Psychometric properties of the Spanish version of the Eating Behaviours and Body Image Test for Preadolescent Girls (EBBIT)

Characterization of eating behavior disorders in school-aged children and adolescents: a population-based study

OBJECTIVE

Cross-sectional study to assess the characteristics of the risk behaviors for eating disorders (EDs) in school children between 10 and 14 years of age in the city of Recife, Pernambuco, Brazil.

METHODS

1405 school-aged children were assessed, using the Eating Behaviours and Body Image Test (EBBIT) to screen for EDs. The normality of the continuing variables was tested using the Kolmogorov-Smirnov test with Lilliefors correction. They were described as medians and interquartile intervals (25 and 75th percentiles).

RESULTS

The criteria that represented a condition of anorexia and/or bulimia nervosa were considered as strong indicators of risk for EDs in school-aged children who indicated the following behaviors with scores superior to the 75th percentile on the scales: "compulsive eating" 3.0% (CI95% 2.2-4.0); "dissatisfaction with body image/restrictive eating" 1.3% (CI95% 0.8-2.0); children scoring superior to the 30th percentile, "compulsive eating" + "dissatisfaction with body image/restrictive eating", 0.6% (CI95% 0.3-1.2); and superior to the 50th percentile; "compensatory behavior for hyperphagia" 6.7% (CI95% 5.4-8.1). In addition, greater vulnerability of the female gender was perceived, as well as an increase in the preliminary risk factors of EDs, such as advanced age, dissatisfaction with the body image linked to restrictive behaviors and the compulsive establishment of an eating pattern.

CONCLUSION

This study shows the dimension of the problem in this ecological context and the urgent need for intervention programs, developed among different sectors, from the perspective of the adolescents' empowerment to prevent and minimize the vulnerability factors of the eating disorders.

Weight misperception, self-reported physical fitness, dieting and some psychological variables as risk factors for eating disorders

The aims of the current study were to explore possible gender differences in weight misperception, self-reported physical fitness, and dieting, and to analyze the relationship between these variables and others, such as self-esteem, body appreciation, general mental health, and eating- and body image-related variables among adolescents. In addition, the specific risk for eating disorders was examined, as well as the possible clusters with respect to the risk status. The sample comprised 655 students, 313 females and 342 males, aged 16.22 ± 4.58. Different scales of perceived overweight, self-reported physical fitness and dieting together with the Body Mass Index (BMI) were considered along with instruments such as the International Physical Activity Questionnaire (IPAQ), General Health Questionnaire (GHQ-28), Self-Esteem Scale (SES), Body Appreciation Scale (BAS) and Eating Disorders Inventory-2 (EDI-2). Since some gender differences were found with respect to these adolescent groups, it is necessary to design prevention programs that not only focus on traditional factors such as BMI or body image, but also on elements like weight perception, self-reported fitness and nutritional education.

Health-related quality of life measurement in children and adolescents in Ibero-American countries, 2000 to 2010

OBJECTIVES

To analyze the characteristics of instruments designed to assess the health-related quality of life (HRQOL) in children, developed or adapted from 2000 to 2010 in Argentina, Chile, Mexico, Spain, and Uruguay.

METHODS

The protocol-led literature review included database searching (e.g., Medline, ISI Science Citation Index) and manual searching to retrieve studies focused on measures of HRQOL, health status, or well-being addressed to children and adolescents. Country-specific filters were applied to identify studies carried out in the participating countries. The characteristics of the instruments and type of studies were analyzed. Descriptive characteristics and psychometric properties were analyzed following the guidelines of the Scientific Advisory Committee of the Medical Outcomes Trust.

RESULTS

Ninety-nine documents were included. Thirty-one questionnaires were identified, 24 instruments were adapted, and the psychometric properties of 20 HRQOL instruments were reported in the study period. There was substantial variability in the number and characteristics of the dimensions included. Reliability was generally acceptable, and the majority of instruments provided data on internal consistency (n = 18) and, to a lesser extent, on test-retest reliability (n = 12). Nearly all studies reported construct validity, but only four analyzed sensitivity to change.

CONCLUSIONS

There is a scarcity of instruments to measure HRQOL of children and adolescents in the countries analyzed. Certain psychometric characteristics have been reasonably well tested, but others, most notably sensitivity to change, have not been tested in most instruments. Extension of this study to other Latin American countries would help to further identify gaps in this area and promote the use of HRQOL measurement in children and adolescents in Spanish-speaking cultures.

