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Melisse B, van den Berg E, de Beurs E. Effectiveness of web-based guided self-help cognitive behavioral therapy-enhanced for binge-eating disorder: An implementation study. Int J Eat Disord 2024; 57:1379-1389. [PMID: 37876352 DOI: 10.1002/eat.24079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023]
Abstract
INTRODUCTION Web-based guided self-help cognitive behavioral therapy-enhanced (CBT-E) is a 12-weeks, 12-sessions, digitalized version of part II of the self-help book Overcoming Binge Eating. This intervention is effective when offered under controlled circumstances in a randomized-controlled-trial. It is unknown how patients with binge-eating disorder (BED) respond to this intervention when offered in real-world clinical-settings. The aim of this study is to examine post-intervention effectiveness of guided self-help CBT-E for BED in real-world settings. METHOD The present study used a cohort-design examining the effectiveness of web-based guided self-help CBT-E according to an intention-to-treat (ITT) analysis. BED patients (n = 278) were assessed pre- and post-intervention. The primary outcome was reduction in binge-eating episodes. Other outcomes were full-recovery (EDE-Q score <2.77 and abstinence from binge-eating episodes), impaired psychosocial functioning, defined as secondary impairment, and general psychopathology post-intervention. RESULTS The number of binge-eating episodes reduced by an average of 16 binge-eating episodes per 4 weeks pre-intervention to five binge-eating episodes during the last 4 weeks of treatment. Abstinence from binge eating was reported by 30%, and 28% reported full recovery. Effect sizes (Cohen's d) were large (d ≥ 1.0) for all outcome measures. There were no differences in outcomes between the ITT and the completers sample. DISCUSSION Guided self-help CBT-E is associated with significant improvements. The effects of guided self-help CBT-E offered in a real-world-setting are comparable to self-help CBT-E offered in a randomized-controlled-trial. However, it should be noted that comparisons with randomized-controlled-trials requires caution. Longer-term follow-up data are necessary to measure persistence of treatment benefits. PUBLIC SIGNIFICANCE Offering CBT-E as a web-based guided self-help intervention has several benefits for patients with BED. Guided self-help CBT-E is associated with significant improvements on the short term when offered in real-world clinical settings.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders & Obesity, Amstelveen, The Netherlands
- Section Clinical Psychology, Leiden University, Leiden, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Elske van den Berg
- Novarum Center for Eating Disorders & Obesity, Amstelveen, The Netherlands
| | - Edwin de Beurs
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
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Meule A, Hilbert A, de Zwaan M, Brähler E, Koch S, Voderholzer U. Cutoff scores of the Eating Disorder Examination-Questionnaire for the German population. Int J Eat Disord 2024; 57:602-610. [PMID: 38258314 DOI: 10.1002/eat.24133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVE The Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used self-report measures for the assessment of eating disorder (ED) symptomatology. However, proposed cutoff scores that may indicate the presence of an ED have been heterogeneous. Therefore, the current study derived cutoff scores from two large samples: one representative for the German population and one composed of persons with EDs at admission to inpatient treatment. METHOD Receiver operating characteristic analysis was used with the EDE-Q global score as independent variable and group (controls: n = 2519, patients: n = 2038) as dependent variable. These analyses were also conducted separately with the patient group divided into persons with anorexia nervosa (AN; n = 1456), bulimia nervosa (BN; n = 370), and other EDs (n = 212) and after matching groups for age and sex distribution. RESULTS The EDE-Q global score discriminated well between controls and patients (AUC >91%, sensitivity >.84, specificity >.79). A score of 1.6 discriminated best between controls and patients in general and persons with AN in particular. Optimal thresholds for discriminating between controls and persons with BN and other EDs ranged between scores of 1.8 and 2.4. DISCUSSION In the German population, cutoff scores between 1.6 and 2.4 may be used to screen for the presence or absence of an ED or evaluate treatment outcome, with slightly higher cutoff scores for persons with BN and other EDs than for persons with AN. PUBLIC SIGNIFICANCE Questionnaire scores have little value when it is unclear which scores indicate the likely presence of an ED, as such scores can be used to estimate the prevalence of or screen for EDs in the general population and evaluate outcome at the end of ED treatment. The current study indicates a score around 2 on the EDE-Q as an optimal threshold for this.
