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

Swanson, Sonja A.; Horton, Nicholas J.; Crosby, Ross D.; Micali, Nadia; Sonneville, Kendrin R.; Eddy, Kamryn T.; Field, Alison E.

doi:10.1002/eat.22308

Cited by 26 publications

(27 citation statements)

References 30 publications

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“…Although the classes that emerged differ from similar analyses on female samples, the findings are consistent with research in females indicating that subclinical symptomatic patterns of eating disorder symptoms are also associated with concurrent and incident depressive symptoms and substance use. 5 …”

Section: Discussionmentioning

confidence: 99%

“…Concerns with one’s appearance and eating disorder behaviors (e.g., binge eating) at subclinical levels can also increase risk for deleterious physical and mental health outcomes. 1–5 Eating disorder diagnostic criteria are largely based on research and clinical work with females. 6,7 The dearth of work on afflicted males may be due to the historic view that males are not at risk, the insensitivity of diagnostic frameworks in indexing the concerns and behaviors of males, insufficient numbers of male patients in clinical treatment settings, and the lack of population-based data on appearance concerns and eating disorder behaviors among males.…”

Section: Introductionmentioning

confidence: 99%

“…5,20–23 Few studies have used LCA to examine appearance concerns and eating disorder behaviors in males across time. One study of 15- to 20-year-old males in the Growing Up Today Study used LCA to examine patterns of appearance concerns and eating disorder behaviors among heterosexual, gay, bisexual, and mostly heterosexual males, detecting patterns focused on weight restriction and muscle-building.…”

Section: Introductionmentioning

confidence: 99%

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Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age

Calzo

Horton

Sonneville

et al. 2016

Journal of the American Academy of Child & Adolescent Psych

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Objective-Research on the manifestations and health correlates of eating disorder symptoms among males is lacking. This study identified patterns of appearance concerns and eating disorder behaviors from adolescence through young adulthood and their health correlates.Method-Participants were 7,067 males from the prospective Growing Up Today Study. Surveys from 1999-2007 (spanning ages 13-26 years) provided repeated measures data on: muscularity and leanness concerns; eating disorder behaviors (purging, overeating, binge eating, use of muscle-building products); and health correlates (obesity, non-marijuana drug use, binge drinking, and depressive symptoms).Results-Latent class analyses of observations at ages 13-15, 16-18, 19-22, and 23-26 identified one large Asymptomatic class and four symptomatic patterns: Body Image Disturbance Correspondence to: Jerel P. Calzo, PhD, Division of Adolescent/Young Adult Medicine Boston Children's Hospital, 300 Longwood Ave., AU-Box 17, BCH3189, Boston, MA 02115; jerel.calzo@childrens.harvard.edu. Supplemental material cited in this article is available online.The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.Drs. Horton, Crosby, Swanson, and Calzo served as the statistical experts for this research.Disclosure: Drs. Calzo, Horton, Sonneville, Swanson, Crosby, Micali, Eddy, and Field report no biomedical financial interests or potential conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (high appearance concerns, low eating disorder behaviors; 1.0%-6.0% per age period); Binge Eating/Purging (binge eating and purging, use of muscle-building products, low appearance concerns; 0.1%-2.5%); Mostly Asymptomatic (low levels of muscularity concern, product use, and overeating; 3.5%-5.0%); and Muscularity Concerns (high muscularity concerns and use of products; 0.6%-1.0%). The Body Image Disturbance class was associated with high estimated prevalence of depressive symptoms. Males in the Binge Eating/Purging and Muscularity Concerns classes had high prevalence of binge drinking and drug use. Despite exhibiting modestly greater appearance concerns and eating disorder behaviors than the Asymptomatic class, being in the Mostly Asymptomatic class was prospectively associated with adverse health outcomes. HHS Public AccessConclusion-Results underscore the importance of measuring concerns about leanness, muscularity, and use of muscle-building products when assessing eating disorder presentations among males in research and clinical settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age

Calzo

Horton

Sonneville

et al. 2016

Journal of the American Academy of Child & Adolescent Psych

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“…In a large sample of females in the United States we previously identified four ED classes and found that those involving purging were at increased risk for binge drinking and drug use[18]. Using data obtained when adolescents were aged 13, when ED were rare, previously we empirically identified 3 DE patterns (binge eating/overeating, weight and shape concern and weight control behaviours and food restriction) among boys and girls from the Avon Longitudinal Study of Parents and Children-ALSPAC (the sample under study)[19].…”

