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Should non‐fat‐phobic anorexia nervosa be included in DSM‐V?
Author(s) -
Becker Anne E.,
Thomas Jennifer J.,
Pike Kathleen M.
Publication year - 2009
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.20727
Subject(s) - anorexia nervosa , psychology , meta analysis , medline , clinical psychology , eating disorders , psychiatry , medicine , pathology , political science , law
Objective Cross‐cultural data suggest that rationales for food refusal vary in anorexia nervosa (AN), and a variant, termed non‐fat‐phobic AN (NFP‐AN), has been described. This review evaluates whether data support modification of the requirement for intense fear of weight gain to meet AN criterion B in DSM‐V. Method We performed a systematic search of the Medline and PsychInfo literature and evaluated the relevant publications by Robins and Guze's (Am J Psychiatry 126, 983–987, 1970) criteria as a standard for diagnostic validity. We also performed a meta‐analysis comparing the severity of eating pathology in AN to (a) NFP‐AN and (b) AN with low drive for thinness (low‐DT‐AN). Results A modest literature indicates that NFP‐AN has wide geographic distribution and occurs in both Western and non‐Western populations alongside cases of typical AN. Aggregating across eligible studies, patients with NFP‐AN or low‐DT‐AN score at least 2/3 of a standard deviation lower on measures of eating pathology than patients with conventional AN. Transcultural comparison of drive for thinness suggests significantly lower norms in non‐Western cultures. Discussion NFP‐AN occurs with wide distribution. Further research is necessary on the course and outcomes of NFP‐AN to characterize its congruence with, or distinction from, conventional AN. We discuss several options for including a description of NFP‐AN in DSM‐V. © 2009 American Psychiatric Association. Int J Eat Disord 2009