Measurement of Eating Pathology Using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3)

Eating disorders are prevalent among college student populations. Although previous iterations of the instrument did not include specific measurement of eating pathology, the Minnesota multiphasic personality inventory-3 (MMPI-3) now includes a specific scale (i.e., Eating Concerns [EAT]) to assess problematic eating behaviors. The current study examined the MMPI-3 assessment of eating pathology among 249 undergraduate women. A pattern emerged where symptoms of internalizing psychopathology on the MMPI-3 were generally associated with symptoms of eating disorder. However, the newly included EAT scale demonstrated the strongest associations with most areas of eating dysfunction. Further, hierarchical regression analyses suggested that the EAT scale added substantial incremental predictive utility (up to 23%) over other MMPI-3 scales combined in assessing eating pathology. Classification accuracy statistics yielded high sensitivity and specificity coefficients when predicting eating disorder risk at an EAT scale score cutoff of 75 T or higher. These findings support the use of the MMPI-3 in assessing eating pathology in college women, although its performance with men and with women not of college age remains to be studied.

Systematic review of body image measures

This systematic review synthesizes and critically appraises measurement properties of influential body image measures. Eight measures that met the definition of an assessment of body image (i.e., an individual's cognitive or affective evaluation of their body or appearance with a positive or negative valence), and scored high on systematic expert priority ranking, were included. These measures were: the Body Appreciation Scale (original BAS and BAS-2), the Body Esteem Scale for Adolescents and Adults, the Body Shape Questionnaire, the Centre for Appearance Research Valence Scale, the Drive for Muscularity Scale, two subscales of the Eating Disorders Examination Questionnaire, one subscale of the Eating Disorder Inventory 3, and two subscales of the Multidimensional Body Relations Questionnaire. Articles assessing these scales' psychometric properties (N = 136) were evaluated for their methodological quality using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist, and a best evidence synthesis was performed. The results supported the majority of measures in terms of reliability and validity; however, suitability varied across populations, and some measurement properties were insufficiently evaluated. The measures are discussed in detail, including recommendations for their future use in research and clinical practice.

Eating Attitudes of Women Living With a Vision Impairment

Internalization of cultural standards of attractiveness and subscription to gender-based discourses are significant predictors of disordered eating attitudes in fully sighted women. Yet, whether these variables predict the disordered eating attitudes of women who are legally blind is underexplored. In the current study, we examined how internalization of White European cultural standards of attractiveness and subscription to gender-based discourses (body surveillance and self-silencing) and body shame predicted the disordered eating attitudes of 80, primarily White, heterosexual, Australian women who are legally blind. Participants completed an online survey comprising existing validated measures of all variables. A path analysis was performed using the Hayes PROCESS approach. As predicted, in women living with vision impairment, body surveillance, self-silencing, and shame fully mediated the relation between internalization of cultural standards of attractiveness and disordered eating attitudes. Results showed that in much the same way as sighted women, women living with vision impairment are susceptible to internalizing harmful messages related to socio-cultural standards of attractiveness. We provide further support for including subscription to gender-based discourses in research on women’s body-image disturbances. Data will be available for other researchers from the author via email. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index

Rumination mediates the associations between sexual minority stressors and disordered eating, particularly for men

PURPOSE

Sexual minority individuals experience unique minority stressors leading to negative clinical outcomes, including disordered eating. The psychological mediation framework posits that stress related to discrimination, internalized homonegativity, and concealment makes sexual minority individuals more vulnerable to maladaptive coping processes, such as rumination, known to predict disordered eating. The current study examined the influence of sexual minority stressors and rumination on disordered eating, and whether these associations differed between sexual minority men and women. We hypothesized that perceived discrimination, internalized homonegativity, and concealment would be positively associated with disordered eating, and that rumination about sexual minority stigma would mediate these associations.

METHODS

One-hundred and sixteen individuals who identified as sexual minorities completed a survey study assessing perceived discrimination, internalized homonegativity, concealment, rumination about sexual minority stigma, and disordered eating.

RESULTS

Discrimination and concealment uniquely predicted disordered eating in both men and women. However, rumination emerged as a significant mediator for concealment and (marginally) for discrimination for men only. Internalized homonegativity was not uniquely associated with rumination or disordered eating for men or women.

