Pica and Rumination Questionnaire (PiRuQ)

Abstract

The Cuestionario de Pica y Rumiación (CuPRu), also known as the Pica and Rumination Questionnaire, is a specialized psychometric tool developed in 2023 by Medina-Tepal and colleagues. Its primary function is to screen for symptoms and behaviors related to Pica and Rumination Disorder. The instrument was specifically validated for use with Mexican adolescents and young adults. The initial development phase involved creating an extensive pool of 45 items, which were subsequently refined by an expert panel.

Following empirical data collection, rigorous factor analysis reduced the final scale to 18 items, demonstrating a robust four-factor structure. The instrument measures four distinct domains: regurgitation, gastrointestinal symptoms, consumption of nonfood/raw or unprocessed substances, and Pica symptoms. The CuPRu has been thoroughly evaluated for both reliability and validity, making it a valuable tool for assessing these specific feeding and eating disorders in this population.

Keywords

Rumination Disorder, Mexican Youth, Adolescents, Young Adults, Regurgitation, Gastrointestinal Symptoms, Pica Symptoms, Nonfood Consumption, Eating Disorders.

Authors

Medina-Tepal, Karla Areli, Vázquez-Arévalo, Rosalia, Calleja-Bello, Nazira, Mancilla-Díaz, Juan Manuel.

Purpose

The central purpose of the CuPRu is to provide a standardized, culture-specific measure for identifying and quantifying behaviors indicative of Pica and Rumination Disorder within the Mexican youth population.

Specifically, the 18-item questionnaire evaluates the severity and frequency of four key symptomatic domains: regurgitation, symptoms related to gastrointestinal distress, the consumption of nonfood or unprocessed substances, and general symptoms associated with Pica behaviors. It serves as an efficient screening tool for researchers and clinicians working with this demographic.

Construct

The CuPRu is designed to measure the underlying construct of Atypical Feeding and Eating Behaviors, specifically focusing on the symptoms defined by standard diagnostic manuals for Rumination Disorder and Pica. The scale operationalizes this construct through a four-factor model derived from empirical data.

These four dimensions—Regurgitation, Gastrointestinal Symptoms, Consumption of Nonfood/Raw or Unprocessed Substances, and Pica Symptoms—together represent the full spectrum of disordered behaviors targeted by the instrument. The structural integrity of these factors ensures that the measure accurately captures distinct, yet related, aspects of these feeding disorders.

Validity

The validity of the CuPRu was established using both content and construct validation methods. Content validity was rigorously assessed through expert judgment, utilizing the Aiken V coefficient. The established criterion for item retention was a coefficient value of 0.85 or higher, ensuring high agreement among expert judges regarding the relevance of each item. All items met this stringent threshold, confirming strong expert consensus during the instrument’s refinement phase.

Furthermore, Construct validity was confirmed by the outcomes of the factor analysis procedures. The resulting four-factor model provided empirical support for the theoretical structure of the scale, validating that the items accurately measure the intended psychological constructs of Pica and Rumination symptoms.

Reliability

The reliability of the CuPRu was assessed primarily through its internal consistency. Two key coefficients were calculated to verify the degree of correlation between items within the scale.

The Cronbach’s Alpha coefficient was reported as 0.85, which is considered highly acceptable in psychological measurement, demonstrating that the items reliably measure the same underlying construct. Additionally, the Omega coefficient, often preferred for factorially complex measures, yielded an even stronger value of 0.93. Both indicators confirm that the CuPRu possesses a high level of reliability and consistency across its items and subscales.

Factor Analysis

The structural integrity of the CuPRu was thoroughly examined using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). These analyses confirmed a clear and robust four-factor structure for the final set of 18 items. This structure accounted for 48.35% of the total variance in the observed data.

The model fit indices derived from the CFA demonstrated excellent fit to the data, supporting the validity of the hypothesized four-factor structure. Key fit indices included: CMIN = 2.41, GFI (Goodness of Fit Index) = 0.92, AGFI (Adjusted Goodness of Fit Index) = 0.89, CFI (Comparative Fit Index) = 0.93, RMR (Root Mean Square Residual) = 0.063, and RMSEA (Root Mean Square Error of Approximation) = 0.064.

In addition to traditional factor methods, Item Response Theory (IRT) analysis was applied. The IRT results indicated that all items discriminated adequately, with discrimination values exceeding 1. Furthermore, the location parameters for the majority of items fell within the optimal range of -3 to 3, suggesting appropriate item difficulty and optimal measurement precision across the latent trait continuum.

