The Turkish Version of the Eating Disorder Examination Questionnaire: Reliability and Validity in Adolescents

The Eating Disorder Examination Questionnaire (EDE‐Q) is the self‐report questionnaire version of the Eating Disorder Examination Interview. The aim of the current study was to validate a Turkish version of the EDE‐Q in a sample of Turkish primary and high school students (626 girls and 299 boys) in Istanbul. Subjects also completed the Eating Attitudes Test, the General Health Questionnaire and the Body Image Satisfaction Questionnaire, and they were weighed. Girls had higher scores on all EDE‐Q subtests. EDE‐Q scores increased as body mass ?ndex increased. EDE‐Q total score and subscales were highly correlated with the Eating Attitudes Test and the Body Image Satisfaction Questionnaire, supporting its validity. A small test–retest reliability study provided satisfactory results. The present study suggests that the Turkish version of EDE‐Q is an acceptable, reliable and valid measure in nonclinical adolescent samples. More psychometric studies are needed concerning wider age ranges and various clinical samples. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Convergent Validity of the Eating Disorder Examination and the Eating Disorder Examination‐Questionnaire Among University Women in Norway

The present study compared the Eating Disorder Examination (EDE; 16.0) and the Eating Disorder Examination‐Questionnaire (EDE‐Q; 6.0) and investigated the psychometric properties of the Norwegian translation of the EDE. Fifty‐eight university women aged 19–41 years (mean BMI = 23) were assessed with the EDE and EDE‐Q. Satisfactory internal consistency and inter‐rater reliability were demonstrated for the Norwegian translation of the EDE. Generally high convergent validity between the EDE and EDE‐Q was found, with correlations ranging from 0.60 (Eating Concern) to 0.86 (Weight Concern). Agreement for OBEs and vomiting were excellent, while driven exercising generated lower levels of convergence. Consistent with prior studies, the EDE‐Q generated significantly higher levels of psychopathology, although effect sizes were small. Owing to the significantly higher EDE‐Q scores, it is ill advised to administer these two instruments interchangeably, as this may fail to produce meaningful data. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Replication of a Modified Factor Structure for the Eating Disorder Examination‐Questionnaire: Extension to Clinical Eating Disorder and Non‐clinical Samples in Portugal

Psychometric investigations of the Eating Disorder Examination‐Questionnaire (EDE‐Q) have generally not supported the original scale structure. The present study tested an alternative brief factor structure in two large Portuguese samples: (1) a non‐clinical sample of N = 4117 female students and (2) a treatment‐seeking sample of N = 609 patients diagnosed with eating disorders. Confirmatory factor analysis revealed a poor fit for the original EDE‐Q structure in both the non‐clinical and the clinical samples but revealed a good fit for the alternative 7‐item 3‐factor structure (dietary restraint, shape/weight overvaluation and body dissatisfaction). Factor loadings were invariant across samples and across the different specific eating disorder diagnoses in the clinical sample. These confirmatory factor analysis findings, which replicate findings from studies with diverse predominately overweight/obese samples, supported a modified 7‐item, 3‐factor structure for the EDE‐Q. The reliable findings across different non‐clinical and clinical eating disorder groups provide confidence regarding the potential utility of this brief version. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.     

French adaptation of the eating disorder recovery self‐efficacy questionnaire (EDRSQ): Psychometric properties and conceptual overview

High prevalence of Eating Disorders (EDs) and poor treatment outcome rates have urged research in the assessment of EDs. Self‐efficacy is a key motivational factor in the recovery from EDs. A self‐report measure, the Eating Disorder Recovery Self‐Efficacy Questionnaire (EDRSQ), was recently developed to assess confidence in adopting healthy eating behaviours and in maintaining a realistic body image. The objectives of this study were to (a) translate the EDRSQ to French (EDRSQ‐F), (b) assess the psychometric properties of this French version, and (c) establish normative data for a non‐clinical sample. Participants were 203 undergraduate women. They completed the EDRSQ‐F and measures of ED symptoms, depression and self‐esteem. A confirmatory factor analysis (CFA) revealed a bi‐factorial structure. Both scales demonstrated evidence of reliability and theoretically consistent evidence of construct validity. Findings support the validity of the EDRSQ‐F and suggest it is a useful instrument for the assessment of EDs. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.     