CONCLUSIONS

Sexual minority men who experience discrimination and conceal their sexual orientation may engage in more disordered eating because they dwell on sexual minority stigma. We propose other potential mechanisms that may be relevant for sexual minority women.

Acculturation, Internalization of Western Appearance Norms, and Eating Pathology Among Japanese and Chinese International Student Women

In the context of the sociocultural model of eating disorders, this study investigated the hypothesis that Westernization would be positively associated with eating pathology among non-Western women. International participants from Japan ( n = 26), Peoples Republic of China ( n = 25), Taiwan ( n = 30), and Hong Kong ( n = 25) who were studying in the United States completed the Eating Attitudes Test, Symptoms Checklist, Sociocultural Attitudes Toward Appearance Questionnaire, the American–International Relations Survey, and a demographic questionnaire. Awareness and internalization of Western appearance norms were positively associated with eating disordered symptoms, but acculturation was not. Results lend further support for the sociocultural model. It is suggested that measures of eating pathology and acculturation be closely examined with respect to their cross-cultural relevance, particularly when conducting research involving international populations.

A two-stage epidemiological study of eating disorders and muscle dysmorphia in male university students in Buenos Aires

OBJECTIVE

Studies using traditional screening instruments tend to report a lower prevalence of eating disorders (EDs) in men than is observed in women. It is therefore unclear whether such instruments are valid for the assessment of ED in males. Lack of a formal diagnostic definition of muscle dysmorphia syndrome (MD) makes it difficult to identify men at risk. The study aimed to assess the prevalence of ED and MD in male university students of Buenos Aires.

METHOD

A cross-sectional, two-stage, representative survey was of 472 male students from six different schools in Buenos Aires, mostly aged between 18 and 28 years. The first stage involved administration of self-report questionnaires (Eating Attitude Test-26; scores ≥15 indicate "at risk" status). In Stage 2 students at risk of developing EDs were evaluated with a clinical interview, the Eating Disorder Examination (EDE; 12th edition). Two control students were interviewed for every at risk student.

RESULTS

The prevalence of EDs among university male students was 1.9% (n = 9). All participants with an ED presented with illness classified as eating disorder not otherwise specified (EDNOS). Using the Drive for Muscularity Scale (DMS) with a 52-point threshold we identified possible MD in 6.99% (n = 33) of the sample.

DISCUSSION

The prevalence of ED detected in this study is comparable with previous findings in male populations, and below that observed in female populations. However, the prevalence of possible cases of MD resembles the total rate of EDs in women. Characteristics associated with EDs and MD in men are also discussed.

Relations of Sexual Objectification and Racist Discrimination with Latina Women’s Body Image and Mental Health

In the current study, we tested direct and mediated associations of objectification theory constructs and racist discrimination with eating disorder and depressive symptomatology in a sample of 180 Latina women (age range = 18-66). Results of a path analysis indicated that internalization of sociocultural standards of attractiveness was related to greater eating disorder and depressive symptomatology in part through the mediating roles of body shame and body surveillance, and body surveillance was related to greater eating disorder and depressive symptomatology through the mediating role of body shame. Sexual objectification did not yield hypothesized direct and indirect unique relations with criterion variables. However, racist discrimination was directly associated with greater depressive symptomatology and indirectly associated, through the mediating role of body shame, with greater eating disorder and depressive symptomatology. These results extend tenets of objectification theory to Latina women and point to the role of racist discrimination within this framework.

Disordered Eating Among Asian/Asian American Women

Sociocultural models of eating disorders emphasize the role of internalization of media standards of beauty in eating pathology but rarely examine (a) how racial and cultural factors may be related to women of color’s tendency to endorse Western media beauty ideals or (b) these women’s risk of developing body dissatisfaction and disordered eating issues. This study of Asian/Asian American women ( N = 587) investigated the roles of perceived racial discrimination, ethnic identity, and racial/ethnic teasing in relation to self-esteem, internalization of Western standards of beauty, and body dissatisfaction as predictors of disordered eating in a structural model. Results indicated that, when controlling for body mass, perceived racial discrimination, ethnic identity, and racial/ethnic teasing significantly predicted disordered eating and its correlate variables through direct and indirect links. The findings suggest racial and cultural factors may complement sociocultural models in understanding disordered eating issues among Asian/Asian American women.

