An Investigation of the factorial structure of motivation to recover in Anorexia Nervosa using the Anorexia Nervosa stages of change questionnaire

Objective: To investigate the factorial structure of motivation to change anorexic symptomatology. Method: One hundred and fifteen inpatients with anorexia nervosa completed the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ) at the time of admission. Results: Factor analysis yielded three factors: the Weight Gain factor was comprised of items pertaining to readiness to gain weight; the Eating, Shape and Weight Concerns factor was made up of items referring to the cognitive, affective and behavioural aspects of eating and body image; and the Ego-Alien Aspects factor was comprised of items which are subjectively distressing. In addition, the results supported the existence of a higher-order factor of general motivation to recover. Discussion: The three-factor solution indicates a somewhat more complex factorial structure of motivation to change in anorexia nervosa than has been previously theorised and generally corresponds to symptoms that are experienced as egosyntonic, ambivalent or distressing. Nevertheless, motivational level was generally low across each of the factors, suggesting that high levels of motivation to change may not even characterise those symptoms regarded by clinicians as subjectively aversive.