Cross-national and longitudinal investigation of a short measure of workaholism

Abstract: The present study investigated the factor structure of the 10-item version of the Dutch Work Addiction Scale (DUWAS). The DUWAS-10 is intended to measure workaholism with two correlated factors: working excessively (WE) and working compulsively (WC). The factor structure of the DUWAS-10 was examined among multi-occupational samples from the Netherlands (n=9,010) and Finland (n=4,567) using confirmatory factor analysis (CFA). CFAs revealed that the expected correlated two-factor solution showed satisfactory fit to the data. However, a second-order factor solution, where WE comprised the first-order factors “working frantically” and “working long hours”, and WC the first-order factors “obsessive work drive” and “unease if not working”, showed significantly better fit to the data. The expectation of factorial group invariance of the second-order factor structure between the Dutch and Finnish samples was also supported. Moreover, factorial time invariance was observed across a two-year time lag in a sub-sample of Finnish managers (n=459). In conclusion, the DUWAS-10 was found to be a comprehensive measure of workaholism, meeting the criteria of factorial validity in multiple settings, and can thus be recommended for use in both research and practice.     

Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls

BACKGROUND: There are few theoretically derived questionnaires of physical activity determinants among youth, and the existing questionnaires have not been subjected to tests of factorial validity and invariance. The present study employed confirmatory factor analysis (CFA) to test the factorial validity and invariance of questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity. METHODS: Adolescent girls in eighth grade from two cohorts (N = 955 and 1,797) completed the questionnaires at baseline; participants from cohort 1 (N = 845) also completed the questionnaires in ninth grade (i.e., 1-year follow-up). Factorial validity and invariance were tested using CFA with full-information maximum likelihood estimation in AMOS 4.0. Initially, baseline data from cohort 1 were employed to test the fit and, when necessary, to modify the unidimensional models. The models were cross-validated using a multigroup analysis of factorial invariance on baseline data from cohorts 1 and 2. The models then were subjected to a longitudinal analysis of factorial invariance using baseline and follow-up data from cohort 1. RESULTS: The CFAs supported the fit of unidimensional models to the four questionnaires, and the models were cross-validated, as indicated by evidence of multigroup factorial invariance. The models also possessed evidence of longitudinal factorial invariance. CONCLUSIONS: Evidence was provided for the factorial validity and the invariance of the questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity among adolescent girls.     

Factorial Invariance of Child Self-Report across Age Subgroups: A Confirmatory Factor Analysis of Ages 5 to 16 Years Utilizing the PedsQL 4.0 Generic Core Scales

Background:  The utilization of health-related quality of life (HRQOL) measurement in an effort to improve pediatric health and well-being and determine the value of health care services has grown dramatically over the past decade. The paradigm shift toward patient-reported outcomes (PROs) in clinical trials has provided the opportunity to emphasize the value and essential need for pediatric patient self-report. In order for HRQOL/PRO comparisons to be meaningful for subgroup analyses, it is essential to demonstrate factorial invariance. This study examined age subgroup factorial invariance of child self-report for ages 5 to 16 years on more than 8500 children utilizing the PedsQL™ 4.0 Generic Core Scales.
Method:  Multigroup Confirmatory Factor Analysis (MGCFA) was performed specifying a five-factor model. Two multigroup structural equation models, one with constrained parameters and the other with unconstrained parameters, were proposed to compare the factor loadings across the age subgroups.
Results:  Metric invariance (i.e., equal factor loadings) across the age subgroups was demonstrated based on stability of the Comparative Fit Index between the two models, and several additional indices of practical fit including the Root Mean Squared Error of Approximation, the Non-Normed Fit Index, and the Parsimony Normed Fit Index.
Conclusion:  The findings support an equivalent five-factor structure across the age subgroups. Based on these data, it can be concluded that children across the age subgroups in this study interpreted items on the PedsQL 4.0 Generic Core Scales in a similar manner regardless of their age.     

Measurement of perceived school climate for active travel in children

OBJECTIVES: To describe the development of an original scale that measures perceived school climate for active travel in fourth- and fifth-grade girls and boys. METHODS: The data were analyzed using confirmatory factor analysis (CFA) to provide evidence of factorial validity, factorial invariance, and construct validity. RESULTS: The CFA supported the fit of a 3-factor (encouragement, praise, and importance) correlated model for the school climate for active travel measure. This hierarchical model was invariant between sex and across a 7-month time period, and initial evidence for construct validity was provided. CONCLUSIONS: School climate for active travel is a measurable construct, and preliminary evidence suggests relationships with more support for active travel from friends and family.     

