[Validation of the Eating Attitudes Test (EAT) as a screening tool in the general population]. / Validación del cuestionario Eating Attitudes Test (EAT) como prueba de cribado de trastornos de la conducta alimentaria en la población general.

BACKGROUND AND OBJECTIVE: To validate the best alternative cut-off point of a Spanish version of the Eating Attitudes Test (EAT-40) for the screening of eating disorders cases in the general population. SUBJECTS AND METHOD: The translated questionnaire was administered to a representative sample of 2,734 female students who ranged in age from 13 to 22 years. Participants who scored above 21 points were interviewed, as were a random sample of participants who scored 21 or below. Internal and external validity parameters were estimated for different alternative cut-off scores below the usual EAT score of 30. RESULTS: The best diagnostic prediction was obtained with a cut-off score of 21 points (sensitivity: 73.3%; specificity: 85.1%). A positive predictive value of 20% and a negative predictive value of 98.4% were obtained. CONCLUSIONS: The best diagnostic prediction in a non-clinical setting is obtained with a cut-off score of 21, below that recommended by the authors of the questionnaire.

[Efficacy of interventions aimed at the main carers of dependent individuals aged more than 65 years old. A systematic review]. / Eficacia de las intervenciones dirigidas a cuidadores principales de personas dependientes mayores de 65 años. Una revisión sistemática.

BACKGROUND: In our environment, care of the dependent elderly is usually provided by family members, thereby ensuring autonomy and avoiding institutionalization of the dependent adult. Thirty-three percent of Spanish caregivers have acknowledged the importance of acquiring the knowledge and skills necessary for daily care. Consequently, several interventions have been developed by health professionals from distinct disciplines. OBJECTIVE: The purpose of this study was to systematically review and evaluate the efficacy of published interventions for the caregivers of dependent elderly individuals. MATERIAL AND METHODS: We conducted a systematic review of the literature on interventions in the caregivers of the dependent elderly (older than 65 years old) published between 1996 and 2006. The inclusion criteria included controlled clinical trials with outcome measures related to effectiveness in reducing caregiver burden, anxiety and depression. Our search yielded 15 reports. RESULTS: The interventions produced statistically significant reductions in burden (40%), anxiety (50%) and depression (90%). Interventions requiring active participation by caregivers and those based on cognitive-behavioral therapy were more effective than those focused on knowledge acquisition. CONCLUSION: Due to the heterogeneity of caregiving interventions, evaluation of both the clinical and statistical significance of these interventions is essential. Reducing the chronic stress experienced by caregivers is difficult to achieve. Consequently, future experimental designs should take into account the needs reported by caregivers as well as promote active participation.

Incidence of eating disorders in Navarra (Spain).

PURPOSE: To estimate the overall annual incidence and age group distribution of eating disorders in a representative sample of adolescent female residents of Navarra, Spain. METHODS: We studied a representative sample of 2734 adolescent Navarran females between 13 and 22 years of age who were free of any eating disorder at the start of our study. Eighteen months into the study, we visited the established centers and the eating attitudes test (EAT-40) and eating disorder inventory (EDI) Questionnaires were administered to the entire study population. We obtained a final response of 92%. All adolescents whose EAT score was over 21 points and a randomized sample of those who scored 21 or below, were interviewed. Any person meeting the DSM-IV diagnostic criteria for Anorexia Nervosa (AN), Bulimia Nervosa (BN) or eating disorder not otherwise specified (EDNOS) was considered a case. RESULTS: We detected 90 new cases of eating disorders. Taking into consideration the randomly selected group whose EAT score was 21 points or below, we estimated the overall weighted incidence of eating disorders to be 4.8% (95% CI: 2.8-6.8), after 18 months of observation, in which EDNOS predominated with an incidence of 4.2% (95% CI: 2.0-6.3). The incidence of AN was 0.3% (95% CI: 0.2-0.5), while that of BN was also found to be 0.3% (95% CI: 0.2-0.5). The highest incidence was observed in the group of adolescents between 15 and 16 years of age. CONCLUSIONS: The overall incidence of ED in a cohort of 2509 adolescents after 18 months of follow-up was 4.8% (95% CI: 2.8-6.8), with EDNOS outweighing the other diagnoses. The majority of new cases of eating disorders were diagnosed between ages 15 and 16.

