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Psychometric properties of a Greek translation of the Intuitive Eating Scale-2 (IES-2) in adults from Cyprus

Anastasiades E, Maïano C, Argyrides M, Swami V

Body Image, 2022 Dec;43:348-361.
PMID: 36272259 DOI: 10.1016/j.bodyim.2022.09.014

The construct of intuitive eating is commonly assessed using the 23-item, 4-factor Intuitive Eating Scale-2 (IES-2; Tylka & Kroon Van Diest, 2013). In this study, we assessed the psychometric properties of a novel Greek translation of the IES-2 in adults from Cyprus. In Study 1 (N = 626), an exploratory factor analysis indicated that the IES-2 should be conceptualized as consisting of six factors that showed complete invariance across women and men. Study 2 (N = 793), using exploratory structural equation modelling (ESEM) and beifactor analysis (B-ESEM), indicated that the 6-factor B-ESEM model had adequate fit and evidenced complete invariance across sex once the correlated uniqueness of negatively worded IES-2 items was accounted for. This final model evidenced adequate composite reliability, and a global G-factor evidenced adequate convergent, concurrent, and discriminant validity. In contrast, the IES-2 S-factors showed more equivocal patterns of validity, with some S-factors showing less-than-adequate associations with body image variables, self-esteem, symptoms of disordered eating, and fruit and vegetable intake. In general, these results provide satisfactory evidence of the psychometric properties of the Greek IES-2 in adults from Cyprus, but also suggest that models of IES-2 scores may vary across national or cultural contexts.
The intuitive eating scale-2: re-evaluating its factor structure using a bifactor exploratory structural equation modelling framework

Swami V, Maïano C, Furnham A, Robinson C

Eat Weight Disord, 2022 May;27(4):1349-1357.
PMID: 34292529 DOI: 10.1007/s40519-021-01271-9

PURPOSE: Previous studies examining the appropriateness of the 4-factor model of intuitive eating scale-2 (IES-2) scores have returned equivocal results, which may reflect methodological limitations in the way IES-2 scores are modelled. Here, we applied a bifactor-exploratory structural equation modelling (B-ESEM) framework to better understand IES-2 multidimensionality.
METHODS: A total of 603 participants from the United States completed the IES-2, alongside measures of body appreciation, body acceptance from others, and self-esteem. Our analyses compared the fit of various hypothesised models of IES-2 scores.
RESULTS: Models of IES-2 scores based on confirmatory factor analysis (CFA) uniformly showed poor fit. ESEM models showed superior fit to CFA representations and a B-ESEM model showed improved fit over higher-order CFA and B-CFA representations of IES-2 scores. The optimal model was a B-ESEM model that accounted for, through correlated uniqueness (CU), the methodological artefact introduced by negatively-worded IES-2 items. This B-ESEM-CU model was fully invariant across gender and showed adequate construct validity.
CONCLUSION: The B-ESEM-CU framework appears well-suited to understand the multidimensionality of IES-2 scores. A model of IES-2 scores that yields a reliable latent indicator of global intuitive eating while allowing for simultaneous consideration of additional specific factors will likely provide more accurate accounting of the nature and outcomes of intuitive eating.
LEVEL OF EVIDENCE: Level III, cohort study.
Greek adaptation of the Teruel Orthorexia Scale (TOS) in adults from the Republic of Cyprus: A bidimensional model may not be universal

Argyrides M, Anastasiades E, Maïano C, Swami V

Appetite, 2024 Mar 01;194:107180.
PMID: 38145878 DOI: 10.1016/j.appet.2023.107180

The Teruel Orthorexia Scale (TOS) is a 17-item instrument designed to assess distinct facets of Orthorexia Nervosa (ON) and Healthy Orthorexia (HO). While a bidimensional model of TOS scores has been supported in diverse national and linguistic groups, the psychometric properties of the TOS have not been previously assessed in Greek-speaking populations. To rectify this, we assessed the psychometric properties of a novel Greek translation of the TOS in a sample of adults from Cyprus. A total of 1248 respondents (710 women, 538 men) completed the Greek TOS, as well as previously validated measures of perfectionism, obsessive-compulsive symptomatology, eating restriction, negative affect, and appearance evaluation. Our results showed that a bidimensional model of the TOS had less-than-adequate fit when modelled using both confirmatory factor analysis and exploratory structural equation modeling (ESEM). Conversely, both exploratory factor analysis and ESEM supported extraction of a 3-factor model consisting of a HO facet and separate components of emotional orthorexia and cognitive-social orthorexia. This 3-factor model showed a lack of measurement bias (measurement invariance across gender identity and lack of differential item functioning as function of age and body mass index), but there were differences in latent factor means as function of respondent age and body mass index. The 3-factor model showed adequate evidence of construct validity, with the latent emotional orthorexia and cognitive-social orthorexia facets showing significant and moderate associations with the additional constructs measured in the survey. Broadly speaking, these findings support the psychometric properties of a 3-factor model of the Greek TOS, but also suggest that the bidimensional model of the TOS may not have universal applicability. We encourage further assessments of factorial validity in other national and linguistic contexts.
Psychometric properties of a Bahasa Malaysia (Malay) translation of the Body and Appearance Self-Conscious Emotions Scale (BASES): An assessment using exploratory structural equation modelling

