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Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun.

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DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet].

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Table 20DSM-IV to DSM-5 Bulimia Nervosa Comparison

DSM-IVDSM-5
Disorder Class: Eating DisordersDisorder Class: Feeding and Eating Disorders
A. Recurrent episodes of binge eating, as characterized by both:
  1. Eating, within any 2-hour period, an amount of food that is definitively larger than what most individuals would eat in a similar period of time under similar circumstances.
  2. A feeling that one cannot stop eating or control what or how much one is eating.
SAME
B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting or excessive exercise.SAME
C. The binge eating and inappropriate compensatory behaviors occur, on average, at least twice a week for 3 months.C. The binge eating and inappropriate compensatory behaviors occur, on average, at least once a week for 3 months.
D. Self-evaluation is unjustifiability influenced by body shape and weight.SAME
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.SAME
Specify type:
  • Purging type: During the current episode, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
  • Nonpurging Type: During the current episode, the person has used inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.
Not a criterion.
Not a criterion.Specify if:
  • Partial remission: After full criteria were previously met, some but not all of the criteria have been met for a sustained period of time.
  • Full remission: After full criteria were previously met, none of the criteria have been met for a sustained period of time.
Not a criterion.Current severity1:
  • Mild: An average of 1–3 episodes of inappropriate compensatory behaviors per week.
  • Moderate: An average of 4–7 episodes of inappropriate compensatory behaviors per week.
  • Severe: An average of 8–13 episodes of inappropriate compensatory behaviors per week.
Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors per week.
1

The level of severity may be increased to reflect other symptoms and the degree of functional disability.

From: 3, DSM-5 Child Mental Disorder Classification

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