The Wiley Handbook of Eating Disorders, First Edition. Edited by Linda Smolak and Michael P. Levine.
© 2015 John Wiley & Sons, Ltd. Published 2015 by John Wiley & Sons, Ltd.
Research Tools for Assessing
Eating Disorders
Drew A. Anderson, Katherine Schaumberg, Erin E. Reilly,
and Lisa M. Anderson
Department of Psychology, University of Albany (SUNY), USA
40
Assessment in a research context can be challenging. Research studies, particularly treatment
outcome studies, are costly and involve enormous amounts of time and effort, and decisions
about how and when to conduct assessments can have a significant impact on the conclusions
that can be drawn from a given research study. While there are numerous instruments available
for assessing disordered eating, eating disorders (EDs), and associated psychopathology
(Allison, 2009; Mitchell & Peterson, 2005), not all of these instruments are equally appropriate
for assessment in a research context (Anderson & Murray, 2010). How then should researchers
decide which measures to use in a research study? This chapter will provide some guidelines for
those struggling with decisions about which measures to use in a research context. While we
emphasize the use of assessment measures for treatment outcome research, the guidelines are
applicable across research contexts.
Which Method of Assessment?
Researchers have many methods of assessment from which to choose, from interviews to self‐
report instruments to behavioral measures such as test meals. While it is beyond the reach of
this chapter to discuss all aspects of choosing a method of assessment, we will review some
issues particularly pertinent to the assessment of eating disorders.
Which Method of Assessment is Most Accurate?
It has been widely assumed that structured interviews represent the criterion method by which
to assess ED symptomatology. In fact, one interview, the Eating Disorder Examination (EDE;
Fairburn & Cooper, 1993; Fairburn, Cooper, & O’Connor, 2008), has been frequently described
as the gold standard measure of ED symptomatology (Wade, Tiggemann, Martin, & Heath,
1997; Wilson, 1993; see also Chapter 38). While a number of studies have found discrepancies
between rates of endorsement of ED‐related constructs on interview versus questionnaire
methods of assessment, it has generally been assumed that an interview allows for more detailed
Anderson, D. A., Schaumberg, K., Reilly, E. E., & Anderson, L. M. (2015). Research tools for assessing eating disorders. In L. Smolak & M. P. Levine (Eds.), The Wiley
handbook of eating disorders (Vol. 2, pp. 537–554). Chichester, UK: John Wiley & Sons.
538	 Drew A. Anderson et al.
questioning and thus more accurate rates of responding (Anderson & Murray, 2010). However,
a growing number of studies suggest that some individuals are embarrassed by and ashamed of
their eating‐disordered behavior and thus minimize their symptoms to a greater degree when
having to discuss them face to face as opposed to a questionnaire (Anderson & Murray, 2010).
Thus, it is not clear which method of assessment is most accurate. Until this issue is resolved, we
recommend the use of both interview and self‐report instruments.
Behavioral Measures of Eating Behavior
Denial and minimization are common problems in the assessment of ED symptomatology
(Anderson, Lavender, & De Young, 2010). Moreover, humans are notoriously inaccurate at
reporting food intake (Forrestal, 2011; Rutishauser, 2005; see also Chapter 24). Thus, it can be
extremely useful to get an accurate assessment of eating behavior by directly observing eating using
test meals or other similar approaches. Test meals allow for the assessment of multiple aspects of
eating behavior and can be an excellent way to verify the validity of self‐report assessment tools.
Guidelines have been developed for the use of test meals as an assessment measure (Anderson
& Paulosky, 2004; Williamson, 1990), although, as will be discussed later in this chapter, they
do not appear to have been widely adopted. Nevertheless, we recommend the use of behavioral
measures of eating behavior such as test meals whenever feasible.
How Often to Assess?
The simplest strategy for assessing change is to assess participants before and after an intervention.
