Eating Disorder Inventory Scales Research Articles

Social Media Use and Body Image Disorders: Association between Frequency of Comparing One's Own Physical Appearance to That of People Being Followed on Social Media and Body Dissatisfaction and Drive for Thinness.

(1) Summary: Many studies have evaluated the association between traditional media exposure and the presence of body dissatisfaction and body image disorders. The last decade has borne witness to the rise of social media, predominantly used by teenagers and young adults. This study’s main objective was to investigate the association between how often one compares their physical appearance to that of the people they follow on social media, and one’s body dissatisfaction and drive for thinness. (2) Method: A sample composed of 1331 subjects aged 15 to 35 (mean age = 24.2), including 1138 subjects recruited from the general population and 193 patients suffering from eating disorders, completed an online questionnaire assessing social media use (followed accounts, selfies posted, image comparison frequency). This questionnaire incorporated two items originating from the Eating Disorder Inventory Scale (Body Dissatisfaction: EDI-BD and Drive for Thinness: EDI-DT). (3) Results: We found an association between the frequency of comparing one’s own physical appearance to that of people followed on social media and body dissatisfaction and drive for thinness. Interestingly, the level of education was a confounding factor in this relationship, while BMI was not. (4) Discussion: The widespread use of social media in teenagers and young adults could increase body dissatisfaction as well as their drive for thinness, therefore rendering them more vulnerable to eating disorders. We should consequently take this social evolution into account, including it in general population prevention programs and in patients’ specific treatment plans.

The Eating Disorder Inventory in the screening for DSM-5 binge eating disorder

BackgroundWe assessed whether the Eating Disorder Inventory (EDI) is suitable for screening binge eating disorder (BED) in young women. MethodYoung women (N=2825) from the 1975–79 birth cohorts of Finnish twins were assessed by questionnaires, including subscales of the EDI. For a subset of women (N=548), we established DSM-5 diagnoses of BED; 16 women had lifetime BED. We compared screening properties of the EDI scales using receiver operating characteristic (ROC) analysis, determined optimal cutoff points, and calculated sensitivities and specificities. ResultsThe best screen for DSM-5 BED was the global score of three subscales (Bulimia, Drive for Thinness, Body Dissatisfaction) with an area under the curve (AUC) of 0.86. Its sensitivity was 87% and specificity 76% at cutoff ≥21. Three individual subscales had acceptable screening properties: Bulimia (AUC 0.83; sensitivity 80%, specificity 78% at cutoff ≥2), Drive For Thinness (AUC 0.82; sensitivity 87%, specificity 72% at cutoff ≥7), and Body Dissatisfaction (AUC 0.81; sensitivity 93%, specificity 60% at cutoff ≥8). ConclusionThe EDI performed well as a screening tool for BED in our community-based sample of young twin women. Future studies should assess its value in other populations and in clinical settings.

Beliefs about exercise: Relationship to eating psychopathology and core beliefs among young female exercisers

ObjectiveThis study had two objectives. First, to determine links between levels of eating psychopathology and beliefs about exercise among young women. Second, to determine the predictive effects of unhealthy core beliefs on exercise beliefs. MethodA convenience sample of 185 young female exercisers completed the Eating Disorders Inventory (EDI), the Exercise Beliefs Questionnaire (EBQ) and the Young Schema Questionnaire (YSQ). ResultsThe participants' mean scores on the EDI were as follows: drive for thinness=0.69 (SD=0.82); body dissatisfaction=1.30 (SD=0.86); and bulimia=0.33 (SD=0.42). There were significant, positive correlations of all three EDI scales with EBQ social and EBQ appearance subscales. In addition, YSQ Defectiveness/Shame beliefs predicted EBQ social scores, while YSQ Unrelenting Standards predicted EBQ appearance scores. DiscussionThose women with relatively unhealthy eating attitudes are likely to believe that exercise will prevent negative social consequences, and are likely to be motivated to exercise in order to preserve or enhance their physical appearance. These same types of exercise belief (regarding social consequences and appearance) are predicted by feelings of defectiveness and shame and by unrelenting high personal standards.

