Gymnastik- och idrottshögskolan, GIH

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Proposal for increasing diagnostic clarity in research and clinical practice by renaming and reframing atypical anorexia nervosa as "Restrictive Eating Disorder" (RED)
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.;Karolinska Inst, MEB, Nobels Vag 12A, SE-17177 Stockholm, Sweden..
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..ORCID-id: 0000-0001-9550-3820
Massachusetts Gen Hosp, Eating Disorders Clin & Res Program, Boston, MA USA.;Harvard Med Sch, Dept Psychiat, Boston, MA USA..
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
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2023 (engelsk)Inngår i: Eating Behaviors, ISSN 1471-0153, E-ISSN 1873-7358, Vol. 50, artikkel-id 101750Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Atypical anorexia nervosa (AAN) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM5), is characterized by meeting all criteria for anorexia nervosa (AN) except for weight being within or above the "normal" range despite significant weight loss. The current definition is plagued by several problems, resulting in widely heterogeneous operationalizations in research and clinical practice. As such, the poorly defined diagnosis of AAN negatively impacts affected individuals and frustrates research attempts to better understand the syndrome. We consider conceptual flaws in the AAN description and contend that the undefined weight range and nature of weight loss renders these two factors functionally inapplicable in research and practice. They also represent a departure from the originally intended use of the AAN category, i.e., arresting a negative weight trajectory likely to result in AN, making the target population, and the application of the label, unclear. We propose revised criteria and a new name, restrictive eating disorder (RED), intended to reduce stigma and encompass a wide but better-defined range of presentations. The RED criteria focus on clinically significant restrictive behavior that disrupts normal living (i.e., impairment), and cognitive symptoms of overevaluation, disturbed experience, and lack of recognition of illness seriousness. We believe that RED may enable more appropriate clinical application, but also inspire coordinated research toward a more valid psychiatric nosology in the eating disorders field.

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ELSEVIER , 2023. Vol. 50, artikkel-id 101750
Emneord [en]
Feeding and eating disorders, Diagnosis, Atypical anorexia nervosa, Restriction, Weight loss, Impairment, Criteria, Stigma
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Identifikatorer
URN: urn:nbn:se:gih:diva-7753DOI: 10.1016/j.eatbeh.2023.101750ISI: 001011649000001PubMedID: 37263139OAI: oai:DiVA.org:gih-7753DiVA, id: diva2:1795153
Tilgjengelig fra: 2023-09-07 Laget: 2023-09-07 Sist oppdatert: 2023-09-07

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