The Role of Negative Affect in Emotional Processing of Food-Related Images in Eating Disorders and Obesity.

The aim of the present study was to analyze differences in the emotional processing (valence, arousal, and dominance) of food-related information in patients with eating disorders (ED), patients with obesity, and healthy women. Moreover, the mediator role of negative affect and the moderating role of the diagnostic group (ED vs. non-ED) were analyzed. METHOD: The sample consisted of 94 women (39 with eating disorders, 19 with obesity, and 36 healthy participants). MEASURES: International Affective Picture System (IAPS) food picture exposure task; Self-Assessment Manikin Analog-Visual Scale (SAM) appraising Arousal, Valence, and Dominance; Eating Attitudes Test (EAT-26); Positive and Negative Affect Schedule (PANAS). RESULTS: Patients with purging symptomatology rated food images as more unpleasant than healthy women. Patients with purging and restrictive eating symptomatology showed higher levels of arousal and less dominance over the emotions experienced, compared to patients with obesity and healthy women. The mediation analysis showed that negative affect mediated the relationship between eating symptomatology (EAT-26) and the Valence of food images, as well as the control over the emotions experienced when viewing food images (Dominance). For the moderation analysis participants were regrouped into two groups (ED patients vs. non-ED patients). The direct relationship between eating symptomatology and food image valence was moderated by the diagnostic group. However, the group did not moderate the direct relationship between the EAT-26 and dominance over experienced emotions, or the indirect effect on eating symptomatology through negative affect. These results show the relevance of negative affect in the emotional processing of food-related information, and they support an eating disorder-disordered eating dimensional perspective.

Contribution of executive functions to eating behaviours in obesity and eating disorders.

BACKGROUND: Patients with eating disorders (ED) or obesity show difficulties in tasks assessing decision-making, set-shifting abilities and central coherence. AIMS: The aim of this study was to explore executive functions in eating and weight-related problems, ranging from restricting types of ED to obesity. METHOD: Two hundred and eighty-eight female participants (75 with obesity; 149 with ED: 76 with restrictive eating, 73 with bingeing-purging symptoms; and 64 healthy controls) were administered the Wisconsin Card Sorting Test, the Iowa Gambling Task, and the Group Embedded Figures Test to assess set-shifting, decision-making and central coherence, respectively. RESULTS: Participants with either obesity or ED performed poorly on tests measuring executive functioning compared with healthy controls, even after controlling for age and intelligence. Both participants with obesity and participants with ED showed a preference for global information processing. CONCLUSIONS: The findings suggest that treatments for obesity and ED would benefit from addressing difficulties in cognitive functioning, in addition to the more evident clinical symptoms related to eating, body weight and shape.

Orthorexia nervosa, eating patterns and personality traits: a cross-cultural comparison of Italian, Polish and Spanish university students.

BACKGROUND: The amount of research about orthorexic attitudes and behaviours has increased in the last five years, but is still mainly based on descriptive and anecdotal data, yielding a variety of prevalence data and inconsistent results. The interplay between socio-cultural context and orthorexia has been poorly investigated and is still far from being understood. METHOD: Multicentre, cross-sectional study involving Italian (N = 216), Polish (N = 206) and Spanish (N = 242) university students, assessed through a protocol including informed consent, socio-demographic and anamnestic data sheet and self-administered questionnaires (ORTO-15, Eating Attitudes Test- 26 [EAT-26], Temperament and Character Inventory [TCI]). RESULTS: Higher prevalence of orthorexia (as described by the ORTO-15 cutoff) was found in Poland. Female gender, Body Mass Index (BMI), current Eating Disorder, dieting, EAT-26 score ≥ 20 and low/medium Persistence were associated with orthorexia in the whole sample. The cross-cultural comparison showed several differences among the three subgroups of students. CONCLUSIONS: The associations found between orthorexic attitudes, self-reported current eating disorder, BMI and adherence to a dieting need to be supported by further research. The differences among students from the three countries seem to suggest a possible rolve for cultural elements in the construct of orthorexia.

Funciones ejecutivas y regulación emocional en obesidad y trastornos alimentarios.

