Association of eating disorder symptoms with internalizing and externalizing dimensions of psychopathology among men and women.
OBJECTIVE
A large body of factor analytic research supports the idea that common mental disorders are organized along correlated latent dimensions termed internalizing and externalizing. Eating disorders (EDs) have been associated with both internalizing (mood and anxiety disorders) and externalizing (substance use, antisocial personality disorder) forms of psychopathology. Previous studies found that EDs are most strongly related to internalizing disorders. However, no previous factor analytic studies of EDs and the internalizing/externalizing dimensions have evaluated if EDs align with these spectra similarly for men and women. We examined the location of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) symptoms within this model of psychopathology among a sample of veterans, a population traditionally understudied in EDs.


METHODS
Data were from two studies of veterans and their intimate partners (N = 453 men and 307 women). Participants were administered the Structured Clinical Interview for DSM-IV without skip-outs. Lifetime symptom severity scores were used in confirmatory factor analytic models.


RESULTS
A model with AN, BN, and BED symptoms loading onto the distress subfactor of the internalizing domain fit the data best in the full sample and the male and female subsamples. This model was statistically equivalent for men and women.


CONCLUSIONS
All three EDs loaded onto distress, indicating that these conditions overlap with psychopathology characterized by negative affect. Investigating latent dimensions of psychopathology is one approach to identifying common factors that partially account for patterns of comorbidity among psychiatric disorders, which may aid in translating research findings into clinical practice.
National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.
Karen S
KS
Mitchell
Erika J
EJ
Wolf
Annemarie F
AF
Reardon
Mark W
MW
Miller
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D066067:Military Family / Q000523:psychology; D008960:Models, Psychological; D015233:Models, Statistical; D019964:Mood Disorders / Q000150:complications* / Q000175:diagnosis; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D014481:United States; D014728:Veterans / Q000523:psychology
comorbidity; eating disorders; externalizing; gender; internalizing