PMID- 32600493
OWN - NLM
STAT- MEDLINE
DCOM- 20220414
LR  - 20220414
IS  - 1469-8978 (Electronic)
IS  - 0033-2917 (Linking)
VI  - 52
IP  - 4
DP  - 2022 Mar
TI  - Empirically determined severity levels for binge-eating disorder outperform 
      existing severity classification schemes.
PG  - 685-695
LID - 10.1017/S0033291720002287 [doi]
AB  - BACKGROUND: Eating-disorder severity indicators should theoretically index 
      symptom intensity, impairment, and level of needed treatment. Two severity 
      indicators for binge-eating disorder (BED) have been proposed (categories of 
      binge-eating frequency and shape/weight overvaluation) but have mixed empirical 
      support including modest clinical utility. This project uses structural equation 
      model (SEM) trees - a form of exploratory data mining - to empirically determine 
      the precise levels of binge-eating frequency and/or shape/weight overvaluation 
      that most significantly differentiate BED severities. METHODS: Participants were 
      788 adults with BED enrolled in BED treatment studies. Participants completed 
      interviews and self-report measures assessing eating-disorder and comorbid 
      symptoms. SEM Tree analyses were performed by specifying an outcome model of BED 
      severity and then recursively partitioning the outcome model into subgroups. 
      Subgroups were split based on empirically determined values of binge-eating 
      frequency and/or shape/weight overvaluation. SEM Forests also quantified which 
      variable contributed more improvement in model fit. RESULTS: SEM Tree analyses 
      yielded five subgroups, presented in ascending order of severity: overvaluation 
      <1.25, overvaluation = 1.25-2.74, overvaluation = 2.75-4.24, overvaluation ⩾4.25 
      with weekly binge-eating frequency <4.875, and overvaluation ⩾4.25 with weekly 
      binge-eating frequency ⩾4.875. SEM Forest analyses revealed that splits that 
      occurred on shape/weight overvaluation resulted in much more improvement in model 
      fit than splits that occurred on binge-eating frequency. CONCLUSIONS: 
      Shape/weight overvaluation differentiated BED severity more strongly than 
      binge-eating frequency. Findings indicate a nuanced potential BED severity 
      indicator scheme, based on a combination of cognitive and behavioral 
      eating-disorder symptoms. These results inform BED classification and may allow 
      for the provision of more specific and need-matched treatment formulations.
FAU - Forrest, Lauren N
AU  - Forrest LN
AUID- ORCID: 0000-0003-1481-5078
AD  - Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
AD  - Department of Psychology, Miami University, Oxford, OH, USA.
FAU - Jacobucci, Ross C
AU  - Jacobucci RC
AUID- ORCID: 0000-0001-7818-7424
AD  - Department of Psychology, University of Notre Dame, Notre Dame, IN, USA.
FAU - Grilo, Carlos M
AU  - Grilo CM
AD  - Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
LA  - eng
GR  - R01 DK049587/DK/NIDDK NIH HHS/United States
GR  - R01 DK114075/DK/NIDDK NIH HHS/United States
GR  - R01 DK112771/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20200630
PL  - England
TA  - Psychol Med
JT  - Psychological medicine
JID - 1254142
SB  - IM
MH  - Adult
MH  - *Binge-Eating Disorder/psychology
MH  - Body Image/psychology
MH  - Body Weight
MH  - Humans
MH  - Self Concept
OTO - NOTNLM
OT  - Binge-eating disorder
OT  - SEM Trees
OT  - eating disorders
OT  - exploratory data mining
OT  - severity
EDAT- 2020/07/01 06:00
MHDA- 2022/04/15 06:00
CRDT- 2020/07/01 06:00
PHST- 2020/07/01 06:00 [pubmed]
PHST- 2022/04/15 06:00 [medline]
PHST- 2020/07/01 06:00 [entrez]
AID - S0033291720002287 [pii]
AID - 10.1017/S0033291720002287 [doi]
PST - ppublish
SO  - Psychol Med. 2022 Mar;52(4):685-695. doi: 10.1017/S0033291720002287. Epub 2020 
      Jun 30.