Magister Artium (Psychology) - MA(Psych) / The diagnosis of adult ADHD is a complex process that requires information from different sources. Instruments are used to screen or diagnose adult ADHD. The aim of the study was to identify instruments measuring adult ADHD from good quality research. This systematic review was executed following the recommended PRISMA steps. A comprehensive search was conducted across identified databases. The SFS scoring system was used to critically appraise for methodological rigour and coherence. Meta-synthesis was used to summarize extracted data from 26 articles included in the final summation. Ethics clearance was issued by the UWC Senate Research Committee. Sixteen instruments measuring adult ADHD were identified. Screening instruments measure core symptoms whereas diagnostic instruments assess all criteria. Fourteen instruments were based on DSM-IV criteria and four were based on DSM-V criteria for adult ADHD including rival explanations for the symptoms. The lack of adoption of DSM-V criteria remains a concern given criticism against DSV-IV criteria for adult ADHD. Overall instruments presented acceptable psychometric properties. However, the performance of the instruments was study dependent. A cautionary note is that these indices must be interpreted carefully. Further research must explore the reasons underlying the lack of adoption of DSM-V criteria in research, and the lack of revision of instruments measuring adult ADHD.

This thesis presents two studies that are concerned with evaluating the psychometric properties of the revised version of the Test of Attentional and Interpersonal Style (TAIS; Nideffer, 1976) - the TAIS2 (Nideffer, n.d.). The original TAIS has many psychometric weaknesses but the revised version was developed in an attempt to rectify the problems of the original. The aim of Study One was to explore the internal consistency and construct validity of the TAIS2 attention subscales. These psychometric properties were evaluated on a sample of 119 undergraduate students who completed the TAIS2 along with measures of anxiety and the

Introduction: Dementia is a debilitating health condition affecting all aspects of an individual’s well-being. Quality of life (QOL) and health related quality of life (HRQOL) assessments play a large role in understanding the limitations within the patients’ lifestyle and helping care providers manage their needs better. Therefore, our aims for this thesis were twofold: 1. Explore the symptoms, behaviors, or activities deemed as priorities by caregivers for monitoring dementia progression, impact of treatment, or exploring alternative care, and 2. Examine the measurement properties of QOL and HRQOL measures used for people with dementia living in the community. Methods: For the first aim, a qualitative descriptive study was performed with caregivers of individuals living with dementia. Caregivers from various regions in Canada were enlisted, and virtual listening sessions took place between November 2022 and January 2023. Open-ended questions were employed to prompt participants to express their viewpoints. For the second aim, a systematic review guided by COsensus-based Standards for the selection of health Measurement Instruments (COSMIN) was performed to identify literature surrounding measurement properties of QOL and HRQOL measures used in community-dwelling adults with a diagnosis of dementia. A search was performed through four databases (Ovid MEDLINE, EMBASE, CINAHL, and PsychInfo) to identify literature published up until June 2022, followed by abstract and title screening and full-text review, which was performed in duplicate. Measurement properties extracted included structural validity, internal consistency, reliability (test-retest and inter-rater reliability), construct validity, and responsiveness. Risk of bias assessments and quality assessments were also performed for all identified QOL and HRQOL measures. Results: Through the listening sessions, we identified that mobility limitations, social interactions, emotions, feeding behaviors, cognitive difficulties and extrinsic factors were priority topics that caregivers wanted to highlight when assessing QOL for people with dementia. There were 13 dementia-specific and generic QOL and HRQOL measures included in the systematic review. Results showed varying quality of evidence for each of the measures with many having a moderate to very low score for some of the measurement properties. Conclusion: The first study showed dementia caregivers’ perspectives on how routine activities, mobility, social interactions, and behaviors, are important pillars of QOL and should be assessed in clinical and research settings for individuals living with dementia. The second study highlighted the importance of rigorously testing QOL instruments in order to provide accurate measurements when evaluating health concerns and impact of therapy. QOL measures can help researchers and healthcare providers obtain a comprehensive assessment of the individual they are treating. / Thesis / Master of Science (MSc) / Dementia is a disease that affects an individual’s thinking and memory and can affect one’s quality of life (QOL). Family caregivers have firsthand knowledge of their loved ones’ dementia progression and their needs. QOL questionnaires can be used to better understand the health and well-being of an individual who is living with dementia. For individuals with dementia these measures tell us how dementia is changing an individuals QOL over time and how effective the treatment is on their QOL. In this thesis, we explored caregivers’ perspectives on the behaviours and activities of the person living with dementia that should be assessed when monitoring symptom progression and impact of treatment on QOL. We found that domains related to difficulty with everyday activities, changes in mood and behaviour, cognitive difficulties and extrinsic factors are all important to assess when evaluating the impact of treatment on the individual living with dementia. We also reviewed studies that evaluated the measurement properties of QOL questionnaires in individuals living with dementia in the community. QOL questionnaires can be used to measure these outcomes, but there is mixed quality of evidence on the reliability and validity of QOL questionnaires in people living with dementia.

