Táki Athanássios Cordás

Imagem corporal nos transtornos alimentares

^lpt^aOs autores fazem uma breve revisao da imagem corporal nos transtornos alimentares.^len^aThe authors present a brief review of body image in eating disorders.

A study of the validity and reliability of the Brazilian version of the Body Shape Questionnaire (BSQ) among adolescents

OBJECTIVES: to produce evidence of the validity and reliability of the Body Shape Questionnaire (BSQ) - a tool for measuring an individuals attitude towards his or her body image. METHODS: the study covered 386 young people of both sexes aged between 10 and 18 from a private school and used self-applied questionnaires and anthropometric evaluation. It evaluated the internal consistency, the discriminant validity for differences from the means, according to nutritional status (underweight, eutrophic, overweight and obese), the concurrent validity by way of Spearmans correlation coefficient between the scale and the Body Mass Index (BMI), the waist-hip circumference ratio (WHR) and the waist circumference (WC). Reliability was tested using Wilcoxons Test, the intraclass correlation coefficient and the Bland-Altman figures. RESULTS: the BSQ displayed good internal consistency (±=0.96) and was capable of discriminating among the total population, boys and girls, according to nutritional status (p<0.001). It correlated with the BMI (r=0.41; p<0.001), WHR (r=-0.10; p=0.043) and WC (r=0.24; p<0.001) and its reliability was confirmed by intraclass correlation (r=0.91; p<0.001) for the total population. The questionnaire was easy to understand and could be completed quickly. CONCLUSIONS: the BSQ presented good results, thereby providing evidence of its validity and reliability. It is therefore recommended for evaluation of body image attitudes among adolescents.OBJETIVOS: verificar evidencia de validade e confiabilidade do Body Shape Questionnaire (BSQ) - instrumento que mensura o aspecto atitudinal da imagem corporal. METODOS: PArticiparam 386 jovens, de ambos os sexos, na faixa etaria de 10-18 anos de uma escola particular de ensino, por meio de questionarios auto-aplicaveis e avaliacao antropometrica. Avaliou-se a consistencia interna, a validade discriminante pelas diferencas das medias, segundo estado nutricional (baixo peso, eutrofico, sobrepeso e obesidade), a validade concorrente por meio do coeficiente de correlacao de Spearman entre a escala e o Indice de Massa Corporal (IMC), a razao circunferencia quadril (RCQ) e a circunferencia da cintura (CC). Para confiabilidade, utilizou-se o teste de Wilcoxon, o coeficiente de correlacao intraclasse e as Figuras de Bland-Altman. RESULTADOS: o BSQ apresentou boa consistencia interna (±=0,96) e foi capaz de discriminar populacao total, meninos e meninas, segundo estado nutricional (p<0,001). Correlacionou-se com o IMC (r=0,41; p<0,001), RCQ (r=-0,10; p=0,043) e CC (r=0,24; p<0,001) e confirmou sua confiabilidade por meio da correlacao intra-classe (r=0,91; p<0,001) para populacao total. Registrou-se boa compreensao e tempo de finalizacao. CONCLUSOES: O BSQ apresentou bons resultados confirmando as evidencias de validade e confiabilidade, sendo recomendado para avaliacao do aspecto atitudinal da imagem corporal para adolescentes.

Concurrent and discriminant validity of the Stunkard’s figure rating scale adapted into Portuguese

This study examined the concurrent and discriminant validity of the Figure Rating Scale adapted into Portuguese. The sample was composed of a control group (98 students without eating disorders) and a clinical group (16 women diagnosed with Bulimia Nervosa). Respondents chose schematic figures representing their current and ideal body sizes. The difference between the two choices was calculated to give an ideal discrepancy score. There were high correlations between body mass index and current body size or ideal discrepancy score. The ideal discrepancy scores were greater among the clinical group, indicating that the scale could discriminate between the two groups. The results of this preliminary work indicate that the scale is a valid measure of body image when used in Brazil.

Transtornos alimentares: classificacao e diagnostico

This article presents the current diagnostic criteria for eating disorders: anorexia nervosa and bulimia nervosa. The controversial aspects of anorexia nervosa are discussed.

Adaptação transcultural: tradução e validação de conteúdo da versão brasileira do Commitment Exercise Scale

CONTEXTO: O Commitment Exercise Scale (CES) avalia o comprometimento, o comportamento e a atitude de pacientes com transtornos alimentares em relacao ao exercicio fisico. OBJETIVO: Traducao e adaptacao transcultural do CES para o idioma portugues (BRA), validacao de conteudo e analise da consistencia interna. METODOS: Envolveu cinco etapas: (1) traducao; (2) retraducao; (3) revisao tecnica e avaliacao semântica; (4) validacao de conteudo por profissionais da area - juizes; (5) avaliacao do instrumento por uma amostra de estudantes, por meio da avaliacao do grau de compreensao e analise da consistencia interna do instrumento pelo coeficiente a de Cronbach. RESULTADOS: A escala foi traduzida e adaptada, sendo considerada de facil compreensao (grau de compreensao de 4,3 a 4,9), e demonstrou valores do coeficiente aceitaveis (a de Cronbach: 0,60 a 0,79). CONCLUSAO: A partir do processo de adaptacao transcultural, os resultados satisfatorios possibilitam a recomendacao da versao brasileira do CES. Sao necessarias analises de validacao de construto, fatorial e de reprodutibilidade.

