Understanding and treating body image disturbances in eating disorders through body illusion interventions: a scoping review protocol.

BACKGROUND: We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research. METHODS/DESIGN: The scoping review process will be guided by the methodological framework of Arksey and O'Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles. DISCUSSION: A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed. SYSTEMATIC REVIEW REGISTRATION: https://osf.io/3bcm6/?view_only=83b2e8a2445d4266909992e3dfb51929.

Longitudinal mental health state during the COVID-19 pandemic. Longitudinal change of mental symptoms and its predictors during the COVID-19 pandemic: A prospective longitudinal study on Spanish population.

OBJECTIVE: The general objective of this study is to analyze the change in mental health and post-traumatic symptoms over 6 months during the COVID-19 pandemic in a Spanish community sample, with a particular focus on individual differences in longitudinal change in symptoms and its predictors. METHOD: This longitudinal prospective study surveyed a Spanish community sample three times (T1: during the initial outbreak, T2: after 4 weeks and T3: after 6 months). Four thousand one hundred and thirty-nine participants from all the Spanish regions completed the questionnaires. However, the longitudinal analysis was performed only with participants which responded at least two times (1,423 participants). Mental health assessments included depression, anxiety, and stress (measured by the Depression, Anxiety and Stress Scale (DASS-21) and post-traumatic symptoms were assessed by the Impact of Event Scale-Revised (IES-R). RESULTS: All the mental health variables achieved worse results at T2. Depression, stress, and posttraumatic symptoms did not recover at T3 when compared with the initial measure, while anxiety was practically stable across the timeline. Women, younger age, having a previous mental health diagnosis and contact with individuals with COVID-19 were linked to worse psychological evolution during the 6-months period. A good perception of one's physical health may be a protective factor. CONCLUSIONS: After 6 months of the pandemic, the general population's mental health was still worse than at the initial outbreak for most of the variables analyzed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exploring multisensory integration of non-naturalistic sounds on body perception in young females with eating disorders symptomatology: a study protocol.

BACKGROUND: Bodily illusions can be used to investigate the experience of being in a body by manipulating the underlying processes of multisensory integration. Research suggests that people with eating disorders (EDs) may have impairments in visual, interoceptive, proprioceptive, and tactile bodily perception. Furthermore, people with EDs also show abnormalities in integrating multisensory visuo-tactile and visual-auditory signals related to the body, which may contribute to the development of body image disturbances. Visuo-auditory integration abnormalities have been observed also in people with subthreshold ED symptomatology. However, it remains unclear whether these impairments are specific to bodily signals or if they extend to any auditory signals. METHODS: We will recruit 50 participants (aged 18-24; females assigned at birth) with ED symptomatology (subthreshold group) and 50 control participants. The Eating Disorder Examination Questionnaire will be administered to screen for ED symptomatology and divide the sample into two groups accordingly (control and subthreshold group using a clinical cut-off score of 2.8). The strength of both illusions will be measured implicitly with estimations of body part position and size, and explicitly with self-report questionnaires. As a secondary aim, regression analysis will be run to test the predictive role of susceptibility for both illusions on interoceptive body awareness (measured by the Multidimensional Assessment of Interoceptive Awareness Scale) and sensory-processing sensitivity (measured by the Highly Sensitive Person Scale). DISCUSSION: Our study may contribute to our understanding of the mechanisms underlying body image disturbances. The results may pave the way for novel clinical interventions targeting early symptoms prior to the development of the disorder in young females.

This study aims to investigate whether individuals with subthreshold eating disorder (ED) symptoms show differences in the integration of proprioceptive and auditory cues in relation to body representation, as compared to healthy controls. This will be examined by focusing on two different body parts (finger and waist) with different levels of emotional significance for individuals with EDs. Participants will be screened for ED symptoms and divided into groups accordingly. The strength of the illusions will be measured using estimations of body part position and size, as well as self-report questionnaires. Regression analysis will be used to assess the predictive role of susceptibility to the body illusions on interoceptive body awareness and sensory-processing sensitivity. The results of this study may have implications for understanding the underlying mechanisms of body image disturbances in EDs, and inform the development of clinical interventions for individuals with subthreshold EDs.

Investigating psychological variables for technologies promoting physical activity.

