Development of a measure to assess invalidating childhood environments in the eating disorders.

OBJECTIVE: The role of childhood abuse is well recognised within the eating disorders. However, the impact of parental invalidation of the child's emotional needs has not been investigated. Such invalidation is potentially important because it appears to be associated with the difficulties in tolerating distress that are often seen in adults with eating disorders. This study aims to develop a measure of childhood invalidating environments (Invalidating Childhood Environments Scale; ICES). It also investigated the relationship between childhood experiences, levels of distress tolerance and eating pathology.
METHOD: Seventy-three eating-disordered women and 62 non-eating-disordered women completed a newly developed measure of invalidating environments (ICES), the Eating Disorders Inventory, and a Distress Tolerance Scale.
RESULTS: The ICES had acceptable psychometric and clinical validity. Women who scored highly on the ICES had greater levels of eating disturbance. Within the clinical sample, the data were compatible with a model where difficulties in tolerating distress partially mediate the relationship between perceived invalidation by the father and eating pathology.
CONCLUSIONS: Parental invalidation is a potentially important construct in the eating disorders. This paper demonstrates that the ICES is a valid measure of that construct. This study suggests a clear framework for working with patients, where evidence of an invalidating childhood environment indicates a need to work with patients on their capacity to tolerate distress.