EMPIRICAL ARTICLE
Translation and Validation of a Spanish Version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) Enrique Llorente, PhD1* David H. Gleaves, PhD2 Cortney S. Warren, PhD3 Lourdes Perez-de-Eulate, PhD1 Liya Rakhkovskaya, BS3
ABSTRACT Objective: The goal of this study was to create a Spanish version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) and examine its factorial validity, reliability, and convergent validity in a sample of women from Spain. Method: Two hundred and sixty female college students from Spain completed the Spanish version of the SATAQ-4 and measures for eating pathology. Results: Internal consistency was high; data from EFA and CFA supported the original five-factor structure; and results showed good convergent validity with
Introduction Eating disorders and subclinical symptoms of eating pathology (e.g., chronic dieting, body dissatisfaction, binge eating) are serious yet common health problems that affect females in Western societies (e.g., Western Europe, North America, and Australia).1 Among the multiple factors influencing these problems (e.g., family dynamics, genetic predisposition), sociocultural factors receive considerable research attention because eating pathology Accepted 8 February 2014 Author contribution: The SATAQ-4 was translated into Spanish and published with permission of J. Kevin Thompson and Thomas Cash. EL designed the study, contributed to drafting of the manuscript, and performed initial data analyses. DHG contributed to the design of the study, performed final data analyses, and edited the manuscript. CSW, LPE, and LMR helped to edit the manuscript and managed the data sets. All authors read and approved the final manuscript. The authors declare that they have no competing interests. *Correspondence to: Enrique Llorente, Escuela de Magisterio, C/ ~ez de Santo Domingo, 1, 01006, Vitoria, Spain. E-mail: Juan Ib an [email protected] 1 ~ez de Santo Universidad del Paıs Vasco, UPV/EHU, C/Juan Ib an Domingo, 1, 01006 Vitoria, Alava, Guip uzcoa, Spain 2 University of South Australia, 70 North Terrace, Adelaide, South Australia 5000, Australia 3 University of Nevada, Las Vegas, 4505 S Maryland Pkwy, Las Vegas, Nevada 89119 Published online 24 February 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/eat.22263 C 2014 Wiley Periodicals, Inc. V
170
measures of body-image and eating problems. Discussion: Results strongly support the psychometric properties of the Spanish version of SATAQ-4 and its use to examine perceived pressure for thinness from parents, peers and the media; and thinand muscular/athletic-ideal internalization in Spanish-speaking adult women. C 2014 Wiley Periodicals, Inc. V Keywords: SATAQ-4; body image; thin-ideal internalization; sociocultural influences; Spanish translation (Int J Eat Disord 2015; 48:170–175)
appears to emerge predominantly in Western cultural contexts that highly value a thin physical appearance.2,3 From a sociocultural perspective, body-image problems develop and are maintained because the highly valued thin, young, fit beauty ideals are unrealistic and unattainable for most women.4 As such, women evaluate themselves as failing to meet social ideals and expectations, which is a risk factor for eating disorders and other body-image problems. Often referred to as the tripartite model,5 three of the most powerful and pervasive ways beauty ideals are transmitted and subsequently influence eating pathology are the mass media, family, and peers.6 First, research suggests that exposure to idealized media images that promote Western values of appearance through mass media outlets (magazines, films, television, the internet, etc.)7 is positively related to body dissatisfaction and eating pathology.8,9 Second, more proximate socializing agents, such as parents and siblings, can influence children’s body image through direct appearance-related comments, a communal focus on weight, and commentary about dieting.10 Third, peers can contribute via weightbased teasing, discussions about dieting, and social stratification by who is deemed most attractive. For example, adolescent girls’ concerns about appearance and their perceptions of peer pressure to become thin are significantly related to weight-control International Journal of Eating Disorders 48:2 170–175 2015
TRANSLATION AND VALIDATION OF A SPANISH VERSION OF THE SATAQ-4
