Development and validation of the Stirling Eating Disorder Scales

A meta-analysis of disordered eating and its association with self-criticism and self-compassion

OBJECTIVE

Future treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self-criticism and self-critical perfectionism act as key mechanisms exacerbating ED, and self-compassion protects against self-criticism. This meta-analysis examines associations between self-criticism and self-critical perfectionism on disordered eating (DE), and reviews how self-compassion and self-criticism relate to each other with respect to DE.

METHOD

Searches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self-criticism measures, self-compassion measures, between clinical and nonclinical samples, and between cross-sectional and experimental studies were also conducted.

RESULTS

Random-effects models showed a medium positive link between self-criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self-criticism utilized in literature showed small to large positive links with DE (r = .20-.52). Preliminary evidence also suggests negative relationships between self-compassion and DE (r = -.40 to -.43) and negative relationships between self-compassion and self-criticism (r = -.04 to -.88).

DISCUSSION

Greater levels of self-criticism is linked with greater levels of DE and reduced levels of self-compassion, suggesting a need to tackle self-criticism and nurture self-compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self-criticism and self-compassion for people with DE.

PUBLIC SIGNIFICANCE STATEMENT

Higher levels of self-criticism are linked with higher levels of DE and lower self-compassion. Self-compassion interventions could be more effective and efficient in reducing ED symptoms if self-criticism is tackled early in such treatments.

Association of childhood psychological trauma with eating disorders in undergraduate medical students

AIM

The aim of the study was to study the association of childhood psychological trauma with eating disorders (EDs) and to assess and compare the relationship with food, concerns about weight gain, and restrictive or compensatory practices in male and female undergraduate medical students.

MATERIALS AND METHODS

A cross-sectional, analytical study was performed in a Tertiary Care Medical College and Research Hospital in a suburban area of India. After obtaining ethical clearance, 100 final-year undergraduate students were included in the study with their informed consent. Self-made questionnaire, Childhood Trauma Questionnaire, Stirling ED Scale with Disordered Eating Attitude Scale were used. Spearman's correlation coefficient (Rho) was calculated.

RESULTS

There was a significant correlation of history of childhood psychological trauma in the form of emotional abuse, emotional neglect or physical abuse and physical neglect with higher prevalence of disordered eating behaviors and relationship with food, concern about weight gain, and compensatory practices. No significant relationship was found in a history of sexual abuse.

CONCLUSION

The importance of a healthy psychosocial upbringing and nurturing by parents to prevent development of psychiatric comorbidities is an important finding in this study.

The role of self-esteem in the treatment of patients with anorexia nervosa - A systematic review and meta-analysis

OBJECTIVE

We aimed to provide a comprehensive overview of the role of self-esteem in the treatment of patients with anorexia nervosa (AN). Specifically, our objectives were to investigate the differences in self-esteem between individuals with AN and healthy controls, or individuals with other eating disorders, and to examine self-esteem as an outcome, predictor, moderator, and mediator in AN treatment.

METHOD

The databases PsycINFO, PSYNDEXplus, Ovid MEDLINE®, and ProQuest were searched for studies published from 1990 to 2018. To estimate aggregated effect sizes, we performed random-effects meta-analyses.

RESULTS

A screening of 1,596 abstracts and 203 full-texts identified 68 relevant publications. Results suggest a significantly lower global self-esteem in individuals with AN than in healthy controls (d = -1.90, p < .001). In contrast, global self-esteem of AN and bulimia nervosa (BN) patients was found to be comparable (d = 0.05, p = .529). It might be specific to AN patients that negative self-evaluations may not affect scholastic and professional abilities. Significantly moderate self-esteem increases were observed in treated AN patients at the end of treatment (d = 0.56, p < .001), short-term (d = 0.50, p < .001), and long-term (d = 0.75, p < .001) follow-up. Self-esteem did not predict end of treatment remission-or weight-related outcome and treatment dropout. However, small to moderate predictive effects were detected on short-term (r = .15, p = .007) and long-term remission or weight (r = .33, p = .017). Finally, first indications point to self-esteem as a mediator in adult AN inpatient treatment.

DISCUSSION

The review provides insights relevant for theory, research, and practice. Implications concern the overall support for transdiagnostic approaches and the recommendation to consider low initial self-esteem for decisions on after-care.

