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Validity and reliability of the Dietary Rules Inventory (DRI)

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Abstract

Background

Dietary rules are common in patients with eating disorders, and according to transdiagnostic cognitive behavioural theory for eating disorders, represent a key behaviour maintaining eating-disorder psychopathology. The aim of this study was to describe the design and validation of the Dietary Rules Inventory (DRI), a new self-report questionnaire that assesses dietary rules in patients with eating disorders.

Methods

A transdiagnostic sample of 320 patients with eating disorders, as well as 95 patients with obesity and 122 healthy controls were recruited. Patients with eating disorders also completed the Dutch Eating Behaviour Questionnaire (DEBQ), the Eating Disorder Examination Questionnaire, the Brief Symptoms Inventory and the Clinical Impairment Assessment. Dietary rules were rated on a continuous Likert-type scale (0–4), rating how often (from never to always) they had been applied over the previous 28 days.

Results

DRI scores were significantly higher in patients with eating disorders than in patients with obesity and healthy controls. Principal factor analysis identified that 55.8% of the variance was accounted for by four factors, namely ‘what to eat’, ‘social eating’, ‘when and how much to eat’ and ‘caloric level’. Both global score and subscales demonstrated high internal and test–retest reliability. The DRI global score was significantly correlated with the DEBQ ‘restrained eating’ subscale, as well as eating-disorder and general psychopathology and clinical impairment scores, demonstrating good convergent validity.

Conclusions

These findings suggest that the DRI is a valid self-report questionnaire that may provide important clinical information regarding the dietary rules underlying dietary restraint in patients with eating disorders.

Level of evidence

V, descriptive study

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Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy

    Simona Calugi, Nicole Morandini, Laura Dametti, Massimiliano Sartirana, Deborah Fasoli & Riccardo Dalle Grave

  2. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

    Chiara Milanese

Authors
  1. Simona Calugi
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  2. Nicole Morandini
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  3. Chiara Milanese
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  4. Laura Dametti
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  5. Massimiliano Sartirana
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  6. Deborah Fasoli
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  7. Riccardo Dalle Grave
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Contributions

RDG and SC contributed to the study conception and design. Material preparation, data collection and analysis were performed by SC, NM, CM, LD, MS and DF. The first draft of the manuscript was written by SC and RDG. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Simona Calugi.

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Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Ethics approval

The protocol was approved by the Ethics Committee of Verona and Rovigo (Project identification code 8571). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate

All the participants provided informed written consent for the anonymous use of their data for research purposes. For minors (<18 years), additional informed consent was provided by their parents.

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Patients signed informed consent regarding publishing their data

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The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Calugi, S., Morandini, N., Milanese, C. et al. Validity and reliability of the Dietary Rules Inventory (DRI). Eat Weight Disord 27, 285–294 (2022). https://doi.org/10.1007/s40519-021-01177-6

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  • DOI: https://doi.org/10.1007/s40519-021-01177-6

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