This strategy has the advantages of being time‐ and cost‐effective. However, it does not allow for
a more detailed examination of the treatment process. Treatment outcome research, both within
the ED field and without, is increasingly moving away from investigating simpler questions such
as “Does this therapy work?” to investigating more complex questions of mediation, essentially
“How does this therapy work?” (Kazdin, 2009; Kraemer, Stice, Kazdin, Offord, & Kupfer, 2001;
Kraemer, Wilson, Fairburn, & Agras, 2002; Murphy, Cooper, Hollon, & Fairburn, 2009).
Answering such questions requires much more attention to the timing and frequency of
assessments; in order to demonstrate mediation, change in the mediator needs to be shown to
have occurred prior to change in the outcome of interest, and such changes often occur rapidly
in the treatment process (Kazdin, 2009; Murphy et al., 2009). Thus, the best advice for
assessment might be to assess early and often, perhaps even at every session.
How to Pick Specific Measures
Researchers can choose specific assessment measures for a multitude of reasons. In this section
we will focus on two main justifications for choosing assessment measures and discuss the pros
and cons of each.
Popularity
Sometimes researchers choose measures based on what others have used in previous
studies or what measures are widely used in the literature. There are good reasons to do
so; for example, using common measures allows for easy comparison across studies. This
	 Research Tools for Assessing Eating Disorders 	 539
practice can be problematic, however, when the commonly used measures do not accurately
reflect the constructs of interest in a given research study. Also, the specific measures
that are used commonly in the EDs literature have changed over time (aee
Chapter 38).
Historical Patterns in the Use of Assessment Instruments for Treatment Outcome  An early review
of measures used in studies of bulimia nervosa (BN; Williamson, Anderson, & Gleaves, 1996)
found considerable diversity in the type and number of measures used to evaluate treatment
outcome. Most studies used multiple self‐report questionnaires, and only one measure (the
Eating Attitudes Test [EAT]; Garner & Garfinkel, 1979; Garner, Olmsted, Bohr, & Garfinkel,
1982) was used in 50% or more of the studies. Also, the EDE (Fairburn & Cooper, 1993;
Fairburn et al., 2008) was used in fewer than 20% of studies.
A review in the mid‐2000s (Anderson & Paulosky, 2004) found that patterns of assessment
in treatment outcome research had changed somewhat. Although a large number of measures
were still in use, three instruments had come to dominate the field. In studies of both anorexia
nervosa (AN) and BN, two self‐report measures were overwhelming favorites; the EAT and
variations of the Eating Disorders Inventory (EDI; Garner, 1991; Garner, Olmstead, &
Polivy, 1983). Use of the EDE remained steady. The majority (i.e., over 80%) of the reviewed
studies of BN used self‐report tools (often in the form of food records) to measure binging
and purging.
These patterns have changed considerably in recent years. Tables 40.1–40.5 show the
assessment measures used in recent treatment trials for EDs using cognitive‐behavior
therapy (CBT), family‐based therapy (FBT), interpersonal therapy (IPT), dialectical
behavior therapy (DBT), and mindfulness‐based therapies (see Chapters 56, 57, 60, & 62).
Table 40.6 provides more specific information about the various measures. As can be seen
from these tables, while a wide variety of self‐report measures are still being used, the questionnaire
version of the EDE (EDE‐Q; Fairburn & Beglin, 1994, 2008) has increased in
popularity, particularly in trials of CBT. The EDE itself has also come to be used widely,
again particularly among trials of CBT. This is in some ways not surprising, as the EDE and
EDE‐Q were designed by the primary developer of CBT‐based treatments for EDs
(Fairburn, 2008), and thus are a good theoretical match with CBT. As can be seen in the
tables, however, it has also been used in studies of therapies other than CBT. Neither the
EAT nor the EDI have been commonly used in more recent studies. Also in contrast to
previous reviews, the use of self‐monitoring as an assessment measure has decreased markedly.
