1 - (SYM 45) Exploring Differential Item Functioning of the SCOFF by Food Insecurity Status and Its Interaction with Gender and Perceived Weight Status in U.S. College Students

Emerging evidence suggests that food insecurity (FI) is prospectively (Hazzard et al., 2022; Laraia et al., 2015) and concurrently (Becker et al., 2017, 2019; Hazzard et al., 2021; Christensen et al., 2021) associated with increased eating disorder (ED) pathology. However, few studies have examined how ED screening measures perform among people with and without FI. This is an important question as certain behaviors, such preoccupation with food or meal skipping, may both be present in disordered eating and FI with different motivations (Christensen et al., 2022). A previous study found evidence for differential item performance according to FI level when examining the Eating Disorder Diagnostic Scale (EDDS), but not the short Eating Disorder Examination Questionnaire (EDE-Q) (O’Connor et al., 2022), but questions remain about other ED measures. The purpose of this study was to examine if items on the SCOFF, a common brief ED screening measure, performed differently according to FI status. Additionally, this study took an intersectional approach to examine item performance at the intersection between FI and marginalized identities (i.e., gender-diverse identities, high perceived weight status). Data came from the 2020/2021 Healthy Minds Study (N=122,269). Past-year FI status was determined by the two-item Hunger Vital Sign. Differential item functioning (DIF) tested if SCOFF items performed differently (i.e., demonstrated different probabilities of endorsement) in groups with FI and without FI. Both uniform DIF (constant between-group difference in item-endorsement probability across the latent ED pathology spectrum) and non-uniform DIF (variable between-group difference in item-endorsement probability across the latent ED pathology spectrum) were computed. All five SCOFF items demonstrated statistically significant uniform (at p< .001) and non-uniform DIF (at p < .05). However, none met predetermined thresholds for practical significance. In analyses examining the intersection of FI with gender identity and perceived weight status, most items demonstrated statistically significant, but not practically significant, DIF. Only the item measuring body-size perception demonstrated practically significant DIF for perceived weight status. Findings support using the SCOFF among college students with FI. Further, findings provide preliminary support for using the SCOFF when FI intersects with marginalized gender and weight identities.