The preliminary reliability and validity of the Survey for Eating Disorders (SEDs): a self‐report questionnaire for diagnosing eating disorders

The present study examined the reliability and validity of the Survey for Eating Disorders (SEDs), a self‐report questionnaire intended to assess eating disorders (ED) according to the classification in the DSM‐IV. This appraisal was conducted with a clinical sample of subjects with ED (N = 45), and a student sample (N = 124). In the clinical sample, the SEDs was validated against the Eating Disorder Examination (EDE) which is considered to be the ‘gold standard’ for the assessment of ED. In this sample, there were only two false positive cases of 45 on the SEDs, when patients were reassessed by the EDE interview. Thus, the positive predictive value was as high as 0.96. In the student sample, the SEDs was validated against the Eating Disorders Inventory (EDI) where the results showed strong evidence of concurrent and discriminant validity, and very high test–retest reliability (2 weeks). The SEDs is relatively brief and easy to administer, and these preliminary findings support its reliability and validity. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.     

Convergent Validity of the Eating Disorder Examination and the Eating Disorder Examination‐Questionnaire Among University Women in Norway

The present study compared the Eating Disorder Examination (EDE; 16.0) and the Eating Disorder Examination‐Questionnaire (EDE‐Q; 6.0) and investigated the psychometric properties of the Norwegian translation of the EDE. Fifty‐eight university women aged 19–41 years (mean BMI = 23) were assessed with the EDE and EDE‐Q. Satisfactory internal consistency and inter‐rater reliability were demonstrated for the Norwegian translation of the EDE. Generally high convergent validity between the EDE and EDE‐Q was found, with correlations ranging from 0.60 (Eating Concern) to 0.86 (Weight Concern). Agreement for OBEs and vomiting were excellent, while driven exercising generated lower levels of convergence. Consistent with prior studies, the EDE‐Q generated significantly higher levels of psychopathology, although effect sizes were small. Owing to the significantly higher EDE‐Q scores, it is ill advised to administer these two instruments interchangeably, as this may fail to produce meaningful data. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Eating Disorders,Normative Eating Self‐Efficacy and Body Image Self‐Efficacy: Women in Recovery Homes

Although eating disorders (EDs) and ED symptoms are common among individuals in recovery for substance abuse (SA), long‐term SA treatment programmes rarely address these problems. The present study examined the prevalence of EDs among women residing in Oxford Houses—low‐cost, self‐governed recovery homes for SA. Further, among women both with and without an ED diagnosis, the association between duration of Oxford House residency and eating‐related self‐efficacy scores was examined as an indicator of potential treatment effects on ED symptoms. During a telephone assessment, participants were administered the Structured Clinical Interview for DSM‐IV‐TR Axis I Disorders and the Eating Disorder Recovery Self‐Efficacy Questionnaire. Results indicated that 12 of the 31 women analysed met criteria for an ED (bulimia nervosa, 2; ED not otherwise specified, 10). Differential findings were evident for eating‐related self‐efficacy measures depending on ED diagnostic status and duration of residency. Potential interpretations, limitations and implications are discussed. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Turkish Version of the Eating Disorder Examination Questionnaire: Reliability and Validity in Adolescents

The Eating Disorder Examination Questionnaire (EDE‐Q) is the self‐report questionnaire version of the Eating Disorder Examination Interview. The aim of the current study was to validate a Turkish version of the EDE‐Q in a sample of Turkish primary and high school students (626 girls and 299 boys) in Istanbul. Subjects also completed the Eating Attitudes Test, the General Health Questionnaire and the Body Image Satisfaction Questionnaire, and they were weighed. Girls had higher scores on all EDE‐Q subtests. EDE‐Q scores increased as body mass ?ndex increased. EDE‐Q total score and subscales were highly correlated with the Eating Attitudes Test and the Body Image Satisfaction Questionnaire, supporting its validity. A small test–retest reliability study provided satisfactory results. The present study suggests that the Turkish version of EDE‐Q is an acceptable, reliable and valid measure in nonclinical adolescent samples. More psychometric studies are needed concerning wider age ranges and various clinical samples. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Eating Disorder Examination Questionnaire (EDE‐Q): Norms for Undergraduate Japanese Women

The aim of the present study was to provide normative data for the Eating Disorder Examination Questionnaire (EDE‐Q) among undergraduate Japanese women and to compare these data to norms obtained from previous studies. Undergraduate Japanese women (n = 289), aged 18–24 years, were administered the EDE‐Q. The mean global score in the present study was 1.55 (SD = 1.03). Japanese women reported significantly higher scores of shape concern and weight concern in spite of lower body mass index but a significantly lower score of restraint, compared with women in other normative studies. There were significant differences with respect to the occurrence of some specific eating disorder behaviours between Japanese women and women in the previous studies. Differences in normative data for the EDE‐Q between young Japanese women and young women in the previous studies suggest that there may be certain cultural differences in eating disorder psychopathology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.     

