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Eating disorders in youth: Diagnostic variability and predictive validity
Author(s) -
Loeb Katharine L.,
Le Grange Daniel,
Hildebrandt Tom,
Greif Rebecca,
Lock James,
Alfano Lauren
Publication year - 2011
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.20872
Subject(s) - psychology , logistic regression , context (archaeology) , bulimia nervosa , anorexia nervosa , predictive power , receiver operating characteristic , eating disorders , predictive validity , incremental validity , predictive value , clinical psychology , psychometrics , test validity , statistics , medicine , paleontology , philosophy , mathematics , epistemology , biology
Objective: The primary aim was to examine the utility of DSM‐IV criteria in predicting treatment outcome in a sample of adolescents with eating disorders. Method: We (a) descriptively compared the baseline rates of anorexia nervosa (AN) and bulimia nervosa (BN) across multiple reference points for diagnostic criteria, (b) using ROC curve analyses, assessed the sensitivity and specificity of each diagnostic criterion in predicting clinical outcome, and (c) with logistic regression analyses, examined the incremental predictive value of each criterion. Results: Results show a high degree of variability in the baseline diagnostic profiles as a function of the information used to inform each DSM‐IV criterion. For AN, Criterion A yielded the best predictive validity, with Criteria B‐D providing no significant incremental value. For BN, none of the measures had a significant AUC, and results from logistic regression analyses showed that none of the indicators were robust in predicting outcome. Discussion: For AN, the existing Criterion A is appropriate for children and adolescents, and is sufficient to predict outcome in the context of active refusal to maintain a normal weight as well as multiple informants and behavioral indicators of the psychological aspects of AN. For BN, predictive validity could not be established. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010