Examination of eating disorder psychopathology across sexual and gender identities among a Canadian sample.

OBJECTIVE: Eating disorders (EDs) disproportionately affect sexual and gender minorities, with majority of research conducted among samples in the United States. The purpose of this study was to examine ED psychopathology among adolescents and young adults in Canada with diverse gender and sexual identities. METHOD: Data were collected from 2,714 Canadians, aged 16-30 years old, via an online survey at the end of 2021 during the COVID-19 pandemic. Participants responded to sociodemographic questions (including history of EDs) and reported on eating attitudes and behaviors. Descriptive statistics and multiple modified Poisson and linear regressions were conducted. RESULTS: Over half the sample was heterosexual, 35% were sexual minority cisgender men and women, and 6.5% were transgender and gender non-conforming (TGNC) people. The sample overall reported elevated ED psychopathology based on their eating attitudes and behaviors. TGNC participants reported the most severe ED psychopathology. Generally, sexual minority cisgender women and cisgender men had elevated ED psychopathology compared to their heterosexual counterparts. Regression analyses revealed all gender and sexual minorities reported greater ED psychopathology compared to heterosexual cisgender men. DISCUSSION: The Canadian sample reported elevated ED psychopathology compared to previous studies among various populations. Additional investigations are now needed to observe how ED psychopathology continues to change after the onset of the pandemic. Further research is needed among cisgender men, TGNC people, and sexual minorities to understand the unique stressors they face that lead to high ED psychopathology, and develop appropriate prevention and treatment tools. PUBLIC SIGNIFICANCE: EDs affect people of all gender and sexual identities. People who identify as a gender and/or sexual minority often experience problematic eating attitudes and behaviors, particularly transgender and gender non-conforming people of all sexual identities. More research attention is needed among these populations, especially due to a paucity of research among Canadians, to develop effective diagnostic tools, prevention efforts, and treatment programs specific to gender and sexual identities.

Psychometric properties of the Eating Disorder Examination Questionnaire among Brazilian cisgender gay and bisexual adult men.

OBJECTIVE: One of the most widely used assessment tools for disordered eating attitudes and behaviors, the Eating Disorder Examination Questionnaire (EDE-Q), has not yet been evaluated in Brazilian cisgender gay and bisexual men-an at-risk population given the extent of minority stressors in Brazilian culture. The present study aimed to assess the psychometric properties of the EDE-Q among Brazilian cisgender gay and bisexual adult men. METHOD: The Brazilian EDE-Q was administered to a sample of 1409 gay and bisexual adult men, along with measures of self-objectification, body-ideal internalization, drive for muscularity, muscle dysmorphia symptoms, and body appreciation. The factor structure of the Brazilian EDE-Q was assessed using a two-step, split-sample exploratory (EFA; n = 704) and confirmatory factor analytic approach (CFA; n = 705). Additionally, convergent validity, internal consistency, and 2-week test-retest reliability were assessed. RESULTS: Findings from an EFA and CFA revealed a one-factor structure with 22 items and adequate internal consistency (ω = .92, 95% CI = [.91, .93]). Moreover, the scale demonstrated good 2-week test-retest reliability (ICC = .86, 95% CI = [.82, .88], p < .001). The EDE-Q scores showed positive associations with self-objectification, body-ideal internalization, muscle dysmorphia symptoms, and drive for muscularity, as well as a negative association with body appreciation. DISCUSSION: Results provide support for the use of the EDE-Q using a one-factor structure in Brazilian cisgender gay and bisexual adult men and give insights for future studies on eating disorders in sexual minorities in Latin America. PUBLIC SIGNIFICANCE: The Eating Disorder Examination Questionnaire (EDE-Q) is one of the most widely used self-report measures of eating disorder symptoms. However, there is a lack of research on the validity and reliability of the EDE-Q in Latin American countries. This study evaluated the validity and reliability of the EDE-Q in Brazilian cisgender gay and bisexual adult men. Our findings give insights for future studies on eating disorders in sexual minorities in Latin America.

Diabetes-specific eating disorder and possible associated psychopathologies in adolescents with type 1 diabetes mellitus.

