Eating disorders (ED) are a group of mental disorders, which are quite difficult to treat. In studies on the recovery process of ED, patients’ experience is rarely been taken into account. In addition, there seems to be a gap between patients' objective improvement, as assessed by clinicians, and patients' own subjective evaluation of their recovery. Criteria for Recovery from Eating Disorders (CRED) is a questionnaire used to investigate recovery criteria which are considered important from the patients’ perspective. The purpose of the present study was to examine the factorial structure of CRED and to evaluate its psychometric properties. A sample of 138 patients in ED treatment were asked to complete the CRED along with the WHO questionnaire on quality of life (WHOQoL-BREF) and the eating disorders questionnaire (EDE-Q). Exploratory factor analysis (EFA) was used to explore the factor structure of the CRED. Internal consistency assessment was based on Cronbach’s α. Convergent validity was assessed through correlations of CRED with WHOQoL-BREF and EDE-Q. The EFA led to the removal of 13 items of the original CRED and yielded a conceptually justifiable seven factor model: Body Experience, Psychological Well-being, Social Relationships, Gastrointestinal Symptoms, Bodily Functions, Eating Behaviours, and Compensatory Behaviours. Cronbach’s alphas of the total questionnaire and all seven factors ranged from 0.77 to 0.88. Convergent validity to WHOQoL-BREF and EDE-Q total scores and subscales were found to be quite satisfactory. Our analysis has, thus, led us to propose the CRED-39, a 39-item version of the CRED questionnaire, which seems to be a valid and reliable tool in assessing ED patients’ own view of their recovery process. CRED-39 can be used in clinical practice to address personal needs and to direct individualised interventions.
KEYWORDS: eating disorders, patient perspective, validity, reliability, factor analysis.
Dafni-Alexandra Karapavlou, Dimitris Dikeos, Stylianos Gavriilidis, Maria Ginieri-Coccossis, Fragiskos Gonidakis