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Turkish adaptation and evaluation of psychometric properties of the Eating Habits Questionnaire, the Barcelona Orthorexia Scale and the Orthorexia Nervosa Scale

Yıl 2023, Cilt: 7 Sayı: 3, 325 - 350, 25.12.2023

İlgün Bilekli Bilger İhsan Dağ

https://doi.org/10.5455/kpd.26024438m000100

Öz

Orthorexia nervosa (ON), a condition in which people restrict their diet according to the quality of food, means an intense obsession with healthy eating (Bratman, 1997a). Due to the limitations of the measurement tools used to measure ON, 3 measurement tools have been developed recently. This study aims to evaluate the psychometric properties of the Eating Habits Questionnaire (EHQ), the Barcelona Orthorexia Scale (BOS), and the Orthorexia Nervosa Scale (ONS), which were developed to measure the concept of ON by translating them into Turkish. A total of 712 university students (75.3% female, 23.2% male) with a mean age of 21.26 participated in the study. Participants completed the scale set consisting of the EHQ, BOS, ONS, Teruel Orthorexia Scale (TOS), and Just World Belief Scale (JWBS). The factor structures of the scales were tested with factor analysis. The correlations of the scales with the TOS for convergent validity and with the JWBS for divergent validity were examined. Internal consistency coefficients and test-retest reliability coefficients of the scales were calculated. According to the confirmatory factor analysis, since the model fit indices showed that the three measurement tools did not have a good fit, exploratory factor analysis was performed. According to the results of the analysis, EHQ consists of 2 factors, BOS consists of 5 factors, and ONS consists of 2 factors. The internal consistency coefficients of the scales were determined as .90 for EHQ, .96 for BOS, and .87 for ONS. Test-retest reliability and correlation coefficients checked for convergent and divergent validity are within the desired values. In conclusion, it is seen that all three measurement tools can be used reliably and validly to measure ON in our culture.

Anahtar Kelimeler

ortoreksiya nervoza sağlıklı beslenme adaptasyon güvenirlik geçerlik

Etik Beyan

The necessary ethical approval (dated 15.06.2020 and numbered 35853172-300) was obtained from Hacettepe University Ethics Commission for the implementation of this study.

Teşekkür

This article is derived from the first author's doctoral dissertation. Researchers who wish to use the adapted scales (NOS, ONS, and NLS) in academic research for non-commercial purposes are given permission to use.

Kaynakça

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  • Amerikan Psikiyatri Birliği. (2014). Tanı ölçütleri başvuru el kitabı. (5.baskı)
  • Andrés, A., Saldaña, C. ve Gómez‐Benito, J. (2009). Establishing the stages and processes of change for weight loss by consensus of experts. Obesity, 17(9), 1717-1723.
  • Arusoğlu, G., Kabakçi, E., Köksal, G. ve Kutluay Merdol, T. (2008). Orthorexia nervosa and adaptation of ORTO-11 into Turkish. Turkish Journal of Psychiatry, 19(3), 1-9.
  • Asarkaya, B. (2019). Sağlıklı ortoreksiya ve ortoreksiya nevroza: Ebeveynden algılanan psikolojik kontrol ve uyumlu-uyumsuz mükemmeliyetçilik özellikleri ile ilişkisinin incelenmesi. [Yayınlanmamış yüksek lisans tezi]. İstanbul Maltepe Üniversitesi.
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Yeme Alışkanlıkları Ölçeği, Barselona Ortoreksiya Ölçeği ve Ortoreksiya Nervoza Ölçeğinin Türkçeye uyarlanması ve psikometrik özelliklerinin değerlendirilmesi

