Allison Kelly C, Engel Scott G, Crosby Ross D, de Zwaan Martina, O'Reardon John P, Wonderlich Stephen A, Mitchell James E, West Delia Smith, Wadden Thomas A, Stunkard Albert J
University of Pennsylvania School of Medicine, Department of Psychiatry, Center for Weight and Eating Disorders, 3535 Market St., 3rd Floor, Philadelphia, PA 19104-3309, USA.
Eat Behav. 2008 Dec;9(4):398-407. doi: 10.1016/j.eatbeh.2008.04.004. Epub 2008 May 10.
Uniform diagnostic criteria for the night eating syndrome (NES), a disorder characterized by a delay in the circadian pattern of eating, have not been established. Proposed criteria for NES were evaluated using item response theory (IRT) analysis. Six studies yielded 1,481 Night Eating Questionnaires which were coded to reflect the presence/absence of five night eating symptoms. Symptoms were evaluated based on the clinical usefulness of their diagnostic information and on the assumptions of IRT analysis (unidimensionality, monotonicity, local item independence, correct model specification), using a two parameter logistic (2PL) IRT model. Reports of (1) nocturnal eating and/or evening hyperphagia, (2) initial insomnia, and (3) night awakenings showed high precision in discriminating those with night eating problems, while morning anorexia and delayed morning meal provided little additional information. IRT is a useful tool for evaluating the diagnostic criteria of psychiatric disorders and can be used to evaluate potential diagnostic criteria of NES empirically. Behavioral factors were identified as useful discriminators of NES. Future work should also examine psychological factors in conjunction with those identified here.
夜食综合征（NES）是一种以进食昼夜模式延迟为特征的疾病，目前尚未建立统一的诊断标准。使用项目反应理论（IRT）分析对NES的拟议标准进行了评估。六项研究产生了1481份夜食问卷，这些问卷经过编码以反映五种夜食症状的存在与否。基于症状诊断信息的临床实用性以及IRT分析的假设（单维度性、单调性、局部项目独立性、正确的模型设定），使用双参数逻辑（2PL）IRT模型对症状进行了评估。（1）夜间进食和/或夜间食欲亢进、（2）初始失眠以及（3）夜间觉醒的报告在区分有夜食问题的人方面显示出高精度，而早晨厌食和早餐延迟提供的额外信息很少。IRT是评估精神疾病诊断标准的有用工具，可用于实证评估NES的潜在诊断标准。行为因素被确定为NES的有用鉴别因素。未来的工作还应结合此处确定的因素来研究心理因素。
