Carmina Saldaña

Body dissatisfaction and dietary restraint influence binge eating behavior

As binge eating is a common behavior throughout the general population, we hypothesized that body dissatisfaction would produce binge eating via its prediction of dieting. Six hundred eight individuals were nonrandomly recruited from the community. The mean age and body mass index of participants were 34.76 years (SD, 14.41) and 27.82 kg/m(2) (SD, 9.54), respectively. Participants were asked to complete several self-report questionnaires, which included measures of dieting status, binge eating behavior, body dissatisfaction, overvaluation of weight and shape, and self-esteem. The results showed that dieting was a common behavior; 38.1% of participants reported dieting during the past year. Binge eating during the previous 6 months was reported by 9.9% of the sample and was associated with a higher body mass index as well as more frequent dieting. A model including dieting status, overvaluation of weight and shape, shape satisfaction, and self-esteem showed the best fit for the prediction of binge eating behavior. Moreover, those who dieted and overvalued their weight and shape were 2.01 and 2.31 times more likely, respectively, to binge eat. Structural equation modeling revealed that body dissatisfaction caused dietary restraint, thus triggering binge eating. Both dieting and overvaluation of weight and shape are important risk factors for the development of binge eating disorders. Dieting and binge eating are common behaviors that represent a risk for the development of both excess weight and eating disorders. The structural model proposed in this study could be beneficial in understanding this causal relationship.

Establishing the Stages and Processes of Change for Weight Loss by Consensus of Experts

The present study aimed to establish, by a consensus of experts, the stages and processes of change for weight management in overweight and obese people. The first step involved developing two questionnaires aimed at assessing stages and processes of change for weight loss in overweight and obese people. The processes‐of‐change questionnaire consisted of 12 subscales, and contained 107 items. A three‐round Delphi study was carried out through a website, where participants were asked to give their opinion about the representativeness and clarity of the scale items. The stages‐of‐change questionnaire consisted of five items and was presented in the final round of the study. A team of 66 experts in the obesity field from 29 countries participated in the study. They were selected either because they belonged to the organizing committee of international associations related to obesity, or because of their research career. The required changes in the questionnaire were made according to the opinions of the participants. Some of these were the result of the group statistical response, whereas others were due to the suggestions made by the participants. A final version of the questionnaire consisting of 63 items was eventually obtained. The present study produced two questionnaires to assess stages and processes of change for weight management. The strength of the study lies in the consensus reached by the panel of experts in order to establish the required content of the questionnaires. The two measures provide useful tools for practitioners who wish to tailor weight‐management interventions according to transtheoretical model constructs.

Outcome of cognitive‐behavioural therapy in training practice with anxiety disorder patients

OBJECTIVES This study aims to assess the effectiveness of cognitive-behavioural therapy applied by trainee therapists in patients with anxiety disorders seen in a private university service and to examine whether this effectiveness is comparable to that observed in controlled studies. DESIGN We compared the effectiveness of cognitive-behavioural therapy at a private centre with that observed in meta-analyses and reviews of controlled studies. METHODS Out of the 96 initial patients with anxiety disorder, 64 completed the cognitive-behavioural treatment and 59 also answered a series of questionnaires pre- and post-treatment. The effect size of the intervention was calculated, as were the percentages of patients who improved and those who recovered. RESULTS The pre-post effect size (1.09) was large, although somewhat lower than those observed in a meta-analysis of Spanish studies and in a range of international meta-analyses; moreover, twice as many hours of treatment were administered (M=27.4) and the drop-out rate was higher (33.3%). The percentages of patients who improved (61%) and those who recovered (52.5%) were roughly comparable to those reported in various reviews of studies performed in anxiety disorders. CONCLUSIONS Cognitive-behavioural therapy applied by trainee therapists in a private university service appears effective, although this efficacy may be somewhat lower than that in controlled studies. Moreover, the duration of treatment and the drop-out rate may be higher.

Are coping and catastrophising independently related to disability and depression in patients with whiplash associated disorders

Purpose. The aim is to study how pain coping strategies and catastrophising are related to disability and depression in patients with whiplash-associated disorders (WAD). Specifically, we wanted to test if they are independent predictive variables, after controlling for pain severity, sociodemographic and crash-related variables. Methods. A convenience sample of 147 patients with WAD of less than 3 months of duration was recruited. They were requested to complete the Pain Catastrophising Scale, the two-item version of the Chronic Pain Coping Inventory and to report sociodemographic and crash-related information, pain intensity, disability and depression. Results. Although several pain coping strategies were related with disability in univariate analyses, only asking for assistance was a marginally significant predictive variable in a multiple regression analysis after controlling for catastrophising. Catastrophising was a significant predictive variable after controlling for pain coping strategies. With depression as the outcome, resting and task persistence were the only pain coping strategies which were related in univariate analyses. However, none of them were predictive variables after controlling for catastrophising. Again, catastrophising was a significant predictive variable after controlling for pain coping strategies. Conclusions. Our results show that catastrophising about pain is more important than pain coping strategies in patients with WAD of a short duration. These results can contribute to the conceptual distinction between pain coping strategies and catastrophising.

The transtheoretical model and obesity: a bibliometric study

The Transtheoretical Model of behaviour change is currently one of the most promising models in terms of understanding and promoting behaviour change related to the acquisition of healthy living habits. By means of a bibliographic search of papers adopting a TTM approach to obesity, the present bibliometric study enables the scientific output in this field to be evaluated. The results obtained reveal a growing interest in applying this model to both the treatment of obesity and its prevention. Otherwise, author and journal outputs fit the models proposed by Lotka and Bradford, respectively.

Dimensionality of three versions of the Eating Disorder Inventory in adolescent girls.