Anorexia nervosa in male adolescents: Body image, eating attitudes and psychological traits

Purpose To evaluate body image and its relationship with psychological and behavioral traits associated with anorexia nervosa in male patients. Methods Thirty male adolescents with anorexia nervosa (AN) were compared with 421 male adolescents from the general population. Body image was evaluated with the Subjective Body Dimensions Apparatus. Eating attitudes were evaluated by the Eating Attitudes Test in its 26-item version (EAT-26). In 19 AN patients and 200 boys from the comparison group, the Eating Disorders Inventory (EDI) was also administered. Results AN patients had higher mean scores in the EAT-26 and the Body Dissatisfaction scale on the EDI, but not on the other EDI scales. Both groups overestimated all parts of their bodies but AN patients presented a greater overestimation of shoulders ( p = .007), hips ( p = .01) and thighs ( p = .019). Correlations in the anorexic group were high and negative between body overestimation and body mass index and also high but positive between overestimation and the EAT and the Drive for Thinness scale on the EDI. Overestimation did not correlate significantly with other EDI scales. Conclusions Male patients with anorexia nervosa overestimate some parts of their bodies more often than controls; this overestimation is related to body mass index, abnormal eating attitudes and drive for thinness, but not to other psychological traits evaluated by the EDI.

Psychometric properties and normative data of the Eating Disorder Inventory among 12 to 18 year old Chinese girls in Hong Kong

The present study examined the psychometric properties of the Eating Disorder Inventory (EDI) among Chinese adolescent girls in Hong Kong. We also attempted to provide normative data for the EDI among 12- to 18-year-old Chinese girls in Hong Kong. Two thousand two hundred and fifty-six high school girls between the age of 12 and 18 years participated in this study. Subjects completed the questionnaire package anonymously at their schools. Findings indicate that the internal consistency estimates for the eight EDI scales were in the acceptable range, with alpha ranging from 0.68 for Perfectionism to 0.87 for Body Dissatisfaction. With the exception of a few items, the item-total correlations were also acceptable for the eight scales. Findings of the principal components analysis support the original eight clinically derived EDI constructs. Group comparison analyses reveal significant age differences and race differences in several EDI scales. EDI percentile scores are presented for girls 12–13 and 14–18 years of age in the present study. This study provides further empirical support to the transcultural validity of the EDI. It also highlights the importance of establishing age- and race-specific norms for the inventory.

Gender, eating behavior, and personality characteristics in physically active students.

The aim of this paper was to examine associations between personality traits, eating disorder (ED) behavior, exercise, and gender. The participants (n=1482: 905 women and 577 men) were students from four universities in Norway. The subjects filled out a compound questionnaire including demographics, weekly hours of exercise, type of sport, Karolinska Scales of Personality (KSP), and the Eating Disorder Inventory (EDI). Because of the data collection procedure, it is difficult to provide a clear-cut response rate in this study. The results showed that the risk ratio for women who scored 40 or higher on the EDI was three times higher compared with men. ED behavior did not seem to be associated with high weekly hours of physical activity in general. There were significant gender differences in personality traits. However, women and men with high scores on the EDI showed no differences on the KSP scales, except on "detachment" and "indirect aggression". The most important predictors for weekly hours of physical activity were the EDI scales "drive for thinness" and "body dissatisfaction", and the personality variables "extraversion" and "neuroticism". The factors that contributed most to the differences between students who scored 40 or higher on the EDI and those who scored below 40 on the EDI were neuroticism, BMI, gender, and age.

Screening of males with1 eating disorders

The purpose of this study was to evaluate two different questionnaires for screening of eating disorders (ED) in males; the Eating Disorders Inventory (EDI) and the Survey for Eating Disorders (SEDs). The study sample consisted of 1196 Norwegian males serving as compulsory military recruits (mean age 19.9, SD = 1.4). The best predictors for having a SEDs-based diagnosis of ED were the EDI scales Drive for thinness (D7), bulimia (B), ineffectiveness (I) and interpersonal awareness (IA). When we classified men with an EDI sum score of 40 or higher as having an ED, the sensitivity was 47% and the specificity was 91%, compared to the SEDs diagnosis of ED. Our results suggest modest agreement between the ability of the EDI and that of the SEDs to identify men with ED. Our results indicate the need of further studies including clinical samples to validate the EDI against the SEDs.

