Basic HTML Version
EDRS 2012
18
13
THE NATURAL COURSE OF BINGE EATING FROM
ADOLESCENCE TO YOUNG ADULTHOOD: A
POPULATION-BASED, LONGITUDINAL STUDY
Andrea B Goldschmidt
1
, Melanie M Wall
2
, Katie A Loth
3
,
Michaela M Bucchianeri
3
, Dianne Neumark-Sztainer
3
1
The University of Chicago, Chicago, IL, USA,
2
Columbia
University, New York, NY, USA,
3
University of Minnesota,
Minneapolis, MN, USA
Introduction: The course of binge eating (BE) in adolescence
is variable and little is known about factors that maintain
BE behaviors. In particular, the way in which changes in
psychosocial functioning over time might impact the course of
BE is unclear. Methods: A population-based sample reported
on BE, depression symptoms, self-esteem, body satisfaction,
and weight status at 5-year intervals spanning early/middle
adolescence (Time 1; T1), late adolescence/early young
adulthood (Time 2; T2) and early/middle young adulthood
(Time 3; T3). Logistic regression examined factors predicting
maintenance or cessation of BE. Results: 21.2% (28/132) of
T1 bingers continued to report BE at T2, and 44.6% (58/130)
of T2 bingers continued to report BE at T3. From T1 to T2,
greater improvements in self-esteem predicted cessation of
BE relative to maintenance of BE. From T2 to T3, cessation
of BE relative to maintenance of BE was associated with
improved body satisfaction, greater decreases in depression
symptoms, and greater improvements in self-esteem.
Neither overweight status nor weight change was associated
with maintenance or cessation of BE at any timepoint.
Conclusions: Improvements in psychosocial functioning may
lead to recovery from BE in adolescents and young adults,
although mechanisms responsible for these improvements
require further investigation. Self-esteem appears to be a
particularly salient factor involved in BE recovery and should
be targeted in clinical interventions.
14
Time Trends in Population Prevalence of
Eating Disorder Behaviors and Quality of Life
Deborah Mitchison
1
, Phillipa Hay
1,2
, Jon Mond
3
, Shameran
Slewa-Younan
1
1
School of Medicine, University of Western Sydney, Sydney,
Australia,
2
School of Medicine, James Cook University,
Townsville, Australia,
3
Centre for Rural and Remote Mental
Health, School of Medicine and Public Health, University of
Newcastle, Newcastle, Australia
Introduction:
The objective was to examine the changing
burden of eating disorder (ED) behaviors by estimating
change in prevalence and impact on quality of life (QoL).
Methods:
Representative samples of 3010 participants
in 1998 and 3034 participants in 2008 from the Australian
population were assessed for current ED features and QoL,
using the SF-36.
Results:
From 1998 to 2008, significant increases in the
prevalence of objective binge eating (2.7% to 4.9%) and
extreme dieting (1.5% to 3.3%,), but not purging, was
observed. Lower scores on the SF-36 were significantly
associated with the endorsement of any of these behaviors
in both years. No significant difference was observed in the
impact of the endorsement of these ED behaviors on QoL
between 1998 and 2008. In multiple linear regressions only
objective binge eating significantly predicted mental health
scores on the SF-36 in 1998, while in 2008 extreme weight/
shape concerns, extreme dieting, and subjective binge eating
were also significant predictors. Objective binge eating and
extreme dieting were significant predictors of physical health
scores on the SF-36 in both years.
Conclusions:
The prevalence of ED behaviors increased
between 1998 and 2008, while their impact on QoL remained
stable, suggesting an overall increased burden. Given that
binge eating and extreme dieting are common and associated
with physical and mental health impairment, the need for
interventions to prevent under- and over-eating is highlighted.
15
NEWLY PROPOSED DSM-5 CRITERIA DO NOT
SIGNIFICANTLY INCREASE EATING DISORDER
PREVALENCE IN PATIENTS SEEKING TREATMENT FOR
OBESITY
Jennifer J. Thomas
1,2,3
, Kamryn T. Eddy
1,3
, Mark J.
Gorman
1,3,4
, Stephanie Sogg
1,3,4
, Andrea S. Hartmann
1,3
, Anne
E. Becker
1,3,5
1
Department of Psychiatry, Massachusetts General Hospital,
Boston, MA, USA,
2
Klarman Eating Disorders Center, McLean
Hospital, Belmont, MA, USA,
3
Department of Psychiatry,
Harvard Medical School, Boston, MA, USA,
4
Massachusetts
General Hospital Weight Center, Boston, MA, USA,
5
Department of Global Health & Social Medicine, Harvard
Medical School, Boston, MA, USA
Introduction: The DSM-5 Eating Disorders (ED) Work Group
has proposed binge eating disorder (BED) and avoidant/
restrictive food intake disorder (ARFID) as new categories
within Feeding and Eating Disorders. We evaluated the
clinical utility of DSM-5 ED criteria among patients seeking
weight-loss treatment, hypothesizing similar prevalence
and inter-rater reliability (IRR) under DSM-IV vs. DSM-
5. Methods: 100 adults with obesity (mean BMI = 41.4 kg/
m
2
; 70% female) referred to the Massachusetts General
Hospital Weight Center participated. Clinicians (n = 2 Ph.D.
psychologists) assigned DSM-IV and DSM-5 ED diagnoses
via routine clinical interview. Research assessors (n = 3
Ph.D. psychologists) conferred ED diagnoses via Structured
Clinical Interview for DSM-IV and DSM-5 checklist. Results:
Researchers diagnosed slightly but not significantly more
patients with an ED under DSM-5 (37%) vs. DSM-IV (29%),
Χ
2
(1) = 1.10, p = ns. Prevalence of DSM-5 diagnoses
included BED (9%), BN (2%), sub-BED (5%), sub-BN
(2%), purging disorder (1%), night eating syndrome (11%),
and other EDNOS (7%). No patients received an ARFID
diagnosis. IRR between clinicians and researchers was
“substantial” (K = .64, 84% agreement) for DSM-IV and
“moderate” (K = .55, 77% agreement) for DSM-5 (Landis &
Koch, 1977). Conclusions: Application of proposed DSM-
5 criteria did not result in a higher than expected number
of ED diagnoses in this sample of patients seeking obesity
treatment.
16
CEDA: A structured clinical interview for DSM-
5 eating disorders
Deborah R Glasofer
1,2
, Robyn Sysko
1,2
, Evelyn Attia
1,2
, Ross
Crosby
3,4
, Thomas Hildebrandt
5
, James E Mitchell
3,4
, Stephen
Wonderlich
3,4
, B Timothy Walsh
1,2
1
Columbia University, New York, NY, USA,
2
NYS Psychiatric
Institute, New York, NY, USA,
3
University of North Dakota,
Fargo, ND, USA,
4
Neuropsychiatric Research Institute, Fargo,
ND, USA,
5
Mount Sinai School of Medicine, New York, NY,
USA
Introduction
DSM-5 is expected to be published in Spring,
2013. The section on feeding and eating disorders in DSM-IV
has been modified in several important ways. Therefore, new
diagnostic instruments are necessary. We have developed a
semi-structured interview to assess the presence or absence
of a feeding or eating disorder as defined by the currently
recommended DSM-5 criteria.
Methods
Adolescents and
adults contacting one of several eating disorder programs will
be invited to participate, and be assessed using the Columbia
Eating Disorders Assessment (CEDA) and the Eating
Disorders Examination (EDE). A subset of these individuals
will be reassessed with the CEDA within 7 to 14 days of
the initial assessment.
Results
We will report on the test-
retest reliability of the CEDA, and on the concurrent validity
of this new measure compared to the EDE. Preliminary
data on 6 individuals suggest the interview is accurate,
brief, and acceptable. Additional information on duration of
interview and acceptability to participants will be described.
Conclusions
These data will examine the utility and validity
of a new diagnostic instrument to assess DSM-5 feeding and
eating disorders.
PLENARY/ORAL ABSTRACTS