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BACKGROUND: Although the Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used self-report assessments of eating disorder symptoms, evidence indicates potential limitations with its original factor structure and associated psychometric properties in a variety of populations, including sexual minority populations. The aims of the current investigation were to explore several previously published EDE-Q factor structures and to examine internal consistency and measurement invariance of the best-fitting EDE-Q model in a large community sample of cisgender gay men and cisgender lesbian women. METHODS: Data were drawn from 1624 adults (1060 cisgender gay men, 564 cisgender lesbian women) who participated in The PRIDE Study, a large-scale longitudinal cohort study of sexual and gender minorities from the United States. A series of confirmatory factor analyses (CFAs) were conducted to explore the fit of eight proposed EDE-Q models; internal consistency (Cronbach's alphas, Omega coefficients) and measurement invariance (multi-group CFA) were subsequently evaluated. RESULTS: A brief seven-item, three-factor (dietary restraint, shape/weight overvaluation, body dissatisfaction) model of the EDE-Q from Grilo et al. (Obes Surg. 23:657-662, 2013), consistently evidenced the best fit across cisgender gay men and lesbian women. The internal consistencies of the three subscales were adequate in both groups, and measurement invariance across the groups was supported. CONCLUSIONS: Taken together, these findings support the use of the seven-item, three-factor version of the EDE-Q for assessing eating disorder symptomatology in cisgender gay men and lesbian women. Future studies can confirm the current findings in focused examinations of the seven-item, three-factor EDE-Q in diverse sexual minority samples across race, ethnicity, socioeconomic status, and age ranges.

We asked cisgender gay men and lesbian women in The PRIDE Study to fill out a widely used survey about eating disorders, the Eating Disorder Examination-Questionnaire. We found that a version of this questionnaire based on seven questions including three parts­(1) dietary restraint, (2) shape and weight overvaluation, and (3) body dissatisfaction­had the best fit. These findings can assist doctors and scientists in understanding eating disorders in cisgender gay men and lesbian women.

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OBJECTIVE: The Muscularity-Oriented Eating Test (MOET) is a 15-item unidimensional scale, designed to assess eating practices that occur in the pursuit of a muscular body. The aim of the present study was to describe the translation and cultural adaptation of the MOET to Brazilian Portuguese, to explore its factor structure and measurement invariance, and to evaluate its internal consistency, three-week test-retest reliability, and convergent validity in a community sample of Brazilian men and women. METHOD: After the back-translation procedure, the Brazilian MOET was administered online to a sample of 1246 adults (634 men and 612 women), along with measures of drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating behaviors, and exercise dependence. RESULTS: Findings from an exploratory factor analysis and a confirmatory factor analysis revealed a one-factor structure and adequate internal consistency for men (ω = 0.86; α = 0.86) and women (ω = .84; α = .83). Measurement invariance across gender was supported. In addition, the scale demonstrated good three week test-retest reliability for both men (ICC = .96; p < .001) and women (ICC = .92; p < .001), and the subscales revealed moderate to large associations with drive for muscularity, muscle dysmorphia symptoms, muscular/athletic-ideal internalization, disordered eating, and exercise dependence. CONCLUSION: This study supports the validity and reliability of the MOET in a community sample of Brazilian men and women and represents an advance in measures of muscularity-oriented disordered eating in Brazilian adults, allowing for future cross-cultural studies in this field. PUBLIC SIGNIFICANCE: The Muscularity-Oriented Eating Test (MOET) is a measure of muscularity-oriented disordered eating, which assess strict adherence to diet rules, including the food's macronutrient content, regulation of protein intake, and eating less or more to influence muscle gain. This study evaluated the validity and reliability of the MOET in a community sample of Brazilian men and women. Our findings represent an advance in measures of muscularity-oriented disordered eating in Brazilian adults.

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PURPOSE: Muscle dysmorphia is generally classified as a specific form of body dysmorphic disorder characterized by a pathological drive for muscularity and the preoccupation that one is too small or not sufficiently muscular. The majority of research on the condition has been conducted in cisgender men with a paucity of literature on gender minority people, a population that is at risk for muscle dysmorphia. One of the most widely used measures of muscle dysmorphia symptoms, the Muscle Dysmorphic Disorder Inventory (MDDI), has not been psychometrically validated for use in gender minority samples, the aim of the present study. METHODS: We evaluated the psychometric properties of the MDDI in a sample of 1031 gender-expansive individuals (gender minority people whose gender identity differs from that assumed for their sex assigned at birth and is not exclusively binary man or woman) aged 18-74 who were part of The PRIDE Study, a large-scale, U.S., longitudinal cohort study. RESULTS: Using a two-step, split-sample exploratory and confirmatory factor analytic approach, we found support for the original three-factor structure of the measure. The subscales showed adequate internal consistency, and convergent validity was supported based on significant associations of the MDDI subscale scores with theoretically related scores on a widely used measure of disordered eating. CONCLUSIONS: These findings provided novel support for adequate psychometric properties of the MDDI in a sample of gender-expansive individuals, facilitating the use of this measure in future research on muscle dysmorphia in this understudied and at-risk population.