Eating Disorder Examination Questionnaire (EDE‐Q): Norms for Undergraduate Japanese Women

The aim of the present study was to provide normative data for the Eating Disorder Examination Questionnaire (EDE‐Q) among undergraduate Japanese women and to compare these data to norms obtained from previous studies. Undergraduate Japanese women (n = 289), aged 18–24 years, were administered the EDE‐Q. The mean global score in the present study was 1.55 (SD = 1.03). Japanese women reported significantly higher scores of shape concern and weight concern in spite of lower body mass index but a significantly lower score of restraint, compared with women in other normative studies. There were significant differences with respect to the occurrence of some specific eating disorder behaviours between Japanese women and women in the previous studies. Differences in normative data for the EDE‐Q between young Japanese women and young women in the previous studies suggest that there may be certain cultural differences in eating disorder psychopathology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Spanish Validation of the Accommodation and Enabling Scale for Eating Disorders Among Carers: A Pilot Study

Literature suggests that families may accommodate patients' symptoms in attempts to alleviate family conflict and stress. These accommodating and enabling behaviours may have a negative impact on carers and those they care for. There are no self‐report questionnaires validated in Spanish to measure accommodation among relatives of patients with an eating disorder. The aim of this study was to examine the psychometric properties of the Spanish version of the Accommodation and Enabling Scale for Eating Disorders (AESED‐S) among relatives of eating disorder patients. A cross‐sectional study of 90 relatives was carried out to explore the factor structure, reliability and validity of the AESED‐S. The internal consistency of the Spanish version of the AESED subscales was good, ranging from .89 to .81. The correlation of the five subscales with conceptually related measures (negative caregiving experience and distress) supports the convergent validity of this instrument in this sample. Results indicated that the Spanish version of the AESED provides a reliable and valid tool for assessing family accommodation in the context of having a relative with an eating disorder. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Food for Thought: Ego‐dystonicity and Fear of Self in Eating Disorders

Degree of ego‐dystonicity in obsessions is clinically relevant to the conceptualization and treatment of eating disorders (EDs). Obsessive–compulsive disorder research has suggested that the transformation of intrusive thoughts into obsessions is linked to the degree to which intrusive thoughts threaten core perceptions of the self. This study aims to explore the relationship between the ego‐dystonic nature of obsessions in ED patients and a fear of self, the link between ED symptom severity and ego‐dystonicity in obsessions, and differences between non‐clinical and individuals with EDs in the presence of ego‐dystonic thoughts and a fear of self. Ego‐dystonicity (Ego‐dystonicity Questionnaire (EDQ)) and feared self (Fear of Self Questionnaire (FSQ)) degrees were measured in a clinical sample (n = 57 with EDs) and a non‐clinical sample (n = 45). EDQ and FSQ scores were highly correlated in both samples. EDQ scores were not significantly correlated to ED symptom severity with the exception of the EDQ Irrationality subscale, which was strongly related to compulsion severity. Participants with an ED had significantly higher EDQ and FSQ scores compared with controls. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Association Between Oxytocin Receptor Genotype,Maternal Care,and Eating Disorder Behaviours in a Community Sample of Women

This study aimed to investigate associations between oxytocin receptor gene (OXT‐R) polymorphisms (rs53576 and rs2254298), their interaction with maternal care (GxE), and ED behaviours in a community sample. We studied 3698 women from the Avon Longitudinal Study of Parents and Children (ALSPAC) who participated in a two‐phase prevalence study of lifetime ED and had genotype data. The GG rs53576 genotype was associated with binge eating and purging, and the rs2254298 AG/AA genotype with restrictive eating lifetime. In addition, the rs2254298 AG/AA genotype interacted with poor maternal care to increase the odds of binge eating and purging (odds ratio = 4.40 (95% confidence intervals: 1.11–17.4)). This study replicates previous findings of an association between OXT‐R polymorphisms and ED, and it is the first to show an interaction between OXT‐R genotype and poor maternal care. As such, these findings highlight the important role of oxytocin in understanding the pathophysiology of ED. © 2016 The Authors European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd     

Fear of gaining weight: its validity as a visual analogue scale in anorexia nervosa

Despite fear of gaining weight (FGW) being a criterion for diagnosing anorexia nervosa (AN) there are no validated scales that assess it directly. The convergent validity of a visual analogue scale to assess FGW was tested. On admission to an inpatient unit, 114 females with AN were administered the FGW then, some days later, the Goldfarb Fear of Fat Scale (GFFS) and Eating Disorders Inventory (EDI). Concurrent validity for the FGW and GFFS was strong (r = 0.836), as was construct validity, their relationships to the EDI subscales paralleling each other. The strongest relationship for FGW was with drive for thinness (EDI‐DT) (r = 0.859). In 54 patients at discharge, predictive validity with EDI‐DT was strong (r = 0.771). Reliability was moderate (r = 0.636). With statistical validity established, the FGW could prove useful in integrating theory, clinical work and research in AN. Its direct assessment in this study has already highlighted its strong relationships to some maintaining and risk factors in AN. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.     

