Measures

Please find below details of measures which are relevant to CBT-E, as well as information on permissions.

The Eating Disorder Examination (EDE)

The Eating Disorder Examination (EDE) is widely viewed as the “gold standard” measure of eating disorder psychopathology. It provides a measure of the range and severity of eating disorder features. It can also generate operational eating disorder diagnoses. It is used in most treatment studies and in many other investigations of eating disorder psychopathology. Normative values are available.
The current version of the EDE is edition 17.0D. The main difference from the earlier edition (16.0D) is that it is designed to generate DSM-5 eating disorder diagnoses (American Psychiatric Association, 2013). For any queries relating to this measure, or to obtain training in the administration of this measure please contact: zafra.cooper@yale.edu

The EDE has been translated into multiple languages.

Further reading

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edition). Washington, D.C.: American Psychiatric Association.

Fairburn CG, Cooper Z, O’Connor M. (2008). Eating Disorder Examination (16.0D). In Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press.

Bryant-Waugh RJ, Cooper PJ, Taylor C L & Lask BD. (1996). The use of the Eating Disorder Examination with Children: A pilot study. International Journal of Eating Disorders, 19, 391-397.

Fairburn CG & Cooper Z. (1993). The Eating Disorder Examination (twelfth edition). In: CG Fairburn & GT Wilson (eds.). Binge Eating: Nature, Assessment and Treatment. (pp. 317-360). New York: Guilford Press.

Cooper Z & Fairburn CG. (1987). The Eating Disorder Examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders. International Journal of Eating Disorders, 6, 1-8.


The Eating Disorder Examination (EDE) – Child version

The Eating Disorder Examination (EDE) 17.0D has been adapted for use in children and adolescents aged 8 years and older by Rachel Bryant-Waugh and Beth Watkins. The broad format of the child interview remains the same, as do the explanations of the concepts involved and the instructions for rating. The main differences include the recommendation for pre-interview diary sheet completion, the phrasing of the obligatory questions, the format of questioning, and changes in the administration of certain items.
In terms of normative data, there is a limited amount available for using the EDE with children and adolescents (see below: Hilbert et al., Frampton et al. and Watkins et al.). The studies are fairly small and so it is not possible to break down in to age or sex subgroups.
Dr Rachel Bryant-Waugh offers training in the measure, you are able to contact her for further details about this if required: rachel.bryant-waugh@slam.nhs.uk.
If a self-report measure is required for children and adolescents, Dr Bryant-Waugh recommends using the main EDE-Q with anyone over the age of 14. If required for younger individuals, she suggests two forms may be used (YEDE-Q or EDE-A) but advises against using these with people below the age of 12.

Please see the paper below for the YEDE-Q (Goldschmidt et al.). This was tested with young people who were overweight and uses the 28 day timeframe in line with the main EDE-Q.

There is also a 14 day EDE-Q adapted for adolescents (see Carter et al. below), incorporated in to the CORC, and renamed EDE-A [https://www.corc.uk.net/media/1272/ede-a-adolescentquestionnaire.pdf]. Please refer to the document below for EDE-A instructions and norms (adult).

Please refer to the document below for EDE-A scoring.

Further reading

Mantilla, F. E., Birgegård, A., Clinton, D. (2017). Factor analysis of the adolescent version of the Eating Disorders Examination Questionnaire (EDE-Q): Results from Swedish general population and clinical samples. J. Eat. Disord; 5, 19.

Hilbert, A., Buerger, A., Hartmann, A. S., Spenner, K., Czaja, J., & Warschburger, P. (2013). Psychometric evaluation of the eating disorder examination adapted for children. European Eating Disorders Review, 21, 330–339. doi:10.1002/erv.2221

Frampton, I., Wisting, L., Øveras, M., Midtsund, M., & Lask, B. (2011). Reliability and validity of the Norwegian translation of the Child Eating Disorder Examination (ChEDE). Scandinavian Journal of Psychology, 52, 196‐199. doi: 10.1111/j.1467‐9450.2010.00833.x

Goldschmidt, A. B., Doyle, A. C., & Wilfley, D. E. (2007). Assessment of binge eating on overweight youth using a questionnaire version of the child eating disorder examination with instructions. International Journal of Eating Disorders, 40, 460 – 467. doi:10.1002/eat.20387

Watkins, B., Frampton, I., Lask, B., & Bryant-Waugh, R. (2005). Reliability and validity of the child version of the Eating Disorder Examination: a preliminary investigation. International Journal of Eating Disorders, 38(2), 183-187. doi:10.1002/eat.20165

Carter JC, Stewart DA & Fairburn CG. (2001). Eating Disorder Examination Questionnaire: Norms for adolescent girls. Behaviour Research and Therapy. 39, 625-632.

Bryant-Waugh RJ, Cooper PJ, Taylor C L & Lask BD. (1996). The use of the Eating Disorder Examination with Children: A pilot study. International Journal of Eating Disorders, 19: 391-397. doi: 10.1002/(SICI)1098-108X(199605)19:4<391::AID-EAT6>3.0.CO;2-G


The Eating Disorder Examination Questionnaire (EDE-Q)

The EDE-Q is a self-report questionnaire based upon the EDE interview. It is used when it is impracticable or undesirable to employ the interview. The EDE-Q is very widely used and is also available in many languages. The current version is EDE-Q 6.0. For details of scoring, please use the EDE guidelines above.

The EDE-Q is under copyright (including specific items). It is freely available for non-commercial clinical or research use and no permission need be sought. This includes using the EDE-Q digitally as long as it is for non-commercial clinical or research use. However, please also (i) include copyright information, (ii) replicate the measure exactly (including response categories) and (iii) be aware that the information on norms and use has been designed for the pen and paper version.

