scholarly journals Where does purging disorder lie on the symptomatologic and personality continuum when compared to other eating disorder subtypes? Implications for the DSM

2021 ◽  
Author(s):  
Isabel Krug ◽  
Sarah Elizabeth Giles ◽  
Roser Granero ◽  
Zaida Agüera ◽  
Isabel Sánchez ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Purging Disorder

Epidemiology and Course of Eating Disorders

2010 ◽  
pp. 24-32 ◽  
Author(s):  
Pamela Keel
Keyword(s):  
Public Health ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
The Public ◽  
Purging Disorder ◽  
Not Otherwise Specified ◽  
Public Health Significance ◽  
Health Significance

The epidemiology of eating disorders holds important clues for understanding factors that may contribute to their etiology. In addition, epidemiological findings speak to the public health significance of these deleterious syndromes. Information on course and outcome are important for clinicians to understand the prognosis associated with different disorders of eating and for treatment planning. This chapter reviews information on the epidemiology and course of anorexia nervosa, bulimia nervosa, and two forms of eating disorder not otherwise specified, binge eating disorder and purging disorder.

Co-morbidity and disorder-related distress and impairment in purging disorder

2007 ◽  
Vol 38 (10) ◽  
pp. 1435-1442 ◽  
Author(s):  
P. K. Keel ◽  
B. E. Wolfe ◽  
J. A. Gravener ◽  
D. C. Jimerson
Keyword(s):  
Eating Disorder ◽  
Normal Weight ◽  
Self Report ◽  
Axis Ii ◽  
Clinical Interviews ◽  
Diagnostic And Statistical Manual ◽  
Purging Disorder ◽  
Co Morbidity ◽  
Axis I ◽  
Clinically Significant

BackgroundRecent studies suggest that purging disorder (PD) may be a common eating disorder that is associated with clinically significant levels of distress and high levels of psychiatric co-morbidity. However, no study has established evidence of disorder-related impairment or whether distress is specifically related to PD rather than to co-morbid disorders.MethodThree groups of normal-weight women [non-eating disorder controls (n=38), with PD (n=24), and with bulimia nervosa (BN)-purging subtype (n=57)] completed structured clinical interviews and self-report assessments.ResultsBoth PD and BN were associated with significant co-morbidity and elevations on indicators of distress and impairment compared to controls. Compared to BN, PD was associated with lower rates of current and lifetime mood disorders but higher rates of current anxiety disorders. Elevated distress and impairment were maintained in PD and BN after controlling for Axis I and Axis II disorders.ConclusionsPD is associated with elevated distress and impairment and should be considered for inclusion as a provisional disorder in nosological schemes such as the Diagnostic and Statistical Manual to facilitate much-needed research on this clinically significant syndrome.

scholarly journals Rapid Response to Day Hospital Treatment in Bulimia Nervosa and Purging Disorder: a Randomized Controlled Trial of an Intervention to Facilitate Early Behaviour Change

2021 ◽  
Author(s):  
Danielle Elziabeth MacDonald
Keyword(s):  
Randomized Controlled Trial ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Controlled Trial ◽  
Rapid Response ◽  
Hospital Treatment ◽  
Day Hospital ◽  
Purging Disorder ◽  
Randomized Controlled ◽  
End Of Treatment

Even the most effective treatments for bulimia nervosa and purging disorder have high rates of nonremission and relapse. As such, improving treatment efficacy is an important research priority in this area. Research has consistently demonstrated that rapid response – defined as substantial improvements in key eating disorder behaviours (e.g., binge eating, vomiting, dietary restriction) during the initial weeks of cognitive behavioural therapy (CBT) – is the strongest and most robust predictor of good outcomes at end-of-treatment and in follow-up (Vall & Wade, 2015). Further, research has failed to identify pre-treatment demographic or clinical variables that account for this relationship, suggesting that rapid response is due to elements of CBT itself. This study aimed to demonstrate that rapid response can be clinically facilitated. A four-session CBT intervention focused on encouraging rapid response was compared to a matched-intensity motivational interviewing intervention, both adjunctive to intensive treatment in a randomized controlled trial. The CBT intervention included psychoeducation about rapid response, a focus on goal-setting, and use of behavioural skills for making concrete changes. Forty-four women with bulimia nervosa or purging disorder participated in the study. There were no baseline differences between groups on any demographic or clinical variables. Intent-to-treat results showed that compared to those who received motivational interviewing, participants who received CBT were significantly more likely to make a rapid response to day hospital treatment, and had fewer total eating disorder behaviours and more normalized eating during the first 4 weeks of day hospital treatment. Additionally, between baseline and day hospital end-of-treatment, participants who received CBT made significantly greater improvements on overvaluation of weight and shape and difficulties with emotion regulation. These findings indicate that rapid response to intensive treatment can be clinically facilitated using an adjunctive intervention focused on encouraging rapid and substantial change. These findings also suggest that rapid response may be related to improved outcome via improvements in overvaluation of weight and shape or emotion regulation. This study provides support for theoretical contentions that rapid response is due to CBT-related factors, and provides the framework for future research investigating rapid response as a causal mechanism of good outcome for eating disorders.

