Test–Retest Reliability of Common Measures of Eating Disorder Symptoms in Men Versus Women

Abstract

Approximately 10% to 30% of individuals with eating disorders (EDs) are male, yet because measures often have not been tested among male participants, it is unclear whether the psychometric properties of ED measures are equivalent between sexes. The purpose of this study was to compare the test-retest reliability of common ED measures in men versus women. Participants ( N = 227; 58.1% female) completed self-report measures of body dissatisfaction, restrained eating, disinhibited eating, bulimic symptoms, and desire-for-muscularity at baseline and 2-to-4 weeks later. Intraclass correlations were used to compute retest correlations. Spearman's rho was used to compute retest correlations for skewed and kurtotic variables. We compared 95% confidence intervals for intraclass correlation coefficients to determine whether measures differed in reliability between sexes. Most ED measures had at least acceptable test-retest reliabilities. However, few measures of disinhibited and binge eating demonstrated good reliability in men. Results highlight the utility of several ED measures for assessing symptom change over time, and the need for additional research to identify and correct for sources of gender unreliability among ED self-report measures in men-particularly for assessing constructs that include binge-eating behavior.

Low testosterone is associated with dysregulated eating symptoms in young adult men

“…The Eating Pathology Symptoms Inventory (EPSI; Forbush et al, 2013) was used to assess binge-eating symptoms (e.g., consuming a large amount of food in a short period of time, eating in the absence of hunger) during the past 4 weeks. The EPSI binge-eating subscale has shown adequate test-retest reliability (Forbush et al, 2013;Forbush et al, 2019) and good internal consistency in previous samples of men (α = .74-.86;Forbush, Wildes, & Hunt, 2014;Forbush et al, 2019;Shope, Prows, Racine, & Culbert, 2020) and this study (α = .84). There is also evidence of criterion-related validity.…”

“…The Eating Disorder Examination Questionnaire (EDE‐Q; Fairburn & Beglin, 1994) was used to assess eating concerns (e.g., the tendency to experience feelings of guilt about eating, preoccupation with food/eating, eating in secret) that commonly occur with nonhomeostatic eating (Racine, Hagan, & Schell, 2019) and the frequency of binge‐eating episodes over the past 4 weeks. The eating concerns subscale has been found to have adequate test–retest reliability (Forbush, Hilderbrand, Bohrer, & Chapa, 2019) and internal consistency ( α = .77–.78; Forbush et al, 2019; Lavender, De Young, & Anderson, 2010) in prior samples of men and this study ( α = .78). It has also shown good criterion‐related validity—individuals with binge‐eating disorder have been found to score significantly higher on the eating concerns scale than controls (Vander Wal, Stein, & Blashill, 2011).…”

“…The binge‐eating frequency item has shown adequate convergent validity with other measures of dysregulated eating (Mond, Hay, Rodgers, Owen, & Beumont, 2004), including in this study (see moderate intercorrelations above). However, because self‐reported binge‐eating frequency have been found to be less reliable using questionnaires than interviews (Berg, Peterson, Frazier, & Crow, 2012) and less stable over time, particularly in men (Forbush et al, 2019), analyses using this item were considered exploratory and should be interpreted with some caution.…”

“…The Eating Disorder Examination Questionnaire (EDE-Q; Fairburn & Beglin, 1994) was used to assess eating concerns (e.g., the tendency to experience feelings of guilt about eating, preoccupation with food/ eating, eating in secret) that commonly occur with nonhomeostatic eating (Racine, Hagan, & Schell, 2019) (Mond, Hay, Rodgers, Owen, & Beumont, 2004), including in this study (see moderate intercorrelations above). However, because self-reported binge-eating frequency have been found to be less reliable using questionnaires than interviews (Berg, Peterson, Frazier, & Crow, 2012) and less stable over time, particularly in men (Forbush et al, 2019), analyses using this item were considered exploratory and should be interpreted with some caution.…”

A new approach to eating‐disorder classification: Using empirical methods to delineate diagnostic dimensions and inform care

“…We created these composite items due to low base rates of responses for individual diuretic and diet pill items. Past research supports the internal consistency, test–retest reliability, and factor–structure replicability of the EPSI in a range of samples (Forbush, Hilderbrand, Bohrer, & Chapa, , in press; Tang, Forbush, & Lui, ). In the current study, the median coefficient alpha was .84.…”