Transcultural adaptation and validation of the Child Three-Factor Eating Questionnaire (CTFEQr17) into Brazilian Portuguese
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https://doi.org/10.21615/cesp.7734Palavras-chave:
obesity, eating behaviours, validation, Three-factor Eating QuestionnaireResumo
The Three-Factor Eating Questionnaire is a commonly utilized instrument for evaluating elements of human eating behaviours. A version of this questionnaire, the Child Three-Factor Eating Questionnaire (CTFEQr17), was specifically developed for a paediatric population. This study focused on translating and validating the CTFEQr17 into Brazilian Portuguese for use with children and adolescents, and it was developed in three main stages: translation and expert review, a pilot test with 47 participants to evaluate comprehension, and psychometric validation in a sample of 249 participants. The study found that participants over the age of 10 understood the scale well. An initial Confirmatory Factor Analysis demonstrated excellent fit indices, but factor loadings indicated necessary adjustments. Following refinement, the CTFEQr-16 was obtained, showing good internal consistency and fit (Cronbach's alpha = 0.84). Convergent and discriminant validity were confirmed through specific analyses, and the scale effectively distinguished between different BMI (body mass index) categories. The Brazilian version of the CTFEQr16 showed satisfactory content validity and was comprehensible to children and adolescents, confirming its strong factor structure and high reliability. This makes it a valuable tool for future research and clinical practice in the Brazilian paediatric population.
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Alavi, M., Visentin, D. C., Thapa, D. K., Hunt, G. E., Watson, R., & Cleary, M. (2020). Chi-square for model fit in confirmatory factor analysis. Journal of Advanced Nursing, 76(9), 2209–2211. https://doi.org/10.1111/jan.14399
Amstadter, A. B. (2008). Emotion Regulation and Anxiety Disorders. Journal of Anxiety Disorders, 22(2), 211–221. https://doi.org/10.1016/j.janxdis.2007.02.004
Anderson, L. N., Sandhu, R., Keown‐Stoneman, C. D. G., De Rubeis, V., Borkhoff, C. M., Carsley, S., Maguire, J. L., & Birken, C. S. (2020). Latent class analysis of obesity‐related characteristics and associations with body mass index among young children. Obesity Science & Practice, 6(4), 390–400. https://doi.org/10.1002/osp4.414
Anglé, S., Engblom, J., Eriksson, T., Kautiainen, S., Saha, M.-T., Lindfors, P., Lehtinen, M., & Rimpelä, A. (2009). Three factor eating questionnaire-R18 as a measure of cognitive restraint, uncontrolled eating and emotional eating in a sample of young Finnish females. The International Journal of Behavioral Nutrition and Physical Activity, 6, 41. https://doi.org/10.1186/1479-5868-6-41
Apfeldorfer, G., & Zermati, J. P. (2001). [Cognitive restraint in obesity. History of ideas, clinical description]. Presse Medicale (Paris, France: 1983), 30(32), 1575–1580.
Banna, J. C., Panizza, C. E., Boushey, C. J., Delp, E. J., & Lim, E. (2018). Association between Cognitive Restraint, Uncontrolled Eating, Emotional Eating and BMI and the Amount of Food Wasted in Early Adolescent Girls. Nutrients, 10(9), 1279. https://doi.org/10.3390/nu10091279
Bardal, A. G., Ceccatto, V., & Mezzomo, T. R. (2016). Fatores de risco para recidiva de peso no pós-operatório tardio de cirurgia bariátrica. Scientia Medica, 26(4), ID24224–ID24224. https://doi.org/10.15448/1980-6108.2016.4.24224
Biagio, L. D., Moreira, P., & Amaral, C. K. (2020). Eating behavior in obesity and its correlation with nutritional treatment. Jornal Brasileiro de Psiquiatria, 69, 171–178.
