Kristine H. Luce

The reliability of the Eating Disorder Examination-Self-Report Questionnaire Version (EDE-Q).

OBJECTIVE This research investigated the internal consistency and test-retest reliability of the Eating Disorder Examination-Self-Report Questionnaire Version (EDE-Q), a 41-item measure adapted from the Eating Disorder Examination (EDE). The EDE is a structured clinical interview assessing the key behavioral features and associated psychopathology of eating disorders. RESULTS Results indicated excellent internal consistency and 2-week test-retest reliability for the four subscales of the EDE-Q: Restraint, Weight Concern, Shape Concern, and Eating Concern. There was somewhat less stability in the items measuring the occurrence and frequency of the key behavioral features of eating disorders. CONCLUSIONS Overall, results support the psychometric adequacy of the EDE-Q.

Eating Disorder Examination Questionnaire (EDE-Q): Norms for Undergraduate Women

OBJECTIVE This research presents normative data on the Eating Disorder Examination Questionnaire (Fairburn and Beglin, Int J Eat Disorder, 16, 363-370, 1994) (EDE-Q) for samples of undergraduate women in the United States. METHOD College women (N = 723), ages 18-25, completed the EDE-Q as part of a larger assessment battery. RESULTS Average scores, standard deviations, and percentile ranks for the raw Restraint, Eating Concern, Shape Concern, and Weight Concern subscales and the Global score are reported. Data on the occurrence of objective and subjective bulimic episodes and compensatory behaviors are presented. CONCLUSION These results are helpful for clinicians and researchers in the interpretation of the EDE-Q scores of undergraduate women in the United States. Comparisons are drawn between the results for this sample and those of a United Kingdom sample of young adolescent females, an Australian community sample, and an Australian community age-matched sample.

Randomized, Controlled Trial of an Internet-Facilitated Intervention for Reducing Binge Eating and Overweight in Adolescents

OBJECTIVE. This study examined the efficacy of an Internet-facilitated intervention for weight maintenance and binge eating in adolescents. METHODS. A total of 105 adolescent male and female high school students at risk for overweight (mean age: 15.1 ± 1.0 years) were randomly assigned to a 16-week online intervention, StudentBodies2-BED (n = 52), or the wait-list control group (n = 53). RESULTS. Participants in the StudentBodies2-BED group had significantly lower BMI z scores and BMI from baseline assessment to follow-up assessment, compared with the wait-list control group. In addition, significant reductions in objective binge episodes and subjective binge episodes from baseline assessment to posttreatment assessment and from baseline assessment to follow-up assessment were observed among StudentBodies2-BED participants. The StudentBodies2-BED group also reported significantly reduced weight and shape concerns from posttreatment assessment to follow-up assessment and from baseline assessment to follow-up assessment. Participants in the StudentBodies2-BED group who engaged in objective overeating or binge eating episodes at baseline assessment experienced a significantly greater reduction in BMI at follow-up assessment, compared with the wait-list control group. CONCLUSIONS. Results suggest that an Internet-facilitated intervention is moderately effective in short-term weight loss and weight maintenance and yields a large reduction in binge eating. This study also demonstrates that weight management and reduction of eating disorder psychopathological features can be achieved simultaneously by using an easily disseminated, Internet-facilitated program.

Computer- and Internet-Based Psychotherapy Interventions

Computers and Internet-based programs have great potential to make psychological assessment and treatment more cost-effective. Computer-assisted therapy appears to be as effective as face-to-face treatment for treating anxiety disorders and depression. Internet support groups also may be effective and have advantages over face-to-face therapy. However, research on this approach remains meager.

The adverse effect of negative comments about weight and shape from family and siblings on women at high risk for eating disorders

OBJECTIVE. Our purpose with this work was to examine the relationship between negative comments about weight, shape, and eating and social adjustment, social support, self-esteem, and perceived childhood abuse and neglect. METHODS. A retrospective study was conducted with 455 college women with high weight and shape concerns, who participated in an Internet-based eating disorder prevention program. Baseline assessments included: perceived family negative comments about weight, shape, and eating; social adjustment; social support; self-esteem; and childhood abuse and neglect. Participants identified 1 of 7 figures representing their maximum body size before age 18 and parental maximum body size. RESULTS. More than 80% of the sample reported some parental or sibling negative comments about their weight and shape or eating. Parental and sibling negative comments were positively associated with maximum childhood body size, larger reported paternal body size, and minority status. On subscales of emotional abuse and neglect, most participants scored above the median, and nearly one third scored above the 90th percentile. In a multivariate analysis, greater parental negative comments were directly related to higher reported emotional abuse and neglect. Maximum body size was also related to emotional neglect. Parental negative comments were associated with lower reported social support by family and lower self-esteem. CONCLUSIONS. In college women with high weight and shape concerns, retrospective reports of negative comments about weight, shape, and eating were associated with higher scores on subscales of emotional abuse and neglect. This study provides additional evidence that family criticism results in long-lasting, negative effects.

The point prevalence of bulimic disorders from 1990 to 2004.

