title: Evaluation of the DSM-5 severity indicator for binge eating disorder in a community sample.
abstract: Research has examined various aspects of the diagnostic criteria for binge-eating disorder (BED) but has yet to evaluate the DSM-5 severity criterion. This study examined the DSM-5 severity criterion for BED based on binge-eating frequency and tested an alternative severity specifier based on overvaluation of shape/weight. 338 community volunteers categorized with DSM-5 BED completed a battery of self-report instruments. Participants were categorized first using DSM-5 severity levels and second by shape/weight overvaluation and were compared on clinical variables. 264 (78.1%) participants were categorized as mild, 67 (19.8%) as moderate, 6 (1.8%) as severe, and 1 (0.3%) as extreme. Analyses comparing mild and moderate severity groups revealed no significant differences in demographic variables or BMI; the moderate severity group had greater eating-disorder psychopathology (small effect-sizes) but not depression than the mild group. Participants with overvaluation (N = 196; 60.1%) versus without (N = 130; 39.9%) did not differ significantly in age, sex, BMI, or binge-eating frequency. The overvaluation group had significantly greater eating-disorder psychopathology and depression than the non-overvaluation group. The greater eating-disorder and depression levels (medium-to-large effect-sizes) persisted after adjusting for ethnicity/race and binge-eating severity/frequency, without attenuation of effect-sizes. Findings from this non-clinical community sample provide support for overvaluation of shape/weight as a specifier for BED as it provides stronger information about severity than the DSM-5 rating based on binge-eating. Future research should include treatment-seeking patients with BED to test the utility of DSM-5 severity specifiers and include broader clinical validators.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, United States; Department of Psychology, Yale University, United States. Electronic address: carlos.grilo@yale.edu.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
authors.affiliation: Department of Psychiatry, Yale School of Medicine, United States.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ivezaj
authors.affiliation: Department of Psychiatry, Yale School of Medicine, United States; Yale School of Public Health, United States.
authors.forename: Marney A
authors.initials: MA
authors.lastname: White
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000175:diagnosis*; D001828:Body Image; D015992:Body Mass Index; D001835:Body Weight; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Binge eating disorder; Body image; Diagnosis; Obesity; Severity