Yes / OBJECTIVE: Develop and validate a child and adolescent version of the Three Factor Eating Questionnaire (CTFEQr17), and to assess its psychometric properties and factor structure. We also examined associations between the CTFEQr17 and body mass index (BMI) and food preferences. DESIGN: A two-phase approach was utilised, employing both qualitative and quantitative methodologies. SETTING: Primary and secondary schools, UK. SUBJECTS: In phase 1, 76 children (39 boys; mean age: 12.3±1.4 years) were interviewed to ascertain their understanding of the original TFEQr21 and to develop accessible and understandable items to create the CTFEQr17. In phase 2, 433 children (230 boys; mean age: 12.0±1.7 years) completed the CTFEQr17 and a food preference questionnaire, a subsample (n = 253; 131 boys) had their height and weight measured and 45 children (23 boys) were interviewed to determine their understanding of the CTFEQr17. RESULTS: The CTFEQr17 showed good internal consistency (Cronbach’s α=0.85) and the three factor structure was retained: cognitive restraint (CR), uncontrolled eating (UE) and emotional eating (EE). Qualitative data demonstrated a high level of understanding of the questionnaire (95%). A high CR was found to be significantly associated with a higher body weight, BMI and BMI percentile. High UE and EE scores were related to a preference for high fat savoury and high fat sweet foods. The relationships between CTFEQr17, anthropometry and food preference were stronger in girls compared to boys. CONCLUSIONS: The CTFEQr17 is a psychometrically sound questionnaire for use in children and adolescents, and is associated with anthropometric and food preference measures.

In psychology and other related fields, the study of meaning in life has shown a re-emergence of scientific interest (e.g. Hicks & King, 2009; Ho, Cheung & Cheung, 2010; Steger, Oishi & Kashdan, 2009; Wong, 2011). The recent increase in interest may be attributed to the links made to positive psychological and health outcomes, such as: psychological strengths, subjective well-being and hope amongst others (Diener, 2000; Diener & Ryan, 2009; Fredrickson, 2000; Snyder, 2002; Ungar, 2008, 2011). Research has also shown that a lack of meaning in life has been linked to negative psychological outcomes (Steger et al., 2006; Zika & Chaimberlain, 1992). Whilst authors agree that meaning in life is important the conceptualisation of meaningfulness has been conflicted (Auhagen, 2000). More recently Steger and his colleagues (2006) have conceptualised that meaning in life consists of two inter-dependent constructs; namely the presence of meaning in life and the search for meaning in life. The presence of meaning in life is defined as “the extent to which people comprehend, make sense of and see significance in their lives, accompanied by the degree to which they perceive themselves to have a purpose, mission or overarching aim in life”; and the search for meaning in life refers to the “degree to which people are trying to establish and/or augment their comprehension of meaning in life, significance and purpose” (Steger et al., 2006). Based on this conceptualisation Steger et al. (2006) have developed the MLQ (Meaning in Life Questionnaire) with two separate but interrelated constructs; the Presence of Meaning in life (5-items) and the Search for Meaning in life (5-items). The items of the measure are measured on a 7-point Likert-scale where participants are required to state their agreement with statements ranging from 1 (Absolutely untrue) to 7 (Absolutely true). The aim of this study was to investigate the psychometric properties of the Meaning in Life Questionnaire (Steger et al., 2006) as a measure of the Search for and Presence of Meaning in life so as to validate the scale in an African context. In an endeavour to validate this scale a multicultural group of students from the North-West University in South Africa (n=326) recruited by their lecturers, completed a set of questionnaires. Most of the participants were female (n=243, 74.5%), while male participants made up 24.5% of the sample. The results of this study are in support of the scale’s reliability and validity in an African context. Confirmatory factor analysis confirms the goodness of fit of the scale. The two factor structure was favoured. In conclusion, future research should also investigate the measurement equivalence of the MLQ on the basis of language (see Hambleton & Zenisky, 2011; Van de Vijver & Leung, 2011). Measurement equivalence and item response theory studies may provide evidence on whether there are cross-cultural and language differences in how participants interpret and respond to the MLQ items. One might also assess relationships between meaning in life and positive functioning indicators in this sample. / MSc (Clinical Psychology), North-West University, Potchefstroom Campus, 2014

