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Identifying duration criteria for eating‐disorder remission and recovery through intensive modeling of longitudinal data
Author(s) -
De Young Kyle P.,
Kambanis P. Evelyna,
Bottera Angeline R.,
Mancuso Christopher,
Thomas Jennifer J.,
Franko Debra L.,
Herzog David B.,
Walker D. Catherine,
Anderson Drew,
Eddy Kamryn T.
Publication year - 2020
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.23249
Subject(s) - binge eating disorder , bulimia nervosa , eating disorders , anorexia nervosa , psychology , binge eating , duration (music) , predictive validity , psychiatry , spontaneous remission , longitudinal study , clinical psychology , medicine , art , alternative medicine , literature , pathology
Objective Outcome states, such as remission and recovery, include specific duration criteria for which individuals must be asymptomatic. Ideally, duration criteria provide predictive validity to outcome states by reducing symptom‐return risk. However, available research is insufficient for deriving specific recommendations for remission or recovery duration criteria for eating disorders. Method We intensively modeled the relation between duration criteria length and rates of remission, recovery, and subsequent symptom return in longitudinal data from a treatment‐seeking sample of women with anorexia nervosa (AN) and bulimia nervosa (BN). We hypothesized that the length of the duration criterion would be inversely associated with both rates of remission and recovery and with subsequent rates of symptom return. Results Generalized estimating equations supported our hypotheses for all investigated eating‐disorder features except for symptom return when using the Psychiatric Status Rating for AN. Discussion We recommend that 6 months be used for remission definitions applied to binge eating, purging, and BN symptom composite measures, whereas no duration criteria be used for low weight and AN symptom composites. We further recommend that 6 months be used for recovery definitions applied to BN symptom composites and AN symptom composites, whereas 18 months be used for individual symptoms of binge eating, purging, and low weight. The adoption of these duration criteria into comprehensive definitions of remission and recovery will increase their predictive validity, which in turn, maximizes their utility.