An alternative approach to sub-grouping the eating disorder population : new potential for improving treatment effectiveness?

Abstract

This thesis aimed to explore whether there are alternative ways of assessing and categorising the eating disorders population that might allow for the more appropriate tailoring of treatment to clinical presentation. The main objective was to explore whether distinct clusters of patients could be identified across the eating disorder population when using eating disorder symptoms and additional clinical characteristics, namely attachment and coping style. Secondary analyses focused on conducting a preliminary assessment of the validity of these sub-groups. Participants were recruited from a Community Eating Disorders Service and data collection was integrated into the service assessment process. Follow-up data relating to treatment intervention and outcome at 6 and 12 months were also collected. 191 Participants submitted completed questionnaires and interviews. Following the exclusion of outliers, 165 participants were included in the final cluster analysis, which led to the identification of four sub-groups. Differences were found across the clusters on aspects of general functioning and mood. When compared with DSM-IV diagnoses, clusters accounted for greater variation in key eating disorder symptoms and clinical features. Differences across the clusters in relation to treatment intervention and outcome were identified, although these did not reach statistical significance. Future research might usefully try to replicate these clusters and further assess their external validity, including relationship to treatment outcome. This would further establish whether the cluster solution identified in the present study constitutes a valid and clinically useful means of sub-growing the eating disorder population.

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