Johnson W G, Carr-Nangle R E, Nangle D W, Antony M M, Zayfert C
Department of Psychiatry, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Addict Behav. 1997 Sep-Oct;22(5):631-5. doi: 10.1016/s0306-4603(97)00007-5.
Binge eating is a central diagnostic feature of bulimia nervosa (BN) and binge-eating disorder (BED), yet the phenomenon of bingeing has not been adequately defined, and there is considerable variability in how individuals label eating episodes as binges. We examined the agreement among binge-eating individuals, non-eating-disordered peers, and professional dietitians over whether particular eating episodes were binges. Twenty-nine females with BED, fifteen nonclinical binge eaters (NCB), three peer judges, and three dietitians rated a sample of eating episodes of the binge-eating individuals as either binges or nonbinges based on the types and amounts of food eaten as well as the duration of each eating episode. BED participants labeled a significantly higher proportion of their intakes as binges relative to NCB participants. Peer judges were more likely than were dietitians to label participants' eating episodes as binges. Agreement within dietitian and peer groups was poor to fair, whereas agreement between these groups was fair. Finally, agreement between participants and the external judges (i.e., peers, dietitians) was poor. Possible explanations for these findings as well as implications for the diagnosis of BN and BED are discussed.
暴饮暴食是神经性贪食症（BN）和暴饮暴食症（BED）的核心诊断特征，但暴饮暴食现象尚未得到充分定义，而且个体对饮食发作是否为暴饮暴食的界定存在很大差异。我们研究了暴饮暴食者、非饮食失调的同龄人以及专业营养师在特定饮食发作是否为暴饮暴食问题上的一致性。29名患有BED的女性、15名非临床暴饮暴食者（NCB）、3名同龄人评判员和3名营养师根据所吃食物的种类和数量以及每次饮食发作的持续时间，将暴饮暴食者的饮食发作样本评定为暴饮暴食或非暴饮暴食。与NCB参与者相比，BED参与者将其摄入量中更高比例的部分标记为暴饮暴食。同龄人评判员比营养师更有可能将参与者的饮食发作标记为暴饮暴食。营养师组和同龄人组内部的一致性较差到一般，而这两组之间的一致性一般。最后，参与者与外部评判员（即同龄人、营养师）之间的一致性较差。讨论了这些发现的可能解释以及对BN和BED诊断的影响。
