Eating disorders in youth: Diagnostic variability and predictive validity

Authors


  • Dr. Loeb receives support from federal grants through the National Institutes of Health (National Institute of Mental Health and National Institute for Child Health and Human Development). Dr. Le Grange receives support from the National Institutes of Health (National Institute of Mental Health and National Institute for Child Health and Human Development) and the Baker Foundation, and receives royalties from Guilford Press. Dr. Lock receives support from the National Institutes of Health (National Institute of Mental Health), the Davis Foundation, and the Lucile Packard foundation, and receives royalties from Guilford Press. Dr. Hildebrandt receives support from the National Institutes of Health (National Institute on Drug Abuse). Research on this project was partially supported by grants from the National Institute of Mental Health (NIMH): K24-MH074457 (PI: J. Lock), K23 MH074506-05 (PI: K. Loeb) and K23 MH01923 (PI: D. Le Grange), and the National Institute on Drug Abuse (NIDA): K23 DA024043 (PI: T. Hildebrandt).

Abstract

Objective:

The primary aim was to examine the utility of DSM-IV criteria in predicting treatment outcome in a sample of adolescents with eating disorders.

Method:

We (a) descriptively compared the baseline rates of anorexia nervosa (AN) and bulimia nervosa (BN) across multiple reference points for diagnostic criteria, (b) using ROC curve analyses, assessed the sensitivity and specificity of each diagnostic criterion in predicting clinical outcome, and (c) with logistic regression analyses, examined the incremental predictive value of each criterion.

Results:

Results show a high degree of variability in the baseline diagnostic profiles as a function of the information used to inform each DSM-IV criterion. For AN, Criterion A yielded the best predictive validity, with Criteria B-D providing no significant incremental value. For BN, none of the measures had a significant AUC, and results from logistic regression analyses showed that none of the indicators were robust in predicting outcome.

Discussion:

For AN, the existing Criterion A is appropriate for children and adolescents, and is sufficient to predict outcome in the context of active refusal to maintain a normal weight as well as multiple informants and behavioral indicators of the psychological aspects of AN. For BN, predictive validity could not be established. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010

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