OBJECTIVES To analyze the dimensionality of three versions of the Eating Disorder Inventory (EDI) in adolescent girls. METHOD The sample comprised 738 participants. The Spanish adaptation of the EDI-2 was used. The EDI-2 contains the 64 items of EDI and has the same items as EDI-3. The dimensional structures hypothesized by Garner for the three EDI versions were assessed via a series of Confirmatory Factor Analyses (CFAs). RESULTS The CFA did not confirm Garners proposed structure in any of the three versions. Consequently it was decided to perform Exploratory Factor Analyses (EFA) of the EDI-2 and the EDI-3 to try to identify the underlying structure. The best theoretical and empirical fit was provided by a 7-factor structure. DISCUSSION This article presents a shortened version of the EDI-2 which may prove more suitable for use with adolescent girls in the general population than the original questionnaire. Certain practical suggestions for optimizing the use of the different versions of the EDI are also presented.

Challenges and Applications of the Transtheoretical Model in Patients with Diabetes Mellitus

The transtheoretical model of behavior change has become one of the most influential theoretical models within health psychology. Characterized by treating behavior change as a dynamic process, it has recently been applied to diabetes mellitus. Both interventional and observational studies have applied the transtheoretical model to the care of patients with diabetes in multiple settings; the studies that have been performed have been very heterogeneous in nature. Pooled data from these studies yielded a distribution that describes patients across the stages of change, the main construct of the transtheoretical model. Regarding treatment effectiveness, the empirical data reported in the studies showed that participants did progress through the stages of change when a transtheoretical model-based intervention was applied, and that a higher percentage of participants progressed in the intervention groups than in the control groups. Further research is needed in this field to obtain more information about the constructs of the transtheoretical model and the stages of change. The use of validated questionnaires in the assessment process is also recommended. The studies included in this review show how the transtheoretical model has made a positive contribution to interventions in the field of diabetes.

The Transtheoretical Model in Weight Management: Validation of the Processes of Change Questionnaire

Objective: The processes of change implied in weight management remain unclear. The present study aimed to identify these processes by validating a questionnaire designed to assess processes of change (the P-Weight) in line with the transtheoretical model. The relationship of processes of change with stages of change and other external variables is also examined. Methods: Participants were 723 people from community and clinical settings in Barcelona. Their mean age was 32.07 (SD = 14.55) years; most of them were women (75.0%), and their mean BMI was 26.47 (SD = 8.52) kg/m2. They all completed the P-Weight and the stages of change questionnaire (S-Weight), both applied to weight management, as well as two subscales from the Eating Disorders Inventory-2 and Eating Attitudes Test-40 questionnaires about the concern with dieting. Results: A 34-item version of the P-Weight was obtained by means of a refinement process. The principal components analysis applied to half of the sample identified four processes of change. A confirmatory factor analysis was then carried out with the other half of the sample, revealing that the model of four freely correlated first-order factors showed the best fit (GFI = 0.988, AGFI = 0.986, NFI = 0.986, and SRMR = 0.0559). Corrected item-total correlations (0.322–0.865) and Cronbach’s alpha coefficients (0.781–0.960) were adequate. The relationship between the P-Weight and the S-Weight and the concern with dieting measures from other questionnaires supported the validity of the scale. Conclusion: The study identified processes of change involved in weight management and reports the adequate psychometric properties of the P-Weight. It also reveals the relationship between processes and stages of change and other external variables.

Differential effects of two virtual reality interventions: distraction versus pain control

There is evidence that virtual reality (VR) pain distraction is effective at improving pain-related outcomes. However, more research is needed to investigate VR environments with other pain-related goals. The main aim of this study was to compare the differential effects of two VR environments on a set of pain-related and cognitive variables during a cold pressor experiment. One of these environments aimed to distract attention away from pain (VRD), whereas the other was designed to enhance pain control (VRC). Participants were 77 psychology students, who were randomly assigned to one of the following three conditions during the cold pressor experiment: (a) VRD, (b) VRC, or (c) Non-VR (control condition). Data were collected regarding both pain-related variables (intensity, tolerance, threshold, time perception, and pain sensitivity range) and cognitive variables (self-efficacy and catastrophizing). Results showed that in comparison with the control condition, the VRC intervention significantly increased pain tolerance, the pain sensitivity range, and the degree of time underestimation. It also increased self-efficacy in tolerating pain and led to a reduction in reported helplessness. The VRD intervention significantly increased the pain threshold and pain tolerance in comparison with the control condition, but it did not affect any of the cognitive variables. Overall, the intervention designed to enhance control seems to have a greater effect on the cognitive variables assessed. Although these results need to be replicated in further studies, the findings suggest that the VRC intervention has considerable potential in terms of increasing self-efficacy and modifying the negative thoughts that commonly accompany pain problems.

Psychometric properties of the Perception of Teasing Scale in a Spanish adolescent sample: POTS-S

The present study examines the psychometric properties of the Spanish version of the Perception of Teasing Scale (POTS-S). Participants were 1559 adolescents. They completed a translated version of the POTS and versions validated in Spanish population of the Rosenberg Self-Esteem Scale, the Body Dissatisfaction and Drive for Thinness subscales of the Eating Disorders Inventory-2, and the Children’s Eating Attitudes Test. The results showed that the POTS-S retains the original structure of two factors, weight and competency, with satisfactory fit indices. The POTS-S constitutes a shorter questionnaire than the original version; specifically, it consists of 9 items instead of 11. The POTS-S showed good internal consistency and satisfactory test-retest stability. The relationship between the weight subscale and the variables related to eating and weight were statistically significant. As regards the competency subscale, the correlations were all lower than those for the weight subscale, except in the case of the self-esteem variable. The POTS-S showed good psychometric properties, indicating its suitability as an instrument for assessing the perception of teasing in Spanish adolescents.