Validation of the food craving acceptance and action questionnaire (FAAQ) in pregnancy

Food cravings are common during pregnancy and can trigger disordered eating behaviors, including binge and loss of control eating, which pose risks to maternal and fetal health. Assessing mechanisms underlying food cravings with theoretically informed and empirically validated measures is crucial for advancing research and clinical interventions that target cravings as predictors of disordered eating and its adverse sequelae during gestation. Pregnant individuals (n = 305) completed the ten-item Food Craving Acceptance and Action Questionnaire (FAAQ), a measure of acceptance of (factor 1) and willingness to experience cravings (factor 2), along with the Food Craving Questionnaire - Trait - reduced (FCQ-T-r), the Prenatal Eating Behaviors Screening Tool (PEBS), and Edinburgh Postnatal Depression Scale. Confirmatory factor analyses yielded poor fit for the original ten-item, two-factor structure of the FAAQ but excellent fit for the previously established seven-item, two-factor FAAQ-II (CFI = 0.96, RMSEA = 0.07, TLI = 0.94, with items 1, 3, and 6 removed). Internal consistency reliability was adequate for total (α = 0.68) and subscale scores (α = 0.76, 0.79). FAAQ-II scores correlated significantly with FCQ-T-r scores (r = -0.37 to -0.56, p < .001), supporting construct validity. FAAQ-II scores differentiated participants with versus without clinically significant disordered eating (PEBS ≥34, p < .001) and were significantly associated with pre-pregnancy body mass and mood symptoms. The FAAQ-II demonstrated robust psychometric properties in this sample, supporting its use in assessing acceptance of and willingness to experience food cravings during pregnancy.