Classifying eating disorders based on "healthy" and "unhealthy" perfectionism and impulsivity

ObjectivePerfectionism and impulsivity are associated with eating disorders (EDs). The current study examines whether clinically relevant subgroups of women with EDs can be identified based on healthy and unhealthy perfectionism and impulsivity. MethodLatent profile analyses (LPA) were performed on data of 844 patients (DSM-IV diagnosis: 381 anorexia nervosa, 146 bulimia nervosa, 56 binge-eating disorder, 261 ED not otherwise specified). Healthy and unhealthy forms of perfectionism and impulsivity were assessed by the Frost Multidimensional Perfectionism Scale and the Dickman Impulsivity Inventory, respectively. The Eating Disorder Examination Questionnaire was completed to assess ED psychopathology. Furthermore, in 229 patients additional ED symptoms, depression, self-esteem, obsessive-compulsive symptoms, and personality features were assessed. ResultsThe LPA revealed four profiles; 1. Healthy Impulsivity (HI; n=191), 2. Unhealthy Impulsivity (UI; n=238), 3. Healthy and Unhealthy Perfectionism (HP+UP; n=153), 4. Healthy Perfectionism (HP; n=262). Patients belonging to the HP+UP and the UI classes reported higher levels of ED psychopathology. More severe comorbid symptoms (depressive, obsessive-compulsive and self-esteem) were found in the patients belonging to the HP+UP class. Patients from the HP+UP and HP classes had higher scores for the personality features Harm Avoidance, Persistence and Cooperativeness. DiscussionWomen with EDs could be meaningfully grouped according to perfectionism and impulsivity. These findings can be used to improve treatment matching and intervention strategies. The use of dimensional features, like perfectionism and impulsivity, in ED research, may enable the identification of fundamental underlying mechanisms and provide more insight into potential mechanisms that may drive or maintain disordered eating. (c) 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:673-680)