María Roncero

Mealtime Support in Anorexia Nervosa: A Within-Subject Comparison Study of a Novel Vodcast Intervention

Methods  Participants recruited from the volunteer database.  Inclusion criteria: o Females o 18 – 55 years old o fluent in English  Structured Clinical Interview for DSMIV was used to: o screen HCs for a past/current mental health disorder (s) o confirm diagnosis of AN  Participants were randomised to either vodcast/music condition first. The paradigm was repeated a week later with exposure to the alterative condition.  Measures: o Eating Disorder Examination Questionnaire o Depression Anxiety Stress Scale o Dot-probe task for attentional bias towards food images o Visual Analogue Scales (-5 to +5) assessing subjective feeling of:  anxiety  unpleasant body sensations  preparedness to eat  fullness  hunger  levels of intrusive thoughts  positive mood o Test meal:  chose from 3 different flavoured smoothies (250ml) for consumption whilst listening to the vodcast/music. The experimental paradigm is summarised in the diagram below.

The Use of a Nonimmersive Virtual Reality Programme in Anorexia Nervosa: A Single Case-Report †

OBJECTIVE People with anorexia nervosa (AN) experience high levels of fear and anxiety related to eating. The aim of this case report was to describe the use of a virtual reality (VR) programme developed to facilitate exposure to food as a supplement to treatment for a person with AN. METHOD A 21-year-old patient with AN was given the VR module in addition to the Maudsley Model of Treatment for Adults with Anorexia Nervosa. Weight, eating disorder symptomatology (EDE-Q) and general psychopathology (DASS) were assessed before and after the module was delivered. RESULTS At the end of the module, the patient reported lower levels of anxiety, safety behaviours and fears related to food. Both eating disorder symptoms and distress were reduced. Body mass index increased from 15 to 16.8 kg/m² during the module. CONCLUSION The VR exposure module was associated with a beneficial change in the relationship to food and was perceived to be helpful by the individual.

Study of obsessive compulsive beliefs: relationship with eating disorders.

BACKGROUND The relationship between Eating Disorders (ED) and Obsessive Compulsive Disorder (OCD) has been extensively studied in the last few years. However, little effort has been devoted to studying the link between these disorders with regard to their distorted beliefs. AIMS The first objective of the study was to analyze the differences in OCD-related beliefs among ED subtypes and the general population, controlling for age, Body Mass Index, and obsessionality. The second objective was to explore which OCD beliefs explain ED symptomatology. METHOD Seventy-nine ED patients without OCD comorbidity, divided into diagnostic subtypes, and 50 community participants completed the Obsessive Beliefs Spanish Inventory-Revised and measures of ED and OCD symptomatology. RESULTS There were no differences found among clinical ED subtypes in obsessive beliefs, but the bulimia nervosa purgative subtype and binge eating groups obtained significantly different scores from the community group on Thought-Action-Fusion (TAF)-likelihood and TAF-moral, respectively. OCD symptomatology had the most important predictive effect on ED symptoms, followed by Overestimation of Threat, BMI and FPA-moral. CONCLUSIONS The different patterns of beliefs among subtypes reflect what other studies have suggested about the relevance of the presentation of ED symptoms associated with restriction, purges and binge without purges. Our results agree with the transdiagnostic perspective of ED.

Confirmatory factor analysis and psychometric properties of the Spanish version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales.

The Multidimensional Body-Self Relations Questionnaire (MBSRQ) is the most comprehensive instrument to assess body image. The MBSRQ-Appearance Scales (MBSRQ-AS) is a reduced version that has been validated in other languages. The main aim of the present study was to confirm the factor structure of the Spanish version of the MBSRQ-AS and analyze its psychometric properties in 1041 nonclinical individuals. Confirmatory factor analysis showed excellent goodness of fit indices for the five-factor structure (Appearance Evaluation, Appearance Orientation, Body Areas Satisfaction, Overweight Preoccupation, and Self-Classified Weight). Factors possessed adequate scale score reliability indices. Some of the factors showed significant associations with the Eating Attitudes Test. Significant differences were found between boys/men and girls/women, and among age groups. The Spanish version of the MBSRQ-AS is a valid instrument for use in nonclinical population settings in people from 15 to 46 years old.

