DSM-IV Criteria for Eating Disorders

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DSM-IV Criteria for Eating Disorders


ANOREXIA NERVOSA

Refusal to maintain body weight at or above a minimally normal weight for age and
height (e.g. weight loss leading to maintenance of body weight less than 85% of that
expected; or failure to make expected weight gain during period of growth, leading
to body weight less than 85% of that expected)

Intense fear of gaining weight or becoming fat, even though underweight

Disturbance in the way in which one’s body weight or shape is experienced, undue
influence of body weight or shape on self-evaluation, or denial of the seriousness of
the current low body weight

In postmenarcheal females, amenorrhea, i.e., the absence of at least 3 consecutive
menstrual cycles
o Restricting Type: during the current episode of Anorexia Nervosa, the
person has not regularly engaged in binge-eating or purging behaviors
o Binge-Eating/Purging Type: during the current episode of Anorexia Nervosa,
the person has regularly engaged in binge-eating or purging behaviors
BULIMIA NERVOSA

Recurrent episodes of binge eating. An episode of binge eating is characterized by
both of the following:
o Eating, in a discrete period of time (e.g. within any 2-hour period), an
amount of food that is definitely larger than most people would eat during a
similar period of time and under similar circumstances
o A sense of lack of control over eating during the episode (e.g. a feeling that
one cannot stop eating or control what or how much one is eating)

Recurrent inappropriate compensatory behavior in order to prevent weight gain,
such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other
medications; fasting; or excessive exercise

The binge eating and inappropriate compensatory behaviors both occur, on
average, at least twice a week for 3 months

Self-evaluation is unduly influenced by body shape and weight

The disturbance does not occur exclusively during episodes of Anorexia Nervosa
o Purging Type: during the current episode of Bulimia Nervosa, the person has
regularly engaged in self-induced vomiting or the misuse of laxatives,
diuretics, or enemas
o Nonpurging Type: during the current episode of Bulimia Nervosa, the person
has used other inappropriate compensatory behaviors, such as fasting or
excessive exercise, but has not regular engaged in self-induced vomiting or
the misuse of laxatives, diuretics, or enemas
DSM-IV Criteria for Impulse Control Disorders
INTERMITTENT EXPLOSIVE DISORDER

Several discrete episodes of failure to resist aggressive impulses that result in serious
assaultive acts or destruction of property

The degree of aggressiveness expressed during the episodes is grossly out of
proportion to any precipitating psychosocial stressors

The aggressive episodes are not better accounted for by another mental disorder or
a general medical condition
KLEPTOMANIA

Recurrent failure to resist impulses to steal objects that are not needed for personal
use or for their monetary value

Increasing sense of tension immediately before committing the theft

Pleasure, gratification, or relief at the time of committing the theft

The stealing is not committed to express anger or vengeance and is not in response
to a delusion or hallucination

The stealing is not better accounted for by Conduct Disorder, a Manic Episode, or
Antisocial Personality Disorder.
PYROMANIA

Deliberate and purposeful fire setting on more than one occasion

Tension or affective arousal before the act

Fascination with, interest in, curiosity about, or attraction to fire and its situational
contexts (e.g., paraphernalia, uses, consequences)

Pleasure, gratification, or relief when setting fired, or when witnessing or
participating in their aftermath

The fire setting is not done for monetary gain, as an expression of sociopolitical
ideology, to conceal criminal activity, to express anger or vengeance, to improve
one’s living circumstances, in response to a delusion or hallucination, or as a result
of impaired judgment (e.g., in dementia, Mental Retardation, Substance
Intoxication)

The fire setting is not better accounted for by Conduct Disorder, a Manic Episode,
or Antisocial Personality Disorder.
TRICHOTILLOMANIA

Recurrent pulling out of one’s hair resulting in noticeable hair loss

An increasing sense of tension immediately before pulling out the hair or when
attempting to resist the behavior

Pleasure, gratification, or relief when pulling out the hair

The disturbance is not better accounted for by another mental disorder ad is not
due to a general medical condition (e.g., a dermatological condition)

The disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning
PATHOLOGICAL GAMBLING

Persistent and recurrent maladaptive gambling behavior as indicated by five (or
more) of the following:
o Preoccupied with gambling (e.g., reliving past gambling experiences,
planning the next venture, or thinking of ways to get money with which to
gamble)
o Needs to gamble with increasing amounts of money in order to achieve the
desired excitement
o Repeated unsuccessful efforts to control, cut back, or stop gambling
o Restless or irritable when attempting to cut down or stop gambling
o Gambles as a way of escaping from problems or relieving a dysphoric mood
o After losing money gambling, often returns another day to get even (“chasing
one’s losses”)
o Lies to family members, therapist, or others to conceal the extent of
involvement with gambling
o Has committed illegal acts such as forgery, fraud, theft, or embezzlement to
finance gambling
o Has jeopardized or lost a significant relationship, job, or educational or
career opportunity because of gambling
o Relies on others to provide money to relieve a desperate financial situation
caused by gambling

The gambling behavior is not better accounted for by a Manic Episode.