REbeL peer education: A model of a voluntary, after-school program for eating disorder prevention

Dissonance-based eating disorder prevention leads to decreases in risk factors for these disorders. Although controlled trials have demonstrated that targeted, manualized programs reduce eating disorder risk, concerns regarding implementation and dissemination remain. A primary concern is the difficulty in adapting programs for a high school setting for populations at highest risk: adolescents. This paper describes the REbeL Peer Education model and assesses the initial pilot trials of the intervention. The program is novel in that it utilizes a voluntary, self-selection model that is sustainable in a high school setting, and focuses on empowerment and effective cognitive dissonance based prevention activities. High school peer-educators self-selected into the semi-manualized dissonance based intervention. Group activities were peer led, designed to critique the thin ideal, and designed to empower macro (school and larger community wide) changes in the pilot trial (N=47) assess the effectiveness and feasibility of the intervention. Results of the initial pilot study revealed preliminary support for the feasibility of the program, increases in feelings of empowerment, and decreases in eating disorder cognitions and behaviors with moderate to large effect sizes. Feedback from participants indicated that the intervention was enjoyable, educational, and empowering. This study is the first to adapt dissonance-based prevention models to a semi-manualized, peer-led, prevention program integrated into high school settings.

Treatment adherence and the care programme approach in individuals with eating disorders

Aims and Method

To examine service-level variables predicting treatment adherence in a specialist eating disorder unit. We analysed a sample of 157 individuals consecutively referred to the unit over an 18-month period. Associations were determined using odds ratios.

Results

Individuals with a formal care programme at the point of referral were more likely to stay in treatment. Treatment adherence was not predicted by illness severity or waiting time. Follow-up by a dietician and acceptance of referral to a support group predicted better treatment outcomes.

Clinical Implications

Although the standard care programme approach may be relinquished in the UK, we recommend that this approach or its equivalent be used in specialist eating disorder services to improve treatment adherence.

The relation between anorexic symptoms in women and their reports of trustworthiness in interactions with close persons

The study examined the relation between women's anorexic symptoms and their reports of trustworthiness in interactions with close persons. Ninety-eight females (mean age=24years-10months) completed the anorexic symptom subscale of the SEDS and reported (ascribed) the extent to which they showed reliability, emotional, and honesty trustworthiness behaviors in interactions with their mother, father, and close friend. Negative linear relations were found between anorexic symptoms and ascribed: (a) trustworthiness with close friends; (b) reliability trustworthiness; and (c) at a trend level, honesty trustworthiness. These were qualified by curvilinear relations and by elevated anorexic vs normative group comparisons. It was found that women with elevated anorexic symptoms ascribed lower trustworthiness than did women with the normal range of anorexic symptoms. The findings were interpreted as supporting the conclusion that women with elevated levels of anorexic symptoms are inclined to believe that they are deceptive in their interactions with close persons, primarily friends.

Identification of eating disorder symptoms in Danish adolescents with the SCOFF questionnaire

BACKGROUND

Eating disorders often develop in adolescence and, therefore, instruments are needed that are useful to detect risk behaviour in young people. The SCOFF is a 5-item screening instrument, named SCOFF as an acronym of keywords from the questions. It has been used widely in adult samples, but studies that evaluate the scale in adolescents are missing.

AIMS

The aim of this study was to test the psychometric properties of the SCOFF in adolescents aged 11-20 years and for the first time validate the questionnaire in Danish.

METHODS

A total of 184 adolescents completed the Danish version of the SCOFF and sub-scales from the Eating Disorder Inventory (EDI-3). The sample consisted of 87 patients (mean age = 16) from a specialized eating disorder department in the Region of Southern Denmark and 97 healthy adolescents (mean age = 17) from Danish primary and high schools.

RESULTS

It was found that the reliability of the SCOFF was acceptable, and that cut-off 2 is useful to detect those with potential eating disorder pathology. Item 3 (weight loss) correlated poorly with EDI-3 sub-scales and might be reformulated by addressing the intentionality behind weight loss (due to unhappiness with body) rather than a specific amount of weight loss (1 stone), because this could have somatic reasons.

