Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, Australia.
J Affect Disord. 2018 Jan 1;225:429-437. doi: 10.1016/j.jad.2017.08.062. Epub 2017 Aug 23.
Body dysmorphic disorder (BDD) was categorised in DSM-5 within the newly created 'obsessive-compulsive and related disorders' chapter, however this classification remains subject to debate. Confirmatory factor analysis was used to test competing models of the co-occurrence of symptoms of BDD, obsessive-compulsive disorder, unipolar depression, anxiety, and eating disorders in a community sample of adolescents, and to explore potential sex differences in these models.
Self-report questionnaires assessing disorder symptoms were completed by 3149 Australian adolescents. The fit of correlated factor models was calculated separately in males and females, and measurement invariance testing compared parameters of the best-fitting model between males and females.
All theoretical models of the classification of BDD had poor fit to the data. Good fit was found for a novel model where BDD symptoms formed a distinct latent factor, correlated with affective disorder and eating disorder latent factors. Metric non-invariance was found between males and females, and the majority of factor loadings differed between males and females. Correlations between some latent factors also differed by sex.
Only cross-sectional data were collected, and the study did not assess a broad range of DSM-5 defined eating disorder symptoms or other disorders in the DSM-5 obsessive-compulsive and related disorders chapter.
This study is the first to statistically evaluate competing models of BDD classification. The findings highlight the unique features of BDD and its associations with affective and eating disorders. Future studies examining the classification of BDD should consider developmental and sex differences in their models.
躯体变形障碍（BDD）在 DSM-5 中被归类为新创建的“强迫症及相关障碍”章节内，但这种分类仍存在争议。本研究采用验证性因子分析检验了 BDD 症状、强迫症、单相抑郁、焦虑和饮食障碍在青少年社区样本中的共病症状的竞争模型，并探讨了这些模型中潜在的性别差异。
3149 名澳大利亚青少年完成了评估障碍症状的自报问卷。在男性和女性中分别计算了相关因子模型的拟合度，并比较了最佳拟合模型的参数在男性和女性之间的测量不变性。
BDD 分类的所有理论模型与数据的拟合度都较差。良好的拟合度是在一个新颖的模型中发现的，其中 BDD 症状形成了一个独特的潜在因素，与情感障碍和饮食障碍的潜在因素相关。在男性和女性之间发现了度量非不变性，并且大多数因子负荷在男性和女性之间存在差异。一些潜在因素之间的相关性也存在性别差异。
仅收集了横断面数据，且该研究未评估 DSM-5 定义的广泛的饮食障碍症状或 DSM-5 强迫症及相关障碍章节中的其他障碍。
本研究首次从统计学上评估了 BDD 分类的竞争模型。研究结果突出了 BDD 的独特特征及其与情感和饮食障碍的关联。未来研究在其模型中应考虑到 BDD 的分类的发展和性别差异。