Background: Many technological interventions designed to promote physical activity (PA) have limited efficacy and appear to lack important factors that could increase engagement. This may be due to a discrepancy between research conducted in this space, and software designers' and developers' use of this research to inform new digital applications. Objectives: This study aimed to identify (1) what are the variables that act as barriers and facilitators to PA and (2) which PA variables are currently considered in the design of technologies promoting PA including psychological, physical, and personal/contextual ones which are critical in promoting PA. We emphasize psychological variables in this work because of their sparse and often simplistic integration in digital applications for PA. Methods: We conducted two systematized reviews on PA variables, using PsycInfo and Association for Computing Machinery Digital Libraries for objectives 1 and 2. Results: We identified 38 PA variables (mostly psychological ones) including barriers/facilitators in the literature. 17 of those variables were considered when developing digital applications for PA. Only few studies evaluate PA levels in relation to these variables. The same barriers are reported for all weight groups, though some barriers are stronger in people with obesity. Conclusions: We identify PA variables and illustrate the lack of consideration of these in the design of PA technologies. Digital applications to promote PA may have limited efficacy if they do not address variables acting as facilitators or barriers to participation in PA, and that are important to people representing a range of body weight characteristics.

Eye movements and eating disorders: protocol for an exploratory experimental study examining the relationship in young-adult women with subclinical symptomatology.

BACKGROUND: Recent research indicates that patients with anorexia (AN) show specific eye movement abnormalities such as shorter prosaccade latencies, more saccade inhibition errors, and increased rate of saccadic intrusions compared to participants without AN. However, it remains unknown whether these abnormal eye movement patterns, which may serve as potential biomarkers and endophenotypes for an early diagnosis and preventive clinical treatments, start to manifest also in people with subclinical eating disorders (ED) symptomatology. Therefore, we propose a protocol for an exploratory experimental study to investigate whether participants with subclinical ED symptomatology and control participants differ in their performance on several eye movement tasks. METHODS: The sample will be recruited through convenience sampling. The Eating Disorder Examination Questionnaire will be administered as a screening tool to split the sample into participants with subclinical ED symptomatology and control participants. A fixation task, prosaccade/antisaccade task, and memory-guided task will be administered to both groups. Additionally, we will measure anxiety and premorbid intelligence as confounding variables. Means comparison, exploratory Pearson's correlations and discriminant analysis will be performed. DISCUSSION: This study will be the first to elucidate the presence of specific eye movement abnormalities in participants with subclinical ED symptomatology. The results may open opportunities for developing novel diagnostic tools/therapies being helpful to the EDs research community and allied fields.

Immediate Psychological Response during the Very Early Stage of the Coronavirus Pandemic (COVID-19) in a Spanish Community Sample.

The World Health Organization declared a pandemic due to COVID-19 on 11 March 2020 and remarked on the relevance of studying its consequences on mental health. A cross-sectional study was conducted to evaluate the immediate psychological response to the pandemic and quarantine in Spain.

Respuesta psicológica inmediata durante una etapa muy temprana de la pandemia por coronavirus (COVID-19) en una muestracomunitaria española / Immediate Psychological Response during the Very Early Stage of the Coronavirus Pandemic (COVID-19) in a Spanish Community Sample

Introducción: La Organización Mundial de la Salud declaró la pandemia por COVID-19 el 11 de marzo de 2020 ysubrayó la importancia de estudiar sus consecuencias en lasalud mental de la población. Se presenta un estudio transversal evaluando las respuestas psicológicas a la primera olade la pandemia en España.Metodología. Entre el 23 y 28 de marzo, se realizó unaencuesta online en una muestra española seleccionada trasun muestreo en bola de nieve. Se recogieron variables sociodemográficas, de salud y comportamentales. Se evaluaron laansiedad y depresión a través de la Escala de Depresión, Ansiedad y Estrés (DASS-21), los síntomas postraumáticos a través de la Escala de Impacto del Evento Revisada (IES-R) y lospatrones de autocuidado con la Escala de Autocuidado (SCS).Resultados. Se incluyeron 3524 participantes, 24,1 %mostraron síntomas postraumáticos moderados o severos,21,9 % refirieron síntomas depresivos moderados, severos o extremadamente severos y 32 % síntomas ansiososmoderados, severos o extremadamente severos. El génerofemenino, la menor edad, menor nivel educativo, diagnóstico psiquiátrico previo, peor salud física, contacto con COVID-19, falta de rutinas y algunos síntomas psicológicos serelacionaron con peores respuestas psicológicas.Conclusiones. Se confirma el impacto sobre la saludmental que la primera ola de la pandemia tuvo en España yse identifican algunas variables relacionadas con peor respuesta que pueden resultar útiles en la prevención en salud mental en futuras situaciones equivalentes. (AU)