INTRODUCTION: Introduction: eating disorders (ED) such as anorexia nervosa (AN) or bulimia nervosa (BN), as well as obesity (OB), are related to emotional and neuropsychological impairments on measures of cognitive flexibility, central coherence or decision making. However, little is known about the association among emotional regulation, neuropsychological variables and affect. Objectives: to analyze whether neuropsychological and affect variables can predict emotional regulation in ED and in OB. Methods: thirty females with restricting ED (restricting AN) were assessed, 18 with purging ED (purging AN and BN), 33 with OB and 39 healthy controls matched for intelligence. The Wisconsin Card Sorting Test (WCST) assessed cognitive flexibility, the Group Embedded Figures Test (GEFT) assessed central coherence, the Iowa Gambling Task (IGT) assessed decision making, the Positive and Negative Affect Schedule assessed positive (PANAS-PA) and negative (PANAS-NA) affect, and the Difficulties in Emotion Regulation Scale (DERS) assessed emotional regulation. Results: relative to the healthy control group, ED and OB groups performed worse on IGT (p = 0.002) and GEFT (p = 0.003), had lower scores on PANAS-PA (p = 0.001) and higher scores on DERS (p < 0.001). ED groups had higher scores on PANAS-NA tan both OB and healthy controls (p = 0.001). PANAS-PA, PANAS-NA and IGT accounted for 51.4% of the variance of the DERS (p < 0.001). Conclusions: our study shows a significant association between decision making, affect and emotional regulation in the continuum from AN to OB, and also highlights the importance of including programs focused on decision making and affect in cognitive interventions for ED and OB.

INTRODUCCIÓN: Introducción: los trastornos de la conducta alimentaria (TCA) como la anorexia nerviosa (AN) o la bulimia nerviosa (BN), así como la obesidad (OB), se relacionan con alteraciones neuropsicológicas en flexibilidad cognitiva, coherencia central, toma de decisiones y alteraciones emocionales. Sin embargo, se desconoce la asociación entre regulación emocional, variables neuropsicológicas y variables de afecto. Objetivos: analizar si variables neuropsicológicas y afectivas pueden predecir la regulación emocional en los TCA y en la OB. Métodos: se evaluó a 30 mujeres con TCA restrictivo (AN restrictiva), 18 con TCA purgativo (AN purgativa y BN), 33 OB y 39 controles sanas emparejadas por nivel intelectual. El Wisconsin Card Sorting Test (WCST) evaluó la flexibilidad cognitiva; el Group Embedded Figures Test (GEFT), la coherencia central; el Iowa Gambling Task (IGT), la toma de decisiones; el Positive and Negative Affect Schedule, el afecto positivo (PANAS-PA) y negativo (PANAS-NA); y la Difficulties in Emotion Regulation Scale (DERS), la regulación emocional. Resultados: respecto al grupo control, los grupos TCA y OB rindieron peor en IGT (p = 0,002) y GEFT (p = 0,003) y presentaron menores puntuaciones en PANAS-PA (p = 0,001) y mayores en DERS (p < 0,001). Los grupos TCA puntuaron más alto en PANAS-NA que los grupos OB y control (p = 0,001). El 51,4% de la varianza del DERS fue explicado por PANAS-PA, PANAS-NA e IGT (p < 0,001). Conclusiones: nuestro estudio muestra una asociación entre toma de decisiones y afecto con regulación emocional en el continuo de AN a OB e indica la importancia de incluir programas de toma de decisiones y afecto en las intervenciones cognitivas para TCA y para OB.

Executive functions and emotion regulation in obesity and eating disorders / Funciones ejecutivas y regulación emocional en obesidad y trastornos alimentarios

Introduction: eating disorders (ED) such as anorexia nervosa (AN) or bulimia nervosa (BN), as well as obesity (OB), are related to emotional and neuropsychological impairments on measures of cognitive flexibility, central coherence or decision making. However, little is known about the association among emotional regulation, neuropsychological variables and affect. Objectives: to analyze whether neuropsychological and affect variables can predict emotional regulation in ED and in OB. Methods: thirty females with restricting ED (restricting AN) were assessed, 18 with purging ED (purging AN and BN), 33 with OB and 39 healthy controls matched for intelligence. The Wisconsin Card Sorting Test (WCST) assessed cognitive flexibility, the Group Embedded Figures Test (GEFT) assessed central coherence, the Iowa Gambling Task (IGT) assessed decision making, the Positive and Negative Affect Schedule assessed positive (PANAS-PA) and negative (PANAS-NA) affect, and the Diffi culties in Emotion Regulation Scale (DERS) assessed emotional regulation. Results: relative to the healthy control group, ED and OB groups performed worse on IGT (p = 0.002) and GEFT (p = 0.003), had lower scores on PANAS-PA (p = 0.001) and higher scores on DERS (p < 0.001). ED groups had higher scores on PANAS-NA tan both OB and healthy controls (p = 0.001). PANAS-PA, PANAS-NA and IGT accounted for 51.4% of the variance of the DERS (p < 0.001). Conclusions: our study shows a significant association between decision making, affect and emotional regulation in the continuum from AN to OB, and also highlights the importance of including programs focused on decision making and affect in cognitive interventions for ED and OB

