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      The German Version of the Dutch Eating Behavior Questionnaire: Psychometric Properties, Measurement Invariance, and Population-Based Norms

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          Abstract

          The Dutch Eating Behavior Questionnaire is an internationally widely used instrument assessing different eating styles that may contribute to weight gain and overweight: emotional eating, external eating, and restraint. This study aimed to evaluate the psychometric properties of the 30-item German version of the DEBQ including its measurement invariance across gender, age, and BMI-status in a representative German population sample. Furthermore, we examined the distribution of eating styles in the general population and provide population-based norms for DEBQ scales. A representative sample of the German general population (N = 2513, age ≥ 14 years) was assessed with the German version of the DEBQ along with information on sociodemographic characteristics and body weight and height. The German version of the DEQB demonstrates good item characteristics and reliability (restraint: α = .92, emotional eating: α = .94, external eating: α = .89). The 3-factor structure of the DEBQ could be replicated in exploratory and confirmatory factor analyses and results of multi-group confirmatory factor analyses supported its metric and scalar measurement invariance across gender, age, and BMI-status. External eating was the most prevalent eating style in the German general population. Women scored higher on emotional and restrained eating scales than men, and overweight individuals scored higher in all three eating styles compared to normal weight individuals. Small differences across age were found for external eating. Norms were provided according to gender, age, and BMI-status. Our findings suggest that the German version of the DEBQ has good reliability and construct validity, and is suitable to reliably measure eating styles across age, gender, and BMI-status. Furthermore, the results demonstrate a considerable variation of eating styles across gender and BMI-status.

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          Most cited references20

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          Binge eating as escape from self-awareness.

          This article proposes that binge eating is motivated by a desire to escape from self-awareness. Binge eaters suffer from high standards and expectations, especially an acute sensitivity to the difficult (perceived) demands of others. When they fall short of these standards, they develop an aversive pattern of high self-awareness, characterized by unflattering views of self and concern over how they are perceived by others. These aversive self-perceptions are accompanied by emotional distress, which often includes anxiety and depression. To escape from this unpleasant state, binge eaters attempt the cognitive response of narrowing attention to the immediate stimulus environment and avoiding broadly meaningful thought. This narrowing of attention disengages normal inhibitions against eating and fosters an uncritical acceptance of irrational beliefs and thoughts. The escape model is capable of integrating much of the available evidence about binge eating.
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            [Overweight and obesity in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

            The increase in overweight and obesity is a worldwide health problem. The first wave of the "German Health Interview and Examination Survey for Adults" (DEGS1), conducted from 2008 through 2011, provides current data about overweight and obesity among adults in Germany. Within DEGS1, a representative sample of the 18- to 79-year-old population was interviewed with regard to health relevant issues and physically examined (n = 7,116). From measurements of body height and weight, the body mass index (BMI) was calculated, which was used to define overweight (BMI ≥ 25 kg/m(2)) and obesity (BMI ≥ 30 kg/m(2)). Results are stratified for gender, age group, socioeconomic status and region and compared with results from the German National Health Interview and Examination Survey 1998 (GNHIES98) and the National Examination Surveys 1990/92. According to DEGS1, 67.1% of men and 53.0% of women are overweight. The prevalence of overweight has not changed compared to GNHIES98. The prevalence of obesity, however, has risen substantially, especially among men: in GNHIES98, 18.9% of men and 22.5% of women were obese, in DEGS1, these figures were 23.3% and 23.9%, respectively. The increase in obesity occurred especially among young adults. An English full-text version of this article is available at SpringerLink as supplemental.
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              The children's DEBQ for assessment of restrained, emotional, and external eating in 7- to 12-year-old children.

              Construct an age adapted version of the Dutch Eating Behaviour Questionnaire (DEBQ) for measurement of restrained, emotional and external eating in 7- to 12-year-old children: the DEBQ-C. The DEBQ-C was constructed and tested for its reliability, factorial validity, factorial invariance for sex, overweight (BMI-status), and age, and correlations with measures for unhealthy life style in one sample (382 boys and 387 girls). In a second sample (252 boys and 263 girls) correlations were obtained with measures for body dissatisfaction and parental feeding styles. Single and multigroup confirmatory factor analyses were used. The fit measures for the three factor model and the factorial invariance models with respect to sex, BMI-status, and age were satisfactory. In the (sub) samples of the 7- to 12-year-olds Cronbach's alpha's ranged from .73 to .82 and there were satisfactory correlations (p < .01) with other measures. The DEBQ-C should provide a useful measure for young children's emerging dietary restraint and overeating tendencies. The low prevalence of emotional eating indicates that most young children show the natural reaction to emotional stressors (loss of appetite when feeling lonely, depressed or afraid) and that emotional (over) eating at this age is quite abnormal.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                22 September 2016
                2016
                : 11
                : 9
                : e0162510
                Affiliations
                [1 ]Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
                [2 ]Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig Medical Center, Leipzig, Germany
                [3 ]Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
                [4 ]Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
                [5 ]Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
                Hospital Universitario de la Princesa, SPAIN
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceived and designed the experiments: EB AK AH MdZ.

                • Analyzed the data: MN.

                • Contributed reagents/materials/analysis tools: AK AH MdZ EB MN.

                • Wrote the paper: MN.

                • Interpretation of the data: MN AH MdZ EB AK. Revision of the article: MN AH MdZ EB AK. Final approval: MN AH MdZ EB AK.

                Author information
                http://orcid.org/0000-0002-9115-0674
                Article
                PONE-D-16-19849
                10.1371/journal.pone.0162510
                5033316
                27656879
                204ba89f-fc9a-40e4-849b-4bec6e130ae5
                © 2016 Nagl et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 17 May 2016
                : 1 August 2016
                Page count
                Figures: 0, Tables: 4, Pages: 15
                Funding
                AH was supported by the German Federal Ministry of Education and Research (grant 01EO1501). We acknowledge support from the German Research Foundation (DFG) and Universität Leipzig within the program of Open Access Publishing. The external funding body had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Eating
                Medicine and Health Sciences
                Physiology
                Physiological Processes
                Eating
                Biology and Life Sciences
                Behavior
                Habits
                Eating Habits
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Obesity
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Obesity
                People and Places
                Population Groupings
                Ethnicities
                German People
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Factor Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Factor Analysis
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Biology and Life Sciences
                Psychology
                Psychometrics
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