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Donofre GS, Japur CC, Laus MF, Alvarenga MDS, Silva WRD. Psychometric Properties of Various Factorial Models of the ORTO-15 Tested With Brazilian Respondents. Percept Mot Skills 2024:315125241267134. [PMID: 39033355 DOI: 10.1177/00315125241267134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
The ORTO-15 is a commonly used screening instrument for symptoms of Orthorexia Nervosa (ON), an obsessive overconcern with healthy eating. However, its limitations have been evidenced in several published factorial models. We analyzed the psychometric properties of seven different ORTO-15 factorial models using data from Brazilian adult participants (n = 1455; 71.4% women; M age = 29.5, SD = 8.9 years) from the country's five macro-regions who answered online questions for sample characterization and completed the Portuguese version of the ORTO-15 containing 15 items. We tested the fit of each model separately, analyzing data for men and women with separate confirmatory factor analysis, and using the Weighted Least Squares Mean and Variance Adjusted estimation method and goodness-of-fit indices. We also calculated the average variance extracted and the alpha ordinal and omega coefficients to analyze the convergent validity and reliability of the factors. None of the models tested presented adequate properties of validity and reliability. Although we found some acceptable reliability coefficients, they do not guarantee the validity of the data. Future investigators should be cautious when choosing the ORTO-15 for ON screening.
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Affiliation(s)
- Giovanna Soler Donofre
- Graduate Program in Food, Nutrition and Food Engineering. School of Pharmaceutical Sciences of São Paulo State University (UNESP), Araraquara/SP, Brazil
| | - Camila Cremonezi Japur
- Department of Health Sciences. Ribeirão Preto Medical School. University of São Paulo (USP). Ribeirão Preto/SP, Brazil
| | - Maria Fernanda Laus
- Nutrition Course. University of Ribeirão Preto (UNAERP). Ribeirão Preto/SP, Brazil
- Department of Psychology. Faculty of Philosophy, Sciences and Letters of Ribeirao Preto, University of Sao Paulo (USP). Ribeirão Preto/SP, Brazil
| | - Marle Dos Santos Alvarenga
- Graduate Program in Public health Nutrition. School of Public Health. University of São Paulo (USP). São Paulo/SP, Brazil
| | - Wanderson Roberto da Silva
- Graduate Program in Food, Nutrition and Food Engineering. School of Pharmaceutical Sciences of São Paulo State University (UNESP), Araraquara/SP, Brazil
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Boutin C, Maïano C, Aimé A. Relation between orthorexia nervosa and healthy orthorexia: A latent profile analysis. Appetite 2024; 194:107165. [PMID: 38103792 DOI: 10.1016/j.appet.2023.107165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Orthorexic eating behaviors can be conceptualized as a bidimensional construct encompassing an orthorexia nervosa dimension (ON) and a healthy orthorexia dimension (HO). Although variable-centered studies showed that ON and HO are distinguishable orthorexic eating behaviors, the evidence of whether they can co-occur or be distinct in subgroups of individuals is still limited. The present study aimed to address previous person-centered studies' limitations by examining profiles of ON and HO among a convenience sample of 251 French-speaking Canadian adults (85.7% women; Mage = 33.56). Profile membership was examined as function of participants characteristics such as age, gender, body mass index, frequency of physical activity and sports and vegetarianism. The relation between profile membership, intuitive eating and disordered eating attitudes and behaviors was also assessed. Latent profile analysis (LPA) were used to estimate profiles of ON and HO. Results from LPA did not provide support for the distinguishability of ON and HO. Indeed, they revealed the presence of two profiles showing co-occurring levels of ON and HO that only differed quantitatively: low (68.9% of the sample; low levels of ON and HO) or moderate orthorexic eating behaviors (31.1%; moderate levels of ON and HO). Participants who declared being vegetarian and being more frequently involved in physical activities and sports were more likely to belong to the moderate orthorexic eating behaviors' profile. Finally, participants from the moderate orthorexic eating behaviors' profile showed higher levels of disordered eating attitudes and behaviors, whereas those from the low orthorexic eating behaviors' profile showed higher levels of intuitive eating. Findings from the present study question the distinguishability of ON and HO dimensions. They also suggest that, similarly to ON, HO is also related to higher eating and lifestyle preoccupations.
