{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:26:26Z","timestamp":1788881186569,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH125880"],"award-info":[{"award-number":["R01MH125880"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>While research supports differentiating anorexia nervosa into binge\u2013purge (AN\u2010BP) vs. restricting (AN\u2010R) subtypes, <jats:italic>DSM\u20105\u2010TR<\/jats:italic> does not provide a specific threshold of binge and\/or purge episodes that constitutes an AN\u2010BP vs. AN\u2010R diagnosis. Our review of the literature suggests that cutoffs used for defining AN subtypes are rarely reported and, when reported, are highly heterogeneous. Inconsistent subtyping protocols limit generalizability and understanding of AN\u2010R and AN\u2010BP differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The present study used structural equation modeling (SEM) trees to empirically determine the frequency of binge eating and\/or purging that best differentiates AN subtypes. We then compared empirically determined groups on characteristics frequently found to differ between subtypes. Participants were 731 adolescents and adults with AN (94% female, M<jats:sub>age<\/jats:sub>\u2009=\u200920, 72% clinically diagnosed with AN\u2010R) in a partial hospitalization program who completed assessments of AN and comorbid symptoms at intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SEM tree analyses yielded four subgroups: past\u2010month binge\/purge frequency 0 (AN\u2010R; <jats:italic>n<\/jats:italic>\u2009=\u2009396); frequency 1\u20133 (AN\u2010BP1; <jats:italic>n<\/jats:italic>\u2009=\u2009101); frequency 4\u201315 (AN\u2010BP2; <jats:italic>n<\/jats:italic>\u2009=\u2009130); and frequency\u2009&gt;\u200916 (AN\u2010BP3; <jats:italic>n<\/jats:italic>\u2009=\u200998). AN\u2010R differed from higher frequency groups on 14\/22 clinical characteristics, AN\u2010BP1 differed from higher frequency groups on 11\/22 clinical characteristics, and AN\u2010BP2 differed from higher frequency groups on 2\/22 clinical characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings suggest that one binge eating and\/or purge episode in the past month provides adequate distinction between subtypes. These findings indicate that the DSM's definition of AN\u2010BP may need to be revised to specify that the presence of any binge eating or purging, rather than \u201crecurrent\u201d binge eating or purging, is sufficient for subtyping AN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.24391","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T10:05:48Z","timestamp":1738836348000},"page":"868-877","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Empirically Determining Binge\/Purge Frequency Thresholds for Differentiating Anorexia Nervosa\u2010Restricting Subtype vs. Binge\u2013Purge Subtype"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3057-6812","authenticated-orcid":false,"given":"Sophie R.","family":"Abber","sequence":"first","affiliation":[{"name":"Department of Psychology Florida State University  Tallahassee USA"},{"name":"Eating Disorders Center for Treatment and Research, Department of Psychiatry University of California, San Diego Health  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1517-5992","authenticated-orcid":false,"given":"Devon","family":"Peterkin","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Oregon  Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4262-1238","authenticated-orcid":false,"given":"Carina S.","family":"Brown","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Psychiatry University of California, San Diego Health  California USA"},{"name":"San Diego State University\/University of California san Diego Joint Doctoral Program in Clinical Psychology  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6798-9085","authenticated-orcid":false,"given":"Thomas E.","family":"Joiner","sequence":"additional","affiliation":[{"name":"Department of Psychology Florida State University  Tallahassee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4843-1809","authenticated-orcid":false,"given":"Christina E.","family":"Wierenga","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Psychiatry University of California, San Diego Health  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1481-5078","authenticated-orcid":false,"given":"Lauren N.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Oregon  Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"American Psyachiatric Association.2022. \u201cDiagnostic and statistical manual of mental disorders.\u201d","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000962"},{"key":"e_1_2_10_4_1","first-page":"315","article-title":"The clinical impairment assessment questionnaire (CIA)","author":"Bohn K.","year":"2008","journal-title":"Cognitive Behavioral Therapy for Eating Disorders"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0030001"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2022.2034634"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2589"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e3181646765"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.67.2.319"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1980.01780220068007"},{"key":"e_1_2_10_11_1","volume-title":"The Temperament and Character Inventory (TCI): A Guide to Its Development and Use","author":"Cloninger C. 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