Gender-expansive describes gender identities that do not fit within the binary gender identity system, such as man or woman. We asked gender-expansive participants in The PRIDE Study to fill out a widely used survey about muscle dysmorphia (when someone is worried about not being muscular enough). We found that this issue about muscularity has three parts for gender-expansive people: (1) a desire to be bigger and more muscular, (2) dissatisfaction with the way their body looks, and (3) problems with normal life functions. We find that this survey is appropriate for use in gender-expansive people. These results can help providers and researchers understand the muscle-related problems that gender-expansive people face.

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Despite high levels of body dissatisfaction and an increasing drive for muscularity among Brazilian women, most of the existing literature on muscle dysmorphia focuses on men and has mainly been conducted in Western and English-speaking regions. As a result, one of the most widely used assessment tools for symptoms of the disorder, the Muscle Dysmorphic Disorder Inventory (MDDI), has not yet been evaluated in Brazilian women-an at-risk population. In the present study, we perform a psychometric evaluation of the Brazilian Portuguese translation of the MDDI in a sample of 515 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach, which supported the original three-factor structure of the measure. Additionally, we found good internal consistency, convergent validity, and test-retest reliability of the measure. Collectively, these results support the use of the measure in Brazilian women and provide a foundation to expand the literature in this population.

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OBJECTIVE: To determine sociodemographic correlates of contemporary screen time use among a diverse population-based sample of 9- and 10-year-old children. STUDY DESIGN: In 2021, we analyzed cross-sectional baseline (2016-2018) data from the Adolescent Brain Cognitive Development study (n = 10 755). Multiple linear regression analyses were conducted to estimate associations between sociodemographic factors (sex, race/ethnicity, country of birth, household income, parental education) and 6 contemporary forms of screen time (television, videos [eg, YouTube], video games, social networking, texting, and video chat). RESULTS: On average, children reported 3.99 hours of screen time per day across 6 modalities, with the most time spent watching/streaming television shows/movies (1.31 hours), playing video games (1.06 hours), and watching/streaming videos (1.05 hours). On average, Black children reported 1.58 more hours of screen time per day and Asian children reported 0.35 less hours of screen time per day compared with White children (mean 3.46 hours per day), and these trends persisted across most modalities. Boys reported higher overall screen time (0.75 hours more) than girls, which was primarily attributed to video games and videos. Girls reported more time texting, social networking, and video chatting than boys. Higher income was associated with lower screen time usage across all modalities except video chat. However, in high-income households, Latinx children reported 0.65 more hours of screen time per day than White children. CONCLUSIONS: Given the sociodemographic differences in child screen use, guideline implementation strategies can focus on key populations, encourage targeted counseling by pediatricians, and adapt Family Media Use Plans for diverse backgrounds.

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The utility of traditional eating disorder measures in the assessment of muscularity-oriented disordered eating has been questioned. To address this limitation, the Muscularity-Oriented Eating Test (MOET) was recently developed and validated in a sample of U.S. college men. We aimed to develop a multicultural Spanish-language version of the MOET for use in Latin American samples and validate its use in a sample of Argentinian college men. Combined translation procedures were used to develop a version suitable for different Spanish-speaking populations. A total of 235 students (Mage = 23.47, SD = 5.61) participated in this study by completing a survey including the MOET. A sub-sample (n = 121) completed the MOET again after 1 week. A confirmatory factor analysis of a re-specified model of the original single-factor MOET, allowing for residual correlation between items associated to dietary rules (items 4-12), resulted in an adequate fit (χ2/df = 2.10, CFI = 0.94, TLI = 0.93, RMSEA 0.05 [90% CI = 0.04, 0.06] SRMR = 0.08). Further, the multicultural Spanish-language version of the MOET yielded evidence of internal consistency (omega = 0.83, 95% CI [0.79, 0.88], Cronbach's α = 0.83), a 1-week Intraclass Correlation Coefficient was considered for test-retest reliability (ICC = 0.82), item analysis, convergent validity with measures of eating disorder psychopathology, body dissatisfaction and weight-related behaviors, as well as for divergent validity with an unrelated construct. The availability of a multicultural Spanish-language version of the MOET may have utility in both clinical and research efforts related to muscularity-oriented disordered eating among Latino men.