The impact of spirituality on eating disorder symptomatology in ethnically diverse Canadian women

BACKGROUND

There is currently a gap in our knowledge of how eating disorder symptomatology is impacted by spirituality and religiosity. To date, studies examining the role of ethnicity in women's self-reported levels of eating disorder symptomatology have neglected the roles of spirituality and religiosity.

AIMS

This study addresses this gap in the literature by investigating ethnicity, spirituality, religiosity, body shame, body mass index (BMI) and age in relation to eating disorder symptomatology in women.

METHODS

A representative non-clinical sample of ethnically diverse Canadian women (N = 591) was surveyed.

RESULTS

Younger women, particularly those with higher body shame, BMI and lower spirituality, reported more eating disorder symptomatology. Hispanic and Asian women had higher body shame and lower BMI compared to white women. Spirituality was more strongly related to eating disorder symptomatology than religiosity.

CONCLUSIONS

This is the first study identifying interactive relationships between ethnicity, spirituality, body shame, BMI and age on eating disorder symptomatology in women. Particularly significant is that higher spirituality was related to a lower level of eating disorder symptomatology. These findings have important implications for treatment and women's physical and psychological health and wellness.

Validation of an existing measure of eating disorder risk for use with early adolescents

This study tested a brief eating disorder risk measure, originally developed for use with college students, in young adolescents. The measure is called the COEDS (College Eating Disorders Screen) and is constructed of items written in everyday language used by youth to discuss weight issues, rather than in the language of symptom assessment. A sample of 246 early adolescents (mean age, 13) completed questionnaire measures of puberty, eating disorder behavior, and eating disorder risk two times in a 12-month span. We found that: (a) the COEDS was internally consistent; (b) COEDS scores were stable across one year; and (c) COEDS scores predicted restricting and compensatory behavior one year later, above and beyond prediction from sex, race, prior restricting and compensatory behavior, and prior BMI. The COEDS appears to be a reliable and valid measure for risk assessment in youth; it may prove useful for researchers and clinicians interested in screening for risk and as a means to test whether prevention efforts have reduced risk.

Self-Silencing, Emotional Awareness, and Eating Behaviors in College Women

Self-silencing (or the suppression of expressing one’s thoughts, feelings, and needs) can have a negative impact on the mental health of women, from depression to disordered eating behaviors. The authors examined the relationship between self-silencing and disordered eating as well as intuitive eating. The authors also explored whether emotional awareness would moderate these relationships because conflicts over expressiveness are associated with emotional problems and eating disorders. The sample comprised 140 college women (52% White; 36% Black) under the age of 24 from a midwestern urban university. Their results revealed that emotional awareness moderated the relationships between self-silencing and disordered eating and intuitive eating. Specifically, when there were lower levels of emotional awareness, self-silencing with disordered eating and intuitive eating were unrelated; however, with higher levels of emotional awareness together with more self-silencing, participants presented with more disordered eating and less intuitive eating. The findings highlight the importance of supporting women’s emotional awareness in conjunction with their expressiveness of thoughts, feelings, and needs to increase intuitive eating and decrease disordered eating.

Assessment methods for eating disorders and body image disorders

The growing interest in the treatment and research of eating disorders has stimulated the development of assessment methods, and there are now many questionnaires for evaluating behavioral and attitudinal characteristics of eating pathology. The present article sets out to review the assessment tools that are widely used in clinical practice and research. In particular, it covers self-report measures with summaries of their psychometric properties. It also presents diagnostic questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria. The instruments described include screening questionnaires, measurement tools for specific eating disorder symptoms, measurement of quality of life in eating disorders, and some tools for the measurement of body image disorder, a common feature of eating disorders. There is also a discussion of distorting factors that decrease the authenticity of assessment tools. These problems arise from the definition of some constructs and from the phenomena of denial and concealment, which are frequent among eating-disordered individuals. The frequent co-occurrence of other psychopathological features (e.g., multiimpulsive symptoms) shows that other psychological phenomena should also be evaluated in line with the assessment of eating disorders.

Prevalence of eating disorders symptoms in nonelite ballet dancers and basketball players: An exploratory and controlled study among French adolescent girls

BACKGROUND

Until recently, very few controlled studies have examined the prevalence of eating disorders (ED) symptoms among nonelite adolescent female athletes. Moreover, results are mixed and inconclusive. Therefore, the aim of this exploratory study was to examine the prevalence of ED symptoms (underweight, bulimia, drive for thinness, body dissatisfaction) among French nonelite adolescent female athletes (ballet dancers and basketball players) and nonathletes.