behaviors, such as dieting and excessive exercise.11–14 Taken together, existing findings suggest that perceived pressures from the media, family, and peers lead to body dissatisfaction through two processes of mediation: internalization of societal ideals of appearance and social comparisons (evaluating and comparing self to others).6 A large body of research supports the role these influences on body dissatisfaction and disordered eating in women.2,15,16 Given the importance of the media, family, and peers in perpetuating eating pathology, it is essential to adequately evaluate these factors in women. One of the most commonly used measures of sociocultural influences on body image is the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3).17 This scale has four subscales that measure the degree of awareness of media as sources of beauty ideals (awareness), perceived pressure from media to conform to the beauty ideal (pressure), and internalization or endorsement of the thin and athletic ideals as personally relevant (internalizationgeneral and internalization-athletic, respectively). To date, the SATAQ-3 has been used in numerous studies and translated to various languages to encourage cross-cultural research.14,18–22 However, despite its wide use and utility, it is limited in that it focuses exclusively on media influences.23 Thus, items of SATAQ-3 do not allow for an assessment of peer and parental influences as outlined in the tripartite model. To address this issue, Schaefer et al.23,24 recently created the SATAQ-4, which is a 22-item revision of the questionnaire assessing sociocultural attitudes towards appearance through five subscales that measure: (1) thin-ideal internalization; (2) athleticideal internalization; (3) family pressure; (4) peer pressure; and (5) media pressure to attain the ideal appearance. To date, the SATAQ-4 has been translated into Italian and has shown good factorial validity, reliability, and convergent validity in samples from Italy, England, and Australia.25 As it is currently not available in Spanish, the principal purpose of this study was to translate the English version of the SATAQ-4 into Spanish, and to test its factorial validity, reliability and convergent validity in a sample of female college students from Spain.
Method Participants Participants were undergraduate women (n 5 271) from a university in Northern Spain. The students volunteered to participate and did not receive compensation for their participation. After giving written informed International Journal of Eating Disorders 48:2 170–175 2015
consent, participants completed questionnaires during class time in the presence of a research assistant. The study lacked exclusion criteria for participation and was approved by university ethics board. Participants with missing data (n 5 11) were excluded from the analyses, yielding the final sample of 260 participants. Participants ranged in age from 17 to 37, with a mean age of 20.46 years (SD 5 2.59). Mean sample body mass index (kg/m2) was 21.41 (SD 5 2.66). Measures Demographic Information. Participants self-reported their age, height, and weight. Height and weight measures were used to calculate BMI. Sociocultural Attitudes Towards Appearance Questionnaire-4. The SATAQ-4 is a 22-item questionnaire designed to measure the degree of endorsement of Western cultural standards of appearance.23,24 Responses are rated on a 5-point Likert-type scale from “Completely Disagree” to “Completely Agree.” The SATAQ-4 measures five factors of sociocultural influences: three Pressures subscales (i.e., Parents, Peers, and Media) and two Internalization subscales (Thin/Low Body Fat and Muscular/ Athletic). The three Pressures subscales consist of three factors with four items each. The items reflect perceived sociocultural pressures by the three social agents to strive for Western cultural ideals of beauty (e.g., “I feel pressure from family members to look thinner;” “My peers encourage me to get thinner”). The Internalization: Thin/Low Body Fat subscale consists of five items that measure acceptance of the thin ideal (e.g., “I think a lot about looking thin”). Finally, Internalization: Muscular/ Athletic consists of five items that indicate endorsement and acceptance of the athletic physical ideal (e.g., “It is important for me to look athletic”). Psychometric evaluations of the original English version of the SATAQ-4 indicate high internal consistency in women undergraduates.23 The Spanish authors (E.L. & L.P.E.) translated the SATAQ4 into Spanish. An experienced and fluent Spanish-as-asecond-language English professional translator then translated the Spanish translation back into English. The original English questionnaires were compared to the backtranslated English versions item-by-item. Discrepancies were identified and, if necessary, adjustments to the Spanish translations were made. Finally, a Spanish investigator revised and administered the questionnaires to a small group of Spanish students, whose feedback was incorporated in the final Spanish translation (see Appendix A). Eating Attitudes. The Eating Attitudes Test-26 (EAT26)26 is a 26-item measure of symptoms of eating disorders. We used the translation developed for and validated with a Spanish population by Castro et al.27 Body Shape Preoccupation. The Body Shape Questionnaire (BSQ28) is a 34-item self-report questionnaire that
171
LLORENTE ET AL.
