Forney Katherine Jean, Brown Tiffany A, Crosby Ross D, Klein Kelly M, Keel Pamela K
Department of Psychology, Ohio University, Athens, Ohio, USA.
Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA.
Int J Eat Disord. 2022 Jun;55(6):810-819. doi: 10.1002/eat.23712. Epub 2022 Apr 2.
The current study sought to examine the predictive validity of the purging disorder diagnosis at long-term follow-up by comparing naturalistic outcomes with bulimia nervosa.
Women with purging disorder (N = 84) or bulimia nervosa (N = 133) who had completed comprehensive baseline assessments as part of one of three studies between 2000 and 2012 were sought for follow-up assessment. Nearly all (94.5%) responded to recruitment materials and 150 (69% of sought sample; 83.3% non-Hispanic white; 33.40 [7.63] years old) participated at an average of 10.59 (3.71) years follow-up. Participants completed the Eating Disorder Examination, the Structured Clinical Interview for DSM-IV, and a questionnaire battery. Diagnostic groups were compared on eating disorder (illness status, recovery status, and eating pathology) and related outcomes. Group differences in predictors of outcome were explored.
There were no significant differences in eating disorder presence (p = .70), recovery status (p = .87), and level of eating pathology (p = .17) between diagnostic groups at follow-up. Post hoc equivalence tests indicated group differences were smaller than a medium effect size (p's ≤ .005). Groups differed in diagnosis at follow-up (p = .002); diagnostic stability was more likely than cross-over to bulimia nervosa for women with baseline purging disorder (p = .004).
Although purging disorder and bulimia nervosa do not differ in long-term outcomes, the relative stability in clinical presentation suggests baseline group differences in clinical presentation may be useful in augmenting treatments for purging disorder.
While purging disorder is classified as an "other specified" eating disorder, individuals who experience this disorder have comparable negative long-term outcomes as those with bulimia nervosa. This highlights the importance of screening for and treating purging disorder as a full-threshold eating disorder.
本研究旨在通过比较自然转归情况与神经性贪食症，来检验长期随访时清除障碍诊断的预测效度。
在2000年至2012年间三项研究之一中完成全面基线评估的清除障碍女性（N = 84）或神经性贪食症女性（N = 133）被纳入随访评估。几乎所有（94.5%）对招募材料做出回应，150名（占所寻找样本的69%；83.3%为非西班牙裔白人；33.40 [7.63]岁）参与了平均10.59（3.71）年的随访。参与者完成了饮食失调检查、DSM-IV结构化临床访谈及一系列问卷。对诊断组在饮食失调（疾病状态、康复状态及饮食病理学）及相关转归方面进行比较。探讨转归预测因素的组间差异。
随访时诊断组间在饮食失调存在情况（p = 0.70）、康复状态（p = 0.87）及饮食病理学水平（p = 0.17）方面无显著差异。事后等效性检验表明组间差异小于中等效应量（p值≤ 0.005）。随访时诊断组不同（p = 0.002）；基线为清除障碍的女性诊断稳定性高于转为神经性贪食症的情况（p = 0.004）。
尽管清除障碍和神经性贪食症在长期转归方面无差异，但临床表现的相对稳定性表明，临床表现的基线组间差异可能有助于改进清除障碍的治疗。
虽然清除障碍被归类为“其他特定”饮食失调，但经历该障碍的个体与神经性贪食症患者具有相当的负面长期转归。这凸显了将清除障碍作为一种完全阈值饮食失调进行筛查和治疗的重要性。
