Risk Factors for Adopting Extreme Weight-Control Behaviors among Public School Adolescents in Salvador, Brazil: A Case-Control Study.

OBJECTIVE: This study identifies the risk factors for extreme weight-control behaviors among adolescents in public school in Salvador, northeastern Brazil. METHODS: A case-control study nested to a cross-sectional study, including 252 adolescents of both sexes, age between 11 to 17 years, with 84 cases and 168 age-matched controls was conducted. The variable outcome is represented by extreme weight-control behaviors, integrated by following the variables: self-induced vomiting and the use of laxatives, diuretics, or diet pills. Covariables included body image dissatisfaction, dieting, prolonged fasting, and self-perception of body weight. The study also investigated the demographic and anthropometric variables and economic conditions of the students' families. Conditional logistic regression was used to identify risk factors for the adoption of extreme weight-control behaviors among adolescents. RESULTS: Among the adolescents investigated, the conditional logistic regression explained 22% the occurrence of extreme weight-control behaviors and showed that these behaviors were positively associated to overweight (odds ratio [OR] = 3.61; 95% confidence interval [CI], 1.42-9.17), body image dissatisfaction (OR = 3.87; 95% CI, 1.75-8.54), and the adoption of a restrictive diet (OR = 2.83; 95% CI, 1.16-6.91). CONCLUSIONS: The results of this study suggest that among adolescents, overweight, body image dissatisfaction, and restrictive diet are important risk factors to adoption of extreme weight-control behaviors.

The acceptability of ending a patient's life: a France-Portugal-Spain comparison.

The views of French, Portuguese, and Spanish people on end-of-life decisions were compared. Two hundred seventy-seven adults from Barcelona, Oporto, and Toulouse judged the acceptability of life-ending procedures in 42 scenarios composed of all combinations of 3 factors: the patient's age (30 or 80 years), the patient's life expectancy (days, weeks, or months), and the type of procedure (suicide, suicide assisted by the physician, euthanasia by the physician at the request of a suffering patient, euthanasia of a comatose patient at the family's request, euthanasia of a comatose patient as stipulated in the patient's advance directives, euthanasia of a comatose patient without advance directions and without a request from the family, or euthanasia of a suffering patient without a request from the patient). In all 3 countries, the type of procedure had the major effect. The 4 procedures implemented by the patient or at the patient's request were, on average, considered acceptable. The 2 procedures not implemented at the patient's request were considered unacceptable. Euthanasia of a comatose patient at the request of the family was judged mildly acceptable. The attitudes of the people in Toulouse, Oporto, and Barcelona concerning the acceptability of ending a patient's life have now largely converged, although Spanish participants were statistically significantly more accepting than French and Portuguese participants.

Validación del Eating Attitudes Test como instrumento de cribado de trastornos de la conducta alimentaria en población general / Validation of the Eating Attitudes Test as a screening instrument for eating disorders in general population

Fundamento y objetivo: Validar un punto de corte del Eating Attitudes Test (EAT-40), versión española, para el cribado de trastornos de la conducta alimentaria (TCA) en población general. Material y método: Estudio observacional transversal. Se administró la versión española del EAT-40 a una muestra representativa de 1.543 estudiantes de ambos sexos (entre 12-21 años) escolarizados en la Comunidad Autónoma de Madrid. Se entrevistó a 602 participantes (probables casos y muestra aleatoria de probables controles). Resultados: El punto de corte de 21 obtuvo la mejor predicción diagnóstica, con una sensibilidad del 88,2%, una especificidad del 62,1%, un valor predictivo positivo del 17,7% y un valor predictivo negativo del 62,1%. Conclusiones: El EAT-40, utilizando un punto de corte de 21, es un instrumento de cribado adecuado de casos de TCA en población española (AU)

Background and objective: To validate the best cut-off point of the Eating Attitudes Test (EAT-40), Spanish version, for the screening of eating disorders (ED) in the general population. Material and method: This was a transversal cross-sectional study. The EAT-40 Spanish version was administered to a representative sample of 1.543 students, age range 12 to 21 years, in the Region of Madrid. Six hundred and two participants (probable cases and a random sample of controls) were interviewed. Results: The best diagnostic prediction was obtained with a cut-off point of 21, with sensitivity: 88.2%; specificity: 62.1%; positive predictive value: 17.7%; negative predictive value: 62.1%. Conclusions: Use of a cut-off point of 21 is recommended in epidemiological studies of eating disorders in the Spanish general population (AU)

[Validation of the Eating Attitudes Test as a screening instrument for eating disorders in general population]. / Validación del Eating Attitudes Test como instrumento de cribado de trastornos de la conducta alimentaria en población general.

