CHAPTER 7. Eating Disorder and Menstrual Dysfunction Screening Tools for the Allied Health Professional Jacalyn J. Robert-McComb, PhD Fellow of the American College of Sports Medicine

Learning Objectives To identify commonly used screening tools for eating disorders;To identify commonly used screening tools for eating disorders; To identify screening tools specifically designed for the female athlete; andTo identify screening tools specifically designed for the female athlete; and To identify credible self assessment and educational tools on the web for eating disorders.To identify credible self assessment and educational tools on the web for eating disorders.

Commonly used screening tools for eating disorders SCOFF Questionnaire by Morgan, Reid, and Lacey (can be found in Appendix 4)SCOFF Questionnaire by Morgan, Reid, and Lacey (can be found in Appendix 4) The Eating Attitudes Test (EAT-26) by Garner (see Appendix 5 or view centre.org/orderaet26.html)The Eating Attitudes Test (EAT-26) by Garner (see Appendix 5 or view centre.org/orderaet26.html) centre.org/orderaet26.htmlhttp://river- centre.org/orderaet26.html BULIT-R by Thelen (can be found in Appendix 6)BULIT-R by Thelen (can be found in Appendix 6)

Screening tools specifically designed for the female athlete At the high school and collegiate level, the preparticipation physical examination (PPE) offers an opportunity to screen for components of the female athlete triad. The medical history form is considered the most important aspect of the PPE examination.

It has been suggested that a separate section, consisting of both a gynecological and nutritional component be directed at the female athlete. Straightforward questions concerning body image and disordered eating may lead to underreporting. Therefore, the questionnaire should address specific areas of concern without causing the athlete to minimize her condition. Supplemental information on the medical history form for the female athlete.

Standardized Instruments for the Preparticipation Physical Examination (PPE) for the Female Athlete. There are presently no standardized instruments used in the PPE for female athletes. Results of a survey to National Collegiate Athletic Association (NCAA) Division 1 programs indicated that there is a pressing need for more standardized eating disorder and menstrual dysfunction screening, prevention, and treatment programs among NCCA Division I schools (Beals, 2003).

The Female Athlete Screening Tool (FAST) McNulty et al. (2001) developed a screening tool to identify eating pathology in female athletes.McNulty et al. (2001) developed a screening tool to identify eating pathology in female athletes. The Female Athlete Screening Tool (FAST) has a high internal consistency (Cronbach’s α = 0.87).The Female Athlete Screening Tool (FAST) has a high internal consistency (Cronbach’s α = 0.87). Athletes with eating disorders scored higher on the FAST as compared to athletes without eating pathology and nonathletes with eating disorders (p <.001), demonstrating discriminant validity.Athletes with eating disorders scored higher on the FAST as compared to athletes without eating pathology and nonathletes with eating disorders (p <.001), demonstrating discriminant validity. The FAST can be found in Appendix 8 along with the scoring instructions.The FAST can be found in Appendix 8 along with the scoring instructions.

Credible Educational and Screening Tools on the Web for Eating Disorders Target AudienceTarget Audience Web Site NameWeb Site Name ResourcesResources Kids Kids and Eating Disorders KidsHealth is the largest and most visited site on the Web providing doctor- approved health information about children from before birth through adolescence.

Credible Educational and Screening Tools on the Web for Eating Disorders Target Audience Web Site Name Resources Female Athletes BODYSENSE: A Positive Body Image Initiative for Athletes Dedicated to the promotion of healthy sport settings for athletes with the ultimate goal of preventing eating disorders

Credible Educational and Screening Tools on the Web for Eating Disorders Target Audience Web Site Name Resources College Students College Response: National Eating Disorder Screening Program (NEDSP) The College Response National Eating Disorder Screening Program (NEDSP) is designed to educate and screen college students for eating disorders, and to connect at-risk students with the resources they need.

Credible Educational and Screening Tools on the Web for Eating Disorders Target Audience Web Site Name Resources Adults Dr. John Grohol’s Psych Central Site provides education and screening tools for eating disorders (short 5- item quiz adapted from the SCOFF and the EAT-26) as well as information and screening for other mental illnesses