Examining racial-ethnic and gender differences in the associations between resilience, psychological inflexibility, and eating disorders.

Introduction: This study investigated independent and interactive associations of resilience and psychological flexibility and racial-ethnic and gender identity in relation to ED risk. Methods: Young adults in the 2022-2023 Healthy Minds Study (N = 24,431) completed the Brief Resilience Scale, Acceptance and Action Questionnaire (AAQ-II), and an ED screening tool. Results: Generalized linear models showed that lower resilience and psychological flexibility were associated with increased ED risk across gender and race-ethnicity categories. Asian American/Asians, American Indian/Alaskan Natives, cisgender women, and transgender women also showed elevated ED risk. An interaction between AAQ-II scores and gender identity revealed that transgender females demonstrated a stronger association between psychological inflexibility and ED risk compared to cisgender males. Resilience emerged as a protective factor regardless of racial-ethnic or gender identity. Discussion: Results highlight the importance of addressing resilience in future ED prevention and treatment and considering variability across racial-ethnic identity and gender in studies of ED risk.