CONCLUSIONS

The SCOFF is a very easily applicable questionnaire, which may fulfil the necessary psychometric properties for detection of ED symptoms in Danish adolescents. Before general screening can be recommended, conditions regarding benefits and potential adverse effects still remain to be addressed.

REbeL Peer Education: A model of a voluntary, after-school program for eating disorder prevention

Dissonance-based eating disorder prevention leads to decreases in risk factors for these disorders. Although controlled trials have demonstrated that targeted, manualized programs reduce eating disorder risk, concerns regarding implementation and dissemination remain. A primary concern is the difficulty in adapting programs for a high school setting for populations at highest risk: adolescents. This paper describes the REbeL Peer Education model and assesses the initial pilot trials of the intervention. The program is novel in that it utilizes a voluntary, self-selection model that is sustainable in a high school setting, and focuses on empowerment and effective cognitive dissonance based prevention activities. High school peer-educators self-selected into the semi-manualized dissonance based intervention. Group activities were peer led, designed to critique the thin ideal, and designed to empower macro (school and larger community wide) changes in The pilot trial (N=47) assess the effectiveness and feasibility of the intervention. Results of the initial pilot study revealed preliminary support for the feasibility of the program, increases in feelings of empowerment, and decreases in eating disorder cognitions and behaviors with moderate to large effect sizes. Feedback from participants indicated that the intervention was enjoyable, educational, and empowering. This study is the first to adapt dissonance-based prevention models to a semi-manualized, peer-led, prevention program integrated into high school settings.

Psychometric evaluation of self-report measures of binge-eating symptoms and related psychopathology: A systematic review of the literature

OBJECTIVE

Binge eating is a symptom common to bulimia nervosa, anorexia nervosa (binge/purge subtype), and binge eating disorder. There are many self-report measures available to aid the assessment of eating disorders symptoms, but there has not yet been a systematic review of the literature to identify the most valid and reliable measures for use in assessment and treatment of binge eating.

METHOD

A systematic review of the psychometric properties of self-report measures that assess binge eating symptoms and psychopathology was conducted. Two independent raters assessed the psychometric properties of each measure using a standardized quality analysis tool.

RESULTS

Of the 2,927 studies identified, 72 studies met the inclusion criteria and described the psychometric properties of 29 different self-report measures, and nine specific subscales within these. Results from the quality analysis tool utilized in this study indicated that none of the included measures currently meet all nine criteria of adequate psychometric properties.

DISCUSSION

Most of the included measures had evidence for some adequate psychometric properties. Two measures received six out of nine positive ratings for the assessed psychometric properties, the BITE and the BULIT-R, and thus appear to be the measures with the most evidence of their validity and reliability. Overall, our findings implicate a need for further investigation of the psychometric properties of the available self-report questionnaires in this field.

The relation between Bulimic symptoms and the social withdrawal syndrome during early adolescence

OBJECTIVE

The short-term longitudinal study tested the hypothesis that there was a prospective relation between the social withdrawal syndrome and Bulimic symptoms during early adolescence.

METHOD

Ninety-six adolescents (47 males, mean age=13 years - 10 months) completed standardized scales assessing Bulimic symptoms, trust beliefs in others and loneliness at Time 1/T1 and again 5 months later at Time 2/T2.

RESULTS

Analyses showed that: (1) Bulimic symptoms were negatively correlated with trust beliefs, (2) Bulimic symptoms were positively correlated with loneliness, and (3) trust beliefs were negatively correlated with loneliness. The SEM and mediation analyses showed that trust beliefs at T1 were negatively and concurrently associated with Bulimic symptoms at T1 and longitudinally (and negatively) predicted changes in Bulimic symptoms. It was found that loneliness at T1 statistically mediated those concurrent and longitudinal relations.

CONCLUSION

The findings yielded support for the conclusion that the social withdrawal syndrome, as assessed by low trust beliefs and resulting experiences of loneliness, contributes to Bulimia nervosa during early adolescence.

Development, psychometric properties and preliminary clinical validation of a brief, session-by-session measure of eating disorder cognitions and behaviors: The ED-15

OBJECTIVE

In the treatment research literature on other psychological disorders, there is a move towards session-by-session symptom measurement. The necessary measures need to be brief, focused on core features since the last session, and readily available to clinicians. There is no measure in the eating disorders that meets those criteria. This research reports the development and validation of such a self-report questionnaire.

