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The intuitive eating scale-2: re-evaluating its factor structure using a bifactor exploratory structural equation modelling framework

Swami V, Maïano C, Furnham A, Robinson C

Eat Weight Disord, 2022 May;27(4):1349-1357.
PMID: 34292529 DOI: 10.1007/s40519-021-01271-9

PURPOSE: Previous studies examining the appropriateness of the 4-factor model of intuitive eating scale-2 (IES-2) scores have returned equivocal results, which may reflect methodological limitations in the way IES-2 scores are modelled. Here, we applied a bifactor-exploratory structural equation modelling (B-ESEM) framework to better understand IES-2 multidimensionality.
METHODS: A total of 603 participants from the United States completed the IES-2, alongside measures of body appreciation, body acceptance from others, and self-esteem. Our analyses compared the fit of various hypothesised models of IES-2 scores.
RESULTS: Models of IES-2 scores based on confirmatory factor analysis (CFA) uniformly showed poor fit. ESEM models showed superior fit to CFA representations and a B-ESEM model showed improved fit over higher-order CFA and B-CFA representations of IES-2 scores. The optimal model was a B-ESEM model that accounted for, through correlated uniqueness (CU), the methodological artefact introduced by negatively-worded IES-2 items. This B-ESEM-CU model was fully invariant across gender and showed adequate construct validity.
CONCLUSION: The B-ESEM-CU framework appears well-suited to understand the multidimensionality of IES-2 scores. A model of IES-2 scores that yields a reliable latent indicator of global intuitive eating while allowing for simultaneous consideration of additional specific factors will likely provide more accurate accounting of the nature and outcomes of intuitive eating.
LEVEL OF EVIDENCE: Level III, cohort study.

Matched MeSH terms: Intuition*
Dimensionality and psychometric properties of an Italian translation of the Intuitive Eating Scale-2 (IES-2): An assessment using a bifactor exploratory structural equation modelling framework

Swami V, Maïano C, Todd J, Ghisi M, Cardi V, Bottesi G, et al.

Appetite, 2021 11 01;166:105588.
PMID: 34224761 DOI: 10.1016/j.appet.2021.105588

The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2), but previous studies have typically relied solely on confirmatory factor analysis (CFA) to understand IES-2 dimensionality. In contrast, a bifactor exploratory structural equation modelling (B-ESEM) framework offers a more realistic account of IES-2 multidimensionality. Here, we assessed the psychometric properties of a novel Italian translation using a combination of exploratory factor analysis and B-ESEM. A total of 950 adults completed the IES-2 alongside measures of positive body image, disordered eating, and psychological well-being. Results indicated that a 4-factor B-ESEM model had adequate fit to the data and that fit was improved when the correlated uniqueness of seven negatively worded IES-2 items was accounted for. This model of IES-2 scores showed adequate internal consistency and good test-retest reliability up to three weeks. Evidence of construct validity was good in terms of a global IES-2 factor, and broadly supported in terms of its specific-factors. These results highlight the utility of a B-ESEM framework for understanding the dimensionality of IES-2 scores and may help scholars better understand the extent to which the IES-2 adequately operationalises the construct of intuitive eating.

Matched MeSH terms: Intuition*
Fulltext Probability or Reasoning: Current Thinking and Realistic Strategies for Improved Medical Decisions

Nantha YS

Korean J Fam Med, 2017 Nov;38(6):315-321.
PMID: 29209469 DOI: 10.4082/kjfm.2017.38.6.315

A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting. An extensive literature review of cognitive psychology and medical decision-making theory was performed to illustrate how heuristics could be effectively utilized in daily practice. Since physicians often rely on heuristics in realistic situations, probabilistic estimation might not be a useful tool in everyday clinical practice. Improvements in the descriptive model of decision making (heuristics) may allow for greater diagnostic accuracy.

