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The validation of a Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescent boys and girls

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Abstract

Purpose

Although some studies have been conducted to examine general psychosocial impairment in Iran, there is no research to date on clinical impairment secondary to disordered eating in Iranian adolescents. The purpose of this study was to evaluate the Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescents.

Methods

A total of 1112 adolescents (ageM [SD] = 15.55 [1.59], body mass index [zBMI] M [SD] = – 0.00 [1.0]; 54.6% girls) were recruited from four cities (Tehran [Capital], Tabriz [North-Western], Kurdistan [West], and Rasht [North]) in Iran. After translation and back-translation procedures, the F-CIA, Eating Disorder Examination Questionnaire (EDE-Q), and Beck Depression Inventory-Second Edition (BDI-II) were administered to adolescents. We used confirmatory factor analysis (CFA), measurement invariance, independent samples t tests, Pearson correlation, chi-square tests, and internal consistency to test validity and reliability.

Results

CFA indicated that F-CIA demonstrated good fit to the data and supported a three-factor model. The scale was invariant across gender and zBMI. The F-CIA had good internal consistency (αs = 0.76–0.93) and positive associations (rs = 0.13–0.62; p < 0.001) with zBMI, disordered eating symptoms, and binge/purge symptoms. We found no gender differences across mean scores on the F-CIA, but adolescents with higher zBMI reported higher scores on the F-CIA relative to those with lower zBMIs. Finally, adolescents scoring above CIA cutoffs reported higher zBMI, disordered eating outcomes, and depression.

Conclusion

Findings suggested that the F-CIA is a reliable and valid measure of clinical eating disorder-related impairment in Iranian adolescents.

Level of evidence

III; Evidence obtained from well-designed observational study, including case–control design for relevant aspects of the study.

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Data availability

The data that support the findings of this study are available on request from the first author.

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Acknowledgements

We thank the adolescents who participated in the study, the teachers and principals of the schools.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran

    Reza N. Sahlan

  2. Department of Psychological Science, Georgia College and State University, Milledgeville, GA, USA

    Jessica F. Saunders

  3. Department of Psychology, Arizona State University, Tempe, AZ, USA

    Marisol Perez

  4. Department of Psychology, Furman University, Greenville, USA

    Kerstin K. Blomquist

  5. Department of Psychiatry, Washington University School of Medicine, St. Louis, USA

    Ellen E. Fitzsimmons-Craft

  6. Department of Psychology, University of Western Ontario, 361 Windermere Road, London, ON, N6A 3K7, Canada

    Lindsay P. Bodell

Authors
  1. Reza N. Sahlan
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  2. Jessica F. Saunders
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  3. Marisol Perez
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  4. Kerstin K. Blomquist
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  5. Ellen E. Fitzsimmons-Craft
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  6. Lindsay P. Bodell
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Corresponding author

Correspondence to Lindsay P. Bodell.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study attained Institutional Review Board approval and complied with all ethical guidelines by the Iran University of Medical Sciences.

Human and animal rights statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participant included in the study.

What is already known on this subject?

Few measures of generic (non-ED specific) quality of life measures have been officially validated in Iran to this end. The Farsi translation and validation of the CIA in the current study enable researchers and clinicians in Iran to assess clinical impairment secondary to EDs.

What this study adds?

The F-CIA was supported in the original 3-factor structure with 16 items among adolescents. Additionally, F-CIA was invariant across gender and zBMI status, suggesting that the scale would be compared across those groups. Furthermore, concurrent and discriminant validity, as well as internal consistency reliability of the F-CIA were supported.

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Sahlan, R.N., Saunders, J.F., Perez, M. et al. The validation of a Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescent boys and girls. Eat Weight Disord 27, 665–674 (2022). https://doi.org/10.1007/s40519-021-01204-6

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