Conversely, the use of body mass index (BMI) as an outcome measure has increased
markedly. This is to be expected; this review included trials of FBT for AN where previous
reviews emphasized trials for BN, and more recent trials of CBT have included underweight
individuals. In these cases change in BMI is a critical outcome measure. Finally,
although they have been recommended (e.g., Anderson & Murray, 2010), behavioral measures
of eating, such as test meals, remain rare.
As noted previously, the fact that a small number of assessment instruments have
become popular in treatment outcome research (i.e., the EDE, EDE‐Q, and BMI) is a
positive development in that it allows for comparisons across studies. The EDE and
EDE‐Q also have very respectable psychometrics (Allison, 2009). Thus, although
there  have been some slight concerns about the EDE as an instrument (Anderson,
De Young, & Walker, 2009), we encourage the use of these measures in research contexts
whenever possible.
Table 40.1  Measures used in recent randomized controlled trials: cognitive‐behavioral therapy for eating disorders.
BASS a
BIATQ b
BMI c
BSQ d
BAT e
BITE f
EAT‐26 g
  EDE h
EDE‐Q i
EDI j
Global
AN k
Hunger
Ratings
(Visual
Analogue
Scale) M‐R l
SIAB‐
EX m
Self‐
monitoring
Test
meal SIBID n
TFEQ o
YBC‐
ED p
Fairburn et al.
(2009)
X X X
Pike et al.
(2003)
X X
McIntosh et al.
(2005)
X X X X
Wilfley et al.
(2002)
X X
Hilbert &
Tuschen‐
Caffier (2004)
X X X
Grilo et al.
(2012)1
X X X X
Grilo et al.
(2012)2
X X
Sanchez‐Ortiz
et al. (2011)
X
Mitchell et al.
(2011)
X X X
Byrne et al.
(2011)
X X X X
Fairburn et al.
(2013)
X X X
Dalle Grave
et al. (2013)
X X
Marco et al.
(2013)
X X X X X X
Wagner et al.
(2013)
X X
Munsch et al.
(2012)
X X
Masheb et al.
(2011)
X X X X X
Grilo &
Masheb
(2005)
X X X X X
Ruwaard et al.
(2012)
X X
Wilson et al.
(2010)
X
Note. a
 Body Areas Satisfaction Scale, b
 Body Image Automatic Thoughts Questionnaire, c
 Body Mass Index, d
 Body Shapes Questionnaire, e
 Body Attitudes Test, f 
Bulimic Inventory Test,
Edinburgh, g
 Eating Attitudes Test‐26, h
 Eating Disorders Examination, i
 Eating Disorders Examination Questionnaire, j
 Eating Disorders Inventory‐II, k
 Global Rating of Anorexia‐Nervosa,
l
 Morgan‐Russell Outcome Criteria, m
 Structured Interview for BN/AN, n
 Situational Inventory of Body Image Dysmorphia, o
 Three Factor Eating Questionnaire, p
 Yale‐Brown‐Cornell
Eating Disorders Scale.
1
 Grillo, White, Wilson, Gueorguieva, & Masheb (2012); 2
 Grilo, Crosby, Wilson, & Masheb (2012).
Table 40.2  Measures used in recent randomized controlled trials: family‐based therapy.
BMI a
ChEAT b
Course
of ED c
DSM‐IV d
EATATE e
EAT f
EDE‐Q g
EDE h
EDI i
ICD‐10 j
M‐Rk
Relapse l
SEED m
YBC‐EDn
Dare et al.
(2001)
X X X X
Eisler et al.
(2000)
X X X X X X X
Geist et al.
(2000)
X X
LeGrange et al.
(2007)
X X X
Levine et al.
(2001)
X X
Lock et al.
(2005)
X X X X X
Lock et al.
