Personality-based subtypes of anorexia nervosa: Examining validity and utility using baseline clinical variables and ecological momentary assessment

Jason M. Lavender*, Stephen A. Wonderlich, Ross D. Crosby, Scott G. Engel, James E. Mitchell, Scott J. Crow, Carol B. Peterson, Daniel Le Grange

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Objective: This study sought to empirically derive and validate clinically relevant personality-based subtypes of anorexia nervosa (AN). Methods: Women (N=116) with full or subthreshold AN completed baseline measures of personality, clinical variables, and eating disorder (ED) symptoms, followed by two weeks of ecological momentary assessment (EMA). A latent profile analysis was conducted to identify personality subtypes, which were compared on baseline clinical variables and EMA variables. Results: The best-fitting model supported three subtypes: underregulated, overregulated, and low psychopathology. The underregulated subtype (characterized by high Stimulus Seeking, Self-Harm, and Oppositionality) displayed greater baseline ED symptoms, as well as lower positive affect and greater negative affect, self-discrepancy, and binge eating in the natural environment. The overregulated subtype (characterized by high Compulsivity and low Stimulus Seeking) was more likely to have a lifetime obsessive-compulsive disorder diagnosis and exhibited greater perfectionism; levels of negative affect, positive affect, and self-discrepancy in this group were intermediate between the other subtypes. The low psychopathology subtype (characterized by normative personality) displayed the lowest levels of baseline ED symptoms, co-occurring disorders, and ED behaviors measured via EMA. Conclusions: Findings support the validity of these personality-based subtypes, suggesting the potential utility of addressing within-diagnosis heterogeneity in the treatment of AN.

Original languageEnglish
Pages (from-to)512-517
Number of pages6
JournalBehaviour Research and Therapy
Issue number8
StatePublished - Aug 2013
Externally publishedYes


  • Affect
  • Eating disorders
  • Ecological momentary assessment
  • Empirical classification
  • Latent profile analysis
  • Personality


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