Journal of Abnormal Child Psychology

, Volume 41, Issue 5, pp 775–788 | Cite as

The Eating Attitudes Test-26 Revisited using Exploratory Structural Equation Modeling

  • Christophe Maïano
  • Alexandre J. S. Morin
  • Marie-Christine Lanfranchi
  • Pierre Therme


Most previous studies have failed to replicate the original factor structure of the 26-item version of the Eating Attitudes Test (EAT-26) among community samples of adolescents. The main objective of the present series of four studies (n = 2178) was to revisit the factor structure of this instrument among mixed gender community samples of adolescents using both exploratory structural equation modeling (ESEM) and confirmatory factor analysis (CFA). First, results from the ESEM analyses provided satisfactory goodness-of-fit statistics and reliability coefficients for a six-factor model of the EAT with 18 items (EAT-18) closely corresponding to the original seven-factor structure proposed for the 40-item version of the EAT. Second, these analyses were satisfactorily replicated among a new sample of community adolescents using CFA. The results confirmed the factor loading and intercept invariance of this model across gender and age groups (i.e., early and late adolescence), as well as the complete invariance of the EAT-18 measurement model between ethnicities (i.e., European versus African origins) and across weight categories (i.e., underweight, normal weight and overweight). Finally, the last study provided support for convergent validity of the EAT-18 with the Eating Disorder Inventory and with instruments measuring global self-esteem, physical appearance, social physique anxiety and fear of negative appearance evaluation.


Disordered eating attitudes and behaviors Eating attitudes test EAT Measurement CFA ESEM Exploratory structural equation modeling Measurement invariance Norms Reliability 

Supplementary material

10802_2013_9718_MOESM1_ESM.doc (300 kb)
ESM 1 (DOC 299 kb)