Measuring Orthorexia Nervosa: Psychometric Limitations of the ORTO-15

Orthorexia nervosa has recently been defined as excessive preoccupation with healthy eating, causing significant nutritional deficiencies and social and personal impairments. The ORTO-15 is the most widely used instrument to evaluate orthorexia nervosa, although previous studies obtained inconsistent results about its psychometric properties, and there are no data on the Spanish version. Thus, the main objective of the present study was to analyze the psychometric properties of the Spanish adaptation of the ORTO-15. In order to cross-validate the results, two independent samples were used (Sample 1: n = 807, 74.1% women; Sample 2: n = 242, 63.2% women). The results did not support the original recoding and reversal of the items; thus, the original scores were maintained. The analysis of the internal structure showed that the best interpretable solution was unidimensional, and due to low loadings, four items were removed. The internal consistency (α = .74) and temporal stability (r = .92; p < .001) of the final ORTO-11 version were adequate, higher than the 15-item version. The questionnaire showed significant associations with eating psychopathology (EAT-26 and SR-YBC-EDS; range r = .64 - .29; p < .05). However, this result should be interpreted with caution due to the redundancy observed between the ORTO-15 and the EAT-26. Our results suggest that the psychometric properties of the Spanish version of the ORTO-15 are not adequate. Moreover, the instrument detects people who are on diets, but it is not efficient in detecting the severity of orthorexic behaviors and attitudes. New instruments are needed to continue the study of orthorexia nervosa.

A novel approach to challenging OCD related beliefs using a mobile-app: An exploratory study

BACKGROUND AND OBJECTIVES According to cognitive models, obsessive compulsive symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and the use of counterproductive strategies to manage them. Obsessive Compulsive Disorder (OCD) related beliefs such as inflated responsibility, importance of thoughts and perfectionism increases the likelihood of such misinterpretations. Consistent with a growing body of literature supporting the usefulness of mobile delivered technologies in fostering cognitive behavior change, the present study assessed the effectiveness of a novel cognitive training exercise designed to challenge OCD-related beliefs. This mobile app training exercise consists of users having to pull statements challenging OCD beliefs towards themselves (downwards) and to throw away (push upwards) contra-productive self-statements. METHODS 36 third-year BA students started the trial. Twenty completed pre and post measures of OCD-beliefs, mood and OCD symptoms including relationship-obsessions. Participants were instructed to complete 3 min of daily training for a period of 15 days. RESULTS No significant differences were found between completers and non-completers on demographic and most symptom related measures at Time 1. Repeated-measures MANOVA of the 20 completers showed a significant reduction on all OCD symptoms measures and on OCD-beliefs. No significant reduction was found in depression symptoms. Regression analysis showed change in levels of OCD-beliefs was associated with reduction in OCD symptoms at Time 2 over and above OCD symptoms at Time 1. LIMITATIONS The study is an open trial with non-clinical participants. CONCLUSIONS This mobile delivered training exercise may be useful for the reduction and relapse prevention of OCD-related beliefs and symptoms.

