Validation of the caregiver skills (CASK) scale in a Dutch sample of carers for adolescents with eating disorders.

backgroundCarers are crucial to the recovery process of people with eating disorders (EDs). The Caregiver Skills (CASK) scale was developed to assess key caregiving skills among carers of individuals with EDs. While psychometric evaluations of the English, German and Spanish versions have supported the original six-factor model, no validated Dutch version exists to date. This study aimed to examine the psychometric properties of a Dutch translation of the CASK. Validated caregiving outcome measures can assist in exploring coping skills in clinical practice and support research evaluating both caregiving interventions and ED treatments.

methodsA total of 248 carers (139 female, 109 male; mean age = 48.3 years) completed the CASK prior to assessment at a specialized ED treatment center in the Netherlands. The internal consistency of the total scale and six subscales was assessed using McDonald's omega. Confirmatory factor analysis (CFA) was used to test the original six-factor structure. Gender differences in subscale and total scores were explored using linear mixed-effects models (LMM).

resultsThe original six-factor structure could not be confirmed in CFA, and model fit remained suboptimal after post hoc modifications. However, CFA results for the six subscales separately showed good to acceptable fit, and internal consistency was satisfactory. No gender differences were found in total CASK scores, though male carers reported higher skills on 'Self-Care' and 'Insight and Acceptance', and female carers reported higher skills on 'Frustration Tolerance' and 'Emotional Intelligence'.

conclusionsThe Dutch version of the CASK did not replicate the original six-factor structure at the full-scale level. Nonetheless, the six subscales demonstrated adequate psychometric properties and appear particularly suitable for use at the group level, making the instrument relevant for research and care improvement policies. Further studies are needed to determine whether the CASK can also provide added value at the individual level, for example to guide individualized treatment content, and to evaluate its applicability in more diagnostically and culturally diverse samples. While male and female carers reported comparable overall skills, differences in specific subscale scores highlight the importance of considering gender in the context of skill development and support for carers of individuals with EDs.