An evaluation of the Oxford Adult Eating Disorders Service between 1994 and 2002

This paper examines the outcomes of 631 patients who were assessed at the Oxford Adult Eating Disorders Service between May 1994 and December 2002. After treatment, significant improvements were reported across the total sample for body mass index (BMI), the Beck Depression Inventory, the Beck Anxiety Inventory and the Robson Self Concept Questionnaire. Significant improvements were also reported for all measures of the Eating Disorder Questionnaire (EDE) and for all measures of the Eating Disorder Inventory (EDI) except for perfectionism. Patients with anorexia nervosa showed improvements in both BMI and associated psychopathology. Patients with bulimia nervosa showed a reduction in the number of self‐induced vomiting occasions and the number of objective binges and improvements in the associated psychopathology. Further research is required to identify factors associated with improvements in symptomatology. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association.     

Replication of a Modified Factor Structure for the Eating Disorder Examination‐Questionnaire: Extension to Clinical Eating Disorder and Non‐clinical Samples in Portugal

Psychometric investigations of the Eating Disorder Examination‐Questionnaire (EDE‐Q) have generally not supported the original scale structure. The present study tested an alternative brief factor structure in two large Portuguese samples: (1) a non‐clinical sample of N = 4117 female students and (2) a treatment‐seeking sample of N = 609 patients diagnosed with eating disorders. Confirmatory factor analysis revealed a poor fit for the original EDE‐Q structure in both the non‐clinical and the clinical samples but revealed a good fit for the alternative 7‐item 3‐factor structure (dietary restraint, shape/weight overvaluation and body dissatisfaction). Factor loadings were invariant across samples and across the different specific eating disorder diagnoses in the clinical sample. These confirmatory factor analysis findings, which replicate findings from studies with diverse predominately overweight/obese samples, supported a modified 7‐item, 3‐factor structure for the EDE‐Q. The reliable findings across different non‐clinical and clinical eating disorder groups provide confidence regarding the potential utility of this brief version. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.     

Personality disorders in patients in a day‐treatment programme for eating disorders

The present study examined the prevalence of DSM‐III‐R personality disorders (PDs) and levels of depressive symptoms in patients in a day‐hospital programme for eating disorders. Sixty‐five patients diagnosed with anorexia nervosa and bulimia nervosa were administered the Personality Diagnostic Questionnaire Revised (PDQ‐R), the Eating Disorder Inventory (EDI) and the Beck Depression Inventory (BDI). In total, 49.2 per cent of all patients had at least one PD diagnosis. No significant difference was found between patients with bulimia nervosa and anorexia nervosa. Eating Disorder patients with at least one PD had higher scores on the BDI and three EDI subscales compared to patients without a PD. In general, the prevalence of Personality Disorders in the present sample tended to be closer to results quoted by studies with eating‐disordered outpatients rather than inpatients. Axis I disorders may affect personality state measures. Copyright © 2000 John Wiley & Sons, Ltd and Eating Disorders Association.     

Short‐Term Intensive Family Therapy for Adolescent Eating Disorders: 30‐Month Outcome

Family therapy approaches have generated impressive empirical evidence in the treatment of adolescent eating disorders (EDs). However, the paucity of specialist treatment providers limits treatment uptake; therefore, our group developed the intensive family therapy (IFT)—a 5‐day treatment based on the principles of family‐based therapy for EDs. We retrospectively examined the long‐term efficacy of IFT in both single‐family (S‐IFT) and multi‐family (M‐IFT) settings evaluating 74 eating disordered adolescents who underwent IFT at the University of California, San Diego, between 2006 and 2013. Full remission was defined as normal weight (≥95% of expected for sex, age, and height), Eating Disorder Examination Questionnaire (EDE‐Q) global score within 1 SD of norms, and absence of binge–purging behaviours. Partial remission was defined as weight ≥85% of expected or ≥95% but with elevated EDE‐Q global score and presence of binge–purging symptoms (<1/week). Over a mean follow‐up period of 30 months, 87.8% of participants achieved either full (60.8%) or partial remission (27%), while 12.2% reported a poor outcome, with both S‐IFT and M‐IFT showing comparable outcomes. Short‐term, intensive treatments may be cost‐effective and clinically useful where access to regular specialist treatment is limited. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Self‐Discrepancy and Eating Disorder Symptoms Across Eating Disorder Diagnostic Groups

This study examined self‐discrepancy, a construct of theoretical relevance to eating disorder (ED) psychopathology, across different types of EDs. Individuals with anorexia nervosa (AN; n = 112), bulimia nervosa (BN; n = 72), and binge eating disorder (BED; n = 199) completed semi‐structured interviews assessing specific types of self‐discrepancies. Results revealed that actual:ideal (A:I) discrepancy was positively associated with AN, actual:ought (A:O) discrepancy was positively associated with BN and BED, and self‐discrepancies did not differentiate BN from BED. Across diagnoses, A:O discrepancy was positively associated with severity of purging, binge eating, and global ED psychopathology. Further, there were significant interactions between diagnosis and A:O discrepancy for global ED psychopathology and between diagnosis and A:I discrepancy for binge eating and driven exercise. These results support the importance of self‐discrepancy as a potential causal and maintenance variable in EDs that differentiates among different types of EDs and symptom severity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.     