Yıl 2023, Cilt: 7 Sayı: 3, 325 - 350, 25.12.2023

İlgün Bilekli Bilger İhsan Dağ

https://doi.org/10.5455/kpd.26024438m000100

Öz

Kişilerin beslenmelerini yiyeceklerin kalitesine göre kısıtladıkları bir durum olan ortoreksiya nervoza (ON), sağlıklı beslenmeye yönelik yoğun bir takıntı anlamına gelmektedir. ON’yi ölçmede kullanılan ölçüm araçlarındaki kısıtlılıklardan dolayı yakın zamanda 3 ölçüm aracı geliştirilmiştir. Bu çalışmanın amacı da ON kavramını ölçmek amacıyla geliştirilmiş olan Yeme Alışkanlıkları Ölçeği (YAÖ), Barselona Ortoreksiya Ölçeği (BOÖ) ve Ortoreksiya Nervoza Ölçeği’ni (ONÖ) Türkçeye çevirip uyarlayarak psikometrik özelliklerini değerlendirmektir. Çalışmaya, yaş ortalaması 21.26 olan toplam 712 üniversite öğrencisi (%75.3’ü kadın, %23.2’si erkek) katılmıştır. Katılımcılar YAÖ, BOÖ, ONÖ, Teruel Ortoreksiya Ölçeği (TOÖ) ve Adil Dünya İnancı Ölçeği'nden (ADİÖ) oluşan ölçek setini doldurmuştur. Ölçeklerin faktör yapıları faktör analizi ile sınanmıştır. Ölçeklerin birleşen geçerliği için TOÖ, ayrışan geçerliği için ise ADİÖ ile korelasyonlarına bakılmıştır. Ölçeklerin iç tutarlık katsayıları ve test-tekrar test güvenirlik katsayıları hesaplanmıştır. Yapılan doğrulayıcı faktör analizlerine göre, uyum indeksleri üç ölçüm aracının iyi bir uyuma sahip olmadığını gösterdiğinden açımlayıcı faktör analizleri yapılmıştır. Analiz sonuçlarına göre YAÖ 2 faktörden, BOÖ 5 faktörden, ONÖ 2 faktörden oluşmaktadır. Ölçeklerin iç tutarlık katsayıları ise, YAÖ için .90, BOÖ için .96, ONÖ için .87 olarak tespit edilmiştir. Test-tekrar test güvenirlik katsayıları ve birleşen ve ayrışan geçerlik analizleri için kontrol edilen korelasyon katsayıları istenen değerlerdedir. Sonuç olarak, her üç ölçüm aracının da kültürümüzde ON’yi ölçmek adına güvenilir ve geçerli olarak kullanılabileceği görülmektedir.

Anahtar Kelimeler

ortoreksiya nervoza sağlıklı beslenme güvenirlik geçerlik uyarlama

Etik Beyan

Bu çalışmanın uygulanması için Hacettepe Üniversitesi Etik Komisyonu’ndan gerekli etik onay (15.06.2020 tarihli 35853172-300 sayılı) alınmıştır.

Teşekkür

Bu makale birinci yazarın doktora tez çalışmasından üretilmiştir. Araştırmacılar, uyarlamaları yapılan ölçekleri (BOÖ, ONÖ ve YAÖ) ticari amaçlar dışındaki akademik araştırmalarda kullanma iznine sahiptirler.

