Psychometric Examination of the Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) among Spanish Adolescents and Young Adults

Ci a ion: Pa e na, A.; Alca az-Ibáñez, M.; Sicilia, A. Psychome ic Examina ion o he Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e (BEECOM) among Spanish Adolescen s and Young Adul s. Nu ien s 2023,15, 626. h ps:// doi.o g/10.3390/nu15030626 Academic Edi o : Iole Tomassini Ba ba ossa Recei ed: 22 Decembe 2022 Re ised: 19 Janua y 2023 Accep ed: 22 Janua y 2023 Published: 26 Janua y 2023 Copy igh : © 2023 by he au ho s. Licensee MDPI, Basel, Swi ze land. This a icle is an open access a icle dis ibu ed unde he e ms and condi ions o he C ea i e Commons A ibu ion (CC BY) license (h ps:// c ea i ecommons.o g/licenses/by/ 4.0/). nu ien s A icle Psychome ic Examina ion o he Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e (BEECOM) among Spanish Adolescen s and Young Adul s Ad ian Pa e na †, Manuel Alca az-Ibáñez *,† and Al a o Sicilia Heal h Resea ch Cen e and Depa men o Educa ion, Uni e si y o Alme ía, 04120 Alme ía, Spain *Co espondence: [email p o ec ed] † These au ho s con ibu ed equally o his wo k. Abs ac : The Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e (BEECOM) has been e- quen ly used wi hin he con ex o esea ch on ea ing diso de s (ED). Al hough bo h long (BEECOM-L) and sho (BEECOM-S) e sions o he ins umen exis , hei psychome ic p ope ies ha e no ye been concu en ly in es iga ed ac oss di e en popula ions in e ms o age and gende . The p esen s udy aimed o compa e he psychome ic p ope ies o bo h he BEECOM-L and he BEECOM-S among Spanish male and emale non-clinical adolescen s and young adul s. Da a om 4 samples including 1213 middle school and college s uden s en olled in 10 educa ion cen e s om sou he n Spain (age anging om 12 o 35 yea s, M age = 17.796, SD age = 4.796, 53% emales) we e analyzed us- ing ac o ial, co ela ion, and eg ession analysis echniques. Resul s p o ided e idence ha suppo he eliabili y, measu emen in a iance acco ding o age and gende , and con e gen /inc emen al alidi y o he sco es om bo h he BEECOM-L and BEECOM-S. Conce ning ac o ial alidi y, ma ginally accep able and adequa e goodness-o - i indices we e ob ained o he BEECOM-L and BEECOM-S, espec i ely. The BEECOM-S p o es o be a psychome ically sound ins umen wi h po en ial alue o assessing social compa isons ocused on body, ea ing, and exe cise in non-clinical adolescen s and young adul s om Spain. Keywo ds: ea ing diso de s; ea ing pa hologies; diso de ed ea ing; social compa ison; body image; psychome ics; ac o ial alidi y 1. In oduc ion Ea ing diso de s (ED) a e a g oup o inc easingly p e alen psychia ic pa hologies ha , ha ing a ela i e bad p ognosis, accoun o signi ican mo bidi y and mo ali y in Wes e n coun ies [ 1 – 3 ]. In his ein, he ac ha a ound a hi d o women and hal o men who mee he clinical c i e ia o ED do no seek p o essional help [ 4 ] means ha he social and economic bu den o ED ex ends beyond heal hca e cos s [ 5 ]. As a esul , iden i ying modi iable isk ac o s o ED on which o ocus ea men and p e en ion e o s has been a majo esea ch p io i y [6–8]. A cogni i e p ocess ha has been consis en ly iden i ied as a modi iable isk ac o o ED is he endency owa ds body/appea ance- ela ed social compa ison [ 9 – 12 ]. How- e e , an eme ging line o esea ch has begun o demons a e ha u he conside a ion o compa isons ocused on ac ions aimed a imp o ing body appea ance, such as ea ing o exe cise beha io , may p o ide deepe insigh in o he cogni i e p ocesses unde lying ED [ 13 – 16 ]. This body o esea ch has been buil a ound he only sel - epo ed quan i a i e measu e p oposed o da e o he pu pose o assessing he h ee ace s o ED- ela ed social compa isons ou lined abo e (i.e., he Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e, BEECOM) [17]. Findings om se e al esea ch s udies ha e been consis en in suppo ing he psy- chome ic p ope ies o he BEECOM sco es in e ms o bo h eliabili y and con e - Nu ien s 2023,15, 626. h ps://doi.o g/10.3390/nu15030626 h ps://www.mdpi.com/jou nal/nu ien s Nu ien s 2023,15, 626 2 o 18 gen /inc emen al alidi y [ 14 , 16 – 18 ]. In con as , he a ailable e idence on he ac o ial alidi y o he ins umen is a less conclusi e. Fo example, e idence has