Food Addiction in a Spanish Sample of Eating Disorders: DSM‐5 Diagnostic Subtype Differentiation and Validation Data

Although the concept of ‘food addiction’ (FA) has raised growing interest because of evidence for similarities between substance dependence and excessive food intake, there is a lack of studies that explore this construct among the wide spectrum of eating disorders (EDs). Besides providing validation scores of a Spanish version of the Yale FA Scale (YFAS‐S), this study examined the prevalence of ‘FA’ among ED subtypes compared with healthy‐eating controls (HCs) and the association between ‘FA’ scores, eating symptomatology and general psychopathology. A sample of 125 adult women with ED, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders 5 criteria, and 82 healthy‐eating women participated in the study. All participants were assessed with the YFAS‐S, the ED Inventory‐2 and the Symptom Checklist‐Revised. Results showed that the internal structure of the one‐dimensional solution for the YFAS‐S was very good (α = 0.95). The YFAS‐S has a good discriminative capacity to differentiate between ED and controls (specificity = 97.6% and sensitivity (Se) = 72.8%; area under receiver operating characteristic curve = 0.90) and a good Se to screen for specific ED subtypes. YFAS‐S scores were associated with higher levels of negative affect and depression, higher general psychopathology, more severe eating pathology and greater body mass index. When comparing the prevalence of ‘FA’ between ED subtypes, the lowest prevalence of ‘FA’, measured with the YFAS‐S, was for the anorexia nervosa (AN) restrictive subtype with 50%, and the highest was for the AN binge–purging subtype (85.7%), followed by bulimia nervosa (81.5%) and binge eating disorder (76.9%). In conclusion, higher YFAS‐S scores are associated with bingeing ED‐subtype patients and with more eating severity and psychopathology. Although the ‘FA’ construct is able to differentiate between ED and HC, it needs to be further explored. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.     

Validating the eating disorder inventory (EDI‐2) in two danish samples: A comparison between female eating disorder patients and females from the general population

The Eating Disorder Inventory, Version 2 (EDI‐2) is a questionnaire used clinically and in research all over the world. EDI‐2 is cross‐culturally valid, yet normative values may depend on culture. Norms and reliability of the Danish version have to date been lacking, and will be presented in this article, comparing patients (N = 575) and controls (N = 881). Also, internal reliability of scales is tested for both groups. Differences between norms of the Danish and the North American version of EDI were small but significant for all scales except asceticism (eating disorder patients) and ineffectiveness, interpersonal distrust and maturity fears (normal controls). For both groups the internal consistency was >0.70 for all subscales except asceticism. Although differences across the eating disorder diagnostic groups were dubious, the EDI‐2 is useful to screen for eating problems in the general population as well as to rate progress and outcome among eating disorder patients. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Role of Non‐suicidal Self‐Injury and Binge‐Eating/Purging Behaviours in the Caregiving Experience Among Mothers and Fathers of Adolescents with Eating Disorders

This study investigated the caregiving experiences of mothers and fathers of restrictive and binge‐eating/purging eating disordered (ED) inpatients with and without non‐suicidal self‐injury (NSSI). Sixty‐five mothers and 65 fathers completed the Experience of Caregiving Inventory. All inpatients completed the Self‐Injury Questionnaire—Treatment Related to assess NSSI and the Eating Disorder Evaluation Scale to assess eating disorder symptoms. Mothers reported significant more negative and more positive caregiving experiences compared with fathers. Mothers (but not fathers) of restrictive ED patients reported more positive caregiving experiences compared with mothers of binge‐eating/purging patients. The presence of NSSI in ED patients was associated with more negative caregiving experiences of both parents. Mothers and fathers of ED inpatients differ in caregiving experiences, and both binge‐eating behaviours and NSSI negatively affect their caregiving experience. Therefore, supportive interventions for parents of ED patients are necessary, especially of those patients who engage in NSSI. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Inpatient Treatment for Adolescents with Anorexia Nervosa: Clinical Significance and Predictors of Treatment Outcome