METHOD

The authors generated and refined a brief set of attitudinal and behavioral items. The resulting questionnaire (the ED-15) and an existing measure (Eating Disorders Examination-Questionnaire; EDE-Q) were completed by a large nonclinical adult sample (N = 531), a group of self-reported eating disorder sufferers (N = 63), and a group of women (N = 33) diagnosed with bulimia nervosa or atypical bulimia nervosa and undertaking cognitive-behavioral therapy.

RESULTS

Factor analysis identified two scales (Weight and Shape Concerns; Eating Concerns), with strong internal consistency and test-retest reliability. Correlations with the EDE-Q (r = 0.889) indicates that the ED-15 and EDE-Q measure near-identical constructs. The ED-15 differentiated self-reported eating-disordered and nonclinical groups to the same degree as the longer EDE-Q. Session-by-session analysis of the CBT treatment group demonstrated that the different ED-15 scales changed in different patterns across therapy.

DISCUSSION

The ED-15 is not proposed as an alternative to existing measures, but as a complementary tool, used to measure session-by-session change for clinical and research purposes. Future research will track changes in ED-15 scores across therapy, to determine the importance of very early response to therapy and sudden changes.

The development and application of compassion-focused therapy for eating disorders (CFT-E)

OBJECTIVES

This article outlines specific developments in compassion-focused therapy (CFT) for the treatment of patients with an eating disorder.

METHODS

The article provides a narrative review based on the existing literature and current practices of CFT for eating disorders (CFT-E).

RESULTS

The role of shame, self-criticism, self-directed hostility, and difficulties in generating and experiencing affiliative emotion in patients with an eating disorder is highlighted. The article describes how CFT-E uniquely addresses these issues and discusses the current evidence base for CFT-E. It also provides an outline of recent and potential future developments in CFT-E.

CONCLUSIONS

CFT-E offers a promising treatment for adult outpatients who present to specialist eating disorder services with restricting and binge/purging eating disorders. Recent developments include treatment protocols for patients who are low weight and have an eating disorder and for those presenting with obesity.

Bulimic symptoms and the social withdrawal syndrome

One hundred and thirty-seven undergraduates (81 females; mean age = 21 years-10 months) completed the Bulimic SEDS subscale and standardized measures of trust beliefs in close others (mother, father, and friend), disclosure to them, and loneliness. Structural Equation Modelling yielded: (1) a negative path between Bulimic Symptoms and trust beliefs, (2) a positive path between trust beliefs and disclosure, (3) a negative path between trust beliefs and loneliness, and (4) a negative path between disclosure and loneliness. As expected, trust beliefs statistically mediated the relations between Bulimic Symptoms and both disclosure and loneliness and disclosure statistically mediated the relation between trust beliefs and loneliness. The findings supported the conclusion that individuals with bulimia nervosa are prone to the social withdrawal syndrome comprising a coherent and integrated pattern of low trust beliefs in close others, low disclosure to close others, and high loneliness.

An interactional test of the reformulated helplessness theory of depression in women receiving clinical treatment for eating disorders

The study tested the Reformulated Helplessness model that individuals who show combined internal locus of control, high stability and high globality attributions for negative life events are prone to depression. Thirty-six women (M=29 years-8 months of age) receiving clinical treatment for eating disorders completed: the Attribution Style Questionnaire, the Beck Depression Inventory, and the Stirling Eating Disorder Scales. An HRA yielded a three-way interaction among the attributional dimensions on depressive symptoms. Plotting of the slopes showed that the attribution of negative life events to the combination of internal locus of control, high stability, and a high globality, was associated with the optimal level of depressive symptoms. The findings supported the Reformulated Helplessness as a model of depression.

An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders

OBJECTIVE

This study explored the outcome of introducing Compassion Focused Therapy (CFT) into a standard treatment programme for people with eating disorders. In particular, the aim was to evaluate the principle that CFT can be used with people with eating disorders and improve eating disorder symptomatology.

METHOD

Routinely collected questionnaire data were used to assess cognitive and behavioural aspects of eating disorders and social functioning/well being (n = 99).

