The way in which eating disorders are classified has major implications for their diagnosis and for treatment and research. The most commonly used classification of these disorders is that formalized in the diagnostic criteria of the Diagnostic and Statistical Manual for Mental Disorders of the American Psychiatric Association (DSM). Given its importance, discussion concerning the purpose of the DSM and the criteria used for distinguishing diagnostic categories is warranted, as is a consideration of other possible perspectives.
Current Classification and Diagnosis
The DSM-5 Scheme
The DSM-5 scheme for classifying and diagnosing eating disorders recognizes three specific disorders, anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) and two residual categories termed “other specified feeding or eating disorder” and “unspecified feeding or eating disorder,” respectively (see chapter on DSM 5 categories). No formal diagnostic criteria are specified for these...
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References and Further Reading
Call, C., Walsh, B. T., & Attia, E. (2013). From DSM-IV to DSM-5. Current Opinion in Psychiatry, 26(6), 532–536. A summary of the main changes involved in the move from DSM-IV to DSM-5, emphasising the utility gained by decreasing the frequency of the heterogeneous residual category that existed in DSM-IV.
Fairburn, C. G., & Cooper, Z. (2011). Eating disorders, DSM-5 and clinical reality. British Journal of Psychiatry, 198(1), 8–10. Discussion of the problems of DSM-IV and a consideration of various possible alternative approaches including a suggestion that transdiagnostic research might be helpful to inform DSM-6.
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509–528. Details of the transdiagnostic perspective.
Grilo, C. M. (2013). Why no cognitive body image feature such as overvaluation of shape/weight in the binge eating disorder diagnosis? International Journal of Eating Disorders, 46(3), 208–211. A discussion of the role of over-evaluation of shape and weight in BED together with a suggestion that it should be better recognised in the diagnosis of BED.
Kendell, R., & Jablensky, A. (2003). Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry, 160, 4–12. An excellent discussion of the concepts of validity and utility as applied to psychiatric diagnosis, arguing for a clear distinction between the two.
Mancuso, S. G., Newton, J. R., Bosanac, P., Rossell, S. L., Nesci, J. B., & Castle, D. J. (2015). Classification of eating disorders: Comparison of relative prevalence rates using DSM-IV and DSM-5 criteria. The British Journal of Psychiatry, 206, 519–520. Recent study of relative prevalence rates using DSM-IV and DSM-5 criteria in a community sample.
Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2013). Epidemiology, course, and outcome of eating disorders. Current Opinion in Psychiatry, 26(6), 543–548. The effects of applying DSM-5 criteria to the frequency of the eating disorders and to knowledge about their course and outcome.
Wildes, J. E., & Marcus, M. D. (2015). Application of the Research Domain Criteria (RDoC) framework to eating disorders: Emerging concepts and research. Current Psychiatry Reports, 17(5), 30. An overview of the RDoc framework and a review of research that supports the role of RDoc concepts in the eating disorders.
Additional General Background Reading
Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. New York: Guilford Press. Transdiagnostic CBT-E guide.
Fairburn, C., & Harrison, P. (2003). Eating disorders. Lancet, 361, 407–416. An overview of eating disorders from a transdiagnostic perspective. Source of diagram representing how eating disorders evolve over time.
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Cooper, Z. (2015). Classification: The Transdiagnostic Perspective. In: Wade, T. (eds) Encyclopedia of Feeding and Eating Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-287-087-2_121-1
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DOI: https://doi.org/10.1007/978-981-287-087-2_121-1
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