Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples

In order to examine the concurrent and criterion validity of the questionnaire version of the Eating Disorders Examination (EDE-Q), self-report and interview formats were administered to a community sample of women aged 18-45 (n = 208). Correlations between EDE-Q and EDE subscales ranged from 0.68 for Eating Concern to 0.78 for Shape Concern. Scores on the EDE-Q were significantly higher than those of the EDE for all subscales, with the mean difference ranging from 0.25 for Restraint to 0.85 for Shape Concern. Frequency of both objective bulimic episodes (OBEs) and subjective bulimic episodes (SBEs) was significantly correlated between measures. Chance-corrected agreement between EDE-Q and EDE ratings of the presence of OBEs was fair, while that for SBEs was poor. Receiver operating characteristic (ROC) analysis, based on a sample of 13 cases, indicated that a score of 2.3 on the global scale of the EDE-Q in conjunction with the occurrence of any OBEs and/or use of exercise as a means of weight control, yielded optimal validity coefficients (sensitivity = 0.83, specificity = 0.96, positive predictive value = 0.56). A stepwise discriminant function analysis yielded eight EDE-Q items which best distinguished cases from non-cases, including frequency of OBEs, use of exercise as a means of weight control, use of self-induced vomiting, use of laxatives and guilt about eating. The EDE-Q has good concurrent validity and acceptable criterion validity. The measure appears well-suited to use in prospective epidemiological studies.     

Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report?

Research addressing the assessment of binge eating and associated eating disorder psychopathology has steadily increased in recent years. Few studies have examined the relationship between the various assessment methods. This study compared an investigator-based interview, the Eating Disorder Examination (EDE), with a self-report version of that interview, the EDE-Q. Fifty-two individuals (six men and 46 women) with binge eating disorder (BED) completed both instruments. Modest-to-good agreement and significant correlations (P < 0.0001) were found between the two methods on all four subscales assessing specific eating disorder psychopathology (i.e., Restraint, Eating Concern, Weight Concern, and Shape Concern subscales). However, higher levels of disturbance were consistently reported on the EDE-Q than the EDE interview. The two methods were not significantly or reliably related to one another when assessing binge eating. This may be due in part to the difficulty inherent in identifying binges in subjects with BED. Examination of individual item scores suggest that it might be possible to improve the performance of the EDE-Q by clarifying the definitions of certain complex features, although this should not be at the expense of compromising the practical utility of its self-report format.     

Eating Disorder Examination Questionnaire (EDE-Q): norms for young adult women

In order to establish norms for the Eating Disorder Examination Questionnaire (EDE-Q) among young adult women, the questionnaire was administered to a large general population sample of women aged 18-42 yr in the Australian Capital Territory (ACT) region of Australia. Normative data were derived for EDE-Q subscales and for the occurrence of specific eating disorder behaviours, for each of five age bands (18-22, 23-27, 28-32, 33-37, 38-42 yr). Mean scores (SDs) for the Restraint, Eating Concern, Weight Concern and Shape Concern subscales for the total sample (n = 5,255) were, respectively, 1.30 (1.40), 0.76 (1.06), 1.79 (1.51) and 2.23 (1.65). The mean global score was 1.52 (1.25). The regular occurrence of objective and subjective overeating episodes was reported by 10.6% and 12.7% of participants, respectively. The regular use of self-induced vomiting, laxative misuse, and use of diuretics, was reported by 1.4%, 1.0%, and 0.3%, of participants, respectively, while 2.2% of participants reported regularly using diet pills. "Extreme dietary restraint" and "excessive exercise" were reported by 3.4% and 4.9% of participants, respectively. Both attitudinal and behavioural features of eating disorder psychopathology tended to decrease with increasing age. These data will inform researchers intending to use the EDE-Q in epidemiological studies.     