RESULTS

There were significant improvements on all questionnaire measures during the programme. An analysis by diagnosis found that people with bulimia nervosa improved significantly more than people with anorexia nervosa on most of the subscales. Also, in terms of clinical significance, 73% of those with bulimia nervosa were considered to have made clinically reliable and significant improvements at the end of treatment (compared with 21% of people with anorexia nervosa and 30% of people with atypical eating disorders).

CONCLUSION

This study demonstrates the potential benefits of using CFT with people with eating disorders and highlights the need for further research on this new approach.

KEY PRACTITIONER MESSAGE

CFT offers new ways to conceptualize and formulate some of the self-critical and shame-based difficulties associated with eating disorders. CFT offers a framework that can enable people with eating disorders to conceptualize their difficulties in different ways. CFT can be combined with standard therapies especially cognitive behavioural therapy. CFT can be especially useful in a group context where the relationships between members can become increasingly compassionate, validating, supportive and encouraging.

The relation between the lack of control attributional style for indulgent food consumption and bulimic symptoms

OBJECTIVE

The study examined the potential link between the lack of control attributional style for indulgent food consumption and bulimic symptoms.

METHOD

One hundred and 77 undergraduates (145 female; mean age=19 years-2 months) were administered the Eating Attributional Style Questionnaire and the Sterling Eating Disorder Scales across a five-month period.

RESULTS

SEM analyses confirmed that: (1) uncontrollability attributions for indulgent food consumption were concurrently associated with bulimic symptoms, and (2) external locus of control and uncontrollability attributions for indulgent food consumption predicted changes in bulimic symptoms.

CONCLUSIONS

The findings yielded support for the conclusion that the lack of control attributional style for indulgent food consumption is a probable cause of bulimic symptoms.

An investigation into the psychometric properties of the Stirling Eating Disorder Scales

The Stirling Eating Disorder Scales (SEDS) are widely used in clinical practice, however evidence regarding the internal consistency and validity of the measure is limited. The aim of this study was to investigate the psychometric properties of the SEDS in a mixed eating disorder population. The SEDS and the Eating Disorder Examination (EDE) were administered to 241 consecutive patients attending an adult out-patient eating disorder service in the UK. The internal consistency of the overall SEDS was good, but there was variation in the internal consistency of the individual subscales. There were differences across diagnosis for all SEDS subscales, and some significant correlations were found between the EDE and SEDS subscales. It was not possible to replicate the derivation of the original SEDS subscales using a principal components analysis (PCA); further analysis was conducted on the new subscales that were identified. It is suggested that information obtained from the administration of the SEDS should be interpreted with caution, and also that further exploration of the psychometric properties of the SEDS is warranted.

The Minnesota Eating Behavior Survey: a brief measure of disordered eating attitudes and behaviors

This article describes details of the development and psychometric characteristics of a brief self-report inventory for assessing attitudes and behaviors symptomatic of eating disorders that is currently in use in a longitudinal study of over 700 families with 11-year-old or 17-year-old twin girls. The Minnesota Eating Behavior Survey (MEBS), formerly the Minnesota Eating Disorder Inventory, is a 30-item measure developed for use with children as young as 10 years as well as adults. An examination of the MEBS's psychometric properties in a large, community sample of girls, women, and men demonstrated good factor congruence, internal consistency reliability, three-year stability, as well as evidence of concurrent and criterion validity. This questionnaire has promise as a screening and assessment measure for eating disturbance in cross-sectional and longitudinal research involving individuals of a wide range of ages.

Psychometric properties of the Stirling Eating Disorder Scales with bulimia nervosa patients

BACKGROUND

The Stirling Eating Disorder Scales (SEDS) are described as a well-validated measure of anorexic and bulimic cognitions and behaviors. However, there is little published research that demonstrates or tests the psychometric properties of the SEDS. The aim of this study was to assess the internal consistency of the SEDS with a clinical population at a specialist eating disorders service.

METHOD

This study was a cross-sectional component of a larger study (evaluating cognitive behavioural group treatment for bulimia nervosa). At assessment at a specialist eating disorders service, the SEDS was administered to a clinical sample of women with a diagnosis of bulimia nervosa (N=40). Cronbach's alpha coefficients were used to determine the internal consistency of the scales.

RESULTS

While the internal consistency of the overall SEDS was good, the existing SEDS subscales lacked internal consistency. Only one of the eight subscales (perceived external control) had an acceptable alpha (>.700). By removing up to three questionnaire items for each subscale that most impaired the alpha, only two further subscales were raised to an acceptable alpha. The sample's scores did not closely reflect the reported norms.

