Towards the understanding of the core of general personality disorder factor: g-PD and its relation to hostile attributions.

There is a general consensus that personality disorders (PDs) share a general factor (g-PD) overlapping with the general factor of psychopathology (p-factor). The general psychopathology factor is related to many social dysfunctions, but its nature still remains to some extent ambiguous. We posit that hostile attributions may be explanatory for the factor common for all PDs, i.e., interpersonal problems and difficulty in building long-lasting and satisfying relationships of all kinds. Thus, the main objective of the current project was to expand the existing knowledge about underlying factors of g-PD with regard to hostile attributions. We performed a cross-sectional study on a representative, community sample of Poles (N = 1031). Our hypotheses were primarily confirmed as hostile attributions predicted p-factor. However, the relation was positive only for hostile attributions related to ambiguous situations involving relational harm and physical harm done by female authorities and negative in case of hostile attributions in situations involving physical harm done by peers. Additionally, paranoia-like thoughts strongly related to hostile attributions and independently predicted g-PD. The results contribute to the current discussion on the nature of the g-PD, confirm that hostile attributions and paranoia are a crucial aspect of personality pathology, and indicate the importance of working on these cognitions in the course of therapeutic work.

The links of subjective and psychological well-being with the Dark Triad traits: A meta-analysis.

OBJECTIVE: The aim of this study is to investigate the specific links that the Dark Triad traits have with subjective and psychological well-being through a meta-analysis of the existing literature. BACKGROUND: Over the past few years, associations between the Dark Triad traits and well-being have been a stimulating but understudied topic in personality research. METHOD: Cross-sectional, correlational studies examining these relationships were searched in the PsycINFO, PubMed, and Web of Science databases. Meta-analyses were performed at the dimension- and facet-level to account for the multidimensional structure of the Dark Triad traits. RESULTS: A total of 55 studies were included (n = 26,252). In general, grandiose narcissism and boldness/dominance related to higher well-being, while vulnerable narcissism, antagonism, disinhibition, and Machiavellianism related to lower levels of well-being. Age and gender moderated few of these associations. CONCLUSIONS: We recommend including multidimensional measures of the Dark Triad traits as an essential step to move the field forward.

Ego-Boosting Hormone: Self-Reported and Blood-Based Testosterone Are Associated With Higher Narcissism.

Grandiose narcissism is defined as increased motivation for status and viewing oneself as entitled and superior to others. We hypothesized that these tendencies might be associated with basal levels of testosterone because testosterone is considered the most social hormone-driving dominance and the motivation to achieve social status. We distinguished between two facets of grandiose narcissism: agentic (i.e., the tendency to self-promotion in order to win others' admiration and social influence) and antagonistic (i.e., a reactive strategy used to restore threatened status). In 283 adult men, we examined the association between these facets of narcissism and blood-tested and self-reported testosterone levels. Agentic narcissism-the default narcissistic strategy-was positively associated with both testosterone indicators. Moreover, self-reported and objectively measured testosterone were positively correlated. These findings extend previous work by showing that the facets of narcissism have distinct hormonal underpinnings.

Validation of the Arabic version of the cyberchondria severity scale 12 items (CSS-12-Ar) among a sample of Lebanese adults.

BACKGROUND: To the best of our knowledge, the Cyberchondria Severity Scale-12 (CSS-12) has not been translated into Arabic; therefore, our objective was to assess the psychometric properties of the Arabic version of the CSS (CSS-12-Ar) among a sample of Lebanese adults. METHODS: Participants were enrolled in January 2021. A confirmatory factor analysis (CFA) was carried out using the MPlus software v.7.2, reporting several goodness-of-fit indicators: Relative Chi-square (χ2/df), Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI) and Tucker Lewis Index (TLI). To evaluate measurement invariance across gender, we conducted higher-order multiple group confirmatory analysis using lavaan software. RESULTS: 449 participants enrolled in this study (mean age: 24.34 ± 8.22 years, 70.6% females). Since the correlations between the four-factor model were very high (r > 0.8), we ran the higher-order CFA in which all first-order latent variables were loading a general factor. The analyzed model was well-fitted to the data χ2(50) = 173.34; p < 0.001; CFI = 0.926; RMSEA = 0.074 [0.062, 0.086]. The Cronbach's alpha values were good for the total score (0.92), as well as for excessiveness (0.80), distress (0.77), reassurance (0.81) and compulsion (0.76). The results provided evidence of full scalar invariance across gender. The comparison of latent mean scores revealed no significant differences across gender, in either the cyberchondria total score or its facets. The CSS-12 score was positively associated with anxiety (r = 0.10; p = 0.003) (convergent validity), OCD (r = 0.11; p = 0.016) and stress (r = 0.35; p < 0.001) (concurrent validity). CONCLUSION: The CSS-12-Ar was deemed a suitable scale to measure the severity of cyberchondria among Lebanese university students. We hope that researchers and clinicians can benefit now from this scale.

