Empirical identification and validation of eating disorder phenotypes

描述（由申请人提供）：在本博士后F32 Kirschstein NRSA中，Kamryn Eddy博士提出了一项关于饮食失调（EDs）诊断分类研究的综合研究和培训计划。她的长期研究目标是建立经验有效的儿童、青少年和成人急症的诊断分类系统，这将为临床研究和实践提供信息。目前的急症诊断系统存在的问题，包括其对临床样本的不完善应用，纵向诊断的不稳定性，以及难以将现有的急症诊断标准应用于青少年，这些问题挑战了当前系统的有效性，从而限制了其实用性。在准备预计于2012年出版的DSM-V的过程中，EDs的分类系统正在被重新审查。Eddy博士建议利用两个独特丰富的EDs患者临床样本进行实证检验分类，她在早期职业生涯中一直积极参与数据收集。首先，申请者将使用一组寻求治疗的成年ED女性（N=246）的纵向数据集，随访时间中位数为9.5年，利用三种先进的统计方法（潜在剖面分析、分类分析和潜在转变分析）识别和外部验证ED表型。其次，使用青少年（12-19岁）的临床样本（N=300），申请人将使用两种先进的统计方法（潜在特征分析，分类分析）识别和外部验证ED表型。在两位研究急诊科的专家和一个专家顾问团队的合作下，申请人制定了一项全面的培训计划，为她在急诊科的研究生涯做好必要的技能准备，通过四个目标实现，包括：(1)提高她的统计和数据分析技能，重点是发展可用于急诊科研究的技能；(2)提高她对疾病分类学研究中概念和方法问题的理解，(3)熟悉验证疾病分类学图式的生物学方法，(4)提高她的拨款写作技能，从而提交K申请。公共卫生相关性：ed是青少年和年轻成年女性中最常观察到的一个重要问题，与大量医学发病率、精神共病、死亡率增加和高治疗费用有关。分类研究与DSM-V的准备是相关和及时的，并且可以促进ed的病因学、预防和干预研究。申请人可获得的数据集在ED领域是独一无二的，为探索ED诊断的有效性提供了重要的机会。拟议的研究将实证推导和表征ED表型，相应的培训计划将为申请人提供必要的统计，概念和方法基础，以推进她的研究计划。

DESCRIPTION (provided by applicant): In this postdoctoral F32 Kirschstein NRSA, Dr. Kamryn Eddy proposes a comprehensive research and training plan in the study of diagnostic classification of eating disorders (EDs). Her long-term program of research goal is to establish empirically-valid diagnostic classification systems of EDs in children, adolescents, and adults, which will inform clinical research and practice. Identified problems with the current diagnostic system of EDs, including its imperfect application to clinical samples, longitudinal diagnostic instability, and difficulty in applying existing diagnostic criteria for EDs to youth, challenge the validity of the current system, thereby limiting its utility. In preparation for DSM-V, expected to be published in 2012, the classification system of EDs is being re-examined. Dr. Eddy proposes to empirically examine classification utilizing two uniquely rich clinical samples of individuals with EDs for which she has been actively involved in data collection during her early career. First, using a longitudinal dataset of treatment-seeking adult women with EDs (N=246) followed for a median of 9.5 years, the applicant will identify and externally validate ED phenotypes utilizing three advanced statistical approaches (latent profile analysis, taxometric analysis, and latent transition analysis). Second, using a clinical sample of adolescents (ages 12-19) with EDs (N=300), the applicant will identify and externally validate ED phenotypes using two advanced statistical approaches (latent profile analysis, taxometric analysis). In collaboration with two sponsors who are each experts in the study of EDs and a team of expert consultants, the applicant has developed a comprehensive training plan that will prepare her with a requisite skill set for a research career in the nosology of EDs achieved through four objectives including, (1) to advance her statistical and data-analytic skills with a focus on developing skills that can be used in nosological research, (2) to increase her understanding of conceptual and methodological issues in nosological research, (3) to develop a familiarity with biological approaches to validating nosological schemas, and (4) to improve her grant writing skills leading to the submission of a K application. PUBLIC HEALTH RELEVANCE: EDs are a significant problem most often observed in adolescent and young adult females and associated with substantial medical morbidity, psychiatric comorbidity, increased mortality, and high treatment costs. Classification research is relevant and timely in preparation for DSM-V and may facilitate etiological, prevention, and intervention EDs research. The data sets available to the applicant are unique in the field of EDs and provide significant opportunities to explore the validity of the ED diagnoses. The proposed research will empirically derive and characterize ED phenotypes, and the corresponding training plan will provide the applicant with the statistical, conceptual, and methodological foundation necessary to advance her program of research.