Physical signs and symptoms of eating disorders and disordered eating: Development of a screening test for female college athletes
Abstract
The purpose of this study was to identify physical signs and symptoms indicating eating disorders/disordered eating (ED/DE) among female college athletes in order to develop an effective, valid, and quick-to-administer screening test. Psychosocial questionnaires may be less effective as screening tests due to response bias and the unwillingness of respondents to acknowledge ED/DE. Physical measures may be preferable to or used in conjunction with psychosocial screening tests because physical assessments are more objective and their purpose is more obscure. Subjects included 148 (84.5%) volunteer female Division I, club, and dance team athletes 18–25 years old who attended a large, Midwestern university. Self-report physical signs and symptoms questions were administered. The questionnaire was developed by the investigator and was called the Physiological Aspects of Eating Behaviors Questionnaire (Phys-Q). The PHYS-Q assessed dizziness, abdominal bloating and pain, weakness, cold intolerance, leg edema, constipation, menstrual cycle frequency, and history of stress fractures. A physiological evaluation was used called the Athlete Physical Health Assessment Form (APHA). The APHA was used to record height, weight, body mass index, percent body fat, waist-hip ratio, blood pressure, caffeine use, water intake, parotid gland enlargement, and exercise, menstrual, weight, and dental histories. Last, a validated, structured, diagnostic interview (the Eating Disorder Exam, 12.0D; EDE), was used to identify those with or without ED/DE. Results showed a large number (35%; n = 51) of athletes were ED/DE. Six items from the PHYS-Q and 12 items from the APHA discriminated the ED/DE versus non-ED/DE subjects the best. The combination of these “best” items from both the PHYS-Q and APHA tests were more effective (sensitivity = 86% and specificity = 78%) in identifying ED/DE than the EDI-2 (sensitivity = 64% and specificity = 74%) and BULIT-R (sensitivity = 27% and specificity = 99%) questionnaires. Two possible reasons for the success of the physiologic items were the reduction and/or elimination of response bias and that the items were developed specifically for this population. Recommendations are to include a quick (~10 minutes long) and easy-to-administer physiologic screening test during mandatory pre-participation examinations.
Degree
Ph.D.
Advisors
Black, Purdue University.
Subject Area
Physiological psychology|Mental health|Public health|Physical education|Sports medicine
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