Boateng, G. O., Neilands, T. B., Frongillo, E. A., Melgar-Quiñonez, H. R., & Young, S. L. (2018). Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Frontiers in Public Health, 6, 149. https://doi.org/10.3389/fpubh.2018.00149
Braden, A., Barnhart, W. R., Kalantzis, M., Redondo, R., Dauber, A., Anderson, L., & Tilstra-Ferrell, E. L. (2023). Eating when depressed, anxious, bored, or happy: An examination in treatment-seeking adults with overweight/obesity. Appetite, 184, 106510. https://doi.org/10.1016/j.appet.2023.106510
Bryant, E. J., Thivel, D., Chaput, J.-P., Drapeau, V., Blundell, J. E., & King, N. A. (2018). Development and validation of the Child Three-Factor Eating Questionnaire (CTFEQr17). Public Health Nutrition, 21(14), Article 14.
Cappelleri, J. C., Bushmakin, A. G., Gerber, R. A., Leidy, N. K., Sexton, C. C., Lowe, M. R., & Karlsson, J. (2009). Psychometric analysis of the Three-Factor Eating Questionnaire-R21: Results from a large diverse sample of obese and non-obese participants. International Journal of Obesity (2005), 33(6), 611–620. https://doi.org/10.1038/ijo.2009.74
Cheung, G. W., Cooper-Thomas, H. D., Lau, R. S., & Wang, L. C. (2023). Reporting reliability, convergent and discriminant validity with structural equation modeling: A review and best-practice recommendations. Asia Pacific Journal of Management. https://doi.org/10.1007/s10490-023-09871-y
Cifuentes, L., Campos, A., Silgado, M. L. R., Kelpin, S., Stutzman, J., Hurtado, M. D., Grothe, K., Hensrud, D. D., Clark, M. M., & Acosta, A. (2022). Association between anxiety and eating behaviors in patients with obesity. Obesity Pillars, 3, 100021. https://doi.org/10.1016/j.obpill.2022.100021
Dakanalis, A., Mentzelou, M., Papadopoulou, S. K., Papandreou, D., Spanoudaki, M., Vasios, G. K., Pavlidou, E., Mantzorou, M., & Giaginis, C. (2023). The Association of Emotional Eating with Overweight/Obesity, Depression, Anxiety/Stress, and Dietary Patterns: A Review of the Current Clinical Evidence. Nutrients, 15(5), 1173. https://doi.org/10.3390/nu15051173
de Lauzon-Guillain, B., Basdevant, A., Romon, M., Karlsson, J., Borys, J.-M., Charles, M. A., & FLVS Study Group. (2006). Is restrained eating a risk factor for weight gain in a general population? The American Journal of Clinical Nutrition, 83(1), 132–138. https://doi.org/10.1093/ajcn/83.1.132
de Medeiros, A. C. Q., Yamamoto, M. E., Pedrosa, L. F. C., & Hutz, C. S. (2017). The Brazilian version of the three-factor eating questionnaire-R21: Psychometric evaluation and scoring pattern. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 22(1), 169–175. https://doi.org/10.1007/s40519-016-0256-x
Demir, D., Bektaş, M., Bektaş, İ., Demir, Ş., & Bryant, E. J. (2021). Psychometric properties of the Turkish version of the Child Three-Factor Eating Questionnaire for primary and secondary school students. Public Health Nutrition, 24(3), 427–435. https://doi.org/10.1017/S1368980020001767
Fernández, M. S., Pilatti, A., & Pautassi, R. M. (2022). Eating-to-Cope Motives and Uncontrolled Eating as Mediators Between Negative Emotional States and Food Addiction Among Argentinean Young Adults. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-022-00934-7
Flegal, K. M., & Cole, T. J. (2013). Construction of LMS parameters for the Centers for Disease Control and Prevention 2000 growth charts. National Health Statistics Reports, 63, 1–3.