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Affiliation(s)
- Adrian Meule
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Stefan Koch
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany
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Kamashita R, Setsu R, Numata N, Koga Y, Nakazato M, Matsumoto K, Ando H, Masuda Y, Maral S, Shimizu E, Hirano Y. Atypical social cognition processing in bulimia nervosa: an fMRI study of patients thinking of others' mental states. Biopsychosoc Med 2024; 18:5. [PMID: 38383440 PMCID: PMC10880368 DOI: 10.1186/s13030-023-00297-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/22/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Feeding and eating disorders are severe mental disorders that gravely affect patients' lives. In particular, patients with anorexia nervosa (AN) or bulimia nervosa (BN) appear to have poor social cognition. Many studies have shown the relationship between poor social cognition and brain responses in AN. However, few studies have examined the relationship between social cognition and BN. Therefore, we examined which brain regions impact the ability for social cognition in patients with BN. METHODS We used task-based functional magnetic resonance imaging (fMRI) to examine brain responses during a social cognition task and the Reading Mind in the Eyes Test (RMET). During the fMRI, 22 women with BN and 22 healthy women (HW) took the RMET. Participants also completed the eating disorder clinical measures Bulimic Investigatory Test, Edinburgh (BITE) and Eating Disorders Examination Questionnaire (EDE-Q), the Patient Health Questionnaire (PHQ-9) measure of depression; and the Generalized Anxiety Disorder (GAD-7) measure of anxiety. RESULTS No difference was observed in the RMET scores between women with BN and HW. Both groups showed activation in brain regions specific to social cognition. During the task, no differences were shown between the groups in the BOLD signal (p < 0.05, familywise error corrected for multiple comparisons). However, there was a tendency of more robust activation in the right angular gyrus, ventral diencephalon, thalamus proper, temporal pole, and middle temporal gyrus in BN (p < 0.001, uncorrected for multiple comparisons). Moreover, HW showed a positive correlation between RMET scores and the activation of two regions: medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC); however, no significant correlation was observed in women with BN. CONCLUSIONS While activation in the mPFC and ACC positively correlated to the RMET scores in HW, no correlation was observed in BN patients. Therefore, women with BN might display modulated neural processing when thinking of others' mental states. Further examination is needed to investigate neural processing in BN patients to better understand their social cognition abilities. TRIAL REGISTRATION UMIN, UMIN000010220. Registered 13 March 2013, https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000010220.
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Affiliation(s)
- Rio Kamashita
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Rikukage Setsu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Sato Hospital, Nanyo, Japan
| | - Noriko Numata
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuko Koga
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Department of Clinical Psychiatry, Chiba University Hospital, Chiba, Japan
- International University of Health and Welfare, Narita, Department of Psychiatry, Narita, Japan
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Hiroki Ando
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Sertap Maral
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan.
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Fekih-Romdhane F, Malaeb D, Dabbous M, Hallit R, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the short 9-item drive for muscularity scale (DMS-9). BMC Psychiatry 2023; 23:680. [PMID: 37726706 PMCID: PMC10507918 DOI: 10.1186/s12888-023-05179-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND After the original 15-item Drive for Muscularity Scale developed by McCreary et al. in 2004, a more theoretically based scale that replicates the original DMS subscales with a better conceptual clarity and a shorter number of items, i.e., the DMS-9, has recently been developed by Chaba et al. in 2018. We sought to contribute to the literature especially under the Arab context, by investigating the psychometric properties of an Arabic translation of the DMS-9 in a sample of Arabic-speaking Lebanese university students of both genders. METHODS University students (N = 402; 55.2% females) from multiple universities in Lebanon were invited to fill the survey in this cross-sectional designed study (December 2022 and January 2023). Our sample was chosen using the snowball technique; a soft copy of the questionnaire was created using google forms software, and an online approach was conceived to proceed with the data collection. RESULTS Using an Exploratory Factor Analysis-to- Confirmatory Factor Analysis strategy, we found that the original two-factor model of the DMS proposed in the parent study was adequately replicated in our sample. The two DMS-9 