Sex and Body Mass Index differences after one-year follow-up of an eating disorders risk factors universal prevention intervention in university students in Mexico City / Diferencias por sexo e índice de masa corporal a un año de seguimiento de una intervención de prevención universal para disminuir factores de riesgo para los trastornos de la conducta alimentaria en estudiantes universitarios de la Ciudad de México

Abstract Introduction Interventions based on cognitive dissonance theory are the most effective for preventing eating disorders. Objective To identify the changes at one year follow-up of a universal prevention intervention in disordered eating behaviors (DEB), thin-ideal internalization (TII), and drive for muscularity (DM). Method A pre-experimental, pretest-posttest study was conducted on 602 university student subjects (76.1% women and 23.9% men) with an average age of 20.74 years at a public (30.6%) and a private university (69.4%) in Mexico City. A Split Plot ANOVA was performed with the intrasubject variable equal to each measurement (pretest, posttest, and follow-up), as well as the sex and body mass index (BMI) intersubject variables to analyze whether there was a significant interaction between these variables and the changes in dependent variables, as well as the changes through each measurement by group. Results In the intrasubject analyses, statistically significant differences were found for DEB through the various measurements, without taking the interactions into account. Statistically significant interactions were observed between each measurement and BMI, and between each measurement and sex and BMI for the DM variable. Discussion and conclusion Since a reduction of TII in women and DM in men was achieved, together with a decrease in DEB in women, the workshop can be said to have fully achieved its objectives for women and partly so for men.

Resumen Introducción Las intervenciones basadas en la teoría de la disonancia cognoscitiva son las más efectivas para la prevención de los trastornos de la conducta alimentaria. Objetivo Conocer los cambios a un año de seguimiento de una intervención de prevención universal en las conductas alimentarias de riesgo (CAR), interiorización del ideal estético de la delgadez (IED) y la motivación por la musculatura (MM). Método Se llevó a cabo un estudio pre-experimental pretest-postest en 602 (76.1% mujeres y 23.9% hombres) sujetos estudiantes universitarios con una edad promedio de 20.74 años en una universidad pública (30.6%) y una privada (69.4%) de la Ciudad de México. Se realizó un ANOVA split plot con la variable intrasujetos igual a cada medición (pretest, postest y seguimiento) así como el sexo y el índice de masa corporal (IMC) variables intersujetos, para analizar si existía una interacción significativa entre dichas variables y los cambios sobre las variables dependientes, así como los cambios a través de cada medición por grupo. Resultados en los análisis intrasujetos se encontraron diferencias estadísticamente significativas para las CAR a través de las distintas mediciones, sin tomar en cuenta las interacciones. Se observaron interacciones estadísticamente significativas entre cada medición y el IMC, y entre cada medición con el sexo y el IMC para la variable MM. Discusión y conclusión Se logró la reducción de la IED en las mujeres y de la MM en los hombres, así como la disminución de las CAR en las mujeres por lo que se considera que el taller logra sus objetivos para las mujeres y parcialmente para los varones.

Prática e incentivo paterno a dietas podem predizer comportamentos de risco relacionados a transtornos alimentares? Uma revisão sistemática / Practicing and encouraging the use of diets by the father can predict risk behaviors for eating disorders? A systematic review

RESUMO Objetivos: Avaliar se a modelagem paterna, quanto à prática e/ou ao incentivo a dietas, pode predizer comportamentos de risco relacionados a transtornos alimentares (TAs) em crianças e adolescentes. Métodos: Foi realizada uma revisão sistemática dos estudos publicados até junho de 2022, disponíveis nas bases de dados indexadas — como PubMed, Biblioteca Virtual de Saúde, SciELO e Cochrane Library. Estudos transversais e longitudinais em línguas portuguesa, espanhola e inglesa foram incluídos e avaliados quanto ao risco de viés de acordo com a NewCastle - Ottawa Quality Assessment Scale . Resultados: Quatorze estudos foram considerados na revisão. A maioria deles é transversal (71,4%), proveniente dos Estados Unidos e de países europeus (57,1%), além de apresentar baixo risco de viés (85,7%). Grande parte dos trabalhos encontrou associações entre o incentivo a dietas por parte dos pais (modelagem direta) e comportamentos de risco em crianças e adolescentes, como o uso de métodos de controle de peso, a insatisfação corporal e a restrição alimentar. Poucos estudos relacionaram o hábito de o pai fazer dieta (modelagem indireta) com esses comportamentos. Conclusões: Os dados embasam a ideia de que a modelagem direta, ou seja, o incentivo verbal ao uso de dietas, pode ser muito danosa, principalmente em indivíduos que têm preocupações excessivas com peso e alimentação. Futuras pesquisas são necessárias para avaliar o impacto das práticas alimentares parentais e o desenvolvimento de possíveis ações de prevenção a problemas relacionados ao peso.

ABSTRACT Objectives: To assess whether parental modeling, regarding the practice and/or encouragement of diets, can predict risk behaviors related to eating disorders (EDs) in children and adolescents. Methods: A systematic review of studies published until June 2022, available in indexed databases - such as PubMed, Virtual Health Library, SciELO and Cochrane Library, was carried out. Cross-sectional and longitudinal studies in Portuguese, Spanish and English were included and assessed for risk of bias according to the NewCastle - Ottawa Quality Assessment Scale. Results: Fourteen studies were considered in the review. Most of them are cross-sectional (71.4%), coming from the United States and European countries (57.1%), in addition to presenting a low risk of bias (85.7%). Most of the studies found associations between parental encouragement of diets (direct modeling) and risk behaviors in children and adolescents, such as the use of weight control methods, body dissatisfaction and food restriction. Few studies have related the father's habit of dieting (indirect modeling) with these behaviors. Conclusions: Data support the idea that direct modeling, that is, verbal encouragement to use diets, can be very harmful, especially to individuals who are excessively concerned about weight and food. Future research is needed to assess the impact of parental eating practices and the development of possible actions to prevent weight-related problems.

