The Role of Self-Concept Clarity in the Relations Between Disordered Eating, Gender Diversity, and Autistic and ADHD Traits

Self-concept clarity, the degree to which an individual has a well-defined and stable sense of self, is a well-documented factor in mental health conditions, particularly eating disorders. Difficulties with self-concept clarity are also reported among gender diverse and neurodivergent people, who are overrepresented in eating disorder populations. This cross-sectional study examined associations between self-concept clarity (Self-Concept Clarity Scale), autistic traits (Autism Spectrum Quotient), ADHD traits (Adult ADHD Self-Report Scale), gender diversity (Gender Self-Report), and disordered eating, a pattern of atypical eating behaviors and attitudes including food restriction and binge eating (Eating Disorder Examination Questionnaire). Gender diversity was assessed as binary (identity opposite to sex assigned at birth) and nonbinary traits (identity neither female nor male). Participants were 492 UK adults (324 assigned female at birth; 98.6% cisgender, 1.2% trans/gender diverse, 0.2% preferred not to say; M age = 41.44 years, SD = 13.11) recruited online. Correlational and path analysis investigated direct and indirect relations between gender diversity, neurodivergent traits, and disordered eating through self-concept clarity. Autistic traits were indirectly related to disordered eating through self-concept clarity, while ADHD traits showed both direct and indirect associations. Greater binary and nonbinary gender diverse traits were correlated with higher levels of disordered eating but were no longer significantly related once neurodivergent traits, age, and sex assigned at birth were controlled. Findings suggest low self-concept clarity may provide a mechanism for increased disordered eating in individuals with higher levels of neurodivergent traits, but not among those with gender diverse traits when covariates are considered.