Resumen de Risk factors and clinical correlates in eating disorders
The central scientific objective of the current dissertation was to take a multidisciplinary approach to make use of the full potential information, both scientific and clinical to aid prevention and treatment of EDs. In our studies we assessed a.) social and individual risk factors in EDs (Study 1), b.) empirical ED subtypes based on drive for thinness (DT) and depression (Study 2) and c.) the classification based on these four different empirical ED subtypes without cluster analysis and based on the use of clinical cutoff scores of DT and depression. Finally, we assessed the predictive validity for this subtyping scheme with regard to dropout from CBT in an unselected BN-P population seeking treatment. Our first line of investigation (Study 1) assessed social and self-standards in EDs. The results of the study suggest that compared to healthy controls, standards for physical appearance, family standards and self-achievements were higher in individuals with EDs, that ED patients show higher self-discrepancy between their personal and social values and confidence to attain them and that the conflict with their significant others over these issues was higher. Furthermore, high social and self-standards was associated with developing an ED, which emphasize the importance of assessing risk factors in ED. Finally we also observed differences in the ED subtypes; physical appearance a greater risk factor in BN and EDNOS while social-other standards were more associated with AN. The second research area (Study 2 and 3) explored new empirical ED subtypes along DT and depression. In our initial study (Study 2) we found four new ED subtypes through cluster analysis; “DT”, “DT-Depressive”, “mild DT” and “depressive-moderate DT”. This result indicates that dieting and depression are useful for analyzing and identifying ED subtypes. Study 3 further assessed these empirical subtypes and found that the same subtypes emerged when basing them on scores from clinical well-validated questionnaires and moreover that attrition rates differed between subtypes and that the dropout rate was highest for the “DT-Depressive” subtype. Our findings agree with the growing body of research indicating the importance of dieting and comorbid depression as contributing factors in ED diagnoses. Finally, these findings will hopefully aid in resolving the current controversy surrounding current DSM-ED classifications.