PURPOSE: It was aimed to investigate the frequency of the risk of diabetes-specific eating disorder (DSED) in adolescents with type 1 diabetes mellitus (T1DM) and to reveal the accompanying psychopathologies. METHODS: Adolescents with T1DM aged 12-18 who applied to the pediatric diabetes outpatient clinic between July 2021 and March 2022 were included. Diabetes Eating Problem Survey-Revised (DEPS-R) was applied to all patients to determine the risk of DSED. In order to detect accompanying psychopathologies, Eating Disorder Examination Questionnaire (EDE-Q), Child Anxiety and Depression Scale-Child version (RCADS) and Parenting Style Scale were applied. After completing the scales, semi-structured interviews were conducted with all patients by a child and adolescent psychiatrist. RESULTS: Ninety-two adolescents (45 boys, 47 girls) were included. DSED risk was found in 23.9% of the cases. A positive correlation was found between DEPS-R and EDE-Q scores (p = 0.001, rho = 0.370). RCADS mean scores were significantly higher in the group with DSED risk (p < 0.001). When the Parenting Style Scale was evaluated, psychological autonomy scores were significantly lower in the group with DSED risk (p = 0.029). As a result of the psychiatric interviews, 30 (32.6%) patients had at least 1 psychiatric disorder. Of these, 2 patients were diagnosed with eating disorder. CONCLUSION: Almost one-fourth of adolescents with T1DM were found to be at risk of DSED. Routine screening of adolescents with T1DM with the DEPS-R scale may provide early detection of DSED, and referral of those at risk to child psychiatry enables early diagnosis and intervention for both eating disorders and accompanying psychopathologies. LEVEL OF EVIDENCE: Level III: Evidence obtained from cohort or case-control analytic studies.

Risk factors for eating disorders among Chinese and international university students: a comparative cross-sectional study.

OBJECTIVE: The aim of the study was to investigate the prevalence of eating disorders (EDs) and their association with socio-demographic and behavioural factors among university students. METHODS: A cross-sectional study among university students (Chinese and international) in Nanjing, China. We collected the data from 877 students, of which 811 were eligible for this study. They submitted a self-administered questionnaire (Eating Disorder Examination Questionnaire 6 (EDE-Q6) related to socio-demographic, health variables and lifestyle factors. Data were assessed with the help of SPSS software. RESULTS: A total of 401 Chinese and 410 international university students (49.44% vs. 50.55%) participated in this study. Binary logistic regression showed that young female adults of 18~25 years of age had more risk of developing eating disorders. Higher body mass index (BMI), such as overweight and obesity, were more influential risk factors (p < 0.001) for eating disorders. The significant risks (p < 0.001) EDs were found in students who were athletes, physically active, and involved in various extra-curricular activities. Alcohol and smoking were significant risk factors associated with eating disorders. CONCLUSION: The results indicated higher risks of eating disorders followed by objective binge eating and compensatory behaviour. In this scenario, early assessment and treatment are necessary to reduce the burden of eating disorders and to promote good nutritional practices among university students.

Eating disorder symptoms among adolescent boys and girls in Iran.

OBJECTIVE: Few studies of eating disorder (ED) symptoms among young people in Iran have been conducted. This cross-sectional study examined ED symptoms, assessed by the Eating Disorder Examination Questionnaire (EDE-Q). METHOD: Adolescent boys (n = 498) and girls (n = 607) aged 12-19 years, recruited from schools in four different regions of Iran, completed a survey that included the EDE-Q. ED symptoms, namely, EDE-Q global scores and the occurrence of specific ED behaviors, were compared between boys and girls. RESULTS: Girls had higher global scores and were more likely to report regular extreme dietary restriction than boys (16.6 vs. 12.0%). The effect sizes for these differences were small. The regular occurrence of other behaviors (girls vs. boys-binge eating: 21.1 vs. 18.8%; self-induced vomiting: 3.3 vs. 5.4%; laxative misuse: 6.1 vs. 7.6%; excessive exercise: 5.3 vs. 4.4%) did not significantly differ by gender. Twelve percent of boys and 12.9% of girls met criteria for an operational definition of "probable ED case." CONCLUSION: ED symptoms appear to be relatively common among Iranian adolescent boys and girls. Programs designed to reduce the occurrence and adverse impact of these symptoms may therefore be increasingly important.

Psychometric properties of the Eating Disorder Examination-Questionnaire and psychopathology in Japanese patients with eating disorders.

