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Escala Debq-C
Escala Debq-C
2011;26(4):890-898
ISSN 0212-1611 • CODEN NUHOEQ
S.V.R. 318
Original
Validation of the dutch eating behavior questionnaire for children
(DEBQ-C) for use with Spanish children
R. M. Baños1,2, A. Cebolla2,3, E. Etchemendy2, S. Felipe1, P. Rasal2 and C. Botella2,3
1
University of Valencia. Valencia. Spain. 2Ciber. Fisiopatología, Obesidad y Nutrición. Instituto de Salud Carlos III. Spain.
3
University Jaume I. Castellón. Spain.
890
Introduction Braet et al.14 used also the DEBQ to compare the eating
habits of overweight and normal-weight youngsters,
Childhood overweight and obesity are the most including children and adolescents (from 10 to 14 years
common health disorders in western countries. It is old) showing good psychometric properties. However,
necessary to study factors that influence these condi- they found that the youngest children did not fully
tions in order to improve prevention and treatment comprehend the items on the restrained eating scale.
strategies, particularly because the risk of being over- More recently, Van Strien and Oosterveld18 adapted
weight in adulthood is significantly higher in over- the instrument (DEBQ-C) for boys and girls from
weight children than in normal weight children.1,2 The seven to twelve years old. To do so, the authors adapted
scientific literature has identified several variables that the items, simplified the sentences and reduced
play an influential role in childhood overweight includ- response choices to three (“no”, “sometimes” and
ing medical, social and psychological factors. One of “yes”). They administered this new version to 185
these variables is the presence of dysfunctional eating eight-year-old children and obtained a factorial struc-
behaviors. ture of three factors (the same as in adults), which
Three dietary dysfunctional eating patterns have explained 35.8% variance. The final version of the
been identified: emotional, external and restrained eat- instrument included 20 items (7 on emotional eating, 7
ing. “Emotional eating” has been addressed by the Psy- on restrained eating, and 6 on external eating). This fur-
chosomatic Theory;3 it refers to eating in response to ther adapted version was administered to 769 seven- to
negative emotions in order to relieve stress while disre- twuelve12-year-old children, and a confirmatory facto-
garding internal physiological signals of hunger and rial analysis was applied. Results supported the validity
satiety. Several studies have shown that obese adults of the three-factor structure and showed that this struc-
engage in more emotional eating than non-obese ture was invariant of sex, body mass index (BMI) and
adults;4,5,6 emotional eating has even been explored as a age. Moreover, Cronbach’s α ranging from 0.73 to
risk factor for developing obesity;7 it has been also 0.82 were obtained.
related with a gene expression of depressive feelings,8 The aim of the present study is to evaluate the psy-
and parental control and Dopamine D2 receptor gene.9 chometric properties of the Spanish version of the
“External eating” refers to eating in response to exter- DEBQ-C. Internal consistency, temporal stability (one
nal cues for food, such as sights or smells.10 As with month), age and gender differences, and factorial struc-
emotional eating, external eating involves a decreased ture will be analyzed. Furthermore, three different
sensibility to internal signals of hunger and satiety.6 weight groups (clinical overweight, non clinical over-
This eating behavior was addressed in Schachter’s weight and non clinical normal weight participants)
“Externality theory” of obesity.11 Finally, “Restrained will be compared. Finally, relationships between
eating” was addressed by the restraint theory;12 it refers DEBQ-C scales and eating attitudes (EAT-26) will be
to eating when an individual uses cognitive suppres- explored, and differences between eating disorder
sion of internal hunger signals in order to lose or main- (ED) risky (EAT-26 > 20) and non risky (EAT-26 < 1)
tain a particular weight. on eating behaviors will be investigated.
The Dutch Eating Behavior Questionnaire (DEBQ)
was developed to measure these three eating behaviors
in adults.13 It is composed by 33 questions with 5- Method
choice answers (ranging from “never” to “very often”).
This instrument has been extensively used, and has Participants
proven to be a useful and reliable tool.6,13,14
In order to study eating behaviors in children, sev- A total of 473 children participated in the study (240
eral adaptations of the DEBQ have been proposed. boys and 233 girls). They were drawn from both clini-
Braet and Van Strien15 used the adult version but found cal and non-clinical populations. The non-clinical par-
that most of the nine year old children did not completely ticipants were recruited from four elementary schools,
understand the questions. Hill and Palin16 used a modified and were divided into two groups according to their
version of the dietary Restraint Scale of the DEBQ in weight: the normal weight group (NWG; n = 280) and
eight-year-old children. This version included six of the the non-clinical overweight group (NCOG; n = 31).
ten original questions and the language was adapted to Participants were categorized as overweight when their
appropriate child reading levels. Furthermore, authors weight exceeded the 85th percentile. The BMI per-
simplified the answers by including only three possible centiles for age and gender were based on normative
choices. The results of this study showed adequate con- data for the Spanish population.19 The clinical over-
struct validity, but the authors did not provide informa- weight group (COG; N = 81), was recruited from a
tion on reliability. Halvarsson and Sjöden17 examined Child and Adolescent Cardiovascular Risk Unit, from a
the psychometric properties of the DEBQ in a sample Pediatric Service located in a public hospital specializ-
of nine-to ten-year-old children, and obtained adequate ing in childhood obesity treatments. All were receiving
psychometric properties (Cronbach’s α of 0.83 in total weight loss treatments based on nutritional and behav-
and a range of 0.77 and 0.86 for the DEBQ-C scales). ioral modification, and most of them were also receiv-
Table II
Differences among COG, NCOG and NWG
differences only between the COG and the NCOG (p = ables, but results were similar, and gender and age were
0.04), with the COG scoring higher. No differences not significant for any scale.
involving the NWG were found. Regarding “Restrained
eating”, results also revealed significant differences
among groups, and the post-hoc (Tuckey) analyses Reliability Analysis: Internal consistency
showed differences between the NWG and the COG (p and temporal stability
< 0.001), and between the NWG and the NCOG (p <
0.001), with the NWG scoring lower than the other In order to analyze internal consistency, Cronbach’s
overweight groups. There were no differences between alpha coefficients for the DEBQ-C and the three scales
the COG and the NCOG in this eating behavior. were calculated. The alpha values for the scales were
Finally, regarding “External eating”, results showed 0.69 for “Restrained eating”, 0.78 for “Emotional eat-
significant differences, and the post hoc (Tuckey) ing”, and 0.69 for “External eating”. Due to the low
analysis revealed differences only between the NWG score in “Restrained eating”, the analysis was repeated
and the COG (p = 0.02), with the NWG scoring higher. in order to observe the effects of each item over Cron-
Additional analyses used gender and age as covari- bach’s alpha coefficient. Excluding item 4, the alpha