What do Spanish adolescents think about obsessive-compulsive disorder? Mental health literacy and stigma associated with symmetry/order and aggression-related symptoms

Obsessive-compulsive disorder (OCD) is a frequent and disabling disorder with a long delay in seeking help that could partly be due to poor mental health literacy and stigmatizing attitudes. This study analyzes the mental health literacy and stigma associated with symmetry/order and aggression-related OCD in a Spanish adolescent sample. This age group was chosen because adolescence is a vulnerable period for the development of OCD, and adolescents are often reluctant to seek professional help. One hundred and two non-clinical adolescents read two vignettes describing symmetry/order and aggression-related OCD. Then, referring to these two vignettes, they answered questions related to problem recognition, causality perception, need for treatment, treatment recommendations, and stigma. Results show that a high percentage of adolescents recognize the interference of order- and aggression-related OCD, consider that a peer with order- or aggression-related OCD needs treatment, and would recommend a formal source of help. Although order symptoms are highly recognized as OCD by adolescents, aggression-related OCD is frequently misidentified as schizophrenia or depression. Results also show higher levels of stigmatizing attitudes in adolescents, associated with aggression-OCD (versus order-OCD), especially in male adolescents and adolescents with no previous experience with mental health services/providers. Results suggest the need to develop school-based programs emphasizing OCD content heterogeneity, especially the aggression, sexual, and religious contents, and work toward eliminating stigma.

Confirmatory factor analysis and psychometric properties of the Spanish version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales in early adolescents

The main aim of this study was to confirm the factorial structure of the Spanish version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales in early adolescents from 12 to 14 years. The sample included 355 participants, 189 girls and 166 boys, with ages ranging from 12 to 14 years old. The original MBSRQ-AS 5-factor structure was confirmed, and the model showed a good fit to the data: Appearance Evaluation, Appearance Orientation, Body Areas Satisfaction, Overweight Preoccupation, and Self-Classified Weight. The internal consistency of the test scores was adequate. Girls had higher score s than boys on Appearance Orientation, Overweight Preoccupation, and Self-Classified Weight, and lower scores on Appearance Evaluation and Body Areas Satisfaction. This study confirms the factor structure of the MBSRQ-AS.

Obsessional and Eating Disorder-related Intrusive Thoughts: Differences and Similarities Within and Between Individuals Vulnerable to OCD or to EDs

Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive-compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no-risk group (n = 100). EDITs were more frequent than OITs in the two risk groups. Within-group comparisons showed that in the OCD-risk group, the OIT had more negative consequences (interference, emotional distress, dysfunctional appraisals and neutralizing strategies) than the EDIT, whereas in the ED-risk group, the OIT and the EDIT instigated similar negative consequences. Copyright

Confirmatory factor analysis and psychometric properties of the Yale-Brown-Cornell Eating Disorders Scale Self-Report version (SR-YBC-EDS) in Spanish clinical and non-clinical samples.

OBJECTIVE The aim of the study was to adapt and validate the Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) transformed into a self-report format in Spanish clinical and non-clinical samples. METHOD Eighty-three eating disordered patients and 358 non-clinical participants completed the Self Report-YBC-EDS version (SR-YBC-EDS), the Eating Attitudes Test (EAT), and the Penn State Worry Questionnaire (PSWQ). RESULTS Confirmatory factor analyses of a two-factor second-order model showed adequate values of goodness-of-fit indices for non-clinical (normed χ(2)=13.4578; df =18; NFI=0.980; GFI=1.00; RMSEA=0.00) and clinical samples (normed χ(2)=26.5913; df =18; NFI=0.944; GFI=0.981; RMSEA=0.076). The factor loadings were high (preoccupations range: 0.69-0.91; rituals range: 0.61-0.94). Cronbachs alpha (range α=0.85-0.90) and test-retest 2weeks later (range: 0.84-0.91) were excellent in both samples. SR-YBC-EDS showed moderate-high indices of convergent validity with PSWQ and EAT. For the total score, a cutoff of 13 showed a sensitivity of 90.4%, a specificity of 91.6%, and a diagnostic accuracy of 91.4%. Positive and negative predictive values were excellent (71.4% and 97.6%, respectively). DISCUSSION Findings indicate that the SR-YBC-EDS is a reliable and valid instrument to identify symptoms and assess the severity of ED, and it can be used as a faster and less costly alternative to the YBC-EDS interview.