Equivalência semântica e avaliação da consistência interna da versão em português do Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3)

This study aimed to describe the cross-cultural adaptation of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) into Brazilian Portuguese. The methodology involved the following stages: (1) translation of the questionnaire into Portuguese; (2) back-translation into English; (3) meeting with experts to prepare a draft version; (4) assessment of verbal understanding of the draft by experts and by a sample of the target population; and (5) analysis of the tools internal consistency, using Cronbachs alpha. The questionnaire was translated into Portuguese, and the scales final version included 30 items, as in the original. Both the experts and target population members assessed all the items as easy to understand. Internal consistency was satisfactory, reaching 0.91 for the scale as a whole. The questionnaire has now been translated and adapted into Portuguese, with evidence of clear understanding and internal consistency. However, it is still necessary to assess its measurement equivalence, external validity, and reproducibility.

Transtornos alimentares: fundamentos históricos

Os autores fazem uma breve revisao dos aspectos historicos dos transtornos alimentares. Possiveis correlacoes psicopatologicas com os conceitos diagnosticos atuais sao discutidas.

Clomipramine, a better reference drug for panic/agoraphobia. I. Effectiveness comparison with imipramine

An 8-week, double-blind, flexible-dose trial comparing low doses of clomipramine (mean=50 mg) with moderate doses of imipramine (mean=113.8 mg and propanteline (active placebo), was carried out in 60 out-patients with panic disorder with or without agoraphobia. Efficacy evaluation included global, anxiety and depression rating scales, and the determination of rates of relapse over up to 10 weeks of single-blind placebo follow-up. Both tricyclics were significantly more effective than propanteline, but clomipramine tended to act faster and more consistently than imipramine on most measures. Given the degree of blindness achieved and the significantly lower doses of clomipramine, this seems a better reference drug than imipramine for clinical trials in panic/agoraphobia.

Posture and body image in individuals with major depressive disorder: a controlled study.

OBJECTIVE In this study, we aimed to quantify posture and body image in patients with major depressive disorder during episodes and after drug treatment, comparing the results with those obtained for healthy volunteers. METHOD Over a 10-week period, we evaluated 34 individuals with depression and 37 healthy volunteers. Posture was assessed based on digital photos of the subjects; CorelDRAW software guidelines and body landmarks were employed. Body image was evaluated using the Body Shape Questionnaire. RESULTS During depressive episodes (in comparison with the post-treatment period), patients showed increased head flexion (p<0.001), increased thoracic kyphosis (p<0.001), a trend toward left pelvic retroversion (p=0.012) and abduction of the left scapula (p=0.046). During remission, patient posture was similar to that of the controls. At week 1 (during the episode), there were significant differences between the patients and the controls in terms of head flexion (p<0.001) and thoracic kyphosis (p<0.001); at weeks 8-10 (after treatment), such differences were seen only for shoulder position. The mean score on the Body Shape Questionnaire was 90.03 during the depressive episode, compared with 75.82 during remission (p=0.012) and 62.57 for the controls. CONCLUSION During episodes of depression, individuals with major depressive disorder experience changes in posture and mild dissatisfaction with body image. The findings demonstrate that the negative impact of depression includes emotional and physical factors.

Validation of the Portuguese version of the Social Adjustment Scale on Brazilian samples

BACKGROUND Social dysfunction is reported in several psychiatric diseases and its evaluation is becoming an important measure of treatment outcome. The aim of this study was to obtain normative data, to test the validity and the ability of the Portuguese version of the Self-Report Social Adjustment Scale (SAS-SR) to detect different clinical conditions. METHODS The Portuguese version of the SAS-SR was applied to a carefully selected non-psychiatric sample, and to depressed, panic, bulimic and cocaine-dependent patients. Depressed and panic patients were evaluated in two different clinical conditions: acutely symptomatic and in remission. RESULTS SAS overall and sub-scale scores of the normal sample were consistently lower than all patient groups, indicating better social adjustment in all areas. Panic patients were impaired to a lower level than depressed and cocaine-dependent patients in overall adjustment. Depressed patients in remission, although in better condition, were still impaired in relation to normal subjects in overall social functioning, leisure time and marital areas. In panic patients in remission, normalization was not achieved in overall functioning, work and marital areas. LIMITATIONS Sample size was small in some groups and the evaluation was cross-sectional. CONCLUSIONS The Portuguese version of SAS-SR is a useful instrument for detecting differences between psychiatric patients and normal subjects and for the evaluation of different clinical conditions, recommending its use in outcome studies.