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Construction and validation of a new screening questionnaire for eating disorders: the Inventory for theScreening of Eating Disorders (ISED)

Published online by Cambridge University Press:  11 October 2011

Angela Favaro  and
Paolo Santonastaso
Angela Favaro*
Affiliation:
Dipartimento di Scienze Neurologiche e Psichiatriche, Università degli Studi di Padova, Padova
Paolo Santonastaso
Affiliation:
Dipartimento di Scienze Neurologiche e Psichiatriche, Università degli Studi di Padova, Padova
*
Indirizzo per la corrispondenza: Dr.ssa A. Favaro, Clinica Psichiatrica, Dipartimento di Scienze Neurologiche e Psichiatriche, Via Giustiniani 3, 35128 Padova. Fax: +39-049-875.5574 E-mail: santopla@uxl.unipd.it
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Summary

Objective – The study aims to construct and validate a new screening questionnaire for the identification of cases at risk for eating disorders. Setting and sample – We assessed 218 female adolescent students-recruited in a vocational school in Mestre (VE) and 88 patients consecutively referred to the Eating Disorders Unit of the University of Padova. Procedure and main outcome measures – All subjects completed the new questionnaire, the Inventory for the Screening of Eating Disorders (ISED), and the Eating Attitudes Test (EAT). Sixty-two percent of female students and all the patients underwent a structured diagnostic interview (SCID for DSM-IV) for the diagnosis of eating disorders. The reliability, validity and screening ability of the questionnaire have been assessed. Results – The reliability of the ISED, measured by Cronbach's alpha, is good (α=0.87), as is the convergent validity (correlations with EAT). In order to improve the screening ability, the questionnaire has been further divided in two subscales: one for the identification of cases at risk for anorexia nervosa (ISED-AN) and the other for cases at risk for bulimia nervosa (ISED-BN). The screening ability of the two subscales is greater than that of EAT, although the difference is not statistically significant. The ISED cutoff points have greater positive predictive values than those of EAT in the screening of both anorexia nervosa and bulimia nervosa. Conclusions – The ISED appears to-be a valid and reliable questionnaire among female adolescents. Its use might improve the identification of cases at risk for eating disorders and in particular those at risk for anorexia nervosa.Other studies are needed to confirm the validity and performance of the questionnaire among samples of different ages and socio-economic status.

Riassunto

Scopo – Costruzione e validazione di un nuovo strumento di screening per l'identificazione di casi a rischio per disturbi dell'alimentazione. Setting e campione – Sono state valutate 218 adolescenti studentesse reclutate in un Istituto Tecnico di Mestre (VE) e 88 pazienti con disturbo dell'alimentazione afferite consecutivamente all'Ambulatorio per i Disturbi dell'Alimentazione dell'Università di Padova. Procedure e misure utilizzate – Tutti i soggetti hanno compilatoil nuovo questionario Inventory for the Screening of Eating Disorders (ISED) e l'Eating Attitudes Test (EAT). II 62% delle adolescenti e tutte le pazienti sono state sottoposte a intervista clinica strutturata (SCID per DSM-IV), per valutare la presenza di una diagnosi di disturbo dell'alimentazione. Il questionario è stato valutato nella sua affidabilità, validità e capacità di screening. Risultati – L'affidabilità del questionario, misurata attraverso l'alfa di Cronbach è risultata buona (α = 0.87), come anche la validità convergente (correlazione con EAT). Per potenziare la capacità di screening, il questionario è stato suddiviso in due sottoscale, una specifica per identificare i casi di anoressia nervosa (ISED-AN) e una per i casi di bulimia nervosa (ISED-BN). La capacità di screening delle due sottoscale è risultata superiore a quella dimostrata dall'EAT anche se in modo non statisticamente significativo. I punti di cutoff riportati dall'ISED risultano più efficaci dell'EAT nello screening dei casi sia di anoressia nervosa che di bulimia nervosa. Conclusioni – L'ISED si è dimostrato uno strumento valido e affidabile in soggetti adolescenti di sesso femminile. Il suo utilizzo sembra migliorare l'identificazione dei casi a rischio, in particolare per quanto riguarda l'anoressia nervosa. Ulteriori studi sono necessari per confermare l'efficacia e la validità del questionario in campioni più ampi di soggetti di età edestrazione socio-culturale più varia.

