Effect of response format on endorsement of eating disordered attitudes and behaviors

Abstract

Objective: The present study was designed to compare response rates on a standard self-report questionnaire that was nominally anonymous to an unmatched count questionnaire that allowed for true anonymity in responding.Method: Four hundred and fifty-four college students were asked about several topics, including attitudes towards weight and shape, dieting, and eating disordered behavior using one of two response formats; either a standard questionnaire in true-false format or an unmatched count questionnaire that did not require participants to directly answer sensitive questions.Results: Both males and females had significantly different rates of endorsement between the two methods of assessment on the majority of the eating-related questions.Conclusion: Response format and degree of anonymity affect endorsement of eating-related thoughts and behaviors. Understanding response bias is critical to determining accurate rates of eating disordered thoughts and behaviors. V

Effect of perceived anonymity in assessments of eating disordered behaviors and attitudes

“…Studies utilizing the unmatched count technique, an assessment method that allows for complete response anonymity, have produced endorsement rates of eating disordered and body dissatisfaction-related behaviors that significantly differ from those found via traditional true/ false questionnaires. 9,10 Consistent with the hypothesis that social desirability and shame affect symptom denial and minimization, both studies revealed endorsement rates of sensitive behaviors (e.g., purging among women and anabolic steroid use among men) that were significantly higher in the unmatched count condition when compared with a standard questionnaire condition. These findings have been interpreted as evidence that the complete response anonymity afforded to participants through the unmatched count technique may result in more candid responding.…”

“…Previous unmatched count studies assessing related topics have revealed a similar pattern in which larger mean differences were found for behaviors that might be perceived as highly sensitive by men and women, including self-induced vomiting, laxative/diuretic use, anabolic steroid use, and maintaining a rigid workout routine. 9,10 There are several limitations of the present research. First, participants were nontreatmentseeking undergraduate women and it is unclear whether these results would generalize to a treatment-seeking population.…”

“…9,10 Significantly different endorsement rates of sensitive items have consistently been found between the standard questionnaire and UCT conditions.…”

“…Consistent with previous research, the unmatched count condition yielded significantly higher endorsement rates of most eating disordered behaviors and attitudes when compared to the standard questionnaire condition. 9,10 The hypothesis that the randomized response condition would produce significantly higher critical item endorsement rates was only partially supported. Critical items assessing purging behaviors and extreme dieting exhibited significantly higher endorsement rates via the randomized response condition when compared to the standard condition.…”

“…[6][7][8] From this perspective, participants may be more likely to respond honestly in assessment formats characterized by greater anonymity. 1,2,9 Assessments based on traditional self-report may therefore result in an underestimation of the true prevalence rates of certain sensitive phenomena, including eating disordered behaviors and attitudes.…”