中文版癌症后生育忧虑量表跨癌症类型的测量不变性

目的 确定中文版癌症后生育忧虑量表(Reproductive Concerns After Cancer Scale，RCACS)的因子结构，并检验其在女性不同癌症类型群体间的测量不变性。 方法 对乌鲁木齐市975名18~40岁的女性癌症患者进行调查，在妇科恶性肿瘤、甲状腺癌和乳腺癌人群中分别采用探索性因子分析，以确定中文版RCACS的因子结构。应用多组验证性因子分析，以检验RCACS跨癌症类型的测量不变性。 结果 RCACS在妇科恶性肿瘤、甲状腺癌和乳腺癌人群中分别进行探索性因子分析，均提取出6个公因子；多组验证性因子分析结果显示，中文版RCACS具有跨癌症类型的测量不变性（形态不变性、单位不变性、强不变性、严格不变性）。 结论 中文版RCACS具有稳定的因子结构，在不同癌症类型的群体间具有测量不变性，可用于评估乌鲁木齐市女性癌症患者的生育忧虑水平。     

Factorial validity of the effort–reward imbalance scale: evidence from multi-sample and three-wave follow-up studies

Purpose

The present study investigated whether the factor structure of the effort–reward imbalance (ERI) scale (Siegrist et al. Soc Sci Med 58:1483–1499, 2004) remains same across two white-collar samples (i.e., factorial group invariance) and across three measurement times (i.e., factorial time invariance).

Methods

The factorial group invariance was tested using two different samples including 1,301 managers and 758 young white-collar professionals. The factorial time invariance was tested in the latter sample with a four-year three-wave follow-up design.

Results

The confirmatory factor analysis performed supported the theoretically based structure of the ERI scale, that is, the scale included two first-order factors of effort and overcommitment and one second-order factor of reward with first-order factors of esteem, career opportunities, and job security. The factorial group invariance of this structure was also supported. In addition, the factor loadings of all factors remained same across three measurements; thus, lending support for the factorial time invariance.

Conclusion

The ERI scale was found to be a valid tool to measure costs and gains of social exchanges at work as well as individual orientation toward work in these two occupational samples including a longitudinal study design.     

Calibration of Disease Simulation Model Using an Engineering Approach

Objectives:  Calibrating a disease simulation model's outputs to existing clinical data is vital to generate confidence in the model's predictive ability. Calibration involves two challenges: 1) defining a total goodness-of-fit ( GOF ) score for multiple targets if simultaneous fitting is required, and 2) searching for the optimal parameter set that minimizes the total GOF score (i.e., yields the best fit). To address these two prominent challenges, we have applied an engineering approach to calibrate a microsimulation model, the Lung Cancer Policy Model (LCPM).
Methods:  First, 11 targets derived from clinical and epidemiologic data were combined into a total GOF score by a weighted-sum approach, accounting for the user-defined relative importance of the calibration targets. Second, two automated parameter search algorithms, simulated annealing (SA) and genetic algorithm (GA), were independently applied to a simultaneous search of 28 natural history parameters to minimize the total GOF score. Algorithm performance metrics were defined for speed and model fit.
Results:  Both search algorithms obtained total GOF scores below 95 within 1000 search iterations. Our results show that SA outperformed GA in locating a lower GOF . After calibrating our LCPM, the predicted natural history of lung cancer was consistent with other mathematical models of lung cancer development.
Conclusion:  An engineering-based calibration method was able to simultaneously fit LCPM output to multiple calibration targets, with the benefits of fast computational speed and reduced the need for human input and its potential bias.     

Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults

BackgroundPrevious research on the Center for Epidemiologic Studies Depression Scale (CES-D) has five main limitations. First, no study provided evidence of the factorial equivalence of this instrument across samples of depressive and community participants. Second, only one study included systematic tests of measurement invariance based on confirmatory factor analyses (CFA), and this study did not consider the higher-order factor structure of depression, although it is the CES-D global scale score that is most often used in the context of epidemiological studies. Third, few studies investigated the screening properties of the CES-D in non-English-language samples and their results were inconsistent. Fourth, although the French version of the CES-D has been used in several previous studies, it has never been systematically validated among community and/or depressed adults. Finally, very few studies have taken into account the ordered-categorical nature of the CES-D answer scale. The purpose of the study reported herein was therefore to examine the construct validity (i.e., factorial, reliability, measurement invariance, latent mean invariance, convergence, and screening properties) of the CES-D in a French sample of depressed patients and community adults.MethodsA total sample of 469 participants, comprising 163 clinically depressed patients and 306 community adults, was involved in this study. The factorial validity, and the measurement and latent mean invariance of the CES-D across gender and clinical status, were verified through CFAs based on ordered-categorical items. Correlation and receiver operator characteristic curves were also used to test the convergent validity and screening properties of the CES-D.ResultsThe present results: (i) provided support for the factor validity and reliability of a second-order measurement model of depression based on responses to the CES-D items; (ii) revealed the full measurement invariance of the first- and second-order measurement models across gender; (iii) showed the partial strict measurement invariance (four uniquenesses had to be freely estimated, but the factor variance–covariance matrix also proved fully invariant) of the first-order factor model and the complete measurement invariance of the second-order model across patients and community adults; (iv) revealed a lack of latent mean invariance across gender and across clinical and community subsamples (with women and patients reporting higher scores on all subscales and on the full scale); (v) confirmed the convergent validity of the CES-D with measures of depression, self-esteem, anxiety, and hopelessness; and (vi) demonstrated the efficacy of the screening properties of this instrument among clinical and nonclinical adults.ConclusionThis instrument may be useful for assessing depressive symptoms or for the screening of depressive disorders in the context of epidemiological studies targeting French patients and community men and women with a background similar to those from the present study.     

Psychometric Validation of the Cancer Therapy Satisfaction Questionnaire

Purpose:  To assess the domain structure and to evaluate the psychometric properties of the Cancer Therapy Satisfaction Questionnaire (CTSQ) and the relation between the CTSQ and health-related quality of life (HRQOL).
Methods:  Three hundred sixty-one individuals with breast, colorectal, lung cancer, or melanoma who had received in the last 6 months or were currently receiving more than one cycle of chemo, biological, or hormonal therapy completed the 21-item CTSQ, with a random subsample of 88 patients completing it again 1 week later. Participants also completed quality of life, treatment satisfaction, and other self-reported questions on each occasion. Demographics, ECOG performance status, and clinical information were collected. CTSQ responses were submitted to multitrait analyses and exploratory factor analysis. Psychometric properties and the correlations between the CTSQ and the Quality of Life Questionnaire––Core 30 (QLQ-C30) were evaluated.
Results:  Analyses revealed three domains with good psychometric properties: Feelings about Side Effects, Satisfaction with Therapy, and Expectations of Therapy. Correlations with the QLQ-C30 domains were low to moderate.
Conclusion:  The CTSQ is a newly developed 16-item patient-reported measure with strong psychometric properties and constructs not captured by the QLQ-C30. It can be used to evaluate cancer patients' experiences with intravenous and/or oral chemo, biological, and hormonal therapies.     

The 9-item Bergen Burnout Inventory: Factorial Validity Across Organizations and Measurements of Longitudinal Data

The present study tested the factorial validity of the 9-item Bergen Burnout Inventory (BBI-9)¹⁾. The BBI-9 is comprised of three core dimensions: (1) exhaustion at work; (2) cynicism toward the meaning of work; and (3) sense of inadequacy at work. The study further investigated whether the three-factor structure of the BBI-9 remains the same across different organizations (group invariance) and measurement time points (time invariance). The factorial group invariance was tested using a cross-sectional design with data pertaining to managers (n=742), and employees working in a bank (n=162), an engineering office (n=236), a public sector organization divided into three service areas: administration (n=102), education and culture (n=581), and social affairs and health (n=1,505). Factorial time invariance was tested using longitudinal data pertaining to managers, with three measurements over a four-year follow-up period. The confirmatory factor analysis revealed that the three-factor structure of the BBI-9 was invariant across cross-sectional samples. The factorial invariance was also supported across measurement times. To conclude, the factorial structure of the BBI-9 was found to remain the same regardless of the sample properties and measurement times.     

Measuring the psychological consequences of breast cancer screening: a confirmatory factor analysis of the Psychological Consequences Questionnaire

Objectives

To use confirmatory factor analysis (CFA) to test the proposed factor structure of the Psychological Consequences Questionnaire (PCQ), a measure of the psychological impact of breast cancer screening. A further aim was to examine the robustness of the proposed factor structure across key demographic and clinical variables.

