An examination of the Clinical Impairment Assessment among women at high risk for eating disorder onset

Uniformed Services University of the Health Sciences, Department of Medical and Clinical Psychology, Bethesda, MD 20815, USA.
Behaviour Research and Therapy (Impact Factor: 3.85). 03/2012; 50(6):407-14. DOI: 10.1016/j.brat.2012.02.009
Source: PubMed

ABSTRACT Identifying measures that reliably and validly assess clinical impairment has important implications for eating disorder (ED) diagnosis and treatment. The current study examined the psychometric properties of the Clinical Impairment Assessment (CIA) in women at high risk for ED onset. Participants were 543 women (20.6 ± 2.0 years) who were classified into one of three ED categories: clinical ED, high risk for ED onset, and low risk control. Among high risk women, the CIA demonstrated high internal consistency (α = 0.93) and good convergent validity with disordered eating attitudes (rs = 0.27-0.68, ps < 0.001). Examination of the CIA's discriminant validity revealed that CIA global scores were highest among women with a clinical ED (17.7 ± 10.7) followed by high risk women (10.6 ± 8.5) and low risk controls (3.0 ± 3.3), respectively (p < 0.001). High risk women reporting behavioral indices of ED psychopathology (objective and/or subjective binge episodes, purging behaviors, driven exercise, and ED treatment history) had higher CIA global scores than those without such indices (ps < 0.05), suggesting good criterion validity. These data establish the first norms for the CIA in a United States sample. The CIA is psychometrically sound among high risk women, and heightened levels of impairment among these individuals as compared to low risk women verify the relevance of early intervention efforts.

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Available from: Anna Vannucci, Mar 21, 2014
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    • "The CIA is used on patients of 18 years and older. The CIA has shown good psychometric properties in clinical (Bohn et al., 2008; Bohn and Fariburn, 2008), high risk (Vannucci et al., 2012) and community samples (Reas et al., 2010). "
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    ABSTRACT: Assessing clinically meaningful change is valuable for treatment planning, monitoring course of illness and evaluating outcome. Although DSM eating disorder (ED) diagnoses have been criticized for poor clinical utility, instability, and uncertainty, remission/change of diagnosis is often the standard for evaluating outcome. We tested the validity of the clinically significant reliable change index (CS/RCI) compared to change in DSM-IV ED-diagnoses. We investigated if CS/RCI was concordant to diagnostic change and compared explained variance on measures at follow-up. Using a database for specialized ED treatment in Sweden the sample contained 1042 female patients (246 adolescents/796 adults). CS/RCI was calculated for the Clinical Impairment Assessment (CIA) and the Eating Disorder Examination Questionnaire (EDE-Q). CS/RCI explained more variance in gain scores for psychopathology measures than diagnostic change (DSM-IV). Average agreement between diagnostic change and CS/RCI were 62% and 60% for CIA and EDE-Q, respectively. Diagnostic change always resulted in more positive outcome than CS/RCI. Together with clinical judgment, CS/RCI is a valuable method for determining clinically significant changes in clinical practice and research. It is economically sound and results are easily interpreted and communicated to patients.
    05/2014; 216(2). DOI:10.1016/j.psychres.2014.02.008
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    International Journal of Eating Disorders 04/2013; 46(3). DOI:10.1002/eat.22115 · 3.03 Impact Factor
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    ABSTRACT: A number of studies have provided data on young women for the Clinical Impairment Assessment (CIA, v. 3.0), a measure of psychosocial impairment in eating disorders. However, little data exists on eating disorder samples. The aim of the current study was to investigate psychometric properties of the CIA in a clinical sample, using confirmatory factor analysis based on the originally-proposed model. The CIA was administered alongside with the Eating Disorder Examination (EDE) to 190 individuals referred to an eating disorder service. Psychometric properties of the CIA were acceptable, based on model fit and factor loadings. The CIA appears to be a useful and valid measure for the assessment of impairment in eating disorders.
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