It can make people
scared to death of food, and I really think we have sort of this pseudo-eating disorder sort of thing presenting itself with a lot of, I see this with a lot of my patients where they are
scared to death to eat anything off plan, and that really does have some
major health implications because it creates a lot of stress, and it creates a lot of social impairment, and those have been clinically shown to really be deleterious for your
health.
Many of the scales demonstrated weak psychometrics in at least one of the following ways: (a) lack of psychometric data [i.e., reliability and / or validity; e.g., HFQ, MASC, PBS, Social Adjustment Scale - Self - Report (SAS - SR) and all perceived self - esteem and self - concept scales], (b) items that fall on more than one subscale (e.g., CBCL - 1991 version), (c) low alpha coefficients (e.g., below.60) for some subscales, which calls into question the utility of using these subscales in research and clinical work (e.g., HFQ, MMPI - A, CBCL - 1991 version, BASC, PSPCSAYC), (d) high correlations between subscales (e.g., PANAS - C), (e) lack of clarity regarding clinically - relevant cut - off scores, yielding high false positive and false negative rates (e.g., CES - D, CDI) and an inability to distinguish between minor (i.e., subclinical) and
major (i.e., clinical) «cases» of a disorder (e.g., depression; CDI, BDI), (f) lack of correspondence between items and DSM criteria (e.g., CBCL - 1991 version, CDI, BDI, CES - D, (g) a factor structure that lacks clarity across studies (e.g., PSPCSAYC, CASI; although the factor structure is often difficult to assess in studies of pediatric populations, given the small sample sizes), (h) low inter-rater reliability for interview and observational methods (e.g., CGAS), (i) low correlations between respondents such as child, parent, teacher [e.g., BASC, PSPCSAYC, CSI, FSSC - R,
SCARED, Connors Ratings Scales - Revised (CRS - R)-RSB-, (j) the inclusion of somatic or physical symptom items on mental
health subscales (e.g., CBCL), which is a problem when conducting studies of children with pediatric physical conditions because physical symptoms may be a feature of the condition rather than an indicator of a mental
health problem, (k) high correlations with measures of social desirability, which is particularly problematic for the self - related rating scales and for child - report scales more generally, and (l) content validity problems (e.g., the RCMAS is a measure of anxiety, but contains items that tap mood, attention, peer interactions, and impulsivity).