(2010)
X X X X X
Schmidt
et al. (2007)
X X X
Note. a
 Body Mass Index, b
 Children’s Eating Attitudes Test, c
 Course of Disorder (i.e., duration previous treatment), d
 Criteria for ED—Diagnostic and Statistical Manual for
Mental Disorders 4th ed., text revision, e
 EATATE semistructured interview (based on Longitudinal Interval Follow‐Up Evaluation), f
 Eating Attitudes Test‐40, g
 Eating
Disorders Examination‐Questionnaire, h
 Eating Disorders Examination, i
 Eating Disorders Inventory‐II, j
  Criteria for ED—International Classification of Diseases‐10,
k
 Morgan‐Russell Outcome Criteria, l
 Relapse/Remission Status, m
 Short Evaluation for Eating Disorders, n
 Yale‐Brown‐Cornell Eating Disorders Scale.
	 Research Tools for Assessing Eating Disorders 	 543
Table 40.3  Measures used in recent randomized controlled trials: interpersonal therapy.
BMI a
Course of EDb
EDEc
EDI‐IId
Global Rating ANe
Agras et al.
(2000)
X
McIntosh
et al. (2005)
X X X X X
Wilfley et al.
(2002)
X X
Wilson et al.
(2010)
X
Note. a
 Body Mass Index, b
 Course of Disorder (i.e. duration, length of treatment), c
 Eating Disorder Examination,
d
 Eating Disorders Inventory‐II, e
 Global Rating of Anorexia Nervosa.
Table 40.4  Measures used in recent randomized controlled trials: dialectical behavioral therapy.
BES a
BMI b
DEB‐
Q c
EDE d
EDE‐
Q e
EDI‐
II f
IA‐
E g
MAC‐
S h
PEWS i
QEWP j
Self‐
Moni­
toring
Test
Meal TFEQ k
Chen et al.
(2008)
X X X
Hill et al.
(2011)
X X X X X X
Kröger et al.
(2010)
X X X X X
Robinson &
Safer
(2012)
X X X
Roosen et al.
(2012)
X X X
Safer &
Booil
(2010)
X X X
Safer &
Joyce
(2011)
X X X X X
Telch et al.
(2001)
X X X
Note. a
 Binge Eating Scale, b
 Body Mass Index, c
 Dutch Eating Behaviors Questionnaire, d
 Eating Disorders Examination,
e
 Eating Disorders Examination‐Questionnaire, f
 Eating Disorders Inventory‐II, g
 Interoceptive Awareness Scale‐
Expanded, h
 Mizes Anorectic Cognitions Scale, i
 Preoccupation with Eating, Weight, and Shape Scale, j
 Questionnaire
on Weight and Eating Patterns, k
 Three Factor Eating Questionnaire.
Table 40.5  Measures used in recent randomized control trials: mindfulness‐based therapies.
BES a
Bio­
markers b
BMI c
BSQ d
DEB‐
Q e
Diet
adhere f
EAT‐
26 g
EDE‐
Q h
EDI‐
II i
FAAQ j
G‐FCQ‐T k
MAC‐
S l
PASTAS m
PEWS n
Self‐
monitoring TFEQ o
Alberts et al.
(2012)
X X X X
Daubenmier
et al.
(2011)
X X X
de Zwaan
et al.
(2009)
X X X X
Forman et al.
(2009)
X X X X X
Pearson et al.
(2012)
X X X X X X X
Rain Carei
et al. (2010)
X
Tapper et al.
(2009)
X X X X
Note. a
 Binge Eating Scale, b
 biomarkers (described in Methods), c
 Body Mass Index, d
 Body Shapes Questionnaire, e
 Dutch Eating Behaviors Questionnaire, f
 adherence to prescribed
diet, g
 Eating Attitudes Questionnaire‐26, h
 Eating Disorders Examination‐Questionnaire, i
 Eating Disorders Inventory‐II, j
 Food Related Acceptance and Action Questionnaire,
k
 General Food Craving Questionnaire, l
 Mizes Anorectic Cognitions Scale, m
 Physical Appearance State and Trait Anxiety Inventory‐Stats Version, n
 Preoccupation with Eating
Weight and Shape Scale, o
 Three Factor Eating Questionnaire.