Feeling Sick

2020 ◽  
pp. 63-78
Author(s):  
Pamela K. Keel
Keyword(s):  
Eating Disorders ◽  
Body Weight ◽  
Eating Disorder ◽  
Food Intake ◽  
Genetic Factors ◽  
Twin Studies ◽  
Nausea And Vomiting ◽  
Purging Disorder ◽  
Biological Responses ◽  
The Brain

Eating is fundamental to our survival and subject to numerous biological regulators that influence when, what, and how much we eat. This makes biological factors central to any answer for why someone develops purging disorder. Genetic factors impact body weight and temperament and may even influence a person’s susceptibility to nausea and vomiting. Yet data from family and twin studies suggest that genes may play a slightly smaller role in risk for purging disorder compared to other eating disorders. Instead, biological responses to food intake may explain the unique configuration of purging after consuming normal amounts of food in purging disorder. Compared to those with bulimia, individuals with purging disorder have greater release of hormones that trigger the brain to stop eating. Compared to those with bulimia and those without an eating disorder, individuals with purging disorder release excessive amounts of a hormone that triggers feelings of nausea and stomachache.

scholarly journals A cluster analysis of purging disorder: Validation analyses with eating disorder symptoms, general psychopathology and personality

2020 ◽  
Vol 28 (6) ◽  
pp. 643-656
Author(s):  
Isabel Krug ◽  
Roser Granero ◽  
Sarah Giles ◽  
Nadine Riesco ◽  
Zaida Agüera ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Eating Disorder ◽  
General Psychopathology ◽  
Eating Disorder Symptoms ◽  
Purging Disorder

scholarly journals Weight suppression increases odds for future onset of anorexia nervosa, bulimia nervosa, and purging disorder, but not binge eating disorder

2020 ◽  
Vol 112 (4) ◽  
pp. 941-947 ◽  
Author(s):  
Eric Stice ◽  
Paul Rohde ◽  
Heather Shaw ◽  
Chris Desjardins
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Purging Disorder ◽  
Weight Suppression ◽  
Current Weight

ABSTRACT Background Eating disorders affect 13% of females and contribute to functional impairment and mortality, but few studies have identified risk factors that prospectively correlate with future onset of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Identifying risk factors specific to each eating disorder is critical for advancing etiologic knowledge and designing effective prevention programs. Objectives This study examined whether weight suppression (the difference between a person's highest past weight at their adult height and their current weight) correlates with future onset of AN, BN, BED, and PD. Methods Data from 1165 young women with body image concerns (mean ± SD age: 21.9 ± 6.4 y) who completed annual diagnostic interviews over a 3-y follow-up period were examined. Logistic regression models evaluated the relation of baseline weight suppression to onset risk of each eating disorder controlling for age, dietary restraint, and intervention condition. Results Elevated weight suppression predicted future onset of AN (OR: 1.36; 95% CI: 1.03, 1.80), BN (OR: 1.34; 95% CI: 1.11, 1.62), PD (OR: 1.46; 95% CI: 1.23, 1.74), and any eating disorder (OR: 1.32; 95% CI: 1.12, 1.56), but not BED (OR: 1.10; 95% CI: 0.89, 1.37). Highest past weight correlated with future onset of BN and PD but not onset of AN, BED, or any eating disorder, and baseline current weight was inversely related to future AN onset only, implying that women with the largest difference between their highest past weight and current weight are at greatest risk of eating disorders. Conclusions The results provide novel evidence that weight suppression correlates with future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviors and suggest weight-suppressed women constitute an important risk group to target with selective prevention programs. These trials were registered at clinicaltrials.gov as NCT01126918 and NCT01949649.

Do We Need Another Eating Disorder?

2020 ◽  
pp. 3-20
Author(s):  
Pamela K. Keel
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Purging Disorder

Most people know about anorexia and some know about bulimia, but very few have ever heard of purging disorder. Purging disorder is an eating disorder characterized by self-induced vomiting or misuse of laxatives, diuretics, or other medications to influence weight or shape in individuals who are not underweight and who do not have large binges. This chapter describes how and when purging disorder was first identified, placing it in the context of the identification of other eating disorders and the factors that determine whether a condition should be considered a new mental disorder. It describes how purging disorder came to be included as an “other specified feeding or eating disorder” in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

Sign in / Sign up

Export Citation Format

Share Document