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Int J Eat Disord. 2019 Mar 18. doi: 10.1002/eat.23069. [Epub ahead of print]

The classification of eating disorders in China: A categorical model or a dimensional model.

Author information

1
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Abstract

OBJECTIVE:

According to the ICD-10 and DSM-5, eating disorders (EDs) are classified using a categorical model that assumes the subtypes are qualitatively different from one another. However, it is still intensely debated that a dimensional model is more suitable. The aim of this study is to examine whether EDs have a categorical or dimensional latent structure using a sample of Chinese ED patients.

METHOD:

The sample included 322 patients, diagnosed with an ED from 2010 to 2017 in the Shanghai Mental Health Center, and comparison participants (N = 850), recruited from undergraduate students in one university in Shanghai. Participants were evaluated with the Eating Disorder Inventory-2 (EDI-2) questionnaire and another questionnaire developed by the researchers. Three taxometric procedures (MAXimum EIGenvalue [MAXEIG], latent-mode factor analysis [L-Mode], and Mean Above Minus Below A Cut [MAMBAC]) were applied, respectively, to analyze the patients' clinical symptoms data.

RESULTS:

Patients were divided into three groups according to their clinical diagnosis. The plots of the three taxometric analysis procedures supported the categorical construct in anorexia nervosa, binge-eating/purging group, and bulimia nervosa group. The Comparison Curve Fit Indices of the MAXEIG, L-Mode, and MAMBAC procedures were 0.694, 0.709, 0.704 in the AN-BP group and 0.727, 0.67, 0.62 in the BN group, respectively, which also support the categorical construct.

DISCUSSION:

The results support two distinct classes of ED subtypes among Chinese sample. Further work on applying hybrid model in analysis has been discussed.

KEYWORDS:

anorexia nervosa; bulimia nervosa; classification; eating disorder; taxometric analysis

PMID:
30883838
DOI:
10.1002/eat.23069

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