	 Research Tools for Assessing Eating Disorders 	 545
Table 40.6  Summary of recommended measures.
Measure Constructs assessed Notes
  1.	 Body Areas Satisfaction Scale
(BASS)
Body satisfaction/
dissatisfaction
Developed by Cash (2002);
subscale of the
Multidimensional Body Self‐
Relations Questionnaire
  2.	 Body Image Automatic
Thoughts Questionnaire
(BIATQ)
Cognitive distortions
related to appearance
Developed by Brown et al.
(1990)
  3.	 Body Shapes
Questionnaire (BSQ)
Body satisfaction/
dissatisfaction
Developed by Cooper et al.
(1986)
  4.	 Body Attitudes Test (BAT) Body satisfaction/
dissatisfaction
Developed by Probst et al.
(1995); four subscales:
negative appreciation of body
size: lack of familiarity with
one’s own body: general body
dissatisfaction: and a rest
factor
  5.	 Binge Eating Scale (BES) Presence of binge eating
behaviors, cognitions,
and emotions typical
of those who binge eat
Developed by Gormally et al.
(1982); provides cut‐offs for
nonbingeing, moderate, and
severe bingeing behavior
  6.	 Bulimic Investigatory Test,
Edinburgh (BITE)
Bulimic behaviors Developed by Henderson &
Freeman (1987); includes
symptom and severity
subscales; has only been
validated in adult women and
adolescents of both sexes
  7.	 Children’s Eating
Attitudes Test (ChEAT)
Symptoms and concerns
characteristic of eating
disorders
Developed by Maloney et al.
(1988); adapted version of
the EAT‐26 for children
8–13; may need additional
adaptations for younger
children (Smolak & Levine,
1994)
  8.	 Dutch Eating Behaviors
Questionnaire (DEB‐Q)
General structure of
eating behaviors
Developed by van Strien et al.
(1986); Scales for emotional,
external, and restrained eating
  9.	 EATATE semistructured
interview
Weight and ED history Semistructured interview
(Schmidt et al., 2007) based
on the Longitudinal Interval
Follow‐up Evaluation (Keller
et al., 1987); validation of the
measure not yet published
10. 	Eating Attitudes
Test‐26/40 (EAT‐26/
EAT‐40)
Symptoms and concerns
characteristic of eating
disorders
Developed by Garner &
Garfinkle (1979); cannot be
used to make a diagnosis
(Continued )
546	 Drew A. Anderson et al.
Table 40.6  (Continued )
Measure Constructs assessed Notes
11.	 Eating Disorders
Examination (EDE)
Behavior and attitudinal
symptoms of disordered
eating
Developed by Fairburn, Cooper,
& O’Connor (2008)
12.	 Eating Disorders
Examination‐
Questionnaire (EDE‐Q)
Behavior and attitudinal
symptoms of disordered
eating
Developed by Fairburn &
Beglin (2008)
13.	 Eating Disorders
Inventory‐II (EDI‐II)
Behaviors and psychological
features associated with ED
Developed by Garner (1991)
14.	 Food‐related Acceptance
& Action Questionnaire
(FAAQ)
Psychological flexibility in a
food‐rich environment
Developed by Juarascio et al.
(2011); subscales assessing
acceptance of distressing
food‐related thoughts/
cravings and willingness to
engage in healthy eating
despite these experiences;
measure has only been
validated in undergraduate/
community samples
15.	 General Food Craving
Questionnaire
Possible precipitants and
consequences of general food
cravings
Developed by Nijs, Franken, &
Muris (2007); an adapted
version of the Trait and State
Food Cravings Questionnaire
(Cepeda‐Benito, Gleaves,
Williams, & Erath, 2001)
16.	 Interoceptive Awareness
Scale‐Expanded (IAS‐E)
Awareness of appetite
signals and emotions
Developed by Craighead &
Niemeier (2002); expanded
version of the Interoceptive
Awareness Scale of EDI‐2 in
order to include appetite
awareness and emotional
awareness
17.	 Mizes’ Anorectic
Cognitions Scale
Typical cognitions
relevant to AN/BN
Developed by Mizes & Klesges
(1989). Revised versions
available (Mizes, 1994; Mizes
et al., 2000)
18.	 Morgan Russell Outcome
Criteria (M‐R)
Recovery status in those
with AN
Developed by Morgan &
Hayward (1988); general
criteria only speak to weight
recovery and menstrual status
and dichotomizes success
into “good/intermediate/bad”
19.	 Physical Appearance State
and Trait Anxiety
Inventory‐State Version
(PASTA)
Current anxiety/
nervousness about 16
specific body parts
Developed by Reed et al.