BACKGROUND AND OBJECTIVE: To validate the best cut-off point of the Eating Attitudes Test (EAT-40), Spanish version, for the screening of eating disorders (ED) in the general population. MATERIAL AND METHOD: This was a transversal cross-sectional study. The EAT-40 Spanish version was administered to a representative sample of 1.543 students, age range 12 to 21 years, in the Region of Madrid. Six hundred and two participants (probable cases and a random sample of controls) were interviewed. RESULTS: The best diagnostic prediction was obtained with a cut-off point of 21, with sensitivity: 88.2%; specificity: 62.1%; positive predictive value: 17.7%; negative predictive value: 62.1%. CONCLUSIONS: Use of a cut-off point of 21 is recommended in epidemiological studies of eating disorders in the Spanish general population.

Norms for the Spanish version of the Eating Disorders Examination Questionnaire (S-EDE-Q) / Datos normativos de la versión española del Eating Disorders Examination Questionnaire (S-EDE-Q)

Background: This study presents normative data on the Spanish Version of the Eating Disorders Examination Questionnaire (S-EDE-Q) for adolescents and young adults in Spain. Method: A sample of 1,543 men and women, aged 12 - 21 years, completed the S-EDE-Q as part of a larger assessment battery. Results: Means, standard deviations, clinical signifi cance and percentile ranks for the raw Restraint, Eating Concern, Shape Concern, and Weight Concern subscales and the Global Score by age group and gender are presented. Data on any and regular occurrences of dieting, bingeing and compensatory behaviors by age group and gender are reported. Compared with men, women scored higher on all the subscales and reported more key eating disorders (ED) and compensatory behavior. Compared with adolescents, young adults scored higher on the Restraint and Shape Concern subscales and reported more dietary restraint (DR), objective binge episodes (OBE) and diuretic misuse (DIUR). Conclusions: These results can help researchers and clinicians interpret the S-EDE-Q scores of adolescents and young adults in Spanish-speaking countries (AU)

Antecedentes: este estudio presenta datos normativos de la versión española del Eating Disorders Examination Questionnaire (S-EDE-Q) para adolescentes y adultos jóvenes de ambos géneros en España. Método: una muestra de 1.543 varones y mujeres de 12 a 21 años completaron el S-EDE-Q. Resultados: se presentan medias, desviaciones típicas, significación clínica y percentiles para las cuatro escalas y para la puntuación global por grupos de edad y género. Se aportan datos de ocurrencia de dieta, sobreingesta y conductas compensatorias por grupos de edad y género. Las mujeres obtuvieron puntuaciones más altas en todas las subescalas e informaron de más sintomatología específica de trastornos alimentarios que los varones. Los adultos obtuvieron puntuaciones más altas en las subescalas Restricción alimentaria y Preocupación por la figura e informaron de más restricción, episodios de sobreingesta y abuso de diuréticos que los adolescentes. Conclusiones: estos resultados pueden ser de utilidad para la interpretación de puntuaciones del S-EDE-Q de varones y mujeres adolescentes y jóvenes en países de habla hispana (AU)

Validation of eating disorder examination questionnaire (EDE-Q)--Spanish version--for screening eating disorders.

This research examines the internal consistency, convergent validity, and sensitivity, specificity, and positive and negative predictive value of the Spanish version of the Eating Disorder Examination-Self-Report Questionnaire (S-EDE-Q), as a screening questionnaire for eating disorders (ED) in a community sample. Participants were 1543 male and female Spanish-speaking students (age range: 12-21 years), who volunteered to complete the S-EDE-Q and the EAT-40. The Spanish version of the Eating Disorders Examination (S-EDE) interview, 12th edition, was administered to 602 of the students. Acceptable internal consistency for the four subscales of the S-EDE-Q was obtained (alpha > or = .74). Corrected point-biserial correlation performed with the 22 items included in the S-EDE-Q subscales showed acceptable values for all the items. The EAT-40 Dieting subscale correlated highly and positively with the four S-EDE-Q subscales (r > or = .70). Acceptable results in sensitivity, specificity, and positive and negative predictive value when compared with the EDE were found. Correlation between S-EDE and S-EDE-Q diagnoses was positive and significant. Overall, results support the psychometric adequacy of the S-EDE-Q as a screening questionnaire for ED in community samples.