Keywords

screeninganorexia nervosabulimia nervosaeating disordersscreeninganoressia nervosabulimia nervosadisturbi dell'alimentazione.
Type
Articles
Information
Epidemiology and Psychiatric Sciences , Volume 9 , Issue 1 , March 2000 , pp. 26 - 35
Copyright
Copyright © Cambridge University Press 2000

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References

BIBLIOGRAFIA

Baldessarini, R.J., Finklestein, S. & Arana, G.W. (1983). The predictive power of diagnostic tests and the effect of prevalence of illness. Archives of General Psychiatry 40, 569–573.CrossRefGoogle ScholarPubMed
Beglin, S.J. & Fairburn, C.G. (1992). Evaluation of a new instrument for the detection of eating disorders in community samples. Psychiatry Research 44, 191–201.CrossRefGoogle ScholarPubMed
Button, E.J. & Whitehouse, A. (1981). Subclinical anorexia nervosa. Psychological Medicine 11, 509–516.CrossRefGoogle ScholarPubMed
Clarke, D.M., Smith, G.C. & Herman, H.E. (1993). A comparative study of screening instruments for mental disorders in general hospital patients. International Journalof Psychiatry in Medicine 23, 323–337.CrossRefGoogle ScholarPubMed
Cooper, P.J. & Fairburn, C.G. (1983). Binge-eating and self-induced vomiting in the community: a preliminary study. British Journal of Psychiatry 142, 139–144.CrossRefGoogle ScholarPubMed
Cotrufo, P., Barretta, V., Monteleone, P. & Maj, M. (1998). Full-syndrome, partial-syndrome and subclinical eating disorders: an epidemiological study of female students in Southern Italy. Acta Psychiatrica Scandinavica 98, 112–115.CrossRefGoogle ScholarPubMed
Crisp, A., Callender, J.S., Halek, C. & Hsu, L.K.G. (1992). Long term mortality in anorexia nervosa. British Journal of Psychiatry 161, 104–107.CrossRefGoogle ScholarPubMed
Cuzzolaro, M. & Petrilli, A. (1988). Validazione della versione italiana dell'EAT-40. Psichiatria dell'Infanzia e dell'Adolescenza 55, 209–217.Google Scholar
Fairbum, C.G. & Beglin, S.J. (1990). Studies of the epidemiology of bulimia nervosa. American Journal of Psychiatry 147, 401–408.Google Scholar
Favaro, A. (1997). Identificazione dei casi nei disturbi dell'alimentazione: costruzione di un nuovo questionario. Tesi di Dottorato di Ricerca in Scienze Psichiatriche, Padova.Google Scholar
Favaro, A. & Santonastaso, P. (1995). Dissociative experiences, trauma andeating disorders in a female college sample. European Eating Disorders Review 3, 196–200.CrossRefGoogle Scholar
Ferrara, S. (1998). I disturbi del comportamento alimentare nella popolazione generatefemminile. Uno studio epidemiologico condotto fra le giovani donne di due comunità del padovano. Tesi di Dottorato di Ricerca in Medicina di Comunità, Padova.Google Scholar
First, M.B., Spitzer, R.L., Gibbon, M. & Williams, J.B.W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders. Biometrics Research Department: New York.Google Scholar
Ford, D.E. (1988). Principles of screening applied to psychiatric disorders. General Hospital Psychiatry 10, 177–188.CrossRefGoogle ScholarPubMed
Garfinkel, P.E., Lin, E., Goering, P., Spegg, C., Goldbloom, D.S., Kennedy, S., Kaplan, A.S. & Woodside, D.B. (1995). Bulimia nervosa in a Canadian community sample: prevalence and comparison of subgroups. American Journal of Psychiatry 152, 1052–8.Google Scholar
Garfinkel, P.E., Lin, E., Goering, P., Spegg, C., Goldbloom, D., Kennedy, S., Kaplan, A.S. & Woodside, D.B. (1996). Should amenorrhoea be necessary for the diagnosis of anorexia nervosa? Evidence from a Canadian community sample. British Journal of Psychiatry 168, 500–506.CrossRefGoogle ScholarPubMed
Garner, D.M. & Garfinkel, P.E. (1979). The Eating Attitudes Test: an indexof the symptoms of anorexia nervosa. Psychological Medicine 9, 273–279.CrossRefGoogle Scholar
Garner, D.M., Olmsted, M.P., Bohr, Y. & Garfinkel, P.E. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine 12, 871–878.CrossRefGoogle ScholarPubMed
Garner, D.M., Olmstead, M.P. & Polivy, J. (1983). Development and validation of a multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia. Intemationl Journal of Eating Disorders 2, 15–35.3.0.CO;2-6>CrossRefGoogle Scholar
Goldberg, D., Bridges, K., Duncan-Jones, P. & Grayson, D. (1988). Detecting anxiety and depression in general medical settings. British Medical Journal 297, 897–899.CrossRefGoogle ScholarPubMed
