The validity of DSM‐5 severity specifiers for anorexia nervosa, bulimia nervosa, and binge‐eating disorder
Open accessAbstract
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.
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Research has provided limited support for the DSM-5 low BMI specifier ratings across both European and US samples.
“To date, research has provided limited support for the DSM-5 low BMI specifier ratings across both European [81–84] and US [85, 86] samples.”
From Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies (2020) · cites this paper as [86]
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References 31 · Cited by 59
- Authors
- Smith, K. E., Ellison, J. M., Crosby, R. D., Engel, S. G., Mitchell, J. E., Crow, S. J., Peterson, C. B., Le Grange, D., & Wonderlich, S. A.
- Affiliations
- University of North Dakota (US)
- Essentia Health (US)
- University of Minnesota (US)
- Department of Psychiatry University of California San Francisco California
- Corresponding author
- Smith, Kathryn E.
- ORCID
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2017-06-17
- Volume
- 50
- Issue
- 9
- Pages
- 1109-1113
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC5741971
- OpenAlex
- W2624904764
- Cited by
- 59
- References
- 31
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 12 · 2023: 10 · 2022: 6 · 2021: 2 · 2020: 8 · 2019: 1 · 2018: 5 · 2017: 2
- FWCI
- 5.41
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01‐DK‐61912, R01‐MHDK‐58820)
- National Institute of Mental Health (R01‐MH‐059674, T32‐MH‐082761)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder severity, concurrent validity, predictive validity, compensatory behavior, binge eating episodes, eating disorder psychopathology, depression, anxiety, quality of life, physical health
- MeSH terms
- Adult, Anorexia Nervosa, Female, Humans, Quality of Life, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders, Bulimia Nervosa, Young Adult, Binge-Eating Disorder
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