Development and Initial Evaluation of the Athlete Eating Psychopathology Observation Questionnaire for Sport Professionals

in Journal of Clinical Sport Psychology

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Sebastian S. Sandgren School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
Department of Education and Sports Science, University of Stavanger, Stavanger, Norway

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Emma Haycraft School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom

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Carolyn R. Plateau School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom

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Eating psychopathology symptoms are common in athletes; however, it is unknown which symptoms are detected and to what extent by sport professionals. This study aimed to develop and evaluate a self-report questionnaire to explore which features of eating psychopathology in athletes are detected by sport professionals, and how observation of these symptoms might vary. Thirty-one questions were developed and 232 sport professionals (56% male) participated in the study. Exploratory Factor Analysis revealed a 20-item, five-factor solution (Negative Affect, Dieting Practices, Fear of Eating in Social Contexts, Bingeing and Purging, and Compulsive Exercise). Participants most frequently reported observing athletes’ dieting practices, while symptoms of a fear of eating in social contexts were observed least frequently. This study has developed and preliminarily tested the Athlete Eating Psychopathology Observation Questionnaire (AEPOQ), which now requires further validation. The findings provide important directions for education initiatives with sport professionals regarding identification of eating psychopathology symptoms.

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  • Anderson, C., & Petrie, T.A. (2012). Prevalence of disordered eating and pathogenic weight control behaviors among NCAA division I female collegiate gymnasts and swimmers. Research Quarterly for Exercise and Sport, 83(1), 120124. https://doi.org/10.1080/02701367.2012.10599833

    • Search Google Scholar
    • Export Citation
  • Baglin, J. (2014). Improving your exploratory factor analysis for ordinal data: A demonstration using FACTOR. Practical Assessment, Research & Evaluation, 19(5), 215. https://doi.org/10.7275/dsep-4220

    • Search Google Scholar
    • Export Citation
  • Biggin, I.J., Burns, J.H., & Uphill, M. (2017). An investigation of athletes’ and coaches’ perceptions of mental ill-health in elite athletes. Journal of Clinical Sport Psychology, 11(2), 126147. https://doi.org/10.1123/jcsp.2016-0017

    • Search Google Scholar
    • Export Citation
  • Bonci, C.M., Bonci, L.J., Granger, L.R., Johnson, C.L., Malina, R.M., Milne, L.W., Ryan, R.R., & Vanderbunt, E.M. (2008). National Athletic Trainers’ Association position statement: Preventing, detecting, and managing disordered eating in athletes. Journal of Athletic Training, 43(1), 80108. https://doi.org/10.4085/1062-6050-43.1.80

    • Search Google Scholar
    • Export Citation
  • Bratland-Sanda, S., & Sundgot-Borgen, J. (2013). Eating disorders in athletes: Overview of prevalence, risk factors and recommendations for prevention and treatment. European Journal of Sport Science, 13(5), 499508. https://doi.org/10.1080/17461391.2012.740504

    • Search Google Scholar
    • Export Citation
  • Breslin, G., Shannon, S., Haughey, T., Donnelly, P., & Leavey, G. (2017). A systematic review of interventions to increase awareness of mental health and well-being in athletes, coaches and officials. Systematic Reviews, 6(1), 177. https://doi.org/10.1186/s13643-017-0568-6

    • Search Google Scholar
    • Export Citation
  • Costello, A.B., and Osborne, J.W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research & Evaluation, 10, 19. https://doi.org/10.7275/jyj1-4868

    • Search Google Scholar
    • Export Citation
  • DeFeciani, L. (2016). Eating disorders and body image concerns among male athletes. Clinical Social Work Journal, 44(1), 114123. https://doi.org/10.1007/s10615-015-0567-9

    • Search Google Scholar
    • Export Citation
  • Estanol, E., Shepherd, C., & MacDonald, T. (2013). Mental skills as protective attributes against eating disorder risk in dancers. Journal of Applied Sport Psychology, 25(2), 209222. https://doi.org/10.1080/10413200.2012.712081

    • Search Google Scholar
    • Export Citation
  • Fabrigar, L.R., Wegener, D.T., MacCallum, R.C., & Strahan, E.J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4(3), 272299. https://doi.org/10.1037/1082-989X.4.3.272

    • Search Google Scholar
    • Export Citation
  • Floyd, F.J., & Widaman, K.F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7(3), 286299. https://doi.org/10.1037/1040-3590.7.3.286

