Forbush Kelsie T, Wildes Jennifer E
Department of Psychology, University of Kansas, Kansas.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois.
Int J Eat Disord. 2017 May;50(5):542-550. doi: 10.1002/eat.22634. Epub 2016 Nov 12.
Several theoretical models describe the structure of eating disorders (EDs), and a burgeoning empirical literature has sought to identify whether eating pathology is conceptualized best as categorical (presence or absence of disorder), dimensional (continuous), or a hybrid of categories and dimensions.
This study used structural equation mixture modeling (SEMM) to identify the latent structure of EDs. Items from the Eating Pathology Symptoms Inventory (EPSI) were administered to individuals with EDs (N = 344). Select EPSI scales and body mass index were indicators in subsequent SEMM analyses. The Inventory of Depression and Anxiety Symptoms (IDAS), ED diagnoses, and select demographic variables were used as validators using chi-square or MANOVA.
Categorical models fit the data better than latent dimensional or hybrid models. Latent profile 1 (LP1) was non-fat-phobic restricting anorexia nervosa; LP2, an obese, binge-eating class; LP3, non-purging bulimia nervosa; LP4, fat-phobic restricting anorexia nervosa; and LP5, multiple purging bulimia nervosa. External validation analyses indicated that LP4 and LP5 had the highest non-ED-related psychopathology.
These findings indicate that there is substantial variability in the phenomenology of traditional DSM-based ED categories across latent profiles, and highlight the salience of certain ED phenotypes that have been debated in the literature. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:542-550).
有几种理论模型描述了饮食失调（EDs）的结构，并且不断涌现的实证文献试图确定饮食病理学最好被概念化为类别性的（存在或不存在障碍）、维度性的（连续的），还是类别与维度的混合形式。
本研究使用结构方程混合模型（SEMM）来确定饮食失调的潜在结构。饮食病理学症状量表（EPSI）中的项目被施用于患有饮食失调的个体（N = 344）。在随后的SEMM分析中，选择的EPSI量表和体重指数作为指标。抑郁和焦虑症状量表（IDAS）、饮食失调诊断以及选定的人口统计学变量被用作卡方检验或多变量方差分析的验证指标。
类别模型比潜在维度模型或混合模型更适合数据。潜在剖面1（LP1）为非恐脂性限制型神经性厌食症；LP2为肥胖、暴饮暴食型；LP3为非清除型神经性贪食症；LP4为恐脂性限制型神经性厌食症；LP5为多次清除型神经性贪食症。外部验证分析表明，LP4和LP5具有最高的与饮食失调无关的精神病理学症状。
这些发现表明，基于传统《精神疾病诊断与统计手册》的饮食失调类别在不同潜在剖面中的现象学存在很大差异，并突出了文献中已争论的某些饮食失调表型的显著性。© 2016威利期刊公司（《国际饮食失调杂志》2017年；50:542 - 550）。
