A personality classification system for eating disorders: a longitudinal study.
A personality classification system for eating disorders: a longitudinal study.
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饮食失调的人格分类系统：一项纵向研究。
DOI：
10.1016/j.comppsych.2008.04.002
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发表时间：
2008
影响因子：
7.3
通讯作者：
Herzog,DavidB
中科院分区：
文献类型：
--
作者：
Thompson-Brenner,Heather;Eddy,KamrynT;Franko,DebraL;Dorer,DavidJ;Vashchenko,Maryna;Kass,AndreaE;Herzog,DavidB
背景对饮食失调（ED）的研究表明，凭经验得出的人格亚型可以解释当前诊断系统无法捕获的 ED 样本中的异质性。尚未对人格亚型的纵向结果进行检验。方法在本研究中，通过临床访谈对基线时患有神经性厌食症和神经性贪食症的 213 名个体进行人格病理学评估。在基线和平均 9 年的 6 个月随访间隔中收集有关 ED、共病诊断、整体功能和治疗利用率的访谈数据。 结果 基于人格项目对参与者进行 Q 因子分析，产生了 5 个原型系统，包括高功能型、行为失调型、情绪失调型、回避不安全型和强迫敏感型。维度原型评分与基线功能和纵向结果相关。回避-不安全评分显示与不良功能和结果一致的关联，包括未能显示 ED 改善、5 年后整体功能不良以及 5 年后治疗利用率高。行为失调与基线功能不佳有关，但当重度抑郁症和药物滥用障碍病史共变时，行为失调与 ED 或总体结果没有显着相关性。情绪失调和强迫敏感性与负面结果无关。高功能原型评分始终与积极结果相关。结论纵向结果支持人格亚型对 ED 分类的重要性。
BACKGROUNDStudies of eating disorders (EDs) suggest that empirically derived personality subtypes may explain heterogeneity in ED samples that is not captured by the current diagnostic system. Longitudinal outcomes for personality subtypes have not been examined.METHODIn this study, personality pathology was assessed by clinical interview in 213 individuals with anorexia nervosa and bulimia nervosa at baseline. Interview data on EDs, comorbid diagnoses, global functioning, and treatment utilization were collected at baseline and at 6-month follow-up intervals over a median of 9 years.RESULTSQ-factor analysis of the participants based on personality items produced a 5-prototype system, including high-functioning, behaviorally dysregulated, emotionally dysregulated, avoidant-insecure, and obsessional-sensitive types. Dimensional prototype scores were associated with baseline functioning and longitudinal outcome. Avoidant-Insecure scores showed consistent associations with poor functioning and outcome, including failure to show ED improvement, poor global functioning after 5 years, and high treatment utilization after 5 years. Behavioral dysregulation was associated with poor baseline functioning but did not show strong associations with ED or global outcome when histories of major depression and substance use disorder were covaried. Emotional dysregulation and obsessional-sensitivity were not associated with negative outcomes. High-functioning prototype scores were consistently associated with positive outcomes.CONCLUSIONSLongitudinal results support the importance of personality subtypes to ED classification.