Comparison of assessments of children's eating-disordered behaviors by interview and questionnaire

Objective: In adults, interview methods may detect eating-disordered behaviors more accurately than self-report methods. However, no studies have investigated the relationships between interview and self-report assessments in children. We compared results from the Eating Disorder Examination adapted for Children (ChEDE) with the Adolescent version of the Questionnaire on Eating and Weight Patterns (QEWP-A) and with the Children's Eating Attitude Test (ChEAT) in a nontreatment sample of overweight and normal weight children. Method: The ChEDE, QEWP-A, and ChEAT were administered to 46 overweight (body mass index [BMI] at or above the 85th percentile) and 42 normal weight (BMI at the 15th-85th percentile) children, 10 ± 1.8 years, recruited from the community. Results: The ChEDE and QEWP-A were not concordant for the number or type of eating episodes that occurred in the past month. Compared with the ChEDE, the QEWP-A was reasonably specific, but it was not sensitive for the presence of objective (17% sensitivity, 91% specificity) or subjective bulimic episodes (0% sensitivity, 89% specificity) during the past month. ChEDE and ChEAT global scores were significantly related (Kendall's tau = 0.286, p < .001), but specific items assessing guilt in relation to eating and preoccupation with food were not. Discussion: Although self-report methods of eating disorder assessment in children may provide some general information regarding eating psychopathology in non-treatment-seeking children, they do not accurately reflect the results of a structured interview.