METHOD

The sample of adolescent girls (aged between 12 and 16 years), consisted of 43 basketball players, 52 ballet dancers and 49 nonathlete controls. The eating disorder inventory and a demographic-personal information questionnaire (date of birth, experience of ED, week training time, etc.) were filled out by the participants. Additionally, all participants were measured and weighed. The frequencies of ED symptoms were compared between the groups (athletes versus nonathletes, ballet dancers versus basketball players) using a series of χ² tests.

RESULTS

The χ² tests did not show significant differences in frequencies of underweight and body dissatisfaction symptoms between nonelite athletes and nonathletes. However, results highlighted a nonsignificant trend toward higher frequency of: (i) drive for thinness (P=0.05) symptoms in nonelite athletes compared with nonathletes, and (ii) bulimia (P=0.06) symptoms in nonathletes compared with nonelite athletes. Additional analyses performed among the sport groups revealed that the prevalence of drive for thinness symptoms was significantly two-fold higher in ballet dancers than basketball players (34.6% versus 16.3%). Nevertheless, no significant differences were found in the frequencies of underweight, bulimia and body dissatisfaction symptoms among the sport groups.

CONCLUSION

This study showed that the frequency of ED symptoms is equivalent in nonelite athletes and nonathletes. However, these nonsignificant results should be interpreted with caution regarding the weak statistical power of the analyses and the small sample size. Detailed analysis revealed a significantly higher prevalence of drive for thinness symptoms in ballet dancers in comparison with basketball players. Consequently, these results should be viewed as preliminary and further studies are needed before they can be generalized to French adolescent female athletes.

Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment

Due to the importance of the distorted body experience in eating disorder diagnosis and treatment, we wanted to explore body attitudes of patients with eating disorders before and after 5 months of intensive specialized outpatient day treatment. We assessed 193 patients diagnosed with Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS) using the Body Attitude Test (BAT), Body Mass Index (BMI), Eating Disorder Evaluation Scale (EDES) and Symptom Checklist 90 (SCL-90). Eating disorder subtypes differed in BMI, total body attitudes and negative appreciation of body size at intake, but not at termination of treatment. Following treatment, all patient groups reported large improvements in eating disorder pathology and all but the AN-Restrictive (AN-R) group, reported large improvements in overall psychological functioning. The AN patients demonstrated significant improvement in BMI, however the Anorexia Nervosa purging (AN-P) and Anorexia Nervosa restrictive (AN-R) subtypes differed in their changes in body attitudes. AN-R patients indicated no significant improvement in body attitudes. AN-P patients improved in total body attitudes, except one subscale. Patients with Bulimia Nervosa non-purging (BN-NP) subtype, Bulimia Nervosa purging (BN-P) subtype and EDNOS demonstrated similar improvements in total body attitudes (BAT). Body attitudes provide important insights into differences between eating disorder diagnostic categories and their treatment responsiveness.

Anxiety, Alexithymia, and Depression as Mediators of the Association between Childhood Abuse and Eating Disordered Behavior in African American and European American Women

This study evaluated structural equation models of the associations among family functioning, childhood abuse, depression, anxiety, alexithymia, and eating disorder symptomatology in a sample of 412 European American and 192 African American female undergraduates. Additionally, the specific roles of anxiety, depression, and alexithymia as mediators were assessed. Each of these variables was a significant mediator of the association between childhood abuse and disordered eating. Finally, a test of invariance between the African American and European American subsamples was significant, highlighting the need for additional cross-cultural eating disorder research.

Structure analysis of the Children's Eating Attitudes Test in overweight and at-risk for overweight children and adolescents

BACKGROUND

In school-based samples of children, the Children's Eating Attitudes Test (ChEAT) has a four-factor structure; however, previous studies have not examined its factor structure in samples restricted to overweight youth.

METHODS

The ChEAT was administered to 220 overweight (BMI>or=95th percentile) and 45 at-risk for overweight (BMI 85th-<95th percentile) children and adolescents. Factors were identified by a principal component analysis with varimax rotation. ChEAT factor scores of children with BMI>or=85th percentile were contrasted with those of 152 non-overweight (BMI 5th to <85th percentile) children and adolescents.

