Subtyping women with bulimia nervosa along dietary and negative affect dimensions: further evidence of reliability and validity

J Consult Clin Psychol. 2008 Dec;76(6):1022-33. doi: 10.1037/a0013887.

Abstract

Studies have found that individuals with bulimia nervosa can be classified into dietary and dietary-negative affect subtypes and that the latter exhibit greater eating pathology, psychiatric comorbidity, and functional impairment; a more protracted clinical course; and a worse treatment response. In this report, the authors describe 2 prospective studies that found that young women with threshold (n = 48) and subthreshold (n = 83) bulimic pathology can be classified into dietary and dietary-negative affect subtypes; that two subtyping approaches produced similar results (mean kappa = .94); that the subtyping distinction showed 4-week test-retest reliability (kappa = .61); and that the dietary-negative affect subtype showed greater eating pathology, emotional distress, functional impairment, treatment seeking, and lower likelihood of recovery over 6-month and 3-year follow-ups than the dietary subtype. The dieting-negative affect subtyping distinction evidenced greater test-retest reliability and concurrent and predictive validity than did the purging-nonpurging subtyping distinction. The additional evidence for the reliability and validity of this subtyping scheme, particularly the prognostic utility, suggests it is worth additional inquiry.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Affect*
  • Bulimia Nervosa / classification*
  • Bulimia Nervosa / diagnosis*
  • Bulimia Nervosa / therapy
  • Feeding Behavior*
  • Female
  • Humans
  • Middle Aged
  • Reproducibility of Results
  • Surveys and Questionnaires*
  • Young Adult