The Deliberate Denial of Disordered Eating Behaviors Scale: Development and Initial Validation in Young Women with Subclinical Disordered Eating

The purpose of this study was to develop a self-report measure of deliberate denial of disordered eating behaviors (i.e., conscious omission, concealment, or misrepresentation of behavior related to an eating disorder). Study 1 involved item generation and review by focus groups composed of women with subclinical disordered eating (N = 13) and an expert panel of five eating disorder researchers and clinicians. In Study 2, the scale and validity measures were administered to 311 undergraduate women with subclinical disordered eating via an online survey. Initial items were refined based on focus group and expert panel feedback, resulting in an 18-item scale. In Study 2, a series of exploratory factor analyses were conducted, resulting in a 12-item Deliberate Denial of Disordered Eating Behaviors scale (DDEBS-12) with a unidimensional total score. A parallel analysis confirmed the single-factor structure. In Study 3, a separate sample of 362 undergraduate women with subclinical disordered eating completed the DDEBS-12, and the factor structure was subsequently confirmed via a confirmatory factor analysis. The DDEBS-12 possessed excellent internal consistency, and was correlated as expected with measures of concealment, disordered eating, body dissatisfaction, disclosure, and social desirability, suggesting criterion, convergent, and discriminant validity. This novel scale can be used to examine the role of denial in the onset and maintenance of disordered eating behaviors, and address denial in the identification and prevention of disordered eating.