This study evaluated the clinical significance as well as predictors of outcome for adolescents with severe anorexia nervosa (AN) treated in an inpatient setting. Body mass index (BMI), eating disorder (ED) symptoms [Eating Disorder Inventory‐2 (EDI‐2)], general psychopathology and depression were assessed in 238 patients at admission and discharge. BMI increased from 14.8 + 1.2 to 17.3 + 1.4 kg/m². Almost a fourth (23.6%) of the patients showed reliable changes, and 44.7% showed clinically significant changes (EDI‐2). BMI change did not significantly differ between those with reliable or clinically significant change or no reliable change in EDI‐2. Length of stay, depression and body dissatisfaction were negative predictors of a clinically significant change. Inpatient treatment is effective in about two thirds of adolescents with AN and should be considered when outpatient treatment fails. About one third of patients showed significant weight gain, but did not improve regarding overall ED symptomatology. Future studies should focus on treatment strategies for non‐responders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Eating disorder inventory scores in Russia and Britain: a preliminary comparison

Two hundred and fifty‐one Russian and 66 British female undergraduate students completed the Eating Disorder Inventory‐2 (EDI‐2, Garner, 1991a), and measurements of height and weight were taken. A comparison of the mean scores indicated that the Russians showed significantly greater drive for thinness, perfectionism, maturity fears, asceticism, and impulsivity. The Russians also had a lower mean actual and desired Body Mass Index than the British women. Copyright © 1999 John Wiley & Sons, Ltd and Eating Disorders Association.     

Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology,Depressive Symptoms,and Self‐Esteem among Treatment‐Seeking Adolescents with Bulimia Nervosa

This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment‐seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self‐esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self‐esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self‐esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.     

Food for Thought: Ego‐dystonicity and Fear of Self in Eating Disorders

Degree of ego‐dystonicity in obsessions is clinically relevant to the conceptualization and treatment of eating disorders (EDs). Obsessive–compulsive disorder research has suggested that the transformation of intrusive thoughts into obsessions is linked to the degree to which intrusive thoughts threaten core perceptions of the self. This study aims to explore the relationship between the ego‐dystonic nature of obsessions in ED patients and a fear of self, the link between ED symptom severity and ego‐dystonicity in obsessions, and differences between non‐clinical and individuals with EDs in the presence of ego‐dystonic thoughts and a fear of self. Ego‐dystonicity (Ego‐dystonicity Questionnaire (EDQ)) and feared self (Fear of Self Questionnaire (FSQ)) degrees were measured in a clinical sample (n = 57 with EDs) and a non‐clinical sample (n = 45). EDQ and FSQ scores were highly correlated in both samples. EDQ scores were not significantly correlated to ED symptom severity with the exception of the EDQ Irrationality subscale, which was strongly related to compulsion severity. Participants with an ED had significantly higher EDQ and FSQ scores compared with controls. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

EDI results of Japanese and German women and possible sociocultural explanations

The goal of this study was to compare data for women with bulimia nervosa and for a healthy control group both in Japan and Germany. These data were obtained using the Eating Disorder Inventory (EDI‐2). In Germany, EDI‐2 data and BMI values were collected from 102 nurses in training, 57 female medical students, and 29 patients with bulimia nervosa. In Japan, data were gathered from 243 female ‘short college’ students and 20 patients with bulimia nervosa. The Japanese non‐clinical control group showed significantly higher values on nearly all EDI scales than the German control group. They had a markedly higher drive for thinness, though their BMI values were lower. When the German and the Japanese bulimia nervosa patients were compared, the Japanese patients also showed higher values than their German counterparts on three EDI scales, but these differences were negligible. It is suggested that sociocultural factors in Japan, in particular a significant dependency on social norms, may contribute to the high EDI values. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Prevalence of Binge Eating Disorder in a Sample of College Students in the North of Portugal

Binge eating disorder (BED) has important associated comorbidities and has been recently considered as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition. This study investigates the prevalence of BED in a sample of college students using a two‐stage design. Between October 2008 and July 2009, 805 students attending a public college campus completed the Questionnaire on Eating and Weight Patterns – Revised to screen for possible cases. Eighty‐five students meeting key criteria for BED were invited for a second stage interview using the Eating Disorder Examination. At stage 1, 9.6% of the subjects reported binge eating episodes. At stage 2, a prevalence rate of 0.5% for BED was found, and 1% if the criterion for large amount of food was excluded. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.     

Eating disorders and chronic post traumatic stress disorder: issues of psychopathology and comorbidity

This article reviews in both directions the recent literature on the relationship between Eating Disorders (ED) and chronic Post Traumatic Stress Disorder (PTSD) to shed some light on an area of comorbidity for too long overlooked. PTSD may be the commonest anxiety disorder in ED but it seems to be independent from ED. Clinicians should be aware that PTSD might represent more than just an occasional occurrence in ED clinical work and should know how to approach it. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.