Introducción: los trastornos de la conducta alimentaria (TCA) como la anorexia nerviosa (AN) o la bulimia nerviosa (BN), así como la obesidad (OB), se relacionan con alteraciones neuropsicológicas en flexibilidad cognitiva, coherencia central, toma de decisiones y alteraciones emocionales. Sin embargo, se desconoce la asociación entre regulación emocional, variables neuropsicológicas y variables de afecto. Objetivos: analizar si variables neuropsicológicas y afectivas pueden predecir la regulación emocional en los TCA y en la OB. Métodos: se evaluó a 30 mujeres con TCA restrictivo (AN restrictiva), 18 con TCA purgativo (AN purgativa y BN), 33 OB y 39 controles sanas emparejadas por nivel intelectual. El Wisconsin Card Sorting Test (WCST) evaluó la flexibilidad cognitiva; el Group Embedded Figures Test (GEFT), la coherencia central; el Iowa Gambling Task (IGT), la toma de decisiones; el Positive and Negative Affect Schedule, el afecto positivo (PANAS-PA) y negativo (PANAS-NA); y la Difficulties in Emotion Regulation Scale (DERS), la regulación emocional. Resultados: respecto al grupo control, los grupos TCA y OB rindieron peor en IGT (p = 0,002) y GEFT (p = 0,003) y presentaron menores puntuaciones en PANAS-PA (p = 0,001) y mayores en DERS (p < 0,001). Los grupos TCA puntuaron más alto en PANAS-NA que los grupos OB y control (p = 0,001). El 51,4% de la varianza del DERS fue explicado por PANAS-PA, PANAS-NA e IGT (p < 0,001). Conclusiones: nuestro estudio muestra una asociación entre toma de decisiones y afecto con regulación emocional en el continuo de AN a OB e indica la importancia de incluir programas de toma de decisiones y afecto en las intervenciones cognitivas para TCA y para OB

Enfermedad de moyamoya: aspectos clínicos, neurorradiológicos, neuropsicolológicos y genéticos / Moyamoya disease: clinical, neuroradiological, neuropsychological and genetic perspective

Introducción. La enfermedad de moyamoya (EMM) es una enfermedad cerebrovascular oclusiva caracterizada por estenosis progresiva o la oclusión en la porción terminal de las arterias carótidas internas bilaterales, que afecta tanto a niños como a adultos. Objetivo. Realizar una revisión y actualización sobre la EMM desde una perspectiva clínica, neurorradiológica, neuropsicológica y genética. Desarrollo. En esta patología, que cursa con isquemia o hemorragia cerebral, se desarrolla una red vascular inusual compensatoria (vasos moyamoya) en la base del cerebro en forma de canales colaterales. La EMM puede cursar clínicamente con hemiparesia, disartria, afasia, cefalea, convulsiones, déficits visuales, síncopes o cambios en la personalidad. Neuropsicológicamente, y aun en ausencia de ictus evidentes, los pacientes suelen presentar afectación de la atención, memoria, conducta y funciones ejecutivas. La angiografía y la resonancia magnética de alta resolución han supuesto un avance neurorradiológico hacia una detección precoz de esta enfermedad. Recientemente se ha identificado el RING (really interesting new gene) RNF213, que se considera el factor genético de riesgo más importante conocido hasta ahora en la EMM. Conclusiones. La EMM es una patología rara que afecta de forma predominante a los lóbulos frontales. Los avances genéticos y neurorradiológicos, además de un perfil cognitivo, contribuyen a un diagnóstico y tratamiento tempranos para mejorar la calidad de vida de estos pacientes (AU)

