Journal of Education and Health Promotion

Disordered eating: The psychometric properties of the Persian version of the Eating Attitudes Test‑8

Document Type : Original Article

Authors

. Esmaeil Mousavi Asl 1
. Sajjad Khanjani 2
. Behzad Mahaki 3
. Youkhabeh Mohammadian 4

1 Assistant Professor of Clinical Psychology, Department of Psychiatry, Golestan Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran

3 Department of Biostatistics, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah

4 Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract
BACKGROUND: Disordered eating attitude may lead to full‑blown eating disorders. Recent
longitudinal studies show that disordered eating attitudes either remain stable or even increase from
childhood to adulthood. The current study was done to determine the psychometric properties of the
Eating Attitudes Test‑8 (EAT‑8) and introduce the suitable measure for researchers and therapist in
the field of clinical psychology and psychiatrist.
MATERIALS AND METHODS: The Persian version of the EAT‑8 was produced through forward
translation, reconciliation, and back translation. A sample of 302 students were selected through
convenience sampling method and completed a set of questionnaires, including the EAT‑8,
Eating Attitudes Test‑16 (EAT‑16), Eating Beliefs Questionnaire‑18 (EBQ‑18), self‑esteem scale,
and self‑compassion scale short‑form. The construct validity of the EAT‑8 was assessed using
confirmatory factor analysis and divergent and convergent validity. Internal consistency and test–retest
reliability (2 weeks’ interval) were conducted to evaluate the reliability. Data analysis was conducted
using SPSS (version 22) software and LISREL (version 8.8).
RESULTS: EAT‑8 was found to be valid and reliable measures, with good internal consistency and
good test–retest reliability among students. In terms of convergent validity, EAT‑8 showed a significant
positive correlation with self‑report measures of EAT‑16 and EBQ‑18. EAT‑8 showed a negative
correlation with self‑compassion and self‑esteem, thus demonstrated a good divergent validity. The
results of this study also provide support for the one‑factor model of the EAT‑8.
CONCLUSION: The EAT‑8 showed good validity and reliability and could be useful in assessing
disordered eating in Iranian population. The EAT‑8 shows notable promise as a measure for use in
disordered eating research and clinical settings.

