Psychometric validation of the Italian State Urge to Be Physically Active Questionnaire in eating disorders: Psychopathology correlates and diagnostic differences.

Alongside excessive physical activity, individuals with eating disorders (EDs) frequently report a heightened urge to move and physical restlessness, which may contribute to both somatic and psychological burden. The State Urge to be Physically Active Questionnaire (SUPA-Q) specifically measures this acute, state-like dimension in ED patients, but a validated Italian version is not yet available. Two hundred thirty-three inpatients (93.6% female; Mage = 31.7 ± 14.3) formally diagnosed with EDs completed the SUPAQ-I alongside measures of compulsive exercise, exercise addiction, impulsivity, and ED psychopathology. Psychometric evaluation covered item performance, internal consistency, confirmatory factor analysis, convergent/divergent validity, sensitivity to change, and exploratory clinical cutoffs. Paired-samples t tests assessed score changes. SUPAQ-I scores demonstrated excellent reliability (α = .958, ω = 0.959) and good factorial validity. Scores significantly positively correlated with ED severity (drive for thinness, body dissatisfaction, overcontrol) and negatively with body mass index. Post hoc analyses revealed higher scores occurring in anorexia nervosa compared to binge-eating disorder, which decreased significantly over hospitalization, findings that are consistent with sensitivity to clinical change. High scores predominated in restrictive anorexia nervosa subtypes. Overall, findings support the psychometric adequacy of SUPAQ-I score interpretations for measuring acute movement urges in EDs. It appeared to capture an affect-driven and state-related dimension of movement urges related to, but not fully explained by, existing trait-based exercise measures and showed sensitive to clinical change. Further research is needed to refine cutoffs and examine the generalizability of these findings across populations and settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).