The eating disorder assessment for DSM-5 (EDA-5): Development and validation of a structured interview for feeding and eating disorders

Objective: Existing measures for DSM-IV eating disorder diagnoses have notable limitations, and there are important differences between DSM-IV and DSM-5 feeding and eating disorders. This study developed and validated a new semistructured interview, the Eating Disorders Assessment for DSM-5 (EDA-5).

Method: Two studies evaluated the utility of the EDA-5. Study 1 compared the diagnostic validity of the EDA-5 with the Eating Disorder Examination (EDE) and evaluated the test-retest reliability of the new measure. Study 2 compared the diagnostic validity of an EDA-5 electronic application ("App") with clinician interview and self-reported assessments.

Results: In Study 1, the kappa for EDE and EDA-5 eating disorder diagnoses was 0.74 across all diagnoses (n = 64), with a range of κ = 0.65 for other specified feeding or eating disorder/unspecified feeding or eating disorder to κ = 0.90 for binge eating disorder. The EDA-5 test-retest kappa coefficient was 0.87 across diagnoses. For Study 2, clinical interview versus App conditions revealed a kappa of 0.83 for all eating disorder diagnoses (n = 71). Across individual diagnostic categories, kappas ranged from 0.56 for other specified feeding or eating disorder/unspecified feeding or eating disorder to 0.94 for BN.

Discussion: High rates of agreement were found between diagnoses by EDA-5 and the EDE, and EDA-5 and clinical interviews. Because this study supports the validity of the EDA-5 to generate DSM-5 eating disorders and the reliability of these diagnoses, the EDA-5 may be an option for the assessment of anorexia nervosa, bulimia nervosa, and binge eating disorder. Additional research is needed to evaluate the utility of the EDA-5 in assessing DSM-5 feeding disorders.