Are the Criterion B binge-eating symptoms interchangeable in understanding binge-eating severity? An item response theory analysis

Brianne N. Richson, Kelsie T. Forbush, Katherine Schaumberg, Ross D. Crosby, Carol B. Peterson, Scott J. Crow, James E. Mitchell

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The Criterion B binge-eating symptoms represent five symptoms associated with binge eating. Any three out of five symptoms can be used to meet Criterion B. However, Criterion B symptoms may not be interchangeable in terms of how binge-eating severity is associated with each symptom. Item response theory (IRT) can test how endorsing each symptom relates to the overall level (i.e., severity) of binge-eating measured by Criterion B. We used IRT to identify (a) how each Criterion B symptom corresponded with binge-eating severity in a transdiagnostic binge-eating sample and (b) how well each symptom differentiated individuals with differing levels of severity. Method: Participants (N = 219) were adults (80.8% female) with a current ED that included objective binge-eating episodes assessed via semi-structured interview. A two-parameter logistic IRT model evaluated how endorsement of each Criterion B symptom corresponded with the level of latent binge-eating severity. Results: “Eating large amounts when not hungry” and “eating alone” reflected the highest binge-eating severity. “Eating alone” was the best discriminator across different binge-eating severity levels, whereas “uncomfortably full” was the poorest discriminator across binge-eating severity levels. Discussion: Criterion B symptoms were not interchangeable in terms of what level of binge-eating severity corresponded with symptom endorsement. “Eating large amounts when not hungry” or “eating alone” may signify elevated binge-eating severity, whereas “uncomfortably full” and “feeling disgusted/depressed/guilty” were not necessarily indicative of elevated severity. Results suggested that Criterion B may need to be revised to eliminate symptoms that are redundant with other binge-eating diagnostic criteria.

Original languageEnglish (US)
Pages (from-to)1983-1992
Number of pages10
JournalInternational Journal of Eating Disorders
Volume53
Issue number12
DOIs
StatePublished - Dec 2020

Bibliographical note

Funding Information:
This research was supported by grants from the Clifford B. Kinley Trust, University of Kansas New Faculty General Research Fund, and University of Kansas Research Excellence Initiative Accelerator Grant to Kelsie T. Forbush (PI).

Funding Information:
Clifford B. Kinley Trust; University of Kansas New Faculty General Research Fund; University of Kansas Research Excellence Initiative Accelerator Grant Funding information

Publisher Copyright:
© 2020 Wiley Periodicals LLC

Keywords

  • assessment
  • binge eating
  • diagnosis
  • eating disorders
  • item response theory

PubMed: MeSH publication types

  • Journal Article

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