Validity and reliability of the arabic version of the self-report single-item self-esteem scale (A-SISE).

BACKGROUND: Meta-analytic findings documented a substantial impact of self-esteem on a broad range of psychological and behavioral indicators, thus highlighting its high clinical relevance. Proving a simple and cost-effective measure of global self-esteem to the Arabic-speaking community, who mostly live in low- and middle-income countries, and where research may be challenging, would be highly valuable. In this context, we sought to investigate the psychometric characteristics of an Arabic translation of the Single-Item Self-Esteem Scale (A-SISE) in terms of factor structure, reliability, and construct validity. METHODS: A total of 451 participants were enrolled between October and December 2022. An anonymous self-administered Google Forms link was shared on WhatsApp. To examine the factor structure of the A-SISE, we used the FACTOR software. We conducted an exploratory factor analysis (EFA), using a principal component analysis on the Rosenberg Self-Esteem Scale (RSES) items first, then after adding the A-SISE. RESULTS: The results of the EFA of the RSES revealed two factors (F1 = negatively-worded items; F2 = positively-worded items), which explained 60.63% of the common variance. When adding the A-SISE, the two-factor solution obtained explained 58.74% of the variance, with the A-SISE loading on the second factor. Both RSES and A-SISE correlated significantly and positively with each other, as well as with extroversion, agreeableness, conscientiousness, open mindedness and satisfaction with life. Moreover, they correlated significantly and negatively with negative emotionality and depression. CONCLUSION: These results suggest that the A-SISE is a simple-to-use, cost-effective, valid and reliable measure of self-esteem. We thus recommend its use in future research among Arabic-speaking people in Arab clinical and research settings, particularly when researchers are limited by time or resources constraints.

Psychometric properties of an Arabic translation of the Big Three Perfectionism Scale-Short Form (BTPS-SF) in a community sample of adults.

BACKGROUND: Despite the high clinical relevance of the perfectionism construct as a transdiagnostic contributor to different mental health symptoms, and the recent burgeoning of research in this area across cultures in the past two decades, the Arab region was one of the cultural settings experiencing the slowest progress in this line of research. This study aimed to make a meaningful contribution to the literature by validating an Arabic-language version of the 16-item Big Three Perfectionism Scale-Short Form (BTPS-SF). In particular, we sought to examine structure and concurrent validity, internal consistency, and measurement invariance across gender groups. METHOD: A web-based, convenience sampling method was adopted to collect a sample of Arabic-speaking adults from the general population of Lebanon (N = 515; aged 27.55 ± 10.92 years; 69.9% females). The forward-backward method was applied in translating the Arabic version of the BTPS-SF. RESULTS: The examination of the internal structure, using Confirmatory Factor Analysis (CFA), demonstrated that the three-factor model (i.e., rigid, self-critical, and narcissistic perfectionism) fitted well to the data. All three factors of the Arabic 16-item BTPS-SF yielded excellent reliability estimates, with both Cronbach's alpha and McDonald's omega ranging from 0.83 to 0.86. Multi-group CFA revealed that fit indices showed no significant difference in model fit at the configural, metric, and scalar levels, thus suggesting that the factor loadings, pattern structure, and item intercepts are invariant across gender groups. Finally, BTPS-SF subscales scores correlated positively with psychological distress (i.e., depression, stress and anxiety), and inversely with subjective well-being, indicating an acceptable concurrent validity. CONCLUSION: The present findings allow us to conclude that the Arabic BTPS-SF permits to capture reliably and validly three main factors of perfectionism. We hope that providing this psychometrically sound scale will encourage its large use not only in empirical research, but also in clinical applications, including psychological screening and treatment monitoring.

Coping with the COVID-19 pandemic by Paralympic athletes preparing for elite sport events: A longitudinal study.