    • Search Google Scholar
    • Export Citation
  • Giel, K.E., Hermann-Werner, A., Mayer, J., Diehl, K., Schneider, S., Thiel, A., & Zipfel, S. (2016). Eating disorder pathology in elite adolescent athletes. International Journal of Eating Disorders, 49(6), 553562. https://doi.org/10.1002/eat.22511

    • Search Google Scholar
    • Export Citation
  • Gísladóttir, M., & Svavarsdóttir, E.K. (2011). Educational and support intervention to help families assist in the recovery of relatives with eating disorders. Journal of Psychiatric and Mental Health Nursing, 18(2), 122130. https://doi.org/10.1111/j.1365-2850.2010.01637.x

    • Search Google Scholar
    • Export Citation
  • Gorczynski, P., Currie, A., Gibson, K., Gouttebarge, V., Hainline, B., Castaldelli-Maia, J.M., Mountjoy, M., Purcell, R., Reardon, C.L., Rice, S., & Swartz, L. (2021). Developing mental health literacy and cultural competence in elite sport. Journal of Applied Sport Psychology, 33(4), 387401. https://doi.org/10.1080/10413200.2020.1720045

    • Search Google Scholar
    • Export Citation
  • Gorrell, S., Scharmer, C., Kinasz, K., & Anderson, D. (2020). Compulsive exercise and weight suppression: Associations with eating pathology in distance runners. Eating Behaviors, 36, Article 101358. https://doi.org/10.1016/j.eatbeh.2019.101358

    • Search Google Scholar
    • Export Citation
  • Greenleaf, C., Petrie, T.A., Carter, J., & Reel, J.J. (2009). Female collegiate athletes: Prevalence of eating disorders and disordered eating behaviors. Journal of American College Health, 57(5), 489496. https://doi.org/10.3200/JACH.57.5.489-496

    • Search Google Scholar
    • Export Citation
  • Hinton, P.R., Brownlow, C., McMurray, I., & Cozens, B. (2004). SPSS explained. Routledge.

  • Hurley, A.E., Scandura, T.A., Schriesheim, C.A., Brannick, M.T., Seers, A., Vandenberg, R.J., & Williams, L.J. (1997). Exploratory and confirmatory factor analysis: Guidelines, issues, and alternatives. Journal of Organizational Behavior, 18(6), 667683. https://www.jstor.org/stable/3100253

    • Search Google Scholar
    • Export Citation
  • Joy, E., Kussman, A., & Nattiv, A. (2016). 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British Journal of Sports Medicine, 50(3), 154162. https://doi.org/10.1136/bjsports-2015-095735

    • Search Google Scholar
    • Export Citation
  • Jung, S., & Lee, S. (2011). Exploratory factor analysis for small samples. Behavior Research Methods, 43(3), 701709. https://doi.org/10.3758/s13428-011-0077-9

    • Search Google Scholar
    • Export Citation
  • Kerr, G., Berman, E., & Souza, M.J.D. (2006). Disordered eating in women’s gymnastics: Perspectives of athletes, coaches, parents, and judges. Journal of Applied Sport Psychology, 18(1), 2843. https://doi.org/10.1080/10413200500471301

    • Search Google Scholar
    • Export Citation
  • Kroshus, E., DeFreese, J.D., & Kerr, Z.Y. (2018). Collegiate athletic trainers’ knowledge of the female athlete triad and relative energy deficiency in sport. Journal of Athletic Training, 53(1), 5159. https://doi.org/10.4085/1062-6050-52.11.29

    • Search Google Scholar
    • Export Citation
  • Kyriazos, T.A. (2018). Applied psychometrics: Sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology, 9(8), 2207. https://doi.org/10.4236/psych.2018.98126

    • Search Google Scholar
    • Export Citation
  • Laramée, C., Drapeau, V., Valois, P., Goulet, C., Jacob, R., Provencher, V., & Lamarche, B. (2017). Evaluation of a theory-based intervention aimed at reducing intention to use restrictive dietary behaviors among adolescent female athletes. Journal of Nutrition Education and Behavior, 49(6), 497504.e1. https://doi.org/10.1016/j.jneb.2017.03.009

    • Search Google Scholar
    • Export Citation
  • Lemyre, P.N., Treasure, D.C., & Roberts, G.C. (2006). Influence of variability in motivation and affect on elite athlete burnout susceptibility. Journal of Sport and Exercise Psychology, 28(1), 3248. https://doi.org/10.1123/jsep.28.1.32

