Is multi-impulsive bulimia a distinct type of bulimia nervosa: Psychopathology and EMA findings

Myers, Tricia Cook; Wonderlich, Stephen A.; Crosby, Ross D.; Mitchell, James E.; Steffen, Kristine J.; Smyth, Joshua M.; Miltenberger, Raymond G.

doi:10.1002/eat.20324

Cited by 67 publications

(70 citation statements)

References 25 publications

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“…This association may support the existence of an eating disorder subgroup that exhibits a cluster of impulsive, problematic behaviors. Previously described as "multi-impulsive," these individuals with BN have been found to display poor response to treatment (Fichter, Quadflieg, & Rief, 1994) as well as other negative outcomes (Keel & Mitchell, 1997;Myers et al, 2006). The identification of diet pill use as another behavior that may characterize these individuals is important for further understanding the nature of eating pathology in this particularly severe subgroup of eating disorder patients.…”

Section: Discussionmentioning

confidence: 99%

Features associated with diet pill use in individuals with eating disorders

et al. 2008

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We investigated the relation between diet pill use and eating disorder subtype, purging and other compensatory behaviors, body mass index (BMI), tobacco and caffeine use, alcohol abuse or dependence, personality characteristics, and Axis I and Axis II disorders in 1,345 participants from the multisite Price Foundation Genetics Studies. Diet pill use was significantly less common in women with restricting type of AN than in women with other eating disorder subtypes. In addition, diet pill use was associated with the use of multiple weight control behaviors, higher BMI, higher novelty seeking, and the presence of anxiety disorders, alcohol abuse or dependence, and borderline personality disorder. Findings suggest that certain clinical and personality variables distinguish individuals with eating disorders who use diet pills from those who do not. In the eating disorder population, vigilant screening for diet pill use should be routine clinical practice.Correspondence to Dr Bulik, Department of Psychiatry, University of North Carolina at Chapel Hill , 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160, Voice: (919) 843 1689 Fax: (919) 966-5628, e-mail: cbulik@med.unc.edu. 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. NIH Public Access Author ManuscriptEat Behav. Author manuscript; available in PMC 2009 January 1. Published in final edited form as:Eat Behav. 2008 January ; 9(1): 73-81. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptKeywords Eating disorders; diet pills; weight control behaviors; novelty seeking Abuse of diet pills by individuals with eating disorders is well-documented clinically, with prevalence estimates reported as high as 50% (Celio et al., 2006;Mitchell, Pomeroy, & Huber, 1988;Roerig et al., 2003;Steffen, Roerig, Mitchell, & Crosby, 2006). However, empirical studies of features associated with abuse of diet pills are lacking. Given potential adverse effects associated with abuse of these agents (e.g., side effects, tolerance, withdrawal) (Carek & Dickerson, 1999;Dietz, 1981;Shekelle, Morton, & Maglione, 2003), particularly in populations already at elevated medical risk, it is important to explicate the nature of diet pill abuse and its consequences in individuals with eating disorders.Accordingly, the aim of this study were to report the prevalence of lifetime diet pill use across eating disorder subtypes and identify factors associated with their use. We hypothesized that individuals with the restricting type of anorexia nervosa (RAN) would use diet pills less frequently than those with other subtypes. This may ...

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Section: Discussionmentioning

confidence: 99%

Features associated with diet pill use in individuals with eating disorders

et al. 2008

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“…[2][3][4][5][6][7][8][9] Prior research has been reported using latent class analysis (LCA)/latent profile analysis (LPA). Sullivan et al using LCA found little support for the thresholds used in the DSM-IV for bulimia nervosa (BN).…”

Section: Introductionmentioning

confidence: 99%

Latent profile analysis of a cohort of patients with eating disorders not otherwise specified

Mitchell

Crosby

Wonderlich

et al. 2007

Int. J. Eat. Disord.