INTRODUCTION: This study investigates the impact of the COVID-19 pandemic on mental health, coping styles and their relationship, and training opportunities in elite athletes with disabilities (AwD) preparing for national and international sport events during a ten-month observation period. METHODS: The study covered four time points in 3-month intervals, one retrospective, and three times during the 10 months of the pandemic period with diversified numbers of average new infections per day: A-pre-pandemic, B-third wave of the pandemic (mean = 15 681), C-decrease of the pandemic (mean = 102), and D-fourth wave of the pandemic (mean = 22 591). Main outcome measures included the Coping Inventory for Stressful Situations and the Hospital Anxiety and Depression Scale. RESULTS: The models regarding changes in anxiety (F(3,72)  = 22.43; p < 0.001; partial η2 = 0.48) and depression (F(3,72)  = 23.82; p < 0.001; partial η2  = 0.50) over the four time points of examination were significant. The pattern of relationship between coping styles and mood changes during COVID-19 pandemic periods, that is, a sudden increase in anxiety during dynamic growth of infections (waves of a pandemic) and a steady increase in depression over the course of the pandemic was not found. The difference in planned and actual training decreased significantly over time (p < 0.001). CONCLUSIONS: During the transitionary times of the COVID-19 pandemic, both mental health and training opportunities of AwD were at increased risk. Individual coping styles used by AwD were insufficient resources to cope with the extreme stress caused by the COVID-19 pandemic. Their mental health should be monitored in pandemics and similar situations to ensure appropriate and timely organizational and psychological intervention.

Psychometric properties of the short form of the Freiburg Mindfulness Inventory in the Arabic language.

Interests in including mindfulness techniques in medical and psychological fields have been increasing recently. Accordingly, it is important to validate the short form of the Freiburg Mindfulness Inventory (FMI-14) to help professionals living in Arabic speaking countries. Thus, we aimed to validate the FMI-14 in the Arabic language (FMI-Ar) in Arabic-speaking university students from Lebanon. We carried-out a cross-sectional study between July and September 2021; 363 university students (mean age 22.65 ± 3.48 years, 61.7% females) were enrolled. The McDonald's omega and Cronbach's alpha values for the total score were excellent (0.92 for both). Confirmatory factor analysis of the one-factor model of the FMI-Ar showed satisfactory fit indices: χ2/df = 218.33/77 = 2.83, RMSEA = 0.071 [0.060-0.082], CFI = 0.92, and TLI = 0.90. Additionally, the FMI score was negatively associated with depression (r = -0.51; p = 0.001) and anxiety (r = -0.48; p < 0.001). All hypotheses (factor, convergent, and divergent validity) related to the FMI-Ar were verified in our study. Therefore, professionals can now benefit from the FMI-Ar, a suitable scale to measure mindfulness among Lebanese University students.

Factors of body dissatisfaction among lebanese adolescents: the indirect effect of self-esteem between mental health and body dissatisfaction.

BACKGROUND: Body dissatisfaction (BD) rates are alarmingly high, especially among adolescents, thus. Having a better understanding of correlates associated with BD seems to be an important issue in this developmental context. Furthermore, as adolescence is an essential time in the development of self-perception and self-esteem the current study assesses factors associated with BD among Lebanese adolescents and evaluates the indirect effect of self-esteem between depression/anxiety/stress and BD. METHODS: This is a cross-sectional study among 555 Lebanese adolescents, ages 15-18, who completed an online survey incorporating BD, socioeconomic status, weight and height, physical activity index, Rosenberg Self Esteem Scale, Beirut Distress Scale, Hamilton Anxiety Rating Scale, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index and Global Physical Activity Questionnaire. RESULTS: The results of a stepwise linear regression, taking the body dissatisfaction score as the dependent variable, showed that higher BMI (B = 0.47), feeling pressured by media/TV to lose weight (Beta = 2.80), higher depression (Beta = 0.39), exercising to lose weight (Beta = 1.84) and following a diet to lose weight (Beta = 1.58) were significantly associated with more body dissatisfaction, whereas higher self-esteem (Beta=-0.11) and more psychological distress (Beta=-0.21) were significantly associated with less body dissatisfaction. Self-esteem played an indirect role in the associations between anxiety and body dissatisfaction and stress and body dissatisfaction. CONCLUSIONS: BD is common among young Lebanese adolescents. Treating adolescents with low self-esteem and psychological issues is crucial in preventing anticipated BD and future eating disorders.

Validation of the Arabic version of the ORTO-R among a sample of Lebanese young adults.

