Network-based validation of the psychometric questionnaire EDI-3 for the assessment of eating disorders

Abstract

Assessing the validity of a psychometric test is fundamental to ensure a reliable interpretation of its outcomes. Few attempts have been made recently to complement classical approaches (e.g., factor models) with a novel technique based on network analysis. The objective of the current study is to carry out a network-based validation of the Eating Disorder Inventory 3 (EDI-3), a questionnaire designed for the assessment of eating disorders. Exploiting a reliable, open source sample of 1206 patients diagnosed with an eating disorder, we set up a robust validation process encompassing detection and handling of redundant EDI-3 items, estimation of the cross-sample psychometric network, resampling bootstrap procedure and computation of the median network of the replica samples. We then employed a community detection algorithm to identify the topological clusters, evaluated their coherence with the EDI-3 subscales and replicated the full validation analysis on the subpopulations corresponding to patients diagnosed with either anorexia nervosa or bulimia nervosa. Results of the network-based analysis, and particularly the topological community structures, provided support for almost all the composite scores of the EDI-3 and for 2 single subscales: Bulimia and Maturity Fear. A moderate instability of some dimensions led to the identification of a few multidimensional items that should be better located in the intersection of multiple psychological scales. We also found that, besides symptoms typically attributed to eating disorders, such as drive for thinness, also non-specific symptoms like low self-esteem and interoceptive deficits play a central role in both the cross-sample and the diagnosis-specific networks. Our work adds insights into the complex and multidimensional structure of EDI-3 by providing support to its network-based validity on both mixed and diagnosis-specific samples. Moreover, we replicated previous results that reinforce the transdiagnostic theory of eating disorders.

Psychometric network analysis of the Intuitive Eating Scale‐2 in Chinese general adults

“…Despite the underlying connections between psychometric network analysis and latent variable modeling (Kruis & Maris, 2016), the use of network psychometrics may have certain advantages, such as identifying the network structure of variables (i.e., nodes) and allowing the visualization of the strength of the (partial) correlations between variables (i.e., edges; Hevey, 2018). Thus, psychometric network analysis may provide new perspectives to evaluate the structure and dynamics of psychological tools in mental health settings, including tools for assessing eating behaviors (e.g., Laskowski et al, 2023;Punzi et al, 2023). For example, using psychometric network analysis, Laskowski et al (2023) revealed that the original factor model of the Eating Disorder Examination-Questionnaire (EDE-Q) might not be optimal for women with EDs; thus, they suggested using different scorings of the EDE-Q in women with EDs for screening purposes or for evaluating the effects of interventions.…”

Clinical Factors Associated with Binge-Eating Episodes or Purging Behaviors in Patients Affected by Eating Disorders: A Cross-Sectional Study

“…Among these, the Eating Disorder Inventory (EDI) [ 5 , 6 ] and the Eating Disorder Examination (EDE) are prominent [ 7 ]. The EDI-3 is a standardized, self-report questionnaire assessing the main symptoms and psychological features of EDs [ 8 ]. The EDE-17 is a semi-structured, clinician-administered interview designed to evaluate specific aspects of ED psychopathology, as well as the severity of dysfunctional eating behaviors and attitudes [ 9 ].…”