Bias in binge eating disorder: How representative are recruited clinic samples?

Department of Psychology, San Diego State University and University of California, 92120, USA.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 07/2001; 69(3):383-8. DOI: 10.1037//0022-006X.69.3.383
Source: PubMed


The aim of this study was to investigate sampling bias as it affects recruited clinic samples of binge eating disorder (BED). Demographic and clinical characteristics of a recruited clinic sample were compared with a community sample. The 2 groups met the same operational definition of BED and were assessed using the same primarily interview-based methods. Ethnicity, severity of binge eating, and social maladjustment were found to increase treatment seeking among participants with BED rather than levels of psychiatric distress or comorbidity. These findings suggest that previous studies using recruited clinic samples have not biased estimates of psychiatric comorbidity in BED.

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    • "c o m mostly performed at specialty clinics [3], appear to seek health care at generalist primary care settings [17]. Multiple distinctive differences have been reported between samples recruited in specialist clinic settings and community samples, including proportion of ethnic minority groups, severity of BED, and treatment-seeking behaviors [18] [19] [20]. This raises questions regarding the generalizability of findings from the existing clinical literature. "
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    ABSTRACT: Although community-based studies suggest equivalent levels of physical and psychological impairment by binge eating disorder (BED) in men and women, men with BED are still underrepresented in clinical studies. This study aimed to provide a comprehensive analysis of sex differences in biopsychosocial correlates of treatment-seeking obese patients with BED in primary care. One hundred-ninety obese adults (26% men) were recruited in primary care settings for a treatment study for obesity and BED. Very few significant sex differences were found in the developmental history and in current levels of eating disorder features, as well as psychosocial factors. Women reported significantly earlier age at onset of overweight and dieting and greater frequency of dieting. Men reported more frequent strenuous exercise. Men were more likely than women to meet criteria for metabolic syndrome; men were more likely to show clinically elevated levels of triglycerides, blood pressure, and fasting glucose levels. Despite few sex differences in behavioral and psychosocial factors, metabolic problems associated with obesity were more common among treatment-seeking obese men with BED than women. The findings highlight the importance of including men in clinical studies of BED and active screening of BED in obese men at primary care settings.
    General hospital psychiatry 08/2013; 35(6). DOI:10.1016/j.genhosppsych.2013.07.010 · 2.61 Impact Factor
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    • "Although this research is welcome, it is important to recognise that the poor quality of life observed among individuals with mental health problems who receive specialist treatment reflects, at least in part, the fact that impairment in role functioning is predictive of whether such treatment is received (Andrews, 2000). Uptake of mental health care among individuals with bulimic-type eating disorders, namely, BN, BED and variants of these disorders, may be particularly low and treatment-seeking for these disorders may be particularly closely tied to perceived impairment in quality of life (Fairburn et al., 1996; Mond et al., 2007a, 2009; Wilfley et al., 2001). Hence, and particularly for these more commonly occurring eating disorders, caution needs to be exercised when drawing conclusions about impairment in quality of life based on findings from clinical samples. "
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    ABSTRACT: Studies of quality of life among individuals with eating disorders have relied almost exclusively on clinical samples. We examined impairment in quality of life in a community sample of women with eating disorders recruited as part of an epidemiological study. Measures of health-related quality of life (Medical Outcomes Study 12-item Short-Form Physical and Mental Component Summary scales) and subjective well-being (WHOQOL-BREF Psychological Functioning and Social Relationships subscales) were completed by women with eating disorders (n = 159), primarily variants of bulimia nervosa and binge eating disorder, and a comparison group of healthy women (n = 232). When compared with healthy women, women with eating disorders reported substantial impairment in aspects of quality of life relating to mental health, although item-level analysis indicated considerable variation in the extent to which specific aspects of emotional well-being were affected. Impairment in social relationship and in physical health was less pronounced and due, at least in part, to between-group differences in age, body weight and demographic characteristics. Impairment in certain aspects of perceived physical health was, however, apparent among women with eating disorders, even after controlling for between-group differences in body weight. Community cases of women with eating disorders experience marked impairment in quality of life as this relates to mental health functioning and at least some impairment in physical health functioning. Personality characteristics and ego-syntonic aspects of eating-disordered behaviour may complicate the interpretation of findings relating to impairment in specific aspects of quality of life.
    Australian and New Zealand Journal of Psychiatry 06/2012; 46(6):561-8. DOI:10.1177/0004867411433967 · 3.41 Impact Factor
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    • "Bias may also occur in that individuals who participate in an RCT might not be representative of individuals who spontaneously present for routine treatment to their personal provider. The comparison of the RCT data to the epidemiologic data is also limited by the differences in sample size, recruitment means, and documented differences between treatment-seeking and nontreatment-seeking samples (Wilfley et al., 2001). "
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    ABSTRACT: Recent studies suggest that binge eating disorder (BED) is as prevalent among African American and Hispanic Americans as among Caucasian Americans; however, data regarding the characteristics of treatment-seeking individuals from racial and ethnic minority groups are scarce. The purpose of this study was to investigate racial/ethnic differences in demographic characteristics and eating disorder symptoms in participants enrolled in treatment trials for BED. Data from 11 completed randomized, controlled trials were aggregated in a single database, the Clinical Trials of Binge Eating Disorder (CT-BED) database, which included 1,204 Caucasian, 120 African American, and 64 Hispanic participants assessed at baseline. Age, gender, race/ethnicity, education, body mass index (BMI), binge eating frequency, and Eating Disorder Examination (EDE) Restraint, Shape, Weight, and Eating Concern subscale scores were examined. Mixed model analyses indicated that African American participants in BED treatment trials had higher mean BMI than Caucasian participants, and Hispanic participants had significantly greater EDE shape, weight, and eating concerns than Caucasian participants. No racial or ethnic group differences were found on the frequency of binge eating episodes. Observed racial/ethnic differences in BED symptoms were not substantially reduced after adjusting for BMI and education. Comparisons between the CT-BED database and epidemiological data suggest limitations to the generalizability of data from treatment-seeking samples to the BED community population, particularly regarding the population with lower levels of education. Further research is needed to assess alternative demographic, psychological, and culturally specific variables to better understand the diversity of treatment-seeking individuals with BED.
    Journal of Consulting and Clinical Psychology 12/2011; 80(2):186-95. DOI:10.1037/a0026700 · 4.85 Impact Factor
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