BACKGROUND: Within the literature, there is a variety of different measurement methods for orthorexic behaviours. The ORTO-15 is the one that attracted most research attention. Many scholars criticized the ORTO-15 for its unstable factor structure and over-estimation of the prevalence of orthorexia nervosa. For this purpose, Rogoza and Donini (Eat Weight Disord 26:887-895, 2020) re-assessed the original data and created a new tool, ORTO-R. The development of the ORTO-R theoretically solved many ambiguities associated with its parent measure. However, to date, no study, including the original one, tested the validity of the ORTO-R, leaving its utility somewhat speculative. METHODS: We gathered data from 363 Lebanese individuals, who answered the ORTO-R questions and a set of measures used to determine the validity of the scale (eating attitudes, perfectionism, body dissatisfaction, self-esteem, anxiety, and depression). Within this study, we analysed the internal consistency of the scale and different aspects of its validity (factorial, convergent, and divergent). RESULTS: Results supported all expectations; we successfully confirmed a one-factor measurement model of the ORTO-R, which appeared to be internally consistent. The ORTO-R score correlated positively to other orthorexic behaviours as well as to disordered eating attitudes, perfectionism, anxiety, and depression. It was also negatively related to self-esteem, but was unrelated to body dissatisfaction. CONCLUSION: The ORTO-R may be deemed as a valid instrument for the assessment of orthorexic behaviours. LEVEL OF EVIDENCE: V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Making and maintaining relationships through the prism of the dark triad traits: A longitudinal social network study.

OBJECTIVE: We investigated how Dark Triad traits influence the development and maintenance of social relations. METHOD: Participants completed the Short Dark Triad questionnaire and a measure of social relations at three time points: at the beginning of their first year in high school, 3 months later, and at the end of their first year. We investigated whether the Dark Triad traits are stable over time using Multilevel Modeling (N = 265; 59.6% girls), and how Dark Triad traits predict incoming and outgoing agentic and communal relations using Temporal Exponential Random Graph Models (N = 192; 60.4% girls). RESULTS: Overall, the Dark Triad traits were stable over a one-year period. Narcissism did not predict an increase in communal and agentic relations in the short-term, but predicted slightly less incoming communal and more agentic relations in the long-term. In the short-term, Machiavellianism predicted a small increase while psychopathy predicted a small decrease in the incoming agentic and communal relations. In the long-term, however, neither Machiavellianism nor psychopathy was a significant predictor of any incoming relations. CONCLUSIONS: Our results shed new light on the dynamics of making and maintaining social relations through the prism of the Dark Triad traits.

Situational context influences the degree of hostile attributions made by individuals with schizophrenia or autism spectrum disorder.

OBJECTIVES: Previous work has demonstrated that the tendency to make hostile attributions is not a stable trait but varies across different social situations. Therefore, we sought to investigate whether hostile attributions within clinical samples are better understood as a persistent characteristic or one that varies across contexts. METHODS: The current analyses investigated patterns of attributions among people diagnosed with schizophrenia (SCZ, n = 271) or autism spectrum disorder (ASD, n = 100) and non-clinical control participants (NCC, n = 233) in an existing data set. RESULTS: Results showed that specific relational features in vignettes portraying different social encounters influence the way people make attributions and that variability across contexts is present in both non-clinical and clinical populations. Like non-clinical participants, participants diagnosed with ASD ascribed the greatest hostility to a scene involving an authority figure. In contrast, SCZ participants reported the greatest hostility in response to a scene involving a friend. CONCLUSIONS: These findings suggest that salient environmental factors should be considered when assessing social cognitive skills and biases. PRACTITIONER POINTS: Hostile attributions should be perceived as situational constructs rather than stable and persistent characteristics. Hostile attributions were most prevalent among persons diagnosed with schizophrenia; however, on average, all participants showed greater hostility for situations involving an authority figure, an acquaintance, or a friend relative to those involving a co-worker or stranger. Psychotherapists and clinicians working with people diagnosed with schizophrenia or autism spectrum disorder could work on identifying situation triggers, which may prompt hostile attributions. Psycho-educational and psychotherapeutic interventions can be altered based on individual triggers of hostile attributions, and attempts can be made to lessen these attributions. Paranoia appears to be linked to hostile attributions regardless of the specific clinical diagnosis and should be considered in the therapeutic process.

Cultural Influences on Social Information Processing: Hostile Attributions in the United States, Poland, and Japan.