In psychology and other related fields, the study of meaning in life has shown a re-emergence of scientific interest (e.g. Hicks & King, 2009; Ho, Cheung & Cheung, 2010; Steger, Oishi & Kashdan, 2009; Wong, 2011). The recent increase in interest may be attributed to the links made to positive psychological and health outcomes, such as: psychological strengths, subjective well-being and hope amongst others (Diener, 2000; Diener & Ryan, 2009; Fredrickson, 2000; Snyder, 2002; Ungar, 2008, 2011). Research has also shown that a lack of meaning in life has been linked to negative psychological outcomes (Steger et al., 2006; Zika & Chaimberlain, 1992). Whilst authors agree that meaning in life is important the conceptualisation of meaningfulness has been conflicted (Auhagen, 2000). More recently Steger and his colleagues (2006) have conceptualised that meaning in life consists of two inter-dependent constructs; namely the presence of meaning in life and the search for meaning in life. The presence of meaning in life is defined as “the extent to which people comprehend, make sense of and see significance in their lives, accompanied by the degree to which they perceive themselves to have a purpose, mission or overarching aim in life”; and the search for meaning in life refers to the “degree to which people are trying to establish and/or augment their comprehension of meaning in life, significance and purpose” (Steger et al., 2006). Based on this conceptualisation Steger et al. (2006) have developed the MLQ (Meaning in Life Questionnaire) with two separate but interrelated constructs; the Presence of Meaning in life (5-items) and the Search for Meaning in life (5-items). The items of the measure are measured on a 7-point Likert-scale where participants are required to state their agreement with statements ranging from 1 (Absolutely untrue) to 7 (Absolutely true). The aim of this study was to investigate the psychometric properties of the Meaning in Life Questionnaire (Steger et al., 2006) as a measure of the Search for and Presence of Meaning in life so as to validate the scale in an African context. In an endeavour to validate this scale a multicultural group of students from the North-West University in South Africa (n=326) recruited by their lecturers, completed a set of questionnaires. Most of the participants were female (n=243, 74.5%), while male participants made up 24.5% of the sample. The results of this study are in support of the scale’s reliability and validity in an African context. Confirmatory factor analysis confirms the goodness of fit of the scale. The two factor structure was favoured. In conclusion, future research should also investigate the measurement equivalence of the MLQ on the basis of language (see Hambleton & Zenisky, 2011; Van de Vijver & Leung, 2011). Measurement equivalence and item response theory studies may provide evidence on whether there are cross-cultural and language differences in how participants interpret and respond to the MLQ items. One might also assess relationships between meaning in life and positive functioning indicators in this sample. / MSc (Clinical Psychology), North-West University, Potchefstroom Campus, 2014

STUDY OBJECTIVES: We sought to evaluate the construct validity and factor structure of the Spanish-language version of the Pittsburgh Sleep Quality Index (PSQI) among pregnant Peruvian women. METHODS: A cohort of 642 women were interviewed at ≤ 16 weeks of gestation. During interview, we ascertained information about lifestyles, demographics, sleep characteristics, and mood symptoms. Stress induced sleep disturbance, depressive symptoms, and anxiety symptoms were evaluated using the Ford Insomnia Response to Stress Test (FIRST), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) assessment scales, respectively. Consistency indices, exploratory and confirmatory factor analyses, correlations, and logistic regressions were used. RESULTS: Both exploratory and confirmatory factor analyses indicated a three-factor solution: sleep quality, sleep efficiency, and sleep medication. We observed significantly positive correlations of the PSQI with the FIRST (0.42), the PHQ-9 (0.49), and the GAD-7 (0.46). Poor sleepers (PSQI global score > 5) had significantly increased odds of experiencing stress-induced sleep disturbance (odds ratio, OR = 3.57; 95% CI: 2.40, 5.31), depression (OR = 5.48; 95% CI: 3.58, 8.37), and generalized anxiety disorder (OR = 4.57; 95% CI: 3.08, 6.76). CONCLUSION: The Spanish-language version of the PSQI instrument was found to have good construct validity among pregnant Peruvian women. Consistent with some other studies, the PSQI was found to have a three-factor structure. Further assessment and validation studies are needed to determine whether the three, factor-specific scoring of the PSQI is favored over the PSQI global score in diverse populations.

