Abstract
Despite considerable examination of the Children’s Eating Attitudes Test (ChEAT) in Western societies, there is no study about the ChEAT in Iran. The purpose of the current study was to translate and examine the factor structure and measurement invariance of the Farsi version of the ChEAT (F-ChEAT) among Iranian preadolescents. Iranian preadolescents (N = 717) completed the F-ChEAT and demographic information. Exploratory structural equation modeling (ESEM) was used to examine the factor structure and measurement invariance across gender and age. A 5-factor, 15-item ESEM model showed an excellent fit of the data. Tests of measurement invariance suggested that scores on the latent means could be meaningfully compared across gender and age. Girls had higher latent means on the Food Preoccupation and Caloric Awareness and Control factors, and older preadolescents had higher latent means on all the F-ChEAT factors, except for the Dieting factor. Findings suggest that a 5-factor, 15-item ESEM model of the F-ChEAT was a useful assessment tool to understand disordered eating symptoms in Iranian preadolescents.
Similar content being viewed by others
References
Campbell K, Peebles R (2014) Eating disorders in children and adolescents: state of the art review. Pediatrics 134(3):582–592. https://doi.org/10.1542/peds.2014-0194
Deleel ML, Hughes TL, Miller JA, Hipwell A, Theodore LA (2009) Prevalence of eating disturbance and body image dissatisfaction in young girls: an examination of the variance across racial and socioeconomic groups. Psychol Sch 46(8):767–775. https://doi.org/10.1002/pits.20415
Herle M, Stavola B, Hübel C, Abdulkadir M, Ferreira DS, Loos RJF et al (2019) A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses. Br J Psychiatry 5:1–7. https://doi.org/10.1192/bjp.2019.174
Evans EH, Adamson AJ, Basterfield L, Le Couteur A, Reilly JK, Reilly JJ et al (2017) Risk factors for eating disorder symptoms at 12 years of age: a 6-year longitudinal cohort study. Appetite 108:12–20. https://doi.org/10.1016/j.appet.2016.09.005
Combs JL, Pearson CM, Zapolski TCB, Smith GT (2013) Preadolescent disordered eating predicts subsequent eating dysfunction. J Pediatr Psychol 38(1):41–49. https://doi.org/10.1093/jpepsy/jss094
Smink FR, van Hoeken D, Hoek HW (2012) Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 14(4):406–414. https://doi.org/10.1007/s11920-012-0282-y
Sahlan RN, Saunders JF, Fitzsimmons-Craft EE (2021) Body-, eating-, and exercise-related social comparison behavior and disordered eating in college women in the U.S. and Iran: a cross-cultural comparison. Eat Behav 40:101451. https://doi.org/10.1016/j.eatbeh.2020.101451
Mohammadi MR, Mostafavi SA, Hooshyari Z, Khaleghi A, Ahmadi N, Molavi P et al (2020) Prevalence, correlates and comorbidities of feeding and eating disorders in a nationally representative sample of Iranian children and adolescents. Int J Eat Disord 53(3):349–361. https://doi.org/10.1002/eat.23197
Kaufman J, Birmaher B, Brent DA, Ryan ND, Rao U (2000) K-SADS-PL. J Am Acad Child Adolesc Psychiatry 39(10):1208. https://doi.org/10.1097/00004583-200010000-00002
Maloney MJ, McGuire JB, Daniels SR (1988) Reliability testing of a children’s version of the eating attitude test. J Am Acad Child Adolesc Psychiatry 27(5):541–543. https://doi.org/10.1097/00004583-198809000-00004
Garner DM, Olmsted MP, Bohr Y, Garfinkel PE (1982) The eating attitudes test: psychometric features and clinical correlates. Psychol Med 12(4):871–878. https://doi.org/10.1017/s0033291700049163
Jalali-Farahani S, Chin YS, Mohd Nasir MT, Amiri P (2015) Disordered eating and its association with overweight and health-related quality of life among adolescents in selected high schools of Tehran. Child Psychiatry Hum Dev 46(3):485–492. https://doi.org/10.1007/s10578-014-0489-8
