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A latent class analysis to empirically describe eating disorders through developmental stages

Authors

  • Sonja A. Swanson ScM,

    Corresponding author
    1. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    • Corresponding to: Sonja A. Swanson, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Kresge 9th Floor, Boston, MA 02115. E-mail: sswanson@hsph.harvard.edu

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  • Nicholas J. Horton ScD,

    1. Department of Mathematics and Statistics, Amherst College, Amherst, Massachusetts
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  • Ross D. Crosby PhD,

    1. Neuropsychiatric Research Institute and Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
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  • Nadia Micali MD, PhD,

    1. Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, London, United Kingdom
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  • Kendrin R. Sonneville RD, ScD,

    1. Division of Adolescent Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
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  • Kamryn Eddy PhD,

    1. Harris Center for Education and Advocacy in Eating Disorders, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
    2. Harvard Medical School, Boston, Massachusetts
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  • Alison E. Field ScD

    1. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    2. Division of Adolescent Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
    3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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ABSTRACT

Objectives

The current standards for classifying eating disorders were primarily informed by adult, clinical study populations, while it is unknown whether an empirically based classification system can be supported across preadolescence through young adulthood. Using latent class analyses, we sought to empirically classify disordered eating in females from preadolescence to young adulthood, and assess the association between classes and adverse outcomes.

Method

Latent class models were fit using observations from the 9,039 girls participating in the growing up today study, an on-going cohort following participants annually or biennially since 1996 when they were ages 9–14 years. Associations between classes and drug use, binge drinking, and depressive symptoms were assessed using generalized estimating equations.

Results

Across age groups, there was evidence of six classes: a large asymptomatic class, a class characterized by shape/weight concerns, a class characterized by overeating without loss of control, and three resembling full and subthreshold binge eating disorder, purging disorder, and bulimia nervosa. Relative prevalences of classes varied across developmental stages, with symptomatic classes increasing in prevalence with increasing age. Symptomatic classes were associated with concurrent and incident drug use, binge drinking, and high depressive symptoms.

Discussion

A classification system resembling broader definitions of DSM-5 diagnoses along with two further subclinical symptomatic classes may be a useful framework for studying disordered eating among adolescent and young adult females. © 2014 Wiley Periodicals, Inc. Int (J Eat Disord 2014; 47:762–772)

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