DISCUSSION

More studies are needed to determine the clinical and psychometric validity of the SEDS. However, the present findings indicate that the preliminary psychometric findings do not generalize to other adult clinical populations. Therefore, caution should be used when interpreting the results of the SEDS when working with adults with eating disorders.

Validating the Stirling Eating Disorders Scales (SEDS) in an adolescent population

OBJECTIVE

This study aimed to determine the validity and utility of the Stirling Eating Disorder Scales (SEDS) as a screening instrument for eating disorders in adolescents.

METHOD

A total of 53 patients and 61 age-matched controls all completed the SEDS, and patients completed the Eating Disorders Examination (EDE) for construct comparison purposes.

RESULTS

The SEDS was found to have good criterion and discriminant validity, as well as high internal consistency.

DISCUSSION

The SEDS appears to be useful as a screening tool for adolescents, although many participants had some difficulties with comprehending certain items, which may affect its utility in young populations.

Beyond shape and weight: exploring the relationship between nonbody determinants of self-esteem and eating disorder symptoms in adolescent females

OBJECTIVE

Recent research using the Shape and Weight-Based Self-Esteem (SAWBS) Inventory has shown that basing self-esteem on shape and weight is related to eating disorder and psychiatric symptoms. This study examined the relationship between other determinants of self-esteem assessed in the SAWBS Inventory (e.g., friendships, intimate relationships, school/work competence) and eating disorder and psychological health variables.

METHOD

Female high school adolescents (N = 235) participated in this study. The relative contribution of the self-esteem dimensions to eating disorder and self-esteem was examined.

RESULTS

In addition to shape and weight, basing self-esteem on intimate relationships was also related to higher eating disorder symptoms and lower body and global self-esteem. The only protective factors to emerge in this study were basing self-esteem on competence at school and other activities.

DISCUSSION

Basing self-esteem on intimate relationships was associated with similar physical and health problems to basing self-esteem on shape and weight. The implications of these findings with regard to healthy adolescent development are addressed.

Assessment of shape- and weight-based self-esteem in adolescents

OBJECTIVES

The Adolescent version of the Shape and Weight-Based Self-Esteem (SAWBS-A) Inventory provides a contextual measure of the importance of shape and weight to overall feelings of self-worth. The psychometric properties of the adult SAWBS Inventory have been previously established. The present research examined the psychometric properties of this measure in adolescent females, and compared structural aspects of self-concept in symptomatic and nonsymptomatic individuals.

METHOD

A school sample of 197 adolescents completed the SAWBS-A Inventory and measures to assess concurrent and discriminant validity. A subsample completed the SAWBS-A Inventory a second time, 1 week later.

RESULTS

SAWBS-A scores were stable over 1 week and correlated with measures of eating disorder symptomatology. The scores also discriminated between adolescents reporting few or no disturbed eating symptoms and possible/probable cases. Comparison of self-esteem profiles in these two groups revealed that in addition to body, the groups differed in the extent to which facial appearance contributed to feelings of self-worth.

CONCLUSIONS

The SAWBS-A Inventory may be useful in examining structural dimensions of self-esteem in adolescents.

Measuring self-esteem in dieting disordered patients: the validity of the Rosenberg and Coopersmith contrasted

OBJECTIVE

In order to ascertain the most appropriate measure of self-esteem for dieting disordered patients, this study contrasted the construct and convergent validities of two widely used measures. In addition, dieting disordered subgroups were compared on levels of self-esteem.

METHOD

One hundred and seventeen male and female patients diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified completed the Rosenberg Self-Esteem Scale (SES), the Coopersmith Self-Esteem Inventory (SEI), and measures of dieting disorder pathology and depression.

RESULTS

No significant differences among the three dieting disorder subgroups were found. In determining convergent validity, regression analyses indicated that the SES was a significant predictor of dieting disorder psychopathology whereas the SEI was not. Of the two self-esteem measures, only the SES showed evidence of convergent validity.

DISCUSSION

The results suggest that the SES has sounder construct and convergent validity than the SEI. Hence, the SES may be more appropriate for use with dieting disordered populations.