Introduction: The World Health Organization declared apandemic due to COVID-19 on 11 March 2020 and remarkedon the relevance of studying its consequences on mentalhealth. A cross-sectional study was conducted to evaluatethe immediate psychological response to the pandemic andquarantine in Spain.Methods. From March 23 to 28, an online survey wasconducted in a Spanish community sample. Sociodemographic,health and behavioral variables were surveyed. Depressionand anxiety sypmtoms were measured by the Depressión,Anxiety and Stress Scale (DASS-21), posttraumatic symptomsby the Impact of Event Scale-Revised (IES-R) and self-carepatterns by the Self-Care Scale (SCS).Results. 3524 respondents were included, 24.1%showed moderate or severe psychological impact, 21.9%reported moderate, severe or extremely severe depressionand 32% moderate, severe or extremely severe anxiety.Female gender, younger age, low education, psychiatricdiagnosis, worse physical health, contact history, lack ofroutines, and some psychological symptoms were related toworse psychological responses.Conclusions. This study provides evidence for a negativemental health impact of the pandemic in the Spanishcommunity that started at the early stages and identifiessome variables linked to worse psychological response. (AU)

Psychological Responses According to Gender during the Early Stage of COVID-19 in Spain.

BACKGROUND: Current research has pointed out an increased risk of mental health problems during the COVID-19 pandemic in women compared to men, however the reason for this difference remains unclear. The aim of this research is to study early psychological responses to the pandemic in the Spanish general population, focusing on gender differences. METHODS: Nine to 14 days after the declaration of a state of emergency an online survey was conducted assessing sociodemographic, health, behavioral and COVID-19-related variables. Mental health status was evaluated by the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the Self-Care Scale (SCS). RESULTS: The study included 3520 respondents: 2611 women and 909 men. Women scored significantly higher in DASS-21 and IES-R (p < 0.05) and were more likely to somatize, suffer from hypochondriasis, sleeping disturbances and claustrophobia (p < 0.05). Being a woman can be considered a risk factor for intrusive thoughts, avoidance mechanisms, stress and anxiety (Odd Ratio = 2.7/2.3/2.3/1.6). The risk of presenting posttraumatic symptoms and emotional distress was greater in women (Odd Ratio = 6.77/4.59). General linear models to predict IES-R and DASS-21 scores clarified which variables were gender specific, such as main concerns. CONCLUSIONS: This study provides evidence that at early stages of the pandemic, women mental health was more impacted and that both genders show different concerns. Gender perspective in secondary and tertiary prevention strategies must be taken into account when facing the distress associated with the pandemic.

How did Different Generations Cope with the COVID-19 Pandemic? Early Stages of the Pandemic in Spain / ¿Cómo se Enfrentaron las Diferentes Generaciones a la Pandemia por COVID-19? Primeras Etapas de la Pandemia en España

BACKGROUND: The World Health Organization has highlighted the importance of studying the consequences of the COVID-19 pandemic on mental health. The aim of this study is to examine the role of age in the early psychological responses to the pandemic in a Spanish community sample, focusing on how different generations coped with it. METHOD: An online survey was conducted during the early stages of the quarantine. Sociodemographic, health and behavioral variables were compared for five age groups. Mental health was assessed by the Depression, Anxiety and Stress Scale (DASS-21) and psychological impacts were assessed by the Impact of Event Scale-Revised (IES-R). RESULTS: 3,524 participants were included (Mage = 39.24, SDage = 12.00). Participants aged between 18 and 33 years old showed more hyperactivation and evitation, were more depressed, anxious and stressed. Those aged between 26 and 33 years old showed more intrusion. Those aged between 18 and 25 years old suffered more sleep disturbances, claustrophobia and somatization and maintained worse routines. Elderly people showed better psychological responses in general. CONCLUSIONS: This study provides initial evidence that the negative psychological impact of COVID-19 pandemic hits young people harder. These results should be taken into account when developing specific evidence-based strategies