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Affiliation(s)
- Camille Boutin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
| | - Christophe Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada; Cyberpsychology Laboratory and Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO|Campus de Saint-Jérôme), Saint-Jérôme, Canada.
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
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Argyrides M, Anastasiades E, Maïano C, Swami V. Greek adaptation of the Teruel Orthorexia Scale (TOS) in adults from the Republic of Cyprus: A bidimensional model may not be universal. Appetite 2024; 194:107180. [PMID: 38145878 DOI: 10.1016/j.appet.2023.107180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
The Teruel Orthorexia Scale (TOS) is a 17-item instrument designed to assess distinct facets of Orthorexia Nervosa (ON) and Healthy Orthorexia (HO). While a bidimensional model of TOS scores has been supported in diverse national and linguistic groups, the psychometric properties of the TOS have not been previously assessed in Greek-speaking populations. To rectify this, we assessed the psychometric properties of a novel Greek translation of the TOS in a sample of adults from Cyprus. A total of 1248 respondents (710 women, 538 men) completed the Greek TOS, as well as previously validated measures of perfectionism, obsessive-compulsive symptomatology, eating restriction, negative affect, and appearance evaluation. Our results showed that a bidimensional model of the TOS had less-than-adequate fit when modelled using both confirmatory factor analysis and exploratory structural equation modeling (ESEM). Conversely, both exploratory factor analysis and ESEM supported extraction of a 3-factor model consisting of a HO facet and separate components of emotional orthorexia and cognitive-social orthorexia. This 3-factor model showed a lack of measurement bias (measurement invariance across gender identity and lack of differential item functioning as function of age and body mass index), but there were differences in latent factor means as function of respondent age and body mass index. The 3-factor model showed adequate evidence of construct validity, with the latent emotional orthorexia and cognitive-social orthorexia facets showing significant and moderate associations with the additional constructs measured in the survey. Broadly speaking, these findings support the psychometric properties of a 3-factor model of the Greek TOS, but also suggest that the bidimensional model of the TOS may not have universal applicability. We encourage further assessments of factorial validity in other national and linguistic contexts.
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Affiliation(s)
- Marios Argyrides
- Eating and Appearance Research Laboratory, Department of Psychology, Neapolis University Pafos, Paphos, Cyprus.
| | - Elly Anastasiades
- Eating and Appearance Research Laboratory, Department of Psychology, Neapolis University Pafos, Paphos, Cyprus
| | - Christophe Maïano
- Cyberpsychology Laboratory and Department of Psychoeducation and Psychology, Université Du Québec en Outaouais, Saint-Jérôme, Canada; Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
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Styk W, Gortat M, Samardakiewicz-Kirol E, Zmorzynski S, Samardakiewicz M. Measuring Pathological and Nonpathological Orthorexic Behavior: Validation of the Teruel Orthorexia Scale (TOS) among Polish Adults. Nutrients 2024; 16:638. [PMID: 38474767 DOI: 10.3390/nu16050638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Measuring orthorexia nervosa is challenging due to the use of various existing tools and problems with sample representativeness. Another challenge for the Polish population is the adaptation of existing research tools and the evaluation of their relevance and research reliability. Our research aimed to adapt the TOS to the Polish language and measure pathological and nonpathological orthorexic behavior among the Polish population. The adaptation of the PL-TOS has high psychometric value and allows us to assess healthy and nervous orthorexia levels. This scale can be used not only for further research but also for diagnostic purposes in the daily work of clinicians and psychologists. Our results obtained in the present study indicate a correlation between TOS and both the use of supplements and diet. Higher TOS, ORTO_R and KZZJ_Diet Restrictions scores were obtained for individuals using dietary supplements than for those not using dietary supplements. In the future, it is worth conducting research aimed at various risk groups of individuals with orthorexia to confirm the psychometric properties of this adaptation of the TOS.
