Inventory (STAI), and the Symptom Checklist-90-Revised (SCL-90-R). To test the hypothesis, a structural equation model (SEM) was used.
  
  
  RESULTS
  According to the EDI3-EDRC scores, 23/77 (29.9%) participants demonstrated positive results in the screening. Participants who had positive results in the screening had significantly higher scores on trait and state anxiety, depression, and IU, and lower means of self-esteem and SD. The SEM demonstrated good fit indices and all paths were significant in the predicted directions, confirming the hypothesized model.
  
  
  CONCLUSIONS
  The current results confirm the role of self-esteem and SD in the development of an ED among adolescent females through the mediating action of IU, anxiety, and depression.
authors.affiliation: Ambulatory for Clinical Research and Treatment of Eating Disorders, Mater Domini University Hospital, Catanzaro, Italy.|Department of Health Sciences, University Magna Graecia, Catanzaro, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Aloi
authors.affiliation: Ambulatory for Clinical Research and Treatment of Eating Disorders, Mater Domini University Hospital, Catanzaro, Italy.|Department of Health Sciences, University Magna Graecia, Catanzaro, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Segura-García
keywords: anxiety; eating disorder; intolerance of uncertainty; self-directedness; self-esteem