Transcultural adaptation of the Night Eating Questionnaire (NEQ) for its use in the Spanish population ☆ Violeta Moizé a, ⁎, Marci E. Gluck b , Ferran Torres c , Alba Andreu a , Josep Vidal a, d , Kelly Allison e a Obesity Unit, Department of Endocrinology and Nutrition, Hospital Clinic Universitari, Barcelona, Spain b Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of Health, Phoenix, AZ, United States c Biostatistics and Data Management Platform, IDIBAPS, Hospital Clinic, Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain d Centro de Investigación Biomédica en Red en Diabetes y Enfermedades Metabólicas (CIBER-DEM), Instituto de Salud Carlos III, Barcelona, Spain e University of Pennsylvania School of Medicine, Department of Psychiatry, Center for Weight and Eating Disorders, United States abstract article info Article history: Received 15 December 2011 Received in revised form 28 January 2012 Accepted 21 February 2012 Available online 7 March 2012 Keywords: Night eating syndrome Nocturnal ingestion Eating behavior Assessment Transcultural adaptation Background: Establishing valid and reliable methods of assessing night eating symptoms is an important goal to maximize identification and treatment of the night eating syndrome (NES). The 14-item Night Eating Questionnaire (NEQ) is the only published and validated assessment instrument but is not yet adapted to Spanish. Methods: We examined the factor structure, internal consistency and validity of the NEQ in Spanish. The study had 4 phases: a) translation from English to Spanish; b) back-translation from Spanish to English, c) administration of translated version to a Spanish sample, and d) a re-test in 36 participants two weeks later. Reliability, stability, and scale structure were evaluated by Cronbach's α, test–re-test, and factor analy- sis, respectively. Divergent validity was assessed by correlation with the Spanish versions of the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI-II). Results: Two-hundred forty-four individuals (181 f; BMI 34.3 ± 10 kg/m 2 ; age 40.5 ± 15 y) completed the questionnaire. The mean NEQ score was 12.5 ± 7. The Cronbach's α coefficient for the total score was 0.79, the intraclass correlation was 0.85, and the factor analysis yielded a similar four factor solution as the original scale. Correlation for the test–re-test total score was 0.86. Total NEQ score was significantly correlated with the BDI-II (r = 0.48 p b 0.001), but this correlation was not significant during the test–re-test (r = 0.28, p = 0.10) or with STAI at either time point (0.05, p = 0.40; r = 0.07, p = 0.69, respectively). Conclusions: The Spanish version of the NEQ demonstrated adequate internal consistency for the majority of domains and excellent reproducibility. There was divergent validity with anxiety and a relationship between night eating and depression. These results suggest that the Spanish-version of the NEQ is an instrument that is valid for use in clinical research. © 2012 Elsevier Ltd. All rights reserved. 1. Introduction Night eating syndrome (NES) is characterized by a delayed circadian pattern of eating (Allison et al., 2010), including two core features: eve- ning hyperphagia and/or nocturnal ingestions. The prevalence is 1.5% in the general population (Rand, Macgregor, & Stunkard, 1997; Striegel- Moore, Franko, Thompson, Affenito, & Kraemer, 2006), 4%–43% of persons seeking obesity treatment (Ceru-Björk, Andersson, & Rössner, 2001; Colles, Dixon, & O'Brien, 2007; Napolitano, Head, Babyak, & Blumenthal, 2001; Stunkard et al., 1996), and 9%–42% of persons seeking bariatric surgery (Adami, Meneghelli, Bressani, & Scopinaro, 1999; Allison et al., 2006; Hsu, Betancourt, & Sullivan, 1996). Establish- ing valid and reliable methods of assessing NES remains an important goal to maximize identification and treatment of the disorder. The Night Eating Questionnaire (NEQ) is the only published and validated survey that screens for severity of night eating symptoms (Allison, Lundgren, et al., 2008). It contains 14 items that assess the two core features, as well as additional symptoms, such as morning anorexia, desire to eat at night, sleep difficulties, and depressed mood. One item assesses degree of awareness during nocturnal inges- tions and is used only to differentiate possible cases of sleep-related eating disorder, a parasomnia, from those with NES (Howell & Schenck, 2009). Cronbach's alpha for the original NEQ total score was .70, and principal components analysis yielded a four factor solu- tion: (1) Nocturnal Ingestions, (2) Evening Hyperphagia, (3) Morning Anorexia, and (4) Mood/Sleep (Allison, Lundgren, et al., 2008). Eating Behaviors 13 (2012) 260–263 ☆ Supported in part by the Intramural Research Program of the NIH, NIDDK. ⁎ Corresponding author at: UnidadFuncional de Obesidad, Hospital Clinic, Villarroel Street 170. 08036, Barcelona, Spain. Tel.: +34 93 227 54 00x9846; fax: +34 93 451 66 38. E-mail address: vmoize@clinic.ub.es (V. Moizé). 1471-0153/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.eatbeh.2012.02.005 Contents lists available at SciVerse ScienceDirect Eating Behaviors