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.     

The criterion validity of the Borderline Personality Features Scale for Children in an adolescent inpatient setting

The purpose of the current study was to examine the criterion validity of the Borderline Personality Features Scale for Children (BPFS-C) by assessing the performance of the self-report and a newly developed parent report version of the measure (BPFS-P) in detecting a borderline personality disorder (BPD) diagnosis in adolescent inpatients. This study also examined parent-child agreement and the internal consistency of the BPFS subscales. An inpatient sample of adolescents (n = 51) ranging from ages 12-18 completed the BPFS and were administered the Child Interview for DSM-IV Borderline Personality Disorder (CI-BPD) by trained clinical research staff. ROC analyses revealed that the BPFS-C has high accuracy (AUC = .931; Se = .856; Sp = .840) in discriminating adolescents with a diagnosis of BPD, as measured by the CI-BPD, while the BPFS-P has moderate accuracy (AUC = .795; Se = .733; Sp = .720). Parent-child agreement on total scores was significant (r = .687; p < .005). Cronbach's alphas suggested internal consistency for the four subscales of the BPFS. These findings support the criterion validity of this measure, particularly the self-report version, in adolescent inpatient settings.     

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.     

Psychometric evaluation of the eating disorder inventory (edi) in a clinical group

Abstract

This study examined the psychometric properties of the Eating Disorder Inventory (EDI) with a clinical sample of 79 female clients seen at an outpatient eating disorder program. The means and standard deviations for the bulimia nervosa subgroup in this study (n = 48) compared favorably with the bulimia group in the EDI Manual Supplement (1986) on all eight subscales, except Drive for Thinness. The present non-student sample had significantly lower scores on this particular subscale than did the norm group (mostly students). Another difference was that the local bulimic subgroup had significantly higher present and minimum weights (as a percentage of the expected average weight according to height). The EDI subscales also displayed respectable internal consistency reliability with this sample. In contrast to previous research, however, only five factors were found in a factor analysis rather than eight corresponding to the original subscales for the EDI. Differences between bulimic and a not-otherwise-specified (NOS) diagnostic groups were also found on both the EDI Ineffectiveness and Bulimia subscales (NOS had lower scores). The results of this study are discussed in terms of the importance of undertaking local standardization of tests in clinical settings.     

Associations of symptoms of anxiety disorders and self-reported behavior problems in normal children

61 children, aged between 14 and 18 years, completed the Screen for Child Anxiety Related Emotional Disorders, a scale of anxiety disorders symptoms, and the Youth Self-report, a measure of internalizing, i.e., emotional, and externalizing, i.e., behavioral, problems. Analysis showed that, with the exception of the Social Phobia and the Specific Phobia subscales, Screen total and subscale scores were significantly related to Internalizing problems (rs between .40 and .77). Thus, the more frequently children reported Anxiety Disorder symptoms, the more often they reported emotional problems. Furthermore, in particular, anxious-depressed problems as measured by the Youth Self-report were significantly associated with scores on Screen scales. These results further support the concurrent validity of the Screen.     

Measuring Emotion Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder: Revisiting the Factor Structure of the Emotion Regulation Checklist

Emotion dysregulation (ED) is prevalent among youth with Attention-Deficit/Hyperactivity Disorder (ADHD) and significantly impacts functioning. Nuanced measurement of ED is central to understanding its role in this disorder and informing treatment approaches. The present study examined the factor structure of the Emotion Regulation Checklist (ERC) among children with ADHD with and without Oppositional Defiant Disorder (ODD). Exploratory factor analysis (EFA) conducted in a sample of 328 youth (mean age = 6.08) with ADHD indicated a four-factor solution, comprised of the following factors: Negative Emotion Lability, Positive Emotion Lability, Socially Appropriate Affect, and Socially Incongruent Affect. The Negative and Positive Emotion Lability subscales assess the reactivity of negatively and positively valenced emotions, respectively. The Socially Appropriate and Socially Incongruent Affect subscales provide an assessment of social-emotional functioning. All subscales discriminated between children with ADHD only and ADHD with co-morbid ODD, such that children with ODD had greater emotional lability and social-emotional difficulties. This revised factor structure of the ERC facilitates a uniquely brief, yet multifaceted and specific, assessment of emotional difficulties in children with ADHD that can inform treatment planning and operationalize emotional reactivity and social-emotional functioning in future research efforts.     