ANTECEDENTES: la Organización Mundial de la Salud ha destacado la importancia de estudiar sus consecuencias sobre la salud mental de la COVID-19. Esta investigación estudia el papel de la edad sobre las respuestas psicológicas tempranas a la pandemia. MÉTODO: se realizó una encuesta online en la población adulta de España durante la cuarentena. Las variables sociodemofráficas, de salud y conductuales fueron estudiadas en 5 grupos de edad. El estado mental se estudió a través del DASS-21 (Depression, Anxiety and Stress Scale) y el impacto psicológico a través del IES-R (Impact of Event Scale-Revised). RESULTADOS: 3.524 participantes fueron incluidos (Medad = 39.24, DTedad = 12.00). Los participantes entre 18 y 33 se mostraban más hiperactivados, evitativos, ansiosos, deprimidos y estresados. Aquellos entre 26 y 33 años presentaban más intrusión. Los participantes entre 18 y 25 años dormían peor, presentaban más claustrofobia y somatizaciones, mayores dificultades para mantener rutinas, mientras que los mayores presentaban mejores respuestas en general. CONCLUSIONES: este estudio indica que la población española más joven se ha visto más afectada por las consecuencias psicológicas de la pandemia. Algunas de las diferencias en conductas y preocupaciones que dependieron de la edad deberían tenerse en cuenta para elaborar estrategias de intervención

How did Different Generations Cope with the COVID-19 Pandemic? Early Stages of the Pandemic in Spain.

BACKGROUND: The World Health Organization has highlighted the importance of studying the consequences of the COVID-19 pandemic on mental health. The aim of this study is to examine the role of age in the early psychological responses to the pandemic in a Spanish community sample, focusing on how different generations coped with it. METHOD: An online survey was conducted during the early stages of the quarantine. Sociodemographic, health and behavioral variables were compared for five age groups. Mental health was assessed by the Depression, Anxiety and Stress Scale (DASS-21) and psychological impacts were assessed by the Impact of Event Scale-Revised (IES-R). RESULTS: 3,524 participants were included (Mage = 39.24, SDage = 12.00). Participants aged between 18 and 33 years old showed more hyperactivation and evitation, were more depressed, anxious and stressed. Those aged between 26 and 33 years old showed more intrusion. Those aged between 18 and 25 years old suffered more sleep disturbances, claustrophobia and somatization and maintained worse routines. Elderly people showed better psychological responses in general. CONCLUSIONS: This study provides initial evidence that the negative psychological impact of COVID-19 pandemic hits young people harder. These results should be taken into account when developing specific evidence-based strategies.

Caring for Family Members With Alzheimer's and Burnout Syndrome: Impairment of the Health of Housewives.

Being a housewife may already be a psychosocial risk factor leading to chronic stress and burnout, and this may be aggravated when the housewife must also become the caregiver of a family member with Alzheimer's. The burnout syndrome and how it can affect general health and the presence of emotional disorders were studied in housewives who were family caregivers of an Alzheimer's patient. The sample selected was made up of 193 housewives, 96 of whom were also caregivers for a family member with Alzheimer's. Sociodemographic measures used were the Maslach Burnout Inventory and The General Health Questionnaire. Burnout was found in a significant percentage of participants. Emotional exhaustion, effect on general health, and presence of emotional disorders were higher in caregivers. Emotional exhaustion, general health, and anxiety were more influential, while depersonalization affected the appearance of depressive symptoms more. Being a caregiver and emotional exhaustion appeared to be the best predictors of emotional disorders. It was confirmed that emotional exhaustion influenced appearance of anxiety and depression equally in both groups. In the case of caregivers, an exhaustion-illness spiral was produced. In this group, emotional exhaustion seemed to become more severe as a consequence of the presence of chronic illnesses, and possibly influence the number of hours spent on care and having children living at home. Future research should analyze in greater depth and in a larger sample, the role of these variables and widen the focus of attention to personal variables that could be acting as protective factors and could be subject to intervention. The discussion concludes with some actions that should be included in prevention programs for the groups studied.

Emotional Exhaustion in Housewives and Alzheimer Patients' Caregivers: Its Effects on Chronic Diseases, Somatic Symptoms and Social Dysfunction.