An evaluation of the Oxford Adult Eating Disorders Service between 1994 and 2002

This paper examines the outcomes of 631 patients who were assessed at the Oxford Adult Eating Disorders Service between May 1994 and December 2002. After treatment, significant improvements were reported across the total sample for body mass index (BMI), the Beck Depression Inventory, the Beck Anxiety Inventory and the Robson Self Concept Questionnaire. Significant improvements were also reported for all measures of the Eating Disorder Questionnaire (EDE) and for all measures of the Eating Disorder Inventory (EDI) except for perfectionism. Patients with anorexia nervosa showed improvements in both BMI and associated psychopathology. Patients with bulimia nervosa showed a reduction in the number of self‐induced vomiting occasions and the number of objective binges and improvements in the associated psychopathology. Further research is required to identify factors associated with improvements in symptomatology. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association.     

The development of the childhood retrospective perfectionism questionnaire (CHIRP) in an eating disorder sample

This investigation explored the prevalence and predictive value of childhood obsessive‐compulsive personality traits (OCPTs) in the development of eating disorders (EDs) using a novel retrospective questionnaire. To reduce bias associated with retrospective self‐report data, an identical informant version of the questionnaire was also utilised. Substantial test–retest and inter‐rater reliabilities were found for the questionnaire, as well as concordant validity with the semi‐structured interview from which it was derived. Participants with an ED (n = 246) endorsed more childhood behaviours reflecting OCPTs than the control group (n = 89). This was mirrored in the informant report data (n = 93). The prevalence rate for each OCPT in childhood was significantly higher in the total ED sample compared to the control group. Both proband and informant reports of childhood traits predict the later development of an ED according to a strong dose–response relationship. The potential utility of this measure in future retrospective and prospective research studies is highlighted. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association.     

Male eating disorder patients with and without non-suicidal self-injury: a comparison of psychopathological and personality features

In the present study, we investigated the prevalence and comorbidity of non‐suicidal self‐injury (NSSI) in male eating disorder (ED) patients. In total, 130 male ED patients completed a list of 10 impulse‐control problems (including NSSI), the Eating Disorder Inventory‐2, the Symptom Checklist‐90‐Revised and the Temperament and Character Inventory. Overall, 21% of the male ED patients (n = 27) engaged in at least one type of NSSI, and we did not find significant differences between the ED subtypes. Self‐injurious male ED patients showed significantly more severe ED symptoms and more affective, interpersonal and impulse‐control problems than ED patients without NSSI. As previously described in female ED, our data confirm the affect regulation and impulse regulation functions of NSSI in male ED patients. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Facets of Impulsivity and Compulsivity in Women with Anorexia Nervosa

This study sought to investigate independent associations of impulsivity and compulsivity with eating disorder (ED) symptoms. Women (N = 81) with full or subthreshold Diagnostic and Statistical Manual of Mental Disorders IV anorexia nervosa (AN) completed a semi‐structured interview and self‐report questionnaires. Multiple regression analyses were conducted using ED symptoms as dependent variables and facets of impulsivity and compulsivity as predictor variables (controlling for body mass index and AN diagnostic subtype). For impulsivity facets, lack of perseverance was uniquely associated with eating concern, shape concern and restraint, whereas negative urgency was uniquely associated with eating concern and frequency of loss of control eating; neither sensation seeking nor lack of premeditation was uniquely associated with any ED variables. Compulsivity was uniquely associated with restraint, eating concern and weight concern. Results support independent associations of impulsivity and compulsivity with ED symptoms in adults with AN, suggesting potential utility in addressing both impulsive and compulsive processes in treatment. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.     

Psychometric Evaluation of the Eating Disorder Examination Adapted for Children

The Eating Disorder Examination adapted for children (ChEDE) is the child version of the semi‐structured gold standard eating disorder interview for adults. This study was a comprehensive test statistic evaluation of the German ChEDE in a large sample of children and adolescents with anorexia nervosa, binge eating disorder, loss of control eating, overweight and obesity, as well as non‐eating‐disordered and chronically ill control probands (n = 352). Excellent inter‐rater reliability, adequate internal consistency and satisfactory stability of ChEDE indicators were demonstrated. ChEDE indicators discriminated between diverse forms of eating and weight disturbances and normative eating and were significantly correlated with conceptually related measures. Factorial validity was not convincing; a brief eight‐item scale showed the best fit. Item statistics were mostly acceptable. Overall, the ChEDE's German translation reliably and validly assesses psychopathology across the eating and weight disorder spectrum and facilitates international comparison of eating disorder research. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.     

