title: Classifying empirically valid and clinically meaningful change in eating disorders using the Eating Disorders Inventory, version 2 (EDI-2).
abstract: The study examined the ability of the EDI-2 to classify empirically valid and clinically meaningful change using clinical significance and the Reliable Change Index (CS/RCI), and compared CS/RCI to classification based on diagnostic change. Eating disorder (ED) patients (N=363) were assessed at intake and after 36months on measures of ED and psychiatric symptoms, self-image, interpersonal relationships, treatment satisfaction and general outcome. Patients were categorized using a four-way classification scheme as "Deteriorated", "Unchanged", "Improved" or "No ED"; and using a two-way classification scheme as either in remission or not in remission. Compared to similar two- and four-way classification based on diagnostic change, CS/RCI using the EDI-2 total score demonstrated greatest overall utility in explaining outcome variance. The EDI-2 can generate empirically valid and clinically meaningful classification of change. Systematic application of CS/RCI using the EDI-2 benefits both clinicians and researchers by providing a simple, clinically relevant, scientifically robust, and cost-effective means of classifying outcome. It may be especially relevant in alerting clinicians to problem cases in need of additional or alternative treatment strategies.
authors.affiliation: Centre for Psychiatry Research, Stockholm Health Care Services, Department of Clinical Neuroscience, Karolinska Institutet, Norra stationsgatan 69, 7 tr, 113 64 Stockholm, Sweden; Institute for Eating Disorders, Kruses gate 8, 0263 Oslo, Norway. Electronic address: david.clinton@ki.se.
authors.forename: David
authors.initials: D
authors.lastname: Clinton
authors.affiliation: Centre for Psychiatry Research, Stockholm Health Care Services, Department of Clinical Neuroscience, Karolinska Institutet, Norra stationsgatan 69, 7 tr, 113 64 Stockholm, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Birgegård
mesh_terms: D000293:Adolescent; D000328:Adult; D001068:Feeding and Eating Disorders / Q000145:classification* / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Assessment; Classification; Clinical significance; Eating Disorders Inventory version 2; Outcome; Reliable change