Concordance between youth and caregiver report of eating disorder psychopathology: Development and psychometric properties of the Eating Disorder‐15 for Parents/Caregivers (ED‐15‐P)

Abstract

Objective Outcome measurement in youth with eating disorders relies heavily on self‐report, which is problematic in a population that may deny or minimize symptoms. Caregiver‐report measures are lacking. This study examined the psychometric and clinical properties of a newly‐developed measure designed to assess short‐term change in eating disorder symptomatology as observed by caregivers—the Eating Disorder‐15 for Parents/Caregivers (ED‐15‐P). Method At initial presentation to an outpatient eating disorders assessment, 206 families (primary caregiver and their child up to 18 years old) completed psychological measures. Results The ED‐15‐P demonstrated excellent reliability, preliminary evidence of discriminant and concurrent validity, and good sensitivity to change early in treatment (first 8 weeks). Agreement between primary caregivers and children on eating disorder psychopathology was moderate, while agreement between pairs of caregivers was relatively strong. Level of agreement varied across behaviors and informants, with poorer caregiver‐child agreement on dieting and driven exercise. Discussion Agreement was stronger within caregiver pairs than caregiver‐child pairs, indicating that caregivers and their children have related but unique perspectives on eating disorder symptoms, highlighting the importance of multi‐informant assessment. The ED‐15‐P complements a parallel youth report measure to more comprehensively assess eating disorder psychopathology, with high utility for measuring change over time.

Disadvantage and disordered eating in boys: Examining phenotypic and genotype × environment associations across development.

“…Disordered eating was assessed using the Michigan Twins Project Eating Disorder Survey (MTP-ED; Mikhail, Carroll, et al, 2021), a nine-item parent-report questionnaire for measuring disordered eating in population-based samples. Prior research suggests parent-reported symptoms differentiate youth with and without clinical EDs (Accurso & Waller, 2021) and show similar or greater concordance with objective external measurements (e.g., BMI, clinician-reported symptoms) as adolescent-reported symptoms (Couturier et al, 2007;Steinberg et al, 2004;Swanson et al, 2014). Parent report may be particularly useful for younger boys who may have difficulty understanding disordered eating items.…”

Executive function differences as a function of parent‐reported binge eating and weight: Results from the adolescent brain cognitive development study

“…Furthermore, a different study using a similar single item assessing BE found that parent report of BE was significantly related to child BE 23 . This approach has been used across several research groups in previous studies both utilizing the ABCD dataset 24 and outside of the study 25,26 . Binary responses included in the ABCD dataset were the presence of any parent‐reported BE (coded as 1) or absence of BE (coded as 0).…”

“… 23 This approach has been used across several research groups in previous studies both utilizing the ABCD dataset 24 and outside of the study. 25 , 26 Binary responses included in the ABCD dataset were the presence of any parent‐reported BE (coded as 1) or absence of BE (coded as 0).…”

Psychometric properties of the Parent Eating Disorder Examination Questionnaire

“…When interviewing youth with restrictive EDs and their parents, Couturier et al (2007) found that parents reported more ED symptoms than their children, while Mariano et al (2013) found good concordance between youth and parent informants. On a brief questionnaire measure of ED psychopathology, Accurso and Waller (2021b) found moderate youth-caregiver agreement for most ED attitudes and behaviors, although caregivers endorsed greater levels of dieting than their child while youth endorsed more driven exercise.…”

“…When interviewing youth with restrictive EDs and their parents, Couturier et al (2007) found that parents reported more ED symptoms than their children, while Mariano et al (2013) found good concordance between youth and parent informants. On a brief questionnaire measure of ED psychopathology, Accurso and Waller (2021b) found moderate youth‐caregiver agreement for most ED attitudes and behaviors, although caregivers endorsed greater levels of dieting than their child while youth endorsed more driven exercise. However, when youth with binge‐purge EDs have been assessed via interview, they reported more ED symptoms than their parents and produced scores that were not significantly different from ratings by clinicians (Couturier et al, 2007; Mariano et al, 2013).…”