Screening for Eating Disorders in Undergraduate Women: Norms and Validity of the Spanish Version of the Eating Disorder Examination Questionnaire (EDE-Q)

The purpose of this investigation was to examine the internal consistency reliability and the convergent validity of the Spanish version of the Eating Disorder Examination Questionnaire (EDE-Q) and to provide EDE-Q norms for Spanish undergraduate women. Seven hundred eight college women, aged 18–30 years, volunteered to complete the EDE-Q, BSQ and EDI-2. Satisfactory internal consistency for the four subscales and the global score of the EDE-Q was obtained (Cronbach’s α ≥ .81). The EDI-2 Drive for Thinness and Body Dissatisfaction subscales and the BSQ global factor score correlated highly and positively with the corresponding EDE-Q subscales (r ≥ .72). Average scores, standard deviations and percentile ranks for the raw EDE-Q subscales and data on the occurrence of binge eating and compensatory behaviors are presented. Most of these values were lower than those found in other non-European developed countries. Results support the satisfactory internal consistency and convergent validity of the Spanish version of the EDE-Q. Lower scores in EDE-Q subscales suggest the need to study a lower cut-off point for clinical significance in Spanish college women. These data will help clinicians and researchers to interpret the EDE-Q scores of college women in Spain.     

To weigh or not to weigh: The relationship between self-weighing behavior and body image among adults

Given the high prevalence of overweight and obesity in the U.S., identifying behaviors that aid or hinder weight control efforts continues to be a research priority. Body weight monitoring is a technique used in many popular weight management programs. However, how weight monitoring—particularly self-weighing behavior—relates to psychological constructs like body image is poorly understood. Participants included 268 undergraduates (190 women, 78 men) at a midwestern university who completed questionnaires about self-weighing behavior and body image (Multidimensional Body-Self Relations Questionnaire; Eating Disorder Examination-Questionnaire: Weight and Shape Concern subscales). Among women, more frequent self-weighing was associated with greater Appearance Orientation, Overweight Preoccupation, and Shape Concern. Among men, more frequent self-weighing was associated with greater Body Areas Satisfaction, Health and Fitness Orientation, and positive Health Evaluation. Results suggest that self-weighing is a fairly common behavior, but its relationship with body image is complex and gender-specific.     

The Spanish language version of the Eating Disorder Examination Questionnaire: comparison with the Spanish language version of the eating disorder examination and test-retest reliability

This study compared the Spanish language questionnaire (S-EDE-Q) and interview (S-EDE) versions of the Eating Disorder Examination and examined the short-term test-retest reliability of the questionnaire version. Seventy-seven monolingual Spanish-speaking Latina women recruited from the community completed the S-EDE-Q and were then administered the S-EDE by fully bilingual doctoral-level research clinicians. The same assessment was repeated after approximately one week (5-14 days). The S-EDE-Q and the S-EDE were significantly correlated on frequencies of binge eating and all four subscales. Mean differences in the frequency of binge eating and the Restraint subscale were not significant, but scores on the Eating Concern, Weight Concern, and Shape Concern subscales differed significantly, with the S-EDE-Q yielding higher scores. Test-retest reliability for the S-EDE-Q was modest for binge eating but was excellent for the subscales (Spearman rho ranged 0.71-0.81), albeit somewhat variable for the individual items. Overall, the acceptable convergence between the S-EDE-Q and the S-EDE for many features of eating disorders and the good short-term test-retest findings provide preliminary support for the use of the S-EDE-Q. These findings, derived using a non-clinical sample of monolingual Spanish-speaking Latina women, require replication and extension. Evaluation with a clinical sample is necessary to further establish the reliability of the S-EDE-Q with an eating disordered group.     

A Study of Men and Women from Different Sides of Earth to Determine If Men Are from Mars and Women Are from Venus in Their Beliefs About Love and Romantic Relationships

This study contributes to the literature on gender differences (and similarities) in relationship beliefs by comparing men and women on several relationship beliefs, by comparing men and women from two different cultures (North America and China), and also by examining gender differences in more than 1 subculture within the American sample. In the American sample (n = 693; 73.3% White, 11.7% Black, 8.5% Hispanic/Latino; 80% of middle or higher social class), men, as compared to women, were more willing to marry without love, scored higher on the idealization component of a romanticism scale, were more ludic and agapic but less erotic and pragmatic in their love styles, and were less likely to view emotional satisfaction as important to the maintenance of marriage. Although men were also more agapic than women in the Chinese sample (n = 735; Asian ethnicity), the other gender differences found in the Chinese sample were different from those found in the North American sample: Chinese men were more romantic (particularly in the belief that love can overcome any obstacle) and storgic than Chinese women, but less likely to believe in destiny or fate concerning love. Chinese men were also more likely than Chinese women to view physical pleasure as important for maintaining marriage. Overall, culture explained more variance than did gender in love beliefs. In general, the Chinese had both a more idealistic and a more practical approach to love than did the Americans. Gender differences and similarities did not vary across subcultures within the American culture, although main effects for race/ethnicity and social class were found for a few relationship beliefs.     

