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16-05-2017 | Original Article

Evaluation of the DSM-5 Severity Specifier for Bulimia Nervosa in Treatment-Seeking Youth

Auteurs: Antonios Dakanalis, Fabrizia Colmegna, Maria Assunta Zanetti, Ester Di Giacomo, Giuseppe Riva, Massimo Clerici

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 1/2018

Abstract

A new severity specifier for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (e.g., laxative misuse, self-induced vomiting, fasting, diuretic misuse, and excessive exercise), has been added to the most recent (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a means of addressing variability and heterogeneity in the severity of the disorder. While existing research provides support for the DSM-5 severity specifier for BN in adult patients, evidence for its validity and clinical utility in youth is currently lacking. To address this gap, data from 272 treatment-seeking adolescents with DSM-5 BN (94.2% female, M _age = 15.3 years, SD 1.7) were analysed to examine whether these patients, sub-grouped based on the DSM-5 severity definitions, would show meaningful differences in a broad range of clinical variables and demographic and physical characteristics. Analyses revealed that participants categorized with mild, moderate, severe, and extreme severity of BN significantly differed from each other in 15 variables regarding eating disorder pathological features and putative maintenance factors (i.e., core low self-esteem, perfectionism, social appearance anxiety, body surveillance, and mood intolerance), health-related quality of life and comorbid psychiatric (i.e., affective and anxiety) disorders (large effect sizes). Between-group differences in demographics, body mass index, or age-of-BN onset were not observed. Collectively, our findings provide support for the utility of the frequency of inappropriate weight compensatory behaviours as a severity indicator for BN and suggest that age-at-onset of BN is probably more disorder- than severity-dependent. Implications for future research are outlined.

vorige artikel Intergenerational Transmission of Depressive Symptoms: The Role of Parental Negative Perceptions and Behaviors

volgende artikel Emotional Clarity, Anxiety Sensitivity, and PTSD Symptoms Among Trauma-Exposed Inpatient Adolescents

Since preliminary analysis did not detect any significant differences among participants of Study 1 [38] and those of Study 2 [39] and among the Italian sites (where data for Studies 1 and 2 were originally collected [38, 39]) in the portion of adolescents classified with mild, moderate, severe, and extreme severity of BN, the merged sample of 272 DSM-5 BN patients was sub-grouped into the four DSM-5 severity groups. In addition, preliminary analysis did not detect any significant differences among participants of Study 1 and those of Study 2 and among the Italian specialized care centres for child and adolescent eating disorders (recruitment sites) in any variable of clinical interest considered (in and) for the purposes of the present inquiry including basic demographic (e.g., gender) and physical (body mass index) characteristics of adolescents classified with mild, moderate, severe, and extreme severity of BN; thus, the results that follow are not stratified by site. For interested readers, the results of these preliminary analyses along with details regarding the frequencies of the specific forms of IWCBs across the four (aforementioned) severity groups of BN are available from the corresponding author on request.

We acknowledge that within group outlines on any study variables were not observed; for interested readers, further details along with the ranges for each clinical variable assessed (and displayed in Table 2) for each severity group of BN are available on request from the corresponding author.

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Titel: Evaluation of the DSM-5 Severity Specifier for Bulimia Nervosa in Treatment-Seeking Youth
Auteurs: Antonios Dakanalis
Fabrizia Colmegna
Maria Assunta Zanetti
Ester Di Giacomo
Giuseppe Riva
Massimo Clerici
Publicatiedatum: 16-05-2017
Uitgeverij: Springer US
Gepubliceerd in: Child Psychiatry & Human Development / Uitgave 1/2018
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI: https://doi.org/10.1007/s10578-017-0735-y

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