Floyd, F. J., & Widaman, K. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7(3), 286–299. https://doi.org/10.1037/1040-3590.7.3.286
Fornell, C., & Larcker, D. F. (1981). Evaluating Structural Equation Models with Unobservable Variables and Measurement Error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.2307/3151312
Frappier, I., Jacob, R., Panahi, S., Larose, D., Bryant, E. J., Chaput, J.-P., Thivel, D., & Drapeau, V. (2022). Translation and validation of the Child Three-Factor Eating Questionnaire (CTFEQr17) in French-speaking Canadian children and adolescents. Public Health Nutrition, 25(3), 543–553. https://doi.org/10.1017/S136898002100392X
Goretzko, D., Siemund, K., & Sterner, P. (2024). Evaluating Model Fit of Measurement Models in Confirmatory Factor Analysis. Educational and Psychological Measurement, 84(1), 123–144. https://doi.org/10.1177/00131644231163813
Gouveia, V. V., Moura, H. M. de, Oliveira, I. C. V. de, Ribeiro, M. G. C., Rezende, A. T., & Brito, T. R. de S. (2018). Questionário de Regulação Emocional (QRE): Evidências de Validade de Construto e Consistência Interna. Psico-USF, 23, 461–471. https://doi.org/10.1590/1413-82712018230306
Guadagnoli, E., & Velicer, W. F. (1988). Relation of sample size to the stability of component patterns. Psychological Bulletin, 103(2), 265–275. https://doi.org/10.1037/0033-2909.103.2.265
Héberger, K., & Kollár-Hunek, K. (2019). Comparison of validation variants by sum of ranking differences and ANOVA. Journal of Chemometrics, 33(6), e3104. https://doi.org/10.1002/cem.3104
Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115–135. https://doi.org/10.1007/s11747-014-0403-8
Herman, C. P., & Mack, D. (1975). Restrained and unrestrained eating1. Journal of Personality, 43(4), 647–660. https://doi.org/10.1111/j.1467-6494.1975.tb00727.x
Hoover, L. V., Yu, H. P., Duval, E. R., & Gearhardt, A. N. (2022). Childhood trauma and food addiction: The role of emotion regulation difficulties and gender differences. Appetite, 177, 106137. https://doi.org/10.1016/j.appet.2022.106137
Kaiser, H. F. (1974). An index of factorial simplicity. Psychometrika, 39(1), 31–36. https://doi.org/10.1007/BF02291575
Karlsson, J., Persson, L.-O., Sjöström, L., & Sullivan, M. (2000). Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. International Journal of Obesity, 24(12), 1715–1725. https://doi.org/10.1038/sj.ijo.0801442
Katsikatsou, M., Moustaki, I., & Jamil, H. (2022). Pairwise likelihood estimation for confirmatory factor analysis models with categorical variables and data that are missing at random. British Journal of Mathematical and Statistical Psychology, 75(1), 23–45. https://doi.org/10.1111/bmsp.12243
Koo, T. K., & Li, M. Y. (2016). A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. Journal of Chiropractic Medicine, 15(2), 155–163. https://doi.org/10.1016/j.jcm.2016.02.012
Laessle, R. G., Tuschl, R. J., Kotthaus, B. C., & Pirke, K. M. (1989). A comparison of the validity of three scales for the assessment of dietary restraint. Journal of Abnormal Psychology, 98(4), 504–507. https://doi.org/10.1037//0021-843x.98.4.504
Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4, 863. https://doi.org/10.3389/fpsyg.2013.00863
Lawless, M., Shriver, L. H., Hubbs-Tait, L., Topham, G. L., Swindle, T., & Harrist, A. W. (2021). Bidirectional Associations between Restrained Eating and Body Mass Index in Middle Childhood. Nutrients, 13(5), 1485. https://doi.org/10.3390/nu13051485
Legget, K. T., Cornier, M.-A., Sarabia, L., Delao, E. M., Mikulich-Gilbertson, S. K., Natvig, C., Erpelding, C., Mitchell, T., Hild, A., Kronberg, E., & Tregellas, J. R. (2023). Sex Differences in Effects of Mood, Eating-Related Behaviors, and BMI on Food Appeal and Desire to Eat: A Cross-Sectional Survey Study. Nutrients, 15(3), 762. https://doi.org/10.3390/nu15030762