Social information processing (SIP) theory suggests that attributions play a central role in influencing behavior in the course of social-relational exchanges. Within the SIP framework, social context has been shown to impact how social events are perceived. As a key feature of social context, culture likely plays a central role in shaping attributional processing. This study examined differences in hostile attributional patterns in three cultures with varying levels of collectivism, individualism, and power distance: Poland, United States, and Japan (N = 707). We used the Ambiguous Intentions and Hostility Questionnaire (AIHQ) to compare attributional patterns across cultures. This measure uses five distinct vignettes to assess attributional responding within a range of interpersonal contexts. We examined whether the five-factor structure of the AIHQ maintained across these three cultures. Additionally, we investigated whether variations in attributional patterns occurred cross culturally in response to these ambivalent situations involving varying types of social relationships. Results confirmed acceptable patterns of measurement invariance across American, Japanese, and Polish samples and indicated that specific social-relational features in the vignettes significantly influenced attributional responding.

Fear of happiness through the prism of the dual continua model of mental health.

OBJECTIVE: Two studies were conducted to investigate fear of happiness through the lens of the dual continua model of mental health. METHODS: In Study 1, we examined whether depression (indicator of mental illness) and happiness (indicator of mental health) predicted fear of happiness through a Structural Equation Model. In Study 2, we ran a quasi-experimental design to examine differences in affect (positive and negative), happiness and depression when engaging in either fearless or fearful beliefs of happiness. RESULTS: Fear of happiness was positively and negatively predicted by depression and happiness, respectively. Fearless individuals reported higher positive affect and happiness, and lower negative affect and depression, than fearful individuals. CONCLUSIONS: Fearing happiness might act as a maladaptive self-verifying motive to enhance one's perspective of the world. Given the likelihood of modifying maladaptive cognitive patterns, we highlight different psychological interventions that can address the negative impact of fearful beliefs of happiness.

Introducing ORTO-R: a revision of ORTO-15 : Based on the re-assessment of original data.

BACKGROUND: Orthorexia nervosa has attracted significant attention in the field, however, alongside increasing knowledge, more and more gaps are being identified. One of the fundamental problems concerns measurement of orthorexia nervosa. The most commonly used self-report measure, the ORTO-15, demonstrated an unstable factorial structure across different populations. Therefore, one might question whether the knowledge obtained from past research using ORTO-15 is valid or not. The aim of the present paper is to re-analyse original data used for the validation of ORTO-15 to assess its factorial structure and propose its revision, the ORTO-R. METHODS: The description of the sample and procedure corresponds to the one reported in Donini et al. (Eat Weight Disord 10:28-32, 2005). N = 525 subjects were enrolled. To evaluate whether the factorial structure of ORTO-15, we used confirmatory factor analysis. The results revealed that the ORTO-15 indeed does not capture the structure of orthorexia nervosa adequately and revision is needed. The ORTO-R contains six items from ORTO-15, which were identified as the best markers of orthorexia nervosa. DISCUSSION AND CONCLUSION: In the current paper, we present a refined measure of orthorexia nervosa-the ORTO-R. It is based on a frequently used ORTO-15, overcoming its main limitations. We strongly believe that the current work will act as a bridge, linking past with the future research, and that alongside a new measure, the field of research on orthorexia nervosa will move forward. LEVEL OF EVIDENCE: Level V, descriptive study.

Psychometric Properties and Factor Structure of the German Version of the Fear of COVID-19 Scale.

Fear is a fundamental response in the face of a life-threatening pandemic, such as COVID-19. To assess COVID-19-related fear, the Fear of COVID-19 Scale (FCV-19S) has been recently developed and validated in many countries across the globe. The current study aimed to adapt the FCV-19S into German and to examine its psychometric properties. Participants (N = 866) were asked to complete the FCV-19S, report their perceived risk of contracting the virus, and their willingness to comply with mask wearing. Confirmatory Factor Analysis supported both a two-factor structure (emotional and somatic fear) and a more parsimonious one-factor model. Among demographic variables, only female gender was positively associated with the FCV-19S. Moreover, the measure was associated with increased risk perception and compliance with mask wearing. Results suggest that the FCV-19S has good psychometric properties in German and can be used in future work.

Enthusiastic Acts of Evil: The Assessment of Sadistic Personality in Polish and Italian Populations.

