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The Development of the Brief Eating Disorder in Athletes Questionnaire

MARTINSEN, MARIANNE1; HOLME, INGAR1; PENSGAARD, ANNE MARTE2; TORSTVEIT, MONICA KLUNGLAND3; SUNDGOT-BORGEN, JORUNN4

Medicine & Science in Sports & Exercise: August 2014 - Volume 46 - Issue 8 - p 1666–1675
doi: 10.1249/MSS.0000000000000276
Applied Sciences

Purpose The objective of this study is to design and validate a brief questionnaire able to discriminate between female elite athletes with and without an eating disorder (ED).

Methods In phase I, 221 (89.5%) adolescent athletes participated in a screening including the Eating Disorder Inventory-2 (EDI-2) and questions related to ED. All athletes reporting symptoms associated with ED (n = 96, 94.1%) and a random sample without symptoms (n = 88, 86.3%) attended the ED Examination Interview. On the basis of the screening, we extracted items with good predictive abilities for an ED diagnosis to the Brief ED in Athletes Questionnaire (BEDA-Q) versions 1 and 2. Version 1 consisted of seven items from the EDI-Body dissatisfaction, EDI-Drive for thinness, and questions regarding dieting. In version 2, two items from the EDI-Perfectionism subscale were added. In phase II, external predictive validity of version 1 was tested involving 54 age-matched elite athletes from an external data set. In phase III, predictive ability of posttest assessments was determined among athletes with no ED at pretest (n = 53, 100%). Logistic regression analyses were performed to identify predictors of ED.

Results Version 2 showed higher discriminative accuracy than version 1 in distinguishing athletes with and without an ED with a receiver operating characteristics area of 0.86 (95% confidence interval (CI), 0.78–0.93) compared with 0.83 (95% CI, 0.74–0.92). In phase II, the accuracy of version 1 was 0.77 (95% CI, 0.63–0.91). In predicting new cases, version 2 showed higher diagnostic accuracy than version 1 with a receiver operating characteristic area of 0.73 (98% CI, 0.52–0.93) compared with 0.70 (95% CI, 0.48–0.92).

Conclusion The BEDA-Q containing nine items reveals good ability to distinguish between female elite athletes with and without an ED. The BEDA-Q’s predictive ability should be tested in larger samples.

1Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY; 2Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, NORWAY; 3Faculty of Health and Sport Sciences, University of Agder, Kristiansand, NORWAY; and 4Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, NORWAY

Address for correspondence: Marianne Martinsen, MSc, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, PO Box 4014 Ullevål Stadion, N-0806 Oslo, Norway; E-mail: marianne.martinsen@nih.no.

Submitted for publication October 2013.

Accepted for publication January 2014.

© 2014 American College of Sports Medicine