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

Author: Paterna Roda, Adrián,Alcaraz Ibáñez, Manuel,Sicilia Camacho, Alvaro
Publisher: MDPI
Year: 2023
DOI: 10.3390/nu15030626
Source: https://repositorio.ual.es/bitstream/10835/14227/1/nutrients-15-00626-v2.pdf
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.
Da a A ailabili y S a emen :
The da a p esen ed in his s udy a e a ailable on eques om he
co esponding au ho .
Con lic s o In e es :
The au ho s decla e no con lic o in e es . The unde s had no ole in he design
o he s udy; in he collec ion, analysis, o in e p e a ion o da a; in he w i ing o he manusc ip ; o
in he decision o publish he esul s.
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