Exploring gender differences in body image,eating pathology,and sexual harassment

This study examines the relationship between body image (weight/shape concerns), eating pathology, and sexual harassment among men and women (N = 2446). Hierarchical regressions controlling for depression revealed main effects of gender such that women reported greater weight/shape concerns, eating pathology, dietary restraint, eating concerns, and binge eating compared to men. Main effects for sexual harassment indicated that as harassment increased, participants reported increased weight/shape concerns, eating pathology, dietary restraint, eating concerns, binge eating, and compensatory behaviors. There were small but significant interactions between gender and harassment for eating pathology total score (which included each of the domains listed above), weight/shape concerns, dietary restraint, and eating concerns such that the relationship between increased harassment and increased pathology was stronger for women compared to men. The largest interaction was found for compensatory behaviors, such that while women and men's scores both increased as harassment increased, the relationship was stronger for men.     

Disordered Eating in Undergraduates: Does Gender Role Orientation Influence Men and Women the Same Way?

Previous studies have examined the influence of femininity on disordered eating behavior in female undergraduates, but few studies have examined the relation between gender roles and disordered eating in male undergraduates. The present study examined whether gender roles relate to disordered eating behaviors the same way in male and female undergraduates. 512 undergraduates (58% female) at a large university in the Pacific West region of the United States responded to a survey asking about eating behaviors and gender role orientation. Women displayed higher levels of disordered eating than did men. Undifferentiated and masculine women had higher levels of disordered eating than did androgynous women, whereas undifferentiated and feminine men had higher levels of disordered eating than did masculine and androgynous men.     

THE AMBIVALENCE TOWARD MEN INVENTORY

We present a measure, the Ambivalence toward Men Inventory (AMI), that differentiates between women's hostile and benevolent prejudices and stereotypes about men. The Hostility toward Men (HM) and Benevolence toward Men (BM) subscales of the AMI tap conventional attitudes toward men that have opposing valences. Each subscale assesses subfactors concerning men's power, gender differentiation, and heterosexuality. Three studies with predominately White, male and female participants (two with undergraduates and one with a community sample) establish the factor structure, reliability, convergent validity, and predictive validity of the AMI. The AMI was strongly related to its sister scale, the Ambivalent Sexism Inventory (Glick & Fiske, 1996) and to two established scales of attitudes toward men (Downs & Engleson, 1982; Iazzo, 1983). Only the AMI, however, successfully distinguished between subjectively positive and subjectively negative beliefs about men. A copy of the 20-item AMI is provided as a tool for further exploration of women's ambivalence toward men.     

Gender Differences in the Construct Validity of the Silencing the Self Scale

Gender differences in the construct validity of Jack's (1991) Silencing the Self Scale (STSS) were assessed using 187 female and 169 male undergraduates. Results of exploratory and confirmatory factor analyses revealed gender differences in the scale's latent structure and at best provided only limited support for the validity of the scale's four subscales for women. Among men, the studies exposed a weakness in the scale's construct validity and provided insights into possible alternative interpretations made by men when responding to the scale's items. Convergent and discriminant validity of the scale were assessed by correlating it with measures of neuroticism and attachment. Whereas the construct validity of the STSS for use with women was supported, evidence was weaker for men. For men, data suggest that the STSS, in part, taps a motive to avoid intimacy and relationship situations that limit one's sense of independence and autonomy, a construct incongruous with Jack's notion of self-silencing.     

