Assessment of Alcohol Consumption and Anxiety as Predictors of Risk of Anorexia and Bulimia in Non-Clinicals Samples.

The objective of this study is to assess the effect of alcohol consumption, anxiety, and food restriction before and after consuming alcohol and body image on the risk of anorexia and bulimia in college students from Tijuana, Baja California, through predictive statistical models. A quantitative, descriptive, and cross-sectional design and a non-probabilistic sample of 526 college students from Tijuana, Baja California, México were used. Application of the scales (with acceptable psychometric properties) was conducted in classrooms. Through path analyses, four models were found with adequate indicators of goodness of fit: (1) risk of anorexia in women [Chi Square (X2) = 5.34, p = 0.376, Adjusted Determination Coefficient (R2)= 0.250]; (2) anorexia risk for men (X2 = 13.067, p = 0.192, R2 = 0.058); (3) risk of bulimia in women (X2 = 3.358, p = 0.645, R2 = 0.202); and bulimia risk for men (X2 = 14.256, p = 0.075, R2 = 0.284). The findings provide empirical evidence for the food and alcohol disturbance model.

Imagen y peso corporal en universitarios: Estudio comparativo México-España / Image and body weight in college students: Mexico-Spain comparative study

Resumen Los objetivos principales de este estudio fueron: a. Comparar el índice de masa corporal (IMC) e imagen corporal ([IC] alteración e insatisfacción) dependiendo del sexo y la nacionalidad (española vs. mexicana); y b. Comparar el grado de alteración de la IC dependiendo del IMC y la nacionalidad. Participaron 169 estudiantes universitarios, a quienes se les aplicó el Test de Siluetas de Thompson y Gray (1995), además de obtener su peso y estatura. Los principales hallazgos indican diferencias significativas en el IMC dependiendo de la nacionalidad, no así por sexo; se encontraron altas cifras de sobrepeso y obesidad entre los mexicanos, y altos porcentajes de peso normal entre los españoles. Se encontraron diferencias significativas en la insatisfacción corporal por sexo, y en la alteración por nacionalidad y sexo. Las mujeres de ambas naciones están más insatisfechas que los hombres, mismos que subestiman más sus cuerpos que las mujeres. Los mexicanos alteran en mayor medida que los españoles. Existe mayor subestimación en las personas con sobrepeso y obesidad, relación significativa en la muestra mexicana, pero no en la española. Resultados que son parcialmente congruentes con la literatura previa.

Abstract The objectives of this study were: a. Compare the body mass index (BMI), alteration of body image and body dissatisfaction depending on sex and nationality (Spanish vs. Mexican); y b) Compare the level of body image alteration depending on BMI and nationality. 169 Spanish and Mexican college students participated. To measure body image the silhouettes test of Thompson and Gray (1995) was used, obtaining weight and height. The main findings indicate significant differences in BMI depending of nationality, not like that for sex; high figures of overweight and obesity among Mexicans were found and high percentages of normal weight among Spaniards. Significant differences were found in body dissatisfaction by sex and in the alteration by nationality and sex. Women from both nations are more dissatisfied than men, men underestimate their bodies more than women, Mexican alter to a greater extent than Spaniards. There is greater underestimation in people with overweight and obesity, significant relationship between the Mexican sample, not in the Spanish. The results are partially congruent with the previous literature.

Validación de un instrumento de autoeficacia para la prevención de obesidad en niños escolares / Validation of an instrument of self-efficacy for the prevention of obesity in school children

El objetivo de este estudio fue adaptar y evaluar, desde una perspectiva psicométrica, un instrumento dirigido a medir la autoeficacia relativa al control del peso en niños de enseñanza básica. Mediante laboratorios cognoscitivos, los ítems del instrumento original se adaptaron para su uso en niños de edad escolar, y posteriormente fueron validados por un panel de jueces. Esta versión del instrumento fue aplicada a 1,151 participantes, mujeres y varones, de entre 8 y 13 años de edad (M = 10.2, DE = 0.98), y examinada a través de análisis factorial exploratorio y análisis factorial confirmatorio. El análisis factorial exploratorio arrojó una estructura de cuatro factores, con 25 ítems (α = 0.90), mientras que el AFC derivó un modelo de tres factores, con 20 ítems (α = 0.88), el cual mostró buen ajuste (χ 2 /gl= 2.47; AGFI = 0.95; NFI = 0.93; CFI = 0.95; GFI = 0.96; RMSEA= 0.03, 90% [IC 0.034-0.042]). Se obtuvo un instrumento parsimonioso, con validez y consistencia interna aceptables, el cual permite medir tres componentes básicos de la autoeficacia relativa a la prevención del sobrepeso, que son: actividad física, alimentación y control sobre la alimentación emocional, aspectos no abordados en instrumentos precedentes.