Assessment of Callous-Unemotional Traits in 6 to 12 Year-Old Children with Oppositional Defiant Disorder/Conduct Disorder by Parent Ratings

The factorial structure of the Inventory of Callous-Unemotional Traits (ICU; Frick 2004) has been inconsistent across previous studies using different rater versions (self-report, parent, teacher) and versions in different languages applied to both clinical and nonreferred samples predominantly of adolescents. The present study examined the factorial structure of the parent-report version of the ICU in a clinical sample of boys aged 6–12 years with Oppositional Defiant Disorder/Conduct Disorder (n?=?131) using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Results from the CFA supported previous findings, but even the preferred model with three independent factors (Callousness, Uncaring, and Unemotional) showed inadequate model fit. Subsequent EFA revealed a three-factor model consisting of two new subscales (Callousness/Lack of Guilt or Remorse, Unconcerned about Performance) and the original subscale Unemotional. Internal consistencies of the three subscales and total score were satisfactory, and intercorrelations of the subscales were weak, except for a moderate correlation between the subscales Callousness/Lack of Guilt or Remorse and Unconcerned about Performance. The corresponding subscales of the original and new versions were highly correlated. As expected, the ICU subscale Callousness/Lack of Guilt or Remorse showed associations with other measures of aggressive and oppositional behavior. The other two ICU subscales were not associated with aggression or oppositional/antisocial behavior, but Unconcerned about Performance correlated with a measure of attention problems and Unemotional correlated with the internalizing problem withdrawn. The implications of these findings are discussed, especially as a callous unemotional specifier for the diagnosis of Conduct Disorder is included in DSM-5.     

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.     

Predicting cognitive development and early symptoms of autism spectrum disorder in preterm children: The value of temperament and sensory processing

This study was the first to longitudinally explore the extent to which early temperament and sensory processing were of predictive value for cognitive development and Autism Spectrum Disorder (ASD) symptomatology in a sample of preterm children (N = 50, 22 girls, mean gestational age 27 weeks). At the corrected ages of 10, 18, and 24 months, sensory processing and temperament were assessed, as were cognitive development and ASD symptoms at 36 months. Better cognitive development was predicted by fewer hospitalisation days at birth and by lower Activity Level at 18 months. Temperamental subscales of Negative Affect showed associations with both parent-reported and observational measures of ASD symptomatology, whereas sensory processing only had predictive value for parent-reported symptoms of ASD. The usefulness of temperament and sensory processing for prediction of ASD symptom severity and cognitive outcomes became clear in the second year of life. The results indicate that this area of research is worth additional investigation in the extreme and very preterm population, to explore in further detail whether these two concepts might be able to provide information about which preterms are more likely to develop ASD or cognitive impairments.     

Co-occurrence of non-suicidal self-injury and impulsivity in extreme weight conditions

The aims of the present study were to determine the prevalence of non-suicidal self-injury (NSSI) in different eating disorder (ED) groups and morbid obesity, and to investigate whether NSSI in different ED/obesity groups co-occur with impulsivity. We assessed 535 individuals (365 ED and 170 obese patients) by means of a single item assessing lifetime NSSI and the Barratt Impulsivity Scale, which measures different dimensions of impulsivity. The results showed that 19.1% of the ED patients engaged in at least one act of NSSI during their life-time. NSSI was more prevalent in Bulimia Nervosa, Binge Eating Disorder, Eating Disorder Not Otherwise Specified compared to Anorexia Nervosa, Restrictive type and morbid obesity. Finally, ED/obese patients who engaged in NSSI scored significantly higher on the attentional, motor and non-planning subscales than patients without NSSI. The implications of these findings for the treatment of NSSI in binge/purging ED patients are discussed.     

Attention,autonomic arousal,and personality in behaviorally disordered children

This study assessed the construct validity of the Revised Behavior Problem Checklist (RBPC) by measuring attention, autonomie arousal, and personality in 40 behaviorally disordered children aged 7 to 15 years. Conduct Disorder and Socialized Aggression subscales were characterized by high Psychoticism, Impulsivity, and Lie personality scores, by lower heart rate levels, and by more errors on a continuous performance reaction-time task. Conversely, Attention Problems, Anxiety Withdrawal, and Motor Excess were characterized by greater variability in reaction times. Conduct Disorder alone was related to an external locus of control, while only Attention Problems was characterized by low scores on the WISC Freedom from Distraction factor. These differential relationships suggest (a) support for the construct validity of the RBPC, (b) that antisocial behavior and hyperactivity/attention deficits are dissociated disorders, and (c) that hyperactivity/attention deficits may be characterized by fluctuations in the allocation of attentional resources rather than a core structural deficit in attention.     