Introduction. Moyamoya disease (MMD) is an occlusive cerebrovascular disease characterized by progressive stenosis or occlusion in the terminal portion of the bilateral internal carotid arteries, affecting both children and adults. Aim. To conduct a review and update on MMD from a clinical, neuroradiological, neuropsychological and genetic perspective. Development. In this pathology, which occurs with ischemia or cerebral hemorrhage, an unusual compensatory vascular network (moyamoya vessels) develops at the base of the brain in the form of collateral channels. MMD can present clinically with hemiparesis, dysarthria, aphasia, headache, seizures, visual deficits, syncopes or changes in personality. At the neuropsychological level, and even in the absence of obvious strokes, patients usually present impairment of attention, memory, behavior and executive functions. High resolution angiography and magnetic resonance imaging have been a neuroradiological advance towards an early detection of this disease. At the genetic level, the RING (really interesting new gene) RNF213 has recently been identified, and it is considered the most important genetic risk factor known up to now in the MMD. Conclusions. MMD is a rare pathology that predominantly affects the frontal lobes. The genetic and neuroradiological advances, in addition to a cognitive profile, contribute to early diagnosis and treatment to improve the quality of life of these patients (AU)

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.

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.

Body image and adolescence: A behavioral impairment model.

Adolescence is a period marked by important physical and social changes that can lead to a negative body image. The purpose of this study was to find a model enabling the appearance of behavioral impairment related to body image (restrictions, avoidance, and checking) to be predicted by body image attitudes (concern or Appearance Orientation, and dissatisfaction or Appearance Evaluation), Gender, emotional symptomatology, self-consciousness, ideas of reference (IR) and age. A total of 661 participants (67.47% girls) with an average age of 17.14 years (SD=2.34) filled in the GHQ-28, SCS on self-consciousness, REF referential thinking scale, MBSRQ (AO and AE), and BIAQ. A partial mediation model was found for IR, age and depressive symptomatology between dissatisfaction and concern about body image and Gender, to behavioral impairment related to body image. The results found suggest that age, depressive symptomatology, and IR may be mediator variables in the relationship between dissatisfaction and concern about body image, on body image behavioral impairment. This relationship implies a severity to be considered in intervention and monitoring of body image behavioral impairments in adolescents.

Cognitive flexibility and decision-making in eating disorders and obesity.

OBJECTIVE: The aim of the present study was to compare decision-making and cognitive flexibility in patients with disordered eating and weight, ranging from anorexia nervosa to obesity, and a healthy group. METHOD: Participants were 113 patients (86 with eating disorders and 27 with obesity), and a group of 39 healthy subjects; all completed the Iowa gambling task, the Wisconsin Card Sorting Test and several clinical self-report measures. RESULTS: Eating disordered and obese patients showed impaired performance on the decision-making task, and the obese group showed the worst performance on the set-shifting task. There were no associations between neuropsychological performance and eating or obsessive symptomatology, although significant associations were found with anxiety and depression measures. DISCUSSION: Considering the executive functions as a transdiagnostic process in ED and obesity could provide explanations for the inability to regulate food intake, present in both ED and obese patients. Implications of these executive impairments in the development and maintenance of ED and obesity are discussed.

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 (AU)

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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 © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Similarities and differences between eating disorders and obese patients in a virtual environment for normalizing eating patterns.

Virtual reality has demonstrated promising results in the treatment of eating disorders (ED); however, few studies have examined its usefulness in treating obesity. The aim of this study was to compare ED and obese patients on their reality judgment of a virtual environment (VE) designed to normalize their eating pattern. A second objective was to study which variables predicted the reality of the experience of eating a virtual forbidden-fattening food. ED patients, obese patients, and a non-clinical group (N=62) experienced a non-immersive VE, and then completed reality judgment and presence measures. All participants rated the VE with similar scores for quality, interaction, engagement, and ecological validity; however, ED patients obtained the highest scores on emotional involvement, attention, reality judgment/presence, and negative effects. The obese group gave the lowest scores to reality judgment/presence, satisfaction and sense of physical space, and they held an intermediate position in the attribution of reality to virtually eating a "fattening" food. The palatability of a virtual food was predicted by attention capturing and belonging to the obese group, while the attribution of reality to the virtual eating was predicted by engagement and belonging to the ED group. This study offers preliminary results about the differential impact on ED and obese patients of the exposure to virtual food, and about the need to implement a VE that can be useful as a virtual lab for studying eating behavior and treating obesity.