  1. Anderson, D. A., Lundgren, J. D., Shapiro, J. R., & Paulosky, C. A. (2004). Assessment of eating disorders: review and recommendations for clinical use. Behavior Modification, 28, 763–782.PubMedCrossRefGoogle Scholar
  2. Asparouhov, T., & Muthén, B. (2009). Exploratory structural equation modeling. Structural Equation Modeling, 16, 397–438.CrossRefGoogle Scholar
  3. Belon, K. E., Smith, J. E., Bryan, A. D., Lash, D. N., Winn, J. L., & Gianini, L. M. (2011). Measurement invariance of the eating attitudes test-26 in Caucasian and Hispanic women. Eating Behaviors, 12, 317–320.PubMedCrossRefGoogle Scholar
  4. Berland, N. W., Thompson, J. K., & Linton, P. H. (1986). Correlation between the EAT-26 and the EAT-40, the eating disorders inventory, and the restrained eating inventory. International Journal of Eating Disorders, 5, 569–574.CrossRefGoogle Scholar
  5. Carter, P. I., & Moss, R. A. (1984). Screening for anorexia and bulimia nervosa in a college population: problems and limitations. Addictive Behaviors, 9, 417–419.PubMedCrossRefGoogle Scholar
  6. Chamay-Weber, C., Narring, F., & Michaud, P.-A. (2005). Partial eating disorders among adolescents: a review. Journal of Adolescent Health, 37, 417–427.PubMedCrossRefGoogle Scholar
  7. Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement. Structural Equation Modeling, 14, 464–504.CrossRefGoogle Scholar
  8. Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of fit indexes for testing measurement invariance. Structural Equation Modeling, 9, 233–255.CrossRefGoogle Scholar
  9. Cole, T. J., & Lobstein, T. (2012). Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatric Obesity, 7, 284–294.PubMedCrossRefGoogle Scholar
  10. Cole, T. J., Bellizzi, M., Flegal, K., & Dietz, W. (2000). Overweight and obesity worldwide: international establishing a standard definition for child survey. British Medical Journal, 320, 1240–1243.PubMedCrossRefGoogle Scholar
  11. Cole, T. J., Flegal, K., Nicholls, D., & Jackson, A. (2007). Body mass index cut offs to define thinness in children and adolescents: international survey. British Medical Journal, 335, 194–197.PubMedCrossRefGoogle Scholar
  12. Crawford, J. R., Garthwaite, P. H., & Slick, D. J. (2009). On percentile norms in neuropsychology: proposed reporting standards and methods for quantifying uncertainty over percentile ranks of test scores. The Clinical Neuropsychologist, 23, 1173–1195.PubMedCrossRefGoogle Scholar
  13. Enders, C. K. (2010). Applied missing data analysis. New York: Guilford.Google Scholar
  14. Fabrigar, L. R., Wegener, D., MacCallum, R., & Strahan, E. (1999). Evaluating the use of exploratory factor analysis in psychological reserach. Psychological Methods, 4, 272–299.CrossRefGoogle Scholar
  15. Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509–528.PubMedCrossRefGoogle Scholar
  16. Finney, S. J., & DiStefano, C. (2006). Non-normal and categorical data in structural equation modeling. In G. R. Hancock & R. O. Mueller (Eds.), Structural Equation Modeling: A Second Course (pp. 269–314). Greenwich: IAP.Google Scholar
  17. Garfinkel, P. E., & Newman, A. (2001). The eating attitudes test: twenty-five years later. Eating and Weight Disorders, 6, 1–24.PubMedGoogle Scholar
  18. Garner, D. M., & Garfinkel, P. E. (1979). Eating attitudes test: an index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273–279.PubMedCrossRefGoogle Scholar
  19. Garner, D. M., Olmstead, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitude test: psychometric features and clinical correlates. Psychological Medicine, 12, 871–878.PubMedCrossRefGoogle Scholar
  20. Garner, D. M., Olmstead, M. A., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34.CrossRefGoogle Scholar
  21. Golden, N. H., Katzman, D. K., Kreipe, R. E., Stevens, S. L., Sawyer, S. M., Rees, J., et al. (2003). Eating disorders in adolescents: position paper of the society for adolescent medicine. Journal of Adolescent Health, 33, 496–503.PubMedGoogle Scholar
  22. Hart, E. H., Leary, M. R., & Rejeski, W. J. (1989). The measurement of social physique anxiety. Journal of Sport & Exercise Psychology, 11, 94–104.Google Scholar
  23. Hu, L., & Bentler, P. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.CrossRefGoogle Scholar
  24. Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. C., & Agras, W. S. (2004). Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin, 130, 19–65.PubMedCrossRefGoogle Scholar
  25. Karpowicz, E., Skärsäter, I., & Nevonen, L. (2009). Self-esteem in patients treated for anorexia nervosa. International Journal of Mental Health Nursing, 18, 318–325.PubMedCrossRefGoogle Scholar
  26. Krane, V., Stiles-Shipley, J. A., Waldron, J., & Michalenok, J. (2001). Relationships among body satisfaction, social physique anxiety, and eating behaviors in female athletes and exercisers. Journal of Sport Behavior, 24, 247–264.Google Scholar
  27. Leichner, P., Steiger, H., Puentes-Neuman, G., Perreault, M., & Gottheil, N. (1994). Validation d’une échelle d’attitudes alimentaires auprès d’une population québécoise francophone. Revue Canadienne de Psychiatrie, 39, 49–54.PubMedGoogle Scholar
  28. Little, T. D., Lindenberger, U., & Nesselroade, J. R. (1999). On selecting indicators for multivariate measurement and modeling with latent variables: when “good” indicators are bad and “bad” indicators are good. Psychological Methods, 4, 192–211.CrossRefGoogle Scholar
  29. Lundgren, J. D., Anderson, D. A., & Thompson, J. K. (2004). Fear of negative appearance evaluation: development and evaluation of a new construct for risk factor work in the field of eating disorders. Eating Behaviors, 5, 75–84.PubMedCrossRefGoogle Scholar
  30. MacCallum, R. C., Roznowski, M., & Necowitz, L. B. (1992). Model modifications in covariance structure analysis: the problem of capitalization on chance. Psychological Bulletin, 111, 490–504.PubMedCrossRefGoogle Scholar
  31. MacCallum, R. C., Zhang, S., Preacher, K. J., & Rucker, D. D. (2002). On the practice of dichotomization of quantitative variables. Psychological Methods, 7, 19–40.PubMedCrossRefGoogle Scholar
  32. Maïano, C., Morin, A. J. S., Ninot, G., Monthuy-Blanc, J., Stephan, Y., & Vallée, P. (2008). A short and very short form of the physical self-inventory for adolescents: development and factor validity. Psychology of Sport & Exercise, 9, 830–847.CrossRefGoogle Scholar
  33. Maïano, C., Morin, A. J. S., Monthuy-Blanc, J., Garbarino, J.-M., & Stephan, Y. (2009). Eating disorders inventory: assessment of its construct validity in a non-clinical French sample. Journal of Psychopathology and Behavioral Assessment, 31, 387–404.CrossRefGoogle Scholar
  34. Maïano, C., Morin, A. J. S., Eklund, R. C., Monthuy-Blanc, J., Garbarino, J.-M., & Stephan, Y. (2010). Construct validity of the social physique anxiety scale in a French adolescent sample. Journal of Personality Assessment, 92, 1–10.CrossRefGoogle Scholar
  35. Maïano, C., Morin, A. J. S., Monthuy-Blanc, J., & Garbarino, J.-M. (2010). Construct validity of the fear of negative appearance evaluation scale in a French adolescent’s community sample. European Journal of Psychological Assessment, 26, 19–27.CrossRefGoogle Scholar
  36. Marsh, H. W., Ellis, L., Parada, R., Richards, G., & Heubeck, B. (2005). A short version of the self description questionnaire ii: operationalizing criteria for short-form with new applications of confirmatory factor analyses. Psychological Assessment, 17, 81–102.PubMedCrossRefGoogle Scholar
  37. Marsh, H. W., Hau, K.-T., & Grayson, D. (2005). Goodness of fit evaluation in structural equation modeling. In A. Maydeu-Olivares & J. McArdle (Eds.), Psychometrics. A Festschrift to Roderick P. McDonald. Hillsdale: Erlbaum.Google Scholar
  38. Marsh, H. W., Muthén, B. O., Asparouhov, T., Lüdtke, O., Robitzsch, A., Morin, A. J. S., et al. (2009). Exploratory structural equation modeling, integrating CFA and EFA: application to students’ evaluations of university teaching. Structural Equation Modeling, 16, 439–476.CrossRefGoogle Scholar
  39. McDonald, R. P. (1970). Theoretical foundations of principal factor analysis, canonical factor analysis, and alpha factor analysis. British Journal of Mathematical and Statistical Psychology, 23, 1–21.CrossRefGoogle Scholar
  40. Meredith, W. (1993). Measurement invariance, factor analysis and factorial invariance. Psychometrika, 58, 525–543.CrossRefGoogle Scholar
