Haynos Ann F, Utzinger Linsey M, Lavender Jason M, Crosby Ross D, Cao Li, Peterson Carol B, Crow Scott J, Wonderlich Stephen A, Engel Scott G, Mitchell James E, Le Grange Daniel, Goldschmidt Andrea B
Department of Psychiatry, University of Minnesota, 2450 Riverside Ave., F253, Minneapolis, MN 55454, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
J Psychopathol Behav Assess. 2018 Dec;40(4):691-700. doi: 10.1007/s10862-018-9672-8. Epub 2018 Apr 6.
Perfectionism is hypothesized to contribute to the etiology of anorexia nervosa (AN). However, there is little research regarding whether individuals with AN can be classified according to maladaptive (e.g., evaluative concerns) and adaptive (e.g., high personal standards) facets of perfectionism that predict distinct outcomes and might warrant different intervention approaches. In this study, a latent profile analysis was conducted using data from adults with AN ( = 118). Frost Multidimensional Perfectionism Scale (Frost et al. , 14(5), 449-46, 1990) subscales were used to identify subgroups differing according to endorsed perfectionism features (e.g., adaptive and maladaptive perfectionism). Generalized linear models were used to compare subgroups on eating disorder and affective symptoms measured through questionnaire and ecological momentary assessment. Four subgroups were identified: (a) Low Perfectionism; (b) High Adaptive and Maladaptive Perfectionism; (c) Moderate Maladaptive Perfectionism; and (d) High Maladaptive Perfectionism. Subgroups differed on overall eating disorder symptoms ( < .001), purging ( = .005), restrictive eating ( < .001), and body checking ( < .001) frequency, depressive ( < .001) and anxiety ( < .001) symptoms, and negative ( = .001) and positive ( < .001) affect. The Low Perfectionism group displayed the most adaptive scores and the Moderate and High Maladaptive Perfectionism groups demonstrated the most elevated clinical symptoms. The High Adaptive and Maladaptive Perfectionism group demonstrated low affective disturbances, but elevated eating disorder symptoms. Results support the clinical significance of subtyping according to perfectionism dimensions in AN. Research is needed to determine if perfectionism subtyping can enhance individualized treatment targeting in AN.
完美主义被认为与神经性厌食症（AN）的病因有关。然而，关于患有AN的个体是否可以根据完美主义的适应不良（如评价性担忧）和适应性（如高标准）方面进行分类的研究很少，这些方面预测不同的结果，可能需要不同的干预方法。在本研究中，使用来自成年AN患者（n = 118）的数据进行了潜在剖面分析。使用弗罗斯特多维完美主义量表（弗罗斯特等人，1990年，14(5)，449 - 46）的子量表来识别根据认可的完美主义特征（如适应性和适应不良性完美主义）不同的亚组。使用广义线性模型比较亚组在通过问卷和生态瞬时评估测量的饮食障碍和情感症状方面的差异。确定了四个亚组：（a）低完美主义；（b）高适应性和适应不良性完美主义；（c）中度适应不良性完美主义；（d）高适应不良性完美主义。亚组在总体饮食障碍症状（p <.001）、清除行为（p =.005）、限制性饮食（p <.001）和身体检查（p <.001）频率、抑郁（p <.001）和焦虑（p <.001）症状以及消极（p =.001）和积极（p <.001）情感方面存在差异。低完美主义组表现出最适应的分数，中度和高适应不良性完美主义组表现出最高的临床症状。高适应性和适应不良性完美主义组表现出低情感障碍，但饮食障碍症状升高。结果支持了在AN中根据完美主义维度进行亚型分类的临床意义。需要进行研究以确定完美主义亚型分类是否可以增强AN的个体化治疗针对性。
