title: Parent-child concordance in reporting of child eating disorder pathology as assessed by the eating disorder examination.
abstract: OBJECTIVE
  The aim of this study was to examine parent-youth concordance in reporting of eating disorder pathology, as assessed by the Eating Disorder Examination (EDE) in a clinical pediatric sample.
  
  
  METHODS
  The sample comprised 619 parent-youth dyads of youth (8-18 years) presenting for treatment at a specialist eating disorder clinic. A cross-sectional correlational design was used to examine the association between parent and youth symptom reports.
  
  
  RESULTS
  On the whole, parent-youth inter-rater agreement was poor to moderate. Agreement was acceptable for the presence of behavioral symptoms, with the exception of excessive exercise (PAK = 0.48-0.98). There was poor inter-rater agreement on frequency of behavioral symptoms, with parents providing lower estimates than youth (ICC = 0.07-0.52). Although we predicted that inter-rater agreement on cognitive symptoms would by higher with adolescents than children, both groups were discordant with parent reports. Younger children identified less severe eating disorder cognitions than parents and the opposite occurred for adolescents. An anorexia nervosa presentation and lower malnutrition were not associated with lower inter-rater agreement, as might have been expected through ego syntonicity. Youth with bulimia nervosa presentations reported significantly higher severity of cognitive symptoms and more frequent disordered eating behaviors compared with their parents.
  
  
  CONCLUSIONS
  Results support the utility of parent-youth assessment via the EDE to obtain a wider clinical picture of eating disorder psychopathology in children and adolescents, particularly for younger children. Clinical implications pertinent to administration of the EDE and parent literacy regarding eating disorder symptoms are discussed.
authors.affiliation: School of Psychology, Murdoch University, Perth, Australia.
authors.forename: Paige
authors.initials: P
authors.lastname: Mariano
authors.forename: Hunna J
authors.initials: HJ
authors.lastname: Watson
authors.forename: David J
authors.initials: DJ
authors.lastname: Leach
authors.forename: Julie
authors.initials: J
authors.lastname: McCormack
authors.forename: David A
authors.initials: DA
authors.lastname: Forbes
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D005247:Feeding Behavior / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010290:Parents; D011594:Psychometrics; D011795:Surveys and Questionnaires
keywords: EDE; adolescent; anorexia nervosa; bulimia nervosa; child; concordance; eating disorder not otherwise specified