measures body dissatisfaction. We used translations that were developed for and validated with a Spanish population.29 Statistical Analyses We conducted all statistical analyses using SPSS Statistics version 20 or LISREL version 9.10. We first examined the Kaiser–Meyer–Olkin measure of sampling adequacy (MSA30) to determine if the data were appropriate for factor analysis. Kaiser30 suggested that MSA values in the 0.80–0.90 range or higher are “ideal,” but values greater than 0.70 are adequate, or “middling.” We used exploratory and confirmatory factor analysis (EFA and CFA) to examine the previously identified factor structure of the SATAQ-4. As fit indices for the CFA, we examined the Root Mean Square Error of Approximation (RMSEA), the Standardized Root Mean Square Residual (SRMR), the Tucker– Lewis (or Non-Normed Fit) Index, and the Comparative Fit Index (CFI) (see Hu and Bentler31 for recommendations regarding their interpretation). Because there were some issues with non-normality, we used robust maximum likelihood as the estimation method. Then, internal consistency of subscales derived from the factor analyses was examined using Cronbach’s alpha. Moreover, we assessed convergent validity of the SATAQ-4 subscales by examining correlations between SATAQ-4 and all its five subscales and body dissatisfaction and eating attitudes. Finally, we examined the extent to which these measures of sociocultural influences predicted body dissatisfaction and eating problems using multiple regression analyses. For these analyses, factor scores were created by summing the items associated with each scale.
Results Sampling Adequacy and Examination of Factor Structure
Kaiser’s MSAs for the overall scale and for each individual item for the SATAQ-4 were good (MSA 5 0.89). MSAs for the individual items ranged from 0.84 to 0.94, suggesting that the data were appropriate for factor analysis. An examination of eigenvalues and the scree plot showed that there were five factors with eigenvalues of 1.0 or higher (which explained 78.64% of the total variance) with an obvious leveling out point after the fifth factor, suggesting that five factors fit the data well. An EFA using principal axis factoring and promax rotation (as originally done by Schaefer et al.)25 allowed us to clearly identify the same five-factor solution as the original English SATAQ-4. However, as a more stringent test, we performed a CFA, specifying each variable to load only on the intended factor. To first rule out that the data could 172
not be represented by a one-factor model, we tested that model. Clearly the one-factor model did not fit well (RMSEA 5 0.25; SRMR 5 0.18, TLI 5 0.76; CFI 5 0.78). The five-factor model, on the other hand, fits the data fairly well (RMSEA 5 0.088; SRMR 5 0.068, TLI 5 0.973; CFI 5 0.976). There is not complete agreement in the field regarding interpretation of fit indices, but using Hu and Bentler’s31 relatively conservative criteria (0.95 or higher for TLI and CFI; close to 0.08 for SRMR and close to 0.06 for the RMSEA), only the RMSEA was a bit higher than their recommended criteria. They also noted that RMSEA may over-reject good models at small sample size and thus is less preferable when sample size is small. Factor loadings (completely standardized loadings from the Lamba X Matrix) are presented in Table 1. Factor correlations from the CFA are presented in Table 2. Table 3 shows internal consistency for the Spanish version of the SATAQ-4, including all resulting subscales. Overall, reliability coefficients were good (Cronbach’s Alphas: 0.88–0.97). Concurrent Validity
To additionally examine the validity of the Spanish SATAQ-4, we examined the relationship between the total and subscale scores with both the EAT-26 and BSQ using Pearson correlations and multiple regression. The SATAQ-4 total scores were highly correlated (p < .001) with both the EAT-26 (r 5 .57) and the BSQ (r 5 .72), and each of the subscales also had statistically significant zero-order correlations with the EAT-26 and BSQ (p < .001) (see Table 3). Multiple regression analyses were performed with the five SATAQ-4 subscales as the predictive variables and body dissatisfaction and eating attitudes as the criterion variables. Results of the multiple regression analyses using subscale scores as predictors are presented in Table 4 and show that Internalization: Thin, Internalization: Muscular, and Pressures: Media significantly predicted both measures, above and beyond other variables in the model. However, Pressures: Family was not a significant predictor of eating problems above the other variables. The Pressures: Peers subscale was also not a significant predictor of body dissatisfaction and eating attitudes above and beyond the other variables in the model.