factor scores showed very good McDonald's omega values (ω > 0.8). Findings also showed that gender invariance was achieved at the configural, metric, and scalar levels. Additionally, drive for muscularity scores correlated in the expected way with other study variables, providing support for the convergent and divergent validity of the Arabic DMS-9. Specifically, we found that greater drive for muscularity attitudes and behaviors significantly correlated with more severe muscle dysmorphic symptoms, inappropriate eating attitudes, muscle bias internalization, and lower body appreciation. CONCLUSION Findings preliminarily suggest that the Arabic DMS-9 is psychometrically sound and suitable tool to assess the drive for muscularity construct among Arabic-speaking community adults. Making the Arabic DMS-9 available will hopefully benefit the scientific community working in Arab settings, promote local and international research in this area, and offer descriptive data on how drive for muscularity may interfere with health indicators in the general Arab population.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Medical Gulf University, Ajman, United Arab Emirates
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame des Secours University Hospital, Postal code 3, Byblos, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Melisse B, Blankers M, van den Berg E, de Jonge M, Lommerse N, van Furth E, Dekker J, de Beurs E. Economic evaluation of web-based guided self-help cognitive behavioral therapy-enhanced for binge-eating disorder compared to a waiting list: A randomized controlled trial. Int J Eat Disord 2023; 56:1772-1784. [PMID: 37306246 DOI: 10.1002/eat.24003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The aim is to perform an economic evaluation alongside a randomized controlled trial comparing guided self-help cognitive behavioral therapy-enhanced (CBT-E) for binge-eating disorder (BED) to a waiting list control condition. METHODS BED patients (N = 212) were randomly assigned to guided self-help CBT-E or the 3-month waiting list. Measurements took place at baseline and the end-of-treatment. The cost-effectiveness analysis was performed using the number of binge-eating episodes during the last 28 days as an outcome indicator according to the eating disorder examination. A cost-utility analysis was performed using the EuroQol-5D. RESULTS The difference in societal costs over the 3 months of the intervention between both conditions was €679 (confidence interval [CI] 50-1330). The incremental costs associated with one incremental binge eating episode prevented in the guided self-help condition was approximately €18 (CI 1-41). From a societal perspective there was a 96% likelihood that guided self-help CBT-E led to a greater number of binge-eating episodes prevented, but at higher costs. Each additional quality-adjusted life year (QALY) gained was associated with incremental costs of €34,000 (CI 2494-154,530). With a 95% likelihood guided self-help CBT-E led to greater QALY gain at higher costs compared to waiting for treatment. Based on the National Institute for Health and Clinical Excellence willingness-to-pay threshold of €35,000 per QALY, guided self-help CBT-E can be considered cost-effective with a likelihood of 95% from a societal perspective. DISCUSSION Guided self-help CBT-E is likely a cost-effective treatment for BED in the short-term (3-month course of treatment). Comparison to treatment-as-usual is recommended for future research, as it enables an economic evaluation with a longer time horizon. PUBLIC SIGNIFICANCE Offering treatment remotely has several benefits for patients suffering from binge-eating disorders. Guided self-help CBT-E is an efficacious and likely cost-effective treatment, reducing binge eating and improving quality-of-life, albeit at higher societal costs.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders & Obesity, Amstelveen, The Netherlands
- Section Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Matthijs Blankers
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Elske van den Berg
- Novarum Center for Eating Disorders & Obesity, Amstelveen, The Netherlands
| | - Margo de Jonge
- Novarum Center for Eating Disorders & Obesity, Amstelveen, The Netherlands
| | - Nick Lommerse
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
| | - Eric van Furth
- GGZ Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Jack Dekker
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
| | - Edwin de Beurs
- Section Clinical Psychology, Leiden University, Leiden, The Netherlands
- Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
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Hatoum AH, Burton AL, Abbott MJ. Validation of the revised eating disorder core beliefs questionnaire (ED-CBQ-R) in an Australian sample. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2144717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Amaani H. Hatoum
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Amy L. Burton
- School of Psychology, The University of Sydney, Sydney, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Maree J. Abbott
- School of Psychology, The University of Sydney, Sydney, Australia
