Addressing the EDNOS issue and improving upon the utility of DSM-IV: classifying eating disorders using symptom profiles.

OBJECTIVE: To compare the descriptive and clinical utility of two classification systems: DSM-IV eating disorder diagnoses and proposed symptom profiles. The symptom profiles are based on the presence of overvalued ideas about shape/weight, as well as combinations of three key eating disorder symptoms (e.g. body mass index (BMI) above or below threshold and the presence or absence of bingeing and purging behaviours). METHOD: The two systems were compared on their ability to offer descriptively useful information in classifying individuals with eating disorders. In addition, we examined our system's unique contribution to clinical outcome and its relation to readiness for change. RESULTS: Classifying individuals via symptom profiles provided information about eating disorder not otherwise specified (EDNOS), a prevalent, heterogeneous and under-researched diagnostic category. Symptom profiles outperformed the DSM-IV diagnostic system in the ability to account for variation in patients' decision to enrol in treatment, performing comparably to readiness for change. CONCLUSION: Classifying individuals according to symptom profile and readiness for change appears to have more descriptive and clinical utility than the current diagnostic system.

Assessing readiness for change in adolescents with eating disorders.

The Readiness and Motivation Interview (RMI) is a semistructured interview measure of readiness and motivation to change that can be used for all eating disorder diagnoses. The RMI has demonstrated excellent psychometric properties and has both clinical and predictive utility in adult samples. This study examined the psychometric properties of the RMI in a younger population, namely, 12- to 18-year-old girls with eating disorders. Study participants (N = 65) completed the RMI and measures of convergent, discriminant, and criterion validity. Adolescents with eating disorders were able to conceptualize and articulate their readiness for change and to report the extent to which change efforts were for themselves versus for others. RMI readiness profiles across eating disorder symptom domains in adolescents were comparable to those in adults, with higher reported readiness to change binge eating than to change dietary restriction or compensatory strategies. Differences in internal consistency between adult and adolescent samples are discussed. Interviewing adolescents early in treatment about readiness may assist clinicians in forming an alliance with this difficult-to-engage population, while also providing valuable information for treatment planning.

Rats have trouble associating all three parts of the time-place-event memory code.

The ability of animals to associate an event with predictable time and place information confers a major biological advantage. The current research uses a variety of procedures and paradigms (e.g. place preference, radial arm maze, Morris water maze, T-maze, go no-go) to show that rats, unlike pigeons [e.g. Anim Learn Behav 22 (1994) 143] do not readily make an event-time-place association. They do make associations between event-time and event-place information, however. These findings are in disagreement with Gallistel's (The Organization of Learning, MIT Press, Cambridge, MA ) theory that claims that animals automatically store a memory code that has these three pieces of information. The present research is in line with the work of others who also find that rats do not readily make daily time-place associations [Behav Processes 23 (1997) 232; Behav Processes 52 (2000) 11; Behav Processes 49 (2000) 21; Anim Learn Behav 28 (2000) 298]. An interesting finding that did emerge from the present research was that at least some rats can use a circadian timer to solve a time-of-day discrimination if the task is a go no-go discrimination.