Subtyping women with bulimia nervosa along dietary and negative affect dimensions: further evidence of reliability and validity.
Studies have found that individuals with bulimia nervosa can be classified into dietary and dietary-negative affect subtypes and that the latter exhibit greater eating pathology, psychiatric comorbidity, and functional impairment; a more protracted clinical course; and a worse treatment response. In this report, the authors describe 2 prospective studies that found that young women with threshold (n = 48) and subthreshold (n = 83) bulimic pathology can be classified into dietary and dietary-negative affect subtypes; that two subtyping approaches produced similar results (mean kappa = .94); that the subtyping distinction showed 4-week test-retest reliability (kappa = .61); and that the dietary-negative affect subtype showed greater eating pathology, emotional distress, functional impairment, treatment seeking, and lower likelihood of recovery over 6-month and 3-year follow-ups than the dietary subtype. The dieting-negative affect subtyping distinction evidenced greater test-retest reliability and concurrent and predictive validity than did the purging-nonpurging subtyping distinction. The additional evidence for the reliability and validity of this subtyping scheme, particularly the prognostic utility, suggests it is worth additional inquiry.
Stice
Eric
E
Oregon Research Institute, Eugene, OR 97403, USA. estice@ori.org
Bohon
Cara
C
Marti
C Nathan
CN
Fischer
Kathryn
K
D000328:Adult; D000339:Affect; D052018:Bulimia Nervosa / Q000145:classification* / Q000175:diagnosis* / Q000628:therapy; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult