In collaboration with Payame Noor University and Iranian Health Psychology Association

Document Type : Scientific Research

Authors

1 Department of Psychology . Faculty of human science . Tarbiat Modares University of Tehran, Iran

2 Department of Clinical Psychology .Faculty of human science. Shahed University . Tehran , Iran

3 Professor of Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences.Tehran.Iran

4 Department of psychology . Faculty of human science. Tarbiat modares University . Tehran. iran

Abstract

Objective: The aim of this study was to prepare the Persian version of the orthorexia nervosa Scale and evaluate its psychometric properties. Method: The sample of the present study consisted of 639 people aged 18 to 65 years living in Tehran who were tested using the available sampling method. The Persian version of the orthorexia nervosa Scale was prepared after the translation-retranslation process and was administered along with the eating attitude test (EAT-26) and Reef psychological well-being questionnaire (REEF-18). The validity of the scale was assessed using construct,  convergent and divergent validity was evaluated through Pearson correlation. Moreover, to assess its reliability, Cronbach's alpha calculation method and composite reliability were used. Findings: The results of exploratory factor analysis indicated the existence of three factors: cognitive, emotional and clinical, and the results of confirmatory factor analysis indicated the goodness of fit and eligibility of the obtained model. Significant correlations between the obtained factors with the eating attitude test and Reef psychological well-being questionnaire also confirmed the convergent and divergent validity of the orthorexia nervosa scale. The reliability of the scale was calculated using Cronbach's alpha coefficient and obtained 0.811 for the all scales and ranged 0.69 to 0.735 for specific scales. Moreover, the composite reliability of the scales ranged between 0.78 and 0.82. Conclusion: Conclusions: In general, it can be said that the Persian version of the orthorexia nervosa Scale has a three-factor structure and has the adequate validity and reliability for use in psychological research in the Iranian sample.

