Parental Behavior as a Risk Factor for Eating Disorders: Development of a Measurement Instrument

Authors

DOI:

https://doi.org/10.18050/psiquemag.v14i2.3561

Keywords:

Eating disorders, Risk factor, Psychometric assessment, Body image, Teenagers

Abstract

Eating disorders (ED) are complex conditions influenced by psychological, biological, and sociocultural factors, with parental influence playing a key role in their onset and maintenance. However, no specific instruments assess how parental behaviors may act as risk factors for the development of ED. This study aimed to design and validate an instrument to measure these behaviors from the adolescents' perspective. An instrumental study was conducted with a sample of 300 high school students to whom the initial version of the instrument was administered. Content validity was evaluated using Aiken's V, which allowed the selection of 14 items with adequate coherence, representativeness, and clarity. Exploratory Factor Analysis (EFA) and Exploratory Graph Analysis (EGA) were performed to determine the structure of the instrument. The results indicated a unidimensional model with factor loadings greater than 0.50 for each item. Adequate reliability (α = .90; ω = .90) and 100% stability in network resampling were achieved. These findings confirm that the instrument is valid and reliable for assessing parental influence on EDs. Its application may contribute to the early detection of risk factors and facilitate the development of prevention and intervention strategies in clinical and educational contexts.

Downloads

Download data is not yet available.

References

Aiken, L. R. (1980). Content Validity and Reliability of Single Items or Questionnaires. Educational and Psychological Measurement, 40(4), 955–959. https://doi.org/10.1177/001316448004000419

Allen, K. L., Byrne, S. M., Forbes, D., & Oddy, W. H. (2009). Risk Factors for Full- and Partial-Syndrome Early Adolescent Eating Disorders: A Population-Based Pregnancy Cohort Study. Journal of the American Academy of Child & Adolescent Psychiatry, 48(8), 800–809. https://doi.org/10.1097/CHI.0b013e3181a8136d

Almanasreh, E., Moles, R., & Chen, T. F. (2019). Evaluation of methods used for estimating content validity. Research in Social and Administrative Pharmacy, 15(2), 214–221. https://doi.org/10.1016/j.sapharm.2018.03.066

Ato, M., López, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3), 1038–1059. https://doi.org/10.6018/analesps.29.3.178511

Arauco-Lozada, T., Yupanqui-Lorenzo, D. E., & Ottiniano-Malaga, T. (2024). Development and Validation of the Binge Eating Disorder Scale (BEDS). Nutrición Clínica y Dietética Hospitalaria, 44(2). https://doi.org/10.12873/442arauco

Arija Val, V., Santi Cano, M. J., Novalbos Ruiz, J. P., Canals, J., & Rodríguez Martín, A. (2022). Characterization, epidemiology and trends of eating disorders. Nutrición Hospitalaria. https://doi.org/10.20960/nh.04173

Arjona, Á., Monserrat, M., & Checa, J. C. (2024). Use of Social Media, Satisfaction with Body Image, and the Risk of Manifesting Eating Disorders. Social Sciences, 13(2), 105. https://doi.org/10.3390/socsci13020105

Beck, C. T., & Gable, R. K. (2001). Ensuring Content Validity: An Illustration of the Process. Journal of Nursing Measurement, 9(2), 201–215. https://doi.org/10.1891/1061-3749.9.2.201

Brown, T. A., Forney, K. J., Klein, K. M., Grillot, C., & Keel, P. K. (2020). A 30-year longitudinal study of body weight, dieting, and eating pathology across women and men from late adolescence to later midlife. Journal of Abnormal Psychology, 129(4), 376–386. https://doi.org/10.1037/abn0000519

Carvalho, P. H. B. de, & Ferreira, M. E. C. (2020). Disordered eating and body change behaviours: support for the Tripartite Influence Model among Brazilian male university students. Ciência & Saúde Coletiva, 25(11), 4485–4495. https://doi.org/10.1590/1413-812320202511.35572018

Cella, S., Iannaccone, M., & Cotrufo, P. (2020). Does body shame mediate the relationship between parental bonding, self-esteem, maladaptive perfectionism, body mass index and eating disorders? A structural equation model. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 25(3), 667–678. https://doi.org/10.1007/s40519-019-00670-3

Christensen, A. P. (2020). Towards a Network Psychometrics Approach to Assessment: Simulations for Redundancy, Dimensionality, and Loadings. https://doi.org/10.31234/osf.io/84kgd

Christensen, A. P., & Golino, H. F. (2021). Estimating the Stability of Psychological Dimensions via Bootstrap Exploratory Graph Analysis: A Monte Carlo Simulation and Tutorial. Psych, 3(3), 479–500. https://doi.org/10.3390/psych3030032

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Lawrence Erlbaum Associates. http://utstat.toronto.edu/~brunner/oldclass/378f16/readings/CohenPower.pdf