For queries relating to commercial use of the measure (including commercial software), please contact credo@medsci.ox.ac.uk.

For any other measures which have been derived from the EDE-Q (e.g. EDE-QS), contact the authors for information about their use.

Regarding short versions of the EDE-Q, if commercial use is planned or envisaged (including commercial software) contact credo@medsci.ox.ac.uk as a licence is likely to be required.

Further reading

Aardoom, J. J., Dingemans, A. E., Op’t Landt, M. C. S., & Van Furth, E. F. (2012). Norms and discriminative validity of the Eating Disorder Examination Questionnaire (EDE-Q). Eating behaviors13(4), 305-309.

Fairburn CG, Beglin SJ. (2008). Eating Disorder Examination Questionnaire (6.0). In Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press.

Luce, K. H., Crowther, J. H., & Pole, M. (2008). Eating disorder examination questionnaire (EDE‐Q): Norms for undergraduate women. International Journal of Eating Disorders41(3), 273-276.

Mond JM, Hay PJ, Rodgers B & Owen C. (2006). Eating Disorder Examination Questionnaire (EDE-Q): Norms for young adult women. Behaviour Research and Therapy, 44, 53-62.

Peterson CB & Mitchell JE. (2005). Self-report measures. In JE Mitchell & CB Peterson (eds.), Assessment of eating disorders (pp. 120-128). New York: Guilford Press.

Fairburn CG & Beglin SJ. (1994). Assessment of eating disorder psychopathology: interview or self-report questionnaire? International Journal of Eating Disorders, 16, 363-370.


The Clinical Impairment Assessment (CIA)

The CIA is a brief self-report measure of the impairment resulting from current eating disorder psychopathology. It is designed to be completed immediately after the EDE-Q. It provides both a continuous measure of the severity of secondary impairment and a threshold score associated with “caseness”.

The CIA is under copyright (including specific items). It is freely available for non-commercial clinical or research use and no permission need be sought.

For queries relating to commercial use of the measure, please contact credo@medsci.ox.ac.uk.

Further reading

Bohn K, Doll HA, Cooper Z, O’Connor ME, Palmer RL, Fairburn CG. (2008). The measurement of impairment due to eating disorder psychopathology. Behaviour Research and Therapy, 46, 1105-1110.

Bohn K, Fairburn CG. (2008). Clinical Impairment Assessment Questionnaire (CIA 3.0). In Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press.

Fairburn CG, Beglin SJ. (2008). Eating Disorder Examination Questionnaire (6.0). In Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press.


Clinical Perfectionism Questionnaire (CPQ)

The Clinical Perfectionism Questionnaire (CPQ) is a 12-item self-report measure that examines symptoms of perfectionism over the last 28 days. The measure is available free of charge and is being translated into different languages. Several versions of the measure are in use. It is available here:  https://www.overcomingperfectionism.com/for-clinicians

Further Reading

Fairburn C. G., Cooper Z. and Shafran R. (2003). The Clinical Perfectionism Questionnaire. Oxford: Unpublished scale.

Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). Clinical perfectionism: A cognitive behavioural analysis. Behaviour Research and Therapy, 40, 773–791. doi:10.1016/j.paid.2014.01.003


The Eating Problem Check List (EPCL)

The Eating Problem Check List (EPCL) is a self-report measure designed to assess eating-disorder behaviours and psychopathology in patients with eating disorders session-by-session. It is quick and easy to complete, and could therefore be readily integrated into routine clinical practice, enabling assessment of weekly changes. It can be used as an aid for clinicians and patients to identify improvement and/or deterioration, enabling the prompt focusing of treatment on specific expressions of an individual’s eating-disorder psychopathology.

The total score is obtained by adding the items of section two, while the scores of the two subscales are obtained through the sum of the following items: Concern for body image items – 4, 5, 6, 7, 8; Concern for feeding items – 1, 2, 3, 9.

Further Reading

Dalle Grave, R., Sartirana, M., Milanese, C., El Ghoch. M.  Brocco, C.  Pellicone, C., Calugi, S. (in press). Validity and reliability of the Eating Problem Checklist (EPCL). Eating Disorders.


The Starvation Symptoms Inventory (SSI)

The Starvation Symptoms Inventory (SSI) is a 15-item self-report measure that examines the symptoms of starvation in underweight patients with eating disorders over the last 28 days. It can easily be integrated into routine clinical practice to assess changes in starvation symptoms during the process of weight restoration in those who have specialised eating disorder treatments. It can also be used in studies which assess the effect of an eating disorder treatment.

Further Reading

Calugi, S., Miniati, M., Milanese, C., Sartirana, M., El Ghoch, M., & Dalle Grave, R. (2017). The Starvation Symptom Inventory: Development and Psychometric Properties. Nutrients, 9(9), 967. doi:10.3390/nu9090967


The Dietary Rules Inventory (DRI)

The Dietary Rules Inventory (DRI) is a 28-item self-report measure designed to assess the dietary rules of patients with eating disorders. It is focused on the last 28 days. The 28 items cover the principal dietary rules associated with eating disorder psychopathology.

The DRI It is quick and easy to complete, and could, therefore, be readily integrated into routine clinical practice, providing a better understanding of the dietary rules driving eating behaviours in patients with eating disorders, and therefore, targets for intervention. It can be also used in the studies which assess the effect of the treatment of eating disorder.

Dietary Rules Inventory (DRI) Eng

DRI Instruction for users

Further Reading

Calugi, S., Morandini, N., Milanese, C., Dametti, L., Sartirana, M., Fasoli, D., & Dalle Grave, R. (2021). Validity and reliability of the Dietary Rules Inventory (DRI). Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity. doi:10.1007/s40519-021-01177-6 Full Text