Psychometric characteristics of DSM-5 eating disorder diagnostic criteria: support for a transdiagnostic approach

This study is the first to comprehensively examine psychometric characteristics of the three main DSM-5 eating disorder (ED) diagnoses (Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED)) amongst adult ED patients. Data was collected via an online survey from 126 licensed therapists treating an adult with an ED. Therapists provided an ED DSM-5 diagnosis for a randomly selected patient, as well as endorsed the presence of symptoms from a list of DSM criteria. Criteria endorsement varied across both the entire sample and within diagnoses. Convergence and cohesion also varied within diagnoses. The first factor analysis for DSM-5 ED criteria yielded a five-factor solution for ED criteria accounted for 78.3% of variance: (1) Binge eating, (2) Compensatory and purging behaviors, (3) Shape/weight overvaluation, (4) Drive for thinness, and (5) Absence of binging and purging. Finally, diagnostic efficiency statistics were consistent with this factor model. Overall, our findings support a new, transdiagnostic model with fear of weight gain and weight being main aspects of self-evaluation as common underlying factors amongst all EDs.