Halmi, K.A., Falk, J.R. & Schwartz, E. (1981). Binge-eating and vomiting: a survey of a college population. Psychological Medicine 11, 697–706.CrossRefGoogle ScholarPubMed
Hanley, J.A. & McNeil, B.J. (1982). The meaning and use of the area under Receiver Operating Characteristic (ROC) curve. Radiology 143, 29–36.CrossRefGoogle ScholarPubMed
Hanley, J.A. & McNeil, B.J. (1983). A method of comparing the areas under Receiver Operating Characteristics curves derived from the same cases. Radiology 148, 839–843.CrossRefGoogle ScholarPubMed
Hoek, H.W. (1993). Review of the epidemiological studies of eating disorders. International Review of Psychiatry 5, 61–74.CrossRefGoogle Scholar
Hsiao, J.K., Bartko, J.J. & Potter, W.Z. (1989). Diagnosing diagnoses. Archives of General Psychiatry 46, 664–667.CrossRefGoogle ScholarPubMed
King, M. (1998). The epidemiology of eating disorders. Epidemiologia e Psichiatria Sociale 7, 32–41CrossRefGoogle ScholarPubMed
King, M.B. (1989). Eating Disorders in a General Practice Population: Prevalence, Characteristics and Follow-up at 12 to 18 Months. Psychological Medicine Monograph Supplement No. 14, pp. 1–34.CrossRefGoogle Scholar
Leon, A.C., Portera, L., Olfson, M., Weissman, M.M., Kathol, R.G., Farber, L., Sheehan, D.V. & Pleil, A.M. (1997). False positive results: A challenge for psychiatric screening in primary care. American Journal of Psychiatry 154, 1462–1464.Google ScholarPubMed
McKenzie, D.P. & Clarke, D.M. (1992). Cutoff: a fortran program for establishing thresholds for screening indices. Educational and Psychological Measurement 52, 891–893.CrossRefGoogle Scholar
Meadows, G.N., Palmer, R.L.Newball, E.U.M. & Kenrick, J.M.T. (1986). Eating attitudes and disorder in young women: a general practice based survey. Psychological Medicine 16, 351–357.CrossRefGoogle ScholarPubMed
Mintz, L.B., O'Halioran, M.S., Mulholland, A.M. & Schneider, P.A. (1997). Questionnaire for eating disorder diagnoses: reliability and validity of operationalizing DSM-IV criteria into a self-report format. Journal of Counseling Psychology 44, 63–79.CrossRefGoogle Scholar
Murphy, J.M., Berwick, D.M., Weinstein, M.C., Borus, J.F., Budman, S.H. & Klerman, G.L. (1987). Performance of screening and diagnostic tests. Archives of General Psychiatry 44, 550–555.CrossRefGoogle ScholarPubMed
Santonastaso, P. & Favaro, A. (1997). Aspetti epidemiologici dei disordinidel comportamento alimentare. In Disordini del Comportamento Alimentare: Anoressia Nervosa e BulimiaNervosa (ed. Miiller, E.E. e Brambilla, F.), pp. 329–348. Pythagora: Milano.Google Scholar
Santonastaso, P., Zanetti, T., Sala, A., Favaretto, G., Vidotto, G. & Favaro, A. (1996). Prevalence of eating disorders in Italy: a survey on a sample of sixteen-years-old female students. Psychotherapy and Psychosomatics 65, 158–162.CrossRefGoogle Scholar
Santonastaso, P., Zanetti, T., Ferrara, S., Olivotto, M.C., Magnavita, N., Favaro, A. (1999). A preventive intervention program in adolescent schoolgirls: a longitudinal study. Psychotherapy and Psychosomatics 68, 46–50.CrossRefGoogle ScholarPubMed
Spitznagel, E.L. & Helzer, J.E. (1985). A proposed solution to the base rate problem in the Kappa statistics. Archives of General Psychiatry 42, 725–728.CrossRefGoogle Scholar
Sullivan, P.F., Bulik, C.M., Carter, F.A., Gendall, K.A. & Joyce, P.R. (1996). The significance of a prior history of anorexia in bulimia nervosa. International Journal of Eating Disorders 20, 253–261.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Wells, J.E., Coope, P.A., Gabb, D.C. & Pears, R.K. (1985). The factor structure of the Eating Attitudes Test with adolescent schoolgirls. Psychological Medicine 15, 141–146.CrossRefGoogle ScholarPubMed
Whitaker, A., Johnson, J., Shaffer, D., Rapoport, J.L., Kalikow, K., Walsh, B.T., Davies, M., Braiman, S. & Dolinsky, A. (1990). Uncommon troubles in young people: prevalence estimates of selected psychiatric disorders in a non-referredadolescent population. Archives of General Psychiatry 47, 487–496.CrossRefGoogle Scholar
Williams, P., Hand, D. & Tamopolsky, A. (1982). The problem of screening for uncommon disorders - a comment on the Eating Attitudes Test. Psychological Medicine 12, 431–434.CrossRefGoogle ScholarPubMed
Wood, A., Waller, G., Miller, J. & Slade, P. (1992). The development of Eating Attitude Test scores in adolescence. International Journal of Eating Disorders 11, 279–282.3.0.CO;2-O>CrossRefGoogle Scholar