TABLE 1.
Mobile-application assessment items
| Content | Item |
|---|---|
| ED cognitions | |
| Fear of weight gain | I am terrified of gaining weight |
| Weight/shape dissatisfaction | I feel dissatisfied with my weight or shape |
| Fear of food | I am worried about eating |
| Drive for thinness | I am preoccupied with the desire to be thinner |
| Overvaluation of shape/weight | My worth as a person (how I think about and judge myself) is influenced by my weight and/or shape |
| Fear of losing control | I am afraid of losing control of my eating |
| Body dissatisfaction | I do not like how my body looks |
| Feel fat | I feel fat |
| Social appearance anxiety | I am worried people are judging the way I look negatively |
| Eating anxiety | I felt anxious when I ate |
| Hunger anxiety | When I felt hungry, it made me anxious |
| Repetitive thoughts about food | I am having thoughts about food that I cannot stop |
| Physical sensation of eating | I did not like the physical sensations I felt when eating |
| Urge to restrict | I have the urge to restrict |
| Difficulty drinking in public | I found it difficult to drink something in front of a group of people |
| Difficulty eating in public | I am concerned about other people seeing me eat |
| ED behaviors | |
| Restraint | I have been consciously trying to restrict my food intake to influence my shape or weight |
| Fasting | I have skipped meals or snacks in order to influence my shape or weight |
| Food rules | I have tried to follow definite rules regarding eating in order to influence shape or weight |
| Purging | I vomited in order to lose weight |
| Laxative/diuretic use | I used laxatives or diuretics in order to lose weight |
| Binge eating | I ate a very large amount of food in a short period of time and felt out of control |
| Chewing and spitting | I have chewed and spit |
| Body checking | I have squeezed, looked at, or touched parts of my body to determine their size or form |
| Excessive exercise | I felt compelled to exercise or that I must exercise for a certain amount of time and/or in a strenuous manner |
| Food avoidance | I avoided certain foods because they make me anxious |
| Small portions | I ate very small portions |
| Affect/comorbidities/maintaining mindsets | |
| Anxiety | I feel anxious |
| Stress | I feel stressed |
| Fear | I feel scared |
| Worthlessness | I feel worthless |
| Feeling ineffective | I feel ineffective |
| Guilt | I feel guilty |
| Shame | I feel ashamed |
| Depression | I feel so sad and unhappy I cannot stand it |
| Active suicidal ideation | I am thinking about hurting or killing myself |
| Passive suicidal ideation | I felt like I would be better off dead |
| Nonsuicidal self-injury | I have engaged in self-harm behaviors |
| Fatigue | I feel tired and fatigued |
| Agitation | I feel agitated |
| Difficulty relaxing | I am unable to relax right now |
| Obsessions | Right now I am upset about unpleasant thoughts that come into my mind against my will |
| Compulsion | I felt compelled to act in a certain way to get rid of thoughts I am having, even if it is senseless or excessive |
| Thought suppression | I frequently got uncomfortable thoughts and felt I must do something in order to get rid of them |
| Impulsivity | I had trouble controlling my impulses |
| Bad person | I am having the thought that I am a bad person |
| Emotional avoidance | I tried to avoid my emotions |
| Emotions overwhelming | I experienced my emotions as overwhelming and out of control |
| Post-event processing | I had thoughts or images about an event that occurred over and over again, that is resulting in my feelings getting worse and worse |
| Post-traumatic intrusive thoughts | I had repeated, disturbing memories, thoughts, or images about a stressful experience from the past |
| Heart racing | My heart raced for no good reason |
| Worries overwhelming | My worries overwhelmed me |
| Social interaction anxiety | When I was in a social situation, I felt uncomfortable |
| Social anxiety | I am afraid that others will not approve of me and reject me |
| Interoceptive awareness | I felt very sensitive to changes in my internal bodily sensations |
| Physical sensation discomfort | I had uncomfortable physical sensations in my body |
| Concern over mistakes | I am afraid of making mistakes |
| High standards | I am setting higher goals for myself than most people |
| Intolerance of uncertainty | I cannot stand not knowing what is going to happen in the future |
| Fear of attracting attention | I worried I might do something to attract the attention of other people |
| Avoidance | I avoided a difficult or scary situation |
Note: Directions for cognitions and affect will ask participants to focus on what they are thinking and feeling at the moment. Directions for behaviors will ask participants to report on behaviors since the last time they answered questions through the mobile app. All questions are on a 0–100 scale to ensure high enough variability to model individual networks. Participants are asked these questions four times a day for 30 days. Anchors for most questions range from 0 not at all, 50 somewhat, to 100 extremely.