Method

Following visits to breast cancer screening clinics, women who received a false-positive diagnosis and a matched sample of women who had received all-clear diagnoses were sent a questionnaire package containing the PCQ and a demographics measure. A total of 220 women returned completed questionnaires. CFA was used to test the factor structure and multiple indicator–multiple cause (MIMIC) models were used to test the robustness of the factor structure across the test result group, age, and family history of breast cancer diagnosis.

Results

The CFA results suggested support for both a three- and a one-factor model; a one-factor model was preferred, however, due to the very high covariance between the three latent factors in the three-factor model. A CFA MIMIC model suggested that the test result impacted on the latent factor: women who initially received a false-positive diagnosis showed significantly higher levels of psychological dysfunction after screening.

Conclusions

The PCQ appears to be a promising tool for assessing psychological dysfunction after breast cancer screening; however, a one-factor model received more support than the initially proposed three-factor model. There was little evidence of differential item functioning across key demographic and clinical variables for the PCQ.     

Cost-Effectiveness of Primary versus Secondary Prophylaxis with Pegfilgrastim in Women with Early-Stage Breast Cancer Receiving Chemotherapy

Objective:  Prophylaxis with granulocyte colony-stimulating factor (G-CSF) reduces the risk of febrile neutropenia (FN) in patients receiving myelosuppressive chemotherapy. We estimated the incremental cost-effectiveness of G-CSF pegfilgrastim primary (starting in cycle 1 and continuing in subsequent cycles of chemotherapy) versus secondary (only after an FN event) prophylaxis in women with early-stage breast cancer receiving myelosuppressive chemotherapy with a ≥20% FN risk.
Methods:  A decision-analytic model was constructed from a health insurer's perspective with a lifetime study horizon. The model considers direct medical costs and outcomes related to reduced FN and potential survival benefits because of reduced FN-related mortality. Inputs for the model were obtained from the medical literature. Sensitivity analyses were conducted across plausible ranges in parameter values.
Results:  The incremental cost-effectiveness ratio (ICER) of pegfilgrastim as primary versus secondary prophylaxis was $48,000/FN episode avoided. Adding survival benefit from avoiding FN mortality yielded an ICER of $110,000/life-year gained (LYG) or $116,000/quality-adjusted life-year (QALY) gained. The most influential factors included FN case-fatality, FN relative risk reduction from primary prophylaxis, and age at diagnosis.
Conclusions:  Compared with secondary prophylaxis, the cost-effectiveness of pegfilgrastim as primary prophylaxis may be equivalent or superior to other commonly used supportive care interventions for women with breast cancer. Further assessment of the direct impact of G-CSF on short- and long-term survival is needed to substantiate these findings.     

Exploratory study examining barriers to participation in colorectal cancer screening

Objective:  To examine the Stage of Change distribution for bowel cancer screening in a regional Australian community and the factors associated with varying positions on the continuum of change.
Design:  Survey of a convenience sample.
Setting:  Community sample.
Participants:  A total of 59 (31 male, mean age  =  59) service club members from a South Australian regional community.
Main outcome measure:  Self-reported Stage of Change for bowel cancer screening behaviour.
Results:  Attributing greater embarrassment and discomfort to bowel cancer screening was associated with earlier positions on the Stages of Change. Perceiving that bowel cancer screening might have positive value for personal health was associated with more advanced positions on the continuum of change. Those who perceived breast and prostate screening procedures to be embarrassing or to cause discomfort were significantly less likely to be participating in bowel cancer screening. No significant relationships were found between bowel cancer screening Stage of Change and worry about vulnerability; personal, family or wider social network case reports of bowel cancer; and the population-level value attributed to the cancer screening procedures.
Conclusion:  Bowel cancer screening participation rates are currently lower than those associated with breast and prostate screening. Reducing perceptions of embarrassment and discomfort, increasing awareness of potential health benefits and maximising participation in other screening procedures might increase participation in bowel cancer screening.     