Kaynakça

  • Aksoydan, E. ve Camci, N. (2009). Prevalence of orthorexia nervosa among Turkish performance artists. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 14(1), 33-37.
  • Alvarenga, M. S., Martins, M. C. T., Sato, K. S. C. J., Vargas, S. V., Philippi, S. T. ve 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-Studies on Anorexia, Bulimia and Obesity, 17(1), e29-e35.
  • Amerikan Psikiyatri Birliği. (2014). Tanı ölçütleri başvuru el kitabı. (5.baskı)
  • Andrés, A., Saldaña, C. ve Gómez‐Benito, J. (2009). Establishing the stages and processes of change for weight loss by consensus of experts. Obesity, 17(9), 1717-1723.
  • Arusoğlu, G., Kabakçi, E., Köksal, G. ve Kutluay Merdol, T. (2008). Orthorexia nervosa and adaptation of ORTO-11 into Turkish. Turkish Journal of Psychiatry, 19(3), 1-9.
  • Asarkaya, B. (2019). Sağlıklı ortoreksiya ve ortoreksiya nevroza: Ebeveynden algılanan psikolojik kontrol ve uyumlu-uyumsuz mükemmeliyetçilik özellikleri ile ilişkisinin incelenmesi. [Yayınlanmamış yüksek lisans tezi]. İstanbul Maltepe Üniversitesi.
  • Asil, E. ve Sürücüoğlu, M. S. (2015). Orthorexia nervosa in Turkish dietitians. Ecology of Food and Nutrition, 54(4), 303-313.
  • Badour, C. L. ve Adams, T. G. (2018). Contaminated by trauma: Understanding links between self-disgust, mental contamination, and post-traumatic stress disorder. P.A. Powell, P. G. Overton ve J. Simpson (Ed.), The Revolting Self içinde, (ss. 127-149). Routledge.
  • Bağcı Bosi, A. T., Camur, D. ve Güler, C. (2007). Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey). Appetite, 49(3), 661-666.
  • Barrada, J. R. ve Roncero, M. (2018). Bidimensional structure of the orthorexia: Development and initial validation of a new instrument. Anales De Psicología/Annals of Psychology, 34(2), 283-291.
  • Barthels, F., Meyer, F. ve Pietrowsky, R. (2015). Die Düsseldorfer Orthorexie Skala Konstruktion und Evaluation eines Fragebogens zur Erfassung ortho-rektische Ernährungsverhaltens. Zeitschrif für Klinische Psychologie und Psychotherapie, 44,97-105.
  • Barthels, F., Meyer, F., Huber, T. ve Pietrowsky, R. (2017). Orthorexic eating behaviour as a coping strategy in patients with anorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(2), 269-276.
  • Bauer, S. M., Fusté, A., Andrés, A. ve Saldaña, C. (2019). The Barcelona Orthorexia Scale (BOS): development process using the Delphi method. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 24(2), 247-255.
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  • Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M. ve Cannella, C. (2004). Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 9(2), 151-157.
  • Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M. ve Cannella, C. (2005). Orthorexia nervosa: validation of a diagnosis questionnaire. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 10(2), 28-32.
  • Dunn, T. M. ve Bratman, S. (2016). On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eating Behaviors, 21, 11-17.
  • Dunn, T. M., Gibbs, J., Whitney, N. ve Starosta, A. (2017). Prevalence of orthorexia nervosa is less than 1%: data from a US sample. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(1), 185-192.
  • Erkin, Ö. ve Göl, I. (2019). Determination of health status perception and orthorexia nervosa tendencies of Turkish yoga practitioners: A crosssectional descriptive study. Progress in Nutrition, 21, 105-112.
  • Fidan, T., Ertekin, V., Işikay, S. ve Kırpınar, I. (2010). Prevalence of orthorexia among medical students in Erzurum, Turkey. Comprehensive Psychiatry, 51(1), 49-54.
  • Field, A. (2005). Discovering statistics using SPSS. Sage.
  • Gleaves, D. H., Graham, E. C. ve Ambwani, S. (2013). Measuring 'Orthorexia': development of the eating habits questionnaire. The International Journal of Educational and Psychological Assessment. 12, 1-18.
