Examining the construct validity of the Eating Disorder Inventory

The construct validity of the Eating Disorder Inventory (EDI) was examined in 3 samples. An archival clinic sample (n = 318) of women completed the EDI, a structured interview, and the Millon Clinical Multiaxial Inventory-II (MCMI-II). Confirmatory factor analyses (CFAs) indicated that neither null nor 1-factor models of the EDI fit item-level or item-parcel data. The proposed 8-factor model did not fit at the item level but did fit item-parcel data. Reliability estimates of the 8 scales ranged from .82 to .93, and low-to-moderate interscale correlations among the eating and weight-related scales provided partial support for convergent validity. EDI personality scales showed moderate interscale correlations and were associated with MCMI-II scales. A final CFA of the EDI scales supported a 2-factor model (Eating and Weight, Personality) of the 8 EDI scales. Strong associations between depression and several EDI scale scores were found in a treatment study sample (n = 50). The archival clinic sample scored significantly higher on the 8 EDI scales than the nonpatient college comparison sample (n = 487).     

Reliability and validity of a Japanese version of the Eating Disorder Inventory

The rapid increase of patients with eating disorders in Japan has male necessary the reliable and valid measurement of psychological factors in eating disorders. The purpose of this study was to examine the reliability and validity of the Japanese version of the Eating Disorder Inventory. 766 females without eating disorders and 139 female patients with eating disorders responded to the Eating Attitude Test and the Eating Disorder Inventory. Principal factor extraction with promax rotation isolated 9 interpretable factors with satisfactory internal consistency (Cronbach alpha range=.74-.90). Compared with controls, patients scored significantly higher on all factors after minimizing the influence of Body Mass Index. There were strong correlations among factor scores and scores on the Eating Attitudes Test, particularly among patients. These results indicate the Eating Disorder Inventory as showing psychometrically sound internal consistency and concurrent validity.     

Eating Disorder Recovery

Abstract

Qualitative studies addressing the eating disorder recovery process from the client's point of view are notably absent in the literature. For this case study, we conducted a retrospective examination of the recovery process, as recounted by a 37-year-old female who was diagnosed with anorexia nervosa, binge eating/purging subtype at the age of 30. Two in-person interview sessions provided insight into coping skills, multidisciplinary intervention strategies, and long-term treatment challenges. In sum, the client's perspective can add new information to the understanding of eating disorder recovery from feminist and other theoretical frameworks.     

Discrimination and Eating Disorder Psychopathology: A Meta-Analysis

Eating disorders occur in diverse populations, and discrimination may be a specific factor that is related to higher eating disorder psychopathology among marginalized individuals. To evaluate the current evidence on this topic, a meta-analysis was used to quantitatively synthesize the literature on discrimination and eating disorder psychopathology across a heterogeneous range of studies. Searches were conducted in peer-reviewed journals and accessible unpublished dissertations of all years through January 2020. Studies were coded by two authors using a tailored coding form, and zero-order bivariate correlations were used as effect size measures. There were 55 cross-sectional studies extracted for inclusion in the meta-analysis. Results showed a small-to-medium association between discrimination and eating disorder psychopathology that was consistent across domains. Effect sizes were typically higher for weight discrimination. For binge eating and general eating disorder pathology, effects were smaller in studies that had larger proportions of women, and for binge eating only, effects were higher in college samples. These findings could suggest that discrimination represents a contributory factor related to eating disorder psychopathology across types of discrimination and eating disorder psychopathology. Implications are discussed for future research on discrimination and psychopathology including possible mechanisms.     

Development and validation of the Eating Behavior Inventory

The Eating Behavior Inventory (EBI) is a self-report instrument for assessing behaviors that have been theoretically implicated in weight loss, e.g., self-monitoring of food intake and of weight, refusing offers of food, eating at only one place, shopping from a list, eating in response to emotions. Thirty items were constructed in the form of first-person statements, e.g., I eat in the middle of the night. Each item was to be rated with a 5-point scale according to how often it was true for the respondent. Items were scored such that higher scores always reflected more appropriate (theoretically facilitative of weight control) eating patterns. Validity of individual items and total score was assessed in four studies. Twenty-six of the original items appeared valid and were retained. The resulting total score demonstrated validity in these studies and in two cross-validational comparisons. Internal consistency as measured by split-half reliability and correlations of item scores with total score was acceptable. One month test-retest reliability of item and total scores was satisfactory. Clinical and research applications of the EBI are discussed.An early version of this article was presented at the Taos International Conference on Treatment of Addictive Behaviors, Taos, New Mexico, February 1979.     

