Confirmatory factor analysis for two questionnaires of caregiving in eating disorders

Abstract

Objective: Caring for someone diagnosed with an eating disorder (ED) is associated with a high level of burden and psychological distress which can inadvertently contribute to the maintenance of the illness. The Eating Disorders Symptom Impact Scale (EDSIS) and Accommodation and Enabling Scale for Eating Disorders (AESED) are self-report scales to assess elements of caregiving theorised to contribute to the maintenance of an ED. Further validation and confirmation of the factor structures for these scales are necessary for rigorous evaluation of complex interventions which target these modifiable elements of caregiving. Method: EDSIS and AESED data from 268 carers of people with anorexia nervosa (AN), recruited from consecutive admissions to 15 UK inpatient or day patient hospital units, were subjected to confirmatory factor analysis to test model fit by applying the existing factor structures: (a) four-factor structure for the EDSIS and (b) five-factor structure for the AESED. Results: Confirmatory factor analytic results support the existing four-factor and five-factor structures for the EDSIS and the AESED, respectively. Discussion: The present findings provide further validation of the EDSIS and the AESED as tools to assess modifiable elements of caregiving for someone with an ED.

The Spanish Validation of the Accommodation and Enabling Scale for Eating Disorders Among Carers: A Pilot Study

“…The analysis of the relationships with other variables showed evidence of convergent validity in the correlations of the AESED‐S subscales and the selected variables, which was just as we expected as in line with previous research (Goddard et al, 2011; Hibbs et al, ; Sepúlveda, Todd, et al, ). We found positive and significant correlations between scores on the AESED‐S subscales and the ECI‐negative dimensions, as well as HADS‐Anxiety and HADS‐Depression subscales.…”

“…The development and validation study of the AESED showed that it is a useful tool for evaluating ED carers' accommodation and is also sensitive to change after interventions applied to improve carers' coping skills (Sepúlveda et al, 2009). Recently, research has been published that confirms the factor structure of this questionnaire with data from 268 carers of people with anorexia nervosa and provides further validation of the AESED as a tool to assess modifiable elements of caregiving for someone with an ED (Hibbs et al, ).…”

Parental caregiver burden and recovery of adolescent anorexia nervosa after multi-family therapy

“…Convergent validity has been shown satisfactory, and it is sensitive to a change in symptoms (Sepúlveda et al, 2008). The scale has acceptable to high internal consistency (Cronbach's alpha = 0.84 to 0.91) across the four subscales (Hibbs et al, 2014;Sepúlveda et al, 2008). In the present study, internal consistency (Cronbach's alpha) at base-line was 0.62 (mothers) and 0.58 (fathers) for nutrition, 0.88 (mothers) and 0.79 (fathers) for guilt, 0.71 (mothers) and 0.81 (fathers) for dealing with dysregulated behaviors, and 0.83 (mothers) and 0.88 (fathers) for social isolation.…”

Interventions for the Carers of Patients With Eating Disorders

“…These include the Eating Disorders Symptom Impact Scale (EDSIS), which measures burden [ 27 ]. The Accommodation and Enabling Scale for Eating Disorders (AESED) which measures the tendency of the family to collude with the patient [ 28 , 29 ]. The Caregiver Skills (CASK) scale measures modifiable aspects of caregiver behaviour that, according to the New Maudsley model, are thought to improve outcomes [ 30 ].…”