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CIA_3.0_Instructions_for_users

Uploaded by

Will
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THE CLINICAL IMPAIRMENT ASSESSMENT QUESTIONNAIRE (CIA)

Nature and Use of the CIA


The Clinical Impairment Assessment questionnaire (CIA) is a 16-item self-report measure of
the severity of psychosocial impairment due to eating disorder features (Bohn and Fairburn,
2008). It focuses on the past 28 days. The 16 items cover impairment in domains of life that
are typically affected by eating disorder psychopathology: mood and self-perception,
cognitive functioning, interpersonal functioning and work performance. The purpose of the
CIA is to provide a simple single index of the severity of psychosocial impairment secondary
to eating disorder features.

The CIA is designed to be completed immediately after filling in a measure of current eating
disorder features that covers the same time frame (e.g., the Eating Disorder Examination
questionnaire, EDE-Q; Fairburn and Beglin, 2008). This ensures that patients have their
eating disorder features “at the front of their mind” when filling in the CIA.

The CIA is intended to assist in the clinical assessment of patients both before and after
treatment. It is also suitable for use in epidemiological studies.

Status of the CIA


Tests of reliability, validity, sensitivity to change and the instrument’s ability to predict case
status have been conducted, all of which support its use (Bohn et al, 2008). Scores for
different patient groups will be added to this document in due course.

Investigators are welcome to use the CIA free of charge on three conditions:
1. It is understood that it is under copyright.
2. In any publication the following two citations are used for the instrument:

Bohn K, Doll HA, Cooper Z, O'Connor ME, Palmer RL, Fairburn CG. The measurement of
impairment due to eating disorder psychopathology. Behaviour Research and Therapy
2008; 46: 1105-1110.
Bohn K, Fairburn CG. Clinical Impairment Assessment Questionnaire (CIA 3.0). In
Fairburn CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford
Press, 2008.

Scoring of the CIA


Each item is rated on a Likert scale with the response options being ‘Not at all’, ‘A little’,
‘Quite a bit’, and ‘A lot’. These responses are scored 0, 1, 2 and 3 respectively with a higher
rating indicating a higher level of impairment. Since it is the purpose of the CIA to measure
the overall severity of secondary psychosocial impairment, a global CIA impairment score is
calculated. To obtain the global CIA impairment score the ratings on all items are added
together with prorating of missing ratings, so long as at least 12 of the 16 items have been
rated. The resulting score ranges from 0 to 48 with a higher score being indicative of a
higher level of secondary psychosocial impairment. A ROC analysis showed that a global
impairment score of 16 was the best cut-point for predicting eating disorder case status
(Bohn et al., 2008).

References
Bohn K, Doll HA, Cooper Z, O'Connor ME, Palmer RL, Fairburn CG. The measurement of
impairment due to eating disorder psychopathology. Behaviour Research and Therapy
2008; 46: 1105-1110.
Bohn K, Fairburn CG. Clinical Impairment Assessment Questionnaire (CIA 3.0). In Fairburn
CG. Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press, 2008.
Fairburn CG, Beglin SJ. Eating Disorder Examination Questionnaire (6.0). In Fairburn CG.
Cognitive Behavior Therapy and Eating Disorders. New York: Guilford Press, 2008.

Kristin Bohn and Christopher G Fairburn


Oxford, 2013

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