Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519, USA.
J Consult Clin Psychol. 2011 Aug;79(4):509-14. doi: 10.1037/a0024259.
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 Criterion C, "marked distress about binge eating." This study examined the significance of the marked distress criterion for BED using 2 complementary comparison groups.
A total of 1,075 community volunteers completed a battery of self-report instruments as part of an Internet study. Analyses compared body mass index (BMI), eating-disorder psychopathology, and depressive levels in 4 groups: 97 participants with BED except for the distress criterion (BED-ND), 221 participants with BED including the distress criterion (BED), 79 participants with bulimia nervosa (BN), and 489 obese participants without binge eating or purging (NBPO). Parallel analyses compared these study groups using the broadened frequency criterion (i.e., once weekly for binge/purge behaviors) proposed for the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the 4th edition (DSM-IV) twice-weekly frequency criterion.
The BED group had significantly greater eating-disorder psychopathology and depressive levels than the BED-ND group. The BED group, but not the BED-ND group, had significantly greater eating-disorder psychopathology than the NBPO comparison group. The BN group had significantly greater eating-disorder psychopathology and depressive levels than all 3 other groups. The group differences in eating-disorder psychopathology existed even after controlling for depression levels, BMI, and demographic variables, although some differences between the BN and BED groups were attenuated when controlling for depression levels.
These findings provide support for the validity of the "marked distress" criterion for the diagnosis of BED.
研究已经检验了暴食障碍（BED）研究标准的各个方面的有效性，但尚未评估标准 C“对暴食的明显困扰”的效用。本研究使用 2 个补充比较组来检验 BED 中明显困扰标准的重要性。
共有 1075 名社区志愿者作为互联网研究的一部分完成了一系列自我报告工具。分析比较了 4 组人群的体质指数（BMI）、饮食障碍病理和抑郁水平：97 名符合 BED 标准但不符合困扰标准的参与者（BED-ND）、221 名符合 BED 标准且符合困扰标准的参与者（BED）、79 名患有神经性贪食症的参与者（BN）和 489 名没有暴食或清泻行为的肥胖参与者（NBPO）。平行分析使用 5 版《精神障碍诊断与统计手册》（DSM-5）和 4 版（DSM-IV）提出的更广泛的频率标准（即每周一次暴食/清泻行为）和两周一次的频率标准比较了这些研究组。
BED 组的饮食障碍病理和抑郁水平显著高于 BED-ND 组。BED 组的饮食障碍病理显著高于 NBPO 对照组，而 BED-ND 组则不然。BN 组的饮食障碍病理和抑郁水平显著高于其他 3 组。即使控制了抑郁水平、BMI 和人口统计学变量，饮食障碍病理的组间差异仍然存在，尽管在控制了抑郁水平后，BN 和 BED 组之间的一些差异有所减弱。
这些发现为 BED 诊断中“明显困扰”标准的有效性提供了支持。