The objective of this study was to adapt and evaluate, from a psychometric perspective, an instrument aimed at measuring self-efficacy and weight control in elementary school children. Through cognitive laboratories, the items of the original instrument are adapted for children of school age, and subsequently validated by a panel of judges. This version of the instrument was applied to 1151 participants, girls and boys of between 8 and 13 years old (M = 10.2, SD = 0.98), and examined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The EFA derived a four-factor structure, with 25 items (α = 0.90), while the CFA derived a three factor model, with 20 items (α = 0.88), which showed a good fit (χ 2 /gl = 2.47, AGFI = 0.95, NFI = 0.93, CFI = 0.95, GFI = 0.96, RMSEA = 0.03, 90% [IC 0.034-0.042]). A parsimonious instrument with acceptable internal validity and consistency was obtained, which allows to measure three basic components of self-efficacy relative to the prevention of overweight, which are: physical activity, feeding and control over emotional feeding, not addressed in previous instruments.

Ansiedad como predictor del riesgo de anorexia y bulimia: Comparación entre universitarios de Baja California y Ciudad de México / Anxiety as a predictor of anorexia and bulimia risk: Comparison between universitaries of Baja California and Mexico City

Aunque la ansiedad parece ser una constante en los pacientes con trastorno de la conducta alimentaria, poco se sabe sobre su interacción con otras variables. Por tanto, el objetivo principal de este estudio fue comparar el riesgo de anorexia nerviosa (AN) y bulimia nerviosa (BN) en función del sexo, el grado de ansiedad y la ciudad de residencia. Se trabajó con un diseño no experimental-transversal y una muestra no probabilística conformada por 857 estudiantes universitarios (67% mujeres y 33% hombres), con edad promedio de 21.96 años (DE = 4.84), el 42% residentes en la Ciudad de México y el 58% en la ciudad de Ensenada. Los participantes completaron dos escalas de autorreporte, una para evaluar el riesgo de AN y BN, y otra para medir la ansiedad. Los hallazgos evidencian que el grado de ansiedad difiere en función de la ciudad de residencia, siendo mayor en Ensenada. Además, se encontró una interacción significativa entre las variables; por ejemplo, en los residentes en la ciudad de Ensenada, el riesgo de BN se incrementa cuando la ansiedad aumenta. Por tanto, se confirma no solo la relevancia del sexo y la ansiedad sobre los trastornos de la conducta alimentaria, sino también de la interacción de dichas variables con la ciudad de residencia.

Although anxiety seems to be a constant in patients with eating disorders, little is known about its interaction with other variables. Therefore, the main objective of this study was to compare the risk of anorexia nervosa (AN) and bulimia nerviosa (BN) based on the sex of participants, degree of anxiety and city of residence. The study is a non-experimental and cross-sectional design. The sample was nonrandom and consisted of 857 college students (67% female and 33% male) with a mean age of 21.96 years (SD = 4.84), 42% were Mexico City residents and 58% were from Ensenada city. Participants completed two self-report scales, one for assessing risk of AN and BN, and other to measure anxiety. The findings show that the degree of anxiety differs according to the city of residence, being higher in Ensenada city. In addition, a significant interaction was found between the variables; for instance, the risk of BN in Ensenada city residents increases as anxiety increases. Therefore, it is confirmed not only the importance of sex and anxiety on eating disorders, but also the interaction of these two variables with the city of residence.