(1991)
20.	 Preoccupation with
Eating Weight and Shape
Scale (PEWS)
Frequency and distress
related to eating and
weight/shape‐related
thoughts
Developed by Niemeier et al.
(2002)
	 Research Tools for Assessing Eating Disorders 	 547
Patient Characteristics
Specific patient characteristics can be important when selecting assessment measures. On one
hand, measures are often developed for or with specific populations (e.g., gender, diagnosis)
and difficulties can arise when using measures on populations for which they were not designed
(see Chapters 23 & 37). For example, many body image assessment instruments were developed
on female samples and assess stereotypically female body image concerns (e.g., large hips
and thighs), and some have argued that they may be inappropriate for use in males (Darcy &
Lin, 2012; Thompson & Cafri, 2007). Also, with the advent of the fifth edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM‐5; American Psychiatric
Association, 2013), some older measures may not reflect current diagnostic criteria. Broadly
speaking, researchers should select measures developed on their population of interest and for
which there are appropriate norms.
On the other hand, researchers may have theoretical or practical reasons for wanting to use a
specific measure, or a measure may not be available for their population of interest. Thankfully,
norms have been developed for some measures for different populations than those for which
Table 40.6  (Continued )
Measure Constructs assessed Notes
21.	 Questionnaire on Weight
and Eating Patterns
(QWEP)
Assessment of eating
patterns characteristic
of BED
Developed by Spitzer et al.
(1992); can classify
individuals into no diagnosis,
nonclinical levels of bingeing,
and BED; adolescent and
parent completion forms
available
22.	 The Structured Interview
for Anorexic and Bulimic
Disorders for DSM‐IV and
ICD‐10
Assessment and
diagnostic
categorization of ED
Newest version developed by
Fichter & Quadflieg (2001);
semistructured interview that
shows correlations with the
EDE
23.	 Situational Inventory of
Body Image Dysmorphia
Frequency and intensity
of negative
appearance‐related
feelings in various
situational contexts
Developed by Cash (1994);
useful for determining
situations that are distressing
for persons with body‐image
difficulties
24.	 Short Evaluation for
Eating Disorders
Key ED symptoms (3 for
AN, 3 for BN)
Developed by Bauer, Winn,
Schmidt, & Kordy (2005);
allows user to calculate
severity index for AN/BN
25.	 Three Factor Eating
Questionnaire (TFEQ)
Three dimensions of
human eating
behavior—cognitive
restraint, disinhibition,
hunger
Developed by Stunkard &
Messick (1985)
26.	 Yale‐Brown Eating
Disorders Scale (YB‐ED)
Severity of illness in
those with EDs
Developed by Sunday et al.
(1995). Subscales that assess
rituals/preoccupations and
motivation for change
548	 Drew A. Anderson et al.
the measure was originally designed (see Allison, 2009, for extensive norms for eating disorders
measures). It should be noted, however, that whenever a measure is used in a sample substantially
different from the group on which it was developed, there exists a risk that the measure in
question will exhibit differential item functioning (DIF), or item bias. DIF occurs when specific
items within a measure exhibit different probabilities of item endorsement relative to group
membership. This means that a member of one group would have a decreased probability of
endorsing an item relative to a member of another group when the overall score on the measure
is held constant. If DIF is present within a measure, one can assume reduced variability and
subsequently misleading results regarding the latent trait. While very few eating‐related measures
have been subjected to DIF analysis, those that have been conducted have found substantial
gender‐specific item bias in measures of body checking (Alfano, Hildebrandt, Bannon,
Walker, & Walton, 2011). Thus, even though norms may be available for a measure, a given
score may not accurately reflect the underlying construct of interest. Until this issue is investigated
more thoroughly in the EDs literature, researchers should interpret with some caution
scores on measures developed under different populations than those they are studying.
