Screening for eating disorders across genders in college students: Initial validation of the brief assessment of stress and eating

Given that eating disorders (EDs) are relatively common in college populations, it is important to have reliable and valid tools to identify students so that they can be referred to evidence-based care. Although research supports the psychometric properties of existing ED screens for identifying cases of EDs, most studies have been conducted in samples of young white-majority women or have not reported the psychometric properties of the screening tool in men. Objective: The purpose of the current study was to validate a brief, 10-item screening tool for the identification of EDs—the brief assessment of stress and eating (BASE). Method: Participants were college students (N = 596; 68.2% cisgender women) from a large Midwestern university who completed the BASE and SCOFF. The Eating Disorders Diagnostic Survey was used to generate DSM-5 ED diagnoses. We evaluated area under the curve (AUC) for both receiver operating curves (ROC) and precision-recall curves (PRC). Results: Both the BASE and SCOFF performed significantly better than chance at identifying probable EDs in cisgender women (BASE AUC: ROC =.787, PRC =.633, sensitivity =.733, specificity =.697; SCOFF AUC: ROC =.810, PRC =.684, sensitivity =.793, specificity =.701). However, the BASE (AUC: ROC =.821, PRC =.605, sensitivity =.966, specificity =.495) significantly outperformed the SCOFF (AUC: ROC =.710, PRC =.354, sensitivity =.828, specificity =.514) for identifying probable EDs in cisgender college men. Discussion: The BASE is appropriate for student healthcare and college research settings. Because the BASE outperforms the SCOFF in college men, results from the current study are expected to contribute to improved identification of EDs on college campuses. Public Significance: The BASE is a new screening tool to identify eating disorders. The BASE performed as well as, if not better than, the SCOFF (particularly in men). Given the need for brief, psychometrically strong, and unbiased ED screening tools in college students, the current study helps address an unmet student healthcare need that we expect will contribute to improved identification of EDs on college campuses.