Cross-cultural validity of the eating disorder examination: A study of Chinese outpatients with eating disorders in Hong Kong

Abstract

Objective: To assess the cross-cultural validity of the Cantonese-Chinese version of the Eating Disorder Examination among Chinese outpatients. Patients and Methods: The Cantonese-Chinese version of the Eating Disorder Examination was administered to 42 patients with anorexia nervosa, anorexia nervosa without fat phobia, bulimia nervosa or binge eating disorders and to 12 controls. An eating disorders specialist made the clinical diagnoses. The eating disorder psychopathologies of cases were compared with controls. Results: The Cantonese-Chinese version of the Eating Disorder Examination exhibited satisfactory internal consistency, sensitivity, specificity, positive and negative predictive value for diagnosing subjects with anorexia nervosa, bulimia nervosa and binge eating disorders. All subscales discriminated between patients with anorexia nervosa or bulimia nervosa and controls. Apart from the restraint subscale, the other three subscales discriminated between those with binge eating disorders and controls. Those with anorexia nervosa and anorexia nervosa without fat phobia had similar results except for those of the weight concern subscale. No subjects with eating disorders met the definition for excessive exercise. Conclusion: The Cantonese-Chinese version of the Eating Disorder Examination has good reliability, discrimination and criterion validity. The similarities between responses from those with anorexia nervosa and those with anorexia nervosa without fat phobia made the inclusion of fat phobia as a diagnostic criterion for anorexia nervosa in the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders questionable. The discrepancy between binge eating disorders and control regarding weight and shape concern suggests cognitive features should be considered as diagnostic criteria for binge eating disorders. The definition of excessive exercise may not be appropriate for Hong Kong Chinese population. © 2006 Hong Kong College of Psychiatrists.