Validation of the Turkish parent-reported Diabetes Eating Problem Survey-Revised (DEPS-R) for screening disordered eating behaviors in adolescents with Type 1 diabetes

Abstract

Adolescents with Type 1 diabetes are at increased risk of eating disorders, which have been associated with suboptimal metabolic control and an increased risk of complications. Reliable and culturally adapted screening tools are essential for early identification. However, the parent-reported version of the Diabetes Eating Problem Survey–Revised (DEPS-R) has not yet been validated in Turkish; therefore, this study aimed to evaluate its validity and reliability in adolescents aged 10–17 years years with type 1 diabetes. This methodological validation study included 96 adolescents (45 boys, 51 girls) aged 10–17 years with Type 1 diabetes and their parents. Linguistic and cultural adaptation procedures were conducted in accordance with standard cross-cultural validation guidelines. Parents completed the parent-reported DEPS-R and the Problem Areas in Diabetes–Parents of Teens (P-PAID-T). Adolescents completed the self-reported DEPS-R. Construct validity was assessed using correlation analyses. Exploratory and confirmatory factor analyses were performed to evaluate structural validity. Internal consistency was assessed using Cronbach’s alpha, and test–retest reliability was examined using intraclass correlation coefficients (ICC). The parent-reported DEPS-R demonstrated good internal consistency (Cronbach’s α = 0.852; McDonald’s ω = 0.851) and good test–retest reliability (ICC = 0.83), with a strong correlation between the two administrations (r = 0.89). Exploratory and confirmatory factor analyses supported a single-factor structure and demonstrated with acceptable model fit (χ²/df = 1.629; RMSEA = 0.080; CFI = 0.874; TLI = 0.848). Parent-reported DEPS-R scores were correlated with self-reported DEPS-R scores (r = 0.506, p < 0.001) and P-PAID-T scores (r = 0.458, p < 0.001), supporting construct validity. A positive correlation was also observed between duration of diabetes and DEPS-R scores (r = 0.223, p = 0.029). No significant associations were observed between DEPS-R scores and metabolic indicators, including HbA1c, ketoacidosis episodes, or diabetes-related hospital visits. The Turkish parent-reported DEPS-R is a valid and reliable instrument for screening disordered eating behaviors in adolescents with Type 1 diabetes. Its use in both clinical and research settings may facilitate early detection and improve understanding of the relationship between eating behaviors and metabolic outcomes in this high-risk population. Disordered eating has been reported to be more common among adolescents with type 1 diabetes than among their healthy peers. In this group, disordered eating may lead to poorer metabolic control and make diabetes management more difficult. However, questionnaires completed by adolescents may not always fully reflect actual behaviors, as young people may underreport certain behaviors or may not always be fully aware of them. For this reason, parent-reported assessments such as the parent reported Diabetes Eating Problem Survey–Revised (DEPS-R) may provide an additional and useful perspective for identifying eating-related problems in adolescents with type 1 diabetes. In this study, we evaluated a parent-reported version of the DEPS-R in Turkish families of adolescents with type 1 diabetes. Our findings suggest that this parent-reported version is a reliable tool for identifying possible eating-related problems. Using parent-reported assessments of disordered eating may help healthcare professionals recognize problems earlier and provide timely support for adolescents with type 1 diabetes and their families.