been p o ided ha suppo s he o iginal long 18-i em s uc u e consis ing o 6 i ems each o he h ee lowe -o de ac o s (body-, ea ing-, and exe cise- ela ed compa ison o ien a ion) and a highe -o de ac o (ED- ela ed compa ison o ien a ion) on a sample o non-clinical U.S. college emales [ 17 ]. Howe e , his ac o s uc u e is no suppo ed by he esul s o wo subsequen s udies. Fi s ly, he one conduc ed in a non-clinical sample o I anian uni e si y male and emale s uden s wi h he aim o p o iding a Fa si ansla ion o he o iginal long e sion o he BEECOM (he eina e BEECOM-L) e ealed gende di e ences in he dis ibu ion o se e al i ems ac oss he lowe -o de ac o s [ 18 ]. Secondly, he one conduc ed on a sample o U.S. emales in hei young adul hood e ealed ha se e al i ems did no load clea ly on hei heo e ically ele an lowe -o de ac o s in he clinical subsample in e ms o ED [ 16 ]. This inding led he au ho s o p opose a sho e sion o he ins umen (BEECOM-S) consis ing o 9 i ems (3 o each lowe -o de ac o ) ins ead o 18 i ems, whose adequa e i was subsequen ly co obo a ed in a second non-clinical subsample o o he wise simila socio-demog aphic cha ac e is ics o he i s one [16]. Taken oge he , he a ailable e idence sugges s ha (i) he con en o BEECOM migh be subjec o gende -speci ic in e p e a ions, which would make his ins umen unsui able o making compa isons ac oss g oups based on his a iable and (ii) ha he e ised sho e sion o he ins umen is likely o ou pe o m he o iginal long e sion in psychome ic e ms. Howe e , he limi ed numbe o s udies om which such e idence is d awn, coupled wi h he pa icula socio-demog aphic p o iles o he pa icipan s included in hese s udies, p ecludes gene alizing he abo e conclusions o o he popula ions o in e es in he con ex o ED. A clea example o such a popula ion would be adolescen gi ls and boys unde 17 ( he minimum age o indi iduals on which he psychome ic p ope ies o he BEECOM ha e been es ed so a [ 17 ]), who ep esen an impo an a ge g oup o ED p e en ion e o s [ 19 ]. The la e is clea in he ligh o he e idence sugges ing ha (i) 25–50% o ED onse occu s be o e he age o 17 yea s and (ii) ha he di e ences in p e alence le els adi ionally obse ed in a o o emales a e dec easing [4]. Simul aneous examina ion o he psychome ic p ope ies o bo h e sions o he BEECOM in a wide ange o popula ions in e ms o age and gende han hi he o con- side ed may p o ide aluable in o ma ion on he applicabili y o he ins umen and, in pa icula , wi h ega d o he compa a i e psychome ic pe o mance o he wo e sions. Thus, should e idence con i ming he supe io pe o mance o he sho e sion be ob- ained, hen i s use could be ecommended. This would mean hal ing he applica ion ime o he BEECOM, which may dec ease he esponse bu den and inc ease he esponse a e o su eys including his ins umen [ 20 ]. In addi ion, e idence de i ed om examining whe he he BEECOM sco es a e in a ian ac oss popula ions consis ing o indi iduals o di e en gende and age would allow ecommenda ions o be made conce ning he app op ia eness o using hese sco es in wo main si ua ions: i s ly o make easonably unbiased compa isons be ween hese popula ion g oups [ 21 ] and secondly in he con ex o conduc ing eg ession analysis in ol ing mode a ion es ing, which—as a esul o conside ing g oup membe ship as he mode a ing a iable ins ead o conduc ing subg oup analyses—would bene i om an inc eased le el o s a is ical powe [22]. In iew o he abo e, he main objec i e o he p esen s udy was o compa e he psychome ic p ope ies o he sco es de i ed om he BEECOM-L and he BEECOM-S in e ms o ac o ial alidi y, eliabili y, measu emen in a iance acco ding o age and gende , and con e gen /inc emen al alidi y. Gi en he pauci y o esea ch on he opic and he in- conclusi e na u e o he a ailable e idence, no hypo hesis was ad anced conce ning which e sion o he ins umen would show be e o e all psychome ic pe o mance. Acco ding o indings om p e ious esea ch, i was hypo hesized ha he BEECOM sco es would show high le els o eliabili y in e ms o in e nal consis ency ( α ) o cons uc eliabili y ( ρ ) (i.e., >0.80) [ 14 , 17 , 18 ]. I was also expec ed ha , p o iding e idence o con e gen alidi y, he BEECOM sco es would be posi i ely co ela ed wi h wo main g oups o a iables: Nu ien s 2023,15, 626 3 o 18 i