Un estudio preliminar de una prueba de autodetección a distancia. Riesgo en trastornos alimentarios / A preliminary study of an online self-detection test. Risk in eating disorders

El objetivo de este estudio fue evaluar la utilidad de una prueba de autodetección de riesgo en trastornos alimentarios a distancia (PARTAD), desde una perspectiva cuantitativa, determinando su validez predictiva y poder de clasificación y una cualitativa, analizando el contenido de las opiniones y sugerencias de las usuarias. De la muestra total (n = 3,501) 3,059 eran adolescentes (13-19 años) y jóvenes (20-35 años); 394 mujeres adultas (36-50 años); y 48 adultas maduras (51-60 años). Se construyó un instrumento de 30 ítems dicotómicos y de opción múltiple y se agregaron 2 preguntas abiertas con propósitos de retroalimentación para mejorarlo y para la evaluación cualitativa. El análisis discriminante arrojó una función con fuerte poder discriminatorio entre grupos, con alto y bajo riesgo en trastornos alimentarios, que explica hasta el 88% de la varianza y el 100% de clasificación correcta. También se obtuvo un 23% de comentarios (706), el análisis y clasificación de sus contenidos mostraron los efectos esperados. Los resultados permiten responder afirmativamente en relación con la utilidad del PARTAD.

The aim of this study was to evaluate the usefulness of an Online Test of Self-Detection in Risk for Eating Disorder (OTSDRED) from a quantitative perspective (determining its predictive validity and classification power) and from a qualitative one (analyzing the opinions and suggestions of users). From the total sample (N = 3501) of women, 3059 were adolescents (13- 19 years), youth (20-35 years); 394 adult (36-50 years); and 48 mature adult (51-60 years). An instrument of 30 dichotomous items and multiple choice was built. Two open questions with feedback for improvement purposes and for the qualitative assessment were added. The Discriminant Analysis yielded strong discriminatory power function between groups with high and low risk for eating disorders, explaining up to 88% of the variance and 100% of correct classification. With regard to the qualitative perspective a 23% of comments (706) were obtained; the analysis and classification of its contents showed the expected effects. The results from the quantitative and qualitative analysis allowed affirmative answer regarding the usefulness of OTSDRED.

Riesgo de anorexia y bulimia en función de la ansiedad y la edad de la pubertad en universitarios de Baja California-México / Anorexia and bulimia risk as function of anxiety and puberty in Baja California-Mexico college students

En muestras no clínicas identificar el riesgo de trastorno alimentario, así como las variables asociadas, es fundamental para la prevención. El objetivo principal fue comparar el riesgo de bulimia y anorexia dependiendo del grado de ansiedad y de la edad de la pubertad en estudiantes universitarios. Se llevó a cabo una investigación no experimental, transversal, explicativa incluyendo una muestra no probabilística de 420 universitarios de 18 a 30 años (59% mujeres, 41% hombres), estudiantes de universidad pública de Ensenada, B.C. Se utilizaron el Cuestionario de Alimentación y Salud y la EFRATA de Gómez-Peresmitré; así como el Inventario de Ansiedad de Beck y Steer. Entre los principales hallazgos, se encontró que el riesgo de bulimia es mayor cuando el grado de ansiedad es alto y la edad de la pubertad se presenta a "destiempo"; el riesgo de anorexia sólo se incrementa cuando la ansiedad es alta. Los resultados son congruentes con la literatura previa y se discuten en el marco de la misma.

Identifying the risk of eating disorders as well as associated variables in nonclinical samples is fundamental to prevention. The main objective of this study was to compare bulimia and anorexia risk depending on anxiety degree and the age of puberty onset in university students. A non experimental transversal explanatory study was carried out using a non probabilistic sample of 420 students from a public university at Ensenada, B.C. Age of participants ranged between 18 and 30 years old (59% female, 41% male) in Ensenada, B.C. Timing of puberty was measured using The Food and Health Questionaire (Gómez Peresmitré), especifically the menarquia/spermarquiaself-report, as well as the a Risk Factors Associated with Eating Disorders Scale (EFRATA) ; The Beck Anxiety Inventory (BAI) was also administered to all students. Among the main findings is that risk of bulimia increases with high anxiety degree and untypical puberty onset. Anorexia risk increases only with high degrees of anxiety. Results are in accordance to previous literature and are discussed within that frame.