Naeimi AF, Haghighian HK, Gargari BP, Alizadeh M, Rouzitalab T (2016) Eating disorders risk and its relation to self-esteem and body image in Iranian university students of medical sciences. Eat Weight Disord 21(4):597–605. https://doi.org/10.1007/s40519-016-0283-7
Kelly C, Ricciardelli LA, Clarke JD (1999) Problem eating attitudes and behaviors in young children. Int J Eat Disord 25(3):281–286. https://doi.org/10.1002/(sici)1098-108x(199904)25:3%3c281::aid-eat5%3e3.0.co;2-t
Lynch WC, Eppers-Reynolds K (2005) Children’s eating attitudes test: revised factor structure for adolescent girls. Eat Weight Disord 10(4):222–235. https://doi.org/10.1007/bf03327489
Williamson D, DeLany J, Bentz BG, Bray G, Champagne C, Harsha D (1997) Gender and racial differences in dieting and social pressures to gain weight among children. J Gend Cult Health 2:231–244
Theuwis L, Moens E, Braet C (2010) Psychometric quality of the Dutch version of the Children’s Eating Attitude Test in a community sample and a sample of overweight youngsters. Psychol Belg 49(4):311–330. https://doi.org/10.5334/pb-49-4-311
Legendre M, Côté M, Aimé A, Brault MC, Dion J, Bégin C (2021) The Children’s Eating Attitudes Test: French validation of a short version. Eat Weight Disord. https://doi.org/10.1007/s40519-021-01158-9
Lommi S, Viljakainen HT, Weiderpass E, de Oliveira Figueiredo RA (2020) Children’s Eating Attitudes Test (ChEAT): a validation study in Finnish children. Eat Weight Disord 25(4):961–971. https://doi.org/10.1007/s40519-019-00712-w
Teixeira MDCB, Pereira ATF, Saraiva JMT, Marques M, Soares MJ, Bos SC et al (2012) Portuguese validation of the Children’s Eating Attitudes Test. Arch Clin Psychiatry (São Paulo) 39(6):189–193. https://doi.org/10.1590/S0101-60832012000600002
Sancho C, Asorey O, Arija V, Canals J (2005) Psychometric characteristics of the Children’s Eating Attitudes Test in a Spanish sample. Eur Eat Disord Rev 13(5):338–343. https://doi.org/10.1002/erv.643
Senra C, Seoane G, Vilas V, Sánchez-Cao E (2007) Comparison of 10- to 12-year-old boys and girls using a Spanish version of the Children’s Eating Attitudes Test. Pers Individ Differ 42(6):947–957. https://doi.org/10.1016/j.paid.2006.09.005
Murphy TJ, Hwang H, Kramer MS, Martin RM, Oken E, Yang S (2019) Assessment of eating attitudes and dieting behaviors in healthy children: confirmatory factor analysis of the Children’s Eating Attitudes Test. Int J Eat Disord 52(6):669–680. https://doi.org/10.1002/eat.23062
Chiba H, Nagamitsu S, Sakurai R, Mukai T, Shintou H, Koyanagi K et al (2016) Children’s Eating Attitudes Test: reliability and validation in Japanese adolescents. Eat Behav 23:120–125. https://doi.org/10.1016/j.eatbeh.2016.09.001
Rojo-Moreno L, García-Miralles I, Plumed J, Barberá M, Morales MM, Ruiz E et al (2011) Children’s Eating Attitudes Test: validation in a sample of Spanish school children. Int J Eat Disord 44(6):540–546. https://doi.org/10.1002/eat.20855
Pilecki M, Kowal M, Woronkowicz A, Kryst Ł, Sobiecki J (2013) Psychometric properties of Polish version of the Children’s Eating Attitudes Test. Arch Psychiatry Psychother 15(1):35–43
Marsh HW, Muthén B, Asparouhov T, Lüdtke O, Robitzsch A, Morin AJS et al (2009) Exploratory structural equation modeling, integrating CFA and EFA: application to students’ evaluations of university teaching. Struct Equ Model 16(3):439–476. https://doi.org/10.1080/10705510903008220
Marsh HW, Lüdtke O, Nagengast B, Morin AJ, Von Davier M (2013) Why item parcels are (almost) never appropriate: two wrongs do not make a right–camouflaging misspecification with item parcels in CFA models. Psychol Methods 18(3):257–284. https://doi.org/10.1037/a0032773
Marsh HW, Morin AJ, Parker PD, Kaur G (2014) Exploratory structural equation modeling: an integration of the best features of exploratory and confirmatory factor analysis. Annu Rev Clin Psychol 10:85–110. https://doi.org/10.1146/annurev-clinpsy-032813-153700
Asparouhov T, Muthén B (2009) Exploratory structural equation modeling. Struct Equ Model 16(3):397–438. https://doi.org/10.1080/10705510903008204
