To increase the accessibility of empirically informed risk assessment protocols for suicide prevention and treatment, an updated suicide risk assessment form and decision tree are provided.

Eating disorders (EDs) are more common among younger women compared to older women and in women compared to men. As such, most ED research focuses on late adolescent and young adult females resulting in limited prospective research on gender differences in eating disorder psychopathology across the life span. The present study addresses this gap by examining gender differences in ED diagnoses, eating pathology, and the impact of putative risk factors on eating pathology in women (n ϭ 624) and men (n ϭ 276) over a 30-year period from late adolescence (M (SD) ϭ 20[2] years) to later midlife (M (SD) ϭ 50[2] years). Four assessment waves were conducted, beginning with baseline participation during college and subsequent 10-, 20-, and 30-year follow-up. Retention at 30-year follow-up was 72% (n ϭ 440) for women and 67% (n ϭ 181) for men. Prevalence of DSM-5 ED diagnoses decreased over the 30-year span for women and remained stable for men, with no significant gender difference in point prevalence by age 50. Drive for thinness decreased for women through age 50 and increased for men, while bulimic symptoms decreased as both genders aged. Multilevel models demonstrated that the impact of dieting as a risk factor on drive for thinness decreased prospectively as men aged and remained stable as women aged. Results imply that current risk models require refinement to account for developmental trajectories in which dramatic gender differences observed in late adolescence diminish over time.

Objective-Little empirical attention has been paid to the DSM-5 definition of Binge Eating Disorder (BED), particularly to the associated features of binge episodes. The present study sought to determine how the associated features and undue influence of weight/shape on self-evaluation contribute to evidence of a clinically significant eating disorder.Method-Secondary analyses were conducted on data (N = 80; 76.3% women, 76.3% Caucasian, ages 18-43) collected through an epidemiological study of eating patterns. Descriptive statistics were used to report the sample prevalence of the features, independently and in combination. Correlations and alpha reliability were employed to examine relationships among associated features, distress regarding bingeing, and clinical diagnosis. Regression models and receiveroperating characteristic (ROC) curves were used to determine the utility of the features for explaining variance in distress.Results-Internal consistency reliability for indicators was low, and several features demonstrated low or non-significant associations with distress and diagnosis. Feeling disgusted/ depressed/guilty was the only unique predictor of distress (p = 0.001). For the ROC curves, three features was the best threshold for predicting distress.Discussion-Results support the need to refine the features to ensure better detection of clinically significant eating pathology for research inclusion and treatment of the illness.Few studies (1-3) have examined the validity of the five associated features of binge-eating episodes, three of which, along with distress regarding bingeing, are required for a Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis of Binge Eating Disorder (BED). (4) Further, limited data exist regarding prevalence of these features, and it remains unclear how many features are central to defining BED. Additionally, controversy exists regarding if and how a body image disturbance criterion, namely, "the undue influence of body weight or shape on self-evaluation," (4) should be incorporated in the BED diagnosis (5-8). The present study sought to describe the prevalence of the associated features and determine how those features and undue influence relate to distress regarding binge eating and clinical diagnosis. Overall, we aimed to conduct a preliminary examination of the DSM-5 BED criteria, given that research conducted on BED populations rests on the assumption that the criteria accurately capture the abnormal eating behaviors they are intended to describe. HHS Public Access METHODS ParticipantsThe present study used data collected in 2002 from college cohorts established in 1982, 1992, and 2002 (N = 2060, 71% participation rate); inclusion and exclusion criteria are found in Table 1, and the larger epidemiological study is described in detail elsewhere. (9-11) Participants were also excluded if they were missing data needed to assess the main study variables. This yielded a sample size of N = 80 (76.3% women, mean (SD) age = 28.26 (8.22)) that was 76.3...

Background The DSM-5 introduced purging disorder (PD) as an other specified feeding or eating disorder characterized by recurrent purging in the absence of binge eating. The current study sought to describe the long-term outcome of PD and to examine predictors of outcome. Methods Women (N = 84) who met research criteria for PD completed a comprehensive battery of baseline interview and questionnaire assessments. At an average of 10.24 (3.81) years follow-up, available records indicated all women were living, and over 95% were successfully located (n = 80) while over two-thirds (n = 58) completed follow-up assessments. Eating disorder status, full recovery status, and level of eating pathology were examined as outcomes. Severity and comorbidity indicators were tested as predictors of outcome. Results Although women experienced a clinically significant reduction in global eating pathology, 58% continued to meet criteria for a DSM-5 eating disorder at follow-up. Only 30% met established criteria for a full recovery. Women reported significant decreases in purging frequency, weight and shape concerns, and cognitive restraint, but did not report significant decreases in depressive and anxiety symptoms. Quality of life was impaired in the physical, psychological, and social domains. More severe weight and shape concerns at baseline predicted meeting criteria for an eating disorder at follow-up. Other baseline severity indicators and comorbidity did not predict the outcome. Conclusions Results highlight the severity and chronicity of PD as a clinically significant eating disorder. Future work should examine maintenance factors to better adapt treatments for PD.