Discussion The purpose of this study was to develop a Spanish version of the SATAQ-4 and test its internal International Journal of Eating Disorders 48:2 170–175 2015
TRANSLATION AND VALIDATION OF A SPANISH VERSION OF THE SATAQ-4 TABLE 1.
SATAQ-4 standardized factor loadings from CFA (LX matrix) Internalization
Items
Thin
1 2 6 7 10 3 4 5 8 9 11 12 13 14 15 16 17 18 19 20 21 22
Pressures Muscular
Family
Peers
Media
0.70 0.71 0.87 0.90 0.72 0.70 0.83 0.80 0.83 0.82 0.92 0.89 0.85 0.64 0.76 0.92 0.95 0.92 0.92 0.96 0.96 0.94
Note: SATAQ-4, Sociocultural Attitudes Towards Appearance Questionnaire-4; CFA, Confirmatory Factor Analysis.
TABLE 2.
Correlations among SATAQ-4 factors from the CFA
Factor 1. Internalization: Thin/Low Body Fat 2. Internalization: Muscular/Athletic 3. Pressures: Family 4. Pressures: Peers 5. Pressures: Media
1
2
3
4
5
– 0.70 0.35 0.37 0.46
– 0.23 0.22 0.25
– 0.67 0.39
– 0.43
–
Note: SATAQ-4, Sociocultural Attitudes Towards Appearance Questionnaire-4; CFA, Confirmatory Factor Analysis.
TABLE 3. Internal consistencies and correlations with validity measures
SATAQ-4 Internalization: Thin Internalization: Muscular Pressures: Family Pressures: Peers Pressures: Media
Cronbach’s a
EAT-26
BSQ
0.93 0.90 0.89 0.88 0.94 0.97
0.57 0.60 0.28 0.38 0.32 0.42
0.72 0.65 0.28 0.58 0.47 0.58
Note: SATAQ-4, Sociocultural Attitudes Towards Appearance Questionnaire-4; EAT-26, Eating Attitudes Test; BSQ, Body Shape Questionnaire. All p values were less than .001 (p < .001).
consistency, factor structure, and concurrent validity in a sample of undergraduate Spanish women. Overall, the SATAQ-4 exhibited good psychometric properties: MSAs values and Cronbach’s alphas for the scale and all five subscales were high and similar to those found by Schaefer et al.23 in the original English validation. Factor analysis also showed a good fit to the original scale structure. The pattern of eigenvalues International Journal of Eating Disorders 48:2 170–175 2015
indicated that a five-factor model was appropriate. These results are consistent with previous psychometric evaluations of the SATAQ-4 in female college samples of different countries25. Furthermore, results from CFA showed that, according to most fit indices, the data fit fairly well the five-factor structure, although the RMSEA was a bit higher than recommended criteria. In addition to factorial structure, we found the SATAQ-4 to have good concurrent validity. Consistent with the findings of the original validation study,23,24 SATAQ-4 full scale score correlated highly with measures of eating pathology and body image. Also the five subscales showed medium to large associations with the convergent measures. However, Pressures: Peers subscale did not predict body dissatisfaction or eating problems, above and beyond the other scales, even though it did correlate significantly with them when tested in isolation. This finding may be due to some degree of overlap in the scales, as its correlation with 173
LLORENTE ET AL. TABLE 4.