An Economic Evaluation of Adjuvant Trastuzumab Therapy in HER2-Positive Early Breast Cancer

Objective:  One-year adjuvant trastuzumab therapy increases disease-free and overall survival in the adjuvant treatment of early HER2-positive breast cancer. This study aims to assess the long-term cost-effectiveness of adjuvant trastuzumab treatment in Beijing, Shanghai, and Guangzhou.
Methods:  A Markov health-state transition model was constructed to simulate the natural development of breast cancer based on HERceptin Adjuvant (HERA) trial, estimate costs and disease progression over a lifetime perspective with annual transition cycles, and evaluate the cost-effectiveness of 1-year adjuvant trastuzumab treatment group compared with the standard adjuvant chemotherapy. From the perspective of a China health insurance system, cost was calculated based on a survey from clinical expert panels.
Results:  On the basis of HERA data, the model results showed that the utilization of adjuvant trastuzumab treatment in early breast cancer can prolong 2.87 life years, compared with the standard chemotherapy group. The incremental cost for an additional life-year gained (LYG) was US$7564, US$7933, and US$7929 in Beijing, Shanghai, and Guangzhou, respectively. If measured by quality-adjusted life-year, the incremental cost-effectiveness ratio was US$7676, US$8049, and US$8046, respectively.
Conclusion:  The results suggest that the 1-year adjuvant trastuzumab treatment is cost-effective. Both clinical and economic benefits were superior for the 1-year adjuvant trastuzumab treatment group compared with the standard adjuvant chemotherapy group.     

Comparability of the Patient-Reported Outcomes Measurement Information System Pediatric short form symptom measures across culture: examination between Chinese and American children with cancer

Purpose

Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric forms measure symptoms and function of pediatric patients experiencing chronic disease by using the same measures. Comparability is one of the most important purposes of the PROMIS initiative. This study aimed to test the factorial structures of four symptom measures (i.e., Anxiety, Depression, Fatigue, and Pain Interference) in the original English and the Chinese versions and examine the measurement invariance of the measures across two cultures.

Methods

Four PROMIS Pediatric measures were used to assess symptoms, respectively, in Chinese (n = 232) and American (n = 200) children and adolescents (8–17 years old) in treatment for cancer or in survivorship. The categorical confirmatory factor analysis (CCFA) model was used to examine factorial structures, and multigroup CCFA was applied to test measurement invariance of these measures between the Chinese and American samples.

Results

The CCFA models of the four PROMIS Pediatric symptom measures fit the data well for both the Chinese and American children and adolescents. Minor partial measurement invariance was identified. Factor means and factor variances of the four PROMIS measures were not significantly different between the two populations.

Conclusions

Our results provide evidence that the four PROMIS Pediatric symptom measures have valid factorial structures and a statistical property of measurement invariance across American and Chinese children and adolescents with cancer. This means that the items of these measures were interpreted in a conceptually similar manner by two groups. They could be readily used for meaningful cross-cultural comparisons involving pediatric oncology patients in these two countries.

     

General Health Questionnaire (GHQ-12): the effect of negative items in its factorial structure

The General Health Questionnaire (GHQ-12) detects non severe psychiatric illnesses. Although commonly treated as a general index, the definition of its factorial structure is cause for debate. This study aimed to test this structure comparing three models: two frequently cited in the literature (one- and bi- factorial) and a third, also one-factor, which controls response bias due to the negative wording of items. A total of 1,180 people participated (300 undergraduates, 311 military policemen, 274 elementary school teachers and 295 members of the general population) answering the GHQ-12 and demographic questions. Confirmatory factor analyses showed that the one-factor structure, controlling by the wording effect, gathered the best fit indexes, except among the military. This structure showed greater than 0.80 reliability in all groups. It was concluded that the one-factor model of the GHQ-12 is more appropriate, however, future studies are required with people with different occupations and levels of mental health.     

Deterioration of Quality of Life of High-Risk Breast Cancer Patients Treated with High-Dose Chemotherapy: The PEGASE 01 Quality of Life Study

Objective:  The aim of this study was to compare the quality of life (QOL) of high-risk breast cancer patients included in a randomized clinical trial (PEGASE 01) comparing conventional chemotherapy versus adding an additional high-dose chemotherapy (HDC) cycle with blood stem cell support.
Methods:  A total of 314 patients were included in the clinical trial. QOL evaluations were available for 199 patients. QOL was assessed over a 1-year follow-up period, using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. The results were analyzed using a linear mixed-effects model.
Results:  Toxicity of HDC has a strong negative impact on patients' QOL during the treatment phase. This negative impact tended to last longer in the HDC group, as for most of the QLQ-C30 scales, the QOL scores of HDC patients tend to improve at a slower rate than that of patients receiving standard chemotherapy. In particular, physical functioning remains deteriorated 1 year after inclusion for HDC patients comparatively to conventional chemotherapy patients (85.99 vs. 76.65, P  = 0.021), and the pain score was still higher in the HDC group at that time (28.32 vs. 15.97, P  = 0.004).
Conclusion:  HDC has a negative impact on QOL even after treatment phase. In the absence of an overall survival benefit of using HDC for high-risk breast cancer patients, QOL studies with a longer follow-up play an important role in informing the complex trade-off implied by HDC between higher toxicity, reduced risk of relapse, and QOL decrease after the active phase of treatment.     