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Melisse B, van Furth EF, de Beurs E. The Saudi-Arabic adaptation of the Body Shape Questionnaire (BSQ34): Psychometrics and norms of the full version and the short version (BSQ8C). Front Psychol 2022; 13:1046075. [PMID: 36532987 PMCID: PMC9754054 DOI: 10.3389/fpsyg.2022.1046075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/24/2022] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Saudi Arabia experiences elevated levels of body-shape dissatisfaction which might be related to the increased thin ideal. Studies on body-shape dissatisfaction are scarce, mainly because adapted assessment tools are unavailable. This study describes the Saudi-Arabic adaptation of the Body Shape Questionnaire (BSQ34), preliminary examines the psychometric properties and provides normative data. METHODS The BSQ34 was administered in a convenience community sample (N = 867) between April 2017 and May 2018. Receiver-operating-characteristic curve analysis was used to establish discriminant validity, in a subsample (N = 602) in which the Eating Disorder Examination-Shape concern, was administered, the factor structure investigated with confirmatory-factor analyses and T-scores and percentile scores were determined. RESULTS The BSQ34 discriminated well between low and high levels of body-shape dissatisfaction (area-under-the-curve value = 0.93), had high internal consistency and a unidimensional factor structure, and 23.9% appeared at risk for body-shape dissatisfaction. Analyses were repeated for the shortened BSQ8C, which yielded similar results. DISCUSSION The results indicated that the BSQ34 and BSQ8C appeared suitable measurement tools to screen for body-shape dissatisfaction in a Saudi convenience community sample, mainly comprised young, unmarried, and highly educated women. The BSQ34 supplies more information on the type of concerns respondents have, which is worthwhile when the measure is used in a clinical setting; the BSQ8C is recommended as a short screener. As body-shape dissatisfaction is viewed as a risk factor for the development of eating disorder symptoms, screening for body-shape dissatisfaction with reliable tools is important to detect individuals at risk for eating disorder symptoms and may suggest subsequent preventive steps.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders and Obesity, Amstelveen, Netherlands
- Section Clinical Psychology, Leiden University, Leiden, Netherlands
- GGZ Rivierduinen, Leiden, Netherlands
| | - Eric F. van Furth
- GGZ Rivierduinen, Leiden, Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Edwin de Beurs
- Section Clinical Psychology, Leiden University, Leiden, Netherlands
- Research Department, Arkin Mental Health Institute, Amsterdam, Netherlands
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Melisse B, Blankers M, de Beurs E, van Furth EF. Correlates of eating disorder pathology in Saudi Arabia: BMI and body dissatisfaction. J Eat Disord 2022; 10:126. [PMID: 36002864 PMCID: PMC9404570 DOI: 10.1186/s40337-022-00652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Saudi Arabia is undergoing rapid sociocultural changes, which may have led to an increase of body mass index and eating disorder pathology. The aim of this study is to investigate whether body dissatisfaction, self-esteem, having lived abroad, cultural orientation, perceived stress, media use, and socioeconomic status are correlates of eating disorder pathology with body mass index as a covariate. Additional aims are to investigate if cultural orientation is associated with symptomatology and if stress is a covariate in the association between eating disorder pathology and Western orientation. METHOD Self-report measures were administered in a convenience Saudi community sample (N = 1225) between April 2017 and May 2018. Hierarchical multiple linear regression analyses with eating disorder pathology as dependent variable were performed to establish the associations among the variables. RESULTS After adjusting for the effect of BMI, only body dissatisfaction and eating disorder pathology were moderately associated. Eating disorder pathology and body dissatisfaction were more severe among Saudi citizens with a higher BMI. DISCUSSION Several explanations for the lack of associations of westernization, self-esteem, and stress with eating disorder pathology are reviewed and discussed. The majority of this convenience sample existed of young unmarried Saudi females of high socioeconomic status. Of the total sample, 35% displayed eating disorder pathology which may be a reflection of the high rates of excess weight.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders & Obesity, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands
- Section Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
- Rivierduinen Eating Disorders Ursula, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands
| | - Matthijs Blankers
- Research Department, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
| | - Edwin de Beurs
- Research Department, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
- Section Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Eric F. van Furth
