Examining a staging model for anorexia nervosa: empirical exploration of a four stage model of severity
| Autor: | Hubert Lacey, Sarah Maguire, Scott G. Engel, Lois J. Surgenor, Stephen Touyz, Bryony Bamford, Daniel Le Grange, Kirsty M. Fromholtz, Ross D. Crosby |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
050103 clinical psychology
medicine.medical_specialty Staging lcsh:RC435-571 Stages of illness CASIAN Severity DSM-5 03 medical and health sciences Behavioral Neuroscience 0302 clinical medicine Statistical significance lcsh:Psychiatry Treatment intensity medicine 0501 psychology and cognitive sciences Stage (cooking) Psychiatry Nutrition and Dietetics Receiver operating characteristic business.industry 05 social sciences Anorexia nervosa medicine.disease Prognosis 030227 psychiatry Psychiatry and Mental health Eating disorders Anorexia nervosa (differential diagnoses) Cohort business Clinical psychology Research Article |
| Zdroj: | Journal of Eating Disorders Journal of Eating Disorders, Vol 5, Iss 1, Pp 1-10 (2017) |
| ISSN: | 2050-2974 |
| Popis: | Background An illness staging model for anorexia nervosa (AN) has received increasing attention, but assessing the merits of this concept is dependent on empirically examining a model in clinical samples. Building on preliminary findings regarding the reliability and validity of the Clinician Administered Staging Instrument for Anorexia Nervosa (CASIAN), the current study explores operationalising CASIAN severity scores into stages and assesses their relationship with other clinical features. Method In women with DSM-IV-R AN and sub-threshold AN (all met AN criteria using DSM 5), receiver operating curve (ROC) analysis (n = 67) assessed the relationship between the sensitivity and specificity of each stage of the CASIAN. Thereafter chi-square and post-hoc adjusted residual analysis provided a preliminary assessment of the validity of the stages comparing the relationship between stage and treatment intensity and AN sub-types, and explored movement between stages after six months (Time 3) in a larger cohort (n = 171). Results The CASIAN significantly distinguished between milder stages of illness (Stage 1 and 2) versus more severe stages of illness (Stages 3 and 4), and approached statistical significance in distinguishing each of the four stages from one other. CASIAN Stages were significantly associated with treatment modality and primary diagnosis, and CASIAN Stage at Time 1 was significantly associated with Stage at 6 month follow-up. Conclusions Provisional support is provided for a staging model in AN. Larger studies with longer follow-up of cases are now needed to replicate and extend these findings and evaluate the overall utility of staging as well as optimal staging models. Electronic supplementary material The online version of this article (doi:10.1186/s40337-017-0155-1) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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