Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-31T14:31:11.595Z Has data issue: false hasContentIssue false
  • English
  • Français

Empirically based subgrouping of eating disorders in adolescents: A longitudinal perspective

Published online by Cambridge University Press:  03 January 2018

Thecla Van Der Ham ,
Jacqueline J. Meulman ,
Din C. Van Strien  and
Herman Van Engeland
Thecla Van Der Ham*
Affiliation:
Utrecht University Hospital, Utrecht, The Netherlands
Jacqueline J. Meulman
Affiliation:
Department of Data Theory, Leiden University, The Netherlands
Din C. Van Strien
Affiliation:
Utrecht University Hospital, Utrecht, The Netherlands
Herman Van Engeland
Affiliation:
Utrecht University Hospital, Utrecht, The Netherlands
*
Professor H. van Engeland. Department of Child and Adolescent Psychiatry, Utrecht University Hospital, PO Box 85500, 3508 AG Utrecht, The Netherlands
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Successive DSM versions struggle with the heterogeneity of the eating disorders. Criteria were mainly based on clinical impressions and on descriptive and inferential studies.

Method

In a study of 55 eating-disordered adolescents, we investigated whether patients could be grouped on an empirical basis, using principal components analysis (PCA) with optimal scoring (scaling), i.e. PCA with no a priori assumptions. Clustering was based on Morgan-Russell subscales, each measured four times over the course of illness.

Results

Contrary to DSM – IV criteria, patients did not cluster primarily on the basis of anorectic symptoms; the occurrence of bulimic symptoms was more dominant. Core symptomatology (preoccupation with food, disturbed body perception and inadequate sexual behaviour) did not differ between patients, either at referral or over time.

Conclusions

These results support the spectrum hypothesis of the eating disorders, which considers them as one syndrome with different manifestations.