Exploring the dimensionality and the psychometric properties of the TRIM-18 in the Spanish context / Exploración de la dimensionalidad y de las propiedades psicométricas del TRIM-18 en contexto Español

Introduction: The Transgression-Related Interpersonal Motivations Inventory (TRIM-18) is an instrument that assesses episodic forgiveness composed of three subscales: avoidance, revenge and benevolence. In the present study we examined the dimensionality of the Spanish version of the TRIM-18 (TRIM-18-S). We provided evidences of estimated reliability and construct validity of the interpretation of the scores. Method: A total of 943 participants completed the TRIM-18-S. A subset of 94 participants completed the measure again to allow computation of two-week estimated temporal stability, and 277 participants completed additional measures of empathy, anger, and information regarding the relation with the offender to allow computations supporting construct validity. Results: The TRIM-18-S showed good psychometric properties. Confirmatory factor analysis revealed a three-factor structure. Alphas ranged from .80 to .90. Two week estimated test-retest correlations ranged from .74 to .84. Construct validity was supported by correlations with a single-item measuring forgiveness and with empathy, state anger, and closeness and type of relationship. Conclusions: The scale presents adequate psychometric properties for its potential use in Spanish population (AU)

Introducción: La escala Transgression-Related Interpersonal Motivations (TRIM-18) es un instrumento diseñado para evaluar perdón específico compuesto por tres subescalas: evitación, venganza y benevolencia. En el presente estudio se examina la dimensionalidad de la versión española del TRIM-18 (TRIM-18-S). Se presentan evidencias de fiabilidad y de validez de constructo de la interpretación de las puntuaciones. Método: Un total de 943 sujetos completaron el TRIM-18-S. Una submuestra de 94 participantes completaron la escala otra vez dos semanas después para el cálculo de la estabilidad temporal, y 277 participantes completaron medidas adicionales de empatía, ira e información relacionada con el tipo de ofensor para el cálculo de la validez de constructo. Resultados: El TRIM-18-S mostró buenas propiedades psicométricas. El análisis factorial confirmatorio reveló una estructura tridimensional. Los valores del alfa de Cronbach variaron entre .80 y .90. Los valores obtenidos para la fiabilidad test-retest variaron entre.74 y .84. Se hallaron evidencias de validez de constructo a partir de las correlaciones con el ítem único de medida de perdón y con empatía, ira, cercanía con el ofensor y tipo de relación. Conclusiones: La escala presenta propiedades psicométricas adecuadas para su uso en población español (AU)

Validación del cuestionario Eating Attitudes Test (EAT) como prueba de cribado de trastornos de la conducta alimentaria en la población general / Validation of the Eating Attitudes Test (EAT) as a screening tool in the general population

Fundamento y objetivo: Validar un punto de corte alternativo de la versión española del Eating Attitudes Test (EAT-40) para el cribado de casos de trastornos de la conducta alimentaria en la población general. Sujetos y método: Se administró el cuestionario traducido a una muestra representativa de 2.734 mujeres estudiantes de entre 13 y 22 años de edad. Se entrevistó a las participantes cuya puntuación en el cuestionario fue superior a 21 y a una muestra aleatoria del resto. Se estimaron los parámetros de validez interna y externa obtenidos con puntos de corte distintos de 30, que es el utilizado habitualmente en el EAT. Resultados: La mejor predicción diagnóstica se obtuvo con 21 puntos (sensibilidad del 73,3% y especificidad del 85,1%). El valor predictivo positivo fue del 20% y el valor predictivo negativo, del 98,4%. Conclusiones: La mejor predicción diagnóstica del EAT-40 en un entorno no clínico se obtiene con un punto de corte de 21 puntos, algo inferior al recomendado por los autores del cuestionario (AU)

Background and objective: To validate the best alternative cut-off point of a Spanish version of the Eating Attitudes Test (EAT-40) for the screening of eating disorders cases in the general population. Subjects and method: The translated questionnaire was administered to a representative sample of 2,734 female students who ranged in age from 13 to 22 years. Participants who scored above 21 points were interviewed, as were a random sample of participants who scored 21 or below. Internal and external validity parameters were estimated for different alternative cut-off scores below the usual EAT score of 30. Results: The best diagnostic prediction was obtained with a cut-off score of 21 points (sensitivity: 73.3%; specificity: 85.1%). A positive predictive value of 20% and a negative predictive value of 98.4% were obtained. Conclusions: The best diagnostic prediction in a non-clinical setting is obtained with a cut-off score of 21, below that recommended by the authors of the questionnaire (AU)

Eficacia de las intervenciones dirigidas a cuidadores principales de personas dependientes mayores de 65 años. Una revisión sistemática / Efficacy of interventions aimed at the main carers of dependent individuals aged more than 65 years old. A systematic review