Matched MeSH terms: Intuition
Psychometric properties of a Greek translation of the Intuitive Eating Scale-2 (IES-2) in adults from Cyprus

Anastasiades E, Maïano C, Argyrides M, Swami V

Body Image, 2022 Dec;43:348-361.
PMID: 36272259 DOI: 10.1016/j.bodyim.2022.09.014

The construct of intuitive eating is commonly assessed using the 23-item, 4-factor Intuitive Eating Scale-2 (IES-2; Tylka & Kroon Van Diest, 2013). In this study, we assessed the psychometric properties of a novel Greek translation of the IES-2 in adults from Cyprus. In Study 1 (N = 626), an exploratory factor analysis indicated that the IES-2 should be conceptualized as consisting of six factors that showed complete invariance across women and men. Study 2 (N = 793), using exploratory structural equation modelling (ESEM) and beifactor analysis (B-ESEM), indicated that the 6-factor B-ESEM model had adequate fit and evidenced complete invariance across sex once the correlated uniqueness of negatively worded IES-2 items was accounted for. This final model evidenced adequate composite reliability, and a global G-factor evidenced adequate convergent, concurrent, and discriminant validity. In contrast, the IES-2 S-factors showed more equivocal patterns of validity, with some S-factors showing less-than-adequate associations with body image variables, self-esteem, symptoms of disordered eating, and fruit and vegetable intake. In general, these results provide satisfactory evidence of the psychometric properties of the Greek IES-2 in adults from Cyprus, but also suggest that models of IES-2 scores may vary across national or cultural contexts.

Matched MeSH terms: Intuition*
Fulltext Using mathematics to quantify subjective decisions: application of analytic hierarchy process to risk assessment

Rabihah Md. Sum

Journal of Advanced Research Design, 2018;44(1):7-19.
MyJurnal

Risk management requires human judgements, from risk identification, assessment to response. Although automated tools are useful in handling large amounts of data and in performing complex calculations rapidly, humans undertake the entire risk management process. They bring to the process their intuitions, insights, previous experiences and skills. Therefore, creating a rich source of information of risks faced by an organisation. Ignoring human factors may impoverish information and limit risk management to only measurable factors. This study contributes to the field of decision-making and risk assessment by investigating and discussing in detail how to quantify subjective judgements using the Analytic Hierarchy Process (AHP). AHP is used to assess risk of an insurance company. It discusses how to do risk assessment by combining both intuition and analytic in the decision-making process. The study defines intuition as knowledge and experience, and analytic as the mathematics or quantitative analysis to derive the result. It demonstrates how Analytic Hierarchy Process (AHP) - a flexible multi-attribute or multi-criteria decision making tool, enables risk managers to use both intuition and analytic to do risk assessment. Risk assessment using AHP produces global priority weights representing the overall risk ranking of an insurance company. The study develops a risk assessment problem and uses AHP to organise and structure risks and sub-risks of the problem. It uses formative evaluation method with open-ended questionnaires to obtain feedbacks from risk managers on AHP. Three employees of a risk management department in a government agency assesses the risks using AHP. AHP strengths are easy to use and understand, improves risk assessment and useful for risk assessment problems that have scarce or no data. AHP limitation are the numbers and repetitiveness of the pairwise comparisons. The participants either ignore some of the pairwise questions or they answer randomly instead of deliberate judgements.

Matched MeSH terms: Intuition
A psychometric investigation of Brazilian Portuguese versions of the Caregiver Eating Messages Scale and Intuitive Eating Scale-2

da Silva WR, Neves AN, Ferreira L, Campos JADB, Swami V

Eat Weight Disord, 2020 Feb;25(1):221-230.
PMID: 30076529 DOI: 10.1007/s40519-018-0557-3

