Mitrofanova Elina, Pummell Elizabeth, Martinelli Laura, Petróczi Andrea
School of Life Sciences, Pharmacy and Chemistry, Kingston University, Penrhyn Road, Kingston upon Thames, KT1 2EE, Surrey, UK.
Peter Symonds College, Winchester, SO22 6RX, Hampshire, UK.
Eat Weight Disord. 2021 Apr;26(3):897-909. doi: 10.1007/s40519-020-00919-2. Epub 2020 May 22.
Orthorexia Nervosa (ON) is defined as a pathological eating behaviour stemming from being "healthy" or "pure". Survey-based studies typically rely on the ORTO-15 questionnaire or its variations to detect orthorexia. However, frequent post-hoc adjustments to the ORTO-15 suggest psychometric problems. In this study, we explored people's cognitions about the ORTO-15 items to (1) identify problems specific to ORTO-15 items and (2) explore participants' understanding of ON symptoms.
Fifty adult participants (40% male, mean age = 34.0 ± 14.4 years) completed the ORTO-15, the Eating Attitudes Test (EAT-26) and the Obsessive-Compulsive Inventory-Revised edition (OCI-R). Qualitative data were collected using the modified "think aloud" protocol, which asked participants to 'verbalise' their responses to the ORTO-15 items. These qualitative responses were first analysed conjunctively with the quantitative responses; then subjected to thematic analysis.
ORTO-15 identified 64% of the participants for orthorexic tendencies. In most cases (76%), participants reported no issues completing the ORTO-15. However, in some cases, qualitative responses differed from quantitative ones. When people encountered problems, it was because of poor psychometric construction: lack of clarity, ambiguous wording and multiple statements in a single item. Elaborations around the ORTO-15 items formed four major themes: "preoccupation with physical appearance", "control", "food is fuel" and "alone, not isolated".
Even though in the majority of cases there were no issues with completing ORTO-15, thematic analysis revealed several discrepancies between our participants' perceptions of the ORTO-15 items and the previously proposed diagnostic criteria for ON. The results suggest that ORTO-15 is, at best, a mediocre screening tool for ON, which is sensitive to diet but fails to have sufficient level of specificity to detect the pathological stage. More accurate instruments are needed to further research on ON.
V (cross-sectional descriptive study with qualitative analysis).
正食癖（ON）被定义为一种源于追求“健康”或“纯净”的病理性饮食行为。基于调查的研究通常依靠ORTO - 15问卷或其变体来检测正食癖。然而，对ORTO - 15频繁的事后调整表明其存在心理测量学问题。在本研究中，我们探究了人们对ORTO - 15项目的认知，以（1）识别ORTO - 15项目特有的问题，以及（2）探究参与者对正食癖症状的理解。
五十名成年参与者（40%为男性，平均年龄 = 34.0 ± 14.4岁）完成了ORTO - 15、饮食态度测试（EAT - 26）和修订版强迫观念及强迫行为量表（OCI - R）。使用改良的“出声思考”协议收集定性数据，该协议要求参与者对ORTO - 15项目的回答“出声表达”。这些定性回答首先与定量回答进行联合分析；然后进行主题分析。
ORTO - 15识别出64%的参与者有正食癖倾向。在大多数情况下（76%），参与者报告完成ORTO - 15没有问题。然而，在某些情况下，定性回答与定量回答不同。当人们遇到问题时，是因为心理测量学构建不佳：缺乏清晰度、措辞模糊以及单个项目中有多个陈述。围绕ORTO - 15项目的阐述形成了四个主要主题：“对外表的过度关注”、 “控制”、“食物即燃料”和“独处而非孤立”。
尽管在大多数情况下完成ORTO - 15没有问题，但主题分析揭示了我们的参与者对ORTO - 15项目的认知与先前提出的正食癖诊断标准之间存在一些差异。结果表明，ORTO - 15充其量是一种用于正食癖的普通筛查工具，它对饮食敏感，但缺乏足够的特异性水平来检测病理阶段。需要更准确的工具来进一步研究正食癖。
V（带有定性分析的横断面描述性研究）