s ly wi h compa isons s ic ly ocused on physical appea ance, wi h e ec sizes expec ed o all wi hin a ange o = 0.53 o = 0.76) [ 17 ] and secondly wi h se e al ED ou comes, hese including (i) o e all ED symp oms, wi h e ec sizes expec ed o all wi hin a ange o = 0.37 o = 0.71) [ 16 , 18 ]; (ii) weigh and shape conce ns, wi h e ec sizes expec ed o all wi hin a ange o = 0.38 o = 0.77) [ 13 , 17 , 23 ]; and (iii) die a y es ain , wi h e ec sizes ex- pec ed o all wi hin a ange o = 0.20 o = 0.46) [ 13 , 18 ]. Finally, i was hypo hesized ha , consis en wi h he esul s o p e ious esea ch p o iding e idence o inc emen al alidi y o he BEECOM sco es [ 16 , 17 ], hese would accoun o addi ional a iance in all h ee ED ou comes unde conside a ion o e and abo e ha accoun ed o by bo h body mass index (BMI) and he sco es de i ed om a measu e s ic ly ocused on appea ance- ela ed compa isons. In he e en ha e idence was ob ained o suppo measu emen in a iance o he BEECOM sco es ac oss age and gende g oups, a seconda y goal o he p esen s udy was o examine gende and age di e ences in ED- ela ed compa ison o ien a ion. I was hypo hesized ha , in line wi h p e ious esea ch examining appea ance- ocused compa isons [ 10 , 12 , 24 ], small- o-in e media e-sized di e ences would be ound in a o o g oups consis ing o emales and younge adul s. 2. Ma e ials and Me hods 2.1. Sample Size Calcula ion The sample size o he s udy was d awn using wo di e en p ocedu es. Fi s ly, a Mon e Ca lo simula ion was conduc ed in Mplus e sion 7 (h p://www.s a model.com/ index.sh ml, accessed on 21 Decembe 2022) [ 25 ] o de e mine he sample size needed o ob ain eliable es ima ions o he pa ame e s in ol ed in he con i ma o y ac o analyses (CFA) [ 26 ]. This simula ion was conduc ed aking in o accoun he main ea u es o he mos complex model (i.e., he one co esponding o he BECCOM-L) in e ms o he num- be o ac o s/indica o s, he mean alues expec ed o ac o loadings, and he possible absence o no mali y o he da a. The esul s o his simula ion sugges ed ha , assuming a missing da a alue o 1%, a sample size o 250 pa icipan s pe g oup was su icien o p o ide 80% s a is ical powe in he es ima ion o he model pa ame e s. Secondly, a powe analysis using G*Powe e sion 3.1 (Hein ich Heine Uni e si y Düsseldo , Düsseldo , Ge many) [ 27 ] was conduc ed o de e mine he sample size needed o conduc he eg es- sion analyses. The esul s sugges ed ha ha 1021 pa icipan s we e needed o de ec small e ec sizes (i.e., 2 = 0.025; α = 0.05 wo ailed; 95% powe ) in eg ession models in ol ing 11 p edic o s. 2.2. Pa icipan s A o al o 1297 high school, middle school, and college s uden s en olled in 10 di e en educa ion cen e s om sou he n Spain we e in i ed o pa icipa e in he s udy using a non-p obabilis ic sampling echnique. The ollowing inclusion c i e ia we e applied: (i) o he olde age g oup, ha ing a simila age o ha o he pa icipan s included in he s udies in which he BEECOM-L and he BEECOM-S we e p oposed (i.e., be ween 17 and 35 yea s old) [ 16 , 17 ]; (ii) o he younge age g oup, being aged be ween 12 and 16 yea s old; and (iii) o bo h age g oups, o p o ide in o med consen o pa icipa e in he esea ch, which was addi ionally eques ed om pa en s o legal gua dians o indi iduals aged unde 18 yea s old. Failu e o p o ide in o med consen ei he by hemsel es (n= 18) o by pa en s o legal gua dians (n= 29) led o he exclusion o 47 po en ial pa icipan s. Da a we e excluded om he analyses when he pa icipan s (i) epo ed ha ing a clinical diagnosis in e ms o ED (n= 10); (ii) iden i ied hemsel es as non-bina y in e ms o gende (n= 14); o (iii) ailed he embedded alidi y check ques ion (n= 13). Thus, da a om 1213 pa ici- pan s who mos ly iden i ied hemsel es in e ms o e hnici y as Whi e/Caucasian (96%) we e analyzed conside ing he ollowing ou subg oups: (i) younge emales (n= 287; M age = 14.066, SD age = 1.262); (ii) olde emales (n= 360; M age = 21.369, SD age = 3.490); (iii) younge males (n= 295; M age = 14.190, SD age = 1.127); and (i ) olde males (n= 271; Mage = 20.926, SDage = 3.845). Nu ien s 2023,15, 626 4 o 18 2.3. Ins umen s 2.3.1. Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e (BEECOM) We used ou Spanish ansla ion (see File S1) o he BEECOM [ 17 ]. The 18 i ems comp ising he ins umen a e a ed on a 7-poin scale om 1 (ne e ) o 7 (always). The i ems a e g ouped in o 3 ac o s consis ing o 6 i ems (long e sion) o 3 i ems (sho e sion) ha assess body compa isons (e.g., “I compa e my body shape o ha o my pee s”), ea ing compa isons (e.g., “Du ing meals, I compa e wha I am ea ing o wha o he s a e ea ing”), and exe cise compa isons (e.g., “I pay close a en ion when I hea pee s alking abou exe cise in o de o de e mine i I am exe cising as much as hey a e”). Highe sco es imply highe equency o body, ea ing, and exe cise compa isons. Values o in e nal consis ency ( α ) and composi e eliabili y ( ρ ) ≥ 0.875 and 0.876 (BEECOM-L), and ≥ 0.807 and 0.813 (BEECOM-S) we e espec i ely ound in he p esen s udy (see Table 1 o de ails). Table 1. Composi e eliabili y ( ρ ) and in e nal consis ency ( α ) o s udy measu es ac oss popula ion subg oups. Younge Females (n= 287) Olde Females (n= 360) Younge Males (n= 295) Olde Males (n= 271) Ins umen Dimensionali y Fac o ρ α ρ α ρ α ρ α BEECOM-L Highe -O de ED- ela ed social compa ison 0.926 0.963 0.901 0.963 0.925 0.956 0.882 0.940 BEECOM-L Fi s -O de (Fac o 1) Body compa ison o ien a ion 0.928 0.928 0.954 0.954 0.902 0.905 0.914 0.915 BEECOM-L Fi s -O de (Fac o 2) Ea ing compa ison o ien a ion 0.923 0.921 0.920 0.917 0.890 0.887 0.881 0.876 BEECOM-L Fi s -O de (Fac o 3) Exe cise compa ison o ien a ion 0.923 0.922 0.925 0.926 0.904 0.900 0.876 0.875 BEECOM-S Highe -O de ED- ela ed social compa ison 0.913 0.917 0.898 0.921 0.919 0.906 0.865 0.882 BEECOM-S Fi s -O de (Fac o 1) Body compa ison o ien a ion 0.881 0.876 0.915 0.910 0.837 0.825 0.846 0.845 BEECOM-S Fi s -O de (Fac o 2) Ea ing compa ison o ien a ion 0.894 0.892 0.898 0.895 0.882 0.879 0.841 0.832 BEECOM-S Fi s -O de (Fac o 3) Exe cise compa ison o ien a ion 0.872 0.869 0.854 0.854 0.847 0.847 0.813 0.807 PACS-R Unidimensional Physical appea ance compa isons 0.965 0.953 0.980 0.969 0.962 0.943 0.972 0.958 EDE-QS Unidimensional O e all ED symp oms 0.941 0.890 0.941 0.889 0.936 0.865 0.932 0.864 EDE-QS Sub-scale (i ems 4, 5 & 6) Weigh and shape conce ns 0.803 0.790 0.793 0.807 0.743 0.707 0.703 0.693 EDE-QS Sub-scale (i ems 1 & 2) Die a y es ain 0.777 0.622 0.642 0.508 0.657 0.478 0.632 0.469 No e. PACS-R = Physical Appea ance Compa ison Scale-Re ised; BEECOM = Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e (-L = Long e sion, -S = Sho e sion); EDE-QS = Ea ing Diso de Examina ion Ques ionnai e Sho ; ED = ea ing diso de s. 2.3.2. Physical Appea ance Compa ison Scale-Re ised (PACS-R) We used a Spanish ansla ion [ 10 ] o he PACS-R [ 28 ]. The 11 i ems comp ising he ins umen (e.g., “When I’m ou in public, I compa e my body size o he body size o o he s”) a e a ed on a 5-poin scale om 0 (Ne e ) o 4 (Always). Highe sco es imply highe equency o physical appea ance compa isons. E idence has been ound ha suppo s he alidi y and eliabili y o he sco es o his ins umen in bo h male and emale indi iduals om Spain [ 10 , 12 ]. Values ≥ 0.943 ( α ) and 0.962 ( ρ ) we e ound o he o al sco e o he PACS-R in he p esen s udy (see Table 1 o de ails). 2.3.3. Ea ing Diso de Examina ion—Ques ionnai e Sho (EDE-QS) We used a Spanish ansla ion [ 29 , 30 ] o he EDE-Q [ 31 ], which inco po a ed he wo main modi ica ions p oposed in he sho e sion o he ins umen (i.e., a ecall pe iod on 7 ins ead o 28 days and 4 ins ead o 7 esponse ca ego ies) [ 32 ]. The 12 i ems comp ising he ins umen (e.g., “Ha e you been delibe a ely ying o limi he amoun o ood you ea o in luence you weigh o shape [whe he o no you ha e succeeded]”), a e a ed on a 4-poin scale om 0 (0 days o No a all) o 3 (6–7 days o Ma kedly) and co e essen ial symp oms o ano exia ne osa, bulimia ne osa, and binge ea ing diso de [ 32 ]. Acco ding o he pu poses o he p esen s udy, and consis en wi h p e ious esea ch, h ee di e en sco es de i ed om he ins umen we e used: (i) a sco e e lec ing o e all ED symp oma ology [ 14 , 16 – 18 ]; (ii) an agg ega e sco e o i ems co e ing die a y es ain symp oms (i.e., I ems 1 and 2) [ 13 , 16 , 18 ]; and (iii) an agg ega e sco e o i ems co e ing weigh and shape conce ns (i.e., I ems 4, 5, and 6) [ 13 , 17 , 23 , 33 ]. Values ≥ 0.864 ( α ) and 0.932 ( ρ ) we e ound o he o al sco es o he EDE-QS in he p esen s udy (see Table 1 o de ails). Nu ien s 2023,15, 626 5 o 18 2.3.4. Demog aphics Demog aphic da a conce ning da e o bi h, gende , e hnici y, cu en diagnosis o ED, and sel - epo ed heigh and weigh we e collec ed ia a se o ques ions c ea ed o he p esen s udy. Heigh and weigh we e employed o calcula e BMI (kg/m 2 ). Gi en ha he s udy sample consis ed o bo h adolescen s and adul s, BMI alues we e subsequen ly adjus ed acco ding o pe cen ile dis ibu ion aking in o accoun age and gende no ms [ 34 ]. 