The purpose of this study was to evaluate the methods currently available to measure the functional outcomes of physiotherapy treatment for low back problems. As a preliminary step, all extant questionnaires were located and evaluated against practical criteria to determine their likely utility in clinical practice. This process identified a large number of questionnaires, however, only six back-specific questionnaires fulfilled the practical criteria for clinical application. Four of these questionnaires were selected for further evaluation along with a generic health status assessment instrument, the SF-36 Health Survey. Current recommendations suggest that a low-back specific and a generic questionnaire are required for comprehensive assessment of the impact of low back problems. The four back-specific questionnaires selected were the Oswestry Disability Questionnaire, the Quebec Back Pain Disability Scale, the Roland-Morris Disability Questionnaire and the Waddell Disability Index. An evaluation of the literature on the clinimetric properties of these questionnaires revealed that little information was available for the Quebec and Waddell questionnaires and no information was available for any of the questionnaires for a clinical population of people with low back pain seeking physiotherapy treatment in an Australian setting. The primary aim of the research was identify which, if any, of the questionnaires should be recommended for measuring outcomes of physiotherapy treatment for low back pain. Consecutive ambulatory (non-admitted) patients presenting for physiotherapy treatment at three public hospital physiotherapy outpatient departments, three community health services, and four private practices were invited to enter the study. Patients were included if they were seeking treatment for a low back problem, were aged 18 or over, and could read and write English. Subjects completed the questionnaires on two occasions six-weeks apart. One hundred and forty subjects returned the first set of questionnaires, and 106 the second set. The mean age of the sample at pre-test was 51 (SD 17) and ranged from 18 to 89 years. Sixty-six percent were female, 41% were employed and 12% were receiving compensation for their back problem. Duration of the back complaint was more than six weeks for 56% of subjects, and 60% reported five or more previous episodes or continuous pain. Referred pain in the buttock thigh or leg was reported by 70% of subjects. The first aim was to compare the questionnaires for acceptability and comprehensibility. Data quality was high for all the questionnaires (less than 5% missing data). As expected, subjects found the more complex SF-36 Health Survey more difficult to complete than three of the low-back questionnaires. However, less than 10% of subjects found any of the questionnaires more than a little difficult to complete. The next aim was to explore the internal structure and inter-relationships of the low-back questionnaires and the three physical scales of the SF-36 Health Survey (Physical Functioning, Role-Physical and Bodily Pain). Analysis of item-item correlation, item-total correlation and Cronbach�s alpha confirmed that all scales were internally consistent. Factor analysis confirmed item homogeneity (unidimensionality) of all questionnaires except the Roland-Morris Disability Questionnaire. The questionnaires were significantly intercorrelated, but correlations exceeded .70 only for the Oswestry, Quebec and Waddell questionnaires. The next aim of the research was to compare test-retest reliability of the questionnaires. The Oswestry, Quebec and SF-36 Physical Functioning scale had sufficient reliability and scale width for clinical application. Despite previous reports of high reliability, the Roland-Morris scale was significantly less reliable than several of the other questionnaires. This indicates the importance of establishing the measurement properties of a test in the population or setting in which it