- Rivierduinen Eating Disorders Ursula, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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Goel NJ, Burnette CB, Weinstock M, Mazzeo SE. Eating Disorder Examination-Questionnaire: Evaluating factor structures and establishing measurement invariance with Asian/Hawaiian/Pacific Islander, Black, and White American college men. Int J Eat Disord 2022; 55:481-493. [PMID: 35261058 PMCID: PMC9315007 DOI: 10.1002/eat.23696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study evaluated the factor structure and invariance of the Eating Disorder Examination-Questionnaire (EDE-Q) in a sample of Asian/Hawaiian/Pacific Islander (n = 163), Black (n = 155), and White (n = 367) American university men. METHOD Twelve different EDE-Q factor structures reported in the literature were evaluated using multi-group confirmatory factor analyses, and measurement invariance assessed. RESULTS A respecified four-factor structure proposed by Parker et al. (2016) showed superior fit and was invariant across groups. Significant differences emerged across all latent factors, with small to medium effects. Asian/Hawaiian/Pacific Islander men reported significantly higher scores on factors assessing Appearance Concern, Overvaluation of Shape/Weight, and Eating Concerns, and were more likely to endorse regular objective binge eating (OBE) and fasting episodes than their Black and White peers. Both White and Asian/Hawaiian/Pacific Islander men reported greater dietary restraint than Black men. Among this sample, frequencies of regular compensatory exercise ranged from 10% to 16%, fasting 6% to 14%, and OBEs 1% to 10%. DISCUSSION Results provide further support for the use of alternate EDE-Q factor structures, especially among non-White men. In this study, Asian/Hawaiian/Pacific Islander men reported the highest levels of ED psychopathology relative to White and Black men, indicating they might be particularly vulnerable to EDs. PUBLIC SIGNIFICANCE This study failed to find support for using the original Eating Disorder Examination-Questionnaire four-factor structure to detect disordered eating in Asian, Black, and White American college men. An alternate model proposed by Parker et al. in 2016 may be more appropriate. Asian men also reported the highest levels of eating psychopathology relative to their peers, suggesting they may be at high risk for developing eating disorders.
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Affiliation(s)
- Neha J. Goel
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Carolyn Blair Burnette
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA,Division of Epidemiology and Community HealthSchool of Public Health, University of MinnesotaMinneapolisMinnesotaUSA
| | - Madison Weinstock
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Suzanne E. Mazzeo
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA,Department of PediatricsVirginia Commonwealth University School of MedicineRichmondVirginiaUSA
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Hatoum AH, Burton AL, Abbott MJ. Assessing negative core beliefs in eating disorders: revision of the Eating Disorder Core Beliefs Questionnaire. J Eat Disord 2022; 10:18. [PMID: 35144689 PMCID: PMC8830168 DOI: 10.1186/s40337-022-00542-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Increased theoretical and empirical attention has been given to examining the role of core beliefs in both the development and maintenance of eating disorders (EDs). The Eating Disorder Core Beliefs Questionnaire (ED-CBQ) is self-report measure designed to assess five dimensions of core beliefs relating to eating disorders; self-loathing, unassertive/inhibited, demanding/needing help and support, abandoned/deprived, and high standards for the self. The present study aimed to evaluate the psychometric properties of the ED-CBQ and to develop a revised and improved version of the original measure after evaluating its factor structure and related properties. METHODS A sample of undergraduate university students (N = 763) completed an online test battery of questionnaires. Putative ED-symptomatic (n = 384) and non-ED (n = 379) subgroups were created from self-reported responses from the Eating Disorder Examination Questionnaire (EDEQ). Confirmatory factor analyses (CFAs) were performed, and internal consistency, construct validity, group differences and clinical utility was examined. RESULTS An initial CFA did not support the original five-factor 40-item ED-CBQ. A revised version was developed that possessed equal or superior psychometric properties to the original 40-item measure. The ED-CBQ-R demonstrated superior model fit, similar levels of reliability and construct validity, and the ability to discriminate between putative ED diagnostic groups. CONCLUSIONS Our results suggest that the ED-CBQ-R is a valid, reliable, but more importantly an efficient and accessible measure with the potential to be utilised both clinically and in research settings.
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Affiliation(s)
- Amaani H Hatoum
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Amy L Burton
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.
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