Where do Eating Disorders belong in the Diagnostic Taxonomy?

饮食失调在诊断分类中属于什么位置？

• 批准号: 7494065
• 负责人: Kelsie Terese Forbush
• 金额: $ 2.95万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-30 至 2010-08-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7494065
• 关键词: Accounting; Address; Anorexia Nervosa; Behavior; Behavioral Genetics; Binge Eating; Binge eating disorder; Bulimia; Categories; Class; Comorbidity; DSM-V; Data; Data Analyses; Data Set; Databases; Diagnosis; Diagnostic; Diagnostic and Statistical Manual; Disease; Disinhibition; Distress; Eating; Eating Disorders; Etiology; Fright; Household; Impulse Control Disorders; Investigation; Iowa; Lead; Mental disorders; Modeling; Molecular; Neurotic Disorders; Participant; Personality Disorders; Phase; Placement; Predisposition; Psychopathology; Rate; Recruitment Activity; Research; Sampling; Structural Models; Students; Surveys; Symptoms; Syndrome; System; Taxonomy; United States; Universities; Weight Gain; base; body dissatisfaction; disease classification; dysphoria; mortality; novel; purge

DESCRIPTION (provided by applicant): Recent studies suggest that a dimensional, hierarchical model of mental disorders has clear advantages over a categorical nosology. It appears that such a model is better able to account for the excessive diagnostic comorbidity, poor diagnostic stability, and weak reliability observed in many psychological disorders. However, before a quantitative model can be applied to a subsequent edition of the DSM, it must be broadened and refined. Specifically, more disorders need to be included in structural analyses of psychopathology because the majority of DSM diagnoses have been excluded from existing models. Perhaps the most serious omission from hierarchical models of mental illness are the eating disorders, which are associated with the highest mortality rate of any class of psychiatric disorders. The long-term objective of this project is to to expand previously proposed models of mental illness, with a specific focus on eating disorders. The Specific Aims are to (1) determine where anorexic and bulimic syndromes fit into extant hierarchical models of mental illness, (2) expand extant models of mental illness by including a greater variety of Axis I and II disorders, in order to facilitate the correct placement of eating disorders within the hierarchy, and (3) examine the dispositional factors that are shared between eating disorder symptoms and other psychopathological symptoms in order to replicate and extend structural models at the syndrome- level. If the newly included disorders do not fit cleanly into extant models, this research will result in a revised hierarchical model of mental disorders relevant to the DSM. This investigation will be conducted in two phases. Phase 1 will consist of a retrospective analysis of participants from the National Comorbidity Survey - Replication (N=5,692) and will address Specific Aims 1 and 2. Phase 2 represents a novel study that will be conducted in a large student sample (N=400) recruited from the University of Iowa and will address Specific Aim 3. The proposed set of studies will be the first to include eating disorders among hierarchical models of mental illness. Taken together, the large nationally representative dataset in combination with symptom-level data has the potential to increase our understanding of the topography and etiology of eating and related disorders. In particular, the inclusion of additional disorders could lead to increased diagnostic validity of DSM categories and subtypes and may contribute to molecular and behavior genetic studies of eating disorders, particularly if heritable factors include susceptibility to other forms of mental illness. Thus, this line of research will lead to a more comprehensive empirically based system of psychopathology relevant to the DSM classification of disorders.

描述（由申请人提供）：最近的研究表明，精神障碍的维度、分层模型比分类疾病学具有明显的优势。看来这样的模型能够更好地解释在许多心理障碍中观察到的过多的诊断合并症、较差的诊断稳定性和较弱的可靠性。然而，在将定量模型应用于 DSM 的后续版本之前，必须对其进行扩展和完善。具体来说，更多的疾病需要纳入精神病理学的结构分析中，因为大多数 DSM 诊断已被排除在现有模型之外。也许精神疾病分级模型中最严重的遗漏是饮食失调，它与所有类别精神疾病中死亡率最高。该项目的长期目标是扩展先前提出的精神疾病模型，特别关注饮食失调。具体目标是 (1) 确定厌食症和暴食症综合征在现有精神疾病分层模型中的位置，(2) 通过纳入更多种类的轴 I 和轴 II 疾病来扩展现有的精神疾病模型，以促进饮食失调在层次结构中的正确放置，以及 (3) 检查饮食失调症状和其他精神病理症状之间共有的性格因素，以便复制和扩展结构 综合症水平的模型。如果新纳入的疾病不能完全符合现有模型，这项研究将导致修订与 DSM 相关的精神疾病分层模型。此次调查将分两个阶段进行。第一阶段将包括对全国合并症调查参与者的回顾性分析 - 复制（N = 5,692），并将解决具体目标 1 和 2。第二阶段代表一项新颖的研究，将在爱荷华大学招募的大量学生样本（N = 400）中进行，并将解决具体目标 3。拟议的一组研究将是第一个将饮食失调纳入精神疾病分层模型的研究。总而言之，具有全国代表性的大型数据集与症状水平数据相结合，有可能增加我们对饮食及相关疾病的地形和病因学的理解。特别是，纳入其他疾病可能会提高 DSM 类别和亚型的诊断有效性，并可能有助于饮食失调的分子和行为遗传学研究，特别是如果遗传因素包括对其他形式的精神疾病的易感性。因此，这一研究方向将产生一个与 DSM 疾病分类相关的更全面的、基于经验的精神病理学系统。