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The Chinese Eating Disorder Brief Screening Scale (CEDBS): Development and Psychometric Validation in General and
Shiwei Chen1, Ruizhen Zhu1, Qing Kang1
1Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Objective:
Despite growing recognition of eating disorders (EDs) as a public health concern in China, validated instruments suitable for efficient large-scale screening remain limited. This study aimed to develop and validate the Chinese Eating Disorder Brief Screening Scale (CEDBS).
Method:
Scale development and validation were structured across two studies. Study 1 involved item generation and refinement through expert evaluation, cognitive interviews, and a pilot study (N = 146). Study 2 examined psychometric properties in large non-clinical (N = 3573) and clinical (N = 325) samples. Analyses included exploratory and confirmatory factor analysis for construct validity, McDonald's ω and intraclass correlation coefficients (ICC) for reliability, Pearson correlations for convergent and discriminant validity, and receiver operating characteristic (ROC) analysis for screening accuracy.
Results:
The final 10-item CEDBS demonstrated a unidimensional structure, high internal consistency (ω = 0.95), and acceptable test-retest reliability (ICC = 0.81). CEDBS scores correlated strongly with established ED-specific measures (eating disorder inventory subscales: rs = 0.51-0.87; eating disorder examination-questionnaire global score: r = 0.74; eating attitudes test-26: r = 0.81) and showed a moderate correlation with the anxiety scale (r = 0.35), supporting discriminant validity. ROC analysis yielded an area under the curve of 0.88, with an optimal cutoff of 16.5 (sensitivity = 0.75, specificity = 0.84).
Discussion:
The CEDBS demonstrates preliminary psychometric support as a brief screening tool for identifying probable ED cases in Chinese populations. An integer cutoff score of 17 may be considered for practical use.