Validation of eating disorder examination questionnaire (EDE-Q) -Spanish version- for screening eating disorders

This research examines the internal consistency, convergent validity, and sensitivity, specificity, and positive and negative predictive value of the Spanish version of the Eating Disorder Examination-Self- Report Questionnaire (S-EDE-Q), as a screening questionnaire for eating disorders (ED) in a community sample. Participants were 1543 male and female Spanish-speaking students (age range: 12-21 years), who volunteered to complete the S-EDE-Q and the EAT-40. The Spanish version of the Eating Disorders Examination (S-EDE) interview, 12th edition, was administered to 602 of the students. Acceptable internal consistency for the four subscales of the S-EDE-Q was obtained (α ≥ .74). Corrected pointbiserial correlation performed with the 22 items included in the S-EDE-Q subscales showed acceptable values for all the items. The EAT-40 Dieting subscale correlated highly and positively with the four SEDE- Q subscales (r ≥ .70). Acceptable results in sensitivity, specificity, and positive and negative predictive value when compared with the EDE were found. Correlation between S-EDE and S-EDEQ diagnoses was positive and significant. Overall, results support the psychometric adequacy of the SEDE- Q as a screening questionnaire for ED in community samples (AU)

Este estudio examina la consistencia interna, validez convergente, y la sensibilidad, especificidad y valor predictivo positivo y negativo de la versión española del Eating Disorder Examination-Self-Report Questionnaire (EDE-Q), como cuestionario de screening de los trastornos de la conducta alimentaria (TCA) en una muestra comunitaria. Un total de 1543 estudiantes hispano-hablantes de 12 a 21 años de ambos géneros completaron la versión española del EDE-Q y el cuestionario EAT-40. La versión española de la edición 12 de la entrevista Eating Disorders Examination (EDE) fue administrada a 602 estudiantes. Se obtuvo aceptable consistencia interna para las cuatro subescalas de la versión española del EDEQ (α ≥ .74). Correlación biserial puntual corregida realizada con los 22 ítems incluidos en las subescalas de la versión española del EDE-Q mostró valores aceptables para todos los ítems. La subescala Dieta del EAT-40 correlacionó positiva y significativamente con las cuatro subescalas de la versión española del EDE-Q (r ≥ .70). Resultados aceptables en sensibilidad, especificidad y valor predictivo positivo y negativo fueron hallados en comparación con la entrevista EDE. La correlación entre los diagnósticos obtenidos por las versiones españolas de la EDE y del EDE-Q fue positiva and significativa. Los resultados demuestran la adecuidad de la versión española del EDE-Q como cuestionario de screening de TCA en muestras comunitarias (AU)

Comparison of single- and double-stage designs in the prevalence estimation of eating disorders in community samples.

The aim of this research was to compare two different case-identification designs: (a) a one-stage anonymous design using the Eating Disorders Examination-Questionnaire (EDE-Q; Fairburn & Beglin, 1994) as diagnostic instrument and (b) a two-stage-non-anonymous design using the Eating Attitudes Test (EAT; Garner & Garfinkel, 1979) and the EDE-Q as screening instruments and the clinical interview Eating Disorders Examination (EDE; Fairbumrn & Cooper, 1993) as diagnostic instrument, in the estimation of eating disorders prevalence in community samples. Both epidemiological designs were compared in: eating disorders prevalence, population at risk, and weekly frequency of associated symptomatology (binge eating episodes, self-vomiting) within a sample of 559 scholars (14 to 18 year-old males and females) studying in the region of Madrid. Eating disorders prevalence estimation using single-stage design was 6.2%, and 3% using the two-stage design; however, these differences were not significant (p = .067). No significant differences between the two procedures were found either in population at risk or in weekly frequency of reported self-vomiting. Reported binge eating episodes were higher in the one-stage design. The use of a two-stage procedure with clinical interview (vs. questionnaire) leads to a better understanding of the items (specially the most ambiguous ones) and thus, to a more accurate prevalence estimation.

