Validation of a Short-Form Fear of Food Questionnaire in Patients With Functional Dyspepsia and Gastroparesis

The Fear of Food Questionnaire (FFQ) assesses fear of food. The FFQ may be particularly relevant to individuals with functional dyspepsia (FD) and gastroparesis (Gp), but it has not yet been validated in this population despite the use of the total score as a measure of symptom improvement in clinical research. The five-factor structure and length of the original FFQ may limit its clinical utility. We sought to: (1) test the original, unidimensional, and hierarchical factor structures in an FD/Gp population; (2) create a short-form FFQ; and (3) evaluate the convergent and divergent validity and clinical utility of the short-form.

Confirmatory factor analysis tested the factor structure of the original measure in 276 consecutive adult patients presenting for Gp evaluation (66% female, 80% White, M_age = 42.5). Unique variable analysis was used to develop a short-form, unidimensional FFQ. Exploratory graph analysis examined the fit of the short-form measure.

Findings suggest the original five-factor structure and a unidimensional factor structure are not appropriate in an FD/Gp population. Unique variable analysis revealed redundant items, yielding a 9-item short-form ("FFQ-9"). Exploratory graph analysis suggested appropriate model fit of the FFQ-9. The FFQ-9 showed strong convergent and divergent validity and clinical utility.

The FFQ-9 appears to be a valid, clinically useful measure of fear of food in patients with FD/Gp. In our sample, higher FFQ-9 scores correlated with higher symptom severity as assessed with the PAGI-SYM and with lower quality of life as assessed with the PAGI-QOL. Future research should test whether FFQ-9 scores are sensitive to change in FD/Gp treatment and evaluate the FFQ-9 in other populations.