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Assessment of Eating Disorders

Posted Sep 22 2008 5:37pm

A number of fine instruments are available to help healthcare professionals assess for eating disorders. Structured instruments, self-report measures, medical, and nutrition assessments offer support for the tasks of diagnosing and treating these illnesses. Professionals from various disciplines (i.e., medicine, psychology, psychotherapy, nutrition) will find utility in the broad variety of available assessment materials.

The type of instrument selected for use will depend on the training and background of the healthcare professional, as well as the goal for assessment. Do you need help with accurate diagnosis? Are you attempting to formulate a treatment plan? Is healthy nutrition your primary goal?

While assessment instruments are not a substitute for a well conducted interview (diagnostic or nutritional), information obtained through the use of assessment materials can assist significantly in understanding a patient's symptoms and clinical presentation, as well as in developing a treatment plan and addressing therapeutic needs.

To assist with diagnosis, semi-structured instruments, such as the Eating Disorder Examination, the Interview for Diagnosis of Eating Disorders, The Yale-Brown-Cornell Eating Disorder Scale, and the Structured Clinical Interview for DSM Axis I Disorders, have high reliability. (In a future post, Treatment Notes will examine the diagnostic interview).

A variety of self-report measures can also be extremely useful in the assessment process. According to Assessment of Eating Disorders, self-report instruments can be useful to quantify symptoms, verify diagnosis, examine specific clinical features, and examine change in a patient's symptoms over time.

Useful self-report measures include:

  • The Eating Disorder Inventory (EDI-3). The EDI-3 includes 12 sub-scales useful for treatment planning and provides normative scores for clinical and illustrative purposes. Responses on individual items provide fruitful content for therapeutic exploration as well.

    Click here to see information about  sample items from the EDI-3: Edi

    Download sample Items EDI-3.jpg Source: Kring, A., Davison, G., & Neale, J. (2005). Abnormal Psychology (10th Ed.). Newe Jersy: John Wiley & Sons.

Measures of dietary restraint such as the Restraint Scale and the Dutch Eating Disorder Questionnaire are useful for dietary assessment, as is the Questionnaire of Eating and Weight Patterns. The Eating Disorders Clinical Pocket Guide offers a wide variety of useful checklists for professionals of varying disciplines.

For assessment related to quality of life, the Impact of Weight on Quality of Life and the Eating Disorders Quality of Life Scale add value to a comprehensive assessment.

Family therapy and family assessment deserves more attention in a future post, however, I would be remiss if I did not mention the importance of family assessment and the assessment of family needs and family strengths here (see Mitchell and Peterson for more about family assessment as well).

Medical assessment, nutritional assessment, and therapeutic assessment worksheets can also be found in the highly recommended resource Eating Disorders: Time for change by Laura Goodman and Mona Villapiano.

Finally, don't forget traditional assessment instruments such as the Beck Depression Inventory and personality measures such as the Millon Clinical Multi-Axial Inventory.

A future Treatment Notes post will highlight instruments useful for body image disturbance.

Source: Mitchell, J.E., & Peterson, C. B. (2005). Assessment of Eating Disorders. New York: The Guilford Press.

Villapiano, M., & Goodman, L.J. (2001). Eating Disorders: Time for change. Philadelphia: Brunner-Routledge.

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