Depression and anxiety mediate the relationship between insomnia and eating disorders in college women

Abstract

Objective: This study examined the associations between insomnia, anxiety, and depression in college women with eating disorders (EDs). Participants: Six hundred and ninety women from 28 US colleges who screened positive for an ED were assessed for psychiatric comorbidities. Women were, on average, 22.12 years old, mostly White (60.1%) and undergraduates (74.3%). Methods: Two mediation models were tested to determine if depression and/or anxiety mediated the relationship between insomnia and ED symptomatology. Results: One-fifth of the sample (21.7%) reported clinically moderate and severe levels of insomnia. Both depression (B = .13, p <. 001) and anxiety (B = .13, p <. 001) significantly mediated the relationship between insomnia and ED psychopathology. Conclusions: Insomnia is relatively common in college-age women with EDs. Findings suggest that this association between ED and sleep disturbances can be explained, in part, by changes in depression and anxiety. Clinicians should consider incorporating mental health assessments for insomnia, depression, and anxiety into current ED prevention, intervention, and screening efforts on college campuses.

Keywords:

• Anxiety
• college students
• depression
• eating disorders
• insomnia

Acknowledgments

The authors would like to thank all participating universities, research participants, and study staff for their time and dedication to this trial, without whom this work would not be possible. We would also like to thank Drs. Andrea Kass Graham, Dawn Eichen, Corinna Jacobi, and Megan Jones Bell for their contributions to this grant.

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of Americaand received approval from the Institutional Review Boards of Washington University in St. Louis and Stanford University.

Additional information

Funding

This research was supported by funding from the National Institutes of Health (NIH) R01 MH100455, K08 MH120341, T32 HL007456, and T32 HL130357.