The Caregiver Eating Messages Scale (CEMS) was developed to assess perceived restrictive or critical caregiver messages in relation to food intake and pressure to eat, whereas the Intuitive Eating Scale-2 (IES-2) measures one's tendency to follow internal cues of hunger and satiety when making eating-related decisions. Both scales are useful in the arsenal of eating behaviour scholars. Here, we developed Brazilian Portuguese translations of both scales and assessed their psychometric properties in Brazilian adults. A total of 288 participants (men = 52.8%) completed the CEMS, IES-2, Body Appreciation Scale (BAS), and a demographic questionnaire. The results of confirmatory factor analysis indicated that the factor structure of both scales had adequate fit following the elimination of items and addition of covariances. Evidence of adequate factorial, convergent and discriminant validity, as well as reliability was identified. Furthermore, correlations of CEMS and IES-2 with BAS scores and body mass index were obtained. Both instruments' models were found to be invariant across sex, with men having significantly higher scores on three subscales of the IES-2 only. These results provide evidence for the psychometric properties of the CEMS and IES-2 in Brazilian Portuguese-speaking adults.Level of Evidence: V, cross-sectional descriptive study.

Matched MeSH terms: Intuition*
Dimensional structure, psychometric properties, and sex and ethnic invariance of a Bahasa Malaysia (Malay) translation of the Intuitive Eating Scale-2 (IES-2)

Swami V, Todd J, Zahari HS, Mohd Khatib NA, Toh EKL, Barron D

Body Image, 2020 Mar;32:167-179.
PMID: 31981992 DOI: 10.1016/j.bodyim.2020.01.003

The Intuitive Eating Scale-2 (IES-2; Tylka & Kroon Van Diest, 2013) is a widely-used measure of facets of intuitive eating. We examined the psychometric properties of a Bahasa Malaysia (Malay) translation of the IES-2 in a sample of Malaysian Malay and Chinese adults (N = 921). Participants completed a Malay translation of the IES-2 along with demographic items and measures of psychological well-being, positive and negative body image, and internalisation of appearance ideals. Exploratory factor analyses (EFAs) with Malay subsamples indicated that IES-2 scores reduced to 4 factors in women and 3 in men, both of which diverged from the parent model. Confirmatory factor analysis failed to confirm the parent 4-factor model, and indices for the EFA-derived models were acceptable but not ideal. Of the models tested, the EFA-derived 3-factor model had the best fit indices. Scores on this model had adequate internal consistency and were invariant across sex and ethnicity, but between-group differences in subscale scores were non-significant or negligible. Evidence of the construct validity of Malay IES-2 scores was mixed, particularly in men. These results lead us to question the degree to which intuitive eating as a construct is applicable to Malaysian populations specifically and non-Western populations generally.

Matched MeSH terms: Intuition*
Fulltext Intuitive Eating Behaviour among Young Malay Adults in Malaysian Higher Learning Institutions

Muhammad R, Ismail WNDRAW, Firdus S, Abdul Hamid SB, Mohd Asmawi UM, Md Nor N

Nutrients, 2023 Feb 08;15(4).
PMID: 36839227 DOI: 10.3390/nu15040869

Despite the significance of dietary knowledge interventions, there is a lack of established studies on intuitive eating behaviour among young Malay adults in Malaysia. This cross-sectional study aimed to determine the intuitive eating score, identify the intuitive eating factors, and determine the association of intuitive eating with weight-control behaviours and binge eating. A total of 367 respondents completed self-administered questionnaires on sociodemographic characteristics, namely the Intuitive Eating Scale (IES-2) and The Diabetes Eating Problems Survey (DEPS). The findings reported IES-2 mean scores of 3.52 ± 0.32 and 3.47 ± 0.35 for both men and women. No difference in total IES-2 scores was found between genders for Unconditional Permission to Eat (UPE) and Reliance on Hunger and Satiety Cue (RHSC) subscales (p > 0.05). However, among all four subscales of IES-2, there was a gender difference in the mean EPR and B-FCC subscale scores (p < 0.05). A statistically significant difference was found in intuitive eating, which refers to a belief in one's body's ability to tell one how much to eat, in women across living areas (p < 0.05). The result shows that there is a relationship between weight-control behaviour and binge eating and dieting, with the coefficient of the relationship (R2) of 0.34. As a result, intuitive eating throughout young adulthood is likely to be related to a decreased prevalence of obesity, dieting, poor weight-management behaviours, and binge eating.

Matched MeSH terms: Intuition