Personality heterogeneity in adolescents with anorexia nervosa: a factor-mixture analysis

Distinct personality profiles have been identified in adults with anorexia nervosa and carry important clinical implications given their associations with anorexic symptoms, comorbidities, and treatment response. Few studies explored these profiles in adolescents, limiting the applicability and expectations related to such model in this population. By using factor-mixture modelling, the present study aimed to identify personality-based profiles in adolescents with anorexia nervosa and assess their concurrent validity by exploring their associations with anorexic symptoms, psychiatric disorders, psychological difficulties and executive behavioural functions. Adolescents diagnosed with anorexia nervosa were recruited in eating disorder treatment units based in Academic Health Centers. Clinical interviews were conducted by members of the treatment team and self-reported questionnaires were used to document variables of interest. Latent profile, factorial, and factor-mixture models were fit to the personality data. The best fitting solution comprised two classes that were distinguished by elevated internalizing traits (Class 1) and elevated externalizing traits (Class 2). Body dissatisfaction and anxiety symptoms were higher in Class 1 while bulimic-purgative behaviours and self-harm were more prevalent in Class 2. Although our model requires further validation, our results highlight the relevance of assessing personality structure in adolescents with anorexia nervosa since it could inform distinct psychological mechanisms underlying symptomatology and guide an intervention tailored to the patient's needs.