Comparison of Single- and Double-Stage Designs in the Prevalence Estimation of Eating Disorders in Community Samples

The aim of this research was to compare two different case-identification designs: (a) a one-stage anonymous design using the Eating Disorders Examination-Questionnaire (EDE-Q; Fairburn & Beglin, 1994) as diagnostic instrument and (b) a two-stage-non-anonymous design using the Eating Attitudes Test (EAT; Garner & Garfinkel, 1979) and the EDE-Q as screening instruments and the clinical interview Eating Disorders Examination (EDE; Fairburn & Cooper, 1993) as diagnostic instrument, in the estimation of eating disorders prevalence in community samples. Both epidemiological designs were compared in: eating disorders prevalence, population at risk, and weekly frequency of associated symptomatology (binge eating episodes, self-vomiting) within a sample of 559 scholars (14 to 18 year-old males and females) studying in the region of Madrid. Eating disorders prevalence estimation using single-stage design was 6.2%, and 3% using the two-stage design; however, these differences were not significant (p = .067). No significant differences between the two procedures were found either in population at risk or in weekly frequency of reported self-vomiting. Reported binge eating episodes were higher in the one-stage design. The use of a two-stage procedure with clinical interview (vs. questionnaire) leads toa better understanding of the items (specially the most ambiguous ones) and thus, to a more accurate prevalence estimation (AU)

El objetivo era comparar la adecuación de dos protocolos en la estimación de prevalencia de trastornos de la conducta alimentaria (TCA): Protocolo de una fase, anónimo, usando como instrumento diagnóstico «Eating Disorders Examination-Questionnaire» (EDE-Q; Fairburn & Beglin, 1994); y Protocolo de doble fase, no anónimo, usando como instrumentos de «cribado» el «Eating Attitudes Test» (EAT; Garner & Garfinkel, 1979) y el EDE-Q; y como instrumento diagnóstico el «Eating Disorders Examination» (EDE; Fairburn & Cooper, 1993). Ambos protocolos fueron comparados en estimación de prevalencia de TCA, población en riesgo y frecuencia semanal de sintomatología asociada (episodios de sobreingesta y vómitos autoinducidos), en 559 adolescentes (ambos sexos) 14 - 18 años escolarizados en la Comunidad de Madrid. La estimación de prevalencia TCA con el protocolo de una fase fue 6,2%; y con el protocolo de dos fases, 3%, aunque las diferencias no fueron significativas (p = 0,067). No hubo diferencias significativas en cuanto a población en riesgo ni en frecuencia semanal de vómitos autoinducidos obtenida por ambos protocolos. La frecuencia semanal de atracones fue superior en el grupo de una fase. El protocolo de dos fases permite una mejor comprensión de los ítems y, por tanto, es más aconsejable para una estimación más precisa de la prevalencia de TCA (AU)

Prevalence of eating disorders among adolescent and young adult scholastic population in the region of Madrid (Spain).

OBJECTIVE: The prevalence of eating disorders (EDs) in a representative scholastic sample was evaluated, and the demographic factors associated with ED were assessed. METHOD: The study used a two-stage epidemiological design. The study population was a randomly selected sample of 1545 students (12- to 21-year-old males and females) in the region of Madrid (Spain). RESULTS: ED prevalence was 3.43%. Prevalence estimations were as follows: 5.34% for females: 2.72% for eating disorders not otherwise specified (EDNOS), 2.29% for bulimia nervosa (BN), and 0.33% for anorexia nervosa (AN); and 0.64% for males: 0.48% for EDNOS, 0.16% for BN, and 0.00% for AN. Some demographic factors that were shown to be associated with ED included the following: sex, age, single child, single-parent families, and father or mother's death. DISCUSSION: Despite the methodological improvements over previous epidemiological studies developed in Spain, there were no significant differences in the prevalence estimations.

Evaluación de Insatisfacción Corporal en adolescentes: efecto de la forma de administración de una escala / Assessment of Body Dissatisfaction in adolescents: effect of the way of administration a scale

El objetivo de este trabajo es averiguar si la forma de administrar una subescala de evaluación de Insatisfacción Corporal (IC), procedente de un cuestionario más amplio, afecta a la tendencia de respuesta.En la investigación participaron 147 adolescentes estudiantes de secundaria de entre 14 y 17 años y de ambos sexos, los cuales fueron asignados a tres condiciones de investigación. Al primer grupo se le administró sola la subescala de IC del Eating Disorders Inventory (EDI-2), al segundo grupo se le administró la subescala IC del EDI dentro de todo el cuestionario EDI-2, y al tercer grupo se les suministró la misma subescala mezclada con otro cuestionario, el Eating Atittudes Test (EAT-40).Los resultados muestran que no existen diferencias significativas en las puntuciones obtenidas en IC, en las tres formas diferentes de administración de la misma escala. Las chicas obtienen mayores valores de IC que los chicos. La confirmación de estos resultados en otras edades y muestras más amplias, permitirá que en la investigación de IC a través de una escala tan difundida como la del EDI, pueda hacerse sin administrar todo el EDI completo (AU)