Establishing the optimal male cut-off point: confirmatory factor analysis of the eating disorder examination-questionnaire (EDE-Q) in a representative sample of Spanish university students

Abstract

Purpose Although the EDE-Q is derived from the "gold standard" for the assessment of Eating Disorders (ED), its factor structure is controversial, particularly in male samples. The aim of the study was to examine the psychometric properties and factor structure of the EDE-Q, as well to stablish a sensitive and speci c cut-off point validated by EDE clinical interview.Methods A series of Con rmatory Factor Analyses were performed among a representative sample of 796 male university students, of whom 139 were interviewed. Sensitivity and speci city were calculated by Receiver Operating Characteristic (ROC) analysis to determinate the most appropriate cut-off value.Results The original factor structure was not con rmed, showing a better t with a 2-factor solution. For the Spanish male sample, a cut-off ≥ 1.09 for at-risk of ED cases and ≥ 2.41 for clinical cases presents an optimal balance between sensitivity and speci city.Conclusions The establishment of speci c cut-off points for males may help to reduce the underdiagnosis of ED in this population.Level of evidence III Evidence obtained from well-designed case-control study.

Gender Differences in Treatment Outcomes for Eating Disorders: A Case-Matched, Retrospective Pre–Post Comparison

“…Studies reveal that men with EDs, compared to women, are often less concerned with thinness [ 22 , 23 , 24 ], seek to increase body mass and muscularity instead [ 25 , 26 ], and may also present with different patterns in emotion regulation [ 27 ]. Given that established assessment tools rarely address men-associated ED symptoms, recent developments include men-oriented norms and extensions for established ED questionnaires [ 28 , 29 , 30 ] as well as men-specific assessment instruments [ 31 , 32 , 33 , 34 ].…”

Strengths and weaknesses of the German translation of the Inflexible Eating Questionnaire and of eating disorder assessment in general

“…Note that the original version of the EDE-Q scored item 8 on both the WC and the SC subscale. This within-item-multidimensionality caused estimation problems in our analyses (not positive definite covariance matrix), so that we assigned this item to WC only (the same problem has been reported Rica et al, 2022 , for example). Even assigning item 8 only to the WC or the SC subscale (because the item addresses both weight and shape concerns), respectively, still yielded a not positive definite covariance matrix.…”

“…This is in line with prominent theories of body image (e.g., self-discrepancy theory, objectification theory; Cash, 2012 ; Vartanian, 2012 ). In addition, Penelo et al ( 2013 ) and Rica et al ( 2022 ) reported a 2-factorial structure (RS and EC+WC+SC). Moreover, in some analyses items were dropped from the final solution (see Rand-Giovannetti et al, 2020 Table 1 for an overview), so that no overarching latent structure is discernible for the instrument.…”

Physical Appearance Perfectionism: Psychometric Properties and Factor Structure of an Assessment Instrument in a Representative Sample of Males

“…Eating Disorder Examination Questionnaire (EDE-Q; Fairburn and Beglin, 1994;Peláez-Fernández et al, 2012;Rica et al, 2021): The questionnaire has 28 items, that asks directly about attitudes related to key features of ED psychopathology in a 28-day time frame. The same four subscales (i.e., Restraint, Eating concern, Weight concern and Shape concern), of the EDE interview are calculated through 22 attitudinal items, and responses are given on a 7-point Likert-type scale from 0 (never) to 6 (every day).…”