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Abstract：
BACKGROUND: Disordered eating behaviors (DEBs), a risk factor for the development of eating disorders (EDs), are prevalent in young people and different DEBs frequently co-occur. Previous studies on DEB-patterns have largely used traditional retrospective questionnaires to assess DEBs. In addition, most previous studies did not specifically exclude individuals with clinical EDs, which limits current knowledge concerning purely subclinical patterns of DEBs. In the present study, we aimed to explore phenotypes and group sizes of subclinical patterns of DEBs reported in everyday life via smartphone-based ecological momentary assessment (EMA) in adolescents and young adults from the general population without lifetime EDs. In secondary analyses, we further aimed to investigate whether DEB-patterns would be associated with additional previously identified risk factors for ED-development.
METHODS: EMA was conducted in a community sample of 14-21-year-olds from Dresden, Germany, over four days for up to eight times a day and covered engagement in four DEBs: skipping eating, restrained eating, eating large amounts of food, and loss-of-control eating. Data were analyzed from N = 966 individuals without lifetime EDs with an EMA compliance rate of at least 50% (81.9% of the total sample; average compliance: 84.6%). Latent profile analyses were performed to identify subclinical patterns of DEBs, stratified by sex. Associations between symptomatic profiles and ED-risk factors were tested via regression analyses.
RESULTS: Based on theoretical deliberations, statistical indices, interpretability, and parsimony, a three-profile solution, namely no DEBs, high-mixed DEBs, and low-mixed DEBs, was selected for both sexes. Both symptomatic profiles in both sexes were associated with more unfavorable manifestations in additional ED risk factors compared to the no DEBs profile, with the highest number of associations being observed in the female high-mixed profile.
CONCLUSIONS: The present findings suggest that problematic manifestations of DEBs in young people may occur even in the absence of an ED diagnosis and that they are associated with additional risk factors for EDs, warranting increased efforts in targeted prevention, early identification and intervention in order to counteract symptom progression.
METHODS: EMA was conducted in a community sample of 14-21-year-olds from Dresden, Germany, over four days for up to eight times a day and covered engagement in four DEBs: skipping eating, restrained eating, eating large amounts of food, and loss-of-control eating. Data were analyzed from N = 966 individuals without lifetime EDs with an EMA compliance rate of at least 50% (81.9% of the total sample; average compliance: 84.6%). Latent profile analyses were performed to identify subclinical patterns of DEBs, stratified by sex. Associations between symptomatic profiles and ED-risk factors were tested via regression analyses.
RESULTS: Based on theoretical deliberations, statistical indices, interpretability, and parsimony, a three-profile solution, namely no DEBs, high-mixed DEBs, and low-mixed DEBs, was selected for both sexes. Both symptomatic profiles in both sexes were associated with more unfavorable manifestations in additional ED risk factors compared to the no DEBs profile, with the highest number of associations being observed in the female high-mixed profile.
CONCLUSIONS: The present findings suggest that problematic manifestations of DEBs in young people may occur even in the absence of an ED diagnosis and that they are associated with additional risk factors for EDs, warranting increased efforts in targeted prevention, early identification and intervention in order to counteract symptom progression.
摘要：
背景：饮食失调行为（DEB），饮食失调（ED）发展的危险因素，在年轻人中很普遍，不同的DEB经常同时出现。以前关于DEB模式的研究主要使用传统的回顾性问卷来评估DEB。此外,以前的大多数研究都没有明确排除患有临床ED的个体，这限制了目前关于DEB纯粹亚临床模式的知识。在本研究中,我们旨在通过基于智能手机的生态瞬时评估(EMA),在没有终生ED的普通人群中,在青少年和年轻成人中,探索日常生活中报告的DEB亚临床模式的表型和群体规模.在二级分析中，我们进一步旨在调查DEB模式是否与先前确定的ED发展的其他风险因素相关.
方法：EMA是在德累斯顿14-21岁的社区样本中进行的，德国,超过四天，每天多达八次，并涵盖了四个DEB的参与：不吃东西，克制吃，吃大量的食物，失去控制的饮食。从没有终生ED的N=966个个体分析数据,EMA依从率至少为50%(总样本的81.9%;平均依从:84.6%)。进行潜在特征分析以确定DEB的亚临床模式，按性别分层。通过回归分析检验症状谱与ED危险因素之间的关联。
结果：基于理论讨论，统计指数，可解释性,和简约，一个三剖面的解决方案，即没有DEB，高混合DEB，和低混合DEB，为两性选择。与没有DEB的情况相比，两种性别的两种症状都与其他ED危险因素中更多的不利表现相关。在女性高混合人群中观察到的关联数量最多。
结论：目前的研究结果表明，即使没有ED诊断，年轻人中的DEB也可能出现有问题的表现，并且它们与ED的其他危险因素有关。保证在有针对性的预防方面加大力度，早期识别和干预以抵消症状进展。
方法：EMA是在德累斯顿14-21岁的社区样本中进行的，德国,超过四天，每天多达八次，并涵盖了四个DEB的参与：不吃东西，克制吃，吃大量的食物，失去控制的饮食。从没有终生ED的N=966个个体分析数据,EMA依从率至少为50%(总样本的81.9%;平均依从:84.6%)。进行潜在特征分析以确定DEB的亚临床模式，按性别分层。通过回归分析检验症状谱与ED危险因素之间的关联。
结果：基于理论讨论，统计指数，可解释性,和简约，一个三剖面的解决方案，即没有DEB，高混合DEB，和低混合DEB，为两性选择。与没有DEB的情况相比，两种性别的两种症状都与其他ED危险因素中更多的不利表现相关。在女性高混合人群中观察到的关联数量最多。
结论：目前的研究结果表明，即使没有ED诊断，年轻人中的DEB也可能出现有问题的表现，并且它们与ED的其他危险因素有关。保证在有针对性的预防方面加大力度，早期识别和干预以抵消症状进展。
