Reading tea leaves or tracking true constructs? An assessment of personality-based latent profiles in eating disorders.

Background: Eating disorder (ED) subtyping studies have often extracted an undercontrolled, an overcontrolled and a resilient profile based on trait impulsivity and perfectionism. However, the extent to which methodological choices impact the coherence and distinctness of resulting subtypes remains unclear. Objective: In this paper, we aimed to assess the robustness of these findings by extracting personality-based subtypes on a sample of ED patients (N = 221) under different analytic conditions. Methods: We ran four latent profile analyses (LPA), varying the extent to which we constrained variances and covariances during model parametrization. We then performed a comparative analysis also including state ED symptom measures as indicators. Finally, we used cross-method validation via k-means clustering to further assess the robustness of our profiles. Results: Our results demonstrated a four-profile model based on variances in impulsivity and perfectionism to fit the data well. Across model solutions, the profiles with the most and least state and trait disturbances were replicated most stably, while more nuanced variations in trait variables resulted in less consistent profiles. Inclusion of ED symptoms as indicator variables increased subtype differentiation and similarity across profiles. Validation cluster analyses aligned most with more restrictive LPA models. Conclusion: These results suggest that ED subtypes track true constructs, since subtypes emerged method-independently. We found analytic methods to constrain the theoretical and practical conclusions that can be drawn. This underscores the importance of objective-driven analytic design and highlights its relevance in applying research findings in clinical practice.

Perfectionism and impulsivity based risk profiles in eating disorders.

OBJECTIVE: The categorical classification of eating disorders (ED) has several limitations, for example, high symptom variability within the diagnosis and limited predictive validity for treatment response. An alternative is classifying individuals with ED based on personality traits, which can reflect underlying etiological mechanisms. We aimed to find latent profiles based on facets of maladaptive and adaptive perfectionism, impulsivity and ED symptoms. METHOD: The sample comprised of 274 women-164 had an ED diagnosis and 110 were controls. Two separate latent profile analyses were performed-one on the mixed sample (controls and individuals with ED) and the other on the sample of individuals with ED only. RESULTS: We identified a five-class model to be the best fit for the mixed sample. The classes were: (a) moderately impulsive, (b) high functioning, (c) purely perfectionistic, (d) emotionally dysregulated, (e) behaviorally dysregulated. Among the individuals with ED, a four-class solution was found to be the best fit. The classes were very similar in their response patterns on indicator variables to response patterns observed in the mixed sample, except the emotionally and behaviorally dysregulated classes that formed into one class. DISCUSSION: In addition to the well-known high-functioning, overcontrolled and undercontrolled classes, two to three undercontrolled classes (moderately impulsive, behaviorally, and emotionally dysregulated class) emerged. Those classes differentiated on perfectionism and impulsivity levels as well as on ED symptom severity and psychiatric comorbidities-all of which may influence maintenance of ED, appropriate treatment choice and therefore treatment response.