Kathryn E Smith1,2, Jo M Ellison3, Ross D Crosby1,2, Scott G Engel1,2, James E Mitchell1,2, Scott J Crow4, Carol B Peterson4, Daniel Le Grange5, Stephen A Wonderlich1,2. 1. Neuropsychiatric Research Institute, Fargo, North Dakota. 2. Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota. 3. Essentia Health, Fargo, North Dakota. 4. Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota. 5. Department of Psychiatry, University of California, San Francisco, California.
Abstract
OBJECTIVE: The DSM-5 includes severity specifiers (i.e., mild, moderate, severe, extreme) for anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED), which are determined by weight status (AN) and frequencies of binge-eating episodes (BED) or inappropriate compensatory behaviors (BN). Given limited data regarding the validity of eating disorder (ED) severity specifiers, this study examined the concurrent and predictive validity of severity specifiers in AN, BN, and BED. METHOD: Adults with AN (n = 109), BN (n = 76), and BED (n = 216) were identified from previous datasets. Concurrent validity was assessed by measures of ED psychopathology, depression, anxiety, quality of life, and physical health. Predictive validity was assessed by ED symptoms at the end of the treatment in BN and BED. RESULTS: Severity categories did not differ in baseline validators, though the mild AN group evidenced greater ED symptoms compared to the severe group. In BN, greater severity was related to greater end of treatment binge-eating and compensatory behaviors, and lower likelihood of abstinence; however, in BED, greater severity was related to lower ED symptoms at the end of the treatment. DISCUSSION: Results demonstrated limited support for the validity of DSM-5 severity specifiers. Future research is warranted to explore additional validators and possible alternative indicators of severity in EDs.
OBJECTIVE: The DSM-5 includes severity specifiers (i.e., mild, moderate, severe, extreme) for anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED), which are determined by weight status (AN) and frequencies of binge-eating episodes (BED) or inappropriate compensatory behaviors (BN). Given limited data regarding the validity of eating disorder (ED) severity specifiers, this study examined the concurrent and predictive validity of severity specifiers in AN, BN, and BED. METHOD: Adults with AN (n = 109), BN (n = 76), and BED (n = 216) were identified from previous datasets. Concurrent validity was assessed by measures of ED psychopathology, depression, anxiety, quality of life, and physical health. Predictive validity was assessed by ED symptoms at the end of the treatment in BN and BED. RESULTS: Severity categories did not differ in baseline validators, though the mild AN group evidenced greater ED symptoms compared to the severe group. In BN, greater severity was related to greater end of treatment binge-eating and compensatory behaviors, and lower likelihood of abstinence; however, in BED, greater severity was related to lower ED symptoms at the end of the treatment. DISCUSSION: Results demonstrated limited support for the validity of DSM-5 severity specifiers. Future research is warranted to explore additional validators and possible alternative indicators of severity in EDs.
Authors: Scott G Engel; David A Wittrock; Ross D Crosby; Stephen A Wonderlich; James E Mitchell; Ronette L Kolotkin Journal: Int J Eat Disord Date: 2006-01 Impact factor: 4.861
Authors: Carol B Peterson; James E Mitchell; Scott J Crow; Ross D Crosby; Stephen A Wonderlich Journal: Am J Psychiatry Date: 2009-11-02 Impact factor: 18.112
Authors: Scott G Engel; Stephen A Wonderlich; Ross D Crosby; James E Mitchell; Scott Crow; Carol B Peterson; Daniel Le Grange; Heather K Simonich; Li Cao; Jason M Lavender; Kathryn H Gordon Journal: J Abnorm Psychol Date: 2013-08
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Authors: Judith Sinzig; Triinu Peters; Johannes Hebebrand; Christian Engelhardt; Manuel Föcker; Katharina Bühren; Brigitte Dahmen; Katja Becker; Linda Weber; Christoph U Correll; Karin Maria Egberts; Stefan Ehrlich; Veit Roessner; Christian Fleischhaker; Alexander von Gontard; Freia Hahn; Ekkehart Jenetzky; Michael Kaess; Tanja Legenbauer; Tobias J Renner; Ulrike M E Schulze; Ida Wessing; Gisela Antony; Beate Herpertz-Dahlmann Journal: Eur Child Adolesc Psychiatry Date: 2020-07-14 Impact factor: 4.785