Development and validation of the Eating Disorder Recovery Self-Efficacy Questionnaire
by Marinilli Pinto, Angela, Ph.D., University of Maryland, Baltimore County, 2004
Self-efficacy plays an important role in successful behavior change. While researchers have explored weight loss and dieting self-efficacy in obesity, little work has been done to examine self-efficacy among eating disorder patients. Lack of research in this area is due, in part, to the absence of a valid measure for assessing self-efficacy in this clinical group. The present study is the first to develop and initially validate a self-report scale to measure self-efficacy to recover from an eating disorder, the Eating Disorder Recovery Self-Efficacy scale (EDRS). Participants were 124 patients diagnosed with anorexia or bulimia nervosa or subclinical eating disorders being treated at the Johns Hopkins Eating Disorders Program. Patients completed the EDRS and other self-report measures to assess eating disorder symptoms and related psychopathology. Inpatients completed the EDRS at three points during treatment and were assessed on weight gain rate and frequency of problem behaviors. As expected, the EDRS contains two internally consistent factors, Normative Eating and Body Image Self-Efficacy. Good support for the scale’s convergent validity is provided by findings of moderate to large correlations between EDRS subscales and other validated measures of eating disorder pathology. Theoretically consistent relationships between the EDRS and constructs that are related to, but distinct from, self-efficacy (e.g., depression, struggle to maintain behavior change) provide additional support for construct validity. Discriminant validity of the EDRS is reflected in small correlations between EDRS subscales and measures of general psychological correlates of eating disorder patients. Among inpatients, Normative Eating Self-Efficacy increased significantly from admission to discharge, suggesting that this scale may be used to assess change in self-efficacy during treatment. Although increases in Body Image Self-Efficacy were not significant, movement in efficacy scores was in the expected direction. The current study did not demonstrate a clear relationship between self-efficacy and behavioral outcome. Further investigation is needed to clarify how EDRS subscales are related to weight gain, treatment adherence, and eating disorder behavior and to examine the utility of the EDRS with young adolescents. Overall, results of this study suggest that the EDRS is a psychometrically sound measure to assess self-efficacy in eating disorder patients.