Instrument

Test Type: Original

Format: Items are rated using five-point Likert-type options, scored from 0 (Never) to 4 (Always).

Language Available: Spanish

Population Group: Human (Male and Female adolescents and young adults).

Age Group: The validation sample spanned individuals across Childhood (6-12 years), Adolescence (13-17 years), and Young Adulthood (18-29 years).

Population Details: The respondents were adolescents and young adults residing in Mexico, making the scale culturally specific to this demographic.

Test Methodology: The rigorous methodology utilized included assessment of Test Validity (Construct Validity, Content Validity), Test Reliability (Internal Consistency), Factor Analysis (Confirmatory Factor Analysis, Exploratory Factor Analysis), and Item Response Theory (IRT).

Keywords

Rumination Disorder, Mexican Youth, Adolescents, Young Adults, Regurgitation, Gastrointestinal Symptoms, Pica Symptoms, Psychometrics, Scale Development.

Authors

Medina-Tepal, Karla Areli

Author ORCID Identifier: No data is Available

Affiliation: Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala

Affiliation Email addresses: [email protected]

Correspondence Address: Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Tlalnepantla, Mexico, [email protected]

Vázquez-Arévalo, Rosalia

Author ORCID Identifier: No data is Available

Affiliation: Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Grupo de Investigación en Nutrición

Affiliation Email addresses: No data is Available

Calleja-Bello, Nazira

Author ORCID Identifier: No data is Available

Affiliation: Universidad Nacional Autónoma de México, Facultad de Psicología

Affiliation Email addresses: No data is Available

Mancilla-Díaz, Juan Manuel

Author ORCID Identifier: No data is Available

Affiliation: Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Grupo de Investigación en Nutrición

Affiliation Email addresses: No data is Available

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching purposes.

Commercial Use: No.

Fee: No fee is associated with the use of the scale.

Test Year: 2023.

Reference’s

Medina-Tepal, K. A., Vázquez-Arévalo, R., Calleja-Bello, N., & Mancilla-Díaz, J. M. (2023). Construcción y validación del Cuestionario de Pica y Rumiación (CuPRu) en adolescentes y adultos jóvenes mexicanos [Construction and validation of the Pica and Rumination Questionnaire in Mexican adolescents and young adults]. Revista de Psicología Clínica con Niños y Adolescentes, 10(2), 1–10. DOI: 10.33776/rpcna.v10.i2.4632

Items of the Cuestionario de Pica y Rumiación (CuPRu)

The CuPRu is an 18-item measure, with items rated on a five-point Likert-type scale (0-4). The measure is structured into four distinct subscales:

• Regurgitation

• Gastrointestinal symptoms

• Consumption of nonfood/raw or unprocessed substances

• Pica symptoms

The specific items of the questionnaire are available in the source reference: Medina-Tepal et al. (2023), Table 6, Pages 6-7.

Regurgitar

• Después de comer regurgito los alimentos, es decir, siento que los alimentos regresan a mi boca y los vuelvo a masticar, escupir o tragar

• En la última semana regurgité

• Cuando me siento muy preocupado o estresado regurgito.

• Regurgito sin causa aparente.

• Cuando los alimentos regresan a mi boca (regurgito) siento nauseas o vómito.

Síntomas gastrointestinales

• Siento ardor o acidez en el pecho, estómago o garganta

• Siento inflamado el estómago como si tuviera aire adentro y como consecuencia me duele o arde.

• Cuando como chile o cosas picantes siento que me arde el estómago o la garganta

• Siento inflamado el estómago y me dan ganas de vomitar.

Consumo de sustancias no comestibles crudas o no procesadas

• Número de sustancias no alimentarias consumidas.

• Frecuencia de sustancias no alimentarias consumidas

• Número de sustancias crudas o no procesadas consumidas.

• Número de sustancias no alimentarias consumidas.

Síntomas de Pica

• Encuentro agradable o placentero consumir sustancias no comestibles, crudas o no procesadas

• Dedico mucho tiempo a pensar en comer alguna sustancia no comestible cruda o no procesada.

• Me avergüenza aceptar que consumo sustancias no comestibles, crudas o no procesadas.

• A pesar de las consecuencias negativas en mi salud, sigo consumiendo alimentos no comestibles, crudos o no procesados.

• Tengo problemas de salud por comer alimentos crudos o sustancias no comestibles.