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Objective: This article examined possible ways of classifying eating disorders not otherwise specified (EDNOS) using latent profile analysis (LPA).Method: Of 687 patients being seen for an evaluation for an eating disorder, 284 were classified as having anorexia nervosa (AN) or bulimia nervosa (BN). LPA was performed on the remaining 403 cases (EDNOS).Results: Five clusters were identified that characterized individuals who appeared to be: (1) subsyndromal restrictor AN patients that denied a great deal of eating disorder (ED) psychopathology; (2) subsyndromal ED patients, some but not all of whom were low weight; (3) subsyndromal BN with higher rates of vomiting than binge-eating; (4) primarily overweight individuals with low levels of ED pathology; or (5) overweight patients who most resembled binge eating disorder (BED).Conclusion: Most EDNOS cases resembled AN, BN, or BED cases and can be conceptualized several ways, one of which is to see them as existing on a continuum with the DSM-IV ED. V V C 2007 by Wiley Periodicals, Inc.

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“…Of these, nine have used LCA. [3][4][5][6][7][8][9][10][11] However, these nine studies vary considerably in terms of sample composition and analytic strategy. Two of the studies 7,9 used unique sets of indicators that were not eating disorder symptoms while two additional studies 8,10 involved community samples that included a majority of healthy subjects with minimal endorsement of symptoms; these four studies were not used in defining the true model.…”

Section: Simulating An Underlying Modelmentioning

confidence: 99%

“…These techniques have particular relevance for the field of eating disorder research, where much recent attention has focused on establishing the validity of systems for classifying eating disorders 1 and revising diagnostic criteria for DSM-5. 2 A number of studies have utilized LCA [3][4][5][6][7][8][9][10][11] or LPA [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] to identify eating disorder phenotypes. However, despite the recent popularity of these methods in the field of eating disorders, little consideration has been…”

Section: Introductionmentioning

confidence: 99%

“…Attention should be paid to what decision rules are used by each study, as AIC performs poorly and aBIC may be an optimal choice in most relevant settings. Prior studies that have smaller sample sizes 6,7,9,12,14,15,22 should be interpreted with appropriate caution. Similarly, previous analyses of datasets with missing data, particularly when NMAR is suspected, are prone to bias as well.…”

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confidence: 99%

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A Monte Carlo investigation of factors influencing latent class analysis: An application to eating disorder research

Swanson

Lindenberg

Bauer

et al. 2011

Intl J Eating Disorders

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Objective: Latent class analysis (LCA) has frequently been used to identify qualitatively distinct phenotypes of disordered eating. However, little consideration has been given to methodological factors that may influence the accuracy of these results.Method: Monte Carlo simulations were used to evaluate methodological factors that may influence the accuracy of LCA under scenarios similar to those seen in previous eating disorder research.Results: Under these scenarios, the aBIC provided the best overall performance as an information criterion, requiring sample sizes of 300 in both balanced and unbalanced structures to achieve accuracy proportions of at least 80%. The BIC and cAIC required larger samples to achieve comparable performance, while the AIC performed poorly universally in comparison. Accuracy generally was lower with unbalanced classes, fewer indicators, greater or nonrandom missing data, conditional independence assumption violations, and lower base rates of indicator endorsement.Discussion: These results provide critical information for interpreting previous LCA research and designing future classification studies. V V C 2011 by Wiley Periodicals, Inc.

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Is multi-impulsive bulimia a distinct type of bulimia nervosa: Psychopathology and EMA findings

Abstract: Clinical classification of MIB was empirically supported through LCA. Although the classes failed to differ in bulimic behavior, MIB appears to represent a group of bulimic individuals with significant trauma histories and associated psychopathology.

Cited by 67 publications

References 25 publications

Features associated with diet pill use in individuals with eating disorders

Features associated with diet pill use in individuals with eating disorders

Latent profile analysis of a cohort of patients with eating disorders not otherwise specified

A Monte Carlo investigation of factors influencing latent class analysis: An application to eating disorder research

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