Anton SD, Han H, Newton RL Jr, Martin CK, York-Crowe E, Stewart TM et al (2006) Reformulation of the Children’s Eating Attitudes Test (ChEAT): factor structure and scoring method in a non-clinical population. Eat Weight Disord 11(4):201–210. https://doi.org/10.1007/bf03327572
Bernier CD, Kozyrskyj AL, Benoit C, Becker AB, Marchessault G (2010) Body image and dieting attitudes among preadolescents. Can J Diet Pract Res 71(3):e34-40. https://doi.org/10.3148/71.3.2010.122
Fairburn CG, Beglin SJ (2008) Eating Disorder Examination Questionnaire (EDE-Q 60). In: Fairburn CG (ed) Cognitive behavior therapy and eating disorders. Guilford Press, New York, pp 309–313
Sahlan RN, Saunders JF, Perez M, Blomquist KK, Fitzsimmons-Craft EE, Bodell LP (2021) The validation of a Farsi version of the Loss of Control over Eating Scale (F-LOCES) among Iranian adolescent boys and girls. Eat Behav 41:101502. https://doi.org/10.1016/j.eatbeh.2021.101502
Sahlan RN, Saunders JF, Perez M, Blomquist KK, Fitzsimmons-Craft EE, Bodell LP (2021) The validation of a Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescent boys and girls. Eat Weight Disord. https://doi.org/10.1007/s40519-021-01204-6
Erickson SJ, Gerstle M (2007) Developmental considerations in measuring children’s disordered eating attitudes and behaviors. Eat Behav 8(2):224–235. https://doi.org/10.1016/j.eatbeh.2006.06.003
Sahlan RN, Saunders JF, Mond JM, Fitzsimmons-Craft EE (2021) Eating disorder symptoms among adolescent boys and girls in Iran. Int J Eat Disord 54(1):19–23. https://doi.org/10.1002/eat.23420
Sahlan RN, Williams BM, Forrest LN, Saunders JF, Fitzsimmons-Craft EE, Levinson CA (2021) Disordered eating, self-esteem, and depression symptoms in Iranian adolescents and young adults: a network analysis. Int J Eat Disord 54(2):132–147. https://doi.org/10.1002/eat.23365
Kee C, Lim K, Sumarni M, Teh C, Chan Y, Hafizah MN et al (2017) Validity of self-reported weight and height: a cross-sectional study among Malaysian adolescents. BMC Med Res Methodol 17(1):1–8. https://doi.org/10.1186/s12874-017-0362-0
World Health Organization (2007) Growth reference 5–19 years: BMI-for-age (5–19 years). Peжим дocтyпy: http://www.who.int/growthref/who2007_bmi_for_age/en
Brislin RW (1986) The wording and translation of research instruments. In: Lonner W, Berry J (eds) Field methods in cross-cultural research. Sage, Beverly Hills, pp 137–164
Cha ES, Kim KH, Erlen JA (2007) Translation of scales in cross-cultural research: issues and techniques. J Adv Nurs 58(4):386–395. https://doi.org/10.1111/j.1365-2648-2007.04242.x
Herdman M, Fox-Rushby J, Badia X (1997) ‘Equivalence’ and the translation and adaptation of health-related quality of life questionnaires. Qual Life Res 6(3):237–247. https://doi.org/10.1023/a1026410721664
Muthén LK, Muthén BO (1998–2017) Mplus User’s Guide. Muthén & Muthén, Los Angeles
Lt Hu, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model 6(1):1–55. https://doi.org/10.1080/10705519909540118
Chen FF (2007) Sensitivity of goodness of fit indexes to lack of measurement invariance. Struct Equ Model 14(3):464–504. https://doi.org/10.1080/10705510701301834
George D, Mallery P (2003) SPSS for Windows step by step: a simple guide and reference, 11.0 update. Allyn and Bacon, Boston
Dunn TJ, Baguley T, Brunsden V (2014) From alpha to omega: a practical solution to the pervasive problem of internal consistency estimation. Br J Psychol 105(3):399–412. https://doi.org/10.1111/bjop.12046
McDonald RP (1999) Test theory: a unified treatment. Erlbaum, Mahwah
Kline RB (2011) Principles and practice of structural equation modeling, 3rd edn. Guilford Press, New York
Ambrosi-Randić N, Pokrajac-Bulian A (2005) Psychometric properties of the Eating Attitudes Test and Children’s Eating Attitudes Test in Croatia. Eat Weight Disord 10(4):e76-82. https://doi.org/10.1007/bf03327495