Effects of disordered eating behaviors and sedentary lifestyle prevention program in male and female Mexican adolescents / Efectos de un programa de prevención de conductas alimentarias de riesgo y sedentarismo en adolescentes mexicanos, hombres y mujeres

Abstract Introduction Adolescents are the group with the highest risk of developing disordered eating behaviors (DEB). Preventing this problem is of the utmost importance due to the physical and psychological consequences. Objective To evaluate the effects of a universal prevention program for disordered eating behaviors (DEB), thin ideal internalization (TII), drive for muscularity (DM), and sedentary lifestyle among Mexican adolescents. Method A quasi-experimental study with repeated measures (pre-test, post-test, six-month, and one-year follow-up) was carried out in a non-probabilistic sample of 523 adolescents (46.7% of females) aged 15-19 years (Mage = 16.07). We worked in two private high schools, one of them was designed as control group (CG), and the other as intervention group (IG). For both, female and male adolescents', data were collected using the Brief Questionnaire for Disordered Eating Behaviors (BQDEB) and the short form of the International Physical Activity Questionnaire (IPAQ). To evaluate TII the Attitudes toward Body Figure Questionnaire was applied in females, while in males Drive for Muscularity Scale (DMS) was used. Results After one-year, repeated measures analyses of variance (ANOVAs) revealed a significant reduction of the mean DEBs scores both in female (p = .01) and male (p = .03) adolescents of the IG with respect to CG. In IG, females decreased significantly the mean TII score as well as the mean DM score in males. Physical Activity increased in IG females from pre-test to posttest; however, the effect was not maintained over time. Discussion and conclusion These findings have important implications for future interventions with Mexican adolescents. We must take sex differences into account to choose activities and strategies that will enhance the effects of the program.

Resumen Introducción Los adolescentes constituyen el grupo con mayor riesgo de desarrollar conductas alimentarias de riesgo (CAR). Prevenirlas es de suma importancia debido a las consecuencias físicas y psicosociales. Objetivo Evaluar los efectos de un programa de prevención universal en conductas alimentarias de riesgo (CAR), interiorización del ideal de delgadez (IID), obsesión por la musculatura (OM) y sedentarismo en adolescentes mexicanos. Método Estudio cuasi-experimental con medidas repetidas (pre-test, post-test, seguimiento a seis meses y un año) en una muestra no probabilística de 523 adolescentes (46.7% mujeres) de 15-19 años de edad (Medad = 16.07). Se trabajó en dos escuelas preparatorias privadas, una como grupo control (GC) y otra como grupo intervenido (GI). Para mujeres y hombres, los datos se recolectaron usando el Cuestionario Breve para Conductas Alimentarias de Riesgo (CBCAR) y la versión corta del Cuestionario Internacional de Actividad Física (IPAQ). Para evaluar el IID en mujeres, se utilizó el Cuestionario de Actitudes hacia la Figura Corporal (CAFC) y en hombres la Escala para Obsesión por la Musculatura (DMS). Resultados Después de un año, el ANOVA de medidas repetidas mostró una reducción significativa en la media de CAR, tanto en mujeres (p = .01) como en hombres (p = .03) del GI respecto al GC. En el GI, la media de IID en mujeres disminuyó significativamente, así como la media de OM en hombres. La actividad física aumentó en las mujeres del GI desde el pre-test hasta el post-test; sin embargo, el efecto no se mantuvo en el tiempo. Discusión y conclusión Estos hallazgos tienen implicaciones para futuras intervenciones con adolescentes mexicanos. Se deben tomar en cuenta las diferencias por sexo para elegir las actividades y las estrategias que potenciarían los efectos del programa.

Riesgo para desarrollar interiorización del ideal estético de la delgadez en adolescentes mexicanas Título abreviado: Asociación de riesgo e ideal estético de delgadez / Risk to develop body thin-ideal internalization in Mexican female adolescents

Resumen En mujeres se ha reportado que a mayor índice de masa corporal (IMC), mayor interiorización del ideal estético de la delgadez (IIED), y mayor seguimiento de conductas alimentarias de riesgo (CAR). El objetivo de esta investigación consistió en determinar la presencia de CAR y de IIED en mujeres adolescentes de Hidalgo, México y su asociación tanto entre ellas como con el IMC, el porcentaje de grasa corporal (PGC), los tiempos de comida (TC) y la actividad física (AF). El estudio fue de tipo transversal con un diseño no experimental descriptivo y de asociación en una muestra no probabilística de 220 mujeres de preparatoria, de entre 14 a 18 años de edad (Medad= 15.9 ± .99), quienes respondieron una batería de cuestionarios validados. Para obtener el IMC, cada participante fue pesada y medida, mientras que el PGC se obtuvo por bioimpedancia eléctrica. Los resultados arrojaron que 17.3 % de la muestra presentó riesgo moderado y 15.5 % alto de CAR; mientras que 23.2 % registró riesgo de IIED. Se encontró que el IMC aumenta significativamente 2.7 veces el riesgo de IIED y de CAR 2.5 veces; la IIED incrementa 11.8 veces el riesgo de CAR (Odd Ratio; . < .05). Se concluye que, en la muestra de estudio, las CAR y la IIED están presentes; que a mayor IIED mayor riesgo de estas y que un exceso de peso corporal, basado en el IMC, aumenta el riesgo tanto de CAR como de IIED. Es necesario que los programas de prevención para mujeres adolescentes consideren lo anterior de manera conjunta para garantizar su éxito.

