Eating Disorders During Emerging Adulthood: A Systematic Scoping Review.

Abstract

Background: Eating disorders (EDs)
during the transition to adulthood can derail social, psychological, and
vocational development. Effective treatment is of paramount importance,
yet young adults' treatment needs are typically less well met than
those of adolescents. In recent years, there has been a considerable
shift in how developmental psychologists understand the transition to
adulthood, with this life-phase reconceptualized as “emerging adulthood”
(EA) (~18–25 years). Engagement with burgeoning developmental research
is likely key to providing more effective care for young people
experiencing EDs.

Aims: To review ED research which has
utilized the concept of EA, and to assess the usefulness of this concept
for ED research and practice.

Methods: A systematic scoping review
was conducted in accordance with the Joanna Briggs Institute guidelines
for scoping reviews. Three databases (Psychinfo, PubMed, Embase) were
searched for papers which explicitly focused on EDs during EA. No
restrictions as to publication type, language, study design, or
participants were applied. Included studies were assessed for
developmental “informedness,” and findings were qualitatively
synthesized.

Results: Thirty-six studies (N =
25,475) were included in the review. Most studies used quantitative
methodologies, were cross-sectional in design and focused on identifying
psychological and social factors which contribute to etiology of EDs.
Many studies (N = 22) used well-defined samples of emerging adults (EAs); few studies (N
= 8) included developmental measures relevant to EAs. Findings indicate
that whilst factors implicated in EDs in adolescence and adulthood are
relevant to EAs, EA-specific factors (e.g., identity exploration) may
also contribute. Conventional ED services and treatments present
difficulties for EAs, whilst those adapted to EAs' needs are feasible,
acceptable, and more effective than treatment-as-usual. Directions for
future research and clinical implications are discussed.

Conclusion: Existing research indicates
that the EA concept is relevant for understanding EDs during the
transition to adulthood, and ED services should implement adaptations
which exploit the opportunities and overcome the challenges of this
developmental stage. EA is currently an underused concept in ED
research, and future engagement with the developmental literature by
both researchers and clinicians may be key to understanding and treating
EDs during transition to adulthood.