Psychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosa
Abstract Background Individuals with anorexia nervosa (AN) often face significant challenges in maintaining motivation for recovery. Understanding the perceived pros and cons associated with the disorder is crucial for promoting recovery. This study aimed to translate, adapt, and validate the Pros a...
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| Language: | English |
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BMC
2025-06-01
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| Series: | Journal of Eating Disorders |
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| Online Access: | https://doi.org/10.1186/s40337-025-01314-x |
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| author | Xu Han Mei-chun Cheung Xueni Li Lucy Serpell |
| author_facet | Xu Han Mei-chun Cheung Xueni Li Lucy Serpell |
| author_sort | Xu Han |
| collection | DOAJ |
| description | Abstract Background Individuals with anorexia nervosa (AN) often face significant challenges in maintaining motivation for recovery. Understanding the perceived pros and cons associated with the disorder is crucial for promoting recovery. This study aimed to translate, adapt, and validate the Pros and Cons of Anorexia Nervosa Scale (P-CAN) for use with Chinese adults with AN, thereby facilitating a clearer understanding of the motivations and barriers encountered by these patients. Methods This study employed a cross-sectional survey design to collect data from 207 Chinese adults with AN (Mage25.58 and SD 6.011). Content validity was assessed by a panel of professionals. Reliability testing included internal consistency, test-retest reliability, item-total correlation, and correlation analysis between subscales. Principal Component Analysis (PCA) assessed the factor structure, focusing on two components (Pro and Con-AN) and ten subscales—Safe/Structured, Appearance, Fertility/Sexuality, Special, Fitness, Communicate Emotions/Distress for Pro-AN and Trapped, Guilt, Hatred, Stifled for Con-AN as per the original scale. Criterion validity was evaluated using the eating pathology tested by Eating Disorder Examination Questionnaire (EDE-Q) and Body Mass Index (BMI). Results The content validity of the overall scale was 0.86. The Pro-AN and Con-AN subscales exhibited strong internal consistency (α = 0.84 and 0.82) and test-retest reliability (r = 0.912 and 0.704, p < 0.001). Item-Total Correlations exceeded 0.3 for all items except item 2, and there was no significant correlation between the Pro-AN and Con-AN subscales. The PCA results indicated that the Chinese P-CAN retained two components, which are consistent with the original scale. Differences emerged in more granular dimensions that may not be appropriate within the Chinese context. Significant correlations were found between the Pro-AN (r = 0.279, p < 0.001) and Con-AN (r = 0.240, p < 0.001) subscales and eating pathology and Con-AN was significantly correlated with BMI (r = -0.214, p < 0.01). Conclusions The P-CAN has shown promising psychometric properties among Chinese patients with AN. In terms of dimensionality, the Chinese context aligns closely with the original scale’s binary division into Pro-AN and Con-AN. However, the further differentiation into ten dimensions, may not be culturally appropriate for the Chinese context. |
| format | Article |
| id | doaj-art-cc183f40e4eb4569988e43b0a825cf07 |
| institution | Kabale University |
| issn | 2050-2974 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Eating Disorders |
| spelling | doaj-art-cc183f40e4eb4569988e43b0a825cf072025-08-20T03:47:24ZengBMCJournal of Eating Disorders2050-29742025-06-0113111110.1186/s40337-025-01314-xPsychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosaXu Han0Mei-chun Cheung1Xueni Li2Lucy Serpell3Department of Social Work, The Chinese University of Hong KongDepartment of Social Work, The Chinese University of Hong KongPeking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital)University College LondonAbstract Background Individuals with anorexia nervosa (AN) often face significant challenges in maintaining motivation for recovery. Understanding the perceived pros and cons associated with the disorder is crucial for promoting recovery. This study aimed to translate, adapt, and validate the Pros and Cons of Anorexia Nervosa Scale (P-CAN) for use with Chinese adults with AN, thereby facilitating a clearer understanding of the motivations and barriers encountered by these patients. Methods This study employed a cross-sectional survey design to collect data from 207 Chinese adults with AN (Mage25.58 and SD 6.011). Content validity was assessed by a panel of professionals. Reliability testing included internal consistency, test-retest reliability, item-total correlation, and correlation analysis between subscales. Principal Component Analysis (PCA) assessed the factor structure, focusing on two components (Pro and Con-AN) and ten subscales—Safe/Structured, Appearance, Fertility/Sexuality, Special, Fitness, Communicate Emotions/Distress for Pro-AN and Trapped, Guilt, Hatred, Stifled for Con-AN as per the original scale. Criterion validity was evaluated using the eating pathology tested by Eating Disorder Examination Questionnaire (EDE-Q) and Body Mass Index (BMI). Results The content validity of the overall scale was 0.86. The Pro-AN and Con-AN subscales exhibited strong internal consistency (α = 0.84 and 0.82) and test-retest reliability (r = 0.912 and 0.704, p < 0.001). Item-Total Correlations exceeded 0.3 for all items except item 2, and there was no significant correlation between the Pro-AN and Con-AN subscales. The PCA results indicated that the Chinese P-CAN retained two components, which are consistent with the original scale. Differences emerged in more granular dimensions that may not be appropriate within the Chinese context. Significant correlations were found between the Pro-AN (r = 0.279, p < 0.001) and Con-AN (r = 0.240, p < 0.001) subscales and eating pathology and Con-AN was significantly correlated with BMI (r = -0.214, p < 0.01). Conclusions The P-CAN has shown promising psychometric properties among Chinese patients with AN. In terms of dimensionality, the Chinese context aligns closely with the original scale’s binary division into Pro-AN and Con-AN. However, the further differentiation into ten dimensions, may not be culturally appropriate for the Chinese context.https://doi.org/10.1186/s40337-025-01314-xAnorexia nervosaPros and cons of anorexia nervosa scaleScale validationChina |
| spellingShingle | Xu Han Mei-chun Cheung Xueni Li Lucy Serpell Psychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosa Journal of Eating Disorders Anorexia nervosa Pros and cons of anorexia nervosa scale Scale validation China |
| title | Psychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosa |
| title_full | Psychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosa |
| title_fullStr | Psychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosa |
| title_full_unstemmed | Psychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosa |
| title_short | Psychometric properties of the Chinese version of the pros and cons of anorexia nervosa (P-CAN-C) scale: a validation study in patients with anorexia nervosa |
| title_sort | psychometric properties of the chinese version of the pros and cons of anorexia nervosa p can c scale a validation study in patients with anorexia nervosa |
| topic | Anorexia nervosa Pros and cons of anorexia nervosa scale Scale validation China |
| url | https://doi.org/10.1186/s40337-025-01314-x |
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