The Psychometric Properties of the Eating Attitudes Test Short Form (EAT-26) in a College Sample
Fatıma Elif Ergüney Okumuş, Hanife Özlem Sertel BerkDetermining risk groups is an essential element of preventive studies in eating disorders. In this regard, the Eating Attitudes Test Short Form developed by Garner, Olmstad, Bohr, & Garfinkel (1982) is the most commonly used scale all around the world. Hence, the aim of this study is to investigate the psychometric properties of the Turkish version of Eating Attitudes Test-26 (EAT-26). A total of fifteen hundred voluntary college students (1000 in the first phase for exploratory factor analyses and 500 in the second phase for confirmatory factor analyses and other validity and reliability analyses) enrolled in the study. The Eating Attitudes Test-40 (EAT-40), Brief Symptom Inventory, and Eating Disorders Examination Questionnaire were used for analyzing the validity of EAT-26. Concurrent validity, discriminant validity, and factor analyses were calculated. In terms of reliability, Cronbach’s Alpha Coefficient Analyses and test-retest methods were used. Exploratory factor analyses showed that the items of EAT-26 loaded on three factors that explained 38.5% of total variance. These factors are Preoccupation with eating, Restriction, and Social Pressure. Confirmatory factor analyses of these three factors yielded close to acceptable goodness of fit values. EAT-26 was significantly correlated with Eating Attitudes Test-40, EAT-26, and Brief Symptom Inventory in a positive direction. Participants with a higher score in EAT-26 reported significantly higher scores in the Eating Disorder Examination Questionnaire and Brief Symptom Inventory. The Turkish version of Eating Attitudes Test-26 demonstrated good internal consistency (Cronbach’s Alpha = .84), and the test re-test reliability was .78. The study provides initial support for the reliability and validity of the Turkish version of EAT-26. Nevertheless, future research is needed for the crossvalidation of Eating Attitudes Test-26 in clinical samples.
Yeme Tutum Testi Kısa Formunun (YTT-26) Üniversite Örnekleminde Türkçeye Uyarlanması ve Psikometrik Özelliklerinin Değerlendirilmesi
Fatıma Elif Ergüney Okumuş, Hanife Özlem Sertel BerkYeme bozukluğunu önleme çalışmalarında özellikle risk gruplarının belirlenmesi önem taşımaktadır. Bu çalışmanın amacı Garner, Olmstad, Bohr ve Garfinkel (1982) tarafından geliştirilen ve riskli yeme tutumlarının araştırılmasında tüm dünyada en yaygın kullanılan ölçeklerden Yeme Tutum Testi’nin kısa formu olan Yeme Tutum Testi-26’nın (YTT-26) Türkçeye uyarlanmasıdır. Araştırmaya açımlayıcı faktör analizinin yapıldığı ilk aşamada 1000, doğrulayıcı faktör analizinin ve diğer geçerlik-güvenirlik analizlerinin yapıldığı ikinci aşamada 500 olmak üzere toplamda 1500 üniversite öğrencisi katılmıştır. Çalışmada Yeme Tutum Testi 26’ya ek olarak, geçerlik sınamaları amacıyla Yeme Bozukluğu Değerlendirme Ölçeği, Kısa Semptom Envanteri, Yeme Tutum Testi-40 da kullanılmıştır. Ölçeğin geçerliği; yapı geçerliği kapsamında faktör analizi, yakınsak geçerlik ve ayırıcı geçerlik yöntemleriyle, güvenirliği ise iç tutarlık analizi ve test-tekrar test yöntemiyle değerlendirilmiştir. Yeme Tutum Testi-26 için yapılan açımlayıcı faktör analizi sonuçları toplam varyansın %38.5’ini açıklayan Yeme Meşguliyeti, Kısıtlama ve Sosyal Baskı olarak adlandırılan üç faktörlü bir yapı ortaya koymuştur. Doğrulayıcı faktör analizi ise bu 3 faktörlü yapının uyum değerlerinin kabul edilebilir düzeye yakın olduğunu göstermiştir. Yeme Tutum Testi-26 ile Yeme Tutum Testi-40, Yeme Bozukluğu Değerlendirme Ölçeği ve Kısa Semptom Envanteri’nin ilgili faktörleri arasında pozitif yönde anlamlı korelasyonlar bulunmuştur. Ayrıca YTT-26’dan kesme puanın üzerinde alanlar ile kesme puanın altında alanların Yeme Bozukluğu Değerlendirme Ölçeği ve Kısa Semptom Envanteri skorları anlamlı düzeyde farklılaşmıştır. Ölçeğin Cronbach Alpha iç tutarlık katsayısı .84, test-tekrar test durağanlık katsayısı ise .78 olarak bulunmuştur. Araştırma sonuçları, ölçeğin yeme tutumlarını değerlendirmede geçerli ve güvenilir bir ölçüm aracı olarak kullanılabileceğine dair önemli bulgular sunmaktadır. İleriki çalışmalarda farklı örneklemlerde ve klinik gruplarda ölçeğin çapraz geçerliğinin araştırılması önem taşımaktadır.