    • Search Google Scholar
    • Export Citation
  • Martin, J., Padierna, A., González, N., Aguirre, U., Lafuente, I., Muñoz, P., & Quintana, J.M. (2014). Evaluation of the psychometric characteristics of the Spanish version of the Anorectic Behaviour Observation Scale. International Journal of Clinical Practice, 68(1), 8393. https://doi.org/10.1111/ijcp.12223

    • Search Google Scholar
    • Export Citation
  • Martinsen, M., Bratland-Sanda, S., Eriksson, A.K., & Sundgot-Borgen, J. (2010). Dieting to win or to be thin? A study of dieting and disordered eating among adolescent elite athletes and non-athlete controls. British Journal of Sports Medicine, 44(1), 7076. https://doi.org/10.1136/bjsm.2009.068668

    • Search Google Scholar
    • Export Citation
  • McArdle, S., Meade, M.M., & Moore, P. (2016). Exploring attitudes toward eating disorders among elite athlete support personnel. Scandinavian Journal of Medicine & Science in Sports, 26(9), 11171127. https://doi.org/10.1111/sms.12515

    • Search Google Scholar
    • Export Citation
  • Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N.L., Sherman, R., Steffen, K., & Budgett, R., & Ljungqvist, A. (2014). The IOC consensus statement: Beyond the female athlete triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48(7), 491497. https://doi.org/10.1136/bjsports-2014-093502

    • Search Google Scholar
    • Export Citation
  • Nattiv, A., Loucks, A.B., Manore, M.M., Sanborn, C.F., Sundgot-Borgen, J., & Warren, M.P. (2007). The female athlete triad. American College of Sports Medicine position stand. Medicine & Science in Sports & Exercise, 39(10), 18671882. https://doi.org/10.1249/mss.0b013e318149f111

    • Search Google Scholar
    • Export Citation
  • Neal, T.L., Diamond, A.B., Goldman, S., Klossner, D., Morse, E.D., Pajak, D.E., Putukian, M., Quandt, E.F., Sullivan, J.P., & Wallack, C., & Welzant, V. (2013). Inter-association recommendations for developing a plan to recognize and refer student-athletes with psychological concerns at the collegiate level: An executive summary of a consensus statement. Journal of Athletic Training, 48(5), 716720. https://doi.org/10.4085/1062-6050-48.4.13

    • Search Google Scholar
    • Export Citation
  • Nowicka, P., Eli, K., Ng, J., Apitzsch, E., & Sundgot-Borgen, J. (2013). Moving from knowledge to action: A qualitative study of elite coaches’ capacity for early intervention in cases of eating disorders. International Journal of Sports Science & Coaching, 8(2), 343355. https://doi.org/10.1260/1747-9541.8.2.343

    • Search Google Scholar
    • Export Citation
  • Peos, J.J., Norton, L.E., Helms, E.R., Galpin, A.J., & Fournier, P. (2019). Intermittent dieting: Theoretical considerations for the athlete. Sports, 7(1), 22. https://doi.org/10.3390/sports7010022

    • Search Google Scholar
    • Export Citation
  • Plateau, C.R., Arcelus, J., McDermott, H.J., & Meyer, C. (2015). Responses of track and field coaches to athletes with eating problems. Scandinavian Journal of Medicine & Science in Sports, 25(2), e240e250. https://doi.org/10.1111/sms.12286

    • Search Google Scholar
    • Export Citation
  • Plateau, C.R., McDermott, H.J., Arcelus, J., & Meyer, C. (2014). Identifying and preventing disordered eating among athletes: Perceptions of track and field coaches. Psychology of Sport and Exercise, 15(6), 721728. https://doi.org/10.1016/j.psychsport.2013.11.004

    • Search Google Scholar
    • Export Citation
  • Plateau, C.R., Shanmugam, V., Duckham, R.L., Goodwin, H., Jowett, S., Brooke-Wavell, K.S., Laybourne, A., Arcelus, J., & Meyer, C. (2014). Use of the compulsive exercise test with athletes: Norms and links with eating psychopathology. Journal of Applied Sport Psychology, 26(3), 287301. https://doi.org/10.1080/10413200.2013.867911

