Perfectionism and impulsivity based risk profiles in eating disorders

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.

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.

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.

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.