BACKGROUND: Emotional exhaustion causes adverse effects in those who suffer from it. Housewives are not excluded. Domestic and care chores, which are considered to be sources of stress, increase when taking on the role of caregiver for a family member with Alzheimer's disease. OBJECTIVE: To analyse the influence of emotional exhaustion, somatic symptoms and social dysfunction, based on the activity they carry out. METHODOLOGY: Cross-sectional survey. 193 women participated, of which: housewives (HWs) (n = 97), and Alzheimer's patient caregiver-housewives (CHWs) (n = 96). The evaluation tools were: sociodemographic/working data questionnaire (ad hoc), Maslach Burnout Inventory (MBI) and Goldberg General Health Questionnaire (GHQ-28). RESULTS: High rates of emotional exhaustion are observed, as well as an existing positive link between chronic diseases, somatic symptoms and social dysfunction. The structural model indicates that emotional exhaustion predicts the amount and extent of diseases, somatic symptoms and social dysfunction. The influence is higher in CHWs. LIMITATIONS: Sample procedure implemented at convenience; the variable of the grade of dependence of the Alzheimer's patient caregiver was not included in the study. CONCLUSIONS: The domestic and care chores that HWs and CHWs carry out affect their health. Hence the need to develop psychoeducative programmes that are adapted to the particular needs of these women and focused on the different areas of their everyday lives.

Spanish Adaptation and Validation of the Transplant Effects Questionnaire (TxEQ-Spanish) in Liver Transplant Recipients and Its Relationship to Posttraumatic Growth and Quality of Life.

The valid assessment of the impact of transplantation on psychological well-being is highly relevant to optimize treatment. However, to date there is no standardized instrument available in Spain. The Transplant Effects Questionnaire (TxEQ) evaluates the specific problems associated with organ transplantation, such as worry about transplant, guilt regarding the donor, disclosure of having undergone transplantation, adherence to medical treatment and responsibility toward the donor, family, friends, or medical staff. Against this backdrop the English original version of the TxEQ was translated into Spanish and validated in a sample of 240 liver transplant recipients. Participants also filled in the Posttraumatic Growth Inventory (PTGI), and the 12-Item Short Form Health Survey (SF-12v.2). Confirmatory factor analysis of the TxEQ-Spanish revealed a five-factor structure equivalent to the English original version, and satisfactory internal consistency (Cronbach's alpha: worry α = 0.82, guilt α = 0.77, disclosure α = 0.91, adherence α = 0.82, responsibility α = 0.83). Results showed that better mental quality of life was associated with higher adherence and disclosure, as well as less worry and guilt. Higher posttraumatic growth was significantly associated with worry, guilt, and responsibility. Interestingly, the most powerful predictor of posttraumatic growth was worry. Analysis of variance showed an interaction effect of PTG and mental quality of life on adherence, with medium PTG being associated with significantly stronger adherence in participants with better mental quality of life. In conclusion our study could successfully adapt and validate the Spanish version of the TxEQ in a large sample of liver transplant recipients. Our findings show a complex relationship between emotional reactions to transplantation, mental quality of life, and posttraumatic growth, which give further insight into inner processes supporting psychological well-being and adherence after liver transplantation.

Purging behaviors and therapeutic prognosis of women with eating disorders treated in a healthcare context / Conductas purgativas y pronóstico terapéutico en mujeres con trastornos alimentarios tratadas en el contexto sanitario

Background/Objective: The evidence on efficacy of cognitive-behavioral interventions in Eating Disorders (ED) still shows inconclusive results with respect to the role of purging behaviors, more so in uncontrolled situations. Evolution of ED patients with and without purging behavior was studied 30 months after start of a multicomponent treatment. Method: 162 women (87 purging, 75 non-purging) treated in outpatient or hospitals+outpatient care units in Spain participated. The evaluation instruments were: BSQ, EAT-40, EDI, STAI, BDI and BITE. Results: At the beginning of the treatment, participants with purging behavior showed higher bulimic symptomatology, more body dissatisfaction, drive for thinness, perfectionism and ineffectiveness, anxiety and depressive symptomatology. After thirty months, intervention produced improvement in ED characteristics, emotional alterations and personal development variables, in both groups, but less in patients with no purging behavior. The effect of intervention was stronger in purging patients and variables with larger effect size: body dissatisfaction, bulimic symptomatology and anxiety. Conclusions: Purging behaviors must be considered in the design of these treatments with a view to prognosis (AU)