Abstract It has been reported that when females increase their body mass index (BMI), body thin-ideal internalization (BTII) increased too, as well as disordered eating behaviors (DEB). The aim of this study was to assess the presence of DEB and BTII in adolescent females from Hidalgo, Mexico. We also analyze the association between both variables, and between BMI, body fat percentage (BFP), meal times (MT) and physical activity (PA). A cross-sectional non-experimental descriptive and of association study was carried out in a no probabilistic sample of 220 high school females, aged from 14 to 18 (Mage= 15.9 ± .99). Self-reported validated questionnaires in Mexican samples were used to assess each one of the variables: the Brief Questionnaire for Risky Eating Behaviors, the Attitudes toward Body Figure Questionnaire, Risk Factors Associated to Eating Disorders for Mexican Pubescents Questionnaire (only the meal times factor was used) and the short version of the International Physical Activity Questionnaire (IPAQ). BMI was obtained by measuring each subject's weight and height; the body fat percentage (BFP) was measured through Biolectrical Impedance. The protocol was revised and approved by the Ethics and Research Committee of Health Sciences Institute of the Universidad Autónoma del Estado de Hidalgo. Descriptive analyses were held, as well as Odd Ratio to estimate the risk association. Total sample showed 17.3 % of moderate risk and 15.5 % of high risk for developing DEB; 23.2 % of the sample reported risk for BTII. From the total of females with DEB (moderate and high risk) 68.6 % also scored risk of body thin-ideal internalization. According to the BMI, results showed that 29.5 % of the sample had overweight and obesity; meanwhile for the BFP in the same categories the value was 85 %. The analysis by BMI showed that adolescents with overweigh (50 % and 39.1 %, respectively) and obesity (47.4 % and 31.6 %, respectively) achieved the highest values for both, DEB and BTII. Interestingly, participants with normal BMI had also important percentages for DEB (26.9 %) as well as BTII (17.9 %). With respect to BFP, females with overweight (41.5 % and 24.4 %, respectively) and obesity (35.6 % and 25.3 %, respectively) had the highest percentages for both DEB and BTII. Again, adolescents with normal BFP showed percentages for DEB (6.4%) and BTII (9.7 %). Findings showed that 68.6 % of the participants with risk of IIED, "never" and "few times" used to eliminate the dinner, and that 80.5 % of the sample had low level for PA. We found that BMI increases significantly 2.7 times the risk of BTII as well as 2.5 times the risk of DEB; BTII increases 11.8 times the risk of DE (Odd Ratio; p < .05). From the present data, it can be concluded that DEB and BTII are present in the sample studied, and its prevalence were higher than other studies among Mexican females. We also concluded that overweight and obese subjects, for both BMI and BFP, were the ones that obtained the higher percentages of DEB and BTII. Finally, BMI increased significantly the risk of DEB and BTII, as well as BTII increased significantly the risk of DEB. It is necessary that female adolescent prevention programs take into account this in a joint way to guarantee their success.

Emotional eating: associations among impulsivity, depression, sex, and weight status in young adults / Alimentação emocional: associações entre impulsividade, depressão, sexo e peso corporal em jovens adultos / Alimentación emocional: asociaciones entre impulsividad, depresión, sexo y peso corporal en jovenes adultos

Emotional Eating (EE) is defined as eating under the influence of negative emotions, and is associated with Eating Disorders, impulsivity, depression and weight gain. However, previous literature is not clear regarding how these variables explain EE. The present study aimed to identify predictors of EE and its relationship to impulsivity, depression, eating style, and weight status in young adults. Sex differences in eating style were examined, and differences in EE between obese/overweight and normal/underweight individuals were tested. Two-hundred college students completed online questionnaires assessing all variables. Low inhibitory control, depression symptoms, female sex, and higher body mass index significantly predicted scores on EE. Obese/overweight and female participants presented increased EE. Correlation analysis evidenced positive associations between EE, Uncontrolled Eating, body mass, and low inhibitory control. Results indicate that EE is related to psychological factors such as impulsivity and depression, and biological factors, such as sex and body mass.

Alimentação Emocional (AE) é definida como comer sob influência de emoções negativas e está associada a transtornos alimentares, impulsividade, depressão e ganho de peso. Entretanto, a literatura não é clara sobre como essas variáveis explicam AE. Este estudo buscou identificar preditores da AE e sua relação com impulsividade, depressão, estilo alimentar e peso corporal em jovens adultos. Foram examinadas diferenças entre sexo no estilo alimentar e diferenças na AE entre indivíduos obesos/com sobrepeso e normais/abaixo do peso. Duzentos estudantes universitários preencheram questionários online avaliando todas variáveis. Baixo controle inibitório, sintomas de depressão, sexo feminino e maior índice de massa corporal predisseram AE. Indivíduos obesos/com excesso de peso e do sexo feminino apresentaram aumento da AE. Foram evidenciadas correlações positivas entre Descontrole Alimentar, peso corporal e baixo controle inibitório. Os resultados indicam que a AE está relacionada a fatores psicológicos, como impulsividade e depressão, e biológicos, como sexo e massa corporal.

Alimentación emocional (AE) se define como comer bajo la influencia de emociones negativas y se asocia con trastornos alimentarios, impulsividad, depresión y aumento de peso. Sin embargo, la literatura no es clara acerca de cómo estas variables explican AE. Este estudio buscó identificar predictores de AE y su relación con impulsividad, depresión, estilo de alimentación y peso corporal en jovenes adultos. Se examinaron diferencias entre sexo en el estilo de alimentación y diferencias en AE entre sujetos obesos/con sobrepeso y normales/con bajo peso. Doscientos estudiantes universitarios completaron cuestionarios en línea evaluando todas variables. Bajo control inhibitorio, síntomas de depresión, género femenino y índice de masa corporal más alto predijeron AE. Personas obesas/con sobrepeso y mujeres mostraron aumento de AE. Se evidenciaron correlaciones positivas entre comida no controlada, peso corporal y bajo control inhibitorio. AE está relacionada con factores psicológicos, como impulsividad y depresión, y biológicos, como género y masa corporal.