Examining the construct validity of the Eating Disorder Inventory.

The construct validity of the Eating Disorder Inventory (EDI) was examined in 3 samples. An archival clinic sample (n = 318) of women completed the EDI, a structured interview, and the Millon Clinical Multiaxial Inventory-II (MCMI-II). Confirmatory factor analyses (CFAs) indicated that neither null nor 1-factor models of the EDI fit item-level or item-parcel data. The proposed 8-factor model did not fit at the item level but did fit item-parcel data. Reliability estimates of the 8 scales ranged from .82 to .93, and low-to-moderate interscale correlations among the eating and weight-related scales provided partial support for convergent validity. EDI personality scales showed moderate interscale correlations and were associated with MCMI-II scales. A final CFA of the EDI scales supported a 2-factor model (Eating and Weight, Personality) of the 8 EDI scales. Strong associations between depression and several EDI scale scores were found in a treatment study sample (n = 50). The archival clinic sample scored significantly higher on the 8 EDI scales than the nonpatient college comparison sample (n = 487).

Eating disorder behavior in physically active Norwegian women.

Competitive female athletes may have higher risk of eating disorders (ED) than recreational athletes, in part because low body fat may be advantageous in sports. However, women who participate in sports or physical activities might also do this for weight reduction, altering body shape, and for other food related reasons. This study was conducted to evaluate the association between hours of leisure time physical activity (PA) and prevalence of ED, and whether the association between the Eating Disorders Inventory (EDI) scales and ED, as classified by the Survey of Eating Disorders (SED), was the same among women with high vs. low physical activity levels. The community-based study sample consisted of 898 female students aged 18-50 years. Subjects filled out the EDI, the SED, and a questionnaire concerning physical activity and demographic data. Physical activity was not associated with increased risk of having a SED-defined diagnosis of an ED or of having an EDI score greater than 40, which is sometimes used to define women at risk for having an eating disorder. Women with a SED-defined ED had higher scores on all subscales of the EDI, but did not differ with respect to age, BMI or hours of weekly activity. The strongest predictors of having a SED-defined ED were body mass index (BMI), two EDI scales, drive of thinness and Bulimia Nervosa, with no differences between the two PA groups. Among women with a SED-defined ED, those with more than 5 h weekly PA did not differ from others with respect to scoring on the EDI or BMI. Results suggest that hours of physical activity may not increase risk of developing ED. Effective interventions are needed to help the growing numbers of persons with body-image and eating difficulties. For some, moderate physical training might be helpful.

The relationship of social physique anxiety to risk for developing an eating disorder in young females.

To examine the relationships of age, social physique anxiety, and body image dissatisfaction to preoccupation with body weight and shape in young females. Height, weight, and skinfold measurements were obtained from 77 nonobese females (7 to 16 years). Social physique anxiety, body image, and preoccupation with body weight and shape were assessed from the Social Physique Anxiety Scale (SPAS), a Body Image Questionnaire (BIQ), and the Eating Disorder Inventory (EDI). Data were analyzed using Pearson correlations, Chi-square, and hierarchical and stepwise multiple regression. Social physique anxiety was moderately correlated to body image dissatisfaction and body weight and shape concerns. Young females who were more anxious about their physique preferred a smaller body shape and experienced more body weight and shape concerns than those less anxious. The SPAS was a stronger predictor for the EDI scales Body Dissatisfaction and Drive for Thinness than the BIQ or age. Social physique anxiety related to a negative body image and risk for developing an eating disorder as assessed by Body Dissatisfaction and Drive for Thinness in young females.