  41. Micali, N., & House, J. (2011). Assessment measures for child and adolescent eating disorders: a review. Child & Adol;escent Mental Health, 16, 122–127.Google Scholar
  42. Mintz, L., & O’Halloran, S. E. (2000). The eating attitudes test: validation with DSM-IV eating disorder criteria. Journal of Personality Assessment, 74, 489–503.PubMedCrossRefGoogle Scholar
  43. Morin, A. J. S., & Maïano, C. (2011a). Cross-Validation of the short form of the physical self-inventory (PSI-S) using exploratory structural equation modeling (ESEM). Psychology of Sport & Exercise, 12, 540–554.CrossRefGoogle Scholar
  44. Morin, A. J. S., & Maïano, C. (2011b). Cross-validation of the very short form of the Physical Self-Inventory (PSI-VS): invariance across genders, age groups, ethnicities and weight statuses. Body Image, 8, 404–410.PubMedCrossRefGoogle Scholar
  45. Morin, A. J. S., Marsh, H. W., & Nagengast, B. (in press). Exploratory structural equation modeling: An introduction. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (2nd ed.). Greewich: IAP.Google Scholar
  46. Muthén, L. K., & Muthén, B. O. (2010). Mplus user’s guide. Los Angeles: Muthén & Muthén.Google Scholar
  47. Nasser, M. (1997). The EAT speaks many languages: review of the used of the EAT in eating disorders research. Eating and Weight Disorders, 2, 174–181.PubMedGoogle Scholar
  48. Neumark-Sztainer, D., Story, M., Hannan, P. J., Perry, C. L., & Irving, L. M. (2002). Weight-related concerns and behaviors among overweight and nonoverweight adolescents: implications for preventing weight-related disorders. Archives of Pediatrics & Adolescent Medicine, 156, 171–178.CrossRefGoogle Scholar
  49. Raciti, M. C., & Norcross, J. C. (1987). The EAT and EDI: screening, interrelationships, and psychometrics. International Journal of Eating Disorders, 6, 579–586.CrossRefGoogle Scholar
  50. Satorra, A., & Bentler, P. (1999). A scaled difference Chi-square test statistic for moment structure analysis. Technical Report University of California, Los Angeles.
  51. Schoemaker, C., Van Strien, T., & Van der Staak, C. (1994). Validation of the eating disorder inventory in a nonclinical population using transformed and untransformed responses. International Journal of Eating Disorders, 15, 387–393.PubMedCrossRefGoogle Scholar
  52. Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports. Advance online publication. doi:  10.1007/s11920-012-0282-y
  53. Smith, G., McCarthy, D., & Anderson, K. (2000). On the sins of short-form development. Psychological Assessment, 12, 102–111.PubMedCrossRefGoogle Scholar
  54. Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128, 825–848.Google Scholar
  55. Streiner, D. L. (2003). Starting at the beginning: an introduction to coefficient alpha and internal consistency. Journal of Personality Assessment, 80, 99–103.PubMedCrossRefGoogle Scholar
  56. Thurnstone, L. L. (1947). Multiple-factor analysis. Chicago: University of Chicago Press.Google Scholar
  57. van Strien, T., & Ouwens, M. (2003). Validation of the Dutch EDI-2 in one clinical and two nonclinical populations. European Journal of Psychological Assessment, 19, 66–84.CrossRefGoogle Scholar
  58. Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3, 4–70.CrossRefGoogle Scholar
  59. Wildes, J. E., Emery, R. E., & Simons, A. D. (2001). The roles of ethnicity and culture in the development of eating disturbance and body dissatisfaction: a meta-analytic review. Clinical Psychology Review, 21, 521–551.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Christophe Maïano
    • 1
    • 5
  • Alexandre J. S. Morin
    • 2
  • Marie-Christine Lanfranchi
    • 3
    • 4
  • Pierre Therme
    • 3
  1. 1.Cyberpsychology Laboratory, Département de Psychoéducation et de PsychologieUniversité du Québec en Outaouais (UQO)Saint-JérômeCanada
  2. 2.Centre for Positive Psychology and EducationUniversity of Western SydneySydneyAustralia
  3. 3.UMR 7287, Institute of Movement Sciences, Etienne-Jules MareyAix-Marseille Univ & CNRSMarseilleFrance
  4. 4.Direction Régionale de la Jeunesse, des Sports et de la Cohésion Sociale - Provence-Alpes Côte-d’AzurMarseilleFrance
  5. 5.Département de Psychoéducation et de PsychologieUniversité du Québec en Outaouais, Campus de Saint-JérômeSaint-JérômeCanada

Personalised recommendations