will be used. The Waddell Disability Index, and the SF-36 Role-Physical and Bodily Pain scales had insufficient scale width to be useful in clinical practice. More than 15% of respondents had an initial score on these scales that would not allow change to be detected with 90% confidence. The next aim of the research was to compare the responsiveness of the questionnaires. None of the questionnaires was consistently identified as more or less responsive than the others although two methods (effect size and Liang�s standardized response mean) suggested the SF-36 Bodily Pain scale was more responsive than some other questionnaires. A secondary aim of this section was to evaluate the validity of the many available responsiveness indices and a novel �reliable change� method. A �known groups� strategy was used to determine whether the responsiveness index could discriminate between the low-back relevant questionnaires and the SF-36 General Health scale, the scores of which did not change across the retest period. With the exception of the novel �reliable change� method the responsiveness indices were all found to be valid indicators of responsiveness. Guyatt�s Responsiveness Index, effect size and Liang�s standardized response mean discriminated at 95% confidence between the reference scale and all the low-back questionnaires. The standardized response mean, t-test, correlation and ROC methods discriminated between the reference scale and five or six of the seven other questionnaires. Guyatt�s index was recommended as the best of the criterion-based methods, and the effect size the best of the distribution-based methods. The three questionnaires identified as having sufficient reliability and scale width, the Oswestry, Quebec and SF-36 Physical Functioning scale, were next analysed for data fit to a Rasch model. All three questionnaires had good data fit and item function was not affected by time, age, gender or whether or not subjects reported avoiding bending. The final aim of this research was to identify by Rasch analysis items to supplement the SF-36 Physical Functioning scale. The new scale, named the Low-Back SF-36 Physical Functioning18, showed comparable reliability and responsiveness to the SF-36 Physical Functioning scale. Further research is required to establish the measurement properties of the Low-Back SF-36 Physical Functioning18 scale in an independent sample. However, it has the potential to improve the clinical measurement of function by providing clinicians with a single measurement tool for comprehensive assessment of patients with low back pain.

The purpose of this study was to evaluate the methods currently available to measure the functional outcomes of physiotherapy treatment for low back problems. As a preliminary step, all extant questionnaires were located and evaluated against practical criteria to determine their likely utility in clinical practice. This process identified a large number of questionnaires, however, only six back-specific questionnaires fulfilled the practical criteria for clinical application. Four of these questionnaires were selected for further evaluation along with a generic health status assessment instrument, the SF-36 Health Survey. Current recommendations suggest that a low-back specific and a generic questionnaire are required for comprehensive assessment of the impact of low back problems. The four back-specific questionnaires selected were the Oswestry Disability Questionnaire, the Quebec Back Pain Disability Scale, the Roland-Morris Disability Questionnaire and the Waddell Disability Index. An evaluation of the literature on the clinimetric properties of these questionnaires revealed that little information was available for the Quebec and Waddell questionnaires and no information was available for any of the questionnaires for a clinical population of people with low back pain seeking physiotherapy treatment in an Australian setting. The primary aim of the research was identify which, if any, of the questionnaires should be recommended for measuring outcomes of physiotherapy treatment for low back pain. Consecutive ambulatory (non-admitted) patients presenting for physiotherapy treatment at three public hospital physiotherapy outpatient departments, three community health services, and four private practices were invited to enter the study. Patients were included if they were seeking treatment for a low back problem, were aged 18 or over, and could read and write English. Subjects completed the questionnaires on two occasions six-weeks apart. One hundred and forty subjects