The fear of food measure: A novel measure for use in exposure therapy for eating disorders

Abstract

OBJECTIVE: Exposure therapy for mealtime anxiety has preliminarily been effective at increasing food intake and decreasing anxiety in individuals with anorexia nervosa (AN). To enhance our knowledge of exposure therapy for AN researchers and clinicians need a comprehensive measure that assesses outcomes relevant to exposure therapy for AN. METHOD: In the current four studies we developed Fear of Food Measure (FOFM) that assesses three cognitive and behavioral outcomes: trait anxiety about eating, food avoidance behaviors, and feared concerns related to eating. RESULTS: In a community (N = 399) and undergraduate female sample (N = 203) the FOFM exhibited a good three-factor structure and convergent and divergent validity. In a sample of women (N = 72) we showed that the anxiety about eating subscale significantly predicted in vivo food intake over and above other established predictors of eating (e.g., restraint). In a clinical sample diagnosed with an eating disorder (N = 41) we showed that anxiety about eating was associated with food intake and anxiety during an exposure meal and that all subscales of the FOFM significantly decreased over the course of a four-session exposure intervention. Finally, we found that participants diagnosed with an eating disorder had higher levels of fear of food than did matched controls (N = 23). DISCUSSION: The FOFM is a psychometrically valid measure that can assess if patients are improving while undergoing exposure therapy and could be used to pinpoint problematic behaviors that can be addressed in exposure therapy.

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