Predicting EAT-26 and BSQ scores from SATAQ-4 subscales EAT-26
Variable Constant Internalization Thin Muscular Pressures Family Peers Media r2 F
B
Beta
29.06
BSQ t
p
B
11.47
Translation and Validation of a Spanish Version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) Enrique Llorente, PhD1* David H. Gleaves, PhD2 Cortney S. Warren, PhD3 Lourdes Perez-de-Eulate, PhD1 Liya Rakhkovskaya, BS3
ABSTRACT Objective: The goal of this study was to create a Spanish version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4) and examine its factorial validity, reliability, and convergent validity in a sample of women from Spain. Method: Two hundred and sixty female college students from Spain completed the Spanish version of the SATAQ-4 and measures for eating pathology. Results: Internal consistency was high; data from EFA and CFA supported the original five-factor structure; and results showed good convergent validity with
Introduction Eating disorders and subclinical symptoms of eating pathology (e.g., chronic dieting, body dissatisfaction, binge eating) are serious yet common health problems that affect females in Western societies (e.g., Western Europe, North America, and Australia).1 Among the multiple factors influencing these problems (e.g., family dynamics, genetic predisposition), sociocultural factors receive considerable research attention because eating pathology Accepted 8 February 2014 Author contribution: The SATAQ-4 was translated into Spanish and published with permission of J. Kevin Thompson and Thomas Cash. EL designed the study, contributed to drafting of the manuscript, and performed initial data analyses. DHG contributed to the design of the study, performed final data analyses, and edited the manuscript. CSW, LPE, and LMR helped to edit the manuscript and managed the data sets. All authors read and approved the final manuscript. The authors declare that they have no competing interests. *Correspondence to: Enrique Llorente, Escuela de Magisterio, C/ ~ez de Santo Domingo, 1, 01006, Vitoria, Spain. E-mail: Juan Ib an [email protected] 1 ~ez de Santo Universidad del Paıs Vasco, UPV/EHU, C/Juan Ib an Domingo, 1, 01006 Vitoria, Alava, Guip uzcoa, Spain 2 University of South Australia, 70 North Terrace, Adelaide, South Australia 5000, Australia 3 University of Nevada, Las Vegas, 4505 S Maryland Pkwy, Las Vegas, Nevada 89119 Published online 24 February 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/eat.22263 C 2014 Wiley Periodicals, Inc. V
170
measures of body-image and eating problems. Discussion: Results strongly support the psychometric properties of the Spanish version of SATAQ-4 and its use to examine perceived pressure for thinness from parents, peers and the media; and thinand muscular/athletic-ideal internalization in Spanish-speaking adult women. C 2014 Wiley Periodicals, Inc. V Keywords: SATAQ-4; body image; thin-ideal internalization; sociocultural influences; Spanish translation (Int J Eat Disord 2015; 48:170–175)
appears to emerge predominantly in Western cultural contexts that highly value a thin physical appearance.2,3 From a sociocultural perspective, body-image problems develop and are maintained because the highly valued thin, young, fit beauty ideals are unrealistic and unattainable for most women.4 As such, women evaluate themselves as failing to meet social ideals and expectations, which is a risk factor for eating disorders and other body-image problems. Often referred to as the tripartite model,5 three of the most powerful and pervasive ways beauty ideals are transmitted and subsequently influence eating pathology are the mass media, family, and peers.6 First, research suggests that exposure to idealized media images that promote Western values of appearance through mass media outlets (magazines, films, television, the internet, etc.)7 is positively related to body dissatisfaction and eating pathology.8,9 Second, more proximate socializing agents, such as parents and siblings, can influence children’s body image through direct appearance-related comments, a communal focus on weight, and commentary about dieting.10 Third, peers can contribute via weightbased teasing, discussions about dieting, and social stratification by who is deemed most attractive. For example, adolescent girls’ concerns about appearance and their perceptions of peer pressure to become thin are significantly related to weight-control International Journal of Eating Disorders 48:2 170–175 2015
TRANSLATION AND VALIDATION OF A SPANISH VERSION OF THE SATAQ-4