Section: Introductionmentioning

confidence: 99%

Eating disorder behaviours amongst adolescents: investigating classification, persistence and prospective associations with adverse outcomes using latent class models

Micali

Horton

Crosby

et al. 2016

Eur Child Adolesc Psychiatry

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Diagnostic criteria for eating disorders (ED) remain largely based on clinical presentations, but do not capture the full range of behaviours in the population. We aimed to derive an empirically based ED behaviour classification using behavioural and body mass index (BMI) indicators at three time-points in adolescence, and to validate classes investigating prospective associations with adverse outcomes. Adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC) provided data on ED at age 14 (n = 6615), 16 (n = 5888), and 18 years (n = 5100), and had weight and height measured. Psychological and behavioural outcomes were assessed at 15.5/16 and 17.5/18 years. We fit gender- and age-stratified latent class models, and employed logistic regression to investigate associations between classes and later outcomes. One asymptomatic and two symptomatic (largely representing higher and lower frequency ED behaviours) classes were observed at each time-point, although their relative prevalence varied by age and gender. The majority of girls in symptomatic classes remained symptomatic at subsequent assessments. Girls in symptomatic classes had higher odds of subsequent anxiety and depressive disorders, binge drinking, drug use, and deliberate self-harm. Data analyses were underpowered amongst boys. The presence of two symptomatic classes (characterised by different ED behaviour frequency) and their prospective association with adverse outcomes suggest a need to refine diagnostic thresholds based on empirical data. Despite some instability of classes, particularly in mid-adolescence, evidence that half of girls in symptomatic classes remained symptomatic suggests persistence of ED behaviours in adolescence, and highlights a need for early identification to reduce chronicity.

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“…In this way, emotion regulation and LOC eating are distinct, but overlapping, developmental processes. Given age-related changes in emotion regulation and propensity towards LOC eating (Swanson et al, 2014; Zeman, Cassano, Perry-Parrish, & Stegall, 2006), there may be developmental windows in which the link between deficient emotion regulation and LOC eating is particularly strong. For example, this link may become more evident throughout adolescence and adulthood as associations between LOC eating and distress relief strengthen over time with repeated pairings, whereas the link may be weaker in early/middle childhood due to less consolidated learned associations between LOC eating and distress relief (Nevin & Grace, 2000).…”

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confidence: 99%

Emotion Regulation and Loss of Control Eating in Community-Based Adolescents

Goldschmidt

Lavender

Hipwell

et al. 2016

J Abnorm Child Psychol

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The current study investigated concurrent and prospective associations between emotion-related constructs and loss of control (LOC) eating in adolescents. Community-based females (N=588) completed annual self-report assessments of LOC eating, emotional awareness, emotion regulation strategies, and neuroticism from ages 16–18 years. Linear regressions and a regression-based multiple mediation model using bootstrapping were computed to examine the relationships among emotion-related constructs and LOC eating frequency. In the concurrent model, age 18 emotional awareness and emotion regulation strategies were associated with age 18 LOC eating, F(6, 416)=12.11, p<.001, accounting for 4.5% of the variance after controlling for demographics, body mass index, and neuroticism, F change=10.81, p<.001. In the prospective model, age 17 emotional awareness predicted age 18 LOC eating, F(7, 425)=11.67, p<.001, accounting for 1.7% of unique variance beyond the effects of age 16 LOC eating and age 17 demographics, body mass index, and neuroticism, F change=4.26, p=.015. In the multiple mediation model, age 18 emotion regulation strategies mediated the association between age 17 neuroticism and age 18 LOC eating, indirect effect estimate=.003, 95% confidence interval=.001–.005, after controlling for age 16 LOC eating and age 17 demographics, body mass index, and emotion regulation variables. Results suggest that deficient emotion regulation may contribute to the onset and maintenance of LOC eating in adolescence (although effects were small), and may partially explain the well-established prospective relationship between negative emotionality and later LOC eating. Prevention and early intervention programs should seek to improve adaptive coping in at-risk populations.

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

Cited by 26 publications

References 30 publications

Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age

Male Eating Disorder Symptom Patterns and Health Correlates From 13 to 26 Years of Age

Eating disorder behaviours amongst adolescents: investigating classification, persistence and prospective associations with adverse outcomes using latent class models

Emotion Regulation and Loss of Control Eating in Community-Based Adolescents

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