The attention to body shape scale: a new measure of body focus

An abnormal degree of attention to one's body shape has been implicated in the development and maintenance of eating pathology. This article reports on three preliminary reliability and validity studies of the Attention to Body Shape Scale (ABS). Although brief, the ABS was found to be internally consistent and relatively stable over 2 weeks for both women and men. As expected, women were more body-focused on the ABS than were men. Preliminary validation studies on college women had encouraging results. Lending evidence of convergent validity, the ABS correlated with measures of eating pathology and dietary restraint. Moreover, although the ABS correlated with a measure of general-appearance orientation, regression analyses showed that the former was more closely linked than the latter to eating pathology. As evidence of discriminant validity, the ABS failed to correlate with dysphoria, body weight, or the tendency to eat in response to emotional or environmental pressures. As predicted by theory, high scores on the ABS were associated with body-image distortion. However, contrary to predictions, the ABS failed to moderate the impact of induced anxiety on body image on two of three measures. The implications of these findings and suggestions for future work are discussed.     

Intersectionality of Race/Ethnicity and Gender Among Women of Color and White Women

Theoretical writings on intersectionality have long emphasized the unique ways women of color experience race/ethnicity and gender, particularly compared to White women; however, little empirical evidence exists in support of this claim. This mixed-methods study adds to the empirical base by comparing and contrasting these experiences among women of color and White women. In a sample of 47 women of color and 18 White women, there were significant racial/ethnic differences in terms of (a) the perceived connection of race/ethnicity and gender, (b) the social contexts in which gender becomes salient, and (c) the meaningfulness of the intersection of race/ethnicity and gender. The findings lend empirical support for intersectionality as a useful psychological framework for understanding multiple social identities.     

An examination of gender differences in the construct validity of the silencing the self scale

Jack’s (1991) theory of self-silencing was originally designed to explain higher rates of depression in women in comparison to men. However, research finding that men score equal or even higher than women on measures of self-silencing has lead theorists to speculate that self-silencing tendencies may be driven by different motivations and have different consequences for women versus men (Jack & Ali, 2010). Using a sample of 247 college students, we examined gender differences in the construct validity of the Silencing the Self Scale (STSS; Jack & Dill, 1992). We hypothesized that women would score higher on the Externalized Self-Perception subscale, but not the other three subscales. Gender differences in the relationship between the STSS subscales and theoretically-relevant constructs were also explored. The results indicated that women on average scored higher than men on the Externalized Self-Perception subscale, whereas men scored higher on the Care as Self-Sacrifice subscale. Further, there was a significant Gender × Care as Self-Sacrifice subscale interaction in the prediction of depression, such that this subscale was negatively correlated to depression in men, and uncorrelated in women. These results clarify how self-silencing might translate into different mental health outcomes for women and men.     

The equivalence of the Child Behavior Checklist/1 1/2-5 across parent race/ethnicity, income level, and language

This study examined the equivalence of the Child Behavior Checklist/1 1/2-5 (CBCL/1 1/2-5) in 682 parents of 2- to 4-year-old children stratified by parent race/ethnicity (African American, Latino, and non-Latino White), family income (low vs. middle-upper), and language version (Spanish vs. English). Externalizing Scale means differed by income and child gender. Internalizing Scale means differed by income and parent race/ethnicity. Differential item analyses showed that few items functioned differently by racial/ethnic, language, and income group. A confirmatory factor analysis demonstrated that the Externalizing Scale provided a good fit with the data across racial/ethnic and income groups. However, model fit was improved for the Internalizing Scale when factor weights were allowed to vary. Findings support the equivalence of the CBCL/1 1/2-5 when used with parents of low-income preschool children from African American and Latino backgrounds, although further study of the factor structure for the Internalizing Scale is recommended.     

An evaluation of the reliability and construct validity of eating disorder measures in White and Black women

Most measures of eating disorder symptoms and risk factors were developed in predominantly White female samples. Yet eating disorders affect individuals of all racial and ethnic backgrounds. Black women appear more vulnerable to certain forms of eating pathology, such as binge eating, and less susceptible to other eating disorder symptoms and risk factors, such as body dissatisfaction, compared with their White peers. Despite concern that extant measures do not adequately assess eating concerns among Black women, the construct validity of scores on most of these measures has not been adequately examined within this population. This study included 2,208 Black and White women who completed the following: the Binge Eating Scale (BES), the Eating Disorder Diagnostic Scale (EDDS), the Eating Attitudes Test-26 (EAT-26), the Eating Disorder Inventory Body Dissatisfaction and Drive for Thinness subscales, the Bulimia Test-Revised (BULIT-R), the Multidimensional Body-Self Relations Questionnaire-Appearance Evaluation subscale (MBSRQ-AE), and the Objectified Body Consciousness Scale (OBCS). Most measures yielded internally consistent scores in both races. Confirmatory factor analyses indicated that loadings for some measures, including the EAT-26 and EDDS, were not invariant across groups and thus do not assess equivalent constructs in White and Black women. However, others, including the BULIT-R, BES, OBCS, and MBSRQ-AE, exhibited factorial invariance in both races. Results suggest scores are likely not equivalent across races for several popular measures of eating disorder symptoms and risk factors. Thus, it is recommended that researchers and clinicians obtain additional information regarding racial/cultural factors when using these instruments with Black women.     

