Empirical identification and validation of eating disorder phenotypes

描述(由申请人提供)：在这篇博士后论文F32 Kirschstein NRSA中，Kamryn Eddy博士提出了一项关于饮食失调(EDS)诊断分类研究的全面研究和培训计划。她的长期研究目标是在儿童、青少年和成人中建立经验性有效的EDS诊断分类系统，这将为临床研究和实践提供信息。发现了当前EDS诊断系统的问题，包括其在临床样本中的应用不完善，纵向诊断不稳定，以及难以将现有的EDS诊断标准应用于青年，挑战了当前系统的有效性，从而限制了其应用。为筹备预计将于2012年出版的需求侧管理--第五次审查，正在重新审查电子设备的分类系统。埃迪博士建议利用两个独特丰富的EDS患者的临床样本对分类进行经验性检查，她在早期职业生涯中一直积极参与这两个样本的数据收集。首先，使用246名寻求治疗的患有ED的成年女性(N=246)的纵向数据集，中位数为9.5年，申请人将利用三种先进的统计方法(潜伏期分析、税收分析和潜伏期转换分析)识别和外部验证ED表型。其次，使用患有EDS(N=300)的青少年(12-19岁)的临床样本，申请者将使用两种先进的统计方法(潜伏期分析、纳税计量分析)识别和外部验证ED表型。申请人与两位病因学研究专家和一组专家顾问合作，制定了一项全面的培训计划，使她具备必要的技能，以从事病因学病因学的研究工作，通过四个目标实现，包括(1)提高她的统计和数据分析技能，重点是发展可用于病因学研究的技能，(2)增加她对病因学研究中的概念和方法问题的了解，(3)熟悉验证病因学模式的生物学方法，以及(4)提高她的赠款写作技能，从而提交K申请。与公共卫生相关：ED是一个严重的问题，最常见于青少年和年轻成年女性，并与大量的医疗发病率、精神共病、死亡率增加和高昂的治疗费用有关。分类研究在为DSM-V做准备时是相关和及时的，可能有助于病因学、预防和干预EDS的研究。申请人可获得的数据集在ED领域是独一无二的，并为探索ED诊断的有效性提供了重要机会。拟议的研究将经验性地得出和表征ED表型，相应的培训计划将为申请者提供推进其研究计划所需的统计、概念和方法论基础。

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.