Realidad Virtual y Psicoeducación: Formatos de Prevención Selectiva en Trastornos de la Conducta Alimentaria / Virtual Reality and Psychoeducation: Selective Prevention Formats in Eating Disorders

La prevención de los trastornos alimentarios es considerada por los psicólogos de la salud como una tarea prioritaria a cubrir. De acuerdo con esta idea se propuso analizar y evaluar la eficacia de dos programas de intervención basados en distintas estrategias. La muestra no probabilística estuvo formada por 58 estudiantes, con edad promedio de 13.43, (DE=1.14). Las participantes se asignaron al azar a dos distintos programas de prevención selectiva: Psicoeducación (n=28; x̅ de edad=13.46, DE=1.17) y Realidad Virtual Reforzada (n=30; x̅ de edad=13.40, DE=1.13). Los resultados muestran que no se detectaron diferencias entre los programas. Al evaluar el efecto de los dos programas por separado (prestest-postest) se obtuvieron resultados positivos y estadísticamente significativos (p < .001) en variables asociadas con imagen corporal y conductas alimentarias de riesgo. Además se observó una disminución importante en el porcentaje de participantes que se ubicaban en riesgo (significancia clínica) como producto de los programas. Estos hallazgos son alentadores debido a la importancia implicada en la disminución de factores de riesgo y el efecto que tiene en la salud de las adolescentes.

The prevention of eating disorders is considered, mainly by psychologists of health, a priority task to cover. In accord to this idea it was decided to analyze and evaluate the effectiveness of two intervention programs based in different strategies. The nonrandom sample consisted of n=58 students with a mean age of x̅ =13.43 (SD=1.14), which were randomly assigned to two different selective prevention programs: Psychoeducation (n = 28; age of x̅ =13.46, SD=1.17) and Virtual reality Reinforced (n=30; age of x̅ =13.40, SD=1.13). The results showed no differences between programs. However, when each was evaluated (pretest / postest) results were positive and statistically significant (p < .001) in those variables associated with body image and disordered eating. In addition there was a significant decrease in the percentage of participants who were placed at risk (clinical significance) as a result of the preventive programs. These findings are encouraging because of the importance involved in reducing risk factors and the effect it has on the health of adolescents.

Conductas alimentarias de riesgo y habilidades sociales en una muestra de adolescentes mexicanas / Risk eating behaviors and social skills in a sample of Mexican adolescents

Research about ED (eating disorder) has shown important advances in the last decades. We have distinguished two main ways of aproaching this topic. On the one hand there are several works in the clinical field, focused in studying the symptomatology, psychiatric taxonomy and treatment of those disorders. On the other hand, there is significant research on the epidemiological field, which is more focused towards the understanding of the phenomenon. In fact, this second approach led to the development of the preventive approach in the late 90s. This approach focuses in the population at risk and this work is framed in the preventive approach. The difference between a TCA and a risk factor is that the first one forms a syndrome, a set of symptoms (quantitatively and qualitatively) grouped as diagnostic criteria identified in the DSM-IV-TR. On the other hand, risk factors are those isolated manifestations or symptoms that appear with a lesser magnitude and frequency. For example, abnormal eating behavior like following a diet to control weight or excessive concern about personal body weight. One of the most important factors that occurs before the development of an ED is following a restricted diet. Hence, the risk for people on a diet of turning into clinical cases increases eight times. Moreover, such behavior has become a normative practice, specifically in Western societies. Thus, several authors have pointed out that patients show autonomy problems previous to the disorder. Examples include interpersonal problems such as introversion, insecurity, dependency, social anxiety, lack of assertiveness, difficulty to establish relationships with the opposite gender, inefficiency feelings, failure and lack of control in the academic, working and social fields. All these are indicators of a latent discrepancy of social skills. Considering that restricted dieting represents a fundamental risk factor on the development of an ED, and under the assumption that the deficit in social skills is a predisposing factor in such disorders, the aim of this work was to determine if there is a relation between various social skills and abnormal eating behaviors (following a restricted diet or concern about weight and food) in Mexican adolescent women. We worked with a sample of N = 700 women, coming from five different public middle schools mixed with or = 12.81 years old and SD = 0.73. The data was collected through two instruments: Health and Nourishing Questionnaire, and Pluridimensional Assertive Behavior Scale, adapted to the Mexican population. Among the more relevant results we found a significant correlation between the following two variables: social skills and eating behaviors (dieting r = 0.148, p<0.01 and concern about weight and food r = 0.081, p< 0.05). Although the correlation was low, it can be interpreted as a tendency in the following way: <>. In a second analysis, in which extreme groups (high and low social skills) were compared, our results confirmed the theory about relating these two variables. The mean values indicate that in the first group (low social skills) restricted dieting was a greater problem [t (306) = -1.329, p= .002] than in the second group (high social skills). Other results showed that more than half of the participants (56%) have followed a restricted dieting in the past and 65% of them are concerned about their body weight. Additionally, a significant correlation between these two variables was found (r = 0.677, p<0.01), confirming that these behaviors have become normative among women at this age and these constitute a latent risk to the development of ED. Furthermore, it is a cause of concern that the findings of this study show that girls are involved in restricted dieting even at an early age (seven years old) and that at six years old they begin to be concerned about their body weight. These results are similar to other studies that show women starting practices that might produce eating disorders at very early stages nowadays, due to being more exposed and more vulnerable to social pressure that promotes the thinness culture. One of the most interesting contributions was the fact that among Mexican adolescent women, similarly to women in the western world (USA, France or Spain), we have found a relation between low levels in social skills and restricted dieting. This phenomenon increases the risk of suffering from an ED, and shows the effects of social pressure referring to the thinness culture in countries such as Mexico, with its still developing society. It is important to point out that, in order to make the relation clear, it is necessary to accomplish more research towards determining a causal relationship between the two variables. In this way, data can be obtained in order to build up prevention strategies in the following way: training in Social Skills (TSS) could act as a protection factor against the development of these disorders. If a deficit in social skills can predict weight control dieting, the TSS might decrease or eliminate the risk in adolescents frequently subdued to dieting and/or show risky eating behavior as a consequence of social pressure towards thinness. Among the limitations of this study we can mention that the results cannot be generalized from the particular study sample. For this purpose we propose working with probabilistic samples and with different features, as well as implementing a new analysis that could show the specific social skills in which the problem is accentuated. This would contribute to search the possible causal link between the variables <> and <>.

