The impact of revised DSM-5 criteria on the relative distribution and inter-rater reliability of eating disorder diagnoses in a residential treatment setting
Autor(en): | Thomas, Jennifer J. Eddy, Kamryn T. Murray, Helen B. Tromp, Marilou D. P. Hartmann, Andrea S. Stone, Melissa T. Levendusky, Philip G. Becker, Anne E. |
Stichwörter: | ADOLESCENTS; AGREEMENT; CLINICAL UTILITY; COMMUNITY; Diagnostic reliability; DSM-5; Eating disorder; Eating disorder not otherwise specified (EDNOS); EDNOS; IV; Other specified feeding or eating disorder (OSFED); PREVALENCE; Psychiatry; SEVERITY | Erscheinungsdatum: | 2015 | Herausgeber: | ELSEVIER IRELAND LTD | Enthalten in: | PSYCHIATRY RESEARCH | Band: | 229 | Ausgabe: | 1-2 | Startseite: | 517 | Seitenende: | 523 | Zusammenfassung: | This study evaluated the relative distribution and inter-rater reliability of revised DSM-5 criteria for eating disorders in a residential treatment program. Consecutive adolescent and young adult females (N=150) admitted to a residential eating disorder treatment facility were assigned both DSM-IV and DSM-5 diagnoses by a clinician (n=14) via routine clinical interview and a research assessor (n=4) via structured interview. We compared the frequency of diagnostic assignments under each taxonomy and by type of assessor. We evaluated concordance between clinician and researcher assignment through inter-rater reliability kappa and percent agreement. Significantly fewer patients received either clinician or researcher diagnoses of a residual eating disorder under DSM-5 (clinician-12.0%; researcher-31.3%) versus DSM-IV (clinician-28.7%; researcher-59.3%), with the majority of reassigned DSM-IV residual cases reclassified as DSM-5 anorexia nervosa. Researcher and clinician diagnoses showed moderate inter-rater reliability under DSM-IV (kappa= .48) and DSM-5 (kappa= .57), though agreement for specific DSM-5 other specified feeding or eating disorder (OSFED) presentations was poor (kappa=.05). DSM-5 revisions were associated with significantly less frequent residual eating disorder diagnoses, but not with reduced inter-rater reliability. Findings support specific dimensions of clinical utility for revised DSM-5 criteria for eating disorders. (C) 2015 Elsevier Ireland Ltd. All rights reserved. |
ISSN: | 01651781 | DOI: | 10.1016/j.psychres.2015.06.017 |
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