Role of Sexual Orientation and Gender-Related Traits in Disordered Eating

This study was designed to examine the role of both sexual orientation and gender-related personality traits in disordered eating attitudes and behavior, including body dissatisfaction. Self-report measures assessing negative and positive gender traits,body dissatisfaction, drive for thinness, dietary restraint, and bulimic symptoms were administered to 266 participants (64 lesbians, 73 heterosexual women, 69 gay men, and 60 heterosexual men; 85% Anglo-Australian Caucasians, 15% Caucasians from Non-English-speaking backgrounds). Consistent with previous research, gay men scored significantly higher than heterosexual men on body dissatisfaction and dietary restraint, whereas lesbians scored significantly lower in comparison to the heterosexual women on body dissatisfaction, drive for thinness, dietary restraint, and bulimia. For men, the additional amount of variance accounted by the gender traits was significantly higher than that accounted for by sexual orientation. For the women, the gender traits also accounted for an additional significant amount of variance; however, overall the amount of variance accounted for by sexual orientation was greater. However, for both men and women, irrespective of their sexual orientation, it was higher scores on negative femininity that predicted higher levels of disordered eating. These results are consistent with previous studies that have found support for the femininity hypothesis in disordered eating.     

Internet Daters’ Body Type Preferences: Race–Ethnic and Gender Differences

Employing a United States sample of 5,810 Yahoo heterosexual internet dating profiles, this study finds race–ethnicity and gender influence body type preferences for dates, with men and whites significantly more likely than women and non-whites to have such preferences. White males are more likely than non-white men to prefer to date thin and toned women, while African-American and Latino men are significantly more likely than white men to prefer female dates with thick or large bodies. Compatible with previous research showing non-whites have greater body satisfaction and are less influenced by mainstream media than whites, our findings suggest Latinos and African Americans negotiate dominant white idealizations of thin female bodies with their own cultures’ greater acceptance of larger body types.     

Reliability and validity of the Norwegian translation of the Child Eating Disorder Examination (ChEDE)

Frampton, I., Wisting, L., Øverås, M., Midtsund, M. & Lask, B. (2011). Reliability and validity of the Norwegian translation of the Child Eating Disorder Examination (ChEDE). Scandinavian Journal of Psychology 52, 196–199. The Child Eating Disorder Examination (ChEDE) is a valid and reliable semi‐structured interview, which measures eating‐disorder specific psychopathology in children and young adolescents. The instrument is an adaptation of version 12.0D of the original Eating Disorder Examination (EDE 12.0) for adults. The Norwegian translation of the ChEDE is currently the only instrument for assessing eating disorder psychopathology in Norwegian children and adolescents. This study aimed to investigate the psychometric properties of the Norwegian translation of the ChEDE 12.0. The Norwegian version of ChEDE 12.0 was administered to 15 Norwegian children with anorexia nervosa (AN), 15 children with diabetes mellitus type 1 (DM) and two groups of 15 age‐matched controls. The groups were compared using a matched pairs design. The results showed that the subscale scores of the AN group were significantly higher than those of the other groups, and the DM comparison group did not differ from its control group. The current AN group scored significantly higher on the Shape Concern subscale than the previous UK sample, with implications for construct validity or cross‐cultural effects worthy of further study. Inter‐rater reliability was generally high (r = 0.91 to 1.00), although there were significant differences between raters on specific items for individual participants. Alpha coefficients for each of the ChEDE subscales indicated a high degree of internal consistency. It was concluded that the Norwegian version of the ChEDE 12 has adequate psychometric properties and can be recommended for clinical and research use with young people with eating disorders in Norway.