Comparing self- and expert rating: a self-report screening version (SIAB-S) of the Structured Interview for Anorexic and Bulimic Syndromes for DSM-IVand ICD-10 (SIAB-EX)
Mm. Fichter et N. Quadflieg, Comparing self- and expert rating: a self-report screening version (SIAB-S) of the Structured Interview for Anorexic and Bulimic Syndromes for DSM-IVand ICD-10 (SIAB-EX), EUR ARCH PS, 250(4), 2000, pp. 175-185
Objective: Carrying out structured interviews in larger numbers by well-tra
ined interviewers is costly and time consuming. Therefore, we developed par
allel to the existing Structured Interview for Anorexic and Bulimic Syndrom
es (SIAB-EX) a similarily designed questionnaire for symptoms of disordered
eating and related areas (SIAB-S). Method: 377 treated eating disordered p
atients were assessed within a two-week time period using both the SIAB-EX
and SIAB-S. Results: Generally, self-ratings based on the SIAB-S were quite
similar to expert ratings. Cohen's kappa showed good agreement between sel
f- and expert ratings. Factor structure based on principal component analys
es of expert ratings or self-ratings led to rather similar results confirmi
ng the robustness of the subscales in self- and expert ratings. Using exper
t rating as a criterion, the self-rating (SIAB-S)- which can more easily be
used for screening purposes - had a sensitivity of 0.70, a specificity of
0.80 and a PPV = 0.91 for the DSM-IV diagnoses of AN and/or BN (worst ever
condition). Diagnostic sensitivity (79/73 %) and specificity (66/63 %) were
in an acceptable range (past/current). If we focus on the differences betw
een the two approaches the following was found: self-rating (compared to ex
pert-rating) resulted in lower scores for items inquiring about binges and
inappropriate compensatory behaviour, attitudes towards food and eating, an
d social interaction. On the other hand, self-rating (compared to expert-ra
ting) led to higher scores for items measuring general psychopathology and
atypical bingeing. Conclusion: Compared to the "gold standard" of data obta
ined with investigator-based standardised or structured interviews, data ba
sed on self-rating with items formulated clearly and concisely can lead to
reliable and valid results. While complex issues (what is a binge) are diff
icult to assess in self-ratings, some (very personal) questions may even be
better asked in a self-report questionnaire.