OBJECTIVE: The Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used tools to assess the core psychopathology of eating disorders (ED). However, recent empirical findings did not support the original four-factor structure. The aims of the present study were to investigate the factor structure of the EDE-Q in Japanese ED patients, to test the reliability and convergent validity of the EDE-Q, to examine group differences between various ED groups and healthy participants, and to explore the main behavioral features of Japanese ED patients using the newly developed Japanese version of EDE-Q. METHOD: A total of 148 ED patients and 469 healthy participants completed the EDE-Q, Eating Attitudes Test-26 (EAT-26), and Eating Disorder Inventory-2 (EDI-2). The factor structure, reliability, and validity of the EDE-Q were assessed in ED patients. Group differences were assessed using the new Japanese version of the EDE-Q (EDE-Q-J). RESULTS: The EDE-Q-J had three factors. Cronbach's alphas ranged from 0.83 to 0.93. Total score and subscale scores of "Dieting" and "Bulimia and Food Preoccupation" of EAT-26 and of "Drive for Thinness," "Body Dissatisfaction," and "Bulimia" of EDI-2 correlated with the global score and three subscale scores of the EDE-Q-J. DISCUSSION: For Japanese female ED patients, the EDE-Q-J had three subscales that were not consistent with the original subscales, but were interpretable. It demonstrated sufficient reliability and validity. Japanese female patients with restricting-type anorexia nervosa (AN-R) displayed less dissatisfaction with shape and weight than healthy participants. AN-R patients in Japan might present with a non-fat-phobic symptom profile.

Differential item functioning analysis for the Eating Disorder Examination Questionnaire among heterosexual and sexual minority men.

PURPOSE: Sexual minority (SM) men are at a higher risk for eating disorders and related issues, relative to heterosexual men. However, it is currently unknown whether commonly used measures of eating pathology are appropriate to use among diverse groups of men. Determining the unique functioning of existing assessments may help better and more accurately understand eating disorder pathology within this population. The present study examined differences in item endorsement between sexual orientation in the Eating Disorder Examination Questionnaire (EDE-Q) through differential item functioning (DIF). METHODS: Heterosexual and SM men (N = 703) completed the EDE-Q and a demographic questionnaire. EDE-Q scores were examined for clinically significant DIF based on participants' self-reported sexual orientation (e.g., heterosexual men vs SM men). RESULTS: SM men reported higher EDE-Q symptom composite scores than heterosexual men. DIF was observed for all EDE-Q items relative to the global score; however, only one item met clinical significance (EDE-Q #19; ∆R2 ≥ 0.13). CONCLUSION: Results suggest that SM men experience greater levels of ED pathology than heterosexual men. While the EDE-Q is a commonly used measure of eating pathology, findings suggest that sexual orientation bias may impact many items on the EDE-Q. However, results from this study indicated that only one item introduces bias that has clinical implications. Additional research is needed to further explore and replicate this finding among more diverse samples of SM and heterosexual men. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Associations among psychopathology and eating disorder symptoms and behaviors in post-bariatric surgery patients.

PURPOSE: A considerable number of post-bariatric surgery patients report problematic eating behaviors (PEBs) and/or eating disorders (EDs). Examining psychosocial variables associated with ED symptoms may identify targets for postoperative interventions to reduce these behaviors and improve surgical outcomes. METHODS: A total of 161 participants completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Eating Disorder Examination-Questionnaire (EDE-Q). Participants were classified into ED risk or no ED risk groups and subjective binge eating (SBE) or no SBE groups. Independent-sample t tests were computed to examine mean differences in total weight loss (%TWL) and MMPI-2-RF scale scores between the ED groups. Relative Risk Ratios (RRRs) were computed to determine which MMPI-2-RF scales were associated with increased risk of ED group membership. RESULTS: The ED risk group lost significantly less weight (19.36% TWL) than the no ED risk group (25.18% TWL). The SBE group lost significantly less weight (17.98% TWL) than the no SBE group (25.57% TWL). Participants in the ED groups scored significantly higher on internalizing and externalizing MMPI-2-RF scales than the no ED groups. These scales were associated with increased risk (1.55-2.55 times the risk) of being classified into the ED groups. CONCLUSIONS: Patients who experienced postoperative ED symptoms lost significantly less weight than patients without ED symptoms. Postoperative ED symptoms are related to, and may be impacted by, higher levels of internalizing and externalizing dysfunction after surgery. Postoperative assessment of and interventions targeting psychosocial dysfunction could decrease ED symptoms. LEVEL OF EVIDENCE: III: Evidence obtained from well-designed cohort or case-control analytic studies.

