Beliefs associated with Eating Disorders and Obsessive-Compulsive Disorder: The Development of the Obsessive Beliefs about Body Size and Eating Survey (OBBSES)

Abstract

There is a great deal of evidence suggesting an elevated rate of comorbidity between eating disorders (EDs) and obsessive-compulsive disorder (OCD). The current study focused on elucidating possible cognitive similarities associated with these disorders through the development of a measure called the Obsessive Beliefs about Body Size and Eating Survey (OBBSES). More specifically, six belief domains identified as important for OCD (Obsessive Compulsive Cognitions Working Group, 1997) were used as a framework for developing a measure (the OBBSES) that can be used to examine these types of beliefs in the context of EDs. The development of the OBBSES involved three phases: phase one included item generation and the grouping of items into initial subscales by an expert panel; phase two involved pilot testing, preliminary psychometric analyses, and item selection in a sample of Vanderbilt undergraduate students; and phase three included a factor analysis and validity study in a sample of Vanderbilt students and community members. The results of the phase three factor analysis suggested a five-factor solution. These five factors were Appearance Perfectionism, Vulnerability to Weight Gain, Eating Control, Magical Thinking, and Thought Control. The results from the phase three validity study suggested that the OBBSES has good convergent validity and good test-retest reliability. The discriminant validity of the OBBSES was less strong; however as eating disorders are highly correlated with depression and anxiety, this result was not surprising. The results of this study suggest that the OBBSES may be a useful tool for examining cognitive similarities between EDs and OCD in order to better understand their co-occurrence and to potentially identify subgroups of patients with specific types of beliefs that may be associated with the development and/or maintenance of both an ED and OCD. Future research should include the administration of the OBBSES in clinical samples of patients with EDs and OCD as well as other anxiety disorders.