Normalizing the eating pattern with virtual reality for bulimia nervosa: a case report / Normalización de la ingesta con realidad virtual en la bulimia nerviosa: un caso clínico

The aim of the present study was to analyze the effects of a virtual reality (VR) component as a therapeutic tool to normalize eating patterns, as part of the cognitive-behavioral treatment of a bulimia nervosa (BN) patient. Results indicated that the patient made significant progress with her eating habits; binges and vomits were eliminated completely. Moreover, when the VR started the patient avoided food, especially meat (5 over 5), and it was reduction of this avoidance in the lasts sessions (2 and 3 over 5). It was also observed a reduction in the avoidance and the fear of eating (from 10 and 9 to 6 and 5 respectively) and increased the impulse control (from 2 to 7). The patient felt that the VR experience seemed real and similar to reality (mean score of 8.3 over 10). Before and after the seven VR sessions, there was a decrease in the drive for thinness, bulimia, ineffectiveness, and BITE symptoms and severity, and in the general psychopathology. Moreover, the patient improved her motivation to change. Results suggest that VR is a relevant and effective complement to traditional treatment in a BN patient. Further studies should continue this line of research by using larger sample sizes with different diagnoses and subtypes and control groups.

El objetivo del presente estudio fue analizar el efecto de un componente de realidad virtual (RV) como una herramienta de terapia para la normalización de la ingesta, como parte de un tratamiento cognitivo conductual para la bulimia nerviosa (BN). Después de un módulo de 7 sesiones de RV, la paciente tuvo un progreso significativo en sus hábitos alimentarios. Los atracones y vómitos se eliminaron completamente. Además, al inicio de las sesiones, la paciente evitaba la comida, especialmente la carne (5 sobre 5), observándose una reducción de la evitación en las últimas sesiones (2 y 3 sobre 5). También se redujeron la evitación y el miedo a comer (de 10 y 9 a 6 y 5, respectivamente) y aumentó el control del impulso (de 2 a 7). La paciente sintió como real la experiencia virtual y fue evaluada como similar a lo que experimenta en la vida real (puntuación media de 8,3 sobre 10). Después de las 7 sesiones de RV, hubo una reducción en el impulso por adelgazar, bulimia, ineficacia, en los síntomas y la gravedad del BITE, y en la psicopatología general. Además, la motivación al cambio mejoró en la paciente. Los resultados indican que la RV es un complemento relevante y efectivo en el tratamiento tradicional en una paciente con BN. Se requieren futuros estudios en esta línea muestras más amplias con diferentes diagnósticos y subtipos y grupo control.

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.

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). Cronbach's 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.

Tratamiento de la imagen corporal en los trastornos alimentarios y cambio clínicamente significativo / The treatment of the body image disturbances in eating disorders and clinically significant change

Las alteraciones de la imagen corporal son un factor mantenedor y de pronóstico en los trastornos alimentarios. Los tratamientos actuales para los trastornos alimentarios se podrían beneficiar de la intervención directa sobre la imagen corporal. En el siguiente trabajo se realiza un estudio controlado en el que se comprara la Terapia Cognitivo Conductual para los trastornos alimentarios con y sin un componente para el tratamiento de la imagen corporal apoyado con técnicas de realidad virtual. El objetivo de este trabajo fue comprobar si ambos tipos de tratamiento producen un cambio clínicamente significativo al finalizar el tratamiento y en el seguimiento al año en la imagen corporal, en la psicopatología especifica de los trastornos alimentarios y en la psicopatología general. Para ello evaluamos y tratamos a 34 participantes diagnosticadas de trastorno alimentario y comparamos sus resultados con un grupo de mujeres de población general con baja vulnerabilidad a los trastornos alimentarios. Los resultados indican que después del tratamiento se ha producido un cambio fiable y clínicamente significativo únicamente en la condición en la que se ha intervenido en la imagen corporal. Las implicaciones de este resultado y sus limitaciones son comentadas

Body image disturbance is a significant maintenance and prognosis factor in eating disorders. Hence, existing eating disorder treatments can benefit from direct intervention in patients’ body image. This paper includes a controlled study comparing cognitive behavioural treatment for eating disorders with and without a component for body image treatment using virtual reality techniques. The objective of this work was to check if both types of treatment produced a change clinically significant at the end of the treatment and the follow-up to the year, in body image, eating disorders and general psychopathology. Thirty-four participants diagnosed with eating disorders were treated and compared with the general population with low vulnerability to eating disorders. Results showed that only in the patients who received the body image treatment obtained a change clinically significant. The implications and limitations of these results are discussed below

Intrusive thoughts in obsessive-compulsive disorder and eating disorder patients: a differential analysis.