The brief (seven-item) eating disorder examination-questionnaire: Evaluation of a non-nested version in men and women.

OBJECTIVE: Several recent studies have examined the psychometric properties of brief measures of eating disorder attitudes based on the Eating Disorder Examination Questionnaire (EDE-Q). A seven-item version (the EDE-Q7) has been proposed but, as yet, has only been investigated by looking at the items when presented as part of the longer EDE-Q (i.e., as a nested version). The current study presented the EDE-Q7 as a standalone instrument and examined factor structure fit and measurement invariance across male and female genders. METHODS: University students (244 women; 155 men; 1 did not identify with either gender) completed questionnaires as part of two independent studies. All individuals completed the EDE-Q7 and measures of eating disorder behaviors. In a mixed-gender subsample (n = 286), measures of depression and eating disorder-specific quality of life were also included. Confirmatory factor analysis of the EDE-Q7 was conducted on males and females independently, in addition to estimates of internal consistency reliability and validity. Measurement invariance was assessed through multigroup confirmatory factor analysis. RESULTS: The EDE-Q7 demonstrated good internal consistency and findings supported measurement invariance by gender. In a mixed-gender subsample, the measure showed positive associations with depression and both eating disorder behaviors and eating disorder-specific quality of life. DISCUSSION: The present study adds to the literature supporting the psychometric properties of the EDE-Q7, extending this to use of the questionnaire as a standalone instrument. Measurement invariance suggests that the measure may be appropriate for college-age men and women, although future studies should establish psychometric properties more fully.

Eating Disorder Examination - Questionnaire short forms: A comparison.

OBJECTIVE: The Eating Disorder Examination - Questionnaire (EDE-Q) is a widely used self-report measure of eating-disordered behaviors and attitudes. Recent studies utilizing confirmatory factor analyses (CFA) have proposed alternative and shorter forms. The aim of this study was to compare the full-length version of the EDE-Q and several proposed short forms (7-item, 8-item, and 18-item) in terms of their psychometric properties, including concurrent, convergent and discriminant validity, factor structure, and sensitivity to change. METHODS: Participants from two eating-disorder clinical samples (N = 175 and 38) and from a nonclinical sample (N = 3,413) completed a battery of measures, including the Portuguese version of the EDE-Q. Analyses compared psychometric properties of the available short forms of the EDE-Q among each other. RESULTS: All forms of the EDE-Q showed good internal consistency values, correlated highly among each other (r > .90) and with different measures of eating psychopathology (r > .80). All EDE-Q forms were able to distinguish between cases and controls with moderate-to-high accuracy and were sensitive to change. CFA failed to support the proposed factor structure for all the EDE-Q forms, except for the 7-item form. DISCUSSION: The present study provides empirical background for choosing between different forms of the EDE-Q. Findings indicate that for nonclinical and for clinical research, including studies of treatment change and outcome, the short forms of the EDE-Q can be used. A shorter version is a viable alternative when less time-consuming alternatives are needed, such to quickly screen for eating-disorder psychopathology or to perform session-by-session treatment monitoring.

Examining vegetarianism, weight motivations, and eating disorder psychopathology among college students.

OBJECTIVE: Previous research has suggested a link between vegetarianism, broadly defined, and symptoms of eating disorders (ED). However, the literature supporting this link is mixed and limited by possible measurement artifacts. Using data from a national sample of college students, the present study examines ED symptomatology among three groups: (a) vegetarians whose meat avoidance is motivated by weight concerns; (b) non-weight motivated vegetarians; and (c) nonvegetarians. METHOD: Participants include 9,910 students from 12 colleges and universities across the United States who participated in the web-based Healthy Bodies Study. ED symptomatology was measured using the Short-Eating Disorder Examination-Questionnaire (S-EDE-Q). First, multi-group confirmatory factor analysis was conducted to test measurement invariance (MI) of the S-EDE-Q across weight-motivated vegetarians, non-weight-motivated vegetarians, and nonvegetarians. Gender- and BMI-adjusted ANCOVA was used to compare S-EDE-Q scores across groups. RESULTS: 9.3% of participants were vegetarian. Cis-women and gender minority students were more likely to be vegetarian; those who became vegetarians after entering college were more likely to report weight-related motivations. Strict MI was supported for the S-EDE-Q global and subscale scores. Weight-motivated vegetarians reported higher levels of restraint, shape/weight overvaluation, body dissatisfaction, and global ED psychopathology relative to other participants. DISCUSSION: To our knowledge, this is the first to explicitly link weight motivations for vegetarianism to ED psychopathology in a large, representative sample of young adults. Results suggest that students presenting with ED symptoms should be assessed for their motivations for adopting a vegetarian diet, and this information should be considered in treatment decisions.