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Affiliation(s)
- Wojciech Styk
- Academic Laboratory of Psychological Tests, Medical University of Lublin, 20-093 Lublin, Poland
| | - Mateusz Gortat
- Institute of Education and Practical Improvement, Association of Young Scientists in Poland, 20-560 Lublin, Poland
| | - Emilia Samardakiewicz-Kirol
- Simulation Laboratory for Patient Safety, Department of Medical Education, Medical University of Lublin, 20-093 Lublin, Poland
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Sezer Katar K, Şahin B, Kurtoğlu MB. Healthy orthorexia, orthorexia nervosa, and personality traits in a community sample in Turkey. Int J Psychiatry Med 2024; 59:83-100. [PMID: 37542522 DOI: 10.1177/00912174231194745] [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] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Orthorexia nervosa is an eating disorder characterized by a rigid preoccupation with a perceived healthy diet. However, little is known about healthy orthorexia compared to orthorexia nervosa. The current study examined the relationship between healthy orthorexia and orthorexia nervosa and personality traits in a Turkish sample. METHODS Three hundred fifty participants from a community sample aged 18-65 were included in the study. Participants completed a sociodemographic data collection form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Teruel Orthorexia Scale (TOS), and the 10-Item Personality Inventory (TIPI). RESULTS The frequency of healthy orthorexia was 32.3% and orthorexia nervosa was 10.2%. There were no differences between genders regarding healthy orthorexia and orthorexia nervosa scores. Healthy orthorexia symptoms were negatively correlated with depression and anxiety (r = -0.11 and r = -0.20, respectively, P < .05), while they were positively correlated with agreeableness (r = 0.17), conscientiousness (r = 0.14), and extraversion (r = 0.15). Orthorexia nervosa symptoms were positively associated with anxiety (r = 0.12), depression (r = 0.10), and healthy orthorexia (r = 0.55). Hierarchical regression analyses demonstrated that depression was negatively associated with healthy orthorexia symptoms, explaining 4% of the variance. The agreeableness trait was positively associated with healthy orthorexia symptoms, explaining 4% of the variance. However, no specific personality trait was associated with orthorexia nervosa symptoms. CONCLUSION To our knowledge, the present study is the first to examine the relationships between personality traits, healthy orthorexia, and orthorexia nervosa symptoms in a Turkish sample. Sociocultural factors may be important for understanding orthorexia nervosa and healthy eating behaviors in this population.
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Affiliation(s)
- Kübra Sezer Katar
- Department of Psychiatry, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Başak Şahin
- Department of Psychiatry, Ankara Etlik City Hospital, Ankara, Turkey
| | - Mustafa Batuhan Kurtoğlu
- Department of Psychology, Faculty of Economics, Administrative and Social Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
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Falgares G, Costanzo G, Manna G, Marchetti D, Barrada JR, Roncero M, Verrocchio MC, Ingoglia S. Healthy orthorexia vs. orthorexia nervosa: Italian validation of the Teruel Orthorexia Scale (TOS). Eat Weight Disord 2023; 28:42. [PMID: 37133773 PMCID: PMC10155145 DOI: 10.1007/s40519-023-01568-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023] Open
Abstract
PURPOSE Orthorexia nervosa (OrNe) is a potentially pathological condition characterized by a fixation on healthy diet. An increasing number of studies have been conducted on this mental preoccupation, but the validity and reliability of some of the psychometric instruments employed in its assessment are still under debate. Among these measures, the Teruel Orthorexia Scale (TOS) seems to be promising, given that it allows to differentiate between OrNe and other non-problematic forms of interest with healthy eating, named as healthy orthorexia (HeOr). The aim of this study was to examine the psychometric properties of an Italian version of the TOS, by testing its factorial structure, internal consistency, test-retest reliability, and validity. METHOD Through an online survey, we recruited 782 participants from different regions of Italy, asking them to complete the following self-report instruments: TOS, EHQ, EDI-3, OCI-R, and BSI-18. From the initial sample, 144 participants agreed to complete a second TOS administration 2 weeks later. RESULTS Data confirmed the validity of the 2-correlated factors structure of the TOS. The questionnaire also showed good reliability, both in terms of internal consistency and temporal stability. With regard to the TOS validity, results showed that OrNe was significantly and positively associated with measures of psychopathology and psychological distress, while HeOr showed no correlations or negative associations with the above-mentioned measures. CONCLUSION Based on these results, the TOS can be considered a promising measure for the assessment of both pathological and non-problematic forms of orthorexic eating behavior also in Italian population. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Affiliation(s)
- Giorgio Falgares
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Giulia Costanzo
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Giovanna Manna
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy.
