The classification of bulimic eating disorders: A community-based cluster analysis study
The classification of bulimic eating disorders: A community-based cluster analysis study
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DOI：
10.1017/s003329170003782x
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发表时间：
1996-07-01
影响因子：
6.9
通讯作者：
Doll, HA
中科院分区：
文献类型：
--
作者：
Hay, PJ;Fairburn, CG;Doll, HA
对于如何最好地对反复暴饮暴食的饮食失调进行分类存在争议。许多反复暴饮暴食的患者不符合两种既定饮食失调的诊断标准，神经性厌食症或神经性贪食症。本研究旨在通过从复发性暴饮暴食患者中确定亚组，测试这些亚组的有效性，并将其预测有效性与DSM-IV方案进行比较，得出一种基于经验且具有临床意义的诊断方案。采用两阶段设计招募了250名复发性暴食的年轻女性作为一般人群样本。使用沃德聚类分析确定样本中的四个亚组。第一亚组有客观或主观贪食发作，呕吐或误服泻药；第二组有客观暴食发作和少量呕吐或泻药滥用；第三组有主观性暴食发作，少量呕吐或误用泻药；第四种是异质性的。该集群解决方案对复制非常健壮。具有较好的描述效度、预测效度和部分构念效度。研究结果支持神经性贪食症的概念，并将其分为清净型和非清净型。他们还提出了一种可能的新型暴饮暴食综合症。暴食症，在DSM-IV中被列为进食障碍的一个例子，没有从聚类分析中出现。
There is controversy over how best to classify eating disorders in which there is recurrent binge eating. Many patients with recurrent binge eating do not meet diagnostic criteria for either of the two established eating disorders, anorexia nervosa or bulimia nervosa. The present study was designed to derive an empirically based, and clinically meaningful, diagnostic scheme by identifying subgroups from among those with recurrent binge eating, testing the validity of these subgroups and comparing their predictive validity with that of the DSM-IV scheme.A general population sample of 250 young women with recurrent binge eating was recruited using a two-stage design. Four subgroups among the sample were identified using a Ward's cluster analysis. The first subgroup had either objective or subjective bulimic episodes and vomiting or laxative misuse; the second had objective bulimic episodes and low levels of vomiting or laxative misuse; the third had subjective bulimic episodes and low levels of vomiting or laxative misuse; and the fourth was heterogeneous in character. This cluster solution was robust to replication. It had good descriptive and predictive validity and partial construct validity.The results support the concept of bulimia nervosa and its division into purging and non-purging subtypes. They also suggest a possible new binge eating syndrome. Binge eating disorder, listed as an example of Eating Disorder Not Otherwise Specified within DSM-IV, did not emerge from the cluster analysis.