La evidencia sobre la eficacia de intervenciones cognitivo-conductuales en los Trastornos de la Conducta Alimentaria (TCA) aún presenta resultados no concluyentes respecto al papel que desempeñan en las conductas purgativas, más aún cuando se realizan en situaciones no controladas. Se pretende conocer la evolución tras un tratamiento multicomponente en pacientes con TCA, con presencia o ausencia de conductas purgativas, después de 30 meses del inicio del tratamiento. Método: Participaron 162 mujeres (87 purgativas y 75 no purgativas), tratadas en régimen ambulatorio o hospitalario+ambulatorio, en España. Los instrumentos de evaluación fueron: BSQ, EAT-40, EDI, STAI, BDI y BITE. Resultados: Al inicio del tratamiento, las participantes con conductas purgativas presentaban mayor sintomatología bulímica, más insatisfacción corporal, obsesión por la delgadez, perfeccionismo e ineficacia, ansiedad y sintomatología depresiva. Tras 30 meses, en ambos grupos, la intervención produjo mejoría en las características de TCA, alteraciones emocionales y variables de desarrollo personal, siendo menor en las pacientes sin conductas purgativas. El efecto de la intervención fue mayor en las participantes purgativas y las variables con mayor tamaño de efecto: insatisfacción corporal, sintomatología bulímica y ansiedad. Conclusiones: Es importante considerar las conductas purgativas en el diseño de estos tratamientos de cara al pronóstico (AU)

Purging behaviors and therapeutic prognosis of women with eating disorders treated in a healthcare context.

Background/Objective: The evidence on efficacy of cognitive-behavioral interventions in Eating Disorders (ED) still shows inconclusive results with respect to the role of purging behaviors, more so in uncontrolled situations. Evolution of ED patients with and without purging behavior was studied 30 months after start of a multicomponent treatment. Method: 162 women (87 purging, 75 non-purging) treated in outpatient or hospitals + outpatient care units in Spain participated. The evaluation instruments were: BSQ, EAT-40, EDI, STAI, BDI and BITE. Results: At the beginning of the treatment, participants with purging behavior showed higher bulimic symptomatology, more body dissatisfaction, drive for thinness, perfectionism and ineffectiveness, anxiety and depressive symptomatology. After thirty months, intervention produced improvement in ED characteristics, emotional alterations and personal development variables, in both groups, but less in patients with no purging behavior. The effect of intervention was stronger in purging patients and variables with larger effect size: body dissatisfaction, bulimic symptomatology and anxiety. Conclusions: Purging behaviors must be considered in the design of these treatments with a view to prognosis.

ANTECEDENTES/OBJETIVO: La evidencia sobre la eficacia de intervenciones cognitivo-conductuales en los Trastornos de la Conducta Alimentaria (TCA) aún presenta resultados no concluyentes respecto al papel que desempeñan en las conductas purgativas, más aún cuando se realizan en situaciones no controladas. Se pretende conocer la evolución tras un tratamiento multicomponente en pacientes con TCA, con presencia o ausencia de conductas purgativas, después de 30 meses del inicio del tratamiento. MÉTODO: Participaron 162 mujeres (87 purgativas y 75 no purgativas), tratadas en régimen ambulatorio o hospitalario + ambulatorio, en España. Los instrumentos de evaluación fueron: BSQ, EAT-40, EDI, STAI, BDI y BITE. RESULTADOS: Al inicio del tratamiento, las participantes con conductas purgativas presentaban mayor sintomatología bulímica, más insatisfacción corporal, obsesión por la delgadez, perfeccionismo e ineficacia, ansiedad y sintomatología depresiva. Tras 30 meses, en ambos grupos, la intervención produjo mejoría en las características de TCA, alteraciones emocionales y variables de desarrollo personal, siendo menor en las pacientes sin conductas purgativas. El efecto de la intervención fue mayor en las participantes purgativas y las variables con mayor tamaño de efecto: insatisfacción corporal, sintomatología bulímica y ansiedad. CONCLUSIONES: Es importante considerar las conductas purgativas en el diseño de estos tratamientos de cara al pronóstico.

