Evaluation of a screening test for female college athletes with eating disorders and disordered eating

Objective: To develop a screening test to detect female college athletes with eating disorders/disordered eating (ED/DE). No validated eating disorder screening tests specifically for athletes have been available. Design and Setting: In this cross-sectional study, subjects from a large midwestern university completed 3 objective tests and a structured diagnostic interview. Measurements: A new test, developed and pilot tested by the researchers (Athletic Milieu Direct Questionnaire, AMDQ), and 2 tests normed for the general population (Eating Disorder Inventory-2, Bulimia Test-Revised) were used to identify ED/DE athletes. A structured, validated, diagnostic interview (Eating Disorder Examination, version 12.0D) was used to determine which test was most effective in screening female college athletes. Subjects: Subjects included 149 female athletes, ages 18 to 25 years, from 11 Division 1 and select club sports. Results: ED/DE subjects (35%) were found in almost every sport. Of the ED/DE subjects, 65% exhibited disordered eating, 25% were bulimic, 8% were classified as eating disordered not otherwise specified (NOS), and 2% were anorexic. The AMDQ more accurately identified ED/DE than any test or combination of items. The AMDQ produced superior results on 7 of 9 epidemiologic analyses; sensitivity was 80% and specificity was 77%, meaning that it correctly classified approximately 4 of every 5 persons who were truly exhibiting an eating disorder or disordered eating. Conclusions: We recommend that the AMDQ subsets, which met statistical criteria, be used to screen for ED/DE to enable early identification of athletes at the disordered eating or NOS stage and to initiate interventions before the disorder progresses.