Neuroticism and low self-esteem as risk factors for incident eating disorders in a prospective cohort study

Objective To assess the role of neuroticism and low self‐esteem as risk factors for eating disorders (ED). Method A representative sample of girls 12–21 years old from Navarre, Spain. Girls free from any ED in 1997 were followed up for 18 months and reevaluated using DSM‐IV criteria. Multivariable logistic models were used to examine associations between neuroticism (Eysenck Inventory) or low self‐esteem (36‐item scale) and incident ED. Results Higher levels of neurotic personality increased the risk of ED (adjusted odds ratio [OR] for the highest quartile, 3.3; 95% Cl; 1.6–4.8). High levels of self‐esteem were protective (OR, 0.32; 95% CI, 0.16–0.66). Neuroticism was a more powerful predictor than low self‐esteem. Discussion Our results provide prospective evidence supporting the role of neuroticism and low self‐esteem as major determinants of ED. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 33: 271–280, 2003.