Keywords

اقاگدی، پریسا و اعتمادی، احمد. (1396). اثربخشی آموزش مدیریت استرس و آرام‌سازی بر تغییر نگرش به تغذیه در نوجوانان دارای اختلال خوردن. فصلنامه علمی- پژوهشی روانشناسی سلامت, 6(21), 5-16.
پورقاسم گرگری، بهرام.، کوشاور، دنیز.، و سیدسجادی، ندا.، و کرمی، صفورا.، و شاهرخی، حسن. (1387). خطر اختلالات خوردن در دانش آموزان دبیرستانی دختر تبریز در سال 1386. مجله پزشکی دانشگاه علوم پزشکی تبریز, 30(4), 21-26.
خانجانی، مهدی.؛ شهیدی، شهریار.؛ فتح آبادی، جلیل.؛ مظاهری، محمد علی و شکری، امید.(1393). ساختار عاملی و ویژگی‌های روان‌سنجی فرم کوتاه (18 سوالی) مقیاس بهزیستی روان‌شناختی ریف در دانشجویان دختر و پسر.  اندیشه و رفتار در روان شناسی بالینی، 9(32)،27-36.
ملازاده اسفنجانی، رحیم.؛کافی، سیدموسی و یگانه، طیبه.(1391). ارتباط سلامت روان با اختلال‌های خوردن در دانشجویان دختر دانشگاه گیلان. مجله علمی دانشگاه علوم پزشکی قزوین, 16(4 (پیاپی 65)), 55-60.
نجارنصب، سمیه و دشت بزرگی، زهرا (1398). تاثیر مصاحبه انگیزشی بر سبک زندگی ارتقاء دهنده سلامت و فشار خون زنان مبتلا به اختلال خوردن. فصلنامه علمی - پژوهشی روانشناسی سلامت, 8(31), 103-118.
Alexopoulos, D. S., & Kalaitzidis, I. (2004). Psychometric properties of Eysenck Personality Questionnaire-Revised (EPQ-R) Short Scale in Greece. Personality and Individual Differences37(6), 1205-1220.
Alvarenga, M. S., Martins, M. C., Sato, K. S., Vargas, S. V., Philippi, S. T., & Scagliusi, F. B. (2012). Orthorexia nervosa behavior in a sample of Brazilian dietitians assessed by the Portuguese version of ORTO-15. Eating and weight disorders : EWD17(1), e29–e35.
Barrada, J. R., & Roncero, M. (2018). Bidimensional structure of the orthorexia: Development and initial validation of a new instrument. Anales de Psicología, 34(2), 283–291. 
Barrett, P. (2007). Structural equation modelling: Adjudging model fit. Personality and Individual Differences, 42(5), 815–824.
Bratman S., Knight D.: Health food junkies. New York, Broadway Books, 2000.
Brown, T. A. (2006). Confirmatory factor analysis for applied research. The Guilford Press.
Brytek-Matera A. (2012). Orthorexia nervosa—an eating disorder, obsessive-compulsive disorder or disturbed eating habit? Archives of Psychiatry and Psychotherapy. 2012;1, 55 –60.
Chamay-Weber, C., Narring, F., & Michaud, P. A. (2005). Partial eating disorders among adolescents: a review. The Journal of adolescent health : official publication of the Society for Adolescent Medicine37(5), 417–427.
Cooper, M. J., Rose, K. S., & Turner, H. (2006). The specific content of core beliefs and schema in adolescent girls high and low in eating disorder symptoms. Eating behaviors7(1), 27–35
Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M., & Cannella, C. (2005). Orthorexia nervosa: validation of a diagnosis questionnaire. Eating and weight disorders : EWD10(2), e28–e32.
Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M., & Cannella, C. (2005). Orthorexia nervosa: validation of a diagnosis questionnaire. Eating and weight disorders : EWD10(2), e28–e32
Dunn, T. M., & Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating behaviors21, 11–17
Fidan, T., Ertekin, V., Işikay, S., & Kirpinar, I. (2010). Prevalence of orthorexia among medical students in Erzurum, Turkey. Comprehensive psychiatry51(1), 49–54.
Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test: psychometric features and clinical correlates. Psychological medicine12(4), 871–878.
Gjersing, L., Caplehorn, J. R., & Clausen, T. (2010). Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations. BMC medical research methodology10, 13.
Green, C. E., Chen, C. E., Helms, J. E., & Henze, K. T. (2011). Recent reliability reporting practices in Psychological Assessment: Recognizing the people behind the data. Psychological Assessment, 23(3), 656–669
Hair, J.F., Black, W.C., Babin, B.J. and Anderson, R.E. (2010) Multivariate Data Analysis. 7th Edition, Pearson, New York.
Hoek, H. W., & van Hoeken, D. (2003). Review of the prevalence and incidence of eating disorders. The International journal of eating disorders34(4), 383–396.
Hu, L. T., & Bentler, P. M. (1999). Cutoff Criteria for Fit Indexes in Covariance Structure Analysis: Conventional Criteria versus New Alternatives. Structural Equation Modeling, 6, 1-55.
Kahleova, H., Levin, S., & Barnard, N. (2017). Cardio-Metabolic Benefits of Plant-Based Diets. Nutrients9(8), 848
Kline, P. (1979). Psychometrics and psychology.London: Acaderric Press
Kummer, A., Dias, F. M., & Teixeira, A. L. (2008). On the concept of orthorexia nervosa. Scandinavian journal of medicine & science in sports18(3), 395–397
Mancilla-Diaz, J. M., Franco-Paredes, K., Vazquez-Arevalo, R., Lopez-Aguilar, X., Alvarez-Rayon, G. L., & Tellez-Giron, M. T. (2007). A two-stage epidemiologic study on prevalence of eating disorders in female university students in Mexico. European eating disorders review : the journal of the Eating Disorders Association15(6), 463–470.
McComb, S. E., & Mills, J. S. (2019). Orthorexia nervosa: A review of psychosocial risk factors.  Appetite140, 50–75.
Meule, A., Holzapfel, C,. Brandl, B,. Greetfeld, M,. Hessler-Kaufmann, J.B,. Skurk, T,. Quadflieg, N,. Hans Hauner,S,. Voderholzer, U. (2020). Measuring orthorexia nervosa: A comparison of four self-report questionnaires, Appetite,
Mintz, L. B., & O’Halloran, M. S. (2000). The Eating Attitudes Test: Validation with DSM-IV Eating Disorder Criteria. Journal of Personality Assessment, 74, 489-503.
Missbach, B., Dunn, T. M., & König, J. S. (2017). We need new tools to assess Orthorexia Nervosa. A commentary on "Prevalence of Orthorexia Nervosa among College Students Based on Bratman's Test and Associated Tendencies".  Appetite108, 521–524.
Missbach, B., Hinterbuchinger, B., Dreiseitl, V., Zellhofer, S., Kurz, C., & König, J. (2015). When Eating Right, Is Measured Wrong! A Validation and Critical Examination of the ORTO-15 Questionnaire in German. PloS one10(8), e0135772.
Niedzielski, A., & Kaźmierczak-Wojtaś, N. (2021). Prevalence of Orthorexia Nervosa and Its Diagnostic Tools-A Literature Review. International journal of environmental research and public health18(10), 5488.
Niedzielski, A., & Kaźmierczak-Wojtaś, N. (2021). Prevalence of Orthorexia Nervosa and Its Diagnostic Tools-A Literature Review. International journal of environmental research and public health18(10), 5488.
Nunes, M. A., Camey, S., Olinto, M. T., & Mari, J. J. (2005). The validity and 4-year test-retest reliability of the Brazilian version of the Eating Attitudes Test-26. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas38(11), 1655–1662.
Oberle, C. D., Samaghabadi, R. O., & Hughes, E. M. (2017). Orthorexia nervosa: Assessment and correlates with gender, BMI, and personality. Appetite108, 303–310.
Oberle, C. D., Watkins, R. S., & Burkot, A. J. (2018). Orthorexic eating behaviors related to exercise addiction and internal motivations in a sample of university students. Eating and weight disorders : EWD23(1), 67–74
Parra-Fernandez, M. L., Rodríguez-Cano, T., Onieva-Zafra, M. D., Perez-Haro, M. J., Casero-Alonso, V., Muñoz Camargo, J. C., & Notario-Pacheco, B. (2018). Adaptation and validation of the Spanish version of the ORTO-15 questionnaire for the diagnosis of orthorexia nervosa. PloS one13(1), e0190722.
Ryff, C. D., & Singer, B. H. (2006). Best News Yet on the Six-Factor Model of Well-Being. Social Science Research, 35, 1103-1119.
Stice, E., (2002), Risk and maintenance factor for eating pathology: A meta analytic review, 128, 825-848.
Syurina, E. V., Bood, Z. M., Ryman, F., & Muftugil-Yalcin, S. (2018). Cultural Phenomena Believed to Be Associated With Orthorexia Nervosa - Opinion Study in Dutch Health Professionals. Frontiers in psychology9, 1419.
Tabachnick, B. G., & Fidell, L. S. (2013). Using Multivariate Statistics (6th ed.). Boston, MA: Pearson.
Varga, M., Thege, B. K., Dukay-Szabó, S., Túry, F., & van Furth, E. F. (2014). When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC psychiatry14, 59
Wheaton, B., Muthen, B., Alwin, D. F., & Summers, G. (1977). Assessing Reliability and Stability in Panel Models. Sociological Methodology, 8, 84-136.