Comparing self- and expert rating: a self-report screening version (SIAB-S) of the structured interview for anorexic and bulimic syndromes for DSM-IV and ICD-10 (SIAB-EX).
OBJECTIVE
Carrying out structured interviews in larger numbers by well-trained interviewers is costly and time consuming. Therefore, we developed parallel to the existing Structured Interview for Anorexic and Bulimic Syndromes (SIAB-EX) a similarily designed questionnaire for symptoms of disordered eating and related areas (SIAB-S).


METHODS
377 treated eating disordered patients were assessed within a two-week time period using both the SIAB-EX and SIAB-S.


RESULTS
Generally, self-ratings based on the SIAB-S were quite similar to expert ratings. Cohen's kappa showed good agreement between self- and expert ratings. Factor structure based on principal component analyses of expert ratings or self-ratings led to rather similar results confirming the robustness of the subscales in self- and expert ratings. Using expert rating as a criterion, the self-rating (SIAB-S)--which can more easily be used for screening purposes--had a sensitivity of 0.70, a specificity of 0.80 and a PPV = 0.91 for the DSM-IV diagnoses of AN and/or BN (worst ever condition). Diagnostic sensitivity (79/73%) and specificity (66/63 %) were in an acceptable range (past/current). If we focus on the differences between the two approaches the following was found: self-rating (compared to expert-rating) resulted in lower scores for items inquiring about binges and inappropriate compensatory behaviour, attitudes towards food and eating, and social interaction. On the other hand, self-rating (compared to expert-rating) led to higher scores for items measuring general psychopathology and atypical binging.


CONCLUSIONS
Compared to the "gold standard" of t data obtained with investigator-based standardised or structured interviews, data based on self-rating with items formulated clearly and concisely can lead to reliable and valid results. While complex issues (what is a binge) are difficult to assess in self-ratings, some (very personal) questions may even be better asked in a self-report questionnaire.
Fichter
M M
MM
Klinik Roseneck, University of Munich, Prien, Germany. MFichter@t-online.de
Quadflieg
N
N
D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis*; D002032:Bulimia / Q000175:diagnosis*; D005104:Expert Testimony; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011569:Psychiatric Status Rating Scales; D012647:Self-Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013577:Syndrome