behaviors, such as dieting and excessive exercise.11–14 Taken together, existing findings suggest that perceived pressures from the media, family, and peers lead to body dissatisfaction through two processes of mediation: internalization of societal ideals of appearance and social comparisons (evaluating and comparing self to others).6 A large body of research supports the role these influences on body dissatisfaction and disordered eating in women.2,15,16 Given the importance of the media, family, and peers in perpetuating eating pathology, it is essential to adequately evaluate these factors in women. One of the most commonly used measures of sociocultural influences on body image is the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3).17 This scale has four subscales that measure the degree of awareness of media as sources of beauty ideals (awareness), perceived pressure from media to conform to the beauty ideal (pressure), and internalization or endorsement of the thin and athletic ideals as personally relevant (internalizationgeneral and internalization-athletic, respectively). To date, the SATAQ-3 has been used in numerous studies and translated to various languages to encourage cross-cultural research.14,18–22 However, despite its wide use and utility, it is limited in that it focuses exclusively on media influences.23 Thus, items of SATAQ-3 do not allow for an assessment of peer and parental influences as outlined in the tripartite model. To address this issue, Schaefer et al.23,24 recently created the SATAQ-4, which is a 22-item revision of the questionnaire assessing sociocultural attitudes towards appearance through five subscales that measure: (1) thin-ideal internalization; (2) athleticideal internalization; (3) family pressure; (4) peer pressure; and (5) media pressure to attain the ideal appearance. To date, the SATAQ-4 has been translated into Italian and has shown good factorial validity, reliability, and convergent validity in samples from Italy, England, and Australia.25 As it is currently not available in Spanish, the principal purpose of this study was to translate the English version of the SATAQ-4 into Spanish, and to test its factorial validity, reliability and convergent validity in a sample of female college students from Spain.
Method Participants Participants were undergraduate women (n 5 271) from a university in Northern Spain. The students volunteered to participate and did not receive compensation for their participation. After giving written informed International Journal of Eating Disorders 48:2 170–175 2015
consent, participants completed questionnaires during class time in the presence of a research assistant. The study lacked exclusion criteria for participation and was approved by university ethics board. Participants with missing data (n 5 11) were excluded from the analyses, yielding the final sample of 260 participants. Participants ranged in age from 17 to 37, with a mean age of 20.46 years (SD 5 2.59). Mean sample body mass index (kg/m2) was 21.41 (SD 5 2.66). Measures Demographic Information. Participants self-reported their age, height, and weight. Height and weight measures were used to calculate BMI. Sociocultural Attitudes Towards Appearance Questionnaire-4. The SATAQ-4 is a 22-item questionnaire designed to measure the degree of endorsement of Western cultural standards of appearance.23,24 Responses are rated on a 5-point Likert-type scale from “Completely Disagree” to “Completely Agree.” The SATAQ-4 measures five factors of sociocultural influences: three Pressures subscales (i.e., Parents, Peers, and Media) and two Internalization subscales (Thin/Low Body Fat and Muscular/ Athletic). The three Pressures subscales consist of three factors with four items each. The items reflect perceived sociocultural pressures by the three social agents to strive for Western cultural ideals of beauty (e.g., “I feel pressure from family members to look thinner;” “My peers encourage me to get thinner”). The Internalization: Thin/Low Body Fat subscale consists of five items that measure acceptance of the thin ideal (e.g., “I think a lot about looking thin”). Finally, Internalization: Muscular/ Athletic consists of five items that indicate endorsement and acceptance of the athletic physical ideal (e.g., “It is important for me to look athletic”). Psychometric evaluations of the original English version of the SATAQ-4 indicate high internal consistency in women undergraduates.23 The Spanish authors (E.L. & L.P.E.) translated the SATAQ4 into Spanish. An experienced and fluent Spanish-as-asecond-language English professional translator then translated the Spanish translation back into English. The original English questionnaires were compared to the backtranslated English versions item-by-item. Discrepancies were identified and, if necessary, adjustments to the Spanish translations were made. Finally, a Spanish investigator revised and administered the questionnaires to a small group of Spanish students, whose feedback was incorporated in the final Spanish translation (see Appendix A). Eating Attitudes. The Eating Attitudes Test-26 (EAT26)26 is a 26-item measure of symptoms of eating disorders. We used the translation developed for and validated with a Spanish population by Castro et al.27 Body Shape Preoccupation. The Body Shape Questionnaire (BSQ28) is a 34-item self-report questionnaire that
171
LLORENTE ET AL.