Satisfacción de gestantes y acompañantes en relación con el Programa de Educación Maternal en Atención Primaria / Pregnants and partners satisfaction with Prenatal Education Program in Primary Care

OBJETIVO: Analizar la satisfacción percibida por las gestantes y sus acompañantes en relación con el contenido de las sesiones del Programa de Educación Maternal y su utilidad respecto al proceso de embarazo, parto y crianza. Personas y métodos: Estudio observacional, descriptivo, transversal y ampliado con metodología cualitativa, realizado en el Centro de Salud de Lepe (Huelva). Se midió cuantitativamente la satisfacción a través de un cuestionario semiestructurado de elaboración propia, previamente validado. Se hizo una valoración cualitativa con cuatro grupos de discusión de 10 personas (tres con gestantes y uno con acompañantes). Se efectuó un análisis estadístico con el programa SPSS y un análisis cualitativo con MaxQda 10. Las consideraciones éticas se establecieron según la legislación vigente. RESULTADOS: Participaron 378 gestantes y 82 acompañantes. Según el análisis cuantitativo, el 77,5% de las mujeres y el 70,7% de los acompañantes mostraron un nivel de satisfacción muy alto. El análisis cualitativo corroboró los altos resultados obtenidos en satisfacción. CONCLUSIÓN: El Programa de Educación Maternal fue percibido por las usuarias y los usuarios como muy satisfactorio y afirmaron que respondía a sus necesidades. Entre las áreas de mejora se destacó la demanda de un mayor número de sesiones y un aumento de los contenidos de las mismas, así como una mejor adecuación del lugar donde se impartían las sesiones y los recursos utilizados, y la coordinación entre los niveles de atención especializada y primaria

OBJECTIVE: To analyze the satisfaction of pregnant women and their partners regarding the content and level of usefulness of Maternal Education in order to improve the process of pregnancy and childbirth. METHODOLOGY: Transversal descriptive study between November 2010 and November 2013, with qualitative methodology added, in the Health Center of Lepe (Huelva), Public Andalusian Health Service. Data were collected from performed a quantitative measure of satisfaction through a semi-structured questionnaire and a qualitative assessment through four focus groups (three with pregnants, one with partners). RESULTS: 378 pregnant women and 82 partners. High levels of satisfaction in pregnant and partners were observed. 77.5% of women and 70.7% of partners showed a very high level of satisfaction. The analysis of qualitative data showed a significant overlap with the quantitative results. CONCLUSION: Antenatal education is perceived by users as a high quality activity, sufficiently responsive to their needs. Survey is a useful, valid and reliable instrument to measure satisfaction with prenatal education. Among the areas for improvement identified in their contributions highlights: the demand for a greater number of classes and an increase in the content thereof; a better location for classes and resources used, as well more coordination between primary and specialized care

The Development of a Checklist to Enhance Methodological Quality in Intervention Programs.

The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed.

Influence of perfectionism on variables associated to eating disorders in dance students / Influencia del perfeccionismo en variables relacionadas con trastornos alimentarios en estudiantes de danza / Influência do perfectionismo nas variáveis associadas aos transtornos alimentares em estudantes de dança

The aim of the present study was to examine the influence of the main two elements of perfectionism (CM, concern over mistakes and PS, personal standards) on eating disorders risk factors in dancers. Based on the literature, we tested the role of CM and PS over diet and mood related symptoms, and the function of performance anxiety and body dissatisfaction as the main mediators in the model. Two hundreds and eighty one female dancers (M = 15.28; SDage = 2.32) from two Spanish dance conservatoires participated in this study. Structural modelling was used to test the hypothesized model. Results confirm the different influence of PS and CM on dieting and the presence of symptoms of mood disorders and performance anxiety just in the debilitative perfectionism path. In conclusion, the presence of CM might be key to differentiate dancers at higher risk of eaing disorder due to its association with the variables traditionally associated to this

El objetivo del presente estudio fue examinar la influencia de los dos elementos principales del perfeccionismo (CM, preocupación ante los errores y PS, exigencias personales) ante los factores de riesgo de los trastornos alimentarios en bailarinas. Con apoyo en la literatura, evaluamos el rol de CM y de PS sobre la dieta y el estado de ánimo, y la función de la ansiedad de rendimiento y la insatisfacción corporal como los principales mediadores en el modelo. Doscientas ocho bailarinas (M = 15.28, DEedad = 2.32) de dos conservatorios de danza españoles participaron en este estudio. Gracias a modelos estructurales, los resultados confirman la influencia de PS y de CM en la dieta, sin embargo la vinculación entre dieta, insatisfacción corporal, estado de ánimo y la ansiedad de rendimiento solo se produce a partir del CM que es la vía del perfeccionismo debilitador. En conclusión, la presencia de CM puede ser la clave para diferenciar entre bailarines con mayor riesgo para desarrollar trastornos alimentarios debido a su asociación con variables tradicionalmente relacionadas con estos