    • Search Google Scholar
    • Export Citation
  • Poucher, Z.A., Tamminen, K.A., Kerr, G., & Cairney, J. (2021). A commentary on mental health research in elite sport. Journal of Applied Sport Psychology, 33(1), 6082. https://doi.org/10.1080/10413200.2019.1668496

    • Search Google Scholar
    • Export Citation
  • Prnjak, K., Jukic, I., & Tufano, J.J. (2019). Perfectionism, body satisfaction and dieting in athletes: The role of gender and sport type. Sports, 7(8), 181. https://doi.org/10.3390/sports7080181

    • Search Google Scholar
    • Export Citation
  • Quatromoni, P.A. (2008). Clinical observations from nutrition services in college athletics. Journal of the American Dietetic Association, 108(4), 689694. https://doi.org/10.1016/j.jada.2008.01.008

    • Search Google Scholar
    • Export Citation
  • Rice, S.M., Purcell, R., De Silva, S., Mawren, D., McGorry, P.D., & Parker, A.G. (2016). The mental health of elite athletes: A narrative systematic review. Sports Medicine, 46(9), 13331353. https://doi.org/10.1007/s40279-016-0492-2

    • Search Google Scholar
    • Export Citation
  • Russell, S., Jenkins, D., Rynne, S., Halson, S.L., & Kelly, V. (2019). What is mental fatigue in elite sport? Perceptions from athletes and staff. European Journal of Sport Science, 19(10), 13671376. https://doi.org/10.1080/17461391.2019.1618397

    • Search Google Scholar
    • Export Citation
  • Schafer, J.L., & Olsen, M.K. (1998). Multiple imputation for multivariate missing-data problems: A data analyst’s perspective. Multivariate Behavioral Research, 33(4), 545571. https://doi.org/10.1207/s15327906mbr3304_5

    • Search Google Scholar
    • Export Citation
  • Schoen, E., Brock, R., & Hannon, J. (2019). Gender bias, other specified and unspecified feeding and eating disorders, and college students: A vignette study. Eating Disorders, 27(3), 291304. https://doi.org/10.1080/10640266.2018.1504536

    • Search Google Scholar
    • Export Citation
  • Sherman, R., Thompson, R.A., Dehass, D., & Wilfert, M. (2005). NCAA coaches survey: The role of the coach in identifying and managing athletes with disordered eating. Eating Disorders, 13(5), 447466. https://doi.org/10.1080/10640260500296707

    • Search Google Scholar
    • Export Citation
  • Sundgot-Borgen, J., & Torstveit, M.K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine, 14(1), 2532. https://doi.org/10.1097/00042752-200401000-00005.

    • Search Google Scholar
    • Export Citation
  • Sundgot-Borgen, J., & Torstveit, M.K. (2010). Aspects of disordered eating continuum in elite high-intensity sports. Scandinavian Journal of Medicine & Science in Sports, 20, 112121. https://doi.org/10.1111/j.1600-0838.2010.01190.x

    • Search Google Scholar
    • Export Citation
  • Tabachnick, B.G., Fidell, L.S. (2001). Using multivariate statistics (4th ed.). Allyn and Bacon.

  • Taber, K.S. (2018). The use of Cronbach’s alpha when developing and reporting research instruments in science education. Research in Science Education, 48(6), 12731296. https://doi.org/10.1007/s11165-016-9602-2

    • Search Google Scholar
    • Export Citation
  • Ursachi, G., Horodnic, I.A., & Zait, A. (2015). How reliable are measurement scales? External factors with indirect influence on reliability estimators. Procedia Economics and Finance, 20, 679686. https://doi.org/10.1016/S2212-5671(15)00123-9

    • Search Google Scholar
    • Export Citation
  • Vandereycken, W.V., & Meerman, R. (1984). Anorexia Nervosa: A clinician’s guide to treatment. Walter de Gruyter.

  • Worsfold, K.A., & Sheffield, J.K. (2021). Practitioner eating disorder detection: The influence of health mindset, thin-ideal internalization, orthorexia and gender role. Early Intervention in Psychiatry, 15(2), 296305. https://doi.org/10.1111/eip.12940

    • Search Google Scholar
    • Export Citation
  • Yong, A.G., & Pearce, S. (2013). A beginner’s guide to factor analysis: Focusing on exploratory factor analysis. Tutorials in Quantitative Methods for Psychology, 9(2), 7994. https://doi.org/10.20982/tqmp.09.2.p079

    • Search Google Scholar
    • Export Citation
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