Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-27T09:37:39.400Z Has data issue: false hasContentIssue false
  • English
  • Français

Clustering of eating disorder symptoms in a general population female twin sample: a latent class analysis

Published online by Cambridge University Press:  02 May 2007

ALEXIS E. DUNCAN ,
KATHLEEN KEENAN BUCHOLZ ,
ROSALIND J. NEUMAN ,
ARPANA AGRAWAL ,
PAMELA A. F. MADDEN  and
ANDREW C. HEATH
ALEXIS E. DUNCAN*
Affiliation:
Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St Louis, MO, USA
KATHLEEN KEENAN BUCHOLZ
Affiliation:
Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St Louis, MO, USA
ROSALIND J. NEUMAN
Affiliation:
Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St Louis, MO, USA
ARPANA AGRAWAL
Affiliation:
Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St Louis, MO, USA
PAMELA A. F. MADDEN
Affiliation:
Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St Louis, MO, USA
ANDREW C. HEATH
Affiliation:
Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St Louis, MO, USA
*
*Address for correspondence: Alexis Duncan, Ph.D., Washington University School of Medicine, Department of Psychiatry, 660 S. Euclid, Box 8134, St Louis, MO 63110, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Previous studies have reported that the current DSM-IV eating disorder (ED) criteria do not adequately describe ED symptomatology. The objective of the current study was to examine the clustering of ED symptoms in a general population sample using latent class analysis (LCA).

Method

ED symptoms from 3723 female young adult twins (mean age 22) were analyzed using LCA, and resulting classes were compared on external validators reflecting ED and other co-morbid psychiatric diagnoses, substance use disorders (SUDs), and suicidality.

Results

The optimal solution consisted of five latent classes characterized as: (1) Unaffected; (2) Low Weight Gain; (3) Weight Concerned; (4) Dieters; and (5) ED. Members of the ED class had significantly higher prevalence of co-morbid psychiatric disorders, SUDs, and suicidality than the Unaffected and Low Weight Gain classes, and elevated rates of suicidality and major depression compared to the Weight Concerned and Dieter classes, which differed from each other primarily in terms of current body mass index (BMI). Dieter class members were more likely to be overweight and obese and less likely to be underweight than Weight Concerned class members. The majority of women with an ED diagnosis were assigned to the ED class, and few differences were found between ED class members with and without an ED diagnosis.

Conclusions

The results add to the evidence that many women with significant ED psychopathology are not being identified by the DSM-IV ED categories.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 8 , August 2007 , pp. 1097 - 1107
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