Type
Papers
Information
The British Journal of Psychiatry , Volume 170 , Issue 4 , April 1997 , pp. 363 - 368
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM – III). Washington. DC: APA.Google Scholar
American Psychiatric Association (1980) (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington. DC: APA Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). Washington DC: APA.Google Scholar
Bruch, H. (1973) Eating Disorders: Obesity, Anorexia Nervosa and the Person Within. New York: Basic Books.Google Scholar
Buja, A. (1992) Remarks on parallel analysis. Multivariate Behavioral Research, 27, 509–540.Google Scholar
Cohen, J. (1988) Statistical Power Analyses for the Behavioral Sciences (2nd edn). Hillsdale, NJ: Lawrence Erlbaum Google Scholar
DaCosta, M. & Halmi, K. (1992) Classifications of anorexia nervosa: question of subtypes. International Journal of Eating Disorders. 11, 305–313.3.0.CO;2-2>CrossRefGoogle Scholar
Gifi, A. (1990) Nonlinear Multivariate Analysis. New York: Wiley.Google Scholar
Gower, J. C. & Meulman, J. J. (1993) The treatment of categorical information in physical anthropology. International Journal of Anthropology. 8, 43–51.CrossRefGoogle Scholar
Haimes, A. L. & Katz, J. L. (1988) Sexual and social maturity versus social conformity in restricting anorectic, bulimic and borderline women. International Journal of Eating Disorders. 7, 331–341.3.0.CO;2-B>CrossRefGoogle Scholar
Heiser, W. J. & Meulman, J. J. (1994) Homogeneity analysis: exploring the distribution of variables and their nonlinear relationships. In Correspondence Analysis in the Social Sciences: Recent Developments and Applications (eds M. Greenacre & J. Blasius), pp. 179–209. New York: Academic Press.Google Scholar
Heiser, W. J. & Meulman, J. J. (1995) Nonlinear methods for the analysis of homogeneity and heterogeneity. In Recent Advances in Descriptive Multivariate Analysis (ed. Krzanowski, W. J.), pp. 51–59. Oxford: Oxford University Press CrossRefGoogle Scholar
Herzog, D. B. & Norman, D K. (1985) Subtyping eating disorders. Comprehensive Psychiatry, 26, 375–380.Google Scholar
Hoek, H.W. (1991) The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care. Psychological Medicine, 21, 455–460.Google Scholar
Holmgren, S., Humble, K., Norring, C., et al(1983) The anorexic bulimic conflict: an alternative diagnostic approach to anorexia nervosa and bulimia. International Journal of Eating Disorders. 2, 3–14.3.0.CO;2-H>CrossRefGoogle Scholar
Kerkhof, A. J. F. M., Van der Wal, J. & Hengeveld, M. W. (1988) Typology of persons who attempted suicide with predictive value for repetition: a prospective cohort study. In Current Issues of Suicidology (eds H. J. Möller, A. Schmidtke & R. Welz), pp. 194–203. Berlin: Springer-Verlag.Google Scholar
Kruskal, J. B. & Shepard, R. N. (1974) A nonmetric variety of linear factor analysis. Psychometrika, 39, 123–157.Google Scholar
Krzanowski, W J. & Marriott, F. H. C. (1994) Multivariate Analysis, Part I: Distributions, Ordination and Inference. London: Edward Arnold.Google Scholar
Laessle, R. G., Wittchen, H U., Fichter, M. M., et al (1989) The significance of subgroups of bulimia and anorexia nervosa: lifetime frequency of psychiatric disorders. International Journal of Eating Disorders, 8, 569–574.3.0.CO;2-0>CrossRefGoogle Scholar
Laessle, R. G., Tuschl, R. J., Waadt, S., et al (1989) The specific psychopathology of bulimia nervosa: a comparison with restrained and unrestrained (normal) eaters. Journal of Consulting and Clinical Psychology, 57, 772–775.Google Scholar
Lowenkopf, E. L. (1982) Anorexia nervosa: some nosological considerations. Comprehensive Psychiatry, 23, 233–240.Google Scholar
Luteyn, F., Starren, J. & van Dijk, H. (1985) Handleiding bij de NPV. Lisse: Swets & Zeitlinger.Google Scholar
Meulman, J. J. (1993) Principal coordinates analysis with optimal transformations of the variables: minimizing the sum of squares of the smallest eigenvalues. British Journal of Mathematical and Statistical Psychology. 46, 287–300.Google Scholar
Mickelide, A. D. & Anderson, A. E. (1985) Subgroups of anorexia nervosa and bulimia: validity and utility. Journal of Psychiatric Research, 19, 121–128.Google Scholar
Morgan, H. G. & Hayward, A. E. (1988) Clinical assessment of anorexia nervosa: the Morgan-Russell Outcome Schedule. British Journal of Psychiatry, 152, 367–371.Google Scholar
Ramsay, J. O. (1989) Monotone regression splines in action. Statistical Science, 4, 425–441.Google Scholar
SPSS (1990) SPSS Categories. Chicago, IL: SPSS Inc.Google Scholar
Strober, M. (1983) An empirically derived typology of anorexia nervosa. In Anorexia Nervosa: Recent Developments (eds P. L. Darby, P. E. Garfinkel, D. M. Garner, et al), pp. 185–196. New York: Alan Liss Google Scholar
Sunday, S. R., Halmi, K. A., Werdam, L., et al (1992) Comparison of body size estimation and eating disorder inventory scores in anorexia and bulimia patients with obese, and restrained and unrestrained controls. International Journal of Eating Disorders, 11, 133–149.Google Scholar
Vandereyclcen, W. & Pierloot, R. (1983) The significance of subclassification on anorexia nervosa: a comparative study of clinical features in 141 patients. Psychological Medicine, 13, 543–549.Google Scholar
van der Ham, T., van Strien, D C. & van Engeland, H. (1994) A four-year prospective follow-up study of 49 eating-disordered adolescents: differences in course of illness. Acta Psychiatrica Scandinavica, 90, 229–235.Google Scholar
van Strien, D. C., van der Ham, T. & van Engeland, H. (1992b) Drop-out characteristics in a follow-up study of 90 eating-disordered patients. International Journal of Eating Disorders, 12, 341–343.Google Scholar
Vlek, C. & Stallen, P. J. (1981) Judging risks and benefits in the small and in the large. Organizational Behavior and Human Performance. 28, 235–271.Google Scholar
Wagenaar, W. A. (1988) Paradoxes of Gambling Behaviour. London: Lawrence Erlbaum.Google Scholar
Welch, G., Hall, A. & Renner, R. (1990) Patient subgrouping in anorexia nervosa using psychologically-based classification. International Journal of Eating Disorders, 9, 311–322.Google Scholar
Winsberg, S. & Ramsay, J. O. (1983) Monotone spline transformations for dimension reduction. Psychometrika, 48, 575–595.Google Scholar
Wonderlich, S. A., Swift, W. J., Slotnick, H. B., et al(1990) DSM-III-R personality disorders in eating disorder subtypes. International Journal of Eating Disorders, 9, 607–609.Google Scholar
Young, F. W., Takane, Y. & De Leeuw, J. (1978) The principal components of mixed measurement level multivariate data: an alternating least squares method with optimal scaling features. Psychometrika, 43, 279–281.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.