Recent Publications
The Eating Disorder Inventory (EDI; Garner et al., 1983) is one of the oldest and most widely used surveys of eating disorder thoughts and behaviors; however, whether it functions similarly across ethnoracial groups is unclear. This study demonstrated the Drive for Thinness, Bulimia, Perfectionism, Maturity Fears, and Interpersonal Distrust subscales measure the same constructs across Hispanic White, non-Hispanic Asian, non-Hispanic Black or African American, and non-Hispanic White adults, supporting use in these demographic groups.
Objective: Bulimia nervosa and related syndromes (BN‐S) are clinically heterogeneous and complex disorders. Frequent co-morbidity with anxiety disorders (ADs) and substance use disorders (SUDs) implicates inherent fear‐ and approach‐based tendencies in BN‐S. This study aimed to clarify how comorbid ADs and SUDs, along with fear‐ and approach‐based traits, influence the presentation and severity of BN‐S.
Method: Women (N = 399) with BN‐S (n = 321) or no history of eating disorders (n = 78) completed the Eating Disorder Examination, Structured Clinical Interview for DSM‐5 Disorders, Behavioural Inhibition System/Behavioural Activation System scales, and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire.
Results: Diagnostic features, symptom frequencies, and eating pathology scores were not significantly affected by comorbidity with ADs or SUDs. Controlling for ADs, participants with BN‐S scored significantly higher than controls on fear‐based traits. Similarly, controlling for SUDs, individuals with BN‐S showed elevated sensitivity to reward. Finally, elevated fear‐ and approach‐based traits both contributed to elevated severity across a range of bulimic symptoms.
Conclusion: Fear‐ and approach‐based traits coexist in individuals with BN‐S and were associated with the same symptoms. Although BN‐S are currently placed within the Hierarchical Taxonomy of Psychopathology's internalizing spectrum, findings indicate overlap with the externalizing spectrum.
Objective: Specific diagnostic criteria for purging disorder (PD) are not currently provided in the DSM-5. The current study aims to compare point prevalence estimates and evidence of predictive validity for four alternative criteria sets for PD for men and women.
Method: Survey data collected in college (N = 3291) and at 10-year follow-up (n = 2223) were used in analyses. Point prevalence was assessed at both time points and compared in men versus women as well as in college versus at 10-year follow-up. Predictive validity was assessed using multiple linear regressions to determine prospective associations for each PD definition versus no eating disorder across external validators.
Results: Point prevalence was greater in women than in men in college across all definitions of PD, and no sex differences were found at follow-up. Point prevalence was greater in college than at follow-up in all but the narrowest definition of PD which required purging, on average, twice per week. Predictive validity was supported for PD defined by self-induced vomiting, laxative or diuretic misuse, with evidence of lower satisfaction with work and career at follow-up.
Discussion: Together, findings support defining PD through self-induced vomiting, laxative use, or diuretic use to influence body shape or weight, on average, at least once per week. Specifying diagnostic criteria for PD that demonstrate evidence of concurrent and predictive validity will contribute to improved diagnostic reliability, screening, assessment, and support future research efforts to improve treatment.