Previous research has failed to find differences in eating disorder and general psychopathology and impairment between people with sub- and full-threshold bulimia nervosa (BN). The purpose of the current study was to test the validity of the distinction between sub- and full-threshold BN and to determine the frequency of objective binge episodes and inappropriate compensatory behaviors that would best distinguish between sub- and full-BN. Community-recruited adults (83.5% female) with current sub-threshold (n = 105) or full-threshold BN (n = 99) completed assessments of eating-disorder psychopathology, clinical impairment, internalizing problems, and drug and alcohol misuse. Receiver operating characteristic curve analysis was used to evaluate whether eating-disorder psychopathology, clinical impairment, internalizing problems, and drug and alcohol misuse could empirically discriminate between sub- and full-threshold BN. The frequency of binge episodes and inappropriate compensatory behaviors (AUC = 0.94) was “highly accurate” in discriminating between sub- and full-threshold BN; however, only objective binge episodes was a significant predictor of BN status. Internalizing symptoms (AUC = 0.71) were “moderately accurate” at distinguishing between sub- and full-BN. Neither clinical impairment (AUC = 0.60) nor drug (AUC = 0.56) or alcohol misuse (AUC = 0.52) discriminated between groups. Results suggested that 11 episodes of binge eating and 17 episodes of inappropriate compensatory behaviors optimally distinguished between sub- and full-BN. Overall, results provided mixed support for the distinction between sub- and full-threshold BN. Future research to clarify the most meaningful way to discriminate between sub- and full-threshold is warranted to improve the criterion-related validity of the diagnostic system.

先前的研究未能发现患有亚阈值和全阈值神经性贪食症 (BN) 的人在进食障碍、一般精神病理学和损伤方面存在差异。当前研究的目的是测试区分亚阈值和全阈值 BN 的有效性，并确定客观暴食发作的频率和最能区分亚阈值和全 BN 的不适当补偿行为。当前亚阈值 ( n  = 105) 或全阈值 BN ( n = 99) 完成了对饮食失调精神病理学、临​​床障碍、内化问题以及药物和酒精滥用的评估。接受者操作特征曲线分析用于评估进食障碍精神病理学、临​​床障碍、内化问题以及药物和酒精滥用是否可以凭经验区分亚阈值和全阈值 BN。暴饮暴食和不适当补偿行为的频率（AUC = 0.94）在区分亚阈值和全阈值 BN 时“非常准确”；然而，只有客观的暴饮暴食事件才是 BN 状态的重要预测指标。内化症状（AUC = 0.71）在区分亚 BN 和全 BN 方面“相当准确”。无论是临床损害 (AUC = 0.60) 还是药物 (AUC = 0.56) 或酒精滥用 (AUC = 0. 52) 群体之间的歧视。结果表明，11 次暴饮暴食和 17 次不适当的补偿行为最能区分亚 BN 和全 BN。总体而言，结果为亚阈值和全阈值 BN 之间的区别提供了混合支持。未来的研究有必要阐明区分亚阈值和全阈值的最有意义的方法，以提高诊断系统的标准相关有效性。