Psychometric Properties of the Eating Disorder Examination Questionnaire (EDE-Q) and the Clinical Impairment Assessment (CIA) Using a Heterogenous Clinical Sample from Arab Countries

Abstract

As the prevalence rates of eating disorders and disordered eating behaviors continue to rise worldwide, it is crucial to make psychometrically validated tools available for clinical use. The current study examined the psychometric properties of the Arabic versions of the Eating Disorder Examination Questionnaire (EDE-Q) and the Clinical Impairment Assessment (CIA) using a sample from the clinical population. The sixth edition of the EDE-Q and the third edition of the CIA were translated into Arabic and administered to 260 Arab participants (203 diagnosed with eating disorders and 57 from the general population) who are natives of various countries in the Middle East and North Africa (MENA) region. Convenience sampling method was used to recruit the participants with a 97% response rate. Participants from the non-clinical group also filled out the Arabic version of the EAT-26 questionnaire to rule out underlying disordered eating behaviors. Data was collected between June 2018 and August 2023. Internal consistency for the global scores of both the EDE-Q and CIA were high, while the coefficients for the four subscales of the EDE-Q and the three subscales of the CIA were moderate. Confirmatory factor analysis on the EDE-Q revealed a good fit for the abbreviated seven-item measurement with three factors, and the same was true for the CIA’s three-factor model. Convergent validity results showed significant correlations between the EDE-Q and the CIA with high coefficients. Known groups validity tests revealed significant differences based on eating disorder behaviors, where those who reported vomiting episodes and laxative misuse scored significantly higher on the EDE-Q than those who did not, and those who reported excessive exercising behavior scored significantly higher on the CIA than those who did not. There were no significant differences observed based on eating disorder diagnoses, nor were there differences among individuals with secondary diagnoses. Test-retest reliability and discriminant validity tests were not carried out. Strengths, limitations, and future directions are thoroughly discussed. The study investigated the reliability, validity, and factor structure of these tools. The findings corroborate previous studies’ support for the EDE-Q’s abbreviated seven-item measurement with three factors and the CIA’s three-factor model. With a comparatively modest sample size, the findings should be considered preliminary for Arabic versions of the tools using a clinical sample, and future studies with larger sample are warranted to confirm them.