PD appears to be a clinically significant and potentially distinctive eating disorder.

Despite patterns of improvement in women, 4.5% reported a clinically significant eating disorder at mid-life, suggesting the need for more research on potential risk factors in this age group, such as pressures for women to maintain a youthful appearance.

Eating disorders represent a significant source of psychological impairment among adolescents. However, most controlled treatment studies have focused on adult populations. This review provides a synthesis of existing data concerning the efficacy of various psychosocial interventions for eating disorders in adolescent samples. Modes of therapy examined in adolescent samples include family therapy, cognitive therapy, behavioral therapy, and cognitive behavioral therapy mostly in patients with anorexia nervosa. At this time, the evidence base is strongest for the Maudsley model of family therapy for anorexia nervosa. Evidence of efficacy for other treatments and other conditions is limited by several methodological factors including the small number of studies, failure to use appropriate control conditions or randomization procedures, and small sample sizes (i.e., fewer than 10 participants per treatment arm). Potential moderators and mediators of treatment effect are reviewed. Finally, results from adolescent studies are contrasted with those from adult studies of eating disorders treatment. Many studies of adult populations comprise late adolescent/young adult participants, suggesting that findings regarding the efficacy of cognitive behavioral therapy for bulimia nervosa in adults likely extend to older adolescent populations.

Maternal attachment, or the affiliation a mother feels towards her child, is an important predictor of maternal health and fetal/infant outcomes. Thus, it is important to identify psychological factors which may impact maternal attachment. This study examined associations among maternal attachment, depression, and body dissatisfaction (BD) throughout weeks of pregnancy. Pregnant women (n5196) were recruited to complete a self-report questionnaire about their experiences during pregnancy. There was no direct association between maternal attachment and BD. However, BD moderated the association between maternal attachment and weeks of pregnancy, and this association was not mediated by depression. High BD may contribute to poorer maternal health and poorer fetal outcomes through blunted growth of maternal attachment during pregnancy. Thus, high BD may be an important target for intervention in women during pregnancy. Future studies should examine longitudinal associations among these variables throughout the perinatal period.

Objective-We varied two defining features of Purging Disorder (PD): breadth of "purging" behaviors (purging only [narrow] vs. purging and nonpurging [broad]) and minimum behavioral frequency (once vs. twice per week) to examine their impact on syndrome validity.Method-Survey data from 1736 women and 755 men were used for analyses.Results-PD point prevalence was higher in women versus men, and prevalence was lowest for the narrow definition requiring purging twice per week. The narrow definition was associated with significant psychosocial impairment and increased effect sizes in validation analyses. Changing minimum behavioral frequencies did not impact associations with external validators.Discussion-A broad definition of PD that included any compensatory behavior reduced distinctions between PD and normality. Reducing minimum frequency to once per week did not reduce homogeneity or evidence of syndrome severity. Purging once per week may represent the optimal starting point in defining the central behavioral feature of PD.Keywords purging disorder; EDNOS; classification; diagnostic validity; epidemiology Purging Disorder (PD) is characterized by recurrent purging after normal or small amounts of food among individuals with body image disturbance who are not underweight.1 PD is currently included as an example of an Eating Disorder Not Otherwise Specified (EDNOS) in the DSM-IV-TR,2 but recent research suggests that PD should be considered for inclusion as a separate provisional diagnostic category in need of further study in the DSM-V.3 , 4 Specifically, cross-sectional studies, laboratory research, and latent class analyses suggest that PD is distinct from normality1 , 5 -11 and Bulimia Nervosa. 1 , 5 , 8 , 11 -15 In addition, epidemiological studies indicate that PD affects between 1.1% to 5.3% of women in their lifetimes.7 , 16 Thus, introducing PD in the DSM-V has the potential to move a substantial proportion of individuals from the heterogeneous17 and overpopulated18 EDNOS category to a potentially meaningful diagnosis.Including PD in the DSM-V would facilitate research by providing an official definition for the syndrome. Currently, several different definitions have been used,3 , 4 ranging from a broadly defined syndrome that includes purging and nonpurging compensatory behaviors19 -22 to studies that restrict the term purging disorder to individuals who engage in self-induced vomiting or abuse of laxatives or diuretics. 1 , 8 , 9 , 16 , 23 Further, the minimum frequency of purging behaviors has not been well-defined. While several studies have METHOD ParticipantsUndergraduate men (n = 1200) and women (n = 2400) from a selective northeastern university were randomly selected in the springs of 1982,27 1992,28 and 200226 to complete a survey of health and eating patterns (see original reports for additional recruitment details). Overall, participation rates were high; 72% of women (n = 1736) and 63% of men (n = 755) completed the survey. Participants ranged in age from 16-45 years (M=20.0; SD=...