Risk factors for a low weight gain in the early stage of adolescent anorexia nervosa inpatient treatment: findings from a pilot study.

PURPOSE: Body weight restoration is a major treatment aim in juvenile inpatients with anorexia nervosa (AN) (i.e., 500-1000 g/week according to the German guidelines). Several studies suggest the early weight gain to be crucial for remission. The identification of patients at risk of a low early weight gain could enable an adequate adaptation of treatment. Thus, we aimed at detecting risk factors of a low weight gain during inpatient treatment. METHODS: The presented work analyzes data from a pilot study in 30 female adolescent inpatients with AN (restricting subtype; age range at admission: 12.6-17.6 years). Premorbid characteristics, history of symptomatology, anthropometric data, and eating-disorder psychopathology were compared between those who gained at least an average of 500 g/week during the first 7 weeks of treatment (high weight gainers, HWG) and those who did not (low weight gainers, LWG). RESULTS: At admission, LWG (n = 15) had a significantly higher BMI(-SDS) and scored significantly higher in the eating-disorder examination questionnaire (EDE-Q) than HWG (n = 15). A logistic regression analysis indicated both parameters to be independently associated with a low weight gain. CONCLUSION: Higher EDE-Q scores seem to be a major risk factor for a low weight gain at the beginning of treatment. Moreover, a higher BMI(-SDS) at admission does not necessarily indicate a less severe AN symptomatic, as it was associated with a lower weight gain in our sample during the first 7 weeks of treatment. Reassessment of our results in larger studies is required to draw firm conclusions for clinical practice. LEVEL OF EVIDENCE: Level V.

Fat preference and fat intake in individuals with and without anorexia nervosa.

Fat restriction is a characteristic eating behavior among individuals with anorexia nervosa (AN), and laboratory meal studies demonstrate restricted fat intake among low-weight patients. The Geiselman Food Preference Questionnaire-I© (FPQ) is a validated self-report measure that yields a fat preference score (FPS). Prior research reported that patients with AN had a significantly lower FPS than did healthy control (HC) participants. The goal of the current study was to compare self-reported fat preference (FPS) to fat intake (multi-item meal (MIM) study) in low-weight ANs and HCs. Specific aims were 1) to determine if the FPS differed between ANs and HCs; 2) to determine if fat and energy intakes differed between ANs and HCs; and 3) to determine if the FPS was associated with fat and energy intakes in ANs and HCs. Forty-four female AN inpatients and 48 female HCs completed the FPQ and participated in a MIM study. Compared to HCs, ANs consumed less energy (469.1 ±â€¯397.7 vs. 856.4 ±â€¯346.8 kcal, p < 0.001), less fat (16.4 ±â€¯20.4 vs. 36.7 ±â€¯18.9 g, p < 0.001), and a smaller percentage of calories from fat (22.9 ±â€¯13.8 vs. 36.6 ±â€¯8.0%, p < 0.001) at the MIM. Compared to HCs, ANs also had a lower FPS (79.7 ±â€¯27.4 vs. 102.3 ±â€¯18.9, p < 0.001). The FPS was significantly and positively correlated with caloric intake (r = 0.481, p < 0.01), total fat (r = 0.453, p < 0.01), and the percentage of calories from fat (r = 0.37, p < 0.05) in ANs as well as in HCs (kcal: r = 0.583, p < 0.001; fat: r = 0.621, p < 0.001; % fat kcal: r = 0.601, p < 0.001). The FPS is related to objective measures of energy and fat intake in patients with AN as well as in healthy individuals.

