Fear and avoidance of foods in anorexia and bulimia nervosa: a preliminary validation of the food phobia survey

Abstract

The Food Phobia Survey (FPS; Vitousek, 1998) is a questionnaire designed to identify the feared and forbidden foods of eating disordered patients. A wide array of contemporary foods typically eaten by eating disordered individuals as well as items that are typically avoided are assessed in terms of frequency eaten, guilt/fear associated with consumption, and hedonic appeal. The current study is a preliminary examination of the properties of the FPS in a clinical sample of patients with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (ED-NOS). Data from a sample of normal individuals were compared with data from a clinical population. On measures of frequency of consumption, fear, guilt, and avoidance, the FPS was found to discriminate between eating disorder patients, dieters, and non-dieters. No significant differences were found according to diagnosis or between restricting and binging subtypes. Consumption patterns suggested by the FPS compared well to those reported by ED patients on self-monitoring forms and other ED measures. In a clinical setting, the FPS may be a valuable therapeutic tool for assessing current food choices and food-related concerns, constructing hierarchies for graded exposure, and evaluating treatment outcomes in terms of fear and avoidance of food items; however, further research with clinical populations is necessary.