From Self-Esteem to Symptoms: A Potential Role for Difficulties Accessing Internal States and Body-Checking Behavior in Disordered Eating Patterns

Drawing on the Seeking Proxies for Internal States (SPIS) model and the concept of Difficulties in Accessing Internal States (DAIS), the present study examined the statistical associations among self-esteem, DAIS, body-checking, and disordered eating patterns (DEP). Within the SPIS framework, self-esteem is conceptualized as an evaluative internal state that may be appraised through externally observable proxies, such as body appearance. Cross-sectional data were collected from 200 adults recruited through Prolific Academic. Hayes' PROCESS macro was used to test simple and serial mediation models examining whether DAIS and body-checking statistically account for associations between state self-esteem and DEP. Lower self-esteem was associated with higher DEP. Both DAIS and body-checking statistically accounted for portions of this association in simple mediation models. In a serial mediation model, the fully sequential pathway (self-esteem → DAIS → body-checking → DEP) remained statistically significant after accounting for shared variance among mediators. Given the cross-sectional design, these findings cannot establish temporal or causal relationships, but the observed pattern of associations is compatible with the proposed conceptual process. Additionally, our findings are based on a nonclinical sample and reflect variability in subclinical eating pathology. Implications for extending the SPIS framework to dimensional eating-related phenomena are discussed.