Assessing eating disorders in adults with type 1 diabetes: An item response theory analysis of the Diabetes Eating Problems Survey-Revised (DEPS-R).

The 16-item Diabetes Eating Problems Survey-Revised (DEPS-R) is one of the few instruments assessing disordered eating behaviors (DEBs) in Type 1 diabetes (T1D). Although a DEPS-R total score of ≥20 is oft used to identify a probable eating disorder, previous work has shown that some items may reflect T1D management struggles, rather than DEB, with other work indicating that different response profiles (e.g., overeating vs. diabulimia) correspond to varying DEB risks. To identify DEPS-R items of greatest utility in detecting DEB in T1D, we used a form of item response theory to evaluate item variation in difficulty and discrimination, as well as scale precision across the latent DEB continuum. Participants were 329 adults with T1D who completed the DEPS-R when joining a participant registry or enrolling in a study on eating and weight concerns in T1D. We found a number of DEPS-R items (e.g., "I skip meals or snacks") that demonstrated low difficulty and low-to-moderate discrimination. These items were often endorsed by even the lowest severity participants yet provided relatively limited information for differentiating the DEB construct. Other items with high difficulty and moderate discrimination (e.g., "I make myself vomit") provided relatively modest information even at the highest pathology levels, as they were unlikely to be endorsed even by the most severe cases. Most high-discrimination items provided the most diagnostic information at the highest pathology levels (e.g., "I try to eat to the point of spilling ketones in my urine"). Results suggest revising the DEPS-R scale, as several items provided limited contribution to DEB detection. (PsycInfo Database Record (c) 2026 APA, all rights reserved).