ANIS

Overview

The Anorexia Nervosa Inventory for Self-Rating (ANIS) is a self-assessment questionnaire designed for diagnostic purposes in clinical practice and research, suitable for individuals aged 12 to 65 years. This paper-and-pencil instrument is intended for use by psychologists, medical doctors, educators, and other health professionals. The ANIS is specifically tailored to assess potentially deviant eating behaviors, particularly those associated with anorexia nervosa and bulimia nervosa. It can be administered in both individual and group settings.

Scope of Application

The ANIS is versatile in its application, including:

Screening for Eating Disorders: Useful in unselected samples such as epidemiologic community studies (e.g., among students) and in both inpatients and outpatients.

Assessing Severity: Effective in evaluating the severity of an already diagnosed eating disorder.

Monitoring Treatment: Helpful in documenting the course of treatment, performing baseline evaluations, controlling quality and process during therapy, and assessing therapy outcomes.

The concise and structured design of the ANIS makes its application and scoring quick and straightforward.

Theoretical Background

The ANIS is partially based on the theoretical concepts of Hilde Bruch (1973) regarding body image disturbance, disturbed proprioceptive and interoceptive awareness, and a pervasive feeling of insufficiency in anorexia nervosa. During the development of the ANIS, the concept of disturbed proprioceptive and interoceptive awareness was found unsuitable for self-assessment. However, the concepts of figure consciousness and insufficiency were validated through factor analysis.

Other areas covered by the ANIS include symptoms frequently associated with anorexia nervosa, such as obsessive-compulsive behaviors related to eating, negative effects of meals, disinhibited eating binges, sexual anxieties, and rejection of intimate contacts.

Items and Subscales

The ANIS was developed by collecting 152 potential items from clinical experience and literature. Expert ratings refined these to 48 items suitable for self-assessment. The final sample consisted of 101 female patients with anorexia nervosa and 118 age-matched female controls. Exploratory factor analysis identified a six-factor solution including 31 items. These factors were confirmed in subsequent studies, including a sample of 1402 German-speaking female students aged 11 to 20 years.

The Six-Factor Solution

Figure Consciousness: Items 3, 6, 9, 12, 15, 19, 21, 23, 27, and 29

Insufficiency: Items 2, 4, 14, 16, 20, 25, and 31

Anancasm: Items 1, 8, 11, 13, and 30

Negative Effects of Meals: Items 7, 17, 22, and 28

Sexual Anxieties: Items 5, 18, and 26

Binge-eating: Items 10 and 24

Items are rated on a six-point scale, from 0 to 5, reflecting the present state of the respondent.

Psychometric Properties

The ANIS demonstrates strong psychometric properties, including:

Objectivity: Consistent application, scoring, and interpretation.

Validity and Reliability: Explains 44.9% of the total variance, with factor stability across different patient groups and healthy controls. Cronbach’s alpha for the total score ranges from 0.89 to 0.94, and exceeds 0.80 for all subscales except anancasm.

The ANIS is a reliable and valid instrument for the assessment of eating disorders, providing a comprehensive evaluation of attitudes and behaviors associated with anorexia nervosa and bulimia nervosa.