A new instrument measuring disturbed eating patterns in community populations: development and initial validation of a five‐item scale (EDS‐5)

This paper reports on the development and validation of a brief scale, the Eating Disturbance Scale (EDS‐5), as a screening instrument for problematic eating disorders in normal populations. A nationwide sample of 6313 subjects completed 22 questions about eating patterns. Using principal component analysis, these questions were cut down to five items, forming a scale. From another epidemiological study (N = 835), 51 female subjects responded to these five questions in addition to a clinical interview. The scale yielded a Cronbach alpha of 0.83 and 0.86, respectively, Also, a sensitivity and specificity of 0.90 and 0.88 was found with respect to DSM‐IV eating disorders. The concurrent and construct validity show significant correlations with Eating Disorder Inventory subscales measuring disturbed eating (M = 0.55, range 0.44–0.73), and even higher correlations with similar factors from the self‐report version of the Eating Disorder Examination (M = 0.73, range 0.60–0.89). The results suggest that the EDS‐5 is sensitive to disordered eating patterns and that this instrument appears promising for screening purposes in community samples. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association.     

A Psychometric Exploration of an Italian Translation of the SCOFF Questionnaire

The SCOFF is a quick and simple screening tool for eating disorders (EDs), intended for use by those who are not specialists in the field. The purpose of the present study is to explore the psychometric properties of an Italian version of the instrument. An Italian translation of the SCOFF was administered, together with a part of the Italian version of the Eating Disorders Inventory‐3, to the following: (i) a sample of psychiatric patients diagnosed with ED according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; (ii) a sample of female psychiatric controls with no ED symptoms; and (iii) a sample of female normal controls without EDs from the general population. Results suggest that the Italian version of the SCOFF provides a reliable and valid tool for screening EDs. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Eating Disorder Diagnostic Scale: Psychometric Features Within a Clinical Population and a Cut‐off Point to Differentiate Clinical Patients from Healthy Controls

The Eating Disorder Diagnostic Scale (EDDS) is a brief self‐report measure for diagnosing anorexia nervosa, bulimia nervosa and binge eating disorder. Research has provided evidence of the reliability and validity of this scale in non‐clinical populations. Our study is the first to examine the psychometric features of the EDDS in a clinical population of eating disordered patients. We identified a cut‐off point that differentiates clinical patients from healthy controls. A clinical group of 59 Dutch female eating disordered patients and a control group of 45 Dutch students completed the EDDS, the Eating Disorder Examination Interview, the Body Attitude Test and the Beck Depression Inventory—II. The EDDS showed good test–retest reliability, internal consistency, criterion validity and convergent validity with other scales assessing eating and general pathology. An overall symptom composite cut‐off score of 16.5 accurately distinguished clinical patients from healthy controls. The EDDS may be a useful instrument in clinical settings and in aetiologic, prevention and treatment research. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Eating Disorders,Substance Use Disorders,and Impulsiveness among Disordered Gamblers in a Community Sample

Disordered gambling and many eating disorders (EDs) involve recurrent loss of impulse control. We examined rates of specific EDs, ED psychopathology, substance use disorders, and their interrelationships with impulsiveness among community members with disordered gambling. Community‐recruited adults with pathological (n = 95) or problem (n = 9) gambling (N = 104; 51% female) completed structured interviews and questionnaires. We observed high rates of substance dependence, lifetime EDs, and current ED psychopathology; 20.8% of women (vs 1.9% of men) had a DSM‐IV ED, and 37.8% (vs 3.9%) had an ED according to proposed DSM‐5 criteria. Although disordered gambling severity was not associated with ED diagnosis or severity of ED psychopathology, greater disordered gambling severity and an ED diagnosis were both associated with increased impulsiveness. These findings suggest that impulsiveness might constitute a common personality characteristic that underlies disordered gambling and EDs. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.     

Effect of self‐monitoring on binge eating: treatment response or ‘binge drift’?

The current study aimed to determine if subjective bulimic episodes (SBEs) and objective bulimic episodes (OBEs) have different reactive effects to self‐monitoring. Fourteen women with bulimia nervosa (57%) or binge eating disorder (43%) were diagnosed using the Eating Disorder Examination (EDE; version 12.0). During the 7‐days post‐interview, participants filled out daily self‐monitoring records indicating the food consumed and any episodes of loss of control over eating. These records were reviewed and coded for OBEs and SBEs using the EDE coding scheme. Paired samples t‐tests indicated that participants' average number of daily OBEs significantly decreased from baseline to the period of self‐monitoring (t = 2.41, p < 0.05, Cohen's d = 0.90), whereas there was a significant increase from baseline to self‐monitoring in their average number of SBEs (t = ?2.41, p < 0.05, Cohen's d = 0.86). Of the 12 participants who showed a decrease in OBEs, 75% showed a concurrent increase in SBEs. The data suggest that the reactivity of OBEs to minimal or brief interventions may in part be due to binge drift, or the reduction of OBEs at the expense of increasing SBEs. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.