Psychometric evaluation of a novel measure of trauma-related eating to cope

Abstract

Posttraumatic stress disorder (PTSD) and disordered eating often co-occur, and this comorbidity is linked to a heightened clinical burden compared to either condition alone. One possible explanation for this co-occurrence is the self-medication model, which proposes that individuals may use food to cope with PTSD symptoms, a concept we refer to as trauma-related eating to cope. Although there is both theoretical and empirical support for this construct, no specific measure has been developed until now. In this study, we aimed to create and validate a novel measure, the Trauma-Related Eating to Cope (TREC) questionnaire, among a diverse sample of 726 trauma-exposed undergraduate students (M_age=22.87, SD=7.20; 49.9 % White; 77 % women). Our data support the 20-item TREC questionnaire as a four-factor scale that can be used to evaluate eating to cope with symptoms specific to each of the four DSM-5 PTSD symptom clusters (χ²(164)= 330.23, p < .001; CFI= .959; TLI= .953; RMSEA= .038). The study findings indicate that the TREC questionnaire is a more precise and targeted tool for measuring eating to cope with PTSD symptoms compared to existing measures of eating to cope motives. Strong evidence was found for the construct and criterion validity of the TREC questionnaire, particularly in relation to PTSD symptoms and a range of disordered eating behaviors, including binge eating, caloric restriction, and emotional eating. These results underscore the potential of the TREC questionnaire for future research on self-medication and its clinical utility as a screening tool for identifying individuals with PTSD who are at risk for developing pathological eating behaviors.