title: A novel measure of compulsive food restriction in anorexia nervosa: validation of the Self-Starvation Scale (SS).
abstract: The characteristic relentless self-starvation behaviour seen in Anorexia Nervosa (AN) has been described as evidence of compulsivity, with increasing suggestion of transdiagnostic parallels with addictive behaviour. There is a paucity of standardised self-report measures of compulsive behaviour in eating disorders (EDs). Measures that index the concept of compulsive self-starvation in AN are needed to explore the suggested parallels with addictions. With this aim a novel measure of self-starvation was developed (the Self-Starvation Scale, SS). 126 healthy participants, and 78 individuals with experience of AN, completed the new measure along with existing measures of eating disorder symptoms, anxiety and depression. Initial validation in the healthy sample indicated good reliability and construct validity, and incremental validity in predicting eating disorder symptoms. The psychometric properties of the SS scale were replicated in the AN sample. The ability of this scale to predict ED symptoms was particularly strong in individuals currently suffering from AN. These results suggest the SS may be a useful index of compulsive food restriction in AN. The concept of 'starvation dependence' in those with eating disorders, as a parallel with addiction, may be of clinical and theoretical importance.
authors.affiliation: Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford OX3 7JX, United Kingdom. Electronic address: lauren.godier@psych.ox.ac.uk.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Godier
authors.affiliation: Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford OX3 7JX, United Kingdom.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000523:psychology*; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D016022:Case-Control Studies; D003192:Compulsive Behavior; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D013217:Starvation / Q000523:psychology*; D055815:Young Adult
keywords: Addiction; Anorexia Nervosa; Compulsivity; Eating disorders; Questionnaire; Starvation