The Cognitive Behavioral Model of Eating Disorders in Iranian Women Students

Abstract

Background: The cognitive-behavioral model of eating disorders (EDs) has not been thoroughly investigated among women in Eastern societies, including Iran. Objectives: This study assessed the validity of the cognitive-behavioral model of eating disorders among Iranian female students. Methods: A cross-sectional study was conducted from September 2021 to February 2022 at Tehran University of Medical Sciences, Azad Islamic University, and the University of Social Welfare and Rehabilitation Sciences. A total of 516 female students aged 18 - 42 years were selected using cluster sampling and completed validated Farsi versions of the Eating Disorder Examination Questionnaire (EDE-Q 6.0), Binge Eating Scale (BES), Clinical Perfectionism Questionnaire (CPQ), Distress Tolerance Scale (DTS), Inventory of Interpersonal Problems-32 (IIP-32), and the Rosenberg Self-Esteem Scale (RSES). Data were analyzed using path analysis in AMOS 23, and confirmatory factor analysis (CFA) was conducted to validate the measurement model. Goodness-of-fit indices, including RMSEA, CFI, and GFI, were used to assess model fit. Results: Path analysis indicated that the enhanced CB-BN model provided the best fit to the data (RMSEA = 0.06, CFI = 0.96, GFI = 0.98). In this model, clinical perfectionism (β = 0.36, P < 0.01), interpersonal problems (β = 0.30, P < 0.01), distress tolerance (β = -0.28, P < 0.01), and low self-esteem (β = -0.45, P < 0.001) were significantly associated with overvaluation of weight and shape, which in turn predicted dietary restraint, binge eating, and purging. The study was conducted in a community sample of 516 Iranian female university students (mean age = 23.7 years). Conclusions: These results provide initial support for the cross-cultural applicability of the revised and original CB-BN models in the Iranian community. Accordingly, these models may help advance the understanding of eating-related concerns and their management among Iranian women.