Costello, A. B., & Osborne, J. W. (2005). Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most From Your Analysis. Practical Assessment, Research, and Evaluation, 10(1). https://doi.org/10.7275/jyj1-4868

D’Anna, G., Lazzeretti, M., Castellini, G., Ricca, V., Cassioli, E., Rossi, E., Silvestri, C., & Voller, F. (2022). Risk of eating disorders in a representative sample of Italian adolescents: prevalence and association with self-reported interpersonal factors. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 27(2), 701–708. https://doi.org/10.1007/s40519-021-01214-4

Dahill, L. M., Touyz, S., Morrison, N. M. V., & Hay, P. (2021). Parental appearance teasing in adolescence and associations with eating problems: a systematic review. BMC Public Health, 21(1), 450. https://doi.org/10.1186/s12889-021-10416-5

Davis, C., Shuster, B., Blackmore, E., & Fox, J. (2004). Looking good—family focus on appearance and the risk for eating disorders. International Journal of Eating Disorders, 35(2), 136–144. https://doi.org/10.1002/eat.10250

Drury, C. R., Hail, L., Rienecke, R. D., Accurso, E. C., Coelho, J. S., Lock, J., Le Grange, D., & Loeb, K. L. (2023). Psychometric properties of the Parent Eating Disorder Examination Questionnaire. International Journal of Eating Disorders, 56(9), 1730–1742. https://doi.org/10.1002/eat.23999

Eisenberg, M. E., Berge, J. M., Fulkerson, J. A., & Neumark-Sztainer, D. (2012). Associations between hurtful weight-related comments by family and significant other and the development of disordered eating behaviors in young adults. Journal of Behavioral Medicine, 35(5), 500–508. https://doi.org/10.1007/s10865-011-9378-9

Epskamp, S., Borsboom, D., & Fried, E. I. (2018). Estimating psychological networks and their accuracy: A tutorial paper. Behavior Research Methods, 50(1), 195–212. https://doi.org/10.3758/s13428-017-0862-1

Fernández-Gómez, E., Martín-Salvador, A., Luque-Vara, T., Sánchez-Ojeda, M. A., Navarro-Prado, S., & Enrique-Mirón, C. (2020). Content Validation through Expert Judgement of an Instrument on the Nutritional Knowledge, Beliefs, and Habits of Pregnant Women. Nutrients, 12(4), 1136. https://doi.org/10.3390/nu12041136

Finney, S. J., & DiStefano, C. (2013). Nonnormal and categorical data in structural equation modeling. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (2nd ed., pp. 439–492). IAP Information Age Publishing.

Flora, D. B., & Curran, P. J. (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods, 9(4), 466–491. https://doi.org/10.1037/1082-989X.9.4.466

Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273–279. https://doi.org/10.1017/S0033291700030762

Garner, D. M., Olmstead, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2(2), 15–34. https://doi.org/10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6

Golino, H. F., & Epskamp, S. (2017). Exploratory graph analysis: A new approach for estimating the number of dimensions in psychological research. PLOS ONE, 12(6), e0174035. https://doi.org/10.1371/journal.pone.0174035

Golino, H. F., Shi, D., Garrido, L. E., Christensen, A. P., Nieto, M. D., Sadana, R., Thiyagarajan, J. A., & Martinez-Molina, A. (2018). Investigating the performance of Exploratory Graph Analysis and traditional techniques to identify the number of latent factors: A simulation and tutorial. https://doi.org/10.31234/osf.io/gzcre

Gruber, M., König, D., Holzhäuser, J., Castillo, D. M., Blüml, V., Jahn, R., Leser, C., Werneck-Rohrer, S., & Werneck, H. (2020). Parental feeding practices and the relationship with parents in female adolescents and young adults with eating disorders: A case control study. PLOS ONE, 15(11), e0242518. https://doi.org/10.1371/journal.pone.0242518

Hair, J. F., Risher, J. J., Sarstedt, M., & Ringle, C. M. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31(1), 2–24. https://doi.org/10.1108/EBR-11-2018-0203

Hampshire, C., Mahoney, B., & Davis, S. K. (2022). Parenting Styles and Disordered Eating Among Youths: A Rapid Scoping Review. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.802567

Iannaccone, M., D’Olimpio, F., Cella, S., & Cotrufo, P. (2016). Self-esteem, body shame and eating disorder risk in obese and normal weight adolescents: A mediation model. Eating Behaviors, 21, 80–83. https://doi.org/10.1016/j.eatbeh.2015.12.010

Killen, J. D., Taylor, C. B., Hayward, C., Haydel, K. F., Wilson, D. M., Hammer, L., Kraemer, H., Blair-Greiner, A., & Strachowski, D. (1996). Weight concerns influence the development of eating disorders: A 4-year prospective study. Journal of Consulting and Clinical Psychology, 64(5), 936–940. https://doi.org/10.1037/0022-006X.64.5.936