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Juan Ramón Barrada
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
| | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | - Maria Cristina Verrocchio
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Sonia Ingoglia
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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Lasson C, Rousseau A, Vicente S, Goutaudier N, Romo L, Roncero M, Barrada JR. Orthorexic eating behaviors are not all pathological: a French validation of the Teruel Orthorexia Scale (TOS). J Eat Disord 2023; 11:65. [PMID: 37106441 PMCID: PMC10139919 DOI: 10.1186/s40337-023-00764-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/26/2023] [Indexed: 04/29/2023] Open
Abstract
As no French validated measurement tool distinguishing healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) currently exists, this study aimed at examining psychometric properties of the French version of the Teruel Orthorexia Scale (TOS). A sample of 799 participants (Mean [SD] age: 28.5 [12.1] years-old) completed the French versions of the TOS, the Düsseldorfer Orthorexia Skala, the Eating Disorder Examination-Questionnaire, and the Obsessive-Compulsive Inventory-Revised. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used. Although the bidimensional model, with OrNe and HeOr, of the original 17-item version showed an adequate fit, we suggest excluding items 9 and 15. The bidimensional model for the shortened version provided a satisfactory fit (ESEM model: CFI = .963, TLI = .949, RMSEA = .068). The mean loading was .65 for HeOr and .70 for OrNe. The internal consistency of both dimensions was adequate (αHeOr = .83 and αOrNe = .81). Partial correlations showed that eating disorders and obsessive-compulsive symptomatology measures were positively related to OrNe and unrelated or negatively related to HeOr. The scores from the 15-item French version of the TOS in the current sample appears to present an adequate internal consistency, pattern of associations in line with what was theoretically expected, and promising for differentiating both types of orthorexia in a French population. We discuss why both dimensions of orthorexia should be considered in this area of research.
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Affiliation(s)
- Clotilde Lasson
- Laboratoire CERPPS (Centre d'Etudes Et de Recherches en Psychopathologie Et Psychologie de La Santé), Université Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France.
