Clinical Significance and Distinctiveness of <scp>DSM</scp> ‐5 Other Specified Feeding or Eating Disorder‐Bulimia Nervosa of Low Frequency and/or Limited Duration in Women
Bibliographic record
Abstract
BACKGROUND: Formation of Diagnostic and Statistical Manual of Mental Disorders (DSM) subcommittees combined with recently approved coding designations for bulimia nervosa (BN) in partial remission highlights the need to examine the validity of the threshold that distinguishes BN from other specified feeding or eating disorders (OSFED) BN of low frequency and/or limited duration (OSFED-BN). METHODS: Women (N = 344) who met DSM-5 criteria for BN (n = 153) or OSFED-BN (n = 118) or had no lifetime eating disorder symptoms (n = 78) completed assessments of height, weight, weight history, percent body fat, structured clinical interviews for DSM-5 disorders, suicidality, trauma, and treatment histories, and self-report questionnaires covering a range of validators related to eating disorders, psychological traits, and general psychopathology. Comparisons across groups tested the validity of OSFED-BN and whether prior history of DSM-5 BN impacted evidence of its clinical significance and distinctiveness. RESULTS: Lower frequency of binge eating was the primary reason for diagnosis of OSFED-BN vs. BN; more than 80% of those with OSFED-BN met or exceeded frequency and duration criteria for inappropriate compensatory behaviors. The current DSM-5 threshold distinguishing BN from its OSFED variant or from BN in partial remission produced few differences relative to several large differences observed for comparisons of these diagnostic groups and non-eating disorder controls. DISCUSSION: Despite being associated with distinct DSM-5 diagnostic codes, BN, BN in partial remission, and OSFED-BN appear to represent a single condition that may, at most, capture some dimensional differences in severity. Findings support lowering the current minimum frequency thresholds for diagnosing BN.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".