returned the first set of questionnaires, and 106 the second set. The mean age of the sample at pre-test was 51 (SD 17) and ranged from 18 to 89 years. Sixty-six percent were female, 41% were employed and 12% were receiving compensation for their back problem. Duration of the back complaint was more than six weeks for 56% of subjects, and 60% reported five or more previous episodes or continuous pain. Referred pain in the buttock thigh or leg was reported by 70% of subjects. The first aim was to compare the questionnaires for acceptability and comprehensibility. Data quality was high for all the questionnaires (less than 5% missing data). As expected, subjects found the more complex SF-36 Health Survey more difficult to complete than three of the low-back questionnaires. However, less than 10% of subjects found any of the questionnaires more than a little difficult to complete. The next aim was to explore the internal structure and inter-relationships of the low-back questionnaires and the three physical scales of the SF-36 Health Survey (Physical Functioning, Role-Physical and Bodily Pain). Analysis of item-item correlation, item-total correlation and Cronbach�s alpha confirmed that all scales were internally consistent. Factor analysis confirmed item homogeneity (unidimensionality) of all questionnaires except the Roland-Morris Disability Questionnaire. The questionnaires were significantly intercorrelated, but correlations exceeded .70 only for the Oswestry, Quebec and Waddell questionnaires. The next aim of the research was to compare test-retest reliability of the questionnaires. The Oswestry, Quebec and SF-36 Physical Functioning scale had sufficient reliability and scale width for clinical application. Despite previous reports of high reliability, the Roland-Morris scale was significantly less reliable than several of the other questionnaires. This indicates the importance of establishing the measurement properties of a test in the population or setting in which it will be used. The Waddell Disability Index, and the SF-36 Role-Physical and Bodily Pain scales had insufficient scale width to be useful in clinical practice. More than 15% of respondents had an initial score on these scales that would not allow change to be detected with 90% confidence. The next aim of the research was to compare the responsiveness of the questionnaires. None of the questionnaires was consistently identified as more or less responsive than the others although two methods (effect size and Liang�s standardized response mean) suggested the SF-36 Bodily Pain scale was more responsive than some other questionnaires. A secondary aim of this section was to evaluate the validity of the many available responsiveness indices and a novel �reliable change� method. A �known groups� strategy was used to determine whether the responsiveness index could discriminate between the low-back relevant questionnaires and the SF-36 General Health scale, the scores of which did not change across the retest period. With the exception of the novel �reliable change� method the responsiveness indices were all found to be valid indicators of responsiveness. Guyatt�s Responsiveness Index, effect size and Liang�s standardized response mean discriminated at 95% confidence between the reference scale and all the low-back questionnaires. The standardized response mean, t-test, correlation and ROC methods discriminated between the reference scale and five or six of the seven other questionnaires. Guyatt�s index was recommended as the best of the criterion-based methods, and the effect size the best of the distribution-based methods. The three questionnaires identified as having sufficient reliability and scale width, the Oswestry, Quebec and SF-36 Physical Functioning scale, were next analysed for data fit to a Rasch model. All three questionnaires had good data fit and item function was not affected by time, age, gender or whether or not subjects reported avoiding bending. The final aim of this research was to identify by Rasch analysis items to supplement the SF-36 Physical Functioning scale. The new scale, named the Low-Back SF-36 Physical Functioning18, showed comparable reliability and responsiveness to the SF-36 Physical Functioning scale. Further research is required to establish the measurement properties of the Low-Back SF-36 Physical Functioning18 scale in an independent sample. However, it has the potential to improve the clinical measurement of function by providing clinicians with a single measurement tool for comprehensive assessment of patients with low back pain.

