Participant characteristics

Sociodemographic characteristics are shown in Table 1. Mean age did not differ across groups (HCG 20.22 ± 2.93; AN 20.78 ± 1.86; BN 19.75 ± 1.03; BED 20.58 ± 2.59 years; p = 0.068). Body mass index differed as expected: AN and BN had lower BMI and BED had higher BMI than healthy controls (all p < 0.001). All participants were female. Smoking and alcohol use were more common in BED than in the other groups (both p < 0.001; Table 1).

Table 1 Sociodemographic and descriptive data on participants

Group comparisons for the Bergen Insomnia Scale (BIS), Depression Anxiety Stress Scale-21 (DASS-21), Memory Functioning Questionnaire (MFQ), and Eating Disorder Examination Questionnaire (EDE-Q) are summarized in Table 2.

Table 2 Comparison of Psychometric Scale Scores Across the GroupsInsomnia (BIS)

BN showed the highest insomnia severity, followed by AN, then BED, all greater than healthy controls (all p < 0.001). Pairwise contrasts indicated BN > AN and AN, BN > BED (examples: BN vs HCG 95% CI [25.06, 27.68]; AN vs HCG 95% CI [15.50, 19.89]).

Affective symptoms (DASS-21)

BN had the most severe depression, anxiety, and stress, with all clinical groups exceeding healthy controls (all p < 0.001). BN also scored higher than AN and BED on each DASS-21 subscale (e.g., Depression BN vs AN 95% CI [4.53, 6.34]).

Memory functioning (MFQ)

Overall perceived memory functioning was lowest in BN and AN and highest in healthy controls; BED was intermediate but above AN and BN (all key contrasts p < 0.001; e.g., MFQ-Total HCG vs BN 95% CI [96.23, 132.07]). Subdomains (general forgetfulness, retrospective functioning, severity of forgetting, use of reminder techniques) follow the same pattern (Table 2).

Eating-disorder pathology (EDE-Q)

Total EDE-Q scores were highest in BN, followed by AN, then BED, with all clinical groups greater than healthy controls (all p < 0.001). By construct, AN and BN showed higher restraint/appearance/weight concerns, whereas BED showed the highest binge-eating scores (all pairwise p < 0.001; Table 2).

Correlation analyses in the AN group demonstrated significant associations between clinical symptoms and eating disorder severity. Anxiety and stress were highly interrelated (r = 0.85, p < 0.001) and both showed strong positive correlations with the EDE-Q global score (r = 0.72 and r = 0.75, respectively, p < 0.001). Depression also correlated positively with the EDE-Q total (r = 0.52, p < 0.001), although these associations were weaker compared to anxiety and stress. Within the MFQ, the total score was moderately associated with anxiety (r = 0.52, p < 0.001) and stress (r = 0.43, p < 0.001), as well as with the EDE-Q total (r = 0.54, p < 0.001). Subscales such as GFF and SF demonstrated robust correlations with both EDE-Q severity indices (r values > 0.60, p < 0.001) and affective symptoms. By contrast, the RF dimension exhibited weaker or nonsignificant associations. Regarding eating disorder subscales, RC, EC, AC, and WC were all strongly correlated with one another (r = 0.78–0.96, p < 0.001), indicating high internal consistency of eating pathology dimensions. Interestingly, BE displayed negative correlations with several EDE-Q subscales (e.g., RC: r = –0.32, WC: r = –0.40, all p < 0.01) and with depression (r = –0.34, p < 0.01), suggesting a distinct clinical profile within the AN sample. Overall, these results highlight that anxiety and stress are the most salient predictors of eating disorder severity, while depressive symptoms and specific cognitive-behavioral features also contribute meaningfully. Detailed correlation coefficients for all subscales are provided in Table 3.

