Evidence for an obsessive-compulsive disorder spectrum: Factor and cluster analysis of nonclinical and subclinical body dysmorphic disorder, eating disorder, and obsessive-compulsive disorder characteristics.

摘要

The drive for thinness, the attainment of the perfect, idealized body, and the need for perfection and order in our daily lives are pervasive issues in American culture. Many authors argue that Obsessive-Compulsive Disorder, Body Dysmorphic Disorder, and eating disorder seem to share overlap on diagnostic, phenomenological, and treatment dimensions (these disorders seem to involve prepotent obsessions and compulsions)---part of an OCD spectrum (as proposed in the literature). The purpose of this study was to examine the underlying nature of these potential OCD-spectrum disorders (OCD, BDD, and eating disorder) and their relationship with each other in a nonclinical sample. This was evaluated using a set of statistical procedures including exploratory factor analysis and cluster analysis. Discriminant function analyses and Analyses of Variance were used to further describe the derived clusters. There were 403 nonclinical participants drawn from an introductory psychology course (mean age = 19.5 years). The Eating Disorder Inventory (Garner, Olmsted, and Polivy, 1983), parts of the Body Dysmorphic Disorder Examination. Self-Report (Rosen & Reiter. 1994), and the Leyton Obsessional Inventory, Child Version (Bamber, Tamplin, Park, Kyte, & Goodyer, 2002) and the Maudsley Obsessional Compulsive Inventory (Hodgson & Rachman, 1977) were used to measure eating disorder, Body Dysmorphic Disorder, and Obsessive-Compulsive Disorder constructs respectively. There were five factors found roughly resembling diagnostic constructs: Appearance Anxiety, Eating Disorder Symptoms. Appearance Avoidance, Weak Ego, and Other's Reactions to Appearance. The participants fell into clusters of low and high endorsers of symptoms/characteristics across diagnostic constructs. High endorsers hedged towards endorsing either more eating disorder/appearance concern symptoms or more OCD symptoms. However, those scoring high in one area also scored at least moderately high in the other areas. These trends indicate that although separate factor constructs resembling diagnostic labels were found in this nonclinical sample (using factor analysis), participants (clusters) were delineated more by level of endorsement across construct domains. There appears to be a more nonspecific elevation of symptoms/characteristics in this nonclinical population than specific subclinical profiles per se. Several implications for further research are given and potential confounds were identified.