Keywords

Eating
factor analysis
psychological tests
psychometrics
self‑report
  1. Azzouzi N, Ahid S, Bragazzi NL, Berhili N, Aarab C, Aalouane R,
    et al. Eating disordersamong Moroccan medical students: Cognition
    and behavior. Psychol Res Behav Manage 2019;12:129‑35.
    2. Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR.
    Prevalence and correlates of eating disorders in adolescents.
    Results from the national comorbidity survey replication
    adolescent supplement. Arch Gen Psychiatry 2011;68:714‑23.
    3. Keshaviah A, Edkins K, Hastings ER, Krishna M, Franko DL,
    Herzog DB, et al. Re‑examining premature mortality in
    anorexia nervosa: A meta‑analysis redux. Compr Psychiatry
    2014;55:1773‑84.
    4. Smith AR, Velkoff EA, Ribeiro JD, Franklin J. Are eating
    disorders and related symptoms risk factors for suicidal thoughts
    and behaviors? A meta-analysis. Suicide Life Threat Behav
    2019;49:221‑39.
    5. Erskine HE, Whiteford HA, Pike KM. The global burden of eating
    disorders. Curr Opin Psychiatry 2016;29:346‑53.
    6. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality
    rates in patients with anorexia nervosa and other eating
    disorders. A meta‑analysis of 36 studies. Arch Gen Psychiatry
    2011;68:724‑31.
    7. Franko DL, Keshaviah A, Eddy KT, Krishna M, Davis MC,
    Keel PK, et al. A longitudinal investigation of mortality in anorexia
    nervosa and bulimia nervosa. Am J Psychiatry 2013;170:917‑25.
    8. Sweeting H, Walker L, MacLean A, Patterson C, Räisänen U,
    Hunt K. Prevalence of eating disorders in males: A review of rates
    reported in academic research and UK mass media. Int J Mens
    Health 2015;14. pii: 10.3149/jmh. 1402.86.
    9. Smink FR, van Hoeken D, Hoek HW. Epidemiology of eating
    disorders: Incidence, prevalence and mortality rates. Curr
    Psychiatry Rep 2012;14:406‑14.
    10. Le Grange D, Louw J, Russell B, Nel T, Silkstone C. Eating attitude
    and behaviours in South African adolescents and young adults.
    Transcult Psychiatry 2006;43:401‑7.
    11. Celikel FC, Cumurcu BE, Koc M, Etikan I, Yucel B. Psychologic
    correlates of eating attitudes in Turkish female college students.
    Compr Psychiatry 2008;49:188‑94.
    12. Yu J, Lu M, Tian L, Lu W, Meng F, Chen C, et al. Prevalence of
    disordered eating attitudes among university students in Wuhu,
    China. Nutr Hosp 2015;32:1752‑7.
    13. Hilbert A, de Zwaan M, Braehler E. How frequent are eating
    disturbances in the population? Norms of the eating disorder
    examination‑questionnaire. PLoS One 2012;7:e29125.
  2. 14. Berger U, Wick K, Hölling H, Schlack R, Bormann B, Brix C, et al.
    Screening of disordered eating in 12‑year‑old girls and boys:
    Psychometric analysis of the German versions of SCOFF and
    EAT‑26. Psychother Psychosom Med Psychol 2011;61:311‑8.
    15. Sanaei H, Dabiran S, Seddigh L. Eating attitudes among adolescent
    girls in Tehran: A schoolbased survey between 2010‑2011. Soc
    Determ Health 2016;2:98‑105.
    16. Rouzitalab T, Gargari BP, Izadi A, Amirsasan R, Azarmanesh D,
    Jafarabadi MA. The prevalence of disordered eating attitude
    and its relation to exercise participation in a sample of physical
    education students. Prog Nutr 2019;21:281‑7.
    17. Pacheco JP, Giacomin HT, Tam WW, Ribeiro TB, Arab C,
    Bezerra IM, et al. Mental health problems among medical students
    in Brazil: A systematic review and meta‑analysis. Braz J Psychiatry
    2017;39:369‑78.
    18. Lazarevich I, Irigoyen‑Camacho ME, Mdel CV. Obesity, eating
    behaviour and mental health among University Students in
    Mexico City. Nutr Hosp 2013;28:1892‑9.
    19. Yu Z, Tan M. Disordered eating behaviors and food addiction
    among nutrition major college students. Nutrients 2016;8:673.
    20. Evans EJ, Hay PJ, Mond J, Paxton SJ, Quirk F, Rodgers B, et al.
    Barriers to help‑seeking in young women with eating disorders:
    A qualitative exploration in a longitudinal community survey.
    Eat Disord 2011;19:270‑85.
    21. Identifying People at Risk. Available from: http://www.nedc.
    com.au/identifyin g‑people‑at‑risk. [Last accessed on 2018 Apr
    04].
    22. Richter F, Strauss B, Braehler E, Altmann U, Berger U.
    Psychometric properties of a short version of the eating attitudes
    test (EAT‑8) in a German representative sample. Eat Behav
    2016;21:198‑204.
    23. Cumella EJ. Obsessive‑compulsive disorder with eating disorders.
    Am J Psychiatry 1999;156:982.
    24. Morgan JF, Reid F, Lacey JH. The SCOFF questionnaire:
    Assessment of a new screening tool for eating disorders. BMJ
    1999;319:1467‑8.
    25. Killen JD, Hayward C, Wilson DM, Taylor CB, Hammer LD,
    Litt I, et al. Factors associated with eating disorder symptoms in
    a community sample of 6th and 7th grade girls. Int J Eat Disord
    1994;15:357‑67.
    26. Garfinkel PE, Newman A. The eating attitudes test: Twenty‑five
    years later. Eating and Weight Disorders‑Studies on Anorexia,
    Bulimia and Obesity. 2001 Mar 1;6(1):1‑21.
