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 [F] Diseases Research  / PubMed Research Articles  /
The validity of DSM-5 severity specifiers for anorexia nervosa, bulimia nervosa, and binge-eating disorder.




The International journal of eating disorders 2017 Jun 17; ()


Smith KE1; Ellison JM2; Crosby RD3; Engel SG4; Mitchell JE5; Crow SJ6; Peterson CB7; Le Grange D8; Wonderlich SA9;

Author Information
  • 1Neuropsychiatric Research Institute, Fargo, North Dakota.
  • 2Essentia Health, Fargo, North Dakota.
  • 3Neuropsychiatric Research Institute, Fargo, North Dakota.
  • 4Neuropsychiatric Research Institute, Fargo, North Dakota.
  • 5Neuropsychiatric Research Institute, Fargo, North Dakota.
  • 6Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
  • 7Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
  • 8Department of Psychiatry, University of California, San Francisco, California.
  • 9Neuropsychiatric Research Institute, Fargo, North Dakota.


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.

© 2017 Wiley Periodicals, Inc.




Publication Type: Journal Article

This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.

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