RESULTS

Factor analysis generated four subscales described as 'body/weight concern,' 'food preoccupation,' 'dieting,' and 'eating concern.' ChEAT total score, body/weight concern, and dieting subscale scores were positively related to BMI-Z and body fat mass (p's<.05). Compared to non-overweight children, overweight and at-risk for overweight children had higher ChEAT total (9.9+/-7.4 vs. 6.6+/-7.8, p<.001), body/weight concern (3.2+/-3.1 vs. 1.3+/-3.0, p<.001), and dieting (1.8+/-2.2 vs. .8+/-2.3, p<.001) subscale scores.

CONCLUSIONS

The previously elucidated factor structure of the ChEAT was primarily supported in a sample of overweight children. The emergence of separate body/weight concern and dieting subscales may relate to these children's experiences with attempted weight reduction.

National athletic trainers' association position statement: preventing, detecting, and managing disordered eating in athletes

OBJECTIVE

To present recommendations for the prevention, detection, and comprehensive management of disordered eating (DE) in athletes.

BACKGROUND

Athletes with DE rarely self-report their symptoms. They tend to deny the condition and are often resistant to referral and treatment. Thus, screenings and interventions must be handled skillfully by knowledgeable professionals to obtain desired outcomes. Certified athletic trainers have the capacity and responsibility to play active roles as integral members of the health care team. Their frequent daily interactions with athletes help to facilitate the level of medical surveillance necessary for early detection, timely referrals, treatment follow-through, and compliance.

RECOMMENDATIONS

These recommendations are intended to provide certified athletic trainers and others participating in the health maintenance and performance enhancement of athletes with specific knowledge and problem-solving skills to better prevent, detect, and manage DE. The individual biological, psychological, sociocultural, and familial factors for each athlete with DE result in widely different responses to intervention strategies, challenging the best that athletics programs have to offer in terms of resources and expertise. The complexity, time intensiveness, and expense of managing DE necessitate an interdisciplinary approach representing medicine, nutrition, mental health, athletic training, and athletics administration in order to facilitate early detection and treatment, make it easier for symptomatic athletes to ask for help, enhance the potential for full recovery, and satisfy medicolegal requirements. Of equal importance is establishing educational initiatives for preventing DE.

MMPI–2 Profiles of Women With Eating Disorders in a Dutch Day Treatment Sample

In this study, we examined the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles of 324 Dutch patients with eating disorders at an eating disorder day treatment program. We studied the MMPI-2 profiles in 5 diagnostic eating disorder groups. All diagnostic subgroups showed high mean elevations of the T scores on the same 6 or 7 scales. Remarkable similarities existed between the mean profile configurations. The MMPI-2 distinguished especially in that patients with restricting anorexia nervosa scored lower on one Validity scale (F), two Clinical scales (1 and 2) and several Supplementary and Content scales of the MMPI-2 compared to the other groups. Only on the validity Scale L did they score higher. The MMPI-2 also distinguished patients with the bulimia nervosa purging type who scored higher on Scale 9 and different on several Content and Supplementary scales. We discuss results with regard to other studies of MMPI (Hathaway & McKinley, 1983) and MMPI-2 profiles of women with anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified in inpatient and outpatient settings.

Disordered eating behavior and obsessive compulsive symptoms in college students: cognitive and affective similarities

Few studies have examined the psychological similarities between disordered eating behavior and obsessive-compulsive (OC) symptoms. The present study examined relationships among disordered eating, OC symptoms, and three cognitive and affective variables (perfectionism, obsessive beliefs, and negative affect). The cognitive and affective variables were significantly associated with disordered eating and with OC symptoms in a sample of 160 college women. Results also indicated that perfectionism is an important link between disordered eating behavior and OC symptoms, although the nature of perfectionism differs somewhat for the two types of behavior. Implications of the current results and directions for future research are discussed.

