DOI
https://doi.org/10.25772/5YXP-3A85
Author ORCID Identifier
https://orcid.org/0000-0002-8191-3359
Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Counseling Psychology
First Advisor
Suzanne Mazzeo, PhD
Abstract
South Asians (SAs) are less likely to be screened, referred, and treated for eating disorders (EDs), although they experience these serious health conditions at rates similar to those of their White counterparts. Available ED assessment tools do not adequately capture cultural nuances in the presentation of eating psychopathology in SAs. Thus, the current study culturally adapted the Eating Disorder Examination-Questionnaire (EDE-Q) to enhance its validity, applicability, and cultural relevance for SA women living in the US. During the cultural adaptation phase, the principal investigator consulted with participant experts (N=24) and research experts (n=4) to create the modified measure. During the psychometric validation phase of the study, data were collected from N=212 participants and an exploratory factor analysis (EFA) conducted to assess the measure’s factor structure. Additional validity, reliability, and receiver operating characteristic (ROC) analyses further evaluated the measure’s psychometric properties and established two appropriate clinical cutoff scores for SA women. During the cultural adaptation process, items were modified to include SA references, and new items were added to assess subjective binge eating episodes (SBEs). Culturally specific items were added that captured the healthy ideal, religious fasting, and social pressures to eat past the point of fullness. During the validation phase, the EFA identified a four-factor model that included 31 ordinal and 9 behavioral frequency items. The four factors are: Appearance Dissatisfaction & Restraint, The Healthy Ideal, Religious Fasting, and Social Pressures to Eat. This new measure – the EDE-Q-South Asian American Women (EDE-Q-SAAW) – demonstrated good convergent validity with other ED measures, as well as discriminant validity from a depression tool and partial divergence from a feeding measure. The EDE-Q-SAAW yields internally consistent scores and demonstrated partial test-retest reliability, depending on the individual items. Two new cutoff scores were identified for use with community versus clinical and primary care samples. The EDE-Q-SAAW is a 40-item, psychometrically valid and reliable measure that can be used to detect EDs in SA American women. This tool will provide more accurate estimates of the true prevalence of EDs in SAs, and enhance understanding of the nature, presentation, and cultural variation of EDs in this underserved group.
Rights
© Neha J. Goel
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
11-18-2024
Included in
Clinical Psychology Commons, Counseling Psychology Commons, Multicultural Psychology Commons