APA (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision), DSM-IV-TR. American Psychiatric Association: Washington, DC.Google Scholar
Brunner, Huber L. R. (2007). Validity of self-reported height and weight in women of reproductive age. Maternal and Child Health Journal 11, 137–144.CrossRefGoogle Scholar
Bucholz, K. K., Cadoret, R., Cloninger, C., Dinwiddie, S. H., Hesselbrock, V. M., Nurnberger, J. I., Reich, T., Schmidt, I. & Schuckit, M. A. (1994). A new, semi-structured psychiatric interview for use in genetic linkage studies: a report of the reliability of the SSAGA. Journal of Studies on Alcohol 55, 149–158.CrossRefGoogle ScholarPubMed
Bulik, C. M., Klump, K. L., Thornton, L., Kaplan, A. S., Devlin, B., Fichter, M. M., Halmi, K. A., Strober, M., Woodside, D. B., Crow, S. J., Mitchell, J. E., Rotondo, A., Mauri, M., Cassano, G., Keel, P. K., Berrettini, W. H. & Kaye, W. H. (2004). Alcohol use disorder comorbidity in eating disorders: a multicenter study. Journal of Clinical Psychiatry 65, 1000–1006.CrossRefGoogle ScholarPubMed
Bulik, C. M., Sullivan, P. F. & Kendler, K. S. (2000). An empirical study of the classification of eating disorders. American Journal of Psychiatry 157, 886–895.CrossRefGoogle ScholarPubMed
Cachelin, F. M. & Maher, B. A. (1998). Is amenorrhea a critical criterion for anorexia nervosa? Journal of Psychosomatic Research 44, 435–440.CrossRefGoogle ScholarPubMed
Clogg, C. C. (1995). Latent class models. In Handbook of Statistical Modeling for the Social and Behavioral Sciences (ed. Arminger, G., Clogg, C. C. and Sobel, M. E.), pp. 311–359. Plenum: New York.CrossRefGoogle Scholar
Corcos, M., Taieb, O., Benoit-Lamy, S., Paterniti, S., Jeammet, P. & Flament, M. F. (2002). Suicide attempts in women with bulimia nervosa: frequency and characteristics. Acta Psychiatrica Scandinavica 106, 381–386.CrossRefGoogle ScholarPubMed
Cottler, L. B., Robins, L. N., Grant, B. F., Blaine, J., Towle, L. H., Wittchen, H.-U. & Sartorius, N. (1991). The CIDI-core substance abuse and dependence questions: cross-cultural and nosological issues. The WHO/ADAMHA Field Trial. British Journal of Psychiatry 159, 653–658.CrossRefGoogle ScholarPubMed
Duncan, A. E., Neuman, R. J., Hesselbrock, V., Kramer, J., Kuperman, S., Reich, T. & Bucholz, K. K. (2005). Are there subtypes of bulimia nervosa based on psychiatric comorbidity? International Journal of Eating Disorders 37, 19–25.CrossRefGoogle Scholar
Garfinkel, P. E., Lin, E., Goering, P., Spegg, C., Goldbloom, D. S., Kennedy, S., Kaplan, A. S. & Woodside, D. B. (1996). Should amenorrhoea be necessary for the diagnosis of anorexia nervosa? Evidence from a Canadian community sample. British Journal of Psychiatry 168, 500–506.CrossRefGoogle ScholarPubMed
Gotestam, K. G. & Agras, W. S. (1995). General population-based epidemiological study of eating disorders in Norway. International Journal of Eating Disorders 18, 119–126.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Heath, A. C., Howells, W., Bucholz, K. K., Glowinski, A. L., Nelson, E. C. & Madden, P. A. F. (2002). Ascertainment of a Mid-Western US female adolescent twin cohort for alcohol studies: assessment of sample representativeness using birth record data. Twin Research 5, 107–112.CrossRefGoogle ScholarPubMed
Heath, A. C., Madden, P. A. F., Grant, J. D., McLaughlin, T. L., Todorov, A. A. & Bucholz, K. K. (1999). Resiliency factors protecting against teenage alcohol use and smoking: influences of religion, religious involvement and values, and ethnicity in the Missouri Adolescent Female Twin Study. Twin Research 2, 145–155.CrossRefGoogle ScholarPubMed
Hudson, J. I., Hiripi, E., Pope, H. G. Jr. & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61, 348–358.CrossRefGoogle ScholarPubMed
Kaye, W. H., Bulik, C. M., Thornton, L., Barbarich, N. & Masters, K. (2004). Comorbidity of anxiety disorders with anorexia and bulimia nervosa. American Journal of Psychiatry 161, 2215–2221.CrossRefGoogle ScholarPubMed
Keel, P. K., Fichter, M. M., Quadflieg, N., Bulik, C. M., Baxter, M. G., Thornton, L., Halmi, K. A., Kaplan, A. S., Strober, M., Woodside, D. B., Crow, S. J., Mitchell, J. E., Rotondo, A., Mauri, M., Cassano, G., Treasure, J., Goldman, D., Berrettini, W. H. & Kaye, W. H. (2004). Application of a latent class analysis to empirically define eating disorder phenotypes. Archives of General Psychiatry 61, 192–200.CrossRefGoogle ScholarPubMed
Keel, P. K., Haedt, A. & Edler, C. (2005). Purging disorder: an ominous variant of bulimia nervosa? International Journal of Eating Disorders 38, 191–199.CrossRefGoogle ScholarPubMed
Kendler, K. S., Karkowski, L. M., Prescott, C. A. & Pedersen, N. L. (1998). Latent class analysis of Temperance Board registrations in Swedish male–male twin pairs born 1902–1949: searching for subtypes of alcoholism. Psychological Medicine 28, 803–813.CrossRefGoogle ScholarPubMed
Kendler, K. S., MacLean, C., Neale, M., Kessler, R. C., Heath, A. C. & Eaves, L. (1991). The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry 148, 1627–1637.Google ScholarPubMed
Mitchell, J. E., Cook-Myers, T. & Wonderlich, S. A. (2005). Diagnostic criteria for anorexia nervosa: looking ahead to DSM-V. International Journal of Eating Disorders 37, S95–S97.CrossRefGoogle ScholarPubMed
Muthén, L. K. & Muthén, B. O. (2004). Mplus Users Guide (3rd edn). Muthén & Muthén: Los Angeles, CA.Google Scholar
National Center for Health Statistics (2000). Clinical Growth Charts (www.cdc.gov/nchs/about/major/nhanes/growthcharts/clinical_charts.htm). Accessed 14 April 2006.Google Scholar
Neuman, R. J., Heath, A. C., Reich, W., Bucholz, K. K., Madden, P. A. F., Sun, L., Todd, R. D. & Hudziak, J. J. (2001). Latent class analysis of ADHD and comorbid symptoms in a population sample of adolescent female twins. Journal of Child Psychology and Psychiatry and Allied Disciplines 42, 933–942.CrossRefGoogle Scholar
Robins, L. N., Cottler, L. B., Bucholz, K. K., Compton, W. M., North, C. S. & Rourke, K. M. (1999). Diagnostic Interview Schedule for DSM-IV (DIS-IV). Washington University School of Medicine: St Louis.Google Scholar
Schwarz, G. (1978). Estimating the dimension of a mode. Annals of Statistics 6, 461–464.CrossRefGoogle Scholar
Striegel-Moore, R. H., Franko, D. L., Thompson, D., Barton, B., Schreiber, G. B. & Daniels, S. R. (2005). An empirical study of the typology of bulimia nervosa and its spectrum variants. Psychological Medicine 35, 1563–1572.CrossRefGoogle ScholarPubMed
Sullivan, P. F., Bulik, C. M. & Kendler, K. S. (1998). The epidemiology and classification of bulimia nervosa. Psychological Medicine 28, 599–610.CrossRefGoogle ScholarPubMed
Wade, T. T. M., Crosby, R. D. & Martin, N. G. (2006). Use of latent profile analysis to identify eating disorder phenotypes in an adult Australian twin cohort. Archives of General Psychiatry 63, 1377–1384.CrossRefGoogle Scholar
Walters, E. E. & Kendler, K. S. (1995). Anorexia nervosa and anorexic-like syndromes in a population-based female twin sample. American Journal of Psychiatry 152, 64–71.Google Scholar
WHO (1993). ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research. World Health Organization: Geneva.Google Scholar
Williamson, D. A., Gleaves, D. H. & Stewart, T. M. (2005). Categorical versus dimensional models of eating disorders: an examination of the evidence. International Journal of Eating Disorders 37, 1–10.CrossRefGoogle ScholarPubMed