Structured Inventory for Anorexic and Bulimic Eating Disorders (SIAB-EX and SIAB-S)

The SIAB is an inventory for the assessment of eating disorders and other symptoms often associated with eating disorders (depression, anxiety) in adolescents and adults aged 12 to 65 years. Items on sexuality and partnership are also included. The SIAB-EX is applied in individual interview settings either face to face or by telephone by trained clinical expert interviewers. The SIAB-S is filled out by the patient or proband.

• Diagnosis of eating disorders according to DSM-IV (APA, 1994) and ICD-10 (WHO, 1992) in clinical therapy. Identification of individual problem areas which should be adressed in therapy. The patient may fill-out the self-rating version before the first interview. This can be used as a basis of the first interview using the expert rating SIAB-EX.

• Clinical research on the course of eating disorders and the effects and outcome of medical treatment and psychotherapy.
• Determination of the phenotype in studies on the genetics of eating disorders.
• Screening for eating disorders in epidemiological studies and identification of high-risk groups for eating disorders by the use of the self-rating SIAB-S. In a second stage diagnoses can be definitely confirmed by application of the expert interview SIAB-EX on individuals with high risk.

The third revision of the SIAB-EX comprises 87 items. Some items are broken down in several partial items. For the diagnostic classification according to DSM-IV and ICD-10 the SIAB was supplemented with some items referring to specific aspects newly introduced by these recent diagnostic systems.

For most items the results are coded on a five-point scale ranging from 0 (symptom/problem not present) to 4 (symptom/problem very severely present). Generally the scale is defined as follows:

0 = symptom/problem area not present

1 = symptom/problem area slightly or rarely present

2 = symptom/problem area markedly or sometimes present

3 = symptom/problem area severely or frequently present

4 = symptom/problem area very severely or very frequently present

The SIAB contains some additional questions needed for the clear diagnostic classification according to DSM-IV and ICD-10. The content of other items refers to all areas relevant to eating disorders as well as other symptoms of disturbed behavior (depression, anxiety).

For most items the cross-sectional status (was the symptom present in the last 3 months) and the maximal expression of the symptom in the past is rated by the expert interviewer. The past rating will usually cover the time from prepuberty up to 3 months before the interview. The present status covers the maximal expression of the symptom/problem area in the last 3 months before the interview if not specified otherwise.

The following DSM-IV diagnoses (APA, 1994) can be made by the SIAB-EX or the SIAB-S: Anorexia Nervosa (restrictive and binge-eating/purging type); Bulimia Nervosa (purging/non-purging type): Binge Eating Disorder and Eating Disorders not otherwise specified.

According to ICD-10 (WHO, 1992) diagnoses of Anorexia Nervosa, Atypical Anorexia Nervosa and Bulimia Nervosa are possible.

The SIAB has several superior characteristics

1. It covers a wide range of symptoms related to eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder NOS).

2. Symptoms are assessed for current and past as well as lifetime
3. Reliability and validity are checked
4. Clinical assessments as well as factor analytic methods were applied resulting in the identification of important areas of psychopathology
5. Besides quantitative information on the psychopathology a solid data base for diagnostic classification according to DSM-IV and ICD-10 is provided
6. There exists a computer algorithm for diagnostic classification of anorexia nervosa (restrictive type, binge eating/purging type), bulimia nervosa (purging and non-purging type), and eating disorders not otherwise specified including binge eating disorder. A computer algorithm for the sum scores of all scales is also available.

Interview SIAB-EX 30-60 minutes, questionnaire SIAB-S about 30 minutes.

Measurement is made at two time points: severity of symptoms in the last three months before assessment (current), and assessment for the past.

In a factor analysis of the SIAB-EX interview the following subscales for the past state were identified (Fichter et al., 1998, Fichter & Quadflieg, 2000, 2001):

Standardized algorithms for computing sum scores and eating disorder diagnoses are available as paperforms and computer algorithms.

Comparison values of 377 males and females which were treated as in-patients because of their eating disorder as well as data on healthy women are available.

Data on diagnostic subgroups Anorexia Nervosa and Bulimia Nervosa according to DSM-IV are also given Results on English-speaking subjects with eating disorders can be provided (see Downloads normative data).

Objectivity regarding data collection, data analysis, and interpretation of the results are given.

Data on convergent and discriminative construct validity, inter-rater reliability (SIAB-EX), internal consistency, and agreement of SIAB-EX and SIAB-S are available.

A free version of the SIAB in English is available for use in scientific studies and clinical practice. The relevant instruments are listed below:

• SIAB Manual
• SIAB-EX - expert interview
• Interview
• DSM-IV Algorithm
• ICD-10 Algorithm
• Scoring Sheet (SIAB-EX)
• SIAB-S - self-rating questionnaire
• Questionnaire
• DSM-IV Algorithm
• ICD-10 Algorithm
• Scoring Sheet (SIAB-S)

1. Fichter, M.M., Elton, M., Engel, K., Meyer, A.E., Mally, H. & Poustka, F. (1991). Structured Interview for Anorexia and Bulimia Nervosa (SIAB). Development of a New Instrument for the Assessment of Eating Disorders. International Journal of Eating Disorders, 10, 571-592.
2. Fichter, M. M., Herpertz, S., Quadflieg, N. & Herpertz-Dahlmann, B. (1998). Structured Interview for Anorexic and Bulimic Disorders for DSM-IV and ICD-10: Updated (Third) Revision. International Journal of Eating Disorders, 24, 227 - 249.
3. Fichter, M. & Quadflieg, N. (1999). Strukturiertes Inventar fuer Anorektische und Bulimische Essstoerungen (SIAB). Fragebogen (SIAB-S) und Interview (SIAB-EX) nach DSM-IV und ICD-10. Handanweisung. Hogrefe, Goettingen.
4. Fichter, M. M. & Quadflieg, N. (2000). Comparing Self- and Expert Rating: A Self-report Screening Version (SIAB-S) of the Structured Interview for Anorexic and Bulimic Syndromes for DSM-IV and ICD-10 (SIAB-EX). European Archives of Psychiatry and Clinical Neuroscience, 250, 175 - 185.
5. Fichter, M. M. & Quadflieg, N. (2001). The Structured Interview for Anorexic and Bulimic Disorders for DSM-IV and ICD-10 (SIAB-EX): Reliability and Validity. European Psychiatry, 16, 38 - 48.
6. Fichter, M. & Quadflieg, N. (2001). Das Strukturierte Interview für Anorektische und Bulimische Ess-Stoerungen nach DSM-IV und ICD-10 zur Expertenbeurteilung (SIAB-EX) und dazugehoeriger Fragebogen zur Selbsteinschaetzung (SIAB-S). Verhaltenstherapie, 11, 314 - 325.
7. Fichter, M. & Quadflieg, N. (2002). SIAB-S. Strukturiertes Inventar fuer Anorektische und Bulimische Essstoerungen (Fragebogen zur Selbstbeurteilung). In: Braehler, E. & Schumacher, J. (eds). Diagnostische Verfahren in der Psychotherapie. Hogrefe, Goettingen, 316-320.
8. Fichter, M. & Quadflieg, N. (2003). Diagnostica e valutazione pscologica dei disturbi della condotta alimentare mediante l'applicazione del SIAB secondo DSM-IV e ICD-10. Noos, 1, 27-47.