Negative affect moderates the link between body image dissatisfaction and disordered eating among psychiatric outpatients in a multi-ethnic Asian setting

INTRODUCTION@#Few studies have investigated the factors that affect the relationship between body image dissatisfaction and disordered eating locally. Our study aimed to investigate the moderating effects of depression and anxiety levels on the body dissatisfaction-disordered eating link in Singapore.@*METHODS@#A total of 329 participants completed a set of questionnaires that included various scales pertaining to eating behaviours, body image, psychological distress and quality of life.@*RESULTS@#Participants were diagnosed with schizophrenia (47.4%), depression (46.8%) and substance use disorders (5.8%). Moderation analyses revealed that depression (F [9, 251] = 18.50, p < 0.001, R@*CONCLUSION@#Greater effort should be dedicated to the screening of disordered eating behaviours in psychiatric outpatients presenting with greater psychological distress.

Unhealthy weight control behaviors, disordered eating, and body image dissatisfaction in adolescents from São Paulo, Brazil

Objective: To identify the frequency of disordered eating (DE) and unhealthy weight control behaviors (UWCB) among adolescents and associations with age, sex, actual weight status, perceived weight status, and body image dissatisfaction. Methods: Cross-sectional study of 1,156 adolescents. DE was assessed using a specific self-report questionnaire, UWCB by specific behaviors that were not typically recommended for weight management, and body dissatisfaction by Stunkard's silhouettes. Results: The frequency of DE was 17.3%, and that of UWCB, 31.9%; 80.1% of participants were dissatisfied with body image. Perception of oneself as overweight was associated with 1.795-fold odds of DE. Those with UWCB had 7.389-fold odds of DE, while DE increased the odds of UWCB 7.280-fold. Girls, participants who perceived themselves as overweight, and those who reported body dissatisfaction were 2.266, 2.381, and 1.752 times more likely to have UWCB, respectively. Conclusion: A high prevalence of UWCB and a moderate prevalence of DE behaviors was found in adolescents from the city of São Paulo, Brazil. Those who perceived themselves as overweight had more DE and UWCB, and both behaviors were related. UWCB was more common in girls and among those dissatisfied with their bodies.

Parental negative weight/shape comments and their association with disordered eating behaviors: A systematic review / Comentarios negativos paternos acerca de peso/forma corporal y su asociación con las conductas alimentarias de riesgo: Una revisión sistemática

Abstract The purpose of this study was to find the association between receiving negative parental weight and shape comments, and the presence of disordered eating behaviors (DEBs) in young adults. A systematic review was conducted answering the following PECO question: Population / young adults; Exposure / negative comments, criticism or teasing about weight and shape by parents; Comparison groups / not applicable; and Outcome / DEBs. Due to the use of different statistical measurements, a narrative was chosen to present the results. An association between negative comments and DEBs was found in male and female university students. Women reported more negative comments, higher body dissatisfaction and DEBs than men. Body dissatisfaction was found as a mediator of negative comments and DEBs, and sex as a moderator between body dissatisfaction and DEBs. The results have implications for the influence social pressure has on the internalization of the thin-ideal and on body dissatisfaction as risk factors for the development of disordered eating behaviours.

Resumen El objetivo de este estudio fue examinar la asociación entre ser receptor de comentarios negativos paternos acerca del peso y la figura corporal, y la presencia de conductas alimentarias de riesgo (CAR) en adultos jóvenes. Se llevó a cabo una revisión sistemática respondiendo a la pregunta PECO siguiente: Población / adultos jóvenes; Exposición / comentarios negativos, críticas o ridiculización por parte de los padres por el peso y la figura corporal; Comparación / no aplicó; y Resultado / CAR. Debido a las diferentes medidas estadísticas utilizadas, se eligió un formato narrativo para presentar los resultados. Estos indicaron asociación entre los comentarios negativos paternos y las CAR en hombres y mujeres estudiantes universitarios. Las mujeres reportaron recibir más comentarios negativos, así como presentar mayor insatisfacción corporal y CAR que los hombres. Entre los comentarios negativos y las CAR se encontró como mediadora a la imagen corporal, y al sexo como un moderador entre la insatisfacción corporal y las CAR. Los resultados tienen implicaciones acerca de la influencia de la presión sociocultural en la interiorización del ideal estético de delgadez y de la insatisfacción corporal como factores de riesgo para el desarrollo de CAR.

Eating disorder symptomatology: Comparative study between Mexican and Canadian university women / Sintomatología de trastornos alimentarios: Estudio comparativo entre mujeres universitarias mexicanas y canadienses

Abstract The objectives of this study were: (1) to compare Mexican and Canadian university students regarding disordered eating behaviors (DEB), body thin-ideal internalization (BTHIN), and body image dissatisfaction (BID); and (2) to examine the relationship of these three variables to body mass index (BMI) and waist circumference (WC). This cross-cultural study was carried out in a sample of 129 university women students aged from 18 to 25 years (M = 20.18, SD =1.59): 52% were Canadian (Moncton University [MU]) and 48% were Mexican (Universidad Autónoma del Estado de Hidalgo [UAEH]). The Brief Questionnaire for Disordered Eating Behaviors and Attitudes Towards Body Figure Questionnaire were applied while the BID was evaluated using a continuum of nine silhouettes. In addition, the weight, height and WC of each participant were recorded. Mexican students had greater values of overweight, obesity, abdominal obesity and DEB, with 4.6 times greater risk than UM students. In contrast, the presence of BTHIN and BID was similar between samples. Considering these findings, women from at least two different ethnic groups are vulnerable to the development of eating disorder symptomatology.