  • Godefroy, V., Trinchera, L.ve Dorard, G. (2021). Optimizing the empirical assessment of orthorexia nervosa through EHQ and clarifying its relationship with BMI. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26(2), 649-659.
  • Göregenli, M. (2004) Şiddet, kötü muamele ve işkenceye ilişkin değerlendirmeler, tutumlar ve deneyimler. (İzmir Araştırması) İzmir Barosu Yayınları.
  • Hagen, N. A., Stiles, C., Nekolaichuk, C., Biondo, P., Carlson, L. E., Fisher, K. ve Fainsinger, R. (2008). The Alberta Breakthrough Pain Assessment Tool for cancer patients: a validation study using a delphi process and patient think-aloud interviews. Journal of Pain and Symptom Management, 35(2), 136-152.
  • Halim, Z. M., Dickinson, K. M., Kemps, E. ve Prichard, I. (2020). Orthorexia nervosa: Examining the Eating Habits Questionnaire’s reliability and validity, and its links to dietary adequacy among adult women. Public Health Nutrition, 23(10), 1684-1692.
  • Heiss, S., Coffino, J. A. ve Hormes, J. M. (2019). What does the ORTO-15 measure? Assessing the construct validity of a common orthorexia nervosa questionnaire in a meat avoiding sample. Appetite, 135, 93-99.
  • Hurley, A. E., Scandura, T. A., Schriesheim, C. A., Brannick, M. T., Seers, A., Vandenberg, R. J. ve Williams, L. J. (1997). Exploratory and confirmatory factor analysis: Guidelines, issues, and alternatives. Journal of Organizational Behavior,18, 667-683.
  • Kaiser, H. F. (1970). A second generation little jiffy. Psychometrika, 35(4), 401–415.
  • Kaiser, H. F. ve Rice, J. (1974). Little jiffy, mark IV. Educational and Psychological Measurement, 34(1), 111-117.
  • Kazdin, A. E. (2017). Research design in clinical psychology. (5.baskı). Cambridge University Press.
  • Kline, P. (1994). An easy guide to factor analysis. Routledge.
  • Kline, P. (1999). The handbook of psychological testing (2.baskı). Routledge.
  • Koven, N. S. ve Senbonmatsu, R. (2013). A neuropsychological evaluation of orthorexia nervosa. Open Journal of Psychiatry, 3(02), 214-222.
  • Linstone, H. A. ve Turoff, M. (Ed.). (1975). The delphi method (ss. 3-12). Addison-Wesley.
  • Lupton, D. (1995). The imperative of health: Public health and the regulated body. Sage.
  • Mathieu, J. (2005). What is orthorexia? Journal of the American Dietetics Association, 105(10), 1510-1512.
  • McBride, A. E. (2010). Food porn. Gastronomica, 10, 38-46.
  • Missbach, B., Dunn, T. M. ve 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”. Appetite, 108(1), 1-4.
  • Missbach, B., Hinterbuchinger, B., Dreiseitl, V., Zellhofer, S., Kurz, C. ve König, J. (2015). When eating right, is measured wrong! A validation and critical examination of the ORTO-15 questionnaire in German. PloS one, 10(8), e0135772
  • Morgan, P. J., Lam-McCulloch, J., Herold-McIlroy, J. ve Tarshis, J. (2007). Simulation performance checklist generation using the Delphi technique. Canadian Journal of Anaesthesia, 54(12), 992-997.
  • Moroze, R. M., Dunn, T. M., Craig, J. H., Yager, J. ve Weintraub, P. (2015). Microthinking about micronutrients: a case of transition from obsessions about healthy eating to near fatal "orthorexia nervosa" and proposed diagnostic criteria. Psychosomatics, 56(4),397-403.
  • Nicolosi, G. (2006). Biotechnologies, alimentary fears and the orthorexic society. Tailoring Biotechnologies, 2(3), 37-56.
  • Niedzielski, A. ve Kaźmierczak-Wojtaś, N. (2021). Prevalence of Orthorexia Nervosa and Its Diagnostic Tools—A Literature Review. International Journal of Environmental Research and Public Health, 18(10), 5488.
  • Novara, C., Pardini, S., Pastore, M. ve Mulatti, C. (2017). Ortoressia Nervosa: un’indagine del costrutto e delle caratteristiche psicometriche della versione Italiana dell’Eating Habits Questionnaire-21 (EHQ-21). Psicoterapia Cognitiva e Comportamentale, 23(3), 291-316.
  • Oberle, C. D., Samaghabadi, R. O. ve Hughes, E. M. (2017). Orthorexia nervosa: Assessment and correlates with gender, BMI, and personality. Appetite, 108, 303-310.
