The eating disorder assessment for DSM‐5 (EDA‐5): Development and validation of a structured interview for feeding and eating disorders

Abstract

Objective Existing measures for DSM-IV eating disorder diagnoses have notable limitations, and there are important differences between DSM-IV and DSM-5 feeding and eating disorders. This study developed and validated a new semi-structured interview, the Eating Disorders Assessment for DSM-5 (EDA-5). Method Two studies evaluated the utility of the EDA-5. Study 1 compared the diagnostic validity of the EDA-5 to the Eating Disorder Examination (EDE) and evaluated the test-retest reliability of the new measure. Study 2 compared the diagnostic validity of an EDA-5 electronic application (“app”) to clinician interview and self-report assessments. Results In Study 1, the kappa for EDE and EDA-5 eating disorder diagnoses was 0.74 across all diagnoses (n= 64), with a range of κ=0.65 for Other Specified Feeding or Eating Disorder (OSFED)/Unspecified Feeding or Eating Disorder (USFED) to κ=0.90 for Binge Eating Disorder (BED). The EDA-5 test-retest kappa coefficient was 0.87 across diagnoses. For Study 2, clinical interview versus “app” conditions revealed a kappa of 0.83 for all eating disorder diagnoses (n=71). Across individual diagnostic categories, kappas ranged from 0.56 for OSFED/USFED to 0.94 for BN. Discussion High rates of agreement were found between diagnoses by EDA-5 and the EDE, and EDA-5 and clinical interviews. As this study supports the validity of the EDA-5 to generate DSM-5 eating disorders and the reliability of these diagnoses, the EDA-5 may be an option for the assessment of Anorexia Nervosa, Bulimia Nervosa, and BED. Additional research is needed to evaluate the utility of the EDA-5 in assessing DSM-5 feeding disorders.

The impact of DSM‐5 on the diagnosis and severity indicator of eating disorders in a treatment‐seeking sample

“…Thus, the diagnostic threshold for low weight may be quite variable. Previous studies have used BMI cutoffs ranging from 17.5 kg/m 2 (Keel et al, ; Nakai et al, ) to 18.5 kg/m 2 (Caudle et al, ; Sysko et al, ) as the threshold for low weight. It may be that the DSM‐5 criteria introduces a group of AN patients who show both behavioral and cognitive aspects of eating disorder psychopathology often associated with BN by moving the BMI threshold to 18.5 kg/m 2 in this study.…”

“…The DSM‐5 criteria for eating disorders were based on SCID‐I interviews and the EDE‐Q, as previously documented (Nakai et al, ). We used a BMI cutoff of <18.5 kg/m 2 for DSM‐5 AN diagnoses, following a cutoff recommended to be used in clinical interviews (Sysko et al, ). The two subtype groups of AN (i.e., AN‐R, AN‐BP) in the DSM‐5 as well as DSM‐IV were created based on the occurrence of any self‐reported binge‐eating and purging symptoms within the past 3 months.…”

Avoidant/Restrictive Food Intake Disorder: a Three-Dimensional Model of Neurobiology with Implications for Etiology and Treatment

“…14 The Eating Disorder Assessment for DSM-5 (EDA-5) 15 can be used to confer ARFID diagnoses; however its psychometric properties in relation to ARFID have not yet been tested. A new semi-structured multi-informant interview—the Pica, ARFID, and Rumination Disorder Interview (PARDI)—has recently been developed to diagnose ARFID in children and adults.…”

Changing profile of eating disorders between 1963 and 2004 in a Japanese sample

“…DSM-5 feeding and eating disorder diagnoses were determined retrospectively by ED specialists using a checklist based on the DSM-5 diagnostic criteria, the Great Ormond Street criteria, and related literature (Bryant-Waugh, 2013;Nicholls, Chater, & Lask, 2000;Sysko et al, 2015), which has been previously documented (Nakai, Nin, Noma, Teramukai, & Wonderlich, 2016;Nakai et al, 2017). DSM-5 feeding and eating disorder diagnoses were determined retrospectively by ED specialists using a checklist based on the DSM-5 diagnostic criteria, the Great Ormond Street criteria, and related literature (Bryant-Waugh, 2013;Nicholls, Chater, & Lask, 2000;Sysko et al, 2015), which has been previously documented (Nakai, Nin, Noma, Teramukai, & Wonderlich, 2016;Nakai et al, 2017).…”