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Differential item functioning analysis for the Eating Disorder Examination Questionnaire among heterosexual and sexual minority men

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Abstract

Purpose

Sexual minority (SM) men are at a higher risk for eating disorders and related issues, relative to heterosexual men. However, it is currently unknown whether commonly used measures of eating pathology are appropriate to use among diverse groups of men. Determining the unique functioning of existing assessments may help better and more accurately understand eating disorder pathology within this population. The present study examined differences in item endorsement between sexual orientation in the Eating Disorder Examination Questionnaire (EDE-Q) through differential item functioning (DIF).

Methods

Heterosexual and SM men (N = 703) completed the EDE-Q and a demographic questionnaire. EDE-Q scores were examined for clinically significant DIF based on participants’ self-reported sexual orientation (e.g., heterosexual men vs SM men).

Results

SM men reported higher EDE-Q symptom composite scores than heterosexual men. DIF was observed for all EDE-Q items relative to the global score; however, only one item met clinical significance (EDE-Q #19; ∆R2 ≥ 0.13).

Conclusion

Results suggest that SM men experience greater levels of ED pathology than heterosexual men. While the EDE-Q is a commonly used measure of eating pathology, findings suggest that sexual orientation bias may impact many items on the EDE-Q. However, results from this study indicated that only one item introduces bias that has clinical implications. Additional research is needed to further explore and replicate this finding among more diverse samples of SM and heterosexual men.

Level of evidence

Level III, case–control analytic study.

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Funding

The present study was supported by Award Number T32MH082761 (PI: Scott Crow) from the National Institute of Mental Health (NIMH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH or National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, USA

    Joseph M. Donahue, Christina Scharmer & Drew Anderson

  2. Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA

    Melissa Simone & Lisa M. Anderson

Authors
  1. Joseph M. Donahue
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  2. Melissa Simone
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  3. Christina Scharmer
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  4. Lisa M. Anderson
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  5. Drew Anderson
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Corresponding author

Correspondence to Joseph M. Donahue.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The procedures detailed in the current study were approved by the University at Albany, State University of New York Internal Review Board (IRB) prior to their implementation.

Informed consent

Participants who participated in the study completed an online informed consent upon entering the study. Participants indicated they reviewed the informed consent document and agreed to participate in the study before completing any study procedures.

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The article is part of the Topical Collection on Males and Eating and Weight Disorders.

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Donahue, J.M., Simone, M., Scharmer, C. et al. Differential item functioning analysis for the Eating Disorder Examination Questionnaire among heterosexual and sexual minority men. Eat Weight Disord 26, 2071–2076 (2021). https://doi.org/10.1007/s40519-020-01035-x

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  • DOI: https://doi.org/10.1007/s40519-020-01035-x

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