  • Ogden, C. L., Carroll, M. D., Kit, B. K. ve Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Jama, 311(8), 806-814.
  • Opitz, M. C., Newman, E., Mellado, A. S. A. V., Robertson, M. ve Sharpe, H. (2020). The psychometric properties of orthorexia nervosa assessment scales: A systematic review and reliability generalization. Appetite, 155, 104797.
  • Parra-Fernández, M. L., Onieva-Zafra, M. D., Fernández-Muñoz, J. J., Głębocka, A., Fernández-Martínez, E. ve Brytek-Matera, A. (2021). The Spanish version of the Eating Habits Questionnaire (EHQ-ES) and its links to symptoms and concerns characteristic of eating disorders among young adults. Nutrients, 13(6), 1993.
  • Parra-Fernández, M. L., Rodríguez-Cano, T., Onieva-Zafra, M. D., Perez-Haro, M. J., Casero-Alonso, V., Fernández-Martinez, E. ve Notario-Pacheco, B. (2018). Prevalence of orthorexia nervosa in university students and its relationship with psychopathological aspects of eating behaviour disorders. BMC Psychiatry, 18(1), 1-8.
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  • Pfeffer, S. E. (2014). Poular food blogger-the Blonde Vegan-admits to eating disorder. People, 15.
  • Rachman, S. (2004). Fear of contamination. Behaviour Research and Therapy, 42(11), 1227-1255.
  • Ramacciotti, C. E., Perrone, P., Coli, E., Burgalassi, A., Conversano, C., Massimetti, G. ve Dell’Osso, L. (2011). Orthorexia nervosa in the general population: a preliminary screening using a self- administered questionnaire (ORTO-15). Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 16(2), e127-e130.
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  • Roncero, M., Barrada, J. R. ve Perpiñá, C. (2017). Measuring orthorexia nervosa: psychometric limitations of the ORTO-15. The Spanish Journal of Psychology, 20, 1-9.
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  • Stochel, M., Janas-Kozik, M., Zejda, J. E., Hyrnik, J., Jelonek, I. ve Siwiec, A. (2015). Validation of ORTO-15 Questionnaire in the group of urban youth aged 15–21. Psychiatria Polska, 49(1), 119-134.
  • Şencan, H. (2005). Sosyal ve davranışsal ölçümlerde güvenilirlik ve geçerlilik. Seçkin Yayınları.
  • Tabachnick, B. G. ve Fidell, L. S. (2007). Using multivariate statistics (5.baskı.). Allyn & Bacon.
  • Valera, J. H., Ruiz, P. A., Valdespino, B. R. ve Visioli, F. (2014). Prevalence of orthorexia nervosa among ashtanga yoga practitioners: a pilot study. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 19(4), 469-472.
  • Vandereycken, W. (2011). Media hype, diagnostic fad or genuine disorder? Professionals' opinions about night eating syndrome, orthorexia, muscle dysmorphia, and emetophobia. Eating Disorders, 19(2), 145-155.
  • Varga, M., Dukay-Szabó, S., Túry, F. ve van Furth Eric, F. (2013). Evidence and gaps in the literature on orthorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 18(2), 103-111.
  • Varga, M., Thege, B. K., Dukay-Szabó, S., Túry, F. ve van Furth, E. F. (2014). When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC Psychiatry, 14(1), 59.
  • Yakın, E., Raynal, P. ve Chabrol, H. (2021). Distinguishing orthorexic behaviors from eating disordered and obsessive–compulsive behaviors: a typological study. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26(6), 2011-2019.
Toplam 85 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Psikoloji
Bölüm Araştırma Makaleleri
Yazarlar

İlgün Bilekli Bilger Bu kişi benim 0000-0002-1860-2363

İhsan Dağ Bu kişi benim 0000-0003-4334-9512

Yayımlanma Tarihi 25 Aralık 2023
Gönderilme Tarihi 6 Haziran 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 7 Sayı: 3

Kaynak Göster

APA Bilekli Bilger, İ., & Dağ, İ. (2023). Yeme Alışkanlıkları Ölçeği, Barselona Ortoreksiya Ölçeği ve Ortoreksiya Nervoza Ölçeğinin Türkçeye uyarlanması ve psikometrik özelliklerinin değerlendirilmesi. Klinik Psikoloji Dergisi, 7(3), 325-350. https://doi.org/10.5455/kpd.26024438m000100
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