Work

Adapting the eating disorder examination questionnaire (EDE-Q) and the clinical impairment assessment (CIA) for an adult inpatient eating disorder service

Year: 2025

Type: article

Abstract: The 28-item Eating Disorder Examination Questionnaire (EDE-Q) and the 16-item Clinical Impairment Assessment (CIA) are widely used for measuring eating disorder psychopathology, but they were both designed for outpatient populations. This two-stage project aimed to adapt the EDE-Q and the CIA to be applicable to an adult inpatient eating disorder service. In the first stage, feedback was sought from staff and patients at a specialist adult inpatient eating disorder service in the south of England, verbally, in writing, and during focus groups. This feedback was used to adapt the questionnaires. In the second stage, the adapted questionnaires were trialled by current patients. Qualitative data were collected via semi-structured interviews from patients who trialled the adapted questionnaires, from which themes were analysed using the Framework Method. Quantitative and qualitative feedback was provided by 11 staff members and 13 patients. This was used to develop adapted, inpatient versions of the EDE-Q (the 18-item EDE-I) and CIA (the 10-item CIA-I). During subsequent interviews (N = 9) patients were positive about the adapted measures, especially the shorter time frame and the removal and rephrasing of specific questions, to better reflect their experiences as inpatients. This project offers a promising adaptation to established psychometric measures for inpatients being treated for an eating disorder. Future research may wish to establish psychometric validation of the EDE-I and CIA-I to support a more appropriate way of measuring psychopathology and progress for people receiving treatment in hospital. This study looked at two questionnaires commonly used to measure eating disorder symptoms. The Eating Disorder Examination Questionnaire and the Clinical Impairment Assessment both ask patients about how often they think or worry about eating, shape and weight; how often they use eating disorder behaviours (such as not eating enough or making themselves sick); and how much their eating disorder gets in the way of them living their lives. These questionnaires were developed for outpatients but are also used with inpatients. Inpatients in a hospital in England told staff that some of the questions on these two questionnaires were not appropriate for them. This study aimed to adapt the two questionnaires to make them more suitable for inpatients, using feedback from staff and patients. Patients were then invited to try using the new inpatient versions of the questionnaires. After this, patients who had tried the new questionnaires were invited to take part in an interview and share their thoughts about the changes. There was positive feedback about the adapted questionnaires, which may be better for measuring eating disorder symptoms and progress, for people in hospital, by asking questions that are more appropriate for their type of treatment.

Source: Journal of Eating Disorders

DOI: 10.1186/s40337-025-01364-1

Authors: Sean Hill, Rohan Borschmann, Alex Lau-Zhu, Layla Hamadi

Institutions: University of Oxford, Oxford Health NHS Foundation Trust, Nottingham Trent University, Imperial College London

Language: English

Topic: Eating Disorders and Behaviors

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,190