Leung, A. K. C., Wong, A. H. C., & Hon, K. L. (2024). Childhood Obesity: An Updated Review. Current Pediatric Reviews, 20(1), 2–26. https://doi.org/10.2174/1573396318666220801093225
Martín-García, M., Vila-Maldonado, S., Rodríguez-Gómez, I., Faya, F. M., Plaza-Carmona, M., Pastor-Vicedo, J. C., & Ara, I. (2016). The Spanish version of the Three Factor Eating Questionnaire-R21 for children and adolescents (TFEQ-R21C): Psychometric analysis and relationships with body composition and fitness variables. Physiology & Behavior, 165, 350–357. https://doi.org/10.1016/j.physbeh.2016.08.015
McLean, J. A., & Barr, S. I. (2003). Cognitive dietary restraint is associated with eating behaviors, lifestyle practices, personality characteristics and menstrual irregularity in college women. Appetite, 40(2), 185–192. https://doi.org/10.1016/s0195-6663(02)00125-3
Nakamura, Y., Ando, S., Yamasaki, S., Okada, N., Nishida, A., Kasai, K., Tanaka, S., Nakatani, H., & Koike, S. (2021). Dietary Restraint Related to Body Weight Maintenance and Neural Processing in Value-Coding Areas in Adolescents. The Journal of Nutrition, 151(7), 2059–2067. https://doi.org/10.1093/jn/nxab068
Penaforte, F. R., Matta, N. C., & Japur, C. C. (2016). ASSOCIAÇÃO ENTRE ESTRESSE E COMPORTAMENTO ALIMENTAR EM ESTUDANTES UNIVERSITÁRIOS. DEMETRA: Alimentação, Nutrição & Saúde, 11(1), Article 1. https://doi.org/10.12957/demetra.2016.18592
Perneger, T. V., Courvoisier, D. S., Hudelson, P. M., & Gayet-Ageron, A. (2015). Sample size for pre-tests of questionnaires. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 24(1), 147–151. https://doi.org/10.1007/s11136-014-0752-2
Pinheiro, N., & Jiménez, M. (2012). TRADUÇÃO E VALIDAÇÃO DA VERSÃO BRASILEIRA DO CHILDREN’S EATING ATTITUDES TEST (CHEAT). Psicologia Argumento, 30(70), Article 70. https://doi.org/10.7213/psicol.argum.6138
Polit, D. F., Beck, C. T., & Owen, S. V. (2007). Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health, 30(4), 459–467. https://doi.org/10.1002/nur.20199
Reichenberger, J., Schnepper, R., Arend, A.-K., & Blechert, J. (2020). Emotional eating in healthy individuals and patients with an eating disorder: Evidence from psychometric, experimental and naturalistic studies. Proceedings of the Nutrition Society, 79(3), 290–299. https://doi.org/10.1017/S0029665120007004
Roberge, J.-B., Harnois-Leblanc, S., McNealis, V., van Hulst, A., Barnett, T. A., Kakinami, L., Paradis, G., & Henderson, M. (2021). Body Mass Index Z Score vs Weight-for-Length Z Score in Infancy and Cardiometabolic Outcomes at Age 8-10 Years. The Journal of Pediatrics, 238, 208-214.e2. https://doi.org/10.1016/j.jpeds.2021.07.046
Rogers, P. J. (1999). Eating habits and appetite control: A psychobiological perspective. The Proceedings of the Nutrition Society, 58(1), 59–67. https://doi.org/10.1079/pns19990009
Rossi, A. A., Pietrabissa, G., Castelnuovo, G., & Mannarini, S. (2024). Cognitive restraint, uncontrolled eating, and emotional eating. The Italian version of the Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18): A three-step validation study. Eating and Weight Disorders: EWD, 29(1), 16. https://doi.org/10.1007/s40519-024-01642-y
Santos, F. D. P., Silva, E. A. F., Baêta, C. L. V., Campos, F. S., & Campos, H. O. (2023). Prevalence of childhood obesity in Brazil: A systematic review. Journal of Tropical Pediatrics, 69(2), fmad017. https://doi.org/10.1093/tropej/fmad017
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodness-of-Fit Measures. Methods of Psychological Research, 8(2). https://www.psycharchives.org/en/item/1a8dea48-0285-4dac-a612-9dc0ff2532f6
Schuck, P. (2004). Assessing reproducibility for interval data in health-related quality of life questionnaires: Which coefficient should be used? Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 13(3), 571–586. https://doi.org/10.1023/B:QURE.0000021318.92272.2a
