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The Dutch Eating Behaviour Questionnaire (short DEBQ) is a 33-item self-report questionnaire, which scales and examines various eating patterns in adults.[1]

The test was developed by the psychologist Tatjana van Strien and is broadly applied in multiple areas. During application, the DEBQ scales three distinct eating behaviors for restrained-, emotional-, and external eating (increased tendency to eat in response to external cues, such as sight or smell of food). Items on the DEBQ range from 1 (never) to 5 (very often), with higher scores indicating greater endorsement of the eating behavior.[2]

This questionnaire was developed to capture eating behaviors involved in the development and maintenance of obesity and strives to improve the maintenance of treatment effects by individually fitting the treatment to the patient.[3]

Application

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The Dutch Eating Behavior Questionnaire was developed to capture eating behaviors implicated in the development and maintenance of obesity and excessive eating. The excessive eating is attributed to confusion between internal arousal states and hunger, probably because of early learning experiences.[4]

While the English and other versions of the DEBQ are available for research purposes, the Dutch version (NVE) is available for clinical use only. The questionnaire can be taken by adults and children starting at the age of nine, but children have their own version of the test with slightly less items.[5] Concerning the reasons for application in children, it is often used to test "reliability, factorial validity, factorial invariance for sex, overweight (BMI-status), and age, and correlations with measures for unhealthy life style" and the correlation between "measures for body dissatisfaction and parental feeding styles". The DEBQ-C can give a measure for young children's emerging dietary restraint and overeating tendencies.[6]

Administering the test requires the item-form and the scoring template. The questionnaire can be given to patients to fill out at home or directly in the waiting room at the physicians practice. It takes approximately ten minutes to complete and five minutes to score the questionnaire. Subsequently, the scoring and interpretation is carried out by a doctor or via an assistant or secretary.[7]

Limitations

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Because the Dutch Eating Behaviour Questionnaire makes use of the concept of self-evaluation, it comprises several limitations.[4]

A common issue, especially in the context of rating scales is extreme or continuous response styles. Subjects who show this kind of response style tend to rate the given questions consistently within either moderate or extreme sections.[4]

Another limitation arises from the social desirability bias, which can be described as the tendency of subjects to react to the presented items in a way that represents the individual in a socially acceptable and favorable way. Due to the limited objectivity of the self-evaluation tests, the possibility to determine the degree of truth is restricted.[8]

The DEBQ-test can also be performed in different environments, which might influence to the emotional state of the subject, can also lead to different distortions within the responses.[9]

Similarly, test-retest reliability results indicate that the items designed to measure three types of eating styles are likely to test trait rather than state factors.[10]

History

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Before the development of the DEBQ, three theories were used to analyze obesity. The first theory is the Psychosomatic Theory that aimed to explain the phenomenon of emotional eating.[11] The Externality Theory focuses on the increased tendency of an individual to eat in response to external cues like smell or sight of food.[12] As a consequence of these theories, the Restrained Eating Theory states that if individuals are in a stressful situation they tend to use self-control processes to suppress food intake.[13]

During experimental studies, the main issue with these theories occurs when the body weight of an individual was evaluated. Specifically, the Psychosomatic Theory assumes that body weight of an individual is controlled according to his/her emotional tendency to overeat. According to the Externality Theory, the measured body weight depends, for example, on the tendency of an individual to overeat in the presence of appealing external cues. On the contrary, it was assumed that for example, dieting was capable of controlling, to some extent, the body weight of an individual.[1] In order to deal with this issue, two other questionnaires were developed - namely, the Questionnaire of Latent Adipositas (Fragebogen für Latente Adipositas) in 1975 and the Herman Restrained Scale (RS).[13] Both scales of measurement revealed not to be appropriate on testing restrained eating, emotional eating and external eating. Consequently, Tatjana van Strien, a Dutch professor in psychology, developed the DEBQ in order to acquire a better understanding of the different patterns of obesity.[1] The Questionnaire is a commonly used tool for assessing mental, external and restrained eating.[14]

Development of DEBQ

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Van Strien conducted a three-part study into the eating habits of overweight individuals to create the DEBQ. The first study focused on comparing the Psychosomatic Theory (emotional eating) and Externality Theory (eating stimulated by the presence of food). While neither have been proven definitively, using these two theories to create a questionnaire was the eventual goal of the study. She and her fellow researchers gathered three different pre-existing eating habit questionnaires: the Eating Patterns Questionnaire (EPQ; focus on emotional eating; five-point format), The Fragenbogen für Latente Adipositas (FLA; focus on restrained and external eating; yes/no format), and the Eating Behavior Inventory (EBI; focused on stimulus control; five-point format).[15][16][17] 120 patients selected for the study by their general practitioners, to control for weight in both normal-weight and overweight patients, then underwent a 100 item questionnaire developed from the EPQ, FLA, and EBI. The results yielded showed that 20 of the 100 questions could not be categorized by emotional, restrained, or external eating habits, and were therefore not carried into the second study.[1]

The second study was conducted with a revised questionnaire composed of 51 questions specific to each category (15 emotional, 15 external, 21 restrained) and had a five-point format. Questions related to emotional eating were now separated into the two subsets defined as “clearly labelled emotions,” such as anger, and “diffuse emotions,” such as loneliness or boredom, to determine motivation. Two sample subsets were drawn instead of one – a cluster sample drawn from 4 different villages in Ede, and another sample drawn from the selections of dieticians. Results showed that external eating is a more homogeneous eating habit across obese patients than those in the normal BMI range.[1]