Resumen Los objetivos de este estudio fueron: 1) comparar entre estudiantes universitarias mexicanas vs. canadienses respecto a conductas alimentarias de riesgo (CAR), interiorización de la figura corporal delgada (IFCD) e insatisfacción con la imagen corporal (ISC); y 2) examinar la relación de esas tres variables con el índice de masa corporal (IMC) y la circunferencia de cintura (CC). En este estudio transcultural participaron 129estudiantes universitarias de 18 a 25 años de edad (M = 20.18, DE =1.59): 52% canadienses (Universidad de Moncton [UM]) y 48% mexicanas (Universidad Autónoma del Estado de Hidalgo [UAEH]). Fueron aplicados el Cuestionario Breve para medir Conductas Alimentarias de Riesgo y el Attitudes Towards Body Figure Questionnaire, mientras que la ISC se evaluó mediante un continuo de nueve siluetas. Además se registró el peso, la talla y la CC de cada participante. Las estudiantes mexicanas registraron significativamente mayor presencia de sobrepeso, obesidad, obesidad abdominal y CAR, con 4.6 veces mayor riesgo que las estudiantes de la UM. Por el contrario, la presencia de IFCD y de ISC fue similar entre las muestras. Con base en estos hallazgos se puede concluir que las mujeres de dos grupos étnicos diferentes son vulnerables al desarrollo de sintomatología de trastornos alimentarios.

¿Cómo llenar un continente no diferenciado con un determinado contenido? Abordaje psicodinámico de un síntoma alimentario / How to fill an undifferentiated continent with a determined content? Psychodynamic approach of an eating symptom

Resumen El objetivo del presente trabajo fue establecer, a través del análisis de un caso clínico, que la falta de distinción entre el adentro y el afuera de la paciente era uno de los factores centrales de su síntoma alimentario: los «atracones¼ con lechuga. Para tal fin se presentan viñetas del proceso terapéutico que, bajo un enfoque psicodinámico y un dispositivo bifocal, fue llevado a cabo con Rosa a lo largo de 10 años, con énfasis en la relación transferencia-contratransferencia. Viñetas y aspectos evocados del caso se teorizan a partir de los planteamientos de diversos autores. El proceso terapéutico permitió construir-reconstruir lo que falló en el desarrollo temprano de Rosa, a través del cual fue edificando una imagen corporal y psíquica de sí misma, enriqueciendo su Self y sus relaciones interpersonales. Esta experiencia clínica invita a pensar que las fallas tempranas se presentan a través de múltiples expresiones -con predominio en cuerpo o en psique- y su tratamiento requirió el abordaje de múltiples aspectos y, en ello, el dispositivo bifocal usado mostró ser una opción pertinente.

Abstract The aim of this study was to establish that the lack of distinction between inside and outside of the patient presented was one of the nuclear factors in Rosa's eating symptom. For this purpose we present the clinical materials issued from the psychotherapeutic process carried on with Rosa during 10 years -one of the two components of the bifocal therapy-emphasizing the transference-countertransference relation. The comprehension achieved from clinical materials is enriched by means of discussing approaches of several authors on relevant concepts. Results showed that what had failed during Rosa's early development was built-rebuilt throughout therapy. She worked on building a bodily and mental image, enriched her self and her relationships with others. This clinical experience is an invitation to think about the great variety of expressions -sometimes by means of the body and sometimes of the psyche- of early failures and also, that treatments must include various aspects, with bifocal therapy being an option.

O estado de humor e a insatisfação corporal possuem relação com os comportamentos de risco para transtornos alimentares em atletas de esportes coletivos do sexo masculino? / Are mood and body image dissatisfaction related to disordered eating behaviors in male team sports athletes?

Os comportamentos de risco para transtornos alimentares (CRTA) dizem respeito a atitudes patogênicas voltadas para a manutenção ou alteração da massa corporal. As frequentes cobranças as quais os atletas são submetidos para melhorarem seu desempenho competitivo podem levá-los a adotarem essas condutas alimentares, buscando um corpo "ideal e compatível" com a modalidade praticada. Contudo, tais comportamentos podem acarretar desidratação, hiponatremia, e reduções da potência anaeróbia e consumo de oxigênio, considerados efeitos prejudiciais para o rendimento esportivo. Algumas variáveis psicológicas podem estar associadas com os CRTA, dentre elas: o estado de humor e a insatisfação corporal (IC). Assim, o objetivo deste trabalho foi avaliar a relação entre o estado de humor e a IC direcionada à muscularidade com os comportamentos de risco para TA em atletas de esportes coletivos do sexo masculino. A amostra deste estudo constou de atletas de esportes coletivos do sexo masculino [futebol (n = 36), basquete (n = 18) e handebol (n = 16)], que treinavam no estado de Pernambuco. As EAAE, EICCE e BRUMS foram utilizadas para avaliar os CRTA, IC e estado de humor, respectivamente. Conduziu-se o teste Shapiro Wilk para verificar a normalidade dos dados e em seguida, a correlação de Pearson para relacionar as variáveis da pesquisa. Os resultados do presente estudo mostraram que os escores da EICCE e BRUMS não estiveram correlacionados aos da EAAE (p > 0,05), indicando que, em atletas de esportes coletivos do sexo masculino, os CRTA não são influenciados pelo humor e IC...(AU)

The disordered eating (DE) concern pathogenic attitudes aimed at the maintenance or alteration of body mass. The frequent charges that athletes undergo to improve their competitive performance may lead them to adopt these dietary behaviors, seeking an "ideal and compatible" body with the modality practiced. However, such behavior can lead to dehydration, hyponatremia, and reductions in anaerobic potency and oxygen consumption, considered to be detrimental effects on sports performance. Some psychological variables may be associated with DE, among them: mood state and body dissatisfaction (BD). Thus, the objective of this study was to evaluate the relationship between the mood state and the muscularity-directed BD with the DE in male athletes. The sample of this study consisted of male and female athletes [(soccer (n = 36), basketball (n = 18) and handball (n = 16)], who trained in the state of Pernambuco. The DES, EICCE and BRUMS were used to evaluate the DE, BD and mood state, respectively. We conducted the Shapiro Wilk test to verify the normality of the data and then the Pearson correlation to relate the variables of the research. The results of the present study showed that the EICCE and BRUMS scores were not correlated with those of the DES (p> 0.05), indicating that, in male athletes, DE are not influenced by mood and BD...(AU)

