Evaluation of the DSM‐5 Severity Indicator for Anorexia Nervosa

Paulo P. P. Machado · Carlos M. Grilo · Ross D. Crosby

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Eating Disorders and Behaviors Nutrition, Health and Food Behavior Child Nutrition and Feeding Issues

Abstract

OBJECTIVE: This study tested the new DSM-5 severity criterion for anorexia nervosa (AN) based on proposed body mass index (BMI) cut-points. METHOD: Participants were a clinical sample of 201 treatment-seeking patients diagnosed with DSM-5 AN in Portugal. Participants were categorised based on DSM-5 severity levels and were compared on demographic and clinical variables assessed with the Eating Disorder Examination-Questionnaire. RESULTS: Based on DSM-5 severity definitions for AN, 73 (36.3%) participants were categorised as mild (≥17.0 BMI), 40 (19.9%) as moderate (16-16.99 BMI), 30 (14.9%) as severe (15-15.99 BMI) and 58 (28.9%) as extreme (<15 BMI). The severity groups did not differ significantly in age or gender. Analyses comparing the severity groups on measures of eating-disorder psychopathology revealed no significant differences on the Eating Disorder Examination-Questionnaire global or subscale scores. The groups also did not differ significantly on the frequency of binge eating or purging episodes within the past 28 days. CONCLUSIONS: Our findings, in this clinical sample of patients with AN in Portugal, provide no evidence for the new DSM-5 severity ratings based on BMI level. Further research on the validity of the DSM-5 specifiers is needed and should test additional clinical or functional variables and especially prognostic utility for course and outcome across eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1994Assessment of eating disorders: Interview or self‐report questionnaire?2008Cognitive Behavior Therapy and Eating Disorders 2013The DSM‐5: Classification and criteria changes 2011Psychometric evaluation of the eating disorder examination and eating disorder examination‐questionnaire: A systematic review of the literature 2014Prevalence and severity of DSM‐5 eating disorders in a community cohort of adolescents 2013DSM-IV und DSM-5: Was hat sich tatsächlich verändert?2014Eating Disorder Examination Questionnaire: Psychometric Properties and Norms for the Portuguese Population

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