Eating Disorders (ED) are one of the prevalent problems among youth that affect health in multiple ways. The main psychopathology of ED is characterized with disordered eating behaviors and negative body image (Fairburn, 2008). Eating attitudes can be defined as cognitions and emotions about eating that indicate eating behaviors. Previous research shows that disordered eating attitudes are related with ED symptoms and general psychopathology both in clinical and community samples (Lai et al., 2013; Usta, Sağlam, Şen, Aygün, & Sert, 2015). Hence, it is important to screen eating attitudes especially for preventive studies in risk groups such as college students. That highlights the importance of the Eating Attitudes Test (EAT) as the most common used scale for screening ED all around the world (Garner & Garfinkel, 1979; Garner et al. 1982). It was originally developed for detecting anorexia nervosa symptoms and its short form EAT-26 is used in both clinical and non-clinical samples. It is also presented that, there is a higher probability of having an ED diagnosis in the non-clinical samples that have scores above than cut-off score from EAT-26 (Mintz & O’Halloran, 2000). The 40-item version of EAT was adapted to Turkish by Savaşır and Erol (1989), although there are some studies that used the short form of EAT, the scale as a whole was not thoroughly investigated in terms of its psychometric features. Therefore, the aim of this study is to examine the validity and reliability of EAT-26 in a Turkish collage sample.
Method
In the translation process, after two psychologists with an advanced English level independently translated the scale into Turkish, the two linguists back translated the scale, and it was sent to its developer for further review and necessary changes were made. A total of 1500 voluntary college students from a variety of universities located in six different cities of Turkey enrolled in the study. The research battery included EAT-26, EAT-40, Brief Symptom Inventory (BSI) and Eating Disorders Examination Questionnaire (EDE-Q). The structural validity of EAT-26 and the Cronbach’s Alpha Coefficient Analyses were conducted with two different samples. In order to examine the validity and the reliability of EAT-26, exploratory factor analyses was performed with the data taken from the sample of 1000 students; confirmatory factor analyses, concurrent validity, discriminant validity, and testretest methods were used with the data taken from a sample of 500 students.
Results
Firstly, according to the findings of exploratory factor analyses, it was determined that the scale had a three-factor structure as in the original version, but the contents are different. Internal consistency analysis indicated that the Cronbach’s Alpha value of the scale was .84. The results of confirmatory factor analysis showed that the three-factor structure of EAT-26 consisting of Preoccupation with eating, Restricting, and Social Pressure were confirmed. In terms of concurrent validity, EAT-26 was significantly correlated with EAT-40, EDE-Q and BSI (r (398)=.48, r (398)=.65, r (398)=.22, p< .001, respectively). Furthermore, participants with a higher score (>20) in EAT-26 reported significantly higher scores in EDE-Q and BSI (Z=26.77, p<.001; Z=9.05, p<.01, respectively). Finally, 134 participants completed EAT-26 in a twoweek period and the test re-test reliability was found .78. The results indicated from these analyses can be evaluated as evidence for the validity and reliability of EAT-26.
Discussion
EAT-26 is the most common used scale for screening disordered eating attitudes all around the world. The factor analyses yielded a 3-factor structure that includes a preoccupation with eating, restricting and social pressure. These factors have similarities with both the findings of previous adaptation studies (Elal, Altuğ, Slade, & Tekcan, 2000; Rogoza, Brytek-Matera, & Garner, 2016), and eating psychopathology (American Psychiatric Association, 2013; Fairburn, 2008), although it was noted that the factorial structure of EAT-26 is variable. Further analysis also supported the validity of scale as it was positively correlated with eating disorder and psychopathology scores. Moreover, the cut off score significantly differentiated the sample in terms of eating disorders symptoms and psychopathology scores. Lastly, both the internal consistency and test re-test analyses showed acceptable levels of reliability. Nevertheless, future research is needed for the cross-validation of EAT-26 in clinical samples. It should also be noted that the results of this study are limited only to the data obtained from the participants that enrolled in this study. Overall, the study provides initial support for the reliability and validity of the Turkish version of EAT-26 for screening disordered eating attitudes.
