Wonderlich Stephen A, Crosby Ross D, Joiner Thomas, Peterson Carol B, Bardone-Cone Anna, Klein Marjorie, Crow Scott, Mitchell James E, Le Grange Daniel, Steiger Howard, Kolden Greg, Johnson Frank, Vrshek Suzanne
University of North Dakota School of Medicine and Health Sciences, Department of Neurosciences, Neuropsychiatric Research Institute, ND 58102, USA.
Psychol Med. 2005 May;35(5):649-57. doi: 10.1017/s0033291704004234.
There is empirical evidence suggesting that individuals with bulimia nervosa vary considerably in terms of psychiatric co-morbidity and personality functioning. In this study, latent profile analysis was used to attempt to identify clusters of bulimic subjects based on psychiatric co-morbidity and personality.
A total of 178 women with bulimia nervosa or a subclinical variant of bulimia nervosa completed a series of self-report inventories of co-morbid psychopathology and personality, and also provided a buccal smear sample for genetic analyses.
Three clusters of bulimic women were identified: an affective-perfectionistic cluster, an impulsive cluster, and a low co-morbid psychopathology cluster. The clusters showed expected differences on external validation tests with both personality and eating-disorder measures. The impulsive cluster showed the highest elevations on dissocial behavior and the lowest scores on compulsivity, while the affective-perfectionistic cluster showed the highest levels of eating-disorder symptoms. The clusters did not differ on genetic variations of the serotonin transporter gene.
This study corroborates previous findings suggesting that the bulimia nervosa diagnostic category is comprised of three classes of individuals based on co-morbid psychopathology and personality. These differences may have significant etiological and treatment implications.
有实证证据表明,神经性贪食症患者在精神共病和人格功能方面存在很大差异。在本研究中,潜在剖面分析被用于尝试根据精神共病和人格来识别贪食症患者的聚类。
共有178名患有神经性贪食症或神经性贪食症亚临床变体的女性完成了一系列关于共病精神病理学和人格的自我报告量表,并且还提供了颊黏膜涂片样本用于基因分析。
识别出了三类贪食症女性:情感-完美主义聚类、冲动聚类和低共病精神病理学聚类。这些聚类在人格和饮食失调测量的外部验证测试中表现出预期的差异。冲动聚类在反社会行为上得分最高,在强迫性上得分最低,而情感-完美主义聚类表现出最高水平的饮食失调症状。这些聚类在血清素转运体基因的遗传变异上没有差异。
本研究证实了先前的发现,即神经性贪食症诊断类别是由基于共病精神病理学和人格的三类个体组成。这些差异可能具有重要的病因学和治疗意义。