The earlier an eating disorder is diagnosed, the less entrenched the behaviors are and the earlier treatment can be provided. Eating disorder assessments can help identify them.
For those that struggle with these dangerous disorders, “the first years of illness appears to offer a critical window for recovery, beyond which outcomes are poorer (1).” This makes expedient and accurate diagnosis crucial to treatment and recovery.
Current Eating Disorder Assessments
Diagnosing these disorders does not solely involve checking off criteria from the Diagnostic and Statistical Manual of Eating Disorders (DSM-5), as even this method has room for professional or client self-report error.
For this reason, specific assessments have been created to streamline testing for eating disorders, essentially making it so that the same criteria are being objectively evaluated no matter who is giving the assessment or where.
Professionals are constantly searching for ways to improve upon and find the most accurate eating disorder assessment tools.
Some of these include the Eating Disorder Examination (EDE), the Structured Clinical Interview for DSM Axis 1 Disorders (SCID-5), the Eating Disorder Diagnostic Scale (EDDS), and the Composite International Diagnostic Interview (CIDI).
The limitations of each of these assessment tools vary. For example, both the EDE and the SCID don’t assess for pica or rumination disorder. The EDE also “lacks information relevant to ARFID (Avoidant and Restrictive Food Intake Disorder) (1).”
There is also an issue with accessibility for each assessment tool. The EDE is free; however, those that want to use it must complete a specialized training that itself has limited accessibility (1). It can also be a lengthy assessment, taking between 45 to 90 minutes to complete.
The SCID has the opposite challenge in that it is not freely available but is briefer than the EDE.
THE CIDI has the most limitations, as it lacks an update that coincides with the International Classification of Disease manual, and, when this update is complete, it will not have an edition on eating disorders or be publically available (1).
These limitations have motivated researchers to keep pursuing and testing new eating disorder assessments that may tick all the boxes of accuracy, brevity, and accessibility.
Enter the Eating Disorder Assessment for DSM-5, which was “developed to provide a guide to conducting semi-structured interviews to assess whether an individual meets criteria for an eating disorder according to the DSM-5 criteria (1).”
This assessment is “web-based and freely available and was developed to minimize participant and interviewer burden.” It is the only assessment currently available that assesses all of the feeding and eating disorders outlined in the DSM-5.
Like many assessment tools, the EDA-5 involves an interview.
The difference between this and other assessments is that the EDA-5 implements an algorithm that “implements diagnostic ‘skip rules’ that avoid asking questions no longer relevant to making a diagnosis (1).”
Essentially, the test learns from answers to previous questions what is no longer applicable and does not continue to ask non-applicable questions. In doing so, responses narrow to symptoms that are applicable to provide more information on those behaviors specific to the individual.
In addition to all of these benefits, the EDA-5 has been proven effective at it’s most important aspect – accuracy.
One study found that the Norwegian version of the EDA-5 “quickly and efficiently generated DSM-5 diagnoses without compromising diagnostic accuracy (1).”
The study ultimately determined that the EDA-5 acts as a “promising alternative to existing diagnostic tools, and may facilitate the identification of eating disorders in clinical settings (1).” The EDA-5 has also been compared to the existing EDDS, and high rates of agreements were found between the two (1).
For those eating disorder professionals seeking an accurate and quick assessment tool, it seems the EDA-5 measures up, and in some ways surpasses, those currently in use.
Resources: Dahlgren, C.L., et al. (2020). Eating disorder diagnostics in the digital era: validation of the Norwegian version of the eating disorder assessment for dsm-5 (EDA-5). Journal of Eating Disorders, 8:30.
About the Author:
Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published September 11, 2020, on EatingDisorderHope.com
Reviewed & Approved on September 11, 2020, by Jacquelyn Ekern MS, LPC