Introduction: Currently, 1 in 7 children are classified as obese, which represents an obesity rate two times higher than that of the last 25 years. Part of the solution to address the positive energy balance underlying weight gain is to target the specific eating behaviours and factors that lead to food intake. One widely used tool to measure eating behaviour is the Three-Factor Eating Questionnaire (TFEQ). Objective: The primary objective of this study was to validate scores of the 21-item Child version of the Three-Factor Eating Questionnaire (TFEQ-R21 C), by examining validity evidence and reliability of TFEQ-R21 C responses in a sample of Canadian children and adolescents. The secondary aim was to examine the associations between the TFEQ-R21 C factors and body mass index (BMI) z-scores and food/taste preferences. Methods: The participants consisted of a sample of 158 children, 63 boys (mean age: 11.5 ± 1.6 years) and 95 girls (mean age: 11.9 ± 1.9 years), recruited from English schools in the Ottawa area. To assess eating behaviour, participants filled out the TFEQ-R21 C, the Power of Food Scale, and the Leeds Food Preference Questionnaire. Height and weight measurements were taken using a stadiometer and a digital scale. An exploratory factor analysis with oblique rotation and an item analysis were conducted to determine the factor structure and validity of the questionnaire. A median split on Cognitive Restraint (CR), Internal Uncontrolled Eating (UE 1), External Uncontrolled Eating (UE 2), and Emotional Eating (EE) was used to dichotomize factor-based scores into high and low categories for each factor, to allow for group comparisons. Bivariate correlations explored relationships between weight, BMI and BMI z-score, and food and taste preference, by sex and age group. To determine if BMI, BMI z-scores, and food/taste preferences were associated with factor scores of the TFEQ-R21 C, two-way ANOVAs were conducted. Results: The exploratory factor analysis replicated the Emotional Eating (EE) and Cognitive Restraint (CR) scales of the original TFEQ-R21, whereas the global factor of Uncontrolled Eating (UE) produced two subscales: Internal Uncontrolled Eating (UE 1) and External Uncontrolled Eating (UE 2). Item 17 did not load onto any of the factors and was subsequently removed. The four-factor model, with item 17 removed (FFEQ-R21 C: 20-item Child version Four-Factor Eating Questionnaire), accounted for 41.2% of the common variance in the data and showed good internal consistency (α= 0.81). The factors of UE 1 (r= 0.27, p<0.001), UE 2 (r= 0.36, p<0.0001), and CR (r= 0.20, p= 0.04) correlated significantly with EE. Younger children reported higher UE 1 scores [F(1,143)= 3.99, p=0.048, f2= 0.028] and CR scores [F(1,143)= 3.99, p= 0.001, f2= 0.089]. Boys who reported a high UE 1 scores had a significantly higher weight [F(1,58)= 6.44, p=0.014, f2= 0.117 ] and BMI z-scores [F(1,58)= 4.45, p=0.039, f2=0.083], compared to those who reported low UE 1 scores. Children with overweight or obesity [F(1,143)= 2.75, p<0.001. f2= 0.035] reported higher EE scores, compared to children of normal weight. Children with high UE 1 scores reported greater preference for high protein and fat foods, and high fat savoury (HFSA) and high fat sweet (HFSW) foods, compared to those with low UE 1 scores. Higher preference for high protein, fat, and carbohydrate foods, and HFSA, HFSW, and low fat savoury foods (LFSA) foods was found in children with high UE 2 scores, compared to those with low UR 2 scores. Children and adolescents with low CR scores reported greater preference for high protein, carbohydrate, and fat foods, compared to those who reported high CR scores. Discussion: This study showed adequate reliability and validity evidence of the TFEQ-R21 C scores, and that the questionnaire is best represented by a 20-item four-factor model in our sample. The FFEQ-R21 C was able to identify relevant eating behaviour traits associated with higher BMI z-scores and food preferences in both sexes and age groups, which were mainly in accordance with previous findings in children and adolescents. These results support the utility of the questionnaire for the assessment and identification of problematic eating behaviour and food preferences in the Canadian pediatric population. Younger children reported higher influence of the psychological constructs of eating behaviour (CR, UE 1, UE 2, and EE), compared to older children. This study provides preliminary evidence that FFEQ-R20 is a reliable and valid self-report tool to measure eating behaviour in children and adolescents to characterize those at higher risk for excess weight. However, further research is needed to examine the validity of the questionnaire in larger samples and in other geographical locations across Canada, as well as the inclusion of extraneous variables such as parental eating behaviour, socioeconomic status, and physical activity levels.