Subclinical sadism has received substantial attention in recent research as a trait that predicts a variety of malevolent behaviors. The objective of this study was to assess the 'psychometric robustness and portability' of the Assessment of Sadistic Personality (ASP). We examined the convergent and discriminant validity, and invariance of translated versions of the ASP within community samples of Polish and Italian individuals. The study included 568 individuals (340 women and 228 men) residing in Italy (Mage = 23.57, SDage = 2.55) and 556 individuals (411 women, 144 men, 1 other) residing in Poland (Mage = 23.48, SDage = 4.60). For cultural invariance purposes, data from a Canadian sample comprising 638 students were used. To establish convergent and discriminant validity, participants completed measures of sadism, the Dark Triad, the Big Five, interpersonal reactivity, and maladaptive traits described in the DSM-5. Across both samples, convergent and discriminant validity were supported. Configural and partial metric invariance were satisfied, and following implementation of alignment optimization, latent mean differences were evaluated between countries. Results of the study supported the psychometric qualities of the ASP across different cultures and languages, and the utility of the ASP as a valid measure extending beyond university samples.

Construct validation of the Narcissistic Admiration and Rivalry Questionnaire in Spanish-speaking countries: Assessment of the reliability, structural and external validity and cross-cultural equivalence.

A recent re-operationalisation of grandiose narcissism has resulted in the distinction of two narcissistic strategies based on the cognitive, affective-motivational and behavioural dynamics: admiration (assertive self-enhancement) and rivalry (antagonistic self-protection). The Narcissistic Admiration and Rivalry Questionnaire (NARQ) was developed to assess this model with two higher-order dimensions. However, cross-validations of the NARQ have not been extensively conducted across diverse population groups and languages. This study aimed to test the internal and external validity (through the relation with envy and self-esteem), reliability and cross-cultural equivalence of the Spanish version of the NARQ. The psychometric properties were evaluated in a Spanish sample (N = 310), and cross-cultural equivalence was tested in participants from Chile (N = 234) and Colombia (N = 256). The results supported the reliability and validity of the Spanish NARQ, as well as the cross-cultural equivalence across Spanish-speaking countries. In addition, we discuss obtained differences across Spanish, Chilean and Colombian sample within two narcissistic strategies.

Interaction between polymorphisms of the oxytocinergic system genes and emotion perception in inpatients with anorexia nervosa.

OBJECTIVE: The empirical literature describes the role of the oxytocinergic system in emotion perception (EP). Variants in the oxytocin (OXT) and oxytocin receptor genes have been associated with mental disorders, including anorexia nervosa (AN), that are characterized by difficulties in socioemotional functioning. Our study aimed to examine whether variability within the genes related to OXT pathways may play a role in facial EP in inpatients with AN. METHOD: Single nucleotide polymorphisms (SNPs) of the following genes: oxytocin receptor (rs2254298, rs53576), OXT (rs6133010), OXT-arginine-vasopressin (rs2740204), CD38 (rs6449197, rs3796863), and human leucyl/cystinylaminopeptidase (rs4869317) were genotyped in 60 AN female inpatients and 60 healthy control females (HCs). Associations between genetic polymorphisms and EP as well as clinical symptoms were examined. RESULTS: The AN group showed decreased EP abilities compared with HCs. SNPs of rs2740204, rs6133010, and rs53576 were associated with differences in EP in women with AN and in HCs. The SNP of rs4869317 was associated with the level of eating disorders symptoms in HCs. CONCLUSIONS: The OXT system may be involved in EP difficulties in AN. SNPs within genes related to OXT pathways may influence EP abilities. The leucyl/cystinylaminopeptidase rs4869317 SNP may be involved in the development of eating disorders psychopathology.

Investigating the structure of ORTO-15: a meta-analytical simulation study.

Missbach et al. (Appetite 108:521-524, https://doi.org/10.1016/j.appet.2016.07.010 , 2016) argued that there is a critical need to develop new tools assessing orthorexia nervosa (ON), as the existing measure (i.e., ORTO-15; Donini, Eat Weight Disord 10:28-32, https://doi.org/10.1007/BF03327537 , 2005) is an unvalidated measure, which fails to adequately assess the prevalence rate of ON. We believe that ignoring past data from ORTO-15 and going in the "baby with the bath water" direction will not catalyse but inhibit ON research. Using data from the review of the psychometric studies analysing the structure of ORTO-15 provided in Missbach et al. (2016), we selected six items, which were present in each study, and estimated effect sizes for the factor loadings. The effect sizes were used in a Monte Carlo simulation study with N = 100, 500, and 1000 to test whether the analysed model is valid. The obtained results confirmed that the six-item version of ORTO-15 is a valid and reliable measure of ON. Although new measures of ON are needed, the past data also provide valuable insight into a better understanding of ON.