Very little is known concerning the secular and longitudinal trends associated with bulimic syndromes. This study offers a unique opportunity to 1) examine rates of bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS) across 1982, 1992, and 2002 in college students, 2) examine and compare the longitudinal courses of BN and EDNOS at 10- and 20-year follow-up, and 3) evaluate secular trends, longitudinal course, and prognostic utility of eating disorder-related variables such as weight, body image disturbance, dieting, and disordered eating behaviors. Thus, this investigation could provide much needed data for a significant source of psychiatric morbidity among young adult women. In the springs of 1982 and 1992, a total of 2400 Harvard undergraduates (1600 women and 800 men) were randomly sampled to participate in a study of weight, body image disturbance, dieting, disordered eating behaviors, and BN. In 1992, participants in the 1982 study were contacted to participate in a follow-up study. In the spring of 2002, this study proposes to collect data from a new cohort of undergraduates (800 women and 400 men) and to contact participants from the 1992 and 1982 cohorts (1189 women and 511 men) for 10- and 20-year follow-up evaluations, respectively. The investigation will be conducted in two phases: a survey phase and an interview phase. The survey phase will replicate methods employed for data collection in 1982 and 1992 in order to insure comparability of results. Surveys include items about demographic background, height and weight; concerns about dieting, body weight, and shape; 5 scales of the Eating Disorders Inventory (Buhrnia. Drive for Thinness, Maturity Fears, Perfectionism, and Interpersonal Distrust); and BN symptoms. In addition, surveys will include the Eating Disorder Diagnostic Scale for termination of DSM-IV symptoms of anorexia nervosa, BN, and binge eating disorder. On the basis of self-report survey data, all subjects diagnosed with BN or EDNOS and controls matched to these subjects on age, sex, race, ethnicity, and SES will be recruited for participation in the interview phase of the study. Interviews will establish the validity of survey assessments, as well as provide data on psychosocial function, comorbidity, and treatment history for a nonclinical sample of individuals with eating pathology. The long-term goals of this study are to capture the changing epidemiology of bulimic disorders; to evaluate the long-term correlates and consequences of bulimic syndromes that support meaningful distinctions between BN and its subthreshold forms; and to identify contributants to the development, maintenance, and outcome of BN.
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