2.4. T ansla ion and P ocedu e Fi s ly, a Spanish e sion o he BEECOM was ob ained by ollowing he p ocedu es ecommended o conduc ing linguis ic adap a ion o ins umen s add essing cons uc s in he body image domain [ 35 ]. In b ie , he p ocedu e in ol ed he ollowing s eps: (i) wo ansla o s independen ly o wa d- ansla ed he BEECOM i ems om English o Spanish; (ii) he wo ansla ions we e checked by a hi d independen ansla o who, a e esol ing he obse ed disc epancies, p oposed a syn hesized ansla ion; (iii) he esul ing Spanish e sion was back- ansla ed in o English by a ou h independen ansla o ; (i ) he o wa d- and back- ansla ions we e examined by a commi ee comp ising all he a o emen ioned ansla o s and he i s au ho o he p esen s udy, who ag eed on he p e- inal e sion; ( ) his e sion was pilo - es ed in a sample o 12 pa icipan s (M age = 17.692, SD age = 3.750; 50% emales); none o hem e e ed o he p esence o i ems ha , in hei opinion, we e ambiguous o di icul o unde s and. Following app o al by he e hics commi ee o he i s au ho ’s ins i u ion, po en ial pa icipan s we e in i ed o pa icipa e in he s udy in class oom se ings by one o he au ho s o he p esen s udy. The esea ch p ojec was desc ibed as a s udy on body, ea ing, and exe cise a i udes. In he case o mino s, p io consen was equi ed om pa en s o legal gua dians o pa icipa e in he esea ch. A e being in o med o he olun a y, anonymous, and non- ewa ded na u e o hei pa icipa ion, hose who p o ided hei in o med consen (96.43%) comple ed a pape -and-pencil ques ionnai e in he class oom se ing, which ook app oxima ely 5–10 min o comple e. The assessmen ins umen s included in he su ey we e coun e balanced using wo di e en a angemen s. Upon comple ion o he ques ionnai e, he pa icipan s we e hanked o hei coope a ion and hen deb ie ed abou he p ecise aim o he s udy. Da a we e collec ed wi hin he i s academic qua e o he 2019–2020 school yea . 2.5. Analy ic Plan Fi s ly, he ac o s uc u e o he long and he sho e sions o he BEECOM was examined ac oss he popula ion subg oups o in e es using CFA echniques in Mplus e sion 7. These analyses we e conduc ed using a ull in o ma ion maximum likelihood es ima ion me hod wi h obus s anda d e o s (MLR). Two main conside a ions we e aken in o accoun while deciding o use his es ima o : (i) ha he esponse o ma o he ins umen (i.e., a 7-poin Like - ype) allowed hei sco es o be sa ely ea ed as con inuous [ 36 ] and (ii) ha MLR was he es ima ion me hod used in he p e ious s udies in es iga ing he ac o s uc u e o he BEECOM [ 16 , 17 ]. As model i indices, alues ≥ 0.95 o ≥ 0.90 o he compa a i e i index (CFI), and ≤ 0.06 o ≤ 0.08 o bo h he oo -mean-squa e e o o app oxima ion (RMSEA) and he s anda dized oo -mean-squa e esidual (SRMR), espec i ely, a e conside ed as excellen o ma ginally accep able [ 37 ]. Po en ial sou ces o model misspeci ica ion we e iden i ied by examining modi ica ion indices (MI) [37]. Resul s de i ed om he CFA we e employed o compu ing composi e eliabili y [ 38 ], which—along wi h he in e nal consis ency alues—se ed o p o ide e idence on eliabili y o bo h e sions o he BEECOM. Secondly, examina ion o he measu emen in a iance o he BEECOM sco es ac oss he popula ion subg oups was conduc ed using mul ig oup CFA ollowing he p ocedu e desc ibed elsewhe e [ 21 ]. This in ol ed es ing he ollowing six p og essi ely cons ained models: Model 0 (o baseline model), which examined he equi alence o he ac o s uc- u e based on he simul aneous ee es ima ion o he pa ame e s in all he subg oups Nu ien s 2023,15, 626 6 o 18 o in e es ; Model 1, which addi ionally examined he equi alence o he ac o loadings o he h ee i s -o de ac o s; Model 2, which addi ionally es ed he equi alence o he h ee ac o loadings o he highe -o de ac o ; Model 3, which addi ionally es ed he equi alence o