Introducción: el cuidado de un anciano dependiente en nuestroentorno social es asumido por los miembros de su familia o cuidadoresprincipales (CP); ellos son los responsables de mantenerla autonomía del anciano y de su permanencia en el entorno familiar.El 33% de los CP españoles manifiestan la importancia deadquirir conocimientos y habilidades para el cuidado, por lo queprofesionales de la salud de distintas disciplinas han diseñadodiferentes programas de intervención.Objetivo: el propósito de este estudio fue realizar una revisiónsistemática sobre la eficacia de las intervenciones dirigidas a CPde ancianos dependientes.Material y métodos: se realizó una revisión sistemática de la literaturacientífica publicada sobre intervenciones dirigidas a CPde personas mayores de 65 años dependientes, realizadas de1996 a 2006. Los criterios de inclusión fueron: artículos primarioscon selección aleatoria grupo experimental/grupo control y queanalizaran la eficacia de la intervención sobre la sobrecarga, laansiedad o la depresión. La muestra final la compusieron 15 estudiosque cumplían los criterios de inclusión.Resultados: las intervenciones mostraron resultados estadísticamentesignificativos sobre la sobrecarga (40%), la ansiedad(50%) y la depresión (90%).Las intervenciones con participación activa de los CP y basadasen terapia cognitivo conductual fueron más eficaces que aquellascuyo contenido se centró exclusivamente en la adquisiciónde conocimientos.Conclusiones: la heterogeneidad de las intervenciones hacenimprescindible, en esta área de estudio, valorar la relevancia clínicade los resultados además de la significación estadística. Dadoque los efectos del cuidado son estresores crónicos difícilmentemodificables, en futuros estudios se debería planteardiseños experimentales, sin olvidar las necesidades expresadaspor los propios CP y promoviendo su participación activa(AU)

Background: in our environment, care of the dependent elderlyis usually provided by family members, thereby ensuring autonomyand avoiding institutionalization of the dependent adult.Thirty-three percent of Spanish caregivers have acknowledgedthe importance of acquiring the knowledge and skills necessaryfor daily care. Consequently, several interventions have been developedby health professionals from distinct disciplines.Objective: the purpose of this study was to systematically reviewand evaluate the efficacy of published interventions for the caregiversof dependent elderly individuals.Material and methods: we conducted a systematic review of theliterature on interventions in the caregivers of the dependent elderly(older than 65 years old) published between 1996 and 2006.The inclusion criteria included controlled clinical trials with outcomemeasures related to effectiveness in reducing caregiverburden, anxiety and depression. Our search yielded 15 reports.Results: the interventions produced statistically significant reductionsin burden (40%), anxiety (50%) and depression (90%).Interventions requiring active participation by caregivers andthose based on cognitive-behavioral therapy were more effectivethan those focused on knowledge acquisition. Conclusion: due to the heterogeneity of caregiving interventions,evaluation of both the clinical and statistical significance of theseinterventions is essential. Reducing the chronic stress experiencedby caregivers is difficult to achieve. Consequently, future experimentaldesigns should take into account the needs reportedby caregivers as well as promote active participation(AU)

Sentido del cuidado y sobrecarga / Finding meaning of caregiving and overload

Introducción: los cuidadores de enfermos de Alzheimer muestran altos grados de sobrecarga y, a menudo, también síntomas de ansiedad y/o depresión. Objetivo: estudiar la relación existente entre la variable sentido del cuidado y el grado de sobrecarga y la presencia de morbilidad psiquiátrica (ansiedad y depresión) en familiares que tienen a su cargo el cuidado prolongado de un enfermo de Alzheimer. Material y métodos: los sujetos de este estudio fueron 80 cuidadores familiares de enfermos de Alzheimer. Además de recoger las características sociodemográficas de estos cuidadores, se emplearon los siguientes instrumentos: la Escala de Sentido del Cuidado, versión castellana de la Finding Meaning Through Caregiving Scale, la Escala de Sobrecarga del Cuidador y, para estudiar la morbilidad psiquiátrica, el Cuestionario de Salud General. Resultados y conclusiones: se obtuvo una relación inversamente significativa entre la puntuación de sentido total del cuidado y las puntuaciones de sobrecarga (p < 0,01), ansiedad (p < 0,05) y depresión (p < 0,05) de los cuidadores. Es decir, en la medida en que los cuidadores refirieron encontrar un sentido a su tarea, su grado de sobrecarga y morbilidad psiquiátrica se redujo de manera significativa. Por tanto, es importante tener en cuenta la variable sentido en futuras evaluaciones e intervenciones con estos cuidadores (AU)

Introduction: caregivers of Alzheimer patients show high levels of burden and, frequently, symptoms of anxiety and/or depression. Objective: to analyze the relationship between finding meaning in caregiving and the degree of burden and the presence of psychiatric morbidity (anxiety and depression). Material and method: the study sample was composed of 80 family caregivers of Alzheimer patients. The social-demographic data and characteristics of this group were gathered and the following instruments were used: the Spanish version of the Finding Meaning Through Caregiving Scale, The Burden Inventory Interview and, to assess the presence of psychiatric morbidity in the caregiver, the General Health Questionnaire was used. Results and conclusions: a significant inverse relationship was found between the score for total meaning of care and the scores for burden (p < 0.01), anxiety (p < 0.05) and depression (p < 0.05) among caregivers. That is, when caregivers indicated that they found meaning in caregiving, their level of additional burden and psychiatric morbidity was significantly reduced. Therefore, the variable of meaning should be taken into account in future evaluations and interventions in the caregivers of Alzheimer’s patients (AU)