Decision-making role preferences and information needs: a comparison of colorectal and breast cancer

Objective  An exploratory study has been carried out to examine decision-making role preferences and information needs for a sample of people with colorectal cancer ( n =48). The work replicated a larger study carried out for women with breast cancer ( n =150), and this paper compares and contrasts findings for both disease groups.
Design  A cross-sectional design was employed, involving structured interviews. The main variables investigated were decision-making preference (using a decisional role preference card sort), perceived decisional role and information need (using an information needs questionnaire).
Results  The majority (78%) of the colorectal cancer patients preferred to play a passive role in decision making, in contrast to 52% of women with breast cancer in previous work. Eighty per cent of the colorectal sample and 61% of the women with breast cancer perceived that the doctor had made treatment decisions. Priority information needs for both groups related to cure, spread of disease and treatment options.
Conclusions  The two most striking findings from the comparison between the two disease groups relate to the differences in decision-making role preferences and the similarities in information needs. The process of involving people with colorectal cancer in treatment decision making warrants further investigation. The similarity in information needs of the two disease groups has implications for health care professionals providing information to people with cancer.     

Cost-Effectiveness of Testing for Breast Cancer Susceptibility Genes

Objectives:  Genetic mutations in breast cancer susceptibility genes BRCA1/2 are associated with an increased risk of breast/ovarian cancers. Cost-effective preventive measures are available for women who test positive. The objective of this study was to determine at what risk of mutation it is cost-effective to test women for BRCA1/2 mutations.
Methods:  A semi-Markov model accrued costs and quality-adjusted life years (QALYs) annually from the societal perspective. The estimates of health-care costs, life expectancy, likelihood of obtaining a mastectomy or oophorectomy, and patient preferences for treatment and certainty about their BRCA1/2 status were based on the literature.
Results:  At a 10% probability of mutation (the current guideline), the test strategy generated 22.9 QALYs over the lifetime and cost $118k, while the no-test strategy generated 22.7 QALYs and cost $117k. The incremental cost-effectiveness ratio of the test strategy was $9k and the differences between costs and effects were not substantial. The test strategy remained cost-effective to a probability of mutation of 0%, as long as utility gained from a negative test result was 0.006 or greater. These results were sensitive to the frequency of inconclusive test results and utility gain from a negative test result.
Conclusions:  The costs and effectiveness of both the test and no-test strategies are very similar even when there is a small probability of mutation. Current guidelines, which can be used by insurance companies to refuse coverage, could deny some women a cost-effective approach. Further research to decrease the frequency of inconclusive results could improve the cost-effectiveness of this test.     

The children's DEBQ for assessment of restrained, emotional, and external eating in 7- to 12-year-old children

OBJECTIVE: Construct an age adapted version of the Dutch Eating Behaviour Questionnaire (DEBQ) for measurement of restrained, emotional and external eating in 7- to 12-year-old children: the DEBQ-C. METHOD: The DEBQ-C was constructed and tested for its reliability, factorial validity, factorial invariance for sex, overweight (BMI-status), and age, and correlations with measures for unhealthy life style in one sample (382 boys and 387 girls). In a second sample (252 boys and 263 girls) correlations were obtained with measures for body dissatisfaction and parental feeding styles. Single and multigroup confirmatory factor analyses were used. RESULTS: The fit measures for the three factor model and the factorial invariance models with respect to sex, BMI-status, and age were satisfactory. In the (sub) samples of the 7- to 12-year-olds Cronbach's alpha's ranged from .73 to .82 and there were satisfactory correlations (p < .01) with other measures. CONCLUSION: The DEBQ-C should provide a useful measure for young children's emerging dietary restraint and overeating tendencies. The low prevalence of emotional eating indicates that most young children show the natural reaction to emotional stressors (loss of appetite when feeling lonely, depressed or afraid) and that emotional (over) eating at this age is quite abnormal.