The present study aims to compare the unwanted intrusions experienced by obsessive-compulsive (OCD) and eating disorder (ED) patients, their appraisals, and their control strategies and analyse which variables predict the intrusions' disruption and emotional disturbance in each group. Seventy-nine OCD and 177 ED patients completed two equivalent self-reports designed to assess OCD-related and ED-related intrusions, their dysfunctional appraisals, and associated control strategies. OCD and ED patients experienced intrusions with comparable frequency and emotional disturbance, but OCD patients experienced greater disruption. Differences appeared between groups on some appraisals and control strategies. Intolerance to uncertainty (OCD group) and thought importance (ED group) predicted their respective emotional disturbance and disruption. Additionally, control importance (OCD group) and thought-action fusion moral (OCD and ED groups) predicted their emotional disturbance. OCD and ED share the presence of intrusions; however, different variables explain why they are disruptive and emotionally disturbing. Cognitive intrusions require further investigation as a transdiagnostic variable.

Tratamiento de la imagen corporal en los trastornos alimentarios: diferencias en la respuesta al tratamiento según el diagnóstico / Body image treatment in eating disorders: differences in treatment response depending on the diagnosis

Las alteraciones de la imagen corporal (IC) son un factor mantenedor y de pronóstico en los trastornos de la conducta alimentaria (TCA). No existen estudios en los que se evalúe la intervención en la IC. En este trabajo realizamos un estudio controlado en el que comparamos la terapia cognitivo conductual para los TCA con y sin un componente para el tratamiento de la IC apoyado en técnicas de realidad virtual. El objetivo fue comprobar si ambos tipos de tratamiento producían un cambio clínicamente significativo. Treinta y cuatro pacientes fueron evaluadas antes, después del tratamiento y en el seguimiento al año, comparándose sus puntuaciones con las obtenidas por la población general. Después del tratamiento, en aquella condición en la que se trató la IC, se alcanzó un cambio clínicamente significativo en todas las pacientes. En la condición en la que no se trató la IC, no se produjo un cambio clínicamente significativo en las pacientes con anorexia nerviosa, por el contrario, en las pacientes con bulimia el cambio sólo se alcanzó en el seguimiento al año (AU)

Body image disturbance is a significant maintenance and prognosis factor in eating disorders. Up to now no controlled studies have compared eating disorder treatments with and without a treatment component centred on body image. This paper includes a controlled study comparing cognitive behavioural treatment for eating disorders with and without a component for body image using virtual reality. The objective of this work was to analyze whether both types of treatment produced a clinically significant change in patients also diagnostic of anorexia and bulimia. Thirty-four participants diagnosed with eating disorders were treated and compared with the general population. The results at the end of the treatment and the follow-up indicate that the condition in which body image was treated produced a clinically significant change in anorexia and bulimia nervosa. In the condition without treatment of body image, no significant change in anorexia was produced. On the other hand, the participants diagnosed with bulimia nervosa produced a clinically significant change during follow-up

Ego-syntonicity and ego-dystonicity of eating-related intrusive thoughts in patients with eating disorders.

The main objective of the present study was to analyse the role of the ego-dystonicity and ego-syntonicity of eating disorder intrusive thoughts (EDITs) in the genesis and maintenance of eating disorders (EDs). Participants were 98 female patients with EDs, 56 Spanish and 42 English (27.19±9.59 years; body mass index (BMI): 18.72±2.87). All of them completed the eating attitudes test, the Eating Attitudes Test, the Eating Intrusive Thoughts Inventory, the Ego-Dystonicity Questionnaire-Reduced version, and the Ego-Syntonicity Questionnaire. Patients indicated that their EDITs were rational and also undesirable and immoral, suggesting that EDITs are not fully ego-syntonic or ego-dystonic. Multivariate analysis of variance (MANOVA) indicated no differences in ego-syntonicity and ego-dystonicity across ED subtypes. Path analyses were performed to investigate the mediating role of the EDITs' ego-syntonicity and ego-dystonicity in their interference, dysfunctional appraisals and control strategies. They showed, first, that the more interference an EDIT caused, the more ego-syntonic and the less ego-dystonic it was and, second, that when the EDITs were assessed as ego-syntonic, patients tried to do what they indicated, whereas when they were assessed as ego-dystonic, patients made efforts to neutralise them. Clinical implications for the conceptualisation and treatment of ED are discussed.