measures body dissatisfaction. We used translations that were developed for and validated with a Spanish population.29 Statistical Analyses We conducted all statistical analyses using SPSS Statistics version 20 or LISREL version 9.10. We first examined the Kaiser–Meyer–Olkin measure of sampling adequacy (MSA30) to determine if the data were appropriate for factor analysis. Kaiser30 suggested that MSA values in the 0.80–0.90 range or higher are “ideal,” but values greater than 0.70 are adequate, or “middling.” We used exploratory and confirmatory factor analysis (EFA and CFA) to examine the previously identified factor structure of the SATAQ-4. As fit indices for the CFA, we examined the Root Mean Square Error of Approximation (RMSEA), the Standardized Root Mean Square Residual (SRMR), the Tucker– Lewis (or Non-Normed Fit) Index, and the Comparative Fit Index (CFI) (see Hu and Bentler31 for recommendations regarding their interpretation). Because there were some issues with non-normality, we used robust maximum likelihood as the estimation method. Then, internal consistency of subscales derived from the factor analyses was examined using Cronbach’s alpha. Moreover, we assessed convergent validity of the SATAQ-4 subscales by examining correlations between SATAQ-4 and all its five subscales and body dissatisfaction and eating attitudes. Finally, we examined the extent to which these measures of sociocultural influences predicted body dissatisfaction and eating problems using multiple regression analyses. For these analyses, factor scores were created by summing the items associated with each scale.
Results Sampling Adequacy and Examination of Factor Structure
Kaiser’s MSAs for the overall scale and for each individual item for the SATAQ-4 were good (MSA 5 0.89). MSAs for the individual items ranged from 0.84 to 0.94, suggesting that the data were appropriate for factor analysis. An examination of eigenvalues and the scree plot showed that there were five factors with eigenvalues of 1.0 or higher (which explained 78.64% of the total variance) with an obvious leveling out point after the fifth factor, suggesting that five factors fit the data well. An EFA using principal axis factoring and promax rotation (as originally done by Schaefer et al.)25 allowed us to clearly identify the same five-factor solution as the original English SATAQ-4. However, as a more stringent test, we performed a CFA, specifying each variable to load only on the intended factor. To first rule out that the data could 172
not be represented by a one-factor model, we tested that model. Clearly the one-factor model did not fit well (RMSEA 5 0.25; SRMR 5 0.18, TLI 5 0.76; CFI 5 0.78). The five-factor model, on the other hand, fits the data fairly well (RMSEA 5 0.088; SRMR 5 0.068, TLI 5 0.973; CFI 5 0.976). There is not complete agreement in the field regarding interpretation of fit indices, but using Hu and Bentler’s31 relatively conservative criteria (0.95 or higher for TLI and CFI; close to 0.08 for SRMR and close to 0.06 for the RMSEA), only the RMSEA was a bit higher than their recommended criteria. They also noted that RMSEA may over-reject good models at small sample size and thus is less preferable when sample size is small. Factor loadings (completely standardized loadings from the Lamba X Matrix) are presented in Table 1. Factor correlations from the CFA are presented in Table 2. Table 3 shows internal consistency for the Spanish version of the SATAQ-4, including all resulting subscales. Overall, reliability coefficients were good (Cronbach’s Alphas: 0.88–0.97). Concurrent Validity
To additionally examine the validity of the Spanish SATAQ-4, we examined the relationship between the total and subscale scores with both the EAT-26 and BSQ using Pearson correlations and multiple regression. The SATAQ-4 total scores were highly correlated (p < .001) with both the EAT-26 (r 5 .57) and the BSQ (r 5 .72), and each of the subscales also had statistically significant zero-order correlations with the EAT-26 and BSQ (p < .001) (see Table 3). Multiple regression analyses were performed with the five SATAQ-4 subscales as the predictive variables and body dissatisfaction and eating attitudes as the criterion variables. Results of the multiple regression analyses using subscale scores as predictors are presented in Table 4 and show that Internalization: Thin, Internalization: Muscular, and Pressures: Media significantly predicted both measures, above and beyond other variables in the model. However, Pressures: Family was not a significant predictor of eating problems above the other variables. The Pressures: Peers subscale was also not a significant predictor of body dissatisfaction and eating attitudes above and beyond the other variables in the model.
