When a counselor hands a client an assessment, the scores carry weight. They can shape a referral, a treatment plan, or a diagnosis. So it matters whether the instrument works equally well for everyone who takes it.
This article, led by first author S. Barstack and published in the Journal of Counseling & Development, looks closely at one widely used instrument, the Eating Disorder Inventory, Third Edition (EDI-3). I was the second author. Our team pulled together the published psychometric evidence on the EDI-3 to give counselors a clear picture of what the research supports.
129
studies synthesized
2004–2020
years of published research covered
.888
average reliability (alpha) for the total score
What the evidence shows
Reliability holds up
Scores were consistent overall. Subscale reliability ranged from .693 to .947, so some subscales are much stronger than others.
Structure depends on who is tested
The instrument’s structure was supported for White women. It was not supported for racial and ethnic minority groups.
Diagnosis is understudied
Only one study tested how well the EDI-3 distinguishes people who do and don’t have an eating disorder.
An instrument can be reliable for some clients and still not measure the same thing for others.
What this means in practice
For counselors, the takeaway is not to stop using the EDI-3. It is to use it with care. Total scores look dependable. Individual subscales vary, so it is worth checking the strength of the subscale you are relying on before you lean on it. And when the client in front of you is not a White woman, the research base gives you much less to stand on.
- Read subscale results as one piece of information, alongside interviews and clinical judgment.
- Be cautious about interpreting scores for clients from racial and ethnic minority groups.
- Don’t treat the EDI-3 as a diagnostic tool on its own; the evidence for that use is thin.
What researchers can do next
We need studies that test the EDI-3’s structure in diverse samples and more research on its diagnostic accuracy. Eating disorders affect people of every background, and assessment research should reflect that.
Every instrument we use with clients rests on a body of evidence, and it is worth knowing who that evidence was gathered from.
The article
Barstack, S., Karkhanis, S., Erford, B. T., Bennett, E., Buchanan, E., Sharpe, C., & Wissel, A. (2023). Synthesis of the Eating Disorder Inventory-Third Edition (EDI-3) psychometric characteristics: Implications for counseling practice and research. Journal of Counseling & Development, 101(3), 359–372.
