Department of Psychology, University of Michigan, USA.
Department of International Health, Ann Arbor, USA; Department of Health Policy and Management, USA.
Appetite. 2022 Aug 1;175:106077. doi: 10.1016/j.appet.2022.106077. Epub 2022 May 7.
The Yale Food Addiction Scale 2.0 (YFAS 2.0) operationalizes food addiction (FA) by applying the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5) criteria for substance use disorder (SUD) to the overconsumption of highly processed foods. The YFAS 2.0 has been quantitatively validated across numerous populations, but has never undergone qualitative analysis.
Using qualitative methods we aimed to determine if the interpretation YFAS 2.0 is aligned with the DSM 5 conceptualization of SUD, to determine if any items are perceived as irrelevant to the lived-experience of FA, and to determine if there are constructs central to the lived-experience of FA that are not captured by the scale.
We interviewed 16 participants who met criteria for FA on the modified YFAS 2.0 using semi-structured interviews to understand each participants' interpretation of items on the scale and their perceptions of how the scale matched their lived-experience of FA. Reflexive thematic analysis was used to code responses and identify themes.
Most interpretations aligned with the DSM 5 conceptualization of SUDs. Withdrawal and tolerance-related items were subject to some misinterpretations. Participants viewed problem-focused symptoms (e.g., interpersonal problems) as the least relevant to their lived-experience. Novel themes not included on the YFAS 2.0 (e.g., emotional eating) emerged.
Our study supports the validity of the YFAS 2.0 by showing consistency with the DSM 5 conceptualization of SUDs and consistency with the lived-experience of individuals who endorse FA. Future research should explore the novel themes that emerged in this study.
耶鲁食物成瘾量表 2.0（YFAS 2.0）通过将精神障碍诊断与统计手册第五版（DSM 5）物质使用障碍（SUD）的标准应用于高度加工食品的过度消费，将食物成瘾（FA）概念化。YFAS 2.0 已经在众多人群中进行了定量验证，但从未进行过定性分析。
使用定性方法，我们旨在确定 YFAS 2.0 的解释是否与 DSM 5 对 SUD 的概念化一致，确定是否有任何项目被认为与 FA 的实际体验无关，以及是否存在与 FA 的实际体验相关但未被量表所捕捉到的结构。
我们使用半结构化访谈采访了 16 名符合修改后的 YFAS 2.0 食物成瘾标准的参与者，以了解每个参与者对量表项目的解释以及他们对量表如何与他们的 FA 实际体验相匹配的看法。采用反思性主题分析对回答进行编码并识别主题。
大多数解释与 DSM 5 对 SUD 的概念化一致。与戒断和耐受相关的项目受到一些误解。参与者认为以问题为中心的症状（例如人际关系问题）与他们的实际体验相关性最低。出现了 YFAS 2.0 未包含的新主题（例如，情绪化进食）。
我们的研究通过显示与 DSM 5 对 SUD 的概念化的一致性以及与支持 FA 的个体的实际体验的一致性，支持了 YFAS 2.0 的有效性。未来的研究应该探索本研究中出现的新主题。