The Body Esteem Scale: Construct Validity of the Female Subscales

The female subscales of the Body Esteem Scale (BES) have demonstrated convergent and discriminant validity in two previous studies. However, relationships between BES dimensions, weight, and other body-image measures have not been adequately examined. in this study, 200 women with a mean age of 27.6 years completed the BES, the Eating Disorder inventory, the Self-Consciousness Scale, the Tennessee Self-Concept Scale, a figure rating task, a phototechnical body-size estimation procedure, and items concerning weight satisfaction and attractiveness. BES Weight Concern was most closely related to weight variables and other body image measures whereas BES Sexual Attractiveness and Physical Condition were more strongly associated with less specific self-perceptions and attitudes. Results support the construct validity of the BES female subscales and their utility for research in populations at increased risk for body-image or eating-disorder disturbances.     

The Body Esteem Scale: construct validity of the female subscales

The female subscales of the Body Esteem Scale (BES) have demonstrated convergent and discriminant validity in two previous studies. However, relationships between BES dimensions, weight, and other body-image measures have not been adequately examined. In this study, 200 women with a mean age of 27.6 years completed the BES, the Eating Disorder Inventory, the Self-Consciousness Scale, the Tennessee Self-Concept Scale, a figure rating task, a phototechnical body-size estimation procedure, and items concerning weight satisfaction and attractiveness. BES Weight Concern was most closely related to weight variables and other body image measures where BES Sexual Attractiveness and Physical Condition were more strongly associated with less specific self-perceptions and attitudes. Results support the construct validity of the BES female subscales and their utility for research in populations at increased risk for body-image or eating-disorder disturbances.     

Outcomes of specific interpersonal problems for binge eating disorder: comparing group psychodynamic interpersonal psychotherapy and group cognitive behavioral therapy

We assessed whether an attachment-based treatment, Group Psychodynamic Interpersonal Psychotherapy (GPIP) had a greater impact compared to Group Cognitive Behavioral Therapy (GCBT) on Cold/Distant and Intrusive/Needy interpersonal problems. Ninety-five individuals with Binge Eating Disorder (BED) were randomized to GPIP or GCBT and assessed at pre-, post-, and six months post-treatment. Both therapies resulted in a significant decrease in all eight interpersonal problem subscales except the Nonassertive subscale. GPIP resulted in a greater reduction in the Cold/Distant subscale compared to GCBT, but no differences were found for changes in the Intrusive/Needy subscale. GPIP may be most relevant for those with BED who have Cold/Distant interpersonal problems and attachment avoidance.     

Validation of eating disorder examination questionnaire (EDE-Q)--Spanish version--for screening eating disorders

This research examines the internal consistency, convergent validity, and sensitivity, specificity, and positive and negative predictive value of the Spanish version of the Eating Disorder Examination-Self-Report Questionnaire (S-EDE-Q), as a screening questionnaire for eating disorders (ED) in a community sample. Participants were 1543 male and female Spanish-speaking students (age range: 12-21 years), who volunteered to complete the S-EDE-Q and the EAT-40. The Spanish version of the Eating Disorders Examination (S-EDE) interview, 12th edition, was administered to 602 of the students. Acceptable internal consistency for the four subscales of the S-EDE-Q was obtained (alpha > or = .74). Corrected point-biserial correlation performed with the 22 items included in the S-EDE-Q subscales showed acceptable values for all the items. The EAT-40 Dieting subscale correlated highly and positively with the four S-EDE-Q subscales (r > or = .70). Acceptable results in sensitivity, specificity, and positive and negative predictive value when compared with the EDE were found. Correlation between S-EDE and S-EDE-Q diagnoses was positive and significant. Overall, results support the psychometric adequacy of the S-EDE-Q as a screening questionnaire for ED in community samples.     

Use of Gilliam Asperger's disorder scale in differentiating high and low functioning autism and ADHD

Little is known about the validity of Gilliam Asperger's Disorder Scale (GADS), although it is widely used. This study of 199 children with high functioning autism or Asperger's disorder, 195 with low functioning autism, and 83 with attention deficit hyperactivity disorder (ADHD) showed high classification accuracy (autism vs. ADHD) for clinicians' GADS Quotients (92%), and somewhat lower accuracy (77%) for parents' Quotients. Both children with high and low functioning autism had clinicians' Quotients (M=99 and 101, respectively) similar to the Asperger's Disorder mean of 100 for the GADS normative sample. Children with high functioning autism scored significantly higher on the cognitive patterns subscale than children with low functioning autism, and the latter had higher scores on the remaining subscales: social interaction, restricted patterns of behavior, and pragmatic skills. Using the clinicians' Quotient and Cognitive Patterns score, 70% of children were correctly identified as having high or low functioning autism or ADHD.     