Comportamentos de risco para os transtornos alimentares e traços perfeccionistas em atletas de atletismo / Disordered eating behaviors and perfectionist traits in track and field athletes

Resumo O objetivo do estudo foi analisar a influência do perfeccionismo nos comportamentos de risco para os transtornos alimentares de atletas adolescentes do sexo feminino da modalidade atletismo. Fizeram parte do estudo 52 atletas da modalidade de atletismo de clubes da cidade de São Paulo/SP com idade entre 12 e 17 anos. Utilizaram-se as subescalas do Eating Attitudes Test (EAT-26) e a Multidimensional Perfectionism Scale (MPS) para avaliar os comportamentos de risco para os transtornos alimentares e os traços perfeccionistas, respectivamente. Conduziu-se a regressão linear múltipla stepwise para analisar a influência dos perfeccionismo nos comportamentos de risco para os transtornos alimentares. Os resultados indicaram influência da MPS nos escores das subescalas Dieta (F(1, 44) = 5,74; p = 0,05) e Autocontrole Oral (F(1, 44) = 6,13; p = 0,04) do EAT-26. No entanto, não foi evidenciado impacto da MPS nos escores da subescala Bulimia e Preocupação com 0 Alimenta (F(1, 44) = 1,26; p = 0,22). Assim, em razão da investigação apresentar delineamento transversal, pressupõe-se que as atletas de atletismo com traços perfeccionistas podem estar mais susceptíveis para a restrição alimentar e a influência ambiental para a ingesta alimentar.

Abstract The aim of the study was to analyze the influence of perfectionism in disordered eating behaviors of track and field adolescent female athletes. Fifty-two track and field athletes of clubs in the city of São Paulo/SP aged between 12 and 17 years were participants. We used the subscales of the Eating Attitudes Test (EAT-26) and the Multidimensional Perfectionism Scale (MPS) to assess disordered eating behaviors and perfectionist traits, respectively. We conducted stepwise linear multiple regression to analyze the influence of perfectionism on disordered eating behaviors. The results indicated the influence of MPS on subscale Diet scores (F(1. 44) = 5.74; p = 0.05) and Oral Self-control (F(1. 44) = 6.13; p = 0.04) the EAT-26. However, there was not an impact of MPS on subscale Bulimia and Food Concern scores (F(1. 44) = 1.26; p = 0.22). Thus, it is assumed that the track and field athletes with perfectionist traits may be more susceptible to dietary restriction and environmental influence food intake.

Drive for thinness and pursuit of muscularity: the role of gender ideologies / Impulso a la delgadez y búsqueda de la muscularidad: el rol de las ideologías de género

The female sociocultural beauty ideal is ultra-thin, while the male beauty ideal is related with a muscular body. In this paper it is argued that these differences may be explained by the gender ideology that men and women have. Data obtained from 615 female students (with a Body Mass Index between 18 and 30) revealed that participants high in a gender ideology scale reported greater drive for thinness and less pursuit of muscularity. In addition, women with low scores in a gender ideology scale showed the opposite pattern: high scores on pursuit of muscularity and low in drive for thinness. Finally, it is discussed why men and women adopt different strategies to deal with these beauty ideals.

El ideal sociocultural femenino es ultra delgado, mientras que el ideal masculino tiene que ver con tener un cuerpo musculado. En este articulo se argumenta que estas diferencias pueden ser explicadas por las ideologías de genero que tienen hombres y mujeres. Los datos obtenidos de 615 mujeres estudiantes (con un Indice de Masa Corporal entre 18 y 30) mostraron que las participantes altas en una escala de ideología de género informaban de un mayor impulso a la delgadez y menos búsqueda de la muscularidad. Además, las mujeres con marcadores bajos en una escala de ideología de genero mostraban el patrón opuesto: puntuaciones altas de búsqueda de la muscularidad y bajas en impulso a la delgadez. Finalmente, se discute porqué hombres y mujeres adoptan diferentes estrategias para lidiar con estos ideales de belleza.

Conductas alimentarias de riesgo y correlatos psicosociales en estudiantes universitarios de primer ingreso con sobrepeso y obesidad / Disordered eating behaviors and psychological correlates among overweight and obese freshmen College students

Resumen: INTRODUCCIÓN: El comienzo de los estudios universitarios es un estresor importante para los jóvenes que se asocia con un incremento en la incidencia de depresión, ansiedad, abuso de alcohol y CAR. OBJETIVO: Analizar la relación entre CAR e IMC, su asociación con variables demográficas y psicológicas y la interacción con el IMC. MÉTODO: En una muestra de 892 estudiantes universitarios de nuevo ingreso (502 mujeres y 390 hombres) (Xedad=19.7; DE=2.9) se midió peso y estatura y se utilizaron cuestionarios validados. RESULTADOS: La prevalencia de CAR fue de 6.1% en mujeres y de 4.1% en hombres. La prevalencia de sobrepeso y obesidad en mujeres fue de 22.6% y de 7.4%, y en hombres fue de 26.6% y de 9.3%, respectivamente. Las mujeres y los hombres con obesidad 10.8% y 11.1% presentaron CAR de frecuencia alta, y las mujeres y hombres con sobrepeso 13.2% y 3.8%, respectivamente. En las mujeres el IMC aumenta el riesgo de CAR 1.6 veces (p < 0.05) y en los hombres 1.4 veces (p > 0.05). No se encontró interacción del IMC en la asociación de CAR con el resto de las variables. DISCUSIÓN Y CONCLUSIÓN: En ambos sexos, las variables relacionadas con la imagen corporal aumentan el riesgo de CAR significativamente (p < 0.05). Los síntomas depresivos, la baja autoestima y el IMC aumentan el riesgo entre las mujeres, y el deseo por la musculatura, nivel socioeconómico y el área de estudio entre los hombres. Se recomienda llevar a cabo una investigación específica sobre CAR en varones, para evitar el subregistro de casos.