En las investigaciones relacionadas con los trastornos de la conducta alimentaria (TCA) se distinguen dos vertientes principales. Por una parte proliferan los trabajos en el ámbito clínico, éstos se enfocan en la sintomatología, en esclarecer la taxonomía psiquiátrica y en el tratamiento de dichos trastornos. Por otra parte, se constata la investigación en el ámbito epidemiológico, la cual está más enfocada en la comprensión del fenómeno. De esta segunda vertiente se deriva, a principios de la década de los noventa, el enfoque preventivo, el cual centra su interés en la población de riesgo. Es en este enfoque en el cual se enmarca el presente trabajo. La distinción entre un TCA y un factor de riesgo es que el primero conforma un síndrome, un conjunto de síntomas (cuantitativa y cualitativamente) agrupados como criterios diagnósticos señalados en el DSM-IV-TR, mientras que los factores de riesgo son aquellas manifestaciones o síntomas aislados que se presentan con menor magnitud y frecuencia. El presente trabajo tuvo como objetivo determinar si existe relación entre las variables: habilidades sociales y conductas alimentarias anómalas (seguimiento de dieta restringida y preocupación por el peso y la comida) en mujeres adolescentes mexicanas. Se trabajó con una muestra de N = 700 mujeres de cinco distintas secundarias públicas mixtas con o = 12.81 de edad y DE = 0.73. Los datos se recopilaron mediante dos instrumentos: el Cuestionario de Alimentación y Salud, y la Escala Pluridimensional de Conducta Asertiva adaptada a población mexicana. Entre los resultados de mayor relevancia se encontró una correlación significativa entre las variables: habilidades sociales y conductas alimentarias anómalas (dieta r = 0.148, p< 0.01 y preocupación por el peso y la comida r = 0.081, p< 0.05). Aunque la correlación fue baja resultó ser positiva, esto se puede interpretar como una tendencia en la siguiente dirección: <>. En un segundo análisis en el cual se compararon grupos extremos (nivel alto y nivel bajo de habilidades sociales), se encontraron resultados que confirman la relación entre estas variables. El valor de las medias indica que en el grupo con nivel bajo de habilidades sociales se reportó una mayor problemática durante el seguimiento de una dieta restringida [t (306) = -1 .329, p = .002], comparado con el grupo de nivel alto de habilidades. Una de las aportaciones más interesantes fue el hecho de que entre las adolescentes mexicanas, a semejanza de mujeres que habitan en países de primer mundo como EU, Francia y España, se encontró una relación entre niveles bajos de habilidades sociales y el seguimiento de una dieta restringida. Este fenómeno incrementa el riesgo de padecer un TCA y pone de manifiesto el efecto de la presión social con referencia a la cultura de la delgadez en países como México, que es una sociedad en vías de desarrollo.