Examining the Stability of DSM-IV and Empirically Derived Eating Disorder Classification: Implications for DSM-5
Examining the Stability of DSM-IV and Empirically Derived Eating Disorder Classification: Implications for DSM-5
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DOI：
10.1037/a0025941
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发表时间：
2011-12-01
影响因子：
5.9
通讯作者：
Halmi, Katherine A.
中科院分区：
文献类型：
--
作者：
Peterson, Carol B.;Crow, Scott J.;Halmi, Katherine A.
目的：本研究的目的是通过潜在类别分析（LCA）得出异质性进食障碍样本中进食障碍症状的经验分类，并检查这些潜在类别（LC）的纵向稳定性和DSM-IV进食障碍（艾德）诊断的稳定性。方法：对429例女性艾德症状患者进行为期2年的进食障碍检查，每6个月进行一次。LCA用于在基线处推导经验分类。潜转移分析（LTA）用于检查LC的纵向稳定性，马尔可夫模型程序用于检查所有时间点的DSM-IV艾德诊断。结果：LCA产生了3类解决方案：暴饮暴食和清洗，暴饮暴食，只有低体重指数。LTA表明，这些LC在2年内表现出比DSM-IV诊断更大的稳定性，LC保持在同一类别的概率范围为0.69至0.91，DSM-IV诊断为0.40至0.75。转换模式也显示LC的稳定性更高，只有21%的类别发生变化，而DSM-IV诊断类别的变化率为63%。结论：经验推导的艾德症状类别在2年时间内显示出比DSM-IV诊断更大的纵向稳定性，这表明修改标准以与基于经验的分类（例如，例如，在一个实施例中，减少暴饮暴食和排泄的频率要求）可以减少DSM-5中的艾德诊断交叉。
Objective: The purpose of this investigation was to derive an empirical classification of eating disorder symptoms in a heterogeneous eating disorder sample using latent class analysis (LCA) and to examine the longitudinal stability of these latent classes (LCs) and the stability of DSM-IV eating disorder (ED) diagnoses. Method: A total of 429 females with ED symptoms were assessed using the Eating Disorder Examination every 6 months for 2 years. LCA was used to derive empirical classification at baseline. Latent transition analysis (LTA) was used to examine the longitudinal stability of LCs, and Markov modeling procedures were used to examine DSM-IV ED diagnoses over all the time points. Results: LCA yielded a 3-class solution: binge eating and purging, binge eating only, and low body mass index. LTA indicated that these LCs showed greater stability over 2 years than DSM-IV diagnoses with the probability of remaining in the same class ranging from 0.69 to 0.91 for LCs and from 0.40 to 0.75 for DSM-IV diagnoses. Transition patterns also revealed more stability for LCs with only 21% changing classes compared with 63% of the DSM-IV diagnostic categories. Conclusion: Empirically derived classes of ED symptoms showed greater longitudinal stability than DSM-IV diagnoses over a 2-year time period, suggesting that modifying the criteria to be consistent with empirically based classification (e. g., reducing frequency requirements of binge eating and purging) may reduce ED diagnostic crossover in DSM-5.