Psychometric Properties and Validity of the Pros and Cons of Anorexia Scale: An Exploration of Anorexia Patients’ Endorsement of Benefits and Burdens of Their Illness, and Severity, Subtype and Motivation

Abstract

Abstract Background The egosyntonic nature of anorexia nervosa (AN) – or valued nature of the illness – has been highlighted as a possible maintaining factor in AN. As such, understanding egosyntonicity is a key issue in both assessment and treatment of AN, and solid instruments capturing the perceived benefits and burdens of AN may be useful to clinicians. Accordingly, the current study analysed the psychometric properties of the Pros and Cons of Anorexia Scale (P-CAN), including its relationship with motivation and illness severity.Methods 100 female AN patients completed the P-CAN, Eating Disorder Examination (ED) Questionnaire, Anorexia Stages of Change Questionnaire, Readiness and Motivation Questionnaire, and Concerns about Change.Results The P-CAN had good psychometric properties. Significant correlations with scales measuring ED psychopathology indicated meaningful concurrent validity. Endorsement of pros, alongside endorsement of the “hatred” con, was linked with greater ED pathology, greater readiness to change, lesser confidence, and lesser concerns about change. Endorsement of cons was linked with lesser ED pathology, lesser readiness to change, and greater concerns about change. The relationship between endorsement of pros and greater ED pathology was mediated by motivation.Conclusions The P-CAN is a clinically useful instrument for measuring perceived pros and cons in individuals with AN.