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The present study examines the question of whether concomitant narcissistic self-disorders indicate a poorer prognosis in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Ninety-one female inpatients who met the DSMIV criteria fo AN or BN were investigated during inpatient treatment by using: a semistructured diagnostic interview, the Eating Disorder Inventory (EDI), the Narcissism Inventory (NI), the Hamburg Obsession-Compulsion Inventory, and the Inventory of Interpersonal Problems (IIP). The patients were divided into two groups: those with and those without narcissistic self-disorders as measured by the NI. Seventy-five patients were assessed at follow-up thirty months after discharge. Fifty-one percent of the follow-up group no longer fulfilled the DSM-IV criteria for AN or BN, and there was no significant correlation with the earlier presence of concomitant narcissistic self-disorders. At follow-up, patients with narcissistic self-disorders had significantly more pathological mean scores than patients without such disorders on four of the eight EDI scales and on four of the eight IIP scales. ANOVA for repeated measures revealed significant improvement over time on seven of the eight EDI scales in both groups. However, significant group-by-time interactions demonstrated that patients with narcissistic self-disorders had improved more over time than patients without selfdisturbances. Furthermore, the obsessive-compulsive Symptoms of those patients with narcissistic self-disorders who no longer fulfilled DSM-IV criteria for AN or BN had significantly decreased. Our findings indicate that the improvement of eating disorder Symptoms corresponds to a decrease in obsessive-compulsive Symptoms. In addition, there is a certain degree of independence between the severity of narcissistic self-disorders and the outcome of AN or BN. The results suggest that concomitant narcissistic self-disorders do not indicate a significantly poorer prognosis in patients with AN and BN.

Emotional eating and eating psychopathology among non-eating-disordered women.

A recent study (Arnow, Kenardy, & Agras, 1995, Journal of Behavioral Medicine, 15, 155-170) has reported on the development and preliminary validation of the Emotional Eating Scale (EES), a questionnaire measure of the tendency to eat in response to affective state. The EES showed high levels of validity among obese binge eaters, but there was no attempt to validate the measure among nonclinical groups. The present study assessed the validity of the EES among nonclinical women, in order to determine whether or not emotional eating is related to unhealthy eating characteristics among the general population. The participants were 51 women with no current or past eating disorder. Each completed the EES and the Eating Disorders Inventory (EDI). Validity of the EES was tested using measures of internal consistency and correlations with EDI scales. The EES scales showed a high level of internal consistency and specific associations with EDI scales (particularly Bulimia, Ineffectiveness, and Interpersonal Distrust). The normative scores for this population were substantially lower than among binge eaters, but similar to those found among other clinical groups. The EES has good levels of validity. It demonstrates that emotional eating is related to bulimic eating attitudes in the broader population, although issues of causality need to be considered. The EES may have a role in the early identification of eating problems in nonclinical groups. Its utility with other eating-disordered groups remains to be established, but there are potential roles in the targeting and evaluation of treatment.

Eye movement abnormalities in anorexia nervosa

The aim of the present study is to investigate smooth pursuit eye movement and saccadic performance in anorexia nervosa during a restored weight period and to determine if functional links can be made between eye movement performance and clinical features. SPEM parameters were recorded for 28 female anorectic out-patients (DSM IV), who had a body weight loss of up to 20% of ideal body weight. Twenty-eight comparison subjects were also tested. Clinically, each patient was assessed using the Eating Disorder Inventory (EDI), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Structured Interview for Personality Disorders (SCID II), the Symptom Checklist-90-Revised (SCL-90-R) and the Hamilton Scale for Depression (HRSD). The anorectic patients performed slightly worse than the comparison subjects on a number of SPEM measures. No relationship was found between SPEM impairment and a global severity index of psychopathology (SCL 90-R GSI) or depressive symptoms. Moreover, OCD symptoms and scores on some EDI scales (such as perfectionism) appear related to the severity of the eye movement alterations. The evidence of SPEM abnormalities in a subgroup of anorectic patients during the remitted state and the relationship of the abnormalities to obsessive-compulsive symptoms are discussed. Results are in agreement with the hypothesis regarding the persistence of neurophysiological as well as psychopathological traits of disorder in anorectic patients.