Discussion The purpose of this study was to develop a Spanish version of the SATAQ-4 and test its internal International Journal of Eating Disorders 48:2 170–175 2015
TRANSLATION AND VALIDATION OF A SPANISH VERSION OF THE SATAQ-4 TABLE 1.
SATAQ-4 standardized factor loadings from CFA (LX matrix) Internalization
Items
Thin
1 2 6 7 10 3 4 5 8 9 11 12 13 14 15 16 17 18 19 20 21 22
Pressures Muscular
Family
Peers
Media
0.70 0.71 0.87 0.90 0.72 0.70 0.83 0.80 0.83 0.82 0.92 0.89 0.85 0.64 0.76 0.92 0.95 0.92 0.92 0.96 0.96 0.94
Note: SATAQ-4, Sociocultural Attitudes Towards Appearance Questionnaire-4; CFA, Confirmatory Factor Analysis.
TABLE 2.
Correlations among SATAQ-4 factors from the CFA
Factor 1. Internalization: Thin/Low Body Fat 2. Internalization: Muscular/Athletic 3. Pressures: Family 4. Pressures: Peers 5. Pressures: Media
1
2
3
4
5
– 0.70 0.35 0.37 0.46
– 0.23 0.22 0.25
– 0.67 0.39
– 0.43
–
Note: SATAQ-4, Sociocultural Attitudes Towards Appearance Questionnaire-4; CFA, Confirmatory Factor Analysis.
TABLE 3. Internal consistencies and correlations with validity measures
SATAQ-4 Internalization: Thin Internalization: Muscular Pressures: Family Pressures: Peers Pressures: Media
Cronbach’s a
EAT-26
BSQ
0.93 0.90 0.89 0.88 0.94 0.97
0.57 0.60 0.28 0.38 0.32 0.42
0.72 0.65 0.28 0.58 0.47 0.58
Note: SATAQ-4, Sociocultural Attitudes Towards Appearance Questionnaire-4; EAT-26, Eating Attitudes Test; BSQ, Body Shape Questionnaire. All p values were less than .001 (p < .001).
consistency, factor structure, and concurrent validity in a sample of undergraduate Spanish women. Overall, the SATAQ-4 exhibited good psychometric properties: MSAs values and Cronbach’s alphas for the scale and all five subscales were high and similar to those found by Schaefer et al.23 in the original English validation. Factor analysis also showed a good fit to the original scale structure. The pattern of eigenvalues International Journal of Eating Disorders 48:2 170–175 2015
indicated that a five-factor model was appropriate. These results are consistent with previous psychometric evaluations of the SATAQ-4 in female college samples of different countries25. Furthermore, results from CFA showed that, according to most fit indices, the data fit fairly well the five-factor structure, although the RMSEA was a bit higher than recommended criteria. In addition to factorial structure, we found the SATAQ-4 to have good concurrent validity. Consistent with the findings of the original validation study,23,24 SATAQ-4 full scale score correlated highly with measures of eating pathology and body image. Also the five subscales showed medium to large associations with the convergent measures. However, Pressures: Peers subscale did not predict body dissatisfaction or eating problems, above and beyond the other scales, even though it did correlate significantly with them when tested in isolation. This finding may be due to some degree of overlap in the scales, as its correlation with 173
LLORENTE ET AL. TABLE 4.
Predicting EAT-26 and BSQ scores from SATAQ-4 subscales EAT-26
Variable Constant Internalization Thin Muscular Pressures Family Peers Media r2 F
B
Beta
29.06
BSQ t
p
B
11.47