OBJECTIVE This study investigated the point prevalence of probable cases of bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS), and specific eating disorder symptomatology among 6,844 undergraduate women at a single site, examining changes across five 3-year time periods and on a yearly basis from 1990 to 2004. METHOD Participants completed a self-report checklist that assessed the diagnostic criteria for BN (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 1994) and the Bulimia Test (Smith and Thelen, J Consult Clin Psychol, 52, 863-872, 1984) (BULIT) or Bulimia Test-Revised (Thelen et al., Psychol Assess, 3, 119-124, 1991) (BULIT-R). RESULTS Chi-square analyses comparing the percentages of probable cases of BN and EDNOS and the percentages of women who reported frequent binge eating and most compensatory weight control strategies were nonsignificant. Only the percentages of women who endorsed overconcern with weight and shape and diuretic use and excessive exercise as compensatory weight control strategies changed over time. CONCLUSION Consistent with Keel et al.s (Keel et al., Psychol Med, 36, 119-127, 2006) findings regarding the point prevalence rates of BN from 1992 to 2002, results indicated that probable cases of eating disorders remained relatively stable. Methodologically, this research illustrates the importance of examining multiple data points when investigating stability or change in behavior.

Reliability of self-report: paper versus online administration

This investigation compared online and paper administration of self-report measures of weight and shape concerns, mood, weight and height. The former was designed as a screening instrument for adolescent students to determine risk for eating disorders. Participants were female sophomores (N=74) from a San Francisco Bay area private high school. A counterbalanced designed was used to control for order effects. Four classes were randomly assigned to one of four conditions: (1) online-paper; (2) paper-online; (3) online-online; and (4) paper-paper. Participants completed self-report questionnaires twice, online and/or on paper, separated by 1 week. Agreement between online and paper assessment of weight and shape concerns and BMI ranged from 0.73 to 0.97 and 0.80 to 1.0, respectively. Agreement for positive mood ranged from 0.58 to 0.85 and negative mood from 0.59 to 0.82. Mean scores for weight and shape concerns and mood variables were significantly lower at the second testing. Online and paper assessment of weight and shape concerns was significantly correlated. However, there was a significant time effect. Mood was less stable and correlations between the two modes of self-report were less correlated. Online assessment may be beneficial and appropriate for many settings.

Do Adherence Variables Predict Outcome in an Online Program for the Prevention of Eating Disorders

Unlike traditional interventions, Internet interventions allow for objective tracking and examination of the usage of program components. Student Bodies (SB), an online eating disorder (ED) prevention program, significantly reduced ED attitudes/behaviors in college-aged women with high body image concerns, and reduced the development of EDs in some higher risk subgroups. The authors investigated how adherence measures were associated with ED attitudes and behaviors after treatment. Female SB participants (n = 209) completed the Eating Disorders Examination-Questionnaire (EDE-Q; C. G. Fairburn & S. J. Beglin, 1994) at baseline, posttreatment, and 1-year follow-up. Total weeks participation and frequency of utilizing the online Web pages/journals predicted pre- to posttreatment changes in EDE-Q Restraint but not in other ED symptoms. In participants with some compensatory behaviors, discussion board and booster session use were associated with increased weight/shape concerns during follow-up. In overweight participants, higher online Web page/journal use was related to decreased EDE-Q Eating Concern scores during follow-up. This is the first study to investigate the relationship between adherence to specific program components and outcome in a successful Internet-based intervention. Results can be used to inform future development and tailoring of prevention interventions to maximize effectiveness and facilitate dissemination.

Psychometric properties of measures of eating disorder risk in Latina college women.

OBJECTIVE Latina college women are at risk for eating disorders (EDs), but assessment is problematic, because the psychometric properties of risk factor measures have not been evaluated with this group. METHOD Reliability and validity estimates of the Eating Disorder Examination Questionnaire, Body Esteem Scale, Sociocultural Attitudes Toward Appearance Questionnaire-3, and Body Shape Questionnaire were examined in a sample of 173 female Latina college students. RESULTS Cronbach α coefficients (.75-.96) and intraclass coefficients (.65-.96) indicated good reliability. Most measures were significantly correlated, providing evidence for convergent validity. Confirmatory factor analyses resulted in good fit indices. DISCUSSION These findings indicate that commonly used measures of ED risk have adequate reliability and validity in Latina college women. Comparison data suggest that ED risk may be similar or even higher in Latina college women relative to Caucasian college women. Prevention efforts with diverse groups are needed.

Do restrained eaters restrict their caloric intake prior to drinking alcohol

This research used multilevel modeling to investigate the hypothesis that restrained eaters increase dietary restriction when they expect to drink alcohol. Undergraduate women (39 restrained eaters; 40 unrestrained eaters) monitored their food and alcohol intake for ten days. Restrained eaters, on average, consumed fewer calories per day than unrestrained eaters. Although the intent to drink alcohol did not impact the overall caloric intake of restrained eaters prior to drinking, restrained eaters reported significantly fewer eating episodes than unrestrained eaters on days the participants intended to drink. Given that restrained eaters generally consumed fewer calories per day and had fewer eating episodes prior to drinking, one major implication of higher levels of intoxication would be increased risk of negative alcohol-related consequences. Future research should extend this study and evaluate negative alcohol-related consequences that occur with higher levels of intoxication.