O objectivo do presente estudo foi analisar a influência dos dois principais elementos do perfeccionismo (CM, preocupação face aos errose PS, exigências pessoais) face aos factores de risco dos transtornos alimentares em bailarinas. Com suporte na literatura, avaliamos o papel de CM ePS sobre a dieta e o estado de humor, e a função da ansiedade relativa ao rendimento e a insatisfação corporal como os principais mediadores do modelo.Participaram no estudo duzentas e oito bailarinas (M= 15.28, DPidade= 2.32) de dois conservatórios de dança espanhóis. Através de modelos estruturais,os resultados confirmam a influência de PS e de CM na dieta, contudo a relação entre dieta, insatisfação corporal, estado de humor e ansiedade relativaao rendimento apenas é predita através de CM que é a via do perfeccionismo debilitador. Em conclusão, a presença de CM pode ser a chave para dife-renciar os bailarinos com maior risco de desenvolverem transtornos alimentares devido à sua associação com variáveis tradicionalmente relacionadascom estes

Methodological convergence of program evaluation designs / Convergencia metodológica de los diseños de evaluación de programas

BACKGROUND: Nowadays, the confronting dichotomous view between experimental/quasi-experimental and non-experimental/ethnographic studies still exists but, despite the extensive use of non-experimental/ethnographic studies, the most systematic work on methodological quality has been developed based on experimental and quasi-experimental studies. This hinders evaluators and planners' practice of empirical program evaluation, a sphere in which the distinction between types of study is changing continually and is less clear. METHOD: Based on the classical validity framework of experimental/quasi-experimental studies, we carry out a review of the literature in order to analyze the convergence of design elements in methodological quality in primary studies in systematic reviews and ethnographic research. RESULTS: We specify the relevant design elements that should be taken into account in order to improve validity and generalization in program evaluation practice in different methodologies from a practical methodological and complementary view. CONCLUSIONS: We recommend ways to improve design elements so as to enhance validity and generalization in program evaluation practice

ANTECEDENTES: por una parte, actualmente todavía existe la visión dicotómica en que se presentan confrontados los estudios experimentales/cuasi-experimentales y no-experimentales/etnográficos; y por otra parte, a pesar del extendido uso de los estudios no-experimentales/etnográficos, el trabajo más sistemático sobre calidad metodológica se ha llevado a cabo en los estudios experimentales y cuasi-experimentales. Esto dificulta la práctica de quienes evalúan y planifican los programas a nivel empírico, un área donde la distinción entre tipos de estudio está en cambio constante y es menos clara. MÉTODO: tomando como referencia el marco clásico de validez en estudios experimentales/cuasi-experimentales, realizamos una revisión de la literatura con el fin de analizar la convergencia de los elementos de diseño en calidad metodológica de los estudios primarios en revisiones sistemáticas e investigación etnográfica. RESULTADOS: explicitamos los elementos de diseño relevantes que habrían de tenerse en cuenta para mejorar la validez y generalización en evaluación de programas en las diferentes metodologías desde una aproximación práctica de complementariedad metodológica. CONCLUSIONES: proponemos recomendaciones para mejorar los elementos de diseño y así potenciar la validez y la generalización en la práctica de evaluación de programas

Methodological convergence of program evaluation designs.

BACKGROUND: Nowadays, the confronting dichotomous view between experimental/quasi-experimental and non-experimental/ethnographic studies still exists but, despite the extensive use of non-experimental/ethnographic studies, the most systematic work on methodological quality has been developed based on experimental and quasi-experimental studies. This hinders evaluators and planners' practice of empirical program evaluation, a sphere in which the distinction between types of study is changing continually and is less clear. METHOD: Based on the classical validity framework of experimental/quasi-experimental studies, we carry out a review of the literature in order to analyze the convergence of design elements in methodological quality in primary studies in systematic reviews and ethnographic research. RESULTS: We specify the relevant design elements that should be taken into account in order to improve validity and generalization in program evaluation practice in different methodologies from a practical methodological and complementary view. CONCLUSIONS: We recommend ways to improve design elements so as to enhance validity and generalization in program evaluation practice.