Sociocultural values of appearance and attachment processes: An integrated model of eating disorder symptomatology

Sociocultural and attachment processes were integrated into a single model predicting eating disorder symptomatology to determine their relative influence. Using normative, self-report data from 146 female undergraduates, path analyses tested the fit of a conceptual model with two hypothesized pathways: (1) higher awareness of sociocultural values about appearance would lead to less perceived appearance satisfaction which would, in turn, lead to eating disordered behavior, and (2) attachment avoidance and anxiety (modeled separately) across mother, father, and romantic partner domains would predict psychological correlates of eating disorders, thereby increasing risk for disordered behaviors. Although both were significant, the sociocultural path was slightly stronger (beta=-.46; path from attachment/psychological correlates to behaviors beta=.27). Further, attachment avoidance exhibited stronger effects than anxiety (explaining 31% and 25% of variance in psychological correlates, respectively). Results underscored the need to consider multiple factors in eating disorder research and treatment programs.

Media images of the "ideal" female body: can acute exercise moderate their psychological impact?

Exposure to the media's "ideal" physique increases mood and body image disturbance, especially for at-risk women. Because exercise decreases mood and body image disturbance, we examined the ability of acute aerobic exercise to moderate the negative psychological impact of exposure to media pictures of the "ideal" female body. Women reporting high drive for thinness and media internalization viewed pictures of either nonphysique or "ideal" physique pictures after engaging in 30min of either aerobic exercise or quiet rest. Compared to the nonphysique pictures, viewing the physique pictures resulted in increased depression and body dissatisfaction. Acute aerobic exercise, however, did not moderate the negative mood states elicited by the media images. Implications of our results and future directions for research are discussed.

Prevalence of eating disorders in elite athletes is higher than in the general population

OBJECTIVE

The objectives of the study were to examine the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), anorexia athletica (AA), and eating disorders not otherwise specified (ED-NOS) in both male and female Norwegian elite athletes and a representative sample from the general Norwegian population.

DESIGN

A 2-step study including self-reported questionnaire and clinical interview.

SETTING/PARTICIPANTS

The entire population of Norwegian male and female elite athletes (n=1620) and controls (n=1696) was evaluated for the presence of eating disorders (EDs).

MAIN OUTCOME MEASUREMENT

Based on the results of the questionnaire, all athletes and controls classified as at risk for EDs, and a representative sample of athletes and controls classified as healthy participated in the clinical part of the study to determine the number of subjects meeting the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for EDs.

RESULTS

More athletes (13.5%) than controls (4.6%; P<0.001) had subclinical or clinical EDs. The prevalence of EDs among male athletes was greater in antigravitation sports (22%) than in ball game (5%) and endurance sports (9%; P<0.05). The prevalence of EDs among female athletes competing in aesthetic sports (42%) was higher than that observed in endurance (24%), technical (17%), and ball game sports (16%).

CONCLUSIONS

The prevalence of EDs is higher in athletes than in controls, higher in female athletes than in male athletes, and more common among those competing in leanness-dependent and weight-dependent sports than in other sports. A collaborative effort among coaches, athletic trainers, parents, physicians, and athletes is optimal for recognizing, preventing, and treating EDs in athletes.

Comparison of assessments of children's eating-disordered behaviors by interview and questionnaire

OBJECTIVE

In adults, interview methods may detect eating-disordered behaviors more accurately than self-report methods. However, no studies have investigated the relationships between interview and self-report assessments in children. We compared results from the Eating Disorder Examination adapted for Children (ChEDE) with the Adolescent version of the Questionnaire on Eating and Weight Patterns (QEWP-A) and with the Children's Eating Attitude Test (ChEAT) in a nontreatment sample of overweight and normal weight children.

METHOD

The ChEDE, QEWP-A, and ChEAT were administered to 46 overweight (body mass index [BMI] at or above the 85th percentile) and 42 normal weight (BMI at the 15th-85th percentile) children, 10 +/- 1.8 years, recruited from the community.

RESULTS

The ChEDE and QEWP-A were not concordant for the number or type of eating episodes that occurred in the past month. Compared with the ChEDE, the QEWP-A was reasonably specific, but it was not sensitive for the presence of objective (17 % sensitivity, 91% specificity) or subjective bulimic episodes (0 % sensitivity, 89 % specificity) during the past month. ChEDE and ChEAT global scores were significantly related (Kendall's tau = 0.286, p <.001), but specific items assessing guilt in relation to eating and preoccupation with food were not.

DISCUSSION

Although self-report methods of eating disorder assessment in children may provide some general information regarding eating psychopathology in non-treatment-seeking children, they do not accurately reflect the results of a structured interview.