Sahlan RN, Akoury LM, Taravatrooy F (2020) Validation of a Farsi version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (F-SATAQ-4) in Iranian men and women. Eat Behav 39:101438. https://doi.org/10.1016/j.eatbeh.2020.101438
Hatami M, Mohd Taib MN, Jamaluddin R, Abu Saad H, Djazayery A (2013) Body change techniques in Iranian adolescents. Relationship to sex and body weight status. Appetite 60(1):27–32. https://doi.org/10.1016/j.appet.2012.10.014
Edlund B, Hallqvist G, Sjödén PO (1994) Attitudes to food, eating and dieting behaviour in 11 and 14-year-old Swedish children. Acta paediatr 83(6):572–577. https://doi.org/10.1111/j.1651-2227.1994.tb13084.x
Gerbasi ME, Richards LK, Thomas JJ, Agnew-Blais JC, Thompson-Brenner H, Gilman SE et al (2014) Globalization and eating disorder risk: peer influence, perceived social norms, and adolescent disordered eating in Fiji. Int J Eat Disord 47(7):727–737. https://doi.org/10.1002/eat.22349
Gratwick-Sarll K, Bentley C, Harrison C, Mond J (2016) Poor self-recognition of disordered eating among girls with bulimic-type eating disorders: cause for concern? Early Interv Psychiatry 10(4):316–323. https://doi.org/10.1111/eip.12168
Field AE, Austin SB, Taylor CB, Malspeis S, Rosner B, Rockett HR et al (2003) Relation between dieting and weight change among preadolescents and adolescents. Pediatrics 112(4):900–906. https://doi.org/10.1542/peds.112.4.900
Sinton MM, Birch LL (2005) Weight status and psychosocial factors predict the emergence of dieting in preadolescent girls. Int J Eat Disord 38(4):346–354. https://doi.org/10.1002/eat.20176
McCabe MP, Ricciardelli LA, Holt K (2005) A longitudinal study to explain strategies to change weight and muscles among normal weight and overweight children. Appetite 45(3):225–234. https://doi.org/10.1016/j.appet.2005.07.009
McCreary DR, Sasse DK (2000) An exploration of the drive for muscularity in adolescent boys and girls. J Am Coll health 48(6):297–304. https://doi.org/10.1080/07448480009596271
Sahlan RN, Blomquist KK, Bodell LP (2022) Psychometric properties of the Farsi version of the Eating Pathology Symptoms Inventory (F-EPSI) among Iranian University men and women. J Eat Disord 10(1):67. https://doi.org/10.1186/s40337-022-00587-w
Elizathe L, Murawski B, Arana F, Rutsztein G (2011) Propiedades Psicométricas del Children’s Eating Attitudes Test (ChEAT): Una escala de identificación de riesgo de trastornos alimentarios en niños. Revista Evaluar 11:18–39. https://doi.org/10.35670/1667-4545.v11.n1.2840
Acknowledgements
We thank the preadolescents who participated in the study, as well as the teachers and principals of the schools.
Funding
No funding was received for conducting this study.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study design. Material preparation and data collection were performed by RNS. Data analysis was performed by RNS and KNS. The first draft of the manuscript was written by RNS. All authors (RNS, KNS, JES) contributed to subsequent versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
This study attained Institutional Review Board approval and complied with all ethical guidelines by the Iran University of Medical Sciences. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Parental consent was obtained for the preadolescents who were interested in the study, and informed consent was obtained from the individual participants as well.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendix
Appendix
Items of the Children’s Eating Attitudes Test (ChEAT) in Farsi.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Sahlan, R.N., Serier, K.N. & Smith, J.E. Using Exploratory Structural Equation Modeling (ESEM) To Examine the Factor Structure and Measurement Invariance of the Farsi Version of the Children’s Eating Attitudes Test (F-ChEAT) among Iranian Preadolescents Across Gender and Age. Child Psychiatry Hum Dev (2022). https://doi.org/10.1007/s10578-022-01466-w
Accepted:
Published:
DOI: https://doi.org/10.1007/s10578-022-01466-w