Applying a multidimensional model of craving to disordered eating behaviors: Development of the Food Approach and Avoidance Questionnaire.

Despite revisions to the DSM-5, current diagnostic criteria poorly capture the phenomena of eating disorders. The construct of food craving may help to explain the range of disordered eating and compensatory behaviors, but current measures do not fully capture the construct. Borrowing from the substance use literature and emphasizing both approach and avoidance craving inclinations, the ambivalence model of craving (AMC) provides a useful framework for predicting broad patterns of disordered eating behaviors. This study sought to develop and preliminarily validate a multidimensional AMC-based measure of food craving. Items for the Food Approach and Avoidance Questionnaire were generated and development and validation data were collected via online survey from community-based adults and university students (N = 1,070). Exploratory factor and item response theory analyses were used for measure development. Linear regressions were used to examine convergent and discriminant validity. Exploratory sensitivity analyses included logistic regressions and receiver operating characteristic curves. As hypothesized, a 2-factor measure was supported. No sex differences emerged in item functioning. The approach factor was associated with greater trait food craving, more uncontrolled eating, and greater likelihood of meeting self-reported diagnostic criteria for bulimia nervosa and binge eating disorder. The avoidance factor was associated with higher levels of restrained eating, drive for thinness, and an increased likelihood of meeting self-reported diagnostic criteria for anorexia nervosa and bulimia nervosa. Preliminary data support a new multidimensional measure of approach and avoidance food craving with potential for a transdiagnostic conceptualization of disordered eating and compensatory behaviors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).