Epidemiological classification of the DSM-III-R for bulimia

The purpose of this study is to operationalize the DSM-III-R criteria for bulimia. This study shows how the lack of DSM-III-R quantification results in high within-group sample variability for bulimic symptomatology and greatly reduces the validity of research outcomes. The study problem for this research is: How can the DSM-III-R criteria for bulimia be measured and quantified in order to procure a more valid sample of bulimics for research and treatment? The first DSM-III-R criterion for bulimia is: Recurrent episodes of binge eating. This criterion was operationalized using the Binge Eating Quiz and by calculating the mean daily binge caloric consumption of 108 female subjects who met the DSM-III-R criteria for bulimia. The second DSM-III-R criterion for bulimia is: A strong feeling of lack of control over eating behavior during the eating binges. This criterion was operationalized by administering the Eating Attitude Test to 108 individuals who met the DSM-III-R criteria for bulimia. The third DSM-III-R criterion for bulimia is: The person regularly engages in either self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain. Of these several purging variables, the one most commonly used by bulimics in this study (N = 108), and in all previous research studies was self-induced vomiting. Self-induced vomiting was measured by giving 108 female subjects devices to be attached to their toilets in order to measure vomit in cubic centimeters. The fourth DSM-III-R criterion for bulimia is: Persistent overconcern with body shape and weight. This criterion was operationalized by a test designed and tested by this researcher, the Body Image Scale (BIS). The BIS was administered to 108 female subjects who met the DSM-III-R criteria for bulimia. The fifth DSM-III-R criterion for the diagnosis of bulimia is: A minimum average of two binge eating episodes a week for at least three months. This criterion is especially vague because a binge to one person may merely infer one candy bar; while to another individual, a binge may suggest a dozen donuts. Although vomiting frequency is also a vague unit of measurement for bulimia, it is perhaps less so than bingeing. Consequently, a minimum average of two vomiting episodes a week for at least three months may be a better measurable characteristic for this DSM-III-R criterion. When the DSM-III-R criteria for bulimia was operationalized on 108 female subjects who answered yes to the five DSM-III-R criteria, only 46.30% (N = 50) scored significantly on the BEQ, Binge Caloric Value Count, EAT, Vomit Count, and the BIS. Consequently, only 50 out of 108 potential subjects would render valid research subject inclusion in bulimic research. Thus, this study shows that the DSM-III-R criteria for bulimia should only be used as an initial screening device for subject inclusion and treatment in research studies. Other tools, such as those used in this study, should then be employed in order to obtain a more valid study sample in order to procure more empirical research outcomes. (Abstract shortened by UMI)