Factor structure of the Eating Disorder Examination-Questionnaire (EDE-Q) in adult men with eating disorders

Abstract

Background Previous investigations on the Eating Disorder Examination-Questionnaire (EDE-Q) factor structures in men have been restricted to non-clinical settings, limiting conclusions about the factorial validity in men with eating disorders (ED). This study aimed to examine the factor structure of the German EDE-Q in a clinical group of adult men with diagnosed ED. Methods ED symptoms were assessed using the validated German version of the EDE-Q. Exploratory factor analysis (EFA) using principal-axis factoring based on polychoric correlations was conducted for the full sample (N = 188) using Varimax-Rotation with Kaiser-Normalization. Results Horn’s parallel analysis suggested a five-factor solution with an explained variance of 68%. The EFA factors were labeled “Restraint” (items 1, 3–6), “Body Dissatisfaction” (items 25–28), “Weight Concern” (items 10–12, 20), “Preoccupation” (items 7 and 8), and “Importance” (items 22 and 23). Items 2, 9, 19, 21, and 24 were excluded due to low communalities. Conclusions Factors associated with body concerns and body dissatisfaction in adult men with ED are not fully represented in the EDE-Q. This could be due to differences in body ideals in men, e.g., the underestimation of the role of concerns about musculature. Consequently, it may be useful to apply the 17-item five-factor structure of the EDE-Q presented here to adult men with diagnosed ED.

Exploring Gender Differences in Early Weight Change and Variability in Adolescents with Anorexia Nervosa during Inpatient Treatment

“…We also only report on immediate treatment responses, raising the question of whether long-term outcomes still remain comparable among gender groups. Finally, we must note that there are several indications that currently used diagnostic criteria and psychopathology assessment tools (such as the EDE-Q) may be suboptimal in capturing AN psychopathology in men [ 25 , 44 ], which may have artificially homogenized our sample, and/or precluded the assessment of further gender differences.…”

“…The EDE-Q shows high levels of convergent validity [ 23 ], and assesses the occurrence of cognitive and behavioral symptoms of disordered eating within the last 28 days along four subscales, labelled “(Dietary) Restraint”, “Eating Concern”, “Shape Concern”, and “Weight Concern”, using 22 attitudinal items rated on a 7-point scale (from 1, never, to 7, every day; six additional items that assess the self-reported frequencies of weight control behaviors are not used for scoring). However, the proposed factor structure has received little support in previous studies, especially in men and mixed-gender samples [ 24 , 25 ]. Moreover, because the Restraint subscale queries eating behaviors that are not allowed under the clinic’s treatment regime, changes in this subscale are irrelevant for evaluating changes in psychopathology.…”

Postoperative Dumping Syndrome, Health-Related Quality of Life, Anxiety, Depression, and Eating Disturbances: Results of a Longitudinal Obesity Surgery Study

“…Eating disorder symptoms were assessed using the 28-item Eating Disorder Examination Questionnaire (EDE-Q) [31]. Since the original factor structure (i.e., restraint, eating concern, weight concern, shape concern) has been shown to be suboptimal in clinical samples with eating disorders and in obesity surgery candidates [32][33][34], the global EDE-Q score including 22 items was used (α t0 = 0.81, α t1 = 0.91 in current study). Higher scores indicate more eating disturbances (cutoff for being at risk for an eating disorder ≥2.3) [35].…”

Psychometric network analysis of the Intuitive Eating Scale‐2 in Chinese general adults

“…Despite the underlying connections between psychometric network analysis and latent variable modeling (Kruis & Maris, 2016), the use of network psychometrics may have certain advantages, such as identifying the network structure of variables (i.e., nodes) and allowing the visualization of the strength of the (partial) correlations between variables (i.e., edges; Hevey, 2018). Thus, psychometric network analysis may provide new perspectives to evaluate the structure and dynamics of psychological tools in mental health settings, including tools for assessing eating behaviors (e.g., Laskowski et al, 2023; Punzi et al, 2023). For example, using psychometric network analysis, Laskowski et al (2023) revealed that the original factor model of the Eating Disorder Examination‐Questionnaire (EDE‐Q) might not be optimal for women with EDs; thus, they suggested using different scorings of the EDE‐Q in women with EDs for screening purposes or for evaluating the effects of interventions.…”

“…Thus, psychometric network analysis may provide new perspectives to evaluate the structure and dynamics of psychological tools in mental health settings, including tools for assessing eating behaviors (e.g., Laskowski et al, 2023; Punzi et al, 2023). For example, using psychometric network analysis, Laskowski et al (2023) revealed that the original factor model of the Eating Disorder Examination‐Questionnaire (EDE‐Q) might not be optimal for women with EDs; thus, they suggested using different scorings of the EDE‐Q in women with EDs for screening purposes or for evaluating the effects of interventions. Similarly, the use of the psychometric network model may be a novel method for providing a better understanding of the dimensionality of the IES‐2 and to provide insights for future research on intuitive eating, including the design and improvement of intuitive eating interventions.…”