{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:18:14Z","timestamp":1784161094550,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T00:00:00Z","timestamp":1729900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro Eating Disorders Rev"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In the Diagnostic and Statistical Manual of Mental Disorders\u20105, severity of bulimia nervosa (BN) is defined by the frequency of purging behaviour. Previous research suggests the number of purging methods as an alternative rating. The current analysis investigated characteristics (sociodemographic and treatment\u2010related variables, body mass index [BMI], eating disorder\u2010specific and general psychopathology) of persons with BN as a function of purging frequency and number of purging methods in order to examine which approach might be better suited for indicating severity of BN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Two\u2010hundred and sixty\u2010one persons (98.5% female; mean age 25.2\u00a0years, SD\u00a0=\u00a09.41; mean BMI 22.0\u00a0kg\/m<jats:sup>2<\/jats:sup>, SD\u00a0=\u00a03.79) with BN completed self\u2010report questionnaires on eating disorder\u2010specific and general psychopathology at admission to inpatient (<jats:italic>n<\/jats:italic>\u00a0=\u00a0214) or daypatient (<jats:italic>n<\/jats:italic>\u00a0=\u00a047) treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher severity based on either purging frequency or number of purging methods tended to relate to lower BMI and higher eating disorder\u2010specific and general psychopathology. In addition, binge\u2010eating frequency differentially related to eating disorder\u2010specific and general psychopathology as a function of severity groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study partially supports the utility of both purging frequency and the number of purging methods as indicators of severity in persons with BN. However, focussing only on purging behaviours may be short\u2010sighted as it appears necessary to consider the number of binge\u2010eating episodes as well when evaluating severity of BN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/erv.3147","type":"journal-article","created":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T13:51:59Z","timestamp":1729950719000},"page":"343-359","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Purging frequency and number of purging methods as indicators of severity in bulimia nervosa: Interactive effects with binge eating episodes"],"prefix":"10.1002","volume":"33","author":[{"given":"Anna L.","family":"Dieffenbacher","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Hospital LMU Munich  Munich Germany"},{"name":"Schoen Clinic Roseneck  Prien am Chiemsee Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Meule","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Regensburg  Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Voderholzer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy University Hospital LMU Munich  Munich Germany"},{"name":"Schoen Clinic Roseneck  Prien am Chiemsee Germany"},{"name":"Department of Psychiatry and Psychotherapy University Hospital of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2010.511909"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1471\u20100153(01)00040\u2010x"},{"key":"e_1_2_7_4_1","volume-title":"Diagnostic and statistical manual of mental disorders: DSM\u2010IV","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_7_5_1","volume-title":"Treatment of patients with eating disorders","author":"American Psychiatric Association","year":"2006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/cps0000078"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327752jpa4901_13"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e3181927389"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20416"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2003.07.008"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640260590893647"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2017.05.013"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22728"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2019.01.009"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1027\/1015\u20105759\/a000058"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2015.01.004"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2019.02.003"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20335"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0023660"},{"issue":"1","key":"e_1_2_7_21_1","first-page":"46","article-title":"Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa","volume":"91","author":"Harrington B. C.","year":"2015","journal-title":"American Family Physician"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/19312458.2016.1271116"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-21442-4"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-59606-7"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1026\/0012\u20101924.53.3.144"},{"key":"e_1_2_7_26_1","unstructured":"JASP Team. (2023).JASP (version 0.17.3). Retrieved fromhttps:\/\/jasp\u2010stats.org\/"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.10.011"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2011.02.014"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3928\/0048\u20105713\u201020020901\u201006"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101497.2001.016009606.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006842\u2010200203000\u201000008"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2776"},{"key":"e_1_2_7_33_1","volume-title":"Gesundheitsfragebogen f\u00fcr Patienten (PHQ D) Komplettversion und Kurzform","author":"L\u00f6we B.","year":"2002"},{"key":"e_1_2_7_34_1","unstructured":"Maechler M. Rousseeuw P. Croux C. Todorov V. Ruckstuhl A. Salibian\u2010Barrera M. Verbeke T. Koller M. Conceicao E. L. &diPalma M. A.(2023).robustbase: Basic robust statistics. R package version 0.99\u20100."},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13428\u2010019\u201001246\u2010w"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.143461"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.88a.20168"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7139.1236"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24010"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191117738046"},{"key":"e_1_2_7_41_1","unstructured":"RCore Team. (2022).R: A language and environment for statistical computing. Retrieved fromhttps:\/\/www.r\u2010project.org\/"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2004.181"},{"key":"e_1_2_7_43_1","unstructured":"RStudio Team. (2022).RStudio: Integrated development for R(Version 2022.07.1). Retrieved fromhttp:\/\/www.rstudio.com"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23694"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.1108"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000739"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2643"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02294395"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.15626\/MP.2018.871"},{"key":"e_1_2_7_51_1","volume-title":"International statistical classification of diseases and related health problems, 10th revision","author":"World Health Organization","year":"2019"}],"container-title":["European Eating Disorders Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/erv.3147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T18:05:02Z","timestamp":1738433102000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/erv.3147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,26]]},"references-count":50,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/erv.3147"],"URL":"https:\/\/doi.org\/10.1002\/erv.3147","archive":["Portico"],"relation":{},"ISSN":["1072-4133","1099-0968"],"issn-type":[{"value":"1072-4133","type":"print"},{"value":"1099-0968","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,26]]},"assertion":[{"value":"2024-01-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}