Abstract: INTRODUCTION: The beginning of college studies involves important stress, which is related to an increase in the incidence of depression, anxiety, alcohol abuse and DEB. OBJECTIVE: To analyze the relationship between DEB and nutritional status measured with BMI, its association with demographic and psychological variables, and the interaction with BMI. METHOD: A sample of 892 college students in their freshman year (502 females and 390 males) (Xage=19.7; SD=2.9) was studied. Weight and height were measured, and validated questionnaires were used. RESULTS: The prevalence of DEB was 6.1% in females and 4.1% in males. The prevalence of overweight and obesity in females was 22.6%, and 7.4% and 26.6% and 9.3% in males, respectively. Among women and men with obesity 10.8% and 11.1% showed high-DEB, whilst among overweight women and men 13.2% and 3.8% showed high-DEB, respectively. BMI increases the risk for DEB 1.6 times among women (p < 0.05), 1.4 times among men (p > 0.05). There was no interaction found between BMI and the other variables. DISCUSSION AND CONCLUSION: The variables related with body image increase the risk of DEB significantly (p < 0.05) in both sexes. Depressive symptoms, low self-steem increase the risk among women, and socioeconomic status and study area increase the risk of DEB among men. The specific research of DEB among males is highly recommended to avoid the under registration of cases.

Disordered eating behaviors in Mexican patients with and without type 2 diabetes mellitus / Conductas alimentarias de riesgo en pacientes mexicanos con y sin diabetes mellitus tipo 2

The aim of this work was to compare the distribution of disordered eating behaviors (DEB) in Mexican adult patients, with and without type 2 diabetes. A cross-sectional descriptive and comparative field research was carried out in a sample of 169 subjects (54% females; 46% males) with a mean age of 47.9 years. The sample was matched in two groups: patients with type 2 diabetes and patients without diabetes. DEB were assessed with a valid Mexican scale named EFRATA (Escala de Factores de Riesgo Asociados a Trastornos Alimentarios). Results confirmed significant differences in food and weight concern (t = 4.15, df 152.09, p = 0.000), normal eating behavior (t = 4.03, df 151.45, p = 0.000) and emotional eating (t = 1.93, df 160.76, p < 0.05), EFRATA's factors in which diabetic subjects obtained higher values in comparison with no diabetic patients. Subjects without diabetes achieved higher value only in binge eating behavior with statistically significant difference (t = 2.11, df 128.8, p < 0.05) in contrast with diabetic patients. Since these findings have been open the possibility to propose specific strategies that encourage healthy eating behaviors, both in adult patients with and without diabetes.

El objetivo de este estudio consistió en comparar la distribución de conductas alimentarias de riesgo en pacientes mexicanos adultos con y sin diabetes tipo 2. Se efectuó un estudio de campo de tipo descriptivo y comparativo en una muestra de 169 sujetos (54% mujeres; 46% hombres) con una media de edad de 47,9 años. Los sujetos fueron divididos en 2 grupos: pacientes con diabetes y pacientes sin diabetes. Para medir las conductas alimentarias de riesgo se empleó la Escala de Factores de Riesgo Asociados a Trastornos Alimentarios (EFRATA). Los resultados confirmaron diferencias significativas en preocupación por el peso y la comida (t = 4,15, df 152,09, p = 0,000), conducta alimentaria normal (t = 4,03, df 151,45, p = 0,000) y en comer por compensación psicológica (t = 1,93, df 160,76, p < 0,05), factores de la EFRATA en los que los pacientes diabéticos registraron valores más altos. En contraste con los pacientes diabéticos, los sujetos sin diabetes alcanzaron el valor más alto con diferencia estadísticamente significativa en el factor comer compulsivo (t = 2,11, df 128,8, p < 0,05). A partir de estos hallazgos se abre la posibilidad de proponer estrategias puntuales que favorezcan conductas alimentarias saludables, tanto para pacientes adultos diabéticos como sin diabetes.

Systematic review of disordered eating behaviors: Methodological considerations for epidemiological research / Revisión sistemática de las conductas alimentarias de riesgo: consideraciones metodológicas para la investigación epidemiológica

Disordered eating behaviors (DEB) such as dieting, fasting, laxatives or diuretics abuse, self-induced vomiting and binge eating may lead serious physiological and psychological consequences in individuals. Epidemiological data helps to the understanding of the magnitude of this problem within population; however point prevalence rates and the trend of DEB are still a subject of constant debate. Therefore the aim of this study is to systematically review empirical studies that have estimated the prevalence of DEB in women and provide some methodological considerations for future epidemiological studies. The search of articles was made through MEDLINE and SCIENCE DIRECT databases from 2000 to 2013. According to inclusion and exclusion criteria 20 studies were reviewed. Results yielded that the point prevalence range of dieting (0.6-51.7%), fasting (2.1-18.5%) and binge eating (1.2-17.3%) are higher than purgative behaviors (0-11%). However finding a trend in DEB over time was difficult since methodologies were significantly different. Methodological considerations for future research in DEB are proposed.

Las conductas alimentarias de riesgo (CAR) de los trastornos alimentarios, tales como dieta, ayuno, abuso de laxantes o diuréticos, vómito autoinducido y atracón, pueden causar graves consecuencias fisiológicas y psicológicas en el individuo. Los datos epidemiológicos ayudan a la comprensión de la magnitud de este problema en la población, sin embargo las tasas de prevalencia puntual y la tendencia de las CAR aún son tema de constante debate. Por lo tanto, el objetivo del presente estudio es revisar sistemáticamente estudios empíricos que estimen la prevalencia de las CAR en mujeres y proveer consideraciones metodológicas para futura investigación epidemiológica. La búsqueda de artículos fue a través de las bases de datos de MEDLINE y SCIENCEDIRECT de 2000 a 2013. Con base en los criterios de inclusión y exclusión 20 estudios fueron analizados. Los resultados arrojaron que el rango de la prevalencia puntual para dieta (0,6-51,7%), ayuno (2,1-18,5%) y atracón (1,2-17,3%) son mayores que el de las conductas purgativas (0-11%). Sin embargo, fue difícil encontrar una tendencia en las CAR a través del tiempo debido a que las metodologías utilizadas fueron significativamente diferentes. Se proponen consideraciones metodológicas para futuras investigaciones en CAR.

