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Personality-Based Subtypes of Anorexia Nervosa: Examining Validity and Utility Using Baseline Clinical Variables and Ecological Momentary Assessment

Date Published: 8/14


Objective—This study sought to empirically derive and validate clinically relevant personalitybased subtypes of anorexia nervosa (AN).

Methods—Women (N=116) with full or subthreshold AN completed baseline measures of personality, clinical variables, and eating disorder (ED) symptoms, followed by two weeks of ecological momentary assessment (EMA). A latent profile analysis was conducted to identify personality subtypes, which were compared on baseline clinical variables and EMA variables.

Results—The best-fitting model supported three subtypes: underregulated, overregulated, and low psychopathology. The underregulated subtype (characterized by high stimulus seeking, selfharm, and oppositionality) displayed greater baseline ED symptoms, as well as lower positive affect and greater negative affect, self-discrepancy, and binge eating in the natural environment. The overregulated subtype (characterized by high compulsivity and low stimulus seeking) was more likely to have a lifetime obsessive-compulsive disorder diagnosis and exhibited greater perfectionism; levels of negative affect, positive affect, and self-discrepancy in this group were intermediate between the other subtypes. The low psychopathology subtype (characterized by normative personality) displayed the lowest levels of baseline ED symptoms, co-occurring disorders, and ED behaviors measured via EMA.

Conclusions—Findings support the validity of these personality-based subtypes, suggesting the potential utility of addressing within-diagnosis heterogeneity in the treatment of AN.


Jason M. Lavendera,*, Stephen A. Wonderlicha,b, Ross D. Crosbya,b, Scott G. Engela,b, James E. Mitchella,b, Scott J. Crowc, Carol B. Petersonc, and Daniel Le Granged
aNeuropsychiatric Research Institute, Fargo, ND, USA
bUniversity of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
cDepartment of Psychiatry, University of Minnesota, Minneapolis, MN, USA
dDepartment of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA

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