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A latent profile analysis of the typology of bulimic symptoms in an indigenous Pacific population: evidence of cross-cultural variation in phenomenology

Published online by Cambridge University Press:  29 March 2010

J. J. Thomas ,
R. D. Crosby ,
S. A. Wonderlich ,
R. H. Striegel-Moore  and
A. E. Becker
J. J. Thomas*
Affiliation:
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, USA Klarman Eating Disorders Center, McLean Hospital, USA Department of Psychiatry, Harvard Medical School, USA
R. D. Crosby
Affiliation:
Neuropsychiatric Research Institute, USA University of North Dakota School of Medicine and Health Sciences, USA
S. A. Wonderlich
Affiliation:
Neuropsychiatric Research Institute, USA University of North Dakota School of Medicine and Health Sciences, USA
R. H. Striegel-Moore
Affiliation:
Department of Psychology, Montana State University, USA
A. E. Becker
Affiliation:
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, USA Department of Psychiatry, Harvard Medical School, USA Department of Global Health and Social Medicine, Harvard Medical School, USA
*
*Address for correspondence: J. J. Thomas, Ph.D., Eating Disorders Clinical and Research Program, Massachusetts General Hospital, WAC 816D, 15 Parkman St, Boston, MA02114, USA. (Email: [email protected])
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Abstract

Background

Previous efforts to derive empirically based eating disorder (ED) typologies through latent structure modeling have been limited by the ethnic and cultural homogeneity of their study populations and their reliance on DSM-IV ED signs and symptoms as indicator variables.

Method

Ethnic Fijian schoolgirls (n=523) responded to a self-report battery assessing ED symptoms, herbal purgative use, co-morbid psychopathology, clinical impairment, cultural orientation, and peer influences. Participants who endorsed self-induced vomiting or herbal purgative use in the past 28 days (n=222) were included in a latent profile analysis (LPA) to identify unique subgroups of bulimic symptomatology.

Results

LPA identified a bulimia nervosa (BN)-like class (n=86) characterized by high rates of binge eating and self-induced vomiting, and a herbal purgative class (n=136) characterized primarily by the use of indigenous Fijian herbal purgatives. Both ED classes endorsed greater eating pathology and general psychopathology than non-purging participants, and the herbal purgative class endorsed greater clinical impairment than either the BN-like or non-purging participants. Cultural orientation did not differ between the two ED classes.

Conclusions

Including study populations typically under-represented in mental health research and broadening the scope of relevant signs and symptoms in latent structure models may increase the generalizability of ED nosological schemes to encompass greater cultural diversity.

Keywords

Classificationeating disordersFijiherbal purgativelatent profile analysis
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 1 , January 2011 , pp. 195 - 206
Copyright
Copyright © Cambridge University Press 2010

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