Concurrent and prognostic utility of subtyping anorexia nervosa along dietary and negative affect dimensions.
Concurrent and prognostic utility of subtyping anorexia nervosa along dietary and negative affect dimensions.
复制标题
根据饮食和负面影响维度对神经性厌食症进行亚型的同时和预后效用。
DOI：
10.1037/ccp0000164
复制
发表时间：
2017
影响因子：
5.9
通讯作者：
Wildes,JenniferE
中科院分区：
文献类型：
--
作者：
Forbush,KelsieT;Hagan,KelseyE;Salk,RachelH;Wildes,JenniferE
神经性贪食症可以根据饮食限制和负面影响的维度可靠地分为亚型。社区和临床研究表明，与基于精神疾病诊断和统计手册（DSM）的亚型相比，饮食负面影响亚型具有更高的重测信度和并发和预测效度。虽然饮食负面情绪亚型已经显示出对涉及暴食的饮食障碍的表征的实用性，但是这个框架可能对理解限制性饮食障碍具有更广泛的意义。本研究的目的是测试饮食负面情绪亚型在神经性厌食症患者中的并发和预测有效性。方法采用潜在特征分析方法，根据饮食控制和负面情绪两个维度对AN进行亚型识别。卡方和多变量方差分析用于表征所鉴定亚型之间的基线差异。结构方程模型被用来测试是否饮食负面影响亚型将优于DSM类别在预测临床相关outcomes.ResultsResults支持一个2-配置文件模型，复制饮食负面影响亚型：潜在的配置文件1（n= 68）有临床升高的分数限制只;潜在的配置文件2（n= 126）有升高的分数限制和负面影响。验证分析表明，饮食负面影响档案的成员资格与更大的终身精神共病和心理社会损害相比，饮食类。饮食负影响亚型仅优于DSM类别在预测生活质量的损害在1年following.ConclusionsFindings突出的临床效用的亚型AN的基础上饮食限制和负面影响，为未来的治疗匹配或个性化的医疗策略。
Bulimia nervosa can be reliably classified into subtypes based on dimensions of dietary restraint and negative affect. Community and clinical studies have shown that dietary-negative affect subtypes have greater test–retest reliability and concurrent and predictive validity compared to subtypes based on the Diagnostic and Statistical Manual of Mental Disorders (DSM). Although dietary-negative affect subtypes have shown utility for characterizing eating disorders that involve binge eating, this framework may have broader implications for understanding restrictive eating disorders.ObjectiveThe purpose of this study was to test the concurrent and predictive validity of dietary-negative affect subtypes among patients with anorexia nervosa (AN; N= 194).MethodLatent profile analysis was used to identify subtypes of AN based on dimensions of dietary restraint and negative affect. Chi-square and multivariate analysis of variance were used to characterize baseline differences between identified subtypes. Structural equation modeling was used to test whether dietary-negative affect subtypes would outperform DSM categories in predicting clinically relevant outcomes.ResultsResults supported a 2-profile model that replicated dietary-negative affect subtypes: Latent Profile 1 (n= 68) had clinically elevated scores on restraint only; Latent Profile 2 (n= 126) had elevated scores on both restraint and negative affect. Validation analyses showed that membership in the dietary-negative affect profile was associated with greater lifetime psychiatric comorbidity and psychosocial impairment compared to the dietary class. Dietary-negative affect subtypes only outperformed DSM categories in predicting quality-of-life impairment at 1-year follow-up.ConclusionsFindings highlight the clinical utility of subtyping AN based on dietary restraint and negative affect for informing future treatment-matching or personalized medicine strategies.