Table 3 Correlation results in the Anorexia nevrosa (AN) group

As shown in Table 4, MFQ-Total scores exhibited strong intercorrelations with all subdimensions (r > 0.83, p < 0.001), indicating high internal consistency across memory functioning domains. Positive associations were observed between MFQ-Total and eating disorder measures, including EDE-Q-Total (r = 0.526, p < 0.001), EDE-Q-EC (r = 0.748, p < 0.001), and EDE-Q-WC (r = 0.379, p = 0.005). In contrast, MFQ-Total was negatively related to EDE-Q-BE (r = − 0.516, p < 0.001). Depression was inversely associated with MFQ domains, particularly MFQ-SF (r = − 0.744, p < 0.001) and MFQ-URT (r = − 0.693, p < 0.001), whereas Anxiety showed a very strong negative correlation with MFQ-SF (r = − 0.989, p < 0.001). Stress was negatively related to both MFQ-Total and its subdimensions (r = − 0.415 to − 0.923, all p < 0.001). Importantly, MFQ-Total and MFQ-SF emerged as critical negative correlates of affective symptom severity, while also showing divergent associations with eating disorder psychopathology. These findings suggest that diminished memory strategy use, especially spontaneous recall and utilization of retrieval cues, is strongly linked with both affective distress and disordered eating behaviors.

Table 4 Correlation results in the Blumnia nevrosa group

As presented in Table 5, BIS-Total scores were positively correlated with Depression (r = 0.627, p < 0.001) and Stress (r = 0.741, p < 0.001), as well as moderately with Anxiety (r = 0.573, p < 0.001). A moderate negative correlation emerged with MFQ-URT (r = − 0.513, p < 0.001). BIS-Total also demonstrated significant associations with eating disorder indices, including EDE-Q-Total (r = 0.533, p < 0.001) and EDE-Q-EC (r = 0.656, p < 0.001), and a weaker relationship with EDE-Q-WC (r = 0.206, p = 0.026). Depression showed very strong correlations with Anxiety (r = 0.888, p < 0.001) and Stress (r = 0.816, p < 0.001), and moderate positive associations with most MFQ subscales, except for a negative relationship with MFQ-URT (r = − 0.202, p = 0.029). Depression was also strongly associated with EDE-Q-Total (r = 0.768, p < 0.001) and EDE-Q-EC (r = 0.740, p < 0.001), while moderately linked with other EDE-Q domains. Anxiety exhibited broad associations, including strong correlations with Stress (r = 0.691, p < 0.001), MFQ-GFF (r = 0.658, p < 0.001), and several EDE-Q indices (r = 0.480–0.958, all p < 0.001). Stress was negatively related to MFQ-URT (r = − 0.594, p < 0.001), but positively correlated with EDE-Q indices, especially EDE-Q-Total (r = 0.629, p < 0.001) and EDE-Q-EC (r = 0.678, p < 0.001). MFQ-Total was strongly intercorrelated with its subscales (r = 0.788–0.988, p < 0.001) and positively associated with EDE-Q-Total, AC, WC, and BE (r = 0.542–0.908, all p < 0.001), but negatively with EDE-Q-RC (r = − 0.534, p < 0.001). At the subscale level, MFQ-GFF showed very strong associations with MFQ-SF (r = 0.972, p < 0.001) and EDE-Q-BE (r = 0.926, p < 0.001), while MFQ-RF and MFQ-SF exhibited consistent negative relationships with EDE-Q-RC (r = − 0.561 to − 0.617, all p < 0.001). MFQ-URT was negatively related to EDE-Q-Total (r = − 0.195, p = 0.036) and WC (r = − 0.369, p < 0.001). Finally, EDE-Q domains demonstrated strong internal associations, with EDE-Q-Total being strongly correlated with EC, AC, WC, and BE (r = 0.526–0.789, all p < 0.001), while EDE-Q-RC displayed negative relationships with all other subscales (r = − 0.512 to − 0.731, p < 0.001).

Table 5 Correlation results in the bind eating disorder group

Table 6 shows the findings obtained from the linear regression analysis applied to examine the prediction status of the EDE-Q-Total Scale Score. All participants diagnosed with ED were included in this analysis (AN, BN and BED, total N = 259). The independent variables explain 84.5% of the DE-Q-Total Scale. BIS_Total Scale score significantly and positively predicts the EDE-Q-Total Scale Score (β = 0.485; p < 0.05). Depression Scale score significantly and positively predicts the EDE-Q-Total Scale Score (β = 0.643; p < 0.05). Anxiety Scale score significantly and positively predicts the EDE-Q-Total Scale Score (β = 1.891; p < 0.05). MFQ_GFF Scale score significantly and positively predicts EDE-Q-Total Scale Score (β = 0.150; p < 0.05). MFQ_RF Scale score significantly and negatively predicts EDE-Q-Total Scale Score (β = −1.341; p < 0.05).

Table 6 Results of Multivariate Linear Regression Analysis (N = 259)