Abstract
Binge eating disorder (BED) presents with substantial psychiatric comorbidity. This latent structure analysis sought to delineate boundaries of BED given its comorbidity with affective and anxiety disorders. A population-based sample of 151 women with BED, 102 women with affective or anxiety disorders, and 259 women without psychiatric disorders was assessed with clinical interviews and self-report-questionnaires. Taxometric analyses were conducted using DSM-IV criteria of BED and of affective and anxiety disorders. The results showed a taxonic structure of BED and of affective and anxiety disorders. Both taxa co-occurred at an above-chance level, but also presented independently with twice-as-large probabilities. Within the BED taxon, diagnostic co-occurrence indicated greater general psychopathology, lower social adaptation, and greater premorbid exposure to parental mood and substance disorder, but not greater eating disorder psychopathology. Eating disorder psychopathology discriminated individuals in the BED taxon from individuals in the affective and anxiety disorders taxon. Diagnostic criteria of BED were more indicative of the BED taxon than were criteria of affective and anxiety disorders. The results show that at the latent level, BED was co-occurring with, yet distinct from, affective and anxiety disorders and was not characterized by an underlying affective or anxiety disorder.
Highlights
Classification of eating disorders is an enduring focus of debate
Comorbid psychopathology continues to complicate the assessment, diagnosis, and treatment of eating disorders, including Binge eating disorder (BED). This raises the question as to whether and how shared characteristics of mental disorders should be considered in classification
The current study elaborated on the boundaries between BED and other mental disorders that are frequently comorbid with BED
Summary
Classification of eating disorders is an enduring focus of debate It relates to our understanding of the nature of pathology and its boundaries with other disorders, especially the preliminarily defined binge eating disorder (BED). Ample evidence has accumulated that BED is a clinically significant disorder, associated with overweight and obesity, impaired quality of life, and increased general psychopathology and psychiatric comorbidity, especially affective and anxiety disorders (Latner & Clyne, 2008; Striegel-Moore & Franko, 2008; Wilfley, Wilson, & Agras, 2003; Wonderlich, Gordon, Mitchell, Crosby, & Engel, 2009). The nature of the relationship between BED and other co-occurring psychiatric disorders has received little attention (see Wonderlich, Joiner, Keel, Williamson, & Crosby, 2007)
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