Swami V, Maïano C, Wong KY, Zahari HS, Barron D

Body Image, 2021 Dec;39:293-304.
PMID: 34739921 DOI: 10.1016/j.bodyim.2021.10.003

The Body and Appearance Self-Conscious Emotions Scale (BASES) measures self-conscious emotions in relation to the body and appearance. While scores have been shown to support a hypothesised 4-factor model consisting of facets of shame, guilt, authentic pride, and hubristic pride, previous studies are limited in their sole reliance on confirmatory factor analysis. Here, we assessed the psychometric properties of a novel Bahasa Malaysia translation of the BASES using an exploratory structural equation modelling (ESEM) framework. Malaysian adults (N = 1049) completed the BASES along with measures of body appreciation, psychological well-being, and secure non-striving. The results of exploratory factor analysis and ESEM in separate split-half subsamples supported a 2-dimensional model consisting of Shame-Guilt and Authentic-Hubristic Pride. This 2-dimensional model was broadly invariant across ethnicity, gender, and age, had adequate internal consistency, and evidenced adequate construct validity in relation to the Authenthic-Hubristic Pride subscale. We interpret our findings as consistent with the view that cultural factors shape the way in which body and appearance-related self-conscious emotions are manifested. Our results also highlight the importance of considering alternative conceptualisations of body and appearance-related self-conscious emotions, which previous studies may have obscured through their reliance on confirmatory factor analyses.
Psychometric properties of a Romanian translation of the Acceptance of Cosmetic Surgery Scale (ACSS): An examination using bifactor exploratory structural equation modelling

Lazarescu G, Maïano C, Vintilă M, Goian C, Swami V

Body Image, 2023 Jun;45:273-283.
PMID: 37001224 DOI: 10.1016/j.bodyim.2023.03.011

The Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005) is a widely used measure for the assessment of attitudes toward cosmetic surgery. Here, we examined the psychometrics of a novel Romanian translation of the ACSS. A total of 1275 Romanian adults (889 women, 386 men) completed the ACSS alongside additional, related measures. Exploratory factor analysis (EFA) with a first split-half subsample supported extraction of the original 3-factor model consisting of Intrapersonal, Social, and Consider dimensions. In a second split-half subsample, we found that a 3-factor bifactor exploratory structural equation model (B-ESEM) had superior fit compared to all alternative models that were tested. This B-ESEM representation had well-defined G-factor with adequate composite reliability, and its S-factors were also generally well-defined. Across subsamples, the optimal model showed strong or partial strong invariance across gender, with women having significantly higher latent means on the Consider factor relative to men. Evidence of convergent validity was also generally good in women, especially for the G-factor of the ACSS, but was attenuated in men. Overall, these findings indicate that the Romanian version of the ACSS has adequate psychometric properties. We also encourage scholars to consider B-ESEM representations of the ACSS in other national settings.
Dimensionality and psychometric properties of an Italian translation of the Intuitive Eating Scale-2 (IES-2): An assessment using a bifactor exploratory structural equation modelling framework

Swami V, Maïano C, Todd J, Ghisi M, Cardi V, Bottesi G, et al.