A Review of Eating Disorders in Athletes

SUMMARY

The current review aims to evaluate the literature on eating disorders and athletes with the purpose of making recommendations for sport psychologists and other relevant personnel on how to proceed in identifying, managing, and preventing eating disorders in school settings. Whereas the intention of this review is to make recommendations for secondary educational settings, research on other populations such as collegiate and young adult athletes was also reviewed where helpful or where information on adolescent athletes was not available. Recommendations for prevention and intervention include ongoing education of athletes and coaches regarding nutrition, body composition, and performance, using appropriate screening to detect eating disorders, and use of a sport management team to aid in athlete recovery.     

Boundary Disturbances and Eating Disorder Symptoms

Female graduate students in counseling and clinical psychology retrospectively rated maternal and paternal boundaries in their families of origin. Subscales of the Eating Disorders Inventory-3 were used to assess disordered eating, including drive for thinness, body dissatisfaction, bulimia symptoms, and overall risk. Results indicated that maternal enmeshment and maternal psychological control were related to disordered eating. Further, daughters who reported that their mothers shielded them from parents’ conflict and adult concerns were less likely to report drive for thinness or bulimic tendencies. With respect to paternal boundary problems, paternal infantilization (overprotection) was significantly related to daughters’ drive for thinness.     

Eating Disorders and Posttraumatic Stress Disorder: A Network Analysis of the Comorbidity

Eating disorders (EDs) and posttraumatic stress disorder (PTSD) commonly co-occur, but the mechanisms driving this co-occurrence are not well understood. The current study explored the relationships between symptoms of ED and PTSD in a sample of male and female undergraduate students in order to identify pathways that may maintain the comorbidity. Network analysis was conducted in a sample of 344 first-year undergraduates to visualize partial correlations between each symptom in the comorbidity. Core symptoms, bridge symptoms, and direct pathways between ED and PTSD symptoms were identified. The PTSD symptoms negative emotions (strength = 1.13) and negative beliefs (strength = 1.11) were the strongest symptoms in the network. The strongest bridge nodes were the ED symptoms restriction (bridge strength = 3.32) and binge eating (bridge strength = 2.63). The strongest edges between ED and PTSD nodes were between binge eating and concentration (part r = .16), restriction and sleep (part r = .14), and binge eating and positive emotions (part r = .11). Findings suggest that PTSD symptoms related to negative alterations in cognitions and mood may be highly influential in the ED-PTSD network due to their relatedness to all other symptoms. The pathway between binge eating and inability to experience positive emotions suggest that the comorbidity may be partially maintained through an affect regulation function of binge eating.     

Integrative Response Therapy for Binge Eating Disorder

Binge eating disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided self-help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and cost-effective than existing, efficacious BED specialty treatments, which are limited in public health utility and impact given their time and expense demands. No existing BED GSH treatment has incorporated affect regulation models of binge eating, which appears warranted given research linking negative affect and binge eating. This article describes Integrative Response Therapy (IRT), a new group-based guided self-help treatment based on the affect regulation model of binge eating, which has shown initial promise in a pilot sample of adults meeting DSM-IV criteria for BED. Fifty-four percent and 67% of participants were abstinent at posttreatment and 3-month follow-up, respectively. There was a significant reduction in the number of binge days over the previous 28 days from baseline to posttreatment [14.44 (± 7.16) to 3.15 (± 5.70); t = 7.71, p < .001; d = 2.2] and from baseline to follow-up [14.44 (± 7.16) to 1.50 (± 2.88); t = 5.64, p < .001; d = 1.7]. All subscales from both the Eating Disorder Examination–Questionnaire and Emotional Eating Scale were significantly lower at posttreatment compared to baseline. One hundred percent of IRT participants would recommend the program to a friend or family member in need. IRT's longer-term efficacy and acceptability are presently being tested in a NIMH-funded randomized controlled trial.     

Thematic Analysis of the Intersection of Spirituality and Eating Disorder Symptoms

The authors interviewed 12 female participants about the intersection of their spiritual beliefs and eating disorder symptoms. Three main themes emerged from the data: (a) spiritual beliefs as helpful, (b) choice not to ask for spiritual help, and (c) guilt.     

The Eating Disorders Inventory Among Asian American College Women

Abstract

The authors examined the effects of social support and self-control in a representative sample of 300 older adults in high-density households in an urban area of Agra City, India. The authors administered the Social Support Questionnaire (I. G. Sarason, H. M. Levine, R. B. Basham, &; B. R. Sarason, 1983) and the Self-Control Schedule (M. Rosenbaum, 1980) to form a 2 (age group: young-old vs. old-old) × 2 (social support: high vs. low) × 2 (self-control: high vs. low) factorial design. Scores on the Life Attitude Profile (G. T. Recker &; E. J. Peacock, 1981) and the Perceived Control Scale (P. Nayyar, 1993) were the dependent variables. The authors hypothesized that social support and self-control would act as moderators for a more positive attitude toward life and increased perceived control. The results supported the predictions: Social support and self-control in interaction with age reduced the crowding stress of high density and enhanced the older participants' perceived control and positive attitudes toward life.