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Int J Eat Disord. 2019 May;52(5):586-590. doi: 10.1002/eat.23034. Epub 2019 Jan 30.

A test of the DSM-5 severity specifier for bulimia nervosa in adolescents: Can we anticipate clinical treatment outcomes?

Author information

1
Department of Psychiatry, University of California, San Francisco, California.
2
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
3
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago (Emeritus), Chicago, Illinois.

Abstract

OBJECTIVE:

This study tested clinical utility of the DSM-5 severity specifier for bulimia nervosa (BN) in predicting treatment response among adolescents (N = 110) within a randomized clinical trial of two psychosocial treatments.

METHOD:

Analyses grouped individuals meeting criteria for BN diagnosis by baseline severity, per DSM-5. Associations among baseline severity classification and BN behavior (i.e., binge eating and compensatory behavior) and eating disorder examination (EDE) Global scores at end-of-treatment (EOT), 6- and 12-month follow-up were examined.

RESULTS:

Associations between severity categories with BN symptoms were not significant at EOT, or follow-up. Test for linear trend in BN behavior was significant at EOT, F = 5.23, p = 0.02, without demonstrating a linear pattern. Relation between severity categories with EDE Global scores was significant at 6-month follow-up, F = 3.76, p = 0.01. Tests for linear trend in EDE Global scores were significant at EOT, F = 5.40, p = 0.02, and at 6 months, F = 10.73, p = 0.002, with the expected linear pattern.

DISCUSSION:

Findings suggest the DSM-5 BN severity specifier holds questionable utility in anticipating outpatient treatment response in adolescents with BN. The specifier may have improved ability to predict attitudinal rather than behavioral treatment outcomes.

KEYWORDS:

adolescents; bulimia nervosa; cognitive behavioral therapy; family-based treatment; severity classification; treatment outcome

PMID:
30701572
PMCID:
PMC6499649
[Available on 2020-05-01]
DOI:
10.1002/eat.23034
[Indexed for MEDLINE]
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