Kluck, A. S. (2010). Family influence on disordered eating: The role of body image dissatisfaction. Body Image, 7(1), 8–14. https://doi.org/10.1016/j.bodyim.2009.09.009

Kohli, T. (2023). Parenting Styles and its Impact on Eating Disorde. International Journal of Social Science and Economic Research, 08(06), 1458–1464. https://doi.org/10.46609/IJSSER.2023.v08i06.020

Kontele, I., Saripanagiotou, S., Papadopoulou, A. M., Zoumbaneas, E., & Vassilakou, T. (2023). Parental Dieting and Correlation with Disordered Eating Behaviours in Adolescents: A Narrative Review. Adolescents, 3(3), 538–549. https://doi.org/10.3390/adolescents3030038

Lloret-Segura, S., Ferreres-Traver, A., Hernández-Baeza, A., & Tomás-Marco, I. (2014). El análisis factorial exploratorio de los ítems: una guía práctica, revisada y actualizada. Anales de Psicología, 30(3). https://doi.org/10.6018/analesps.30.3.199361

Londoño-Pérez, C., & Moreno Ruge, A. M. (2017). Factores Familiares y Personales Predictores de Trastornos de Conducta Alimentaria en Jóvenes. Anales de Psicología, 33(2), 235. https://doi.org/10.6018/analesps.33.2.236781

López-Gil, J. F., García-Hermoso, A., Smith, L., Firth, J., Trott, M., Mesas, A. E., Jiménez-López, E., Gutiérrez-Espinoza, H., Tárraga-López, P. J., & Victoria-Montesinos, D. (2023). Global Proportion of Disordered Eating in Children and Adolescents. JAMA Pediatrics, 177(4), 363. https://doi.org/10.1001/jamapediatrics.2022.5848

Makki, N., Althubyani, S. A., Mobarki, R. Q., Alsayed, J. A., Almohammadi, R. J., & Baabdullah, R. A. (2023). The Effect of Sociocultural Attitudes on Developing Eating Disorders Among Young Females in Almadinah Almunawarah, Saudi Arabia. Cureus. https://doi.org/10.7759/cureus.50576

Morgan, J. F. (2000). The SCOFF questionnaire: a new screening tool for eating disorders. Western Journal of Medicine, 172(3), 164–165. https://doi.org/10.1136/ewjm.172.3.164

Peleg, O., Tzischinsky, O., & Spivak‐Lavi, Z. (2021). Depression and social anxiety mediate the relationship between parenting styles and risk of eating disorders: A study among Arab adolescents. International Journal of Psychology, 56(6), 853–864. https://doi.org/10.1002/ijop.12787

Revicki, D. (2014). Internal Consistency Reliability. In Encyclopedia of Quality of Life and Well-Being Research (pp. 3305–3306). Springer Netherlands. https://doi.org/10.1007/978-94-007-0753-5_1494

Signorelli, A. (2022). Eating disorders and adolescence. From diagnosis to treatment. RIVISTA SPERIMENTALE DI FRENIATRIA, 146(3), 81–103. https://doi.org/10.3280/RSF2022-003005

Soper, D. S. (2021). A-priori sample size calculator for structural equiation models. https://www.danielsoper.com/statcalc/default.aspx

Toro, J., Salamero, M., & Martinez, E. (1994). Assessment of sociocultural influences on the aesthetic body shape model in anorexia nervosa. Acta Psychiatrica Scandinavica, 89(3), 147–151. https://doi.org/10.1111/j.1600-0447.1994.tb08084.x

Unikel-Santoncini, C., Bojórquez-Chapela, I., & Carreño-García, S. (2004). Validation of a brief questionnaire to measure the risk of abnormal eating behaviors. Salud Publica Mex, 46, 509–515. https://saludpublica.mx/index.php/spm/article/view/6572/8096

Ventura‐León, J., Lluncor‐Vasquez, A., & Chuquillanqui‐Silva, M. (2024). A computer tool for Aiken’s coefficients calculation: Applications in clinical and research settings. Journal of Evaluation in Clinical Practice. https://doi.org/10.1111/jep.14134

Zelkowitz, R. L., & Cole, D. A. (2020). Longitudinal relations of self-criticism with disordered eating behaviors and nonsuicidal self-injury. International Journal of Eating Disorders, 53(7), 1097–1107. https://doi.org/10.1002/eat.23284

Published

2025-12-23

Issue

Section

Research Articles

How to Cite

Gamarra-Tafur, L. Y., Faria-Romero, J. A., Reyes-Cariapaza, D. L., Yupanqui-Lorenzo, D. E., & Figueroa-Quiñones, J. (2025). Parental Behavior as a Risk Factor for Eating Disorders: Development of a Measurement Instrument. PsiqueMag, 14(2), 48-63. https://doi.org/10.18050/psiquemag.v14i2.3561