JOURNAL ARTICLE

Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth

Diann M Ackard, Jayne A Fulkerson, Dianne Neumark-Sztainer
International Journal of Eating Disorders 2007, 40 (5): 409-17
17506079

OBJECTIVE: To examine the prevalence and utility of DSM-IV eating disorder (ED) criteria and anorexia (AN), bulimia (BN), and binge eating disorder (BED) among adolescents.

METHOD: An ethnically diverse population-based sample of 4,746 public middle and high school students completed anthropometric measures and Project EAT survey items.

RESULTS: Many youth endorsed body shape perception disturbance (41.5% female; 24.9% male), undue influence of body shape/weight on self-esteem (36.4% female; 23.9% male), and compensatory behavior (9.4% female; 13.5% male). Prevalence among females and males, respectively, was: AN = 0.04%, 0%; BN = 0.3%, 0.2%; BED = 1.9%, 0.3%. Analyses of individual criteria showed high sensitivity and negative predictive values for each disorder and corresponding criteria, low specificity for several AN (27.8%) and BN (32.0%) criteria, and low positive predictive values (0.06-40.2%).

CONCLUSION: Body disparagement and compensatory behaviors indicate eating disturbance, despite low prevalence of EDs. Diagnostic classification may be clinically useful, but is complicated for use in epidemiological populations.

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