Comorbidity and WISC-III profiles of Greek children with attention deficit hyperactivity disorder, learning disabilities, and language disorders

The aim of the present study was to (a) examine the prevalence of ADHD and the comorbid difficulties in a sample of 114 children, 3.6 to 17.6 yr. of age (89 boys, 25 girls) referred to our Unit and (b) evaluate the discriminative ability of the WISC-III scores for children with Attention Deficit Hyperactivity Disorder (n = 22), Learning Disability (n = 50), and Language Disorder (n = 42). Analysis showed only 18% of 114 children had an Attention Deficit Hyperactivity Disorder diagnosis. Multivariate analysis of variance and stepwise discriminant function analysis were applied. Vocabulary and similarities were the best predictors for distinguishing between language disorders and the other two groups. Moreover, the Language Disorder group scored significantly lower on all the subtests while the Attention Deficit Hyperactivity Disorder and Learning Disability groups scored lower on coding and information, respectively. Children with Attention Deficit Hyperactivity Disorder and Learning Disability could not be accurately identified from the WISC-III test or their ACID profile.     

The diagnostic utility of the Screen for Child Anxiety Related Emotional Disorders-71 (SCARED-71)

Objective

This study investigated the diagnostic utility of the 71-item Screen for Child Anxiety Related Emotional Disorders (SCARED-71), as a screening tool for identifying anxiety disorders in youth aged 8-18 years.

Method

The SCARED-71 and the Anxiety Disorder Interview Schedule (ADIS) were administered to clinically referred anxious children (n = 138) and control children (n = 38) as well as their parents.

Results

Results showed that the SCARED-71 differentiated clinically anxious from control children on the total score and on all subscales. Girls generally reported higher levels of anxiety symptoms and there were also significant age effects for various anxiety subscales. Further, reliable cut-off scores were established for the child and parent version of the SCARED-71. The parent version displayed better sensitivity and specificity, and therefore seems to be a more optimal screen for anxiety problems in children and adolescents. Finally, evidence for the predictive validity across anxiety disorders was found.

Conclusion

The SCARED-71 can be used as a screening tool to detect clinically significant anxiety problems in children and adolescents and discriminates reasonably well among specific anxiety disorders.     

Eating disorder examination questionnaire and clinical impairment assessment questionnaire: general population and clinical norms for young adult women in Sweden

Optimal use of assessment instruments for the detection and diagnosis of eating disorders (ED) depends on the availability of normative data. The aim of this work was to, for the first time, collect norms for both the Eating Disorder Examination Questionnaire (EDE-Q) and the newly developed Clinical Impairment Assessment (CIA) Scale from a general population of young women in Sweden, as well as from a clinical population of ED patients in Sweden. Participants were composed of both a randomized sample from the general population of women aged 18–30 years (N = 760) as well as from a clinical population aged 18–66 years (N = 2383). Data for the clinical population was extracted from the Stepwise database. Mean scores, standard deviations and percentile ranks for the global for the EDE-Q (as well as its subscales) and the CIA are presented. Prevalence figures of key eating disorder behaviors are also reported. Comparisons are made between the results in the present study with other existing normative studies on the EDE-Q and the CIA. The present study contributes to improving the accuracy of the interpretation of scores of the widely used self-report measure of ED, the EDE-Q, and the CIA, both of which play important roles in for diagnosis, prevention and intervention of ED.     

Migranten in sozial schwachen Stadtteilen von Berlin

Background

The aim of the present study was to compare psychological distress and substance use between migrant and non-migrant populations in a socially deprived area of Berlin.

Methods

A population-based random sample stratified for age (18?C57?years) and gender (50% female) was retrieved from the registration office. A total of 143 persons were included in the study. The participation rate was 48.5% when contact was established. Psychological distress was assessed using the General Health Questionnaire (GHQ-28) with its four subscales, somatic symptoms, anxiety/insomnia, social dysfunction and severe depression. Substance use was quantified using the Alcohol Use Identification Disorder Test (AUDIT) and the Fagerstr?m Test for Nicotine Dependence (FTND).

Results

Of the study population 51.3% were first or second generation migrants and lived more often in single households. Migrants had lower educational levels and lower employment rates. The mean scores of migrants and non-migrants did not differ on any of the subscales somatic symptoms, anxiety/depression, social dysfunction or severe depression of the GHQ-28. Non-migrants showed significantly higher risks regarding alcohol use.

Discussion

The present study did not reveal any differences regarding symptom profiles in the spectrum of anxiety and depression between non-migrants and migrants who lived in a socially deprived area. Migrants may compensate higher social risk profiles with lower risks regarding alcohol use. Larger samples have to inform on possible differences regarding smoking and other substances.