For this discussion, I choose to compare purging disorder and bulimia. According to the DSM-IV criteria, bulimia entails a self-evaluation that is significantly caused by an individual’s body weight or shape (p.345). On the other hand, purging disorder entails purging behaviors to lose bodyweight (p.339). Thus, the key difference between the purging disorder and bulimia is that bulimia entails self-perception, which compels one to “binge eat,” unlike purging disorder.
Eating disorders are detected and isolated using screening equipment, according to symptoms, risk, and clinical diagnosis. A recent study suggested that a parsimonious threshold for eating disorders and the criterion for the DSM-IV, the sensitivity and specificity of purging disorder are 0.55 and 0.79, respectively (Graham et al., 2018). Assessment of the purging disorder is guided by the DSM-IV, which acknowledges symptoms such as purging behaviors, including self-induced vomiting, laxative, and diuretic abuse (p.339). Thus, the diagnosis identifies episodes of purges, self-esteem issues, and emotional distress.
Nevertheless, research has found that there are factors that might aggravate purging disorder, such that some populations samples are at higher risk. For instance, Hay & Mitchison (2014) found that sexual and physical assault and sports which focus on shape and weight increase the risk for purging disorders. Treatment entails nutritional counseling and psychotherapy to eliminated the self-perception and mood leading to the purging.
A psychiatric interview must be effective to gather any valuable information. Traditionally, children were regarded as small adults during psychiatric interviews. However, this method fails in especially interviews that regard eating disorders. I would use the categorical strategy in interviewing a child or adolescent client with OSFED. This entails asking the patient questions that regard parental and social, cultural, and psychological aspects. This strategy accounts for the age of a patient, taking note that children may have a biased perception since they have not yet attained self-actualization and are undergoing speedy developmental changes. For instance, a teenager is likely to engage in binge eating because of social perception associated with developmental changes or environmental factors like parents and friends. Thus, through categorical interviewing, a child and an adult are not assessed over a standard frame.
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Adults may be interviewed through the adult attachment interview. This clusters adult’s states of mind depending on what they are attached. This way, a psychiatrist identifies factors that appear important to the patient, and their degree of attachment to cause significant psychological impact. This strategy is different from categorization in that it consists of semi-structured questions probing the current understanding of the patient concerning their childhood and things they are attached (Ringer & Crittenden, 2007). In contrast, the categorization strategy investigates the perception of the current life situation of a patient.
I have seen an OSFED condition once with a lady, whom we were in the same camping group three years ago. In the five days of camping, the lady did not eat together with everyone else. She took her food and preserved it to eat it late in the night when almost everyone else was asleep. I think she was suffering from Night Eating Syndrome (NSE), which does not meet any of the criteria for eating disorders in the DSM-IV. On some nights, she ate all her share, and on other nights, she had leftovers. While she did not seem psychologically disturbed, she mostly avoided activities that kept her on the lead during the camping period.
Graham, A., Trockel, M., Weisman, H., Fitzsimmons-Craft, E., Balantekin, K., Wilfley, D., & Taylor, C. (2018). A screening tool for detecting eating disorder risk and diagnostic symptoms among college-age women. Journal Of American College Health, 67(4), 357-366. doi: 10.1080/07448481.2018.1483936
Hay, P., & Mitchison, D. (2014). The epidemiology of eating disorders: genetic, environmental, and societal factors. Clinical Epidemiology, 89. doi: 10.2147/clep.s40841
Ringer, F., & Crittenden, P. (2007). Eating disorders and attachment: the effects of hidden family processes on eating disorders. European Eating Disorders Review, 15(2), 119-130. doi: 10.1002/erv.761