Cross-cultural validity of the Eating Disorder Inventory: a study of Chinese patients with eating disorders in Hong Kong.

OBJECTIVE

To evaluate the cross-cultural validity of the Chinese version of the Eating Disorder Inventory (EDI) in a clinical sample of patients with eating disorders in Hong Kong.

METHOD

After comprehensive clinical assessment, a consecutive series (1990-1996) of Chinese patients with bulimia nervosa (N = 17) and broadly diagnosed anorexia nervosa (N = 26) completed the Chinese EDI. Results were compared with those of Chinese female undergraduates (N = 606) and Canadian patients with eating disorders.

RESULTS

The EDI profiles of bulimic and fat phobic anorectic patients were remarkably and modestly similar to those of their Canadian counterparts. The EDI meaningfully distinguished bulimic patients and fat phobic anorectic patients from local undergraduates, but exhibited deficient criterion-related validity in nonfat phobic anorectic patients.

DISCUSSION

The questionable validity of certain EDI subscales in nonfat phobic patients reflects the ethnospecific constructs upon which they are based, and weakens the efficacy of the EDI in screening for anorexia nervosa in Chinese populations. Apart from illustrating some of the conceptual and methodological issues that need to be tackled in the cross-cultural study of the eating disorders, this study furnishes empirical support for the syndromal homogeneity of bulimia nervosa, and the clinical grouping of anorexia nervosa into fat phobic and nonfat phobic subtypes.