The second study was conducted six times in order to obtain longitudinal results, and create a better method for the final study. A total of 1170 patients (653 women, 517 men) had participated throughout the studies, and clearer dimensions could be determined with this large sample of information. Seven items were deleted from questions involving restrained and external eating from the final study. Eight were initially added to the final study. To avoid redundancies, researchers removed eight more questions related to emotional eating from the final questionnaire, though the report does not specify beyond this, regarding which questions were removed.[1]

Based on the findings from these three studies, the final version of the DEBQ contains 33 items, each rated on a five-point scale, with an additional “non-applicable” option.[1]

Value of the DEBQ in the Academic world

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The Dutch Eating Behavior Questionnaire is perceived as an effective addition to previous practical assessments of eating behaviors in the academic world. It got translated into Greek, Persian, and Chinese and found use in an international context. The DEBQ has been cited over 1400 times in Web Science and is mostly supported by positive comments and successful applications.[18]

References

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  1. ^ a b c d e f g Strien, Tatjana van; Frijters, Jan E. R.; Bergers, Gerard P. A.; Defares, Peter B. (1986). "The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior". International Journal of Eating Disorders. 5 (2): 295–315. doi:10.1002/1098-108X(198602)5:23.0.CO;2-T. ISSN 1098-108X.
  2. ^ "Eating style: A validation study of the Dutch eating behaviour questionnaire in normal subjects and women with eating disorders". Journal of Psychosomatic Research. 31 (2): 161–169. 1987-01-01. doi:10.1016/0022-3999(87)90072-9. ISSN 0022-3999.
  3. ^ "Longitudinal measurement of three eating behavior scales during a period of change". Food Quality and Preference. 10 (1): 1–8. 1998-10-09. doi:10.1016/S0950-3293(98)00013-5. ISSN 0950-3293.
  4. ^ a b c Strien, Tatjana van; Frijters, Jan E. R.; Bergers, Gerard P. A.; Defares, Peter B. (1986). "The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior". International Journal of Eating Disorders. 5 (2): 295–315. doi:10.1002/1098-108X(198602)5:23.0.CO;2-T. ISSN 1098-108X.
  5. ^ "DEBQ". www.hogrefe.com. Retrieved 2021-05-24.
  6. ^ Strien, Tatjana van; Oosterveld, Paul (2008). "The children's DEBQ for assessment of restrained, emotional, and external eating in 7- to 12-year-old children". International Journal of Eating Disorders. 41 (1): 72–81. doi:10.1002/eat.20424. ISSN 1098-108X.
  7. ^ Domoff, Sarah E. (2015), Wade, Tracey (ed.), "Dutch Eating Behavior Questionnaire (DEBQ)", Encyclopedia of Feeding and Eating Disorders, Singapore: Springer, pp. 1–2, doi:10.1007/978-981-287-087-2_127-1, ISBN 978-981-287-087-2, retrieved 2021-05-19
  8. ^ "The advantages and disadvantages of self-insight: New psychological and neural perspectives". Advances in Experimental Social Psychology. 60: 121–173. 2019-01-01. doi:10.1016/bs.aesp.2019.04.003. ISSN 0065-2601.
  9. ^ Heatherton, Todd F.; Wyland, Carrie L. (2003), Lopez, Shane J.; Snyder, C. R. (eds.), "Assessing self-esteem.", Positive psychological assessment: A handbook of models and measures., Washington: American Psychological Association, pp. 219–233, doi:10.1037/10612-014, ISBN 978-1-55798-988-8, retrieved 2021-05-26
  10. ^ "A MULTIVARIATE ANALYSIS OF PERSONOLOGICAL DIFFERENCES IN RESPONSE TO UNFAVORABLE EVALUATIONS OF ONE'S SELF - ProQuest". www.proquest.com. Retrieved 2021-05-26.
  11. ^ Canetti, Laura; Bachar, Eytan; Berry, Elliot M (2002). "Food and emotion". Behavioural Processes. 60 (2): 157–164. doi:10.1016/S0376-6357(02)00082-7.
  12. ^ "Obese Externality | Encyclopedia.com". www.encyclopedia.com. Retrieved 2021-05-24.
  13. ^ a b "The restraint scale: A psychometric investigation". Behaviour Research and Therapy. 21 (3): 253–258. 1983-01-01. doi:10.1016/0005-7967(83)90207-3. ISSN 0005-7967.
  14. ^ Tatjana, van Strien (n.d.). "Tatjana van Strien´s lab". Research Gate. Retrieved 24 May 2021. {{cite web}}: |archive-date= requires |archive-url= (help)CS1 maint: url-status (link)
  15. ^ "Vol. 67, 1975 of Wiener Zeitschrift für die Kunde des Morgenlandes on JSTOR". www.jstor.org. Retrieved 2021-05-27.
  16. ^ Wollersheim, J. P. (1970). "Effectiveness of group therapy based upon learning principles in the treatment of overweight women". Journal of Abnormal Psychology. 76 (3): 462–474. doi:10.1037/h0030272. ISSN 0021-843X. PMID 5490714.
  17. ^ O'Neil, Patrick Mahlen; Currey, Hal S.; Hirsch, Amy A.; Malcolm, Robert J.; Sexauer, James D.; Riddle, F. Elizabeth; Taylor, C. Inga (1979-06-01). "Development and validation of the Eating Behavior Inventory". Journal of behavioral assessment. 1 (2): 123–132. doi:10.1007/BF01322019. ISSN 1573-3505.
  18. ^ "Madridge Publishers". madridge.org. Retrieved 2021-05-24.