    27. Berger U, Hentrich I, Wick K, Bormann B, Brix C, Sowa M,
    et al. Psychometric quality of the “eating attitudes test”
    (German version EAT‑26D) for measuring disordered eating
    in pre‑adolescents and proposal for a 13‑item short version.
    Psychother Psychosom Med Psychol 2012;62:223.
    28. Lombardo C, Russo PM, Lucidi F, Iani L, Violani C. Internal
    consistency, convergent validity and reliability of a brief
    questionnaire on disordered eating (DEQ). Eat Weight Disord
    2004;9:91‑8.
    29. Austin SB. Accelerating progress in eating disorders prevention:
    A call for policy translation research and training. Eat Disord
    2016;24:6‑19.
    30. Mousavi Asl E, Mohammadian Y, Gharraee B, Khanjani S,
    Pazouki A. Assessment of the Emotional Reactivity Through the
    Positive and Negative Emotions: The Psychometric Properties
    of the Persian Version of the Perth Emotional Reactivity Scale.
    Iranian Journal of Psychiatry and Behavioral Sciences. 2020 Aori
    26;14 (2).
    31. Kline RB. Principles and Practice of Structural Equation Modeling.
    4th ed.. New York: Guilford Publications; 2015.
    32. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance
    structure analysis: Conventional criteria versus new alternatives.
    Struct Equ Model Multidiscip J 1999;6:1‑55.
    33. Garner DM, Rosen LW, Barry D. Eating disorders among athletes.
    Research and recommendations. Child Adolesc Psychiatr Clin N
    Am 1998;7:839‑57, x.
    34. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and
    factorial validation of a short form of the Self‑Compassion Scale.
    Clin Psychol Psychother 2011;18:250‑5.
    35. Khanjani S, Foroughi AA, Sadghi K, Bahrainian SA. Psychometric
    properties of Iranian version of self‑compassionscale (short form).
    Pajoohande 2016;21:282‑9.
    36. McLaughlin E. The EAT 16: Validation of a Shortened Form
    of the Eating Attitudes Test; 2014. Available from: https://
    digitalrepository.unm.edu/psy_etds/94.
    37. Mousavias lE, Mahaki B, Bardezard A, Mohammadian Y. Eating
    disorders screening tools: The psychometric properties of the
    Persian version of eating attitude test. Int J Prev Med. 2020 [In
    press].
    38. Burton AL, Mitchison D, Hay P, Donnelly B, Thornton C, Russell J,
    et al. Beliefs about binge eating: Psychometric properties of the
    eating beliefs questionnaire (EBQ‑18) in eating disorder, obese,
    and community samples. Nutrients 2018;10:1306.
    39. Asl EM, Mahaki B, Gharraee B, Farid AA, Shahverdi‑Shahraki A.
    Beliefs about binge eating: The psychometric properties of the
    Persian version of the eating beliefs questionnaire. Journal of
    Research in Medical Sciences. 2020 Jan 1;25(1):73.
    40. Rosenberg M. Society and the adolescent selfimage. New Jersey:
    Princeton University Press; 2015.
    41. Moshki M, Ashtarian H. Perceived health locus of control,
    self‑esteem, and its relations to psychological well‑being status
    in Iranian students. Iran J Public Health 2010;39:70‑7.
    42. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL,
    Dekker J, et al. Quality criteria were proposed for measurement
    properties of health status questionnaires. J Clin Epidemiol
    2007;60:34‑42.
    43. Bull SA, James LR, Van Alstine J, Bennett N, Lind S, Stilwell CD.
    Evaluation of goodness‑of‑fit indices for structural equation
    models. Quant Methods Psychol 1989;105:430.
    44. Browne MW, Cudeck R. Alternative ways of assessing model fit.
    Sociol Methods Res 1992;21:230‑58.
    45. Chermelleh‑Engel K, Moosbrugger H, Müller H. Evaluating the fit
    of structural equation models: Tests of significance and descriptive
    goodness‑of‑fit measures. Methods Psychol Res 2003;8:23‑74.
    46. Burton AL, Abbott MJ. The revised short‑form of the Eating Beliefs
    Questionnaire: Measuring positive, negative, and permissive
    beliefs about binge eating. J Eat Disord 2018;6:37.
    47. Fresnics AA, Wang SB, Borders A. The unique associations
    between self‑compassion and eating disorder psychopathology
    and the mediating role of rumination. Psychiatry Res 2019;274:91‑7.
    48. Braun TD, Park CL, Gorin A. Self‑compassion, body image,
    and disordered eating: A review of the literature. Body Image
    2016;17:117‑31.
    49. Collin P, Karatzias T, Power K, Howard R, Grierson D,
    Yellowlees A. Multi‑dimensional self‑esteem and magnitude
    of change in the treatment of anorexia nervosa. Psychiatry Res
    2016;237:175‑81.
    50. Linardon J, de la Piedad‑Garcia X, Brennan L. Predictors,
    moderators, and mediators of treatment outcome following
    manualised cognitive-behavioural therapy for eating disorders:
    A systematic review. Eur Eat Disord Rev 2017;25:3‑12.
    51. Steindl SR, Buchanan K, Goss K, Allan S. Compassion
    focused therapy for eating disorders: A qualitative review
    and recommendations for further applications. Clin Psychol
    2017;21:62‑73.
Journal of Education and Health Promotion
Volume 10, Issue 11
November 2020
Pages 1-6

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us