Confirmatory factor analyses of the ORTO 15-, 11- and 9-item scales and recommendations for suggested cut-off scores

Möller, Stéphan; Apputhurai, Pragalathan; Knowles, Sandra R.

doi:10.1007/s40519-018-0515-0

Cited by 38 publications

(34 citation statements)

References 30 publications

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“…In many cases, these validation studies are performed using some type of congeneric factor model. However, when many of these validated scales are used in practice, scores are derived by summing the items, despite the fact that validation studies routinely fit congeneric models with different loadings for each of the items (see, e.g., Corbisiero, Mörstedt, Bitto, & Stieglitz, 2017;Moller, Apputhurai, & Knowles (2019). Furthermore, psychological scales that are scored using a sum score and did not undergo a thorough psychometric evaluation before becoming mainstream (such as the Hamilton Depression Rating Scale) continue to receive widespread use despite poor psychometric properties that would likely prohibit use of the scale (Bagby, Ryder, Schuller, & Marshall, 2004).…”

Section: Importance To Psychometrics: Previously Validated Scalesmentioning

confidence: 99%

Thinking twice about sum scores

2020

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A common way to form scores from multiple-item scales is to sum responses of all items. Though sum scoring is often contrasted with factor analysis as a competing method, we review how factor analysis and sum scoring both fall under the larger umbrella of latent variable models, with sum scoring being a constrained version of a factor analysis. Despite similarities, reporting of psychometric properties for sum scored or factor analyzed scales are quite different. Further, if researchers use factor analysis to validate a scale but subsequently sum score the scale, this employs a model that differs from validation model. By framing sum scoring within a latent variable framework, our goal is to raise awareness that (a) sum scoring requires rather strict constraints, (b) imposing these constraints requires the same type of justification as any other latent variable model, and (c) sum scoring corresponds to a statistical model and is not a modelfree arithmetic calculation. We discuss how unjustified sum scoring can have adverse effects on validity, reliability, and qualitative classification from sum score cutoffs. We also discuss considerations for how to use scale scores in subsequent analyses and how these choices can alter conclusions. The general goal is to encourage researchers to more critically evaluate how they obtain, justify, and use multiple-item scale scores.

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Section: Importance To Psychometrics: Previously Validated Scalesmentioning

confidence: 99%

Thinking twice about sum scores

2020

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“…Several scales have been developed from it, such as the ORTO-11 [26] ORTO-11-HU [27], ORTO-9-GE [28], and ORTO-7 [29], some of these scales also using a corrected scoring (called CS) for items 1 and 13 (see 28 for a detailed explanation about the different scoring systems and scales). However, the validity and reliability of this measure and its adaptations has been questioned, and it has been found to have low internal consistency, and limited content validity [30].…”

Section: Diagnosismentioning

confidence: 99%

“…The limitations of the ORTO measures have been acknowledged in the ON literature [23,34,66], however a good quality validated alternative is not yet available. Although the ORTO-15 [21], and its translated and abbreviated versions [28,30], are the most widely used measures of ON tendencies to date, these measures were developed based on items of the Bratman Orthorexia Test (a non-validated screening tool), without reference to any proposed diagnostic criteria for ON [5,29]. Whilst several alternative measures have recently been developed, these too have been criticised, or have not yet been validated.…”

Section: Limitations and Future Researchmentioning

confidence: 99%

Orthorexic tendencies are linked with difficulties with emotion identification and regulation

2020

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Background: Orthorexia nervosa (ON) is characterised by an unhealthy obsession with healthy eating and while it is not recognised as an eating disorder (or any disorder), current research is exploring similarities and differences with such disorders. The literature has shown that individuals with eating disorders have difficulties identifying and describing emotions (known as alexithymia) as well as regulating them. However no research to date has looked at whether people with orthorexic tendencies also suffer from difficulties with emotions. In this paper, we refer to people with orthorexic tendencies but do not assume that their healthy eating is at a pathological level needing clinical attention. Methods: The current study examined this by asking 196 healthy adults with an interest in healthy eating to complete four questionnaires to measure ON (ORTO-15reduced to ORTO-7CS), eating psychopathology (EAT-26), alexithymia (TAS-20) and emotion dysregulation (DERS-16). Results: We found that difficulties identifying and regulating emotions was associated with symptoms of ON, similar to what is found in other eating disorders. We suggest that ON behaviours may be used as a coping strategy in order to feel in control in these participants who have poor emotion regulation abilities. Conclusions: Our results show that individuals with ON tendencies may share similar difficulties with emotions compared to other eating disorders. While important, our results are limited by the way we measured ON behaviours and we recommend that further research replicate our findings once a better and more specific tool is developed and validated to screen for ON characteristics more accurately.

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“…As already stated, an assessment based on self-administered questionnaires entails problems in terms of realibility and possible underestimation/overestimation. The ORTO-15 Questionnaire does not allow to make a diagnosis of ON, and has intrinsic limitations already described by the scientific literature [59], with contradictory results regarding its psychometric properties, including construct validity [9,[60][61][62][63].…”

Section: Limitationsmentioning

confidence: 99%

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students

et al. 2019

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Background The amount of research about orthorexic attitudes and behaviours has increased in the last five years, but is still mainly based on descriptive and anecdotal data, yielding a variety of prevalence data and inconsistent results. The interplay between socio-cultural context and orthorexia has been poorly investigated and is still far from being understood. Method Multicentre, cross-sectional study involving Italian ( N = 216), Polish ( N = 206) and Spanish ( N = 242) university students, assessed through a protocol including informed consent, socio-demographic and anamnestic data sheet and self-administered questionnaires (ORTO-15, Eating Attitudes Test- 26 [EAT-26], Temperament and Character Inventory [TCI]). Results Higher prevalence of orthorexia (as described by the ORTO-15 cutoff) was found in Poland. Female gender, Body Mass Index (BMI), current Eating Disorder, dieting, EAT-26 score ≥ 20 and low/medium Persistence were associated with orthorexia in the whole sample. The cross-cultural comparison showed several differences among the three subgroups of students. Conclusions The associations found between orthorexic attitudes, self-reported current eating disorder, BMI and adherence to a dieting need to be supported by further research. The differences among students from the three countries seem to suggest a possible rolve for cultural elements in the construct of orthorexia.

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Confirmatory factor analyses of the ORTO 15-, 11- and 9-item scales and recommendations for suggested cut-off scores

Abstract: Level V, descriptive study.

Cited by 38 publications

References 30 publications

Thinking twice about sum scores

Thinking twice about sum scores

Orthorexic tendencies are linked with difficulties with emotion identification and regulation

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students

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