Mother/Daughter Agreement on the Eating Attitudes Test and the Eating Disorder Inventory

Adolescent self-reports on the Eating Attitudes Test (EAT-26) and the Eating Disorder Inventory (EDI) are used widely to assess eating disorder symptoms. However, no published study has examined agreement between the youth and another source on these measures. This study assessed mother/daughter agreement on the EAT-26 and EDI. Subjects included 319 middle school girls and their mothers. The median correlation between mother and daughter report on the EAT and EDI scales was .22, with a range of .04 to .49. Mother/daughter agreement was highest on body dissatisfaction. Bulimia scales showed near-zero mother/daughter convergence. Maternal reports of their daughters `eating disorder symptoms were significantly lower than daughter self-report means on all but one subscale, the EAT-26 bulimia subscale. Confirmatory factor analyses revealed that subscale structures did not generalize well to mother reports of their daughters' eating disorders.

Obsessive-compulsive disorder among patients with anorexia nervosa and bulimia nervosa

The present study sought to determine the prevalence of obsessive-compulsive disorder among patients with eating disorders. Ninety-three women who met DSM-III-R criteria for anorexia nervosa or bulimia nervosa were investigated by using a semistructured diagnostic interview, the Yale-Brown Obsessive Compulsive Scale, and the Eating Disorder Inventory. Thirty-four patients (37%) met the DSM-III-R criteria for obsessive-compulsive disorder and also had a clinically significant score of 16 or higher on the Yale-Brown scale. These patients also had significantly higher, and hence pathological, mean scores on five of eight Eating Disorder Inventory scales than patients with eating disorders without concomitant obsessive-compulsive disorder. These results suggest that there is a high prevalence of obsessive-compulsive disorder among patients with anorexia and bulimia nervosa and that this prevalence may be correlated with the severity of the eating disorder.

A transcultural comparison of the eating disorder inventory in former east and West Berlin

The Eating Disorder Inventory (EDI) was used in a transcultural study of East and West Berlin clinical and nonclinical samples at a time when the two parts of the city were still strictly separated. East Berlin patients with anorexia nervosa scored significantly lower than their Western counterparts with regard to the majority of EDI scales. Furthermore, there was a lack of discriminant validity for the -East Berlin clinical and nonclinical samples. It was speculated that this deficit might reflect a lack of transcultural validity in the psychological constructs upon which the questionnaire is based. However, the study revealed some evidence of meaningful correlations with clinical parameters. Finally, evidence was presented supporting internal consistency of the subscales and convergent validity of the EDI with the Eating Attitudes Jest (EAT). © 1992 John Wiley & Sons, Inc.

The eating disorder inventory: Its relation to diagnostic dimensions and follow-up status

The present study investigated the stability of the associations between the Eating Disorder Inventory (EDI) and the two diagnostic dimensions reflecting eating disorder symptomatology and ego functioning previously identified (Norring et al., 1989). By relating the EDI and variables reflecting the two dimensions to each other at three different points of time, the EDI scale Bulimia was found to reflect stably the presence of binge eating. Further, the three personality scales Ineffectiveness, Interpersonal Distrust, and Interoceptive Awareness were found to be related strongly to the dimension of ego functioning at all times. To probe the predictive utility of the EDI, we correlated the initial EDI-scores with variables assessed 1 and 2 years later. The Bulimia scale was found to be a stable predictor of the presence of binge eating at both follow-ups. It is concluded that the EDI reflects both of the diagnostic dimensions suggested to be of importance in eating disorders, but that only the Bulimia scale has definite prognostic utility. The comparison of the concurrent and predictive associations of the EDI, suggested that the other scales measure states rather than more stable and lingering aspects of the patients functioning.

Assessment of bulimia nervosa: An evaluation of the eating disorders examination

The Eating Disorders Examination (EDE) is a semistructured interview designed to assess the specific psychopathology of patients with eating disorders. It is claimed that the EDE is more sensitive than standardized self-report questionnaire measures of the central features of bulimia, such as the Eating Disorder Inventory (EDI). This study examined the relative merits of the EDE, EDI, and Restraint Scale (RS) in discriminating between 15 female patients with bulimia nervosa and 15 highly restrained, nonbulimic controls. The groups differed significantly only on the total score and the Bulimia subscale of the EDI. Significant group differences were found on four of the five subscales of the EDE, the exception being the Restraint subscale. The EDE is recommended for future studies of treatment outcome as a superior measure of the core pathology of bulimia nervosa than standardized questionnaires.