| | - Amélie Rousseau
- Laboratoire CERPPS (Centre d'Etudes Et de Recherches en Psychopathologie Et Psychologie de La Santé), Université Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Siobhan Vicente
- Centre de Recherches Sur La Cognition Et L'Apprentissage-CeRCA-(CNRS, UMR 7295) MSHS, Université de Poitiers, 5 Rue Théodore Lefebvre, 86073, Poitiers Cedex 9, France
| | - Nelly Goutaudier
- Centre de Recherches Sur La Cognition Et L'Apprentissage-CeRCA-(CNRS, UMR 7295) MSHS, Université de Poitiers, 5 Rue Théodore Lefebvre, 86073, Poitiers Cedex 9, France
| | - Lucia Romo
- UR4430 CLIPSYD, Université Paris Nanterre; HU Raymond-Poincaré, Inserm CESP 1018 UPS, Nanterre, France
| | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Juan Ramón Barrada
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain
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Hafstad SM, Bauer J, Harris A, Pallesen S. The prevalence of orthorexia in exercising populations: a systematic review and meta-analysis. J Eat Disord 2023; 11:15. [PMID: 36747235 PMCID: PMC9903632 DOI: 10.1186/s40337-023-00739-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
AIM Orthorexia Nervosa (ON) describes a pathological obsession with proper and high-quality nutrition that is necessary to research further in order to elucidate its prevalence and correlates which may bear implications for prevention and treatment. The aim of this study was to review studies that report the prevalence of ON in people who exercise, calculate an overall prevalence through a random-effects meta-analysis approach and investigate the association of ON prevalence using a random-effects meta-regression. In addition, a sub-group-analysis based on ON-instruments and a sensitivity analysis excluding students samples, were conducted. METHOD Systematic searches were conducted in the following online databases: PubMed, Embase, Web of Science, PsychInfo, CINAHL, Google Scholar and OpenNet. The following search terms were used: Orthore* AND (prevalenc* OR incidenc* OR frequen* OR cut-off OR epidem*). A total of 613 unique hits were reviewed by two blinded authors, and 24 studies were coded and assessed for risk of bias (Holy et.al). The meta-regression included three independent variables (sex, type of sport, and sample size). RESULTS The overall prevalence of ON in the exercising population was 55.3% (95% CI 43.2-66.8). Cochran's Q was 11,436.38 (df = 23, p < 0.0000), and the I2 was 98.4%, indicating high heterogeneity across studies. The sensitivity showed an overall prevalence of 51.3% (95% CI 51.3-70.0). There was a significant difference in prevalence estimates based on the instruments used (Qbet = 33.6, df = 2, p < 0.01). DISCUSSION The overall prevalence of ON in exercising populations was very high. The between-study disparity was large and was partly explained by the ON-instrument administered. One fourth of the studies had a moderate risk of bias. The majority of the studies did not specify relevant demographic information about the sample, and information about the type of sport was frequently missing.
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Affiliation(s)
- Stine Marie Hafstad
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway.
| | - Jonas Bauer
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Post Box 7807, 5020, Bergen, Norway.,Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
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Maïano C, Aimé A, Almenara CA, Gagnon C, Barrada JR. Psychometric properties of the Teruel Orthorexia Scale (TOS) among a French-Canadian adult sample. Eat Weight Disord 2022; 27:3457-3467. [PMID: 36180717 DOI: 10.1007/s40519-022-01482-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/14/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Psychometric properties of the Teruel Orthorexia Scale (TOS) have been examined in several languages (Arabic, English, Portuguese, Spanish, and Turkish), but not in French. PURPOSE The objective was to examine the psychometric properties of the TOS among a French-Canadian adult sample. METHODS Participants were 296 French-speaking Canadian adults (M = 34.2 years, SD = 11.9, 85.1% women). They completed the TOS alongside with several other measures (e.g., alcoholic consumption, cigarette smoking, disturbed eating attitudes and behaviors, frequency of physical activities, intuitive eating, vegetarian diet, and negative affect). RESULTS The results supported the a priori two-factor representation (orthorexia nervosa and healthy orthorexia) of the French version of the TOS and provided further support for the superiority of an exploratory structural equation modeling approach, relative to a confirmatory factor analytic approach. Furthermore, the results supported no differential item functioning as a function of respondents' characteristics (age, body mass index, diagnosis of eating disorders, frequency of physical activities, gender, and vegetarian diet). Latent mean differences were found in healthy orthorexia and orthorexia nervosa factors as a function of respondents' characteristics. Finally, significant correlations were found between TOS factors and convergent measures (alcohol consumption, cigarette smoking, disturbed eating attitudes and behaviors, intuitive eating, and negative affect). CONCLUSION The present study confirmed that the French version of the TOS has satisfactory psychometric properties (i.e., factor validity and reliability, no differential item functioning, and convergent validity). LEVEL OF EVIDENCE V, cross-sectional study.
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Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory and Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Campus de Saint-Jérôme, 5 rue Saint-Joseph, Saint-Jérôme, Québec, J7Z 0B7, Canada. .,Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada.
