Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55454-1495, USA.
J Consult Clin Psychol. 2011 Dec;79(6):777-83. doi: 10.1037/a0025941. Epub 2011 Oct 31.
The purpose of this investigation was to derive an empirical classification of eating disorder symptoms in a heterogeneous eating disorder sample using latent class analysis (LCA) and to examine the longitudinal stability of these latent classes (LCs) and the stability of DSM-IV eating disorder (ED) diagnoses.
A total of 429 females with ED symptoms were assessed using the Eating Disorder Examination every 6 months for 2 years. LCA was used to derive empirical classification at baseline. Latent transition analysis (LTA) was used to examine the longitudinal stability of LCs, and Markov modeling procedures were used to examine DSM-IV ED diagnoses over all the time points.
LCA yielded a 3-class solution: binge eating and purging, binge eating only, and low body mass index. LTA indicated that these LCs showed greater stability over 2 years than DSM-IV diagnoses with the probability of remaining in the same class ranging from 0.69 to 0.91 for LCs and from 0.40 to 0.75 for DSM-IV diagnoses. Transition patterns also revealed more stability for LCs with only 21% changing classes compared with 63% of the DSM-IV diagnostic categories.
Empirically derived classes of ED symptoms showed greater longitudinal stability than DSM-IV diagnoses over a 2-year time period, suggesting that modifying the criteria to be consistent with empirically based classification (e.g., reducing frequency requirements of binge eating and purging) may reduce ED diagnostic crossover in DSM-5.
本研究旨在通过潜在类别分析（LCA）对异质饮食障碍样本中的饮食障碍症状进行实证分类，并检验这些潜在类别（LC）的纵向稳定性和 DSM-IV 饮食障碍（ED）诊断的稳定性。
共有 429 名有 ED 症状的女性在 2 年内每 6 个月接受一次饮食障碍检查。使用 LCA 在基线时得出实证分类。潜过渡分析（LTA）用于检验 LC 的纵向稳定性，马尔可夫建模程序用于检验所有时间点的 DSM-IV ED 诊断。
LCA 得出了 3 类解决方案：暴食和清除、暴食仅、低体重指数。LTA 表明，这些 LC 在 2 年内比 DSM-IV 诊断具有更高的稳定性，同一类别的概率范围从 LC 的 0.69 到 0.91，DSM-IV 诊断的 0.40 到 0.75。转换模式也显示出 LC 的更高稳定性，只有 21%的类别发生变化，而 DSM-IV 诊断类别中有 63%发生变化。
在 2 年的时间内，ED 症状的实证分类比 DSM-IV 诊断具有更高的纵向稳定性，这表明修改标准以符合基于实证的分类（例如，减少暴食和清除的频率要求）可能会减少 DSM-5 中的 ED 诊断交叉。
