Validating the visceral sensitivity index in an eating disorder sample

Abstract

Objective Individuals with eating disorders (EDs) often have difficulty tolerating uncomfortable body sensations. As such, anxiety sensitivity specific to gastrointestinal (GI) sensations, has relevance for EDs. However, to date, no validated measures of this construct exist in EDs. Thus, the present study sought to validate the visceral sensitivity index (VSI), a 15‐item measure originally validated in an irritable bowel syndrome sample, in an ED sample and explore associations with ED symptoms. Method Two hundred and sixty‐six adolescents (n = 116) and adults (n = 150) in an ED partial hospital program completed the VSI and related measures at admission. Confirmatory factor analysis examined the factor structure of the VSI and hierarchical regression analyses explored associations between the VSI and ED symptoms. Results The original version of the VSI had adequate model fit. An alternative 13‐item model removing specific items with poor fit and less theoretical relevance to EDs also demonstrated good fit. The 15‐item and 13‐item VSI had strong internal consistency (α = .93–.94), and correlation results supported the convergent and divergent validity of both versions. Higher visceral sensitivity was associated with elevated body dissatisfaction, cognitive restraint, purging, restricting, and excessive exercise (p‐values <.05), beyond length of illness, body mass index, and trait anxiety. Discussion Results support the relevance of GI‐specific anxiety in EDs and suggest that the original 15‐item VSI and modified 13‐item VSI have strong psychometric properties in an ED sample. Given comparable model fit and psychometric properties, both versions of the VSI may be used for future ED research.

Gastrointestinal‐Specific symptom anxiety in patients with gastroparesis: Relationships to symptom severity and quality of life

“…First, our sample average (44.3) was higher but within one standard deviation of VSI scores reported in the original IBS validation study (Mean = 36.5, SD = 18.5) 16 and a study validating the VSI in patients with eating disorders (Mean = 43.8, SD = 17.9). 20 Interestingly, trait anxiety (HADS-A)…”

“…GI‐specific anxiety was measured using the Visceral Sensitivity Index (VSI), 16 a 15‐item questionnaire previously validated in adults with IBS, 16 and in individuals with eating disorders 20 . Items are scored from 0 (“strongly disagree”) to 5 (“strongly agree”), with total scores ranging from 0 to 75.…”

“…GI-specific anxiety was measured using the Visceral Sensitivity Index (VSI), 16 a 15-item questionnaire previously validated in adults with IBS, 16 and in individuals with eating disorders. 20 Items are scored from 0 ("strongly disagree") to 5 ("strongly agree"), with total scores ranging from 0 to 75. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), with total scores ranging from 0 to 21.…”

Diet, Digestion, and the Dietitian: A Survey of Clinicians’ Knowledge, Attitudes and Practices to Advance the Treatment of Gastrointestinal Disturbances in Individuals with Anorexia Nervosa

“…Additionally, therapeutic relationships that are built on trust and honest communication may reduce symptom-related anxieties [ 47 ]. This may translate to individuals with EDs as heightened visceral sensitivity and GI-specific anxiety are often present [ 29 , 48 ]. Given that dietitians with higher knowledge scores on our survey were more understanding of the interference of GID on AN and quality of life, this may help to strengthen the clinician-patient relationship, which, in turn, can have a positive influence on health outcomes [ 49 ].…”

“…For constipation, increased fibre intake and adequate fluid are often recommended [ 27 ]. Increasing dietary fibre in individuals with AN needs to be implemented with caution as high fibre foods are usually not energy dense and are likely to contribute to the sensation of fullness, both of which could compromise meeting nutrient targets for AN recovery [ 28 , 29 ]. Dietetic management of GID in individuals with AN has not been investigated and it is unclear what techniques, if any, are being utilised in practice.…”