Shaban Mohamed, M. A., AbouKhatwa, M. M., Saifullah, A. A., Hareez Syahmi, M., Mosaad, M., Elrggal, M. E., Dehele, I. S., & Elnaem, M. H. (2022). Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity. Children, 9(12), 1975. https://doi.org/10.3390/children9121975
Shi, J., Mo, X., & Sun, Z. (2012). [Content validity index in scale development]. Zhong Nan Da Xue Xue Bao. Yi Xue Ban = Journal of Central South University. Medical Sciences, 37(2), 152–155. https://doi.org/10.3969/j.issn.1672-7347.2012.02.007
Smith, J., Ang, X. Q., Giles, E. L., & Traviss-Turner, G. (2023). Emotional Eating Interventions for Adults Living with Overweight or Obesity: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 20(3), 2722. https://doi.org/10.3390/ijerph20032722
Souza, M. P. G., Sampaio, R., Cavalcante, A. C. M., Arruda, S. P. M., & Pinto, F. J. M. (2020). COMPORTAMENTO ALIMENTAR E FATORES ASSOCIADOS EM SERVIDORES: CONTRIBUIÇÕES PARA A SAÚDE COLETIVA. Revista de Atenção à Saúde, 18(63). https://doi.org/10.13037/ras.vol18n63.6162
Stellern, J., Xiao, K. B., Grennell, E., Sanches, M., Gowin, J. L., & Sloan, M. E. (2023). Emotion regulation in substance use disorders: A systematic review and meta‐analysis. Addiction (Abingdon, England), 118(1), 30–47. https://doi.org/10.1111/add.16001
Stewart, J. L., Lynn, M. R., & Mishel, M. H. (2005). Evaluating content validity for children’s self-report instruments using children as content experts. Nursing Research, 54(6), 414–418. https://doi.org/10.1097/00006199-200511000-00008
Stunkard, A. J., & Messick, S. (1985). The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. Journal of Psychosomatic Research, 29(1), 71–83. https://doi.org/10.1016/0022-3999(85)90010-8
Taber, K. S. (2018). The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Research in Science Education, 48(6), 1273–1296. https://doi.org/10.1007/s11165-016-9602-2
Type 2 diabetes in children and adolescents. American Diabetes Association. (2000). Diabetes Care, 23(3), 381–389. https://doi.org/10.2337/diacare.23.3.381
Wieland, A., Durach, C. F., Kembro, J., & Treiblmaier, H. (2017). Statistical and judgmental criteria for scale purification. Supply Chain Management: An International Journal, 22(4), 321–328. https://doi.org/10.1108/SCM-07-2016-0230
Xia, Y., & Yang, Y. (2019). RMSEA, CFI, and TLI in structural equation modeling with ordered categorical data: The story they tell depends on the estimation methods. Behavior Research Methods, 51(1), 409–428. https://doi.org/10.3758/s13428-018-1055-2
Ximénez, C. (2009). Recovery of weak factor loadings in confirmatory factor analysis under conditions of model misspecification. Behavior Research Methods, 41(4), 1038–1052. https://doi.org/10.3758/BRM.41.4.1038
Xu, H., Cupples, L. A., Stokes, A., & Liu, C.-T. (2018). Association of Obesity With Mortality Over 24 Years of Weight History: Findings From the Framingham Heart Study. JAMA Network Open, 1(7), e184587. https://doi.org/10.1001/jamanetworkopen.2018.4587
Yana, A. A. G. A., Rusdhi H.A., & Wibowo, M. A. (2015). Analysis of Factors Affecting Design Changes in Construction Project with Partial Least Square (PLS). Procedia Engineering, 125, 40–45. https://doi.org/10.1016/j.proeng.2015.11.007
Yusoff, M. S. B. (2019, June 1). ABC of Content Validation and Content Validity Index Calculation. | Education in Medicine Journal | EBSCOhost. https://doi.org/10.21315/eimj2019.11.2.6
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Copyright (c) 2025 Caroline da Cruz Martins , Maria Alice Da Conceição Ferreira, Jhessy Santos Inácio, Eleanor J. Bryant , Thayro Andrade Carvalho , Sandra Adriana Neves Nunes , Ezequiel Nascimento
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