Investigating Perceptions of the Eating Disorder Examination‐Questionnaire Among Undergraduate Students: A Qualitative Approach

OBJECTIVE: Quantitative methods that have evaluated the Eating Disorder Examination Questionnaire (EDE-Q) have found consistent evidence that the original four-factor structure does not replicate across diverse samples and genders. Emerging evidence in the broader psychology literature shows that qualitative methods can provide nuanced insight into how participants interpret, understand, and respond to self-report survey items. Qualitative methods may also help illuminate patterns of Likert responses and variation in respondents of different genders. Thus, this study used qualitative methods to explore how lay participants perceive and interpret EDE-Q items. METHOD: = 20.55 years, SD = 1.30, 48 men, 48 women, 1 transgender man) responded to the 22 attitudinal EDE-Q items using the Likert-type scale and provided open-ended reflections on their thought processes, interpretations, and relevant contexts for selecting their response. Open-ended responses were analyzed using content analysis to explore understanding of the items and response scales (e.g., confusion, misinterpretation, validity, gendered experiences). RESULTS: Most responses did not have issues; however, (a) shape and weight items were often conflated and participants expressed confusion about them, (b) higher ratings did not consistently reflect greater eating psychopathology, and (c) men described eating psychopathology geared toward gaining weight and muscularity even when selecting low Likert responses. DISCUSSION: Qualitative insights from this study complement concerns stemming from quantitative research on the structural validity of the EDE-Q and suggest potential avenues to clarify essential yet misunderstood concepts.