Personnalité chez les adolescents souffrant de troubles des conduites alimentaires. Perspective dimensionnelle et centrée sur les personnes

Authors: Dufresne, Laurie
Advisor: Bégin, Catherine
Abstract: Personality traits are etiological factors in eating disorders (ED) that are closely related to the symptomatic expression and clinical course of the disorder. The understanding of personality traits in the ED population is a highly relevant avenue to appreciate the psychological processes underlying EDs, with a view to directing the development of adapted and sustainable interventions. Nevertheless, while the literature on the relationship between EDs and personality in adults has been substantial in recent years, our literary overview revealed an unclear state of knowledge among adolescents. Thus, the main objective of this thesis was to deepen the understanding of the relationship between personality traits and the presence of ED during adolescence. To do so, the dimensional theory of personality and the person-centred methodological approach were considered. First, a systematic review of the literature on personality traits in ED adolescents was conducted which aimed to determine the personality dimensions that would distinguish adolescents with and without ED. The quantitative synthesis revealed that adolescents with ED had higher traits related to negative affectivity (vs. emotional stability), detachment (vs. extroversion) and conscientiousness (vs. disinhibition) and that a diagnosis of anorexia nervosa was more strongly associated with the conscientiousness dimension, compared to other types of ED (i.e., bulimia nervosa, eating disorder not otherwise specified). The second study aimed to investigate inter-individual personality differences in adolescents with ED using a person-centred methodological approach. More specifically, the objective was to identify personality-based profiles in adolescents with AN and explored their associations with variables of clinical interest: concomitant psychiatric disorders and psychological difficulties, executive behavioural functions (metacognition and behavioral regulation) and AN symptoms. Through the innovative statistical procedure of factor-mixture modeling, two classes of adolescents with distinct personality profiles were identified. The first profile was characterized by inhibited, submissive and anxious personality traits, similar to the Internalizing/Constricted profile described earlier in the literature. The second profile was distinguished by an elevation of indiscipline, combativeness and dramatization traits, suggesting a more externalized personality profile overall. Subsequent comparative analyses revealed that adolescents from the first class displayed more body dissatisfaction, anxiety symptoms, feelings of ineffectiveness, and concerns about interpersonal relationships, and were more likely to present restricting AN type. Adolescents in the second class were more likely to engage in self-harming behaviours and to present binge-eating/purging AN type. Nevertheless, the two groups were undifferentiated in terms of executive behavioural functioning (metacognition and behavioural regulation). Overall, the present thesis provides a detailed portrait of personality in adolescents with ED. The findings confirm the significant cross-sectional relationships between personality traits and dimensions of ED in adolescents, while highlighting the complexity of these relationships, which differ according to distinct profiles. By demonstrating heterogeneity that extend well beyond diagnostic ED classes, the thesis supports a call for greater consideration of personality in the nosology of ED as well as within clinical practice. Further research should explore temporal relationships between personality, eating pathology and response to treatment using prospective studies.
Document Type: Thèse de doctorat
Issue Date: 2021
Open Access Date: 20 December 2021
Grantor: Université Laval
Collection:Thèses et mémoires

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