The orthorexia nervosa scale: updated and tested in a targeted community sample
Date
2019
Authors
Kramer, Melanie E., author
Rickard, Kathryn, advisor
Conner, Bradley T., committee member
Harris, Mary, committee member
Crain, Tori, committee member
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Abstract
In 2000, physician Steven Bratman coined the term Orthorexia Nervosa (ON) based on his observations that some individuals were so obsessed with healthy eating that it reached a pathological level (Bratman & Knight, 2000). He conceptualized ON as a way to describe an obsession about proper nutrition and a "fixation" on healthy eating (Bratman & Knight, 2000). Currently, very little is known about ON, as evidenced by lack of a formal operational definition or standard diagnostic criteria. Although there are three existing scales that measure ON (Bratman & Knight, 2000; Donini, Marsili, Gaziani, Imbriale, & Cannella, 2005; Gleaves, Graham, & Ambwani, 2013), none of them appear to completely capture all of the facets of ON. This dissertation details the attempt to develop a psychometrically valid and reliable scale, the Orthorexia Nervosa Scale (ONS), that more accurately and fully captures the construct of ON, followed up by examining ON and its relationship to other related constructs – obsessive compulsive disorder, anxiety, and disordered eating symptoms. Initial analyses (exploratory factor analysis and confirmatory factor analysis) of a 103 item pool indicated a 10-factor solution with an adequate model fit once model modifications were made (Kramer, 2016). As part of the current study, items were examined and adjustments were made (e.g. removing and revising items). An EFA and CFA were conducted (n=537 and n=465, respectively), and revealed a 6-factor structure. Additionally, the CFA revealed a good model fit, X2 (650) = 1531.115, p < 0.01, CFI = 0.903, SRMR = 0.07. The six dimensions assessed by the six factors were: 1) Social Concerns, 2) Knowledge/Superiority, 3) Fulfillment/Control, 4) Pureness/Natural Quality of Food, 5) Detox, and 6) Online Forums/Blogs. Data were then collected using a targeted community sample (i.e. targeting healthy eating groups on Facebook) to examine relationships between the ONS, obsessive compulsive disorder, anxiety, and disordered eating symptoms. Two alternative models were tested using path analysis. Analysis revealed good model fit for both models. This highlights the complex factor structure of ON, and indicates the difficulty in replicating the scale. The current study provides a strong foundation for determining a definitive factor structure for ON. While more research is needed to clarify the factor structure, the overall results suggest that the six factors captured by the ONS in the current study will be a useful tool for future research and scale development related to ON.
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Subject
healthy
eating
orthorexia