Development and preliminary validation of the DISCOVER: a brief screening questionnaire for eating, exercise, and body image pathology in men

At least one quarter of adults with conventional eating disorders are men. Men also account for most cases of muscle dysmorphia, which shares many characteristics of eating disorders. No screening tools exist specifically to detect disordered eating and related psychopathology in men. This study developed and preliminarily validated a brief screening tool for eating pathology and muscle dysmorphia in men. In the development phase, we workshopped potential items in qualitative interviews among men with current probable eating disorders or muscle dysmorphia (N = 9). In the validation phase (N = 425), we performed item-level analyses, analyzed the screener’s psychometric properties, and identified a cutoff score. The DISCOVER contained eight items assessing loss of control over eating, dietary restraint, mental preoccupation, compensatory behaviors, body image overvaluation, muscularity dissatisfaction, and impairment. It demonstrated good internal consistency, convergent and divergent validity, and test-retest reliability over two weeks. At its optimal cutoff score of 11, the area under the curve was .86, sensitivity was .88, and specificity was .70. This screener could be used in a variety of clinical settings in which men receive healthcare, as well as in research studies evaluating the psychological and behavioral health of men.