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
| | - Carlos A Almenara
- School of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Cynthia Gagnon
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
| | - Juan Ramón Barrada
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
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Chace S, Kluck AS. Validation of the Teruel Orthorexia Scale and relationship to health anxiety in a U.S. sample. Eat Weight Disord 2022; 27:1437-1447. [PMID: 34379313 DOI: 10.1007/s40519-021-01272-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Scholarly investigation into orthorexia nervosa is relatively new, leading several scholars to develop new measures to adequately assess the concerns thought to underlie this condition. A promising new measure of orthorexia, the Teruel Orthorexia Scale (TOS), was developed using a Spanish sample. PURPOSE This study was the first to investigate the psychometric properties of the English version of the TOS in a U.S. SAMPLE This study also examined the long-hypothesized relationship between orthorexia and health anxiety. METHODS We used exploratory factor analysis (EFA) to evaluate the factor structure of the TOS. We also used correlational methods to test theorized relationships with related concerns. RESULTS ESEM supported a 16-item, 2-factor model. Correlations between the modified TOS (i.e., TOS-16) subscales and measures of obsessive-compulsive and eating disorder symptoms, perfectionism, emotional distress, and body image disturbance demonstrated convergent and discriminant validity of the TOS-16. There was a moderate positive correlation between orthorexia nervosa and health anxiety and, together, pursuit of healthy eating and preoccupation with healthy eating accounted for a significant amount of variance in health anxiety after controlling for eating disorder symptoms. CONCLUSION Overall, this research suggests that the TOS-16 demonstrates psychometric properties as good as or better than other measures commonly used to assess the construct in a U.S. SAMPLE In addition, findings support the consideration of health anxiety as a possible feature of orthorexia nervosa. LEVEL OF EVIDENCE Level V, descriptive research.
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Hallit S, Barrada JR, Salameh P, Sacre H, Roncero M, Obeid S. The relation of orthorexia with lifestyle habits: Arabic versions of the Eating Habits Questionnaire and the Dusseldorf Orthorexia Scale. J Eat Disord 2021; 9:102. [PMID: 34391484 PMCID: PMC8364025 DOI: 10.1186/s40337-021-00455-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/04/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Some of the commonly used tools to assess orthorexia nervosa (OrNe) do not allow a meaningful interpretation of the scores or yield mixed results about the dimensions needed to represent orthorexia. Since no advancement in the theoretical knowledge can be made without a thorough examination of the measurement aspects, this study aimed to evaluate the correlation between orthorexia nervosa (OrNe) and lifestyle habits, notably alcohol drinking, cigarette and waterpipe smoking, and physical exercise, and to validate and assess the psychometric properties of the Arabic versions of the Eating Habits Questionnaire (EHQ) and Düsseldorf Orthorexia Scale (DOS). METHODS A total of 456 adult participants completed a self-administered questionnaire. Exploratory structural equation models were used to test the internal structure of the instruments. Shorter and more explicit versions were proposed for instruments. Pearson and partial correlations were computed between orthorexia scores and healthy behaviors scores. RESULTS Regarding the internal structure of both EHQ and DOS, evidence favored the bi-dimensional construct of orthorexia. Both tools presented two theoretically clearly interpretable factors (OrNe and Healthy Orthorexia-HeOr-). The two questionnaires presented a high convergent validity, as dimensions with the same interpretation were correlated around 0.80. While OrNe was positively correlated with the use of unhealthy substances (higher alcohol use disorder, cigarette, and waterpipe dependence), HeOr was negatively associated with these behaviors. CONCLUSION Our results emphasize the idea that further attention should be paid to the multidimensional structure of orthorexia, as OrNe and HeOr present an opposite pattern of associations with healthy behaviors. An OrNe etiopathogenesis common to eating disorders can explain these differences.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Juan Ramón Barrada
- Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain
| | - Pascale Salameh
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
| | - María Roncero
- Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Sahar Obeid
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon. .,Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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