he i ems’ in e cep s; Model 4, which addi ionally es ed he equi alence o he in e cep s o he h ee ac o loadings o he highe -o de ac o ; Model 5, which addi ionally examined he equi alence o he i s -o de ac o dis u bances; and Model 6, which addi ionally es ed he equi alence o he i em esidual a iances (i.e., he e o a iance o each i em) [ 21 ]. Gi en ha he Sa o a–Ben le scaled chi-squa e es o model i di e ence wi h MLR es ima o s is pa icula ly sensi i e o sample size and he absence o no mali y, e alua ion o changes ( ∆ ) in CFI (< − 0.010 signals lack o in a iance) was al e na i ely conside ed [ 39 ]. In he p esence o e idence suppo ing he in a ian na u e o he BEECOM sco es ac oss he popula ion subg oups unde conside a ion, di e ences in such sco es [ 40 ] we e compu ed. When calcula ing hese di e ences, he pooled s an- da d de ia ion was ob ained by weigh ing he speci ic sample size o he di e en g oups in ol ed in he compa isons [ 41 ]. The magni udes o he esul ing e ec sizes we e in e - p e ed as i ial (d= 0.00 o 0.20), small (d= 0.20 o 0.50), in e media e (d= 0.50 o 0.80), o la ge (d> 0.80) [40]. Thi dly, e idence o con e gen alidi y was ob ained by compu ing ze o-o de co e- la ions ( ) be ween he BEECOM sco es and sco es on (i) physical appea ance compa isons and (ii) h ee di e en ED ou comes (i.e., o e all ED symp oms, weigh and shape conce ns, and die a y es ain ). The magni udes o he esul ing e ec sizes we e in e p e ed as i - ial (0.00 o 0.10), small (0.10 o 0.30), mode a e (0.30 o 0.50), o la ge (>0.50) [ 40 ]. Fou hly, e idence o inc emen al alidi y was ob ained by conduc ing a se o linea eg ession analysis in which (i) he sco es de i ed om bo h e sions o he BEECOM and (ii) BMI and PACS-R sco es (as co a ia es) we e in oduced as independen a iables, whe eas h ee di e en ED ou comes (i.e., o e all ED symp oms, weigh and shape conce ns, and die a y es ain ) we e in oduced as dependen a iables. Finally, possible di e ences in he s eng h o he mul i a ia e ela ionships be ween he BEECOM sco es and he ED ou comes ac oss popula ions subg oups we e examining using Model 1 o PROCESS mac o o SPPS ollowing he p ocedu e desc ibed elsewhe e [ 42 ]. This mean in oducing wo new g oups o independen a iables in o he eg ession models desc ibed in his pa a- g aph. The i s such g oup consis ed o a mul i-ca ego ical mode a ing a iable in ol ing he ou s udy popula ion subg oups. This a iable was indica o -coded in PROCESS wi h he younge emale g oup as he e e ence g oup, yielding h ee dummy a iables (younge males s. younge emales [D 1 ], olde emales s. younge emales [D 2 ], and olde males s. younge emales [D 3 ]). The second o hese g oups consis ed o he p oduc e ms be ween he p edic o a iable and he mode a o (i.e., BEECOM sco es x D 1–3 ). This p ocedu e es ed he in e ac ions in ol ing each o he candida e p edic o s (i.e., each o he speci ic BEECOM sco es) in sepa a e models. As a esul o his p ocedu e, condi ional s anda dized e ec s o BEECOM sco es on he h ee ED ou comes unde conside a ion (i.e., simple slopes) o each o he ou popula ion subg oups we e ob ained. In o de o deal wi h e en ual iola ions o some o he assump ions inhe en in he applica ion o eg ession echniques (e.g., homoscedas ici y o a iance o esidual no mali y), he las wo se s o analyses desc ibed in his pa ag aph we e conduc ed by applying a bias-co ec ed and accele a ed boo s apping echnique o 5000 esamples [ 22 ]. Missing da a (0.72%) we e handled using ull in o ma ion impu a ion me hods implemen ed in Mplus e sion 7 (h p://www.s a model.com/index.sh ml, accessed on 21 Decembe 2022). A signi icance le el o 0.05 was used in all he s a is ical analyses. Nu ien s 2023,15, 626 7 o 18 3. Resul s 3.1. Fac o ial S uc u e Ma ginally accep able and adequa e goodness-o - i indices we e ob ained o he BEECOM-L and he BEECOM-S, espec i ely, in all he popula ion subg oups unde con- side a ion (see Table 2). Fu he inspec ion o MI de i ed om he CFA in ol ing he BEECOM-L e ealed he ollowing i ems as he main sou ces o poo model i : (i) I em 17 (body compa ison o ien a ion ac o ), which was ound o c oss-load on he exe cise compa ison o ien a ion ac o bo h in he olde male (MI = 12.207) and in he younge (MI = 20.903) and olde (MI = 24.780) emale subsamples; (ii) I