Diagnostic Efficiency of DSM-IV Indicators for Binge Eating Episodes
Diagnostic Efficiency of DSM-IV Indicators for Binge Eating Episodes
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DOI：
10.1037/a0022210
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发表时间：
2011-02-01
影响因子：
5.9
通讯作者：
Grilo, Carlos M.
中科院分区：
文献类型：
--
作者：
White, Marney A.;Grilo, Carlos M.
目的：研究已经检查了暴食症（BED）研究标准有效性的各个方面，但尚未评估精神疾病诊断和统计手册（第4版; DSM-IV; American Psychiatric Association，1994）“indicators for impaired control”，其被指定用于帮助确定在暴饮暴食时失去控制（即，暴饮暴食）。我们检查了这些指标的诊断效率，这些指标被提议作为BED研究标准的一部分（吃到不舒服的饱;在不饿的时候吃;比平时吃得更快;秘密进食;在发作后感到厌恶，羞耻或抑郁）。方法：共有916名社区志愿者完成了一系列的措施，包括对每个指标的问题。参与者被分为3组：BED（N = 164），神经性贪食症（BN; N = 83）和非暴饮暴食对照组（N = 669）。在比较BED、BN和合并BED + BN组与对照组的单独分析中，计算每个指标标准的4个条件概率（敏感性、特异性、阳性预测能力[PPP]和阴性预测能力[NPP]）以及总预测值（TPV）和kappa系数。结果如下：PPP和NPP表明所有指标都具有预测价值，因为尴尬（PPP = .80）和感到厌恶（NPP = .93）而单独进食分别是最佳的纳入和排除标准。正确识别暴饮暴食的最佳总体指标（基于TPV和Kappa）是在不饿的时候进食和单独进食。结论：所有5个用于确定暴食的控制受损指标都具有实用性，诊断效率统计数据为临床医生和DSM-5提供了关于其纳入或排除有用性的指导。
Objective: Research has examined various aspects of the validity of the research criteria for binge eating disorder (BED) but has yet to evaluate the utility of the 5 Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) "indicators for impaired control" specified to help determine loss of control while overeating (i.e., binge eating). We examined the diagnostic efficiency of these indicators proposed as part of the research criteria for BED (eating until uncomfortably full; eating when not hungry; eating more rapidly than usual; eating in secret; and feeling disgust, shame, or depression after the episode). Method: A total of 916 community volunteers completed a battery of measures including questions about each of the indicators. Participants were categorized into 3 groups: BED (N = 164), bulimia nervosa (BN; N = 83), and non-binge-eating controls (N = 669). Four conditional probabilities (sensitivity, specificity, positive predictive power [PPP], and negative predictive power [NPP]) as well as total predictive value (TPV) and kappa coefficients were calculated for each indicator criterion in separate analyses comparing BED, BN, and combined BED + BN groups relative to controls. Results: PPPs and NPPs suggest all of the indicators have predictive value, with eating alone because embarrassed (PPP = .80) and feeling disgusted (NPP = .93) performing as the best inclusion and exclusion criteria, respectively. The best overall indicators for correctly identifying binge eating (based on TPV and kappa) were eating when not hungry and eating alone because etnbarrassed. Conclusions: All 5 proposed indicators for impaired control for determining binge binge eating have utility, and the diagnostic efficiency statistics provide guidance for clinicians and the DSM-5 regarding their usefulness for inclusion or exclusion.