Appetite, 2021 11 01;166:105588.
PMID: 34224761 DOI: 10.1016/j.appet.2021.105588

The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2), but previous studies have typically relied solely on confirmatory factor analysis (CFA) to understand IES-2 dimensionality. In contrast, a bifactor exploratory structural equation modelling (B-ESEM) framework offers a more realistic account of IES-2 multidimensionality. Here, we assessed the psychometric properties of a novel Italian translation using a combination of exploratory factor analysis and B-ESEM. A total of 950 adults completed the IES-2 alongside measures of positive body image, disordered eating, and psychological well-being. Results indicated that a 4-factor B-ESEM model had adequate fit to the data and that fit was improved when the correlated uniqueness of seven negatively worded IES-2 items was accounted for. This model of IES-2 scores showed adequate internal consistency and good test-retest reliability up to three weeks. Evidence of construct validity was good in terms of a global IES-2 factor, and broadly supported in terms of its specific-factors. These results highlight the utility of a B-ESEM framework for understanding the dimensionality of IES-2 scores and may help scholars better understand the extent to which the IES-2 adequately operationalises the construct of intuitive eating.
The Intuitive Eating Scale-3: Development and psychometric evaluation

Tylka TL, Maïano C, Fuller-Tyszkiewicz M, Linardon J, Burnette CB, Todd J, et al.

Appetite, 2024 May 09;199:107407.
PMID: 38729580 DOI: 10.1016/j.appet.2024.107407

Intuitive eating has been found to protect against disordered eating and preserve well-being. Yet, there are methodological (length), conceptual (inconsideration of medical, value-based, and access-related reasons for food consumption), and psychometric (item wording) concerns with its most common measure, the Intuitive Eating Scale-2 (IES-2). To address these concerns, we developed the IES-3 and investigated its psychometric properties with U.S. community adults. Across three online studies, we evaluated the IES-3's factorial validity using exploratory factor analysis (EFA; Study 1; N = 957; Mage = 36.30), as well as confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), bifactor-CFA, and bifactor-ESEM (Study 2; N = 1152; Mage = 40.95), and cross-validated the optimal model (Study 3; N = 884; Mage = 38.54). We examined measurement invariance across samples and time, differential item functioning (age, body mass index [BMI], gender), composite reliability, and validity. Study 1 revealed a 12-item, 4-factor structure (unconditional permission to eat, eating for physical reasons, reliance on hunger and satiety cues, body-food choice congruence). In Study 2, a bifactor-ESEM model with a global intuitive eating factor and four specific factors best fit the data, which was temporally stable across three weeks. This model also had good fit in Study 3 and, across Studies 2 and 3, and was fully invariant and lacked measurement bias in terms of age, gender, and BMI. Associations between latent IES-3 factors and age, gender, and BMI were invariant across Studies 2 and 3. Composite reliability and validity (relationships with disordered eating, embodiment, body image, well-being, and distress; negligible relationship with impression management) of the retained model were also supported. The 12-item IES-3 demonstrates strong psychometric properties in U.S. community adults. Research is now needed using the IES-3 in other cultural contexts and social identity groups.
Measurement invariance and differential item functioning of the functionality appreciation scale (FAS) in Colombia and Spain

Mebarak M, Maïano C, Mendoza J, Zamora Á, Baños R, Desdentado L, et al.

Body Image, 2024 Sep 07;51:101787.
PMID: 39244790 DOI: 10.1016/j.bodyim.2024.101787

The Functionality Appreciation Scale (FAS) is increasingly used in diverse national and linguistic contexts. However, limited work has assessed the extent to which the instrument demonstrates measurement invariance and differential item functioning (DIF) across nations and respondent characteristics. Here, we examined measurement invariance and DIF of the FAS using archival data from adults in Colombia (Mebarak et al., 2023) and Spain (Zamora et al., 2024). Participants included 1420 (women n = 804, men n = 616) respondents from Colombia and 838 (women n = 415, men n = 423) respondents from Spain who completed translations of the FAS. Confirmatory factor analysis supported a unidimensional structure of the FAS in both national groups. Additionally, the FAS achieved full measurement invariance (up to latent mean invariance) across both groups. We also found that the FAS lacked DIF as a function of age, body mass index (BMI), and gender identity across both national groups. Older participants (relative to younger participants), men (relative to women), and participants with lower BMIs (relative to those with higher BMIs) had higher FAS scores. These results support the notion that the FAS is measuring a common underlying construct across these national groups and respondent characteristics.
The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations

Swami V, Tran US, Barron D, Afhami R, Aimé A, Almenara CA, et al.

Body Image, 2020 Mar;32:199-217.
PMID: 32032822 DOI: 10.1016/j.bodyim.2020.01.006

The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.
Fulltext Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

Swami V, Tran US, Stieger S, Aavik T, Ranjbar HA, Adebayo SO, et al.

Body Image, 2023 Sep;46:449-466.
PMID: 37582318 DOI: 10.1016/j.bodyim.2023.07.010

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

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