Validation of eating disorders examination questionnaire in Mexican women.

BACKGROUND: Efficient assessment of eating disorders (ED) is indispensable for research and clinical practice in Mexico. One of the most commonly used questionnaires, the EDE-Q, has a self-applicable questionnaire format with 28 questions and four subscales drawn from the Eating Disorder Examination (EDE), a semistructured interview developed to evaluate the specific symptomatology of eating disorders. OBJECTIVE: Obtain the factorial structure and construct validity of the EDE-Q questionnaire in Mexican women. METHOD: The language in the EDE-Q was adapted. It was applied to university students (N = 330) and a sample of patients with ED (N = 165) from two ED outpatient treatment services. The anthropometric data of the participants was obtained. Internal consistency was explored using the Cronbach's Alpha coefficient and a confirmatory factor analysis was conducted by group. RESULTS: Cronbach's alpha was 0.9 for the full scale in all groups, while the reliability of each of the subscales fluctuated between 0.8 and 0.9. Confirmatory factor analysis showed that the fit of the seven-item model in three factors was better than that of the original 22-item one and that of the eight-item model for one factor. CONCLUSIONS: This study provides information supporting the seven-item and three-factor version, rather than the original or eight-item versions of the EDE-Q. In the future, the adapted version of the EDE-Q will make it possible to draw comparisons between Mexican samples in other socio-cultural contexts. Future research is required to continue refining the instruments to achieve more representative results from the general ED population.

Does the eating disorder examination questionnaire global subscale adequately predict eating disorder psychopathology in the daily life of obese adults?

The eating disorder examination questionnaire (EDE-Q) Global score is a self-report measure of global eating disorder (ED) psychopathology. This study used ecological momentary assessment (EMA) to evaluate the ecological validity of EDE-Q Global scores among obese adults. Fifty obese adults completed the EDE-Q and 2 weeks of EMA ratings prior to initiating eating episodes and subsequently after eating episodes. EMA items assessed behavioral symptoms [i.e., loss of control (LOC) eating and overeating] and cognitive symptoms (i.e., weight/shape concerns, eating concerns, and restraint). EDE-Q Global was associated with increased EMA weight/shape concerns and fear of LOC at pre-eating recordings. EDE-Q Global was associated with increased EMA post-episode weight/shape concerns, eating concerns, LOC eating, and overeating. There was no association between EDE-Q Global and EMA restraint. Results generally supported the ecological validity of EDE-Q Global scores. Future studies of ED psychopathology in obese adults may benefit from considering EDE-Q Restraint separately. Level of Evidence Level V, descriptive study.

The eating disorder examination-questionnaire 8: A brief measure of eating disorder psychopathology (EDE-Q8).

OBJECTIVE: The aim of this study was to develop, evaluate, and standardize a short form of the well-established Eating Disorder Examination-Questionnaire (EDE-Q). The newly developed EDE-Q8 was required to reflect the originally postulated structure of the EDE-Q. METHOD: Data were drawn from two nationwide representative population surveys in Germany: a survey conducted to develop the EDE-Q8 in 2009 (N = 2,520); and a survey conducted in 2013 (N = 2,508) for the evaluation and calculation of EDE-Q8 percentiles. RESULTS: The EDE-Q8 had excellent item characteristics, very good reliability and a very good model fit for the postulated second-order factorial structure. Furthermore, a strong correlation between the EDE-Q8 and a 13 item short form of the Eating Attitudes Test was observed. DISCUSSION: The EDE-Q8 appears to be particularly suitable in epidemiological research, when an economical assessment of global eating disorder psychopathology is required. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:613-616).

Eating disorder symptoms pre- and postpartum.

The study aimed to investigate symptoms of disordered eating pre- and postpartum using a standardised and widely used measure of eating disorder (ED) psychopathology. A consecutive series of women attending either prenatal (N = 426) or postnatal (N = 345) clinics in metropolitan Stockholm were assessed using the Eating Disorder Examination Questionnaire (EDE-Q). Assessments were conducted at either the first visit to prenatal clinics (10-12 weeks of pregnancy) or 6 to 8 months postpartum. An optimised shortened version of the EDE-Q was best suited for studying eating disorders pre- and postpartum. Using the optimised version of the instrument with 14 items and a cut-off score of ≥2.8, it was estimated that 5.3 % of prepartum and 12.8 % of postpartum mothers were suffering from clinical eating disorders. Seriously disordered eating behaviour during, and especially after, pregnancy may be more common than previously thought. It is imperative that health services focus increased attention on these problems by raising awareness, developing and extending specialist services, as well as through implementing educational programmes and training directed toward frontline healthcare services.