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Despite increasing empirical interest in muscle dysmorphia (MD), a dearth of research has assessed this construct in sexual minority populations. In particular, the psychometric properties of one of the most widely used measures of MD symptoms-the Muscle Dysmorphic Disorder Inventory (MDDI)-have not been evaluated in sexual minority populations despite emerging evidence suggesting differential risk for MD symptoms across sexual orientation groups. In this study, we assessed the psychometric properties of the MDDI in a sample of 715 cisgender gay men and 404 cisgender lesbian women ages 18-50 years who participated in a large-scale national longitudinal cohort study of sexual and gender minority adults. The factor structure of the MDDI was examined in each sample using a two-step, split-sample exploratory and confirmatory factor analytic approach. Exploratory factor analysis supported a three-factor structure in both samples, which were confirmed by confirmatory factor analysis. Moreover, results supported the internal consistency reliability and convergent validity of the MDDI subscales in both samples. Cumulatively, these findings suggest that the MDDI is an appropriate measure of MD symptoms among cisgender gay men and cisgender lesbian women.

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US-Mexico border communities are uniquely vulnerable to human immunodeficiency virus (HIV) transmission given the economic and social challenges these communities face. We surveyed low-income, predominantly Latinx residents receiving sexually transmitted infection testing and/or HIV/acquired immune deficiency syndrome (AIDS) care in the lower Rio Grande Valley of southernmost Texas about their experiences of food insecurity. Participants aged 18 years and over took a self-administered survey available in English or Spanish in a clinic waiting room (N = 251). Ordinary least squares regression results suggested that those with a prior HIV/AIDS diagnosis reported a response for food insecurity that was approximately 0.67 points higher than peers without a prior HIV/AIDS diagnosis (coefficient = 0.67; p < 0.05), even when adjusting for sociodemographic characteristics, social support, perceived discrimination, and neighborhood environment. Interaction results between age and HIV status indicated that younger individuals living with HIV/AIDS experienced uniquely higher food insecurity; those who reported a prior HIV/AIDS diagnosis experienced an additional reduction in food insecurity by approximately 0.06 points for each additional year of age (age × HIV/AIDS interaction coefficient = -0.06; p < 0.05). Community programs serving low-income populations should consider screening for and intervening on food insecurity, especially among young adults living with HIV/AIDS.

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Despite an increase in body dissatisfaction and muscularity concerns among Latin American men, there is a paucity of research relating to muscle dysmorphia in this population. In this study we aimed to evaluate, for the first time in Latin America, the factor structure of the Muscle Dysmorphic Disorder Inventory (MDDI; Hildebrandt, Langenbucher, & Schlundt, 2004). A sample of 551 men who exercise completed measures of body dissatisfaction, disordered eating, and the MDDI. Exploratory factor analysis in a first split-half sample revealed a 3-factor solution similar to the original version, which was then tested through confirmatory factor analysis (CFA) in a second split-half sample. A re-specified model (allowing for error correlations between Items 10-13 and 11-13) presented adequate fit. Omega coefficients revealed adequate internal consistency (> .80) for the Drive for Size and Functional Impairment subscales. The internal consistency for the Appearance Intolerance subscale was .74 and .72 across subset samples. Associations with body dissatisfaction, disordered eating, body mass index, and frequency of training and rest days are presented as evidence of construct validity. Finally, multi-group CFA indicated that the model was invariant across type of exercise. Overall, these data suggest that the MDDI is suitable for use in Spanish-speaking Latin American male populations.

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OBJECTIVE: The eating disorder examination-questionnaire (EDE-Q) is among the most widely used instruments in eating disorder research and clinical practice. However, the underlying structure remains a source of confusion, and contradictory results have emerged in studies among male populations. In the current study, we examined previously proposed models of EDE-Q structure in four community samples of Argentinian men. METHOD: A series of confirmatory factor analyses (CFAs) were performed for five previous factor structure models of the EDE-Q among 232 Argentinian male university students, 277 weightlifters, 275 cross-fit users, and 202 athletes. A multigroup CFA was conducted in the model we retained, to assess measurement invariance across groups. RESULTS: A respecified model of the brief eight-item one-factor proposal provided acceptable fit to the data over the original four-factor structure and three other proposed models. Results from the multigroup CFA showed that the retained model was invariant across samples. CONCLUSION: Our results provide support for retaining a one-factor EDE-Q structure over a multifactor solution for research purposes among male community samples in Argentina. These data underscore the importance of undertaking psychometric assessment of eating disorder symptom measures before their utilization in specific populations.

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