Classifying binge eating‐disordered adolescents based on severity levels

Abstract

The new severity criterion for binge-eating disorder (BED), introduced by the most recent (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a means of addressing within-group variability in severity, was tested in 223 Italian (13-18-year-old) adolescents (86.1% females) with (DSM-5) BED presenting for treatment. Analyses revealed that participants classified with mild (35.9% of the sample), moderate (38.1%) severe (13.4%), and extreme (12.6%) severity of BED, based on their clinician-rated weekly frequency of binge-eating (BE) episodes, were statistically distinguishable in physical characteristics (body mass index) and a range of clinical variables regarding eating-related psychopathology and putative maintenance factors, health-related quality of life, and mood and anxiety disorder comorbidity (medium-tolarge effect sizes). Between-group differences in age-at-onset of BED or demographics were not detected. The findings provide support for the utility of BE frequency as a severity criterion for BED in adolescence. Implications for future studies are discussed.

A systematic review and meta-analysis on the DSM–5 severity ratings for eating disorders.

“…Grilo et al’s (2015b) community-based study found that individuals in the severe and extreme BED categories experienced significantly higher ED-related psychopathology. Relatedly, in a clinical-adolescent-sample, Dakanalis, Zanetti, et al (2018) found that the DSM–5 BED severity ratings significantly differentiated individuals with BED in terms of BMI as well as ED and general psychopathology. Overall, these findings provide mixed support regarding the clinical utility of the current DSM–5 severity index for BED.…”

“…Two studies comprised mainly adult females from the community (i.e., 70% females; Grilo et al, 2015b, 2015c). Two studies utilized adolescent participants from clinical settings (Dakanalis, Colmegna, et al, 2018; Dakanalis, Zanetti, et al, 2018), while one study used community-based adolescent participants (Smink et al, 2014). Three studies employed only females from clinical settings (Dalle Grave et al, 2018; Krug et al, 2021; Smith et al, 2017), and one study (Krug et al, 2022) used an all-male clinical sample…”

“…Twelve papers, comprising 10 clinical-based studies (e.g., Dakanalis, Colmegna, et al, 2017) and two community-based studies (Grilo et al, 2015b; Smink et al, 2014) investigated the clinical utility of DSM–5 BED severity ratings. Out of these 12 papers, only Dakanalis, Zanetti, et al (2018) used an adolescent only sample. The studies included a total of 3,356 participants with BED.…”

“…Seven studies (Dakanalis, Colmegna, et al, 2017; Dakanalis, Riva, et al, 2017; Dakanalis, Zanetti, et al, 2018; Gianini et al, 2017; Grilo et al, 2015a, 2015b; Nakai et al, 2017) were included in the meta-analysis to assess the SMD between BED severity groups in dietary restraint, eating, and weight/shape concerns. The pooled data analyses demonstrated some differences between groups.…”

Validity and reliability of the kiddie schedule for affective disorders and schizophrenia present and lifetime version DSM-5 (K-SADS-PL-5) Spanish version

“…Hyperarousal in social situations is a physiological characteristic that has been shown as a risk factor for later childhood symptoms of social anxiety and it has been proposed as a biological mechanism in the intergenerational transmission of SAD [ 29 ]. The relationship between anxiety disorders and BED has been demonstrated in adolescent clinical samples [ 30 ]. Previous evidence mentions stressful life events in early childhood as predictors of PD and SPH [ 31 ] and to be associated with BED [ 32 ]; a history of symptoms of PTSD also predict the later onset of binges [ 33 ].…”