ems 8 and 16 (ea ing com- pa ison o ien a ion ac o ), which we e ound o c oss-load on he exe cise compa ison o ien a ion ac o in he younge male subsample (MI = 25.405) and in he olde emale subsample (MI = 15.192), espec i ely; and (iii) I em 10 (exe cise compa ison o ien a ion ac o ), which was ound o c oss-load on he ea ing compa ison o ien a ion ac o bo h in he younge male (MI = 15.885) and in he olde emale (MI = 13.135) subsamples. S anda d- ized ac o loadings o bo h e sions o he BEECOM a e shown in Figu e 1. These anged om 0.540 o 0.953 ( i s -o de ac o s) and om 0.717 o 0.951 (highe -o de ac o ) o he BEECOM-L, and om 0.652 o 958 ( i s -o de ac o s) and om 0.705 o 0.928 (highe -o de ac o ) o he BEECOM-S. Table 2. Goodness-o - i indexes ac oss popula ion subg oups and in a iance es ing o he long and sho e sions o he BEECOM. Ve sion Popula ion/Model χ2d χ2/d Compa ison Models CFI ∆CFI RMSEA SRMR Es . 90% CI p Lowe Uppe Long Younge emales (n= 287) 381.252 132 2.888 - 0.934 - 0.072 0.064 0.081 0.000 0.051 Olde emales (n= 360) 293.203 132 2.221 - 0.934 - 0.065 0.055 0.075 0.007 0.049 Younge males (n= 295) 305.732 132 2.316 - 0.910 - 0.070 0.059 0.080 0.001 0.052 Olde males (n= 271) 238.592 132 1.808 - 0.941 - 0.052 0.042 0.063 0.348 0.056 M0: Baseline model (wi hou in a iance) 1205.833 528 2.284 - 0.931 - 0.065 0.060 0.070 0.000 0.052 M1: In a ian i s -o de ac o loadings 1273.711 573 2.223 M1 s. M0 0.929 −0.002 0.064 0.059 0.068 0.000 0.057 M2: M1 + In a ian highe -o de ac o loadings 1290.103 579 2.228 M2 s. M1 0.928 −0.001 0.064 0.059 0.068 0.000 0.061 M3: M2 + In a ian i ems’ in e cep s 1516.660 630 2.407 M3 s. M2 0.910 −0.028 * 0.068 0.064 0.073 0.000 0.066 M3P: M2 + Pa ially in a ian i ems’ in e cep s a1427.879 622 2.296 M3P s. M2 0.918 −0.010 0.065 0.061 0.070 0.000 0.064 M4: M3P + In a ian i s -o de ac o in e cep s 1454.815 625 2.328 M4 s. M3P 0.916 −0.002 0.066 0.062 0.071 0.000 0.078 M5: M4 + In a ian i s -o de ac o dis u bances 1475.005 634 2.327 M5 s. M4 0.914 −0.002 0.066 0.062 0.071 0.000 0.078 M6: M5 + In a ian i em esidual a iances 1544.027 688 2.244 M6 s. M5 0.913 −0.001 0.064 0.060 0.068 0.000 0.082 Younge emales (n= 287) 47.988 24 2.000 - 0.983 - 0.053 0.030 0.074 0.390 0.032 Olde emales (n= 360) 40.702 24 1.696 - 0.983 - 0.049 0.020 0.075 0.487 0.035 Younge males (n= 295) 30.235 24 1.260 - 0.991 - 0.031 0.000 0.061 0.827 0.029 Olde males (n= 271) 28.854 24 1.202 - 0.993 - 0.026 0.000 0.056 0.890 0.033 Sho M0: Baseline model (wi hou in a iance) 145.661 96 1.517 - 0.987 - 0.041 0.027 0.054 0.855 0.032 M1: In a ian i s -o de ac o loadings 161.685 114 1.418 M1 s. M0 0.987 −0.000 0.037 0.023 0.050 0.954 0.036 M2: M1 + In a ian highe -o de ac o loadings 173.387 120 1.445 M2 s. M1 0.986 0.001 0.038 0.025 0.050 0.944 0.044 M3: M2 + In a ian i ems’ in e cep s 274.654 144 1.907 M3 s. M2 0.965 −0.021 * 0.055 0.045 0.064 0.209 0.056 M3P: M2 + Pa ially in a ian i ems’ in e cep s b230.563 140 1.647 M3P s. M2 0.976 −0.010 0.046 0.035 0.057 0.714 0.047 M4: M3P + In a ian i s -o de ac o in e cep s 247.490 143 1.731 M4 s. M3P 0.972 −0.004 0.049 0.039 0.059 0.546 0.068 M5: M4 + In a ian i s -o de ac o dis u bances 261.440 152 1.720 M5 s. M4 0.971 −0.001 0.049 0.039 0.059 0.571 0.068 M6: M5 + In a ian i em esidual a iances 277.779 179 1.552 M6 s. M5 0.974 0.003 0.043 0.032 0.052 0.894 0.071 No e. CFI = compa a i e i index; RMSEA = oo mean squa e e o o app oxima ion; CI = con idence in e al; d = deg ees o eedom; Es . = es ima e; Lo = lowe ; up = Uppe ; SRMR = s anda dized oo mean squa e esidual; M = model. * ∆ CFI < − 0.01 (signals lack o in a iance). a In e cep s o i ems 5, 11, 15, and 18 (younge males), I em 13 (olde emales) and I ems 6, 15, and 18 (olde males) a e eed. b In e cep s o I ems 9 and 12 (younge males) and I ems 6 and 15 (olde males) a e eed. Nu ien s 2023,15, 626 8 o 18 Nu ien s 2023, 15, 626 9 o 20 Figu e 1. Fac o s uc u e o he long (BEECOM-L) and he sho (BEECOM-S) e sions o he Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e [16,17]. ED = ea ing diso de s. The ou ows o alues co espond o he g oups consis ing o younge emales, younge males, olde emales, and olde males, espec i ely. Values ou side squa e b acke s ep esen s anda dized ac o load- ings (λ). Values inside squa e b acke s ep esen s anda dized e o s (SE). Figu e 1. Fac o s uc u e o he long (BEECOM-L) and he sho (BEECOM-S) e sions o he Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e [ 16 , 17 ]. ED = ea ing diso de s. The ou ows o alues co espond o he g oups consis ing o younge emales, younge males, olde emales, and olde males, espec i ely. Values ou side squa e b acke s ep esen s anda dized ac o loadings (λ). Values inside squa e b acke s ep esen s anda dized e o s (SE). 