Theory Testing
It has been argued that the theoretical model underlying treatment should play a critical role
in the choice of assessment instruments (Anderson & Murray, 2010). CBT, DBT, FBT, and
IPT all have some evidence for their efficacy in treating EDs (Hay, 2013; see also Chapters
56, 57, 60, & 62), but all are thought to achieve their effects through different mechanisms
(Arcelus, Haslam, Farrow, & Meyer, 2013; Fairburn, Cooper, & Shafran, 2003; Lock, Le
Grange, Agras, & Dare, 2001; MacPherson, Cheavens, & Fristad, 2013; Murphy et al., 2009;
Murphy, Straebler, Basden, Cooper, & Fairburn, 2012). To test the possible mechanisms of
these treatments, it is necessary to choose assessment instruments that measure the critical
constructs and mechanisms of interest. As an example, CBT postulates that the core psychopathology
of most eating disorders is the overvaluation of shape and weight and their control
(Fairburn, 2008; see also Chapter 56). Accordingly, studies of CBT for EDs should include an
assessment of this construct. DBT, however, suggests that failures in emotion regulation are a
key feature in the maintenance of EDs (MacPherson et al., 2013; see also Chapter 57) and, as
such, studies of DBT for EDs should assess emotion regulation where studies of CBT might not.
Historically, however, the EDs field has not done well in this regard. For example, an earlier
review of CBT for BN found that researchers focused on the overt behavioral symptoms
of BN more than the cognitive and other symptoms of the disorders, and almost no studies
assessed all of the core domains hypothesized to play a role in the maintenance of the disorder
(Anderson & Maloney, 2001). More recently, a review of DBT for EDs found that no studies
to date have directly assessed a key component of the DBT model—that DBT improves emotion
regulation skills and abilities (Bankoff, Karpel, Forbes, & Pantalone, 2012). Moreover,
the IPT model for the development and maintenance of eating disorders (see Chapter 62) has
not yet been directly tested (Murphy et al., 2012).
However, things are improving somewhat. As noted previously, researchers in the EDs field
have begun to call for increased investigation of underlying mechanisms of change by investigating
mediators of treatment (Kraemer et al., 2001, 2002; Murphy et al., 2009). This process
requires careful thought about the instrument or instruments used to assess the proposed underlying
mechanism as well as the timing of administration (Kazdin, 2009; Murphy et al., 2009).
Researchers interested in investigating CBT have the advantage of having measures available that
	 Research Tools for Assessing Eating Disorders 	 549
specifically assess the underlying model of the treatment (i.e., the EDE and EDE‐Q).
Unfortunately, there are few options for researchers wishing to test other models of EDs.
Conclusions and Future Directions
The assessment of EDs and related symptoms has evolved over the past decades. To help
advance the field, we offer the following suggestions:
1	 Make sure to match assessment instruments to the underlying theory being tested. This
will allow for better testing of these theories, as well as possible mediators of change.
2	 Assess as often as is feasible. Because change often happens early in treatment, frequent
assessment is necessary to capture this process.
3	 Use popular measures, but not only popular measures. It is extremely helpful to be able to
compare results across studies, and a common metric facilitates this process. But
supplementary measures may be necessary to assess all aspects of the underlying theory.
New measures may need to be developed to assist in this process.
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of a mindfulness‐based intervention on eating behavior, food cravings, dichotomous thinking and
body image concern. Appetite, 58, 847–851.
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