Development and preliminary validation of a Finnish version of the Eating Disorder Examination Questionnaire (EDE-Q).

BACKGROUND: Eating behaviour can be viewed as a continuum, ranging from extremely restrictive to extremely disinhibited eating. Valid and reliable instruments are needed to ensure detection of individuals with risk for eating disorders (ED). Self-report methods are the most feasible, cost, and time efficient. One of the most widely used self-reports is the Eating Disorder Examination Questionnaire (EDE-Q). AIM: The aim of this study was to develop a Finnish version of the EDE-Q version 6.0 and to assess its psychometric properties in adolescents, adults, and ED patients. METHODS: The present study utilized data from three different samples: adolescents (n = 242), adults (n = 133), and ED patients (n = 52). The patient group comprised different EDs, but individual ED diagnoses were not studied separately. Data was collected January 2014 through June 2015. RESULTS: The Finnish version of the EDE-Q showed acceptable-to-excellent internal consistency on all sub-scales in all three samples and discriminated patients from healthy individuals. Female participants generally scored higher than male and sex differences were more pronounced among the younger age group. CONCLUSIONS: The Finnish version of the EDE-Q can, based on this study, be regarded as reliable, valid, and functional. Further studies are needed to evaluate the population norms and to test the validity in individual ED diagnoses.

Eating-disordered behavior in adolescent boys: eating disorder examination questionnaire norms.

OBJECTIVE: We sought to provide normative data for the Eating Disorder Examination Questionnaire (EDE-Q) for adolescent boys. METHOD: The EDE-Q was completed by 531 boys aged 12-18 years recruited from a number of schools in the Australian Capital Territory (ACT) region of Australia. Data for 1,135 female adolescents, recruited as part of the same research project, are provided for comparative purposes. RESULTS: Scores on each the EDE-Q subscales and, with the exception of excessive exercise, the prevalence of each of the eating disorder behaviors assessed, were substantially higher among girls than among boys. Still, 6.0% of boys reported regular episodes of objective binge eating, 8.3% reported regular episodes of loss of control eating, 5.3% reported regular excessive exercise and 4.9% reported overvaluation of weight or shape. Eating-disordered behavior was more common among older adolescents than among younger adolescents and this was the case for both boys and girls. Reliability coefficients for the EDE-Q subscales were marginally lower in boys (0.70-0.94) than in girls (0.84-0.97). CONCLUSIONS: The EDE-Q appears to be suitable for use in adolescent boys, with the qualification that eating and weight/shape control behaviors that are largely confined to males may not be adequately assessed. The lack of assessment of subjective binge eating episodes may also be problematic. There is a need for research addressing whether and to what extent different features are associated with distress and disability in boys as well as the validity of the EDE-Q assessment of these features when compared with interview assessment.

Eating disorder examination questionnaire: factor structure for adolescent girls and boys.

OBJECTIVE: To examine the factor structure of the EDE-Q among a sample of adolescents. METHOD: A community-based sample of 917 adolescents (522 girls and 395 boys) aged 14-18 years completed the EDE-Q version 6.0 as part of a larger study. Participants were randomly assigned to one of two subsamples to enable separate analyses. RESULTS: A confirmatory factor analysis on the original four factor model of the EDE-Q produced an inadmissible model with a poor fit. Exploratory factor analysis using principal axis factoring produced an alternative three factor model of the EDE-Q among adolescents. The Shape and Weight Concerns, Restriction and Preoccupation and Eating Concern subscales accounted for 65% of the total variance. Subscale and global scores were significantly higher for girls than for boys. A high proportion of both girls (53.6%) and boys (30.5%) reported participating in at least one key eating disordered behaviour during the previous 28 days. DISCUSSION: The results of this study present three new subscales (Shape and Weight Concerns, Restriction and Preoccupation and Eating Concern) which are suggested for use in future research which uses the EDE-Q with community samples of adolescents.