3.2. In a iance Analyses and Di e ences in BEECOM Sco es ac oss Popula ion Subg oups The esul s o in a iance analysis (see Table 2) e ealed subs an ial di e ences be ween he models unde compa ison only in hose aimed a es ing he in a ian na u e o i ems’ in e cep s. These di e ences we e no longe ema kable a e emo ing he equali y es ic ion o 8 o he 72 (BEECOM-L) and 4 o he 36 (BEECOM-S) in e cep s unde examina ion. The e ec sizes o di e ences in s udy a iables ac oss popula ion subg oups a e shown in Table 3. In e ms o ED- ela ed social compa isons, mainly small-sized di e ences we e ound, which ended o a o he g oups consis ing o emale and olde pa icipan s. O all sco es de i ed om he BEECOM, di e ences o a leas in e media e magni ude we e obse ed only be ween olde emale and younge male g oups in e ms o body compa ison o ien a ion, which a o ed he o me . Small di e ences we e also ound o se e al ED ou comes, which ended o a o he emale g oups. Nu ien s 2023,15, 626 9 o 18 Table 3. Sco es o S udy Va iables and E ec Sizes o Di e ences Ac oss Popula ion Subg oups. Younge Females (n= 287) Olde Females (n= 360) Younge Males (n= 295) Olde Males (n= 271) Younge s. Olde Females Younge Females s. Younge Males Younge Females s. Olde Males Olde Females s. Younge Males Olde Females s. Olde Males Younge s. Olde Males Range aMSD MSD MSD MSD d d d d d d Pe cen ile- BMI 0–99.40 50.353 27.862 50.464 27.564 58.405 27.530 54.597 26.811 0.004 0.290 0.155 0.288 0.152 −0.140 BEECOM-L (To al sco e) 1–7 2.463 1.426 2.888 1.482 2.240 1.263 2.544 1.131 0.292 −0.166 0.063 −0.467 −0.256 0.253 BEECOM-L (Body) 1–7 2.859 1.702 3.345 1.809 2.306 1.392 2.574 1.340 0.276 −0.356 −0.186 −0.636 −0.475 0.196 BEECOM-L (Ea ing) 1–7 2.230 1.490 2.738 1.590 2.054 1.300 2.437 1.282 0.328 −0.126 0.149 −0.466 −0.205 0.297 BEECOM-L (Exe cise) 1–7 2.300 1.476 2.580 1.524 2.366 1.460 2.621 1.278 0.186 0.045 0.233 −0.143 0.029 0.185 BEECOM-S (To al sco e) 1–7 2.509 1.478 2.924 1.529 2.302 1.362 2.623 1.194 0.275 −0.146 0.084 −0.427 −0.215 0.250 BEECOM-S (Body) 1–7 2.947 1.777 3.403 1.850 2.410 1.530 2.654 1.433 0.251 −0.324 −0.181 −0.579 −0.445 0.164 BEECOM-S (Ea ing) 1–7 2.152 1.566 2.620 1.696 2.036 1.454 2.356 1.377 0.285 −0.077 0.138 −0.367 −0.168 0.225 BEECOM-S (Exe cise) 1–7 2.427 1.622 2.748 1.629 2.449 1.598 2.857 1.437 0.197 0.014 0.280 −0.185 0.070 0.268 PACS-R 0–4 1.162 0.991 1.356 1.104 0.967 0.888 1.062 0.916 0.184 −0.207 −0.105 −0.384 −0.286 0.105 O e all ED Symp oms 0–3 0.685 0.624 0.651 0.590 0.550 0.567 0.536 0.505 −0.056 −0.226 −0.261 −0.174 −0.207 −0.026 Weigh and shape conce n 0–3 0.880 0.912 0.651 0.590 0.587 0.746 0.581 0.691 −0.012 −0.352 −0.368 −0.341 −0.110 −0.008 Die a y Res ain 0–3 0.643 0.810 0.658 0.743 0.539 0.729 0.548 0.673 0.019 −0.135 −0.127 −0.161 −0.154 0.013 No e. BMI = body mass index; BEECOM = Body, Ea ing, and Exe cise Compa ison O ien a ion Measu e (-L = Long e sion, -S = Sho e sion); PACS-R = Physical Appea ance Compa ison Scale-Re ised; ED = ea ing diso de s. aObse ed ange in he case o Pe cen ile-BMI and possible ange o he emaining a iables. Nu ien s 2023,15, 626 16 o 18 Funding: This esea ch was unded by Minis e io de Ciencia e Inno ación (MCIN, Spain), Agen- cia Es a al de In es igación (AEI; h ps://doi.o g/10.13039/501100011033), Spain, g an numbe PID2019-107674RB-I00. MAI (UAL RRA202101) is unded by Minis e io de Uni e sidades (Plan de Recupe ación, T ans o mación y Resiliencia, Nex Gene a ion EU). Ins i u ional Re iew Boa d S a emen : The s udy was conduc ed in acco dance wi h he Decla a ion o Helsinki and app o ed by he E hics Commi ee o Uni e si y o Alme ía (UALBIO2018/013, 1 Ma ch 2018). In o med Consen S a emen : In o med consen was ob ained om all subjec s in ol ed in he s udy. 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