Spanish version of the Body Appreciation Scale (BAS) for adolescents

The need to study the positive aspects of body image led to the design of the Body Appreciation Scale (BAS). The aim of the present study was to develop a Spanish adaptation of the BAS for adolescents, testing its factor structure, construct validity and any differences between girls and boys. Participants were 312 adolescents aged between 12 and 20; there were 148 females and 164 males. The validation analysis of the BAS revealed a one-factor structure with adequate internal consistency (Cronbach's alpha = .908) and construct validity (correlations with body mass index, influence of the body shape model, perceived stress, coping strategies, self-esteem and variables from the Eating Disorders Inventory-2), as well as significant differences between boys and girls (p < .01). The BAS is suitable for administration in a Spanish adolescent population as a way of analysing the positive aspects of body image.

Perception of weight and psychological variables in a sample of Spanish adolescents

BACKGROUND

This study explored the relationship between body mass index (BMI) and weight perception, self-esteem, positive body image, food beliefs, and mental health status, along with any gender differences in weight perception, in a sample of adolescents in Spain.

METHODS

The sample comprised 85 students (53 females and 32 males, mean age 17.4 ± 5.5 years) with no psychiatric history who were recruited from a high school in Écija, Seville. Weight and height were recorded for all participants, who were then classified according to whether they perceived themselves as slightly overweight, very overweight, very underweight, slightly underweight, or about the right weight, using the question "How do you think of yourself in terms of weight?". Finally, a series of questionnaires were administered, including the Irrational Food Beliefs Scale, Body Appreciation Scale, Self Esteem Scale, and General Health Questionnaire.

RESULTS

Overall, 23.5% of participants misperceived their weight. Taking into account only those with a normal BMI (percentile 5-85), there was a significant gender difference with respect to those who perceived themselves as overweight (slightly overweight and very overweight); 13.9% of females and 7.9% of males perceived themselves as overweight (χ(2) = 3.957, P < 0.05). There was a significant difference for age, with participants who perceived their weight adequately being of mean age 16.34 ± 3.17 years and those who misperceived their weight being of mean age 18.50 ± 4.02 years (F = 3.112, P < 0.05).

CONCLUSION

Misperception of overweight seems to be more frequent in female adolescents, and mainly among older ones. Misperception of being overweight is associated with a less positive body image, and the perception of being very underweight is associated with higher scores for general psychopathology.

Traditional and new strategies in the primary prevention of eating disorders: a comparative study in Spanish adolescents

BACKGROUND

Research conducted to date into the primary prevention of eating disorders (ED) has mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further, promoting a change in attitudes and behavior in the target population.

OBJECTIVE

This study describes an adaptation of the Girls' Group model to the Spanish context, the main objective being to compare two types of intervention, ie, one based on this model and the other following the traditional approach of providing information. The ultimate aim was to implement a prevention program that reduces the risk factors and boosts the protection factors that have been empirically shown to be related to ED.

METHODS

on the basis of previous research on the primary prevention of ed, and taking into account recognized risk and protective factors, the following topics were addressed: nutritional aspects; self-esteem; coping strategies; the ideal image of what is attractive and role of the media; and body image. The total sample (174 girls and 197 boys) was divided into 12 work groups, six for the intervention group (one school) and six for the control group (two schools). School-based input (intervention group) was provided by a pharmacist, a psychologist, a qualified nutritionist/dietician, and specialist support staff (psychologists and/or educators) and teachers of the three schools.

RESULTS

Participation in the intervention group reduced body dissatisfaction (F = 13.41; P < 0.01), the drive to thinness (F = 10.79; P < 0.01), and the influence of the media with respect to the esthetic body shape model (F = 13.90; P < 0.01), while self-esteem (F = 7.34; P < 0.01) and the use of coping strategies (F = 13.74; P < 0.01) both improved. There was also an improvement in the eating habits of participants, with better outcomes being achieved when intervening with females.

CONCLUSIONS

The present study shows that in the primary prevention of eating disorders, better outcomes are achieved by new models which target the attitudes and behavior of adolescents rather than focusing solely on the provision of risk information to raise awareness.