Identificación de casos de riesgo de trastornos alimentarios entre estudiantes de Querétaro / Eating disorders identification of risk cases among students from Queretaro

Los Trastornos de la Conducta Alimentaria [TCA] constituyen un grave problema de salud pública, reconocido a nivel internacional. A través del proyecto "Razones de Peso" en el año 2013 se desarrolló una investigación en secundarias públicas de la localidad de Santiago de Querétaro, con el objetivo de identificar el riesgo de padecer TCA entre adolescentes mujeres y varones, con base en la presencia Conductas Alimentarias de Riesgo [CAR] y preocupaciones asociadas con TCA. La muestra estuvo compuesta por 435 estudiantes (224 mujeres y 211 varones) con una edad promedio de 13.83 años (DE=.72). El instrumento empleado fue una versión del cuestionario EAT-26 adaptada, validada y recomendada por Garner (2004a), autor original de dicho cuestionario. Entre los resultados de la investigación destaca la elevada prevalencia de preocupaciones asociadas a TCA (5.9%) y de CAR (33.1%), en estudiantes de ambos sexos. Además, tanto el grupo considerado "en riesgo de padecer algún TCA", como el grupo de estudiantes que declararon incurrir en CAR, estuvieron conformados por un mayor porcentaje de varones que de mujeres. Se recomienda implementar estudios a dos fases, con muestras estadísticas integradas por mujeres y varones, y la validación con población mexicana, de la versión del EAT-26 empleada para la presente investigación.

Eating Disorders [ED] are a serious public health problem, internationally recognized. Through the project "Razones de Peso", (Reasons that Determine Weight) in 2013 research was carried out in public junior high schools in the City of Santiago de Querétaro. The objective was to identify the risk of suffering from ED among adolescents based on the presence of Disordered Eating Behaviors [DEB] and preoccupations associated with ED. The sample consisted of 435 students (224 girls and 211 boys) with an average age of 13.83 (SD=.72). The instrument used was a version of the EAT-26 questionnaire, adapted, validated and recommended by Garner (2004a), the original questionnaire author. The results highlights the elevated prevalence of concerns associated with ED (5.9%) and DEB (33.1%) in male and female students. Moreover, both the group considered "at risk of developing an ED" as the students group that expressed having DEB, were composed by a higher percentage of boys rather than girls. It is recommended the implementation in two phases studies, with statistical samples made up of girls and boys and the validation with a Mexican population of the EAT-26 version used for this study.

Un estudio preliminar de los factores predictores de la conducta de atracón en tres culturas: México, Argentina y España / A preliminary study of the predictive factors of binge eating behavior in three cultures: Mexico, Spain and Argentina

La conducta de atracón, el incremento en su frecuencia que incide en el riesgo asociado a trastorno alimentario, así como su relación con sobrepeso y obesidad constituyen un problema de salud vigente a nivel nacional e internacional. El objetivo de la investigación fue explorar, identificar y describir los factores de riesgo que se interrelacionan y explican la Conducta de Atracón, poniendo especial interés en las similitudes y diferencias inherentes a muestras de tres diferentes países de habla hispana (México, España y Argentina). La muestra agrupó N = 258 mujeres: mexicanas (n = 85, Medad = 16.18, DE = 0.99); argentinas (n = 75, Medad = 17.00, DE = 1.24) y españolas (n = 98, Medad = 17.00, DE = 1.36). Se utilizaron instrumentos psicométricamente adecuados. Entre los resultados de mayor interés se encontró que el factor comer por compensación psicológica obtiene el peso β más alto en cada grupo y el análisis de senderos confirma su importancia intercultural. El carácter emocional de dicho factor, su aportación a la prevención y su poder predictivo forman parte de la discusión.

The increased frequency of binge eating behavior, and its relationship to overweight and obesity, expressed a national and international real health problem. The objective of this study was to explore, identify and describe the risk factors that interrelate and explain Binge Eating Behavior, paying special attention to the similarities and differences inherent to samples from three different Spanish-speaking countries (Mexico, Spain and Argentina). The total sample consisted of N = 258 women: Mexican (n = 85, Mage = 16.18, SD = 0.99); Argentine (n = 75, Mage = 17.00, SD = 1.24) and Spanish (n = 98, Mage = 17.00, SD = 1.36). The instruments used showed a good psychometrical properties. The eating for psychological compensation factor gets the highest β weight in the three groups and its intercultural relevance is confirmed by the Path Analysis. It is discussed the emotional nature of the eating for psychological compensation factor, its contribution to prevention, and its predictive power.

Role of Peer Influence and Thin-ideal Internalization on Body Dissatisfaction and Disordered Eating in Mexican Girls / Rol de la Influencia de Pares y de la Interiorización del Ideal de Delgadez sobre la Insatisfacción Corporal y Alimentación No Saludable en Jóvenes Mexicanas / O Papel da Influência de Pares e da Interiorização do Ideal de Delgadeza na Insatisfação Corporal e na Alimentação Não Saudável em Jovens Mexicanas

The aim of this study was to examine the role of peer influence and thin-ideal internalization on body dissatisfaction and disordered eating. The Eating Attitudes Test, the Body Shape Questionnaire and the Questionnaire of Sociocultural Influences on the Aesthetic Body Shape Model were administered to 130 female students, with a mean age of 19.44. The results showed that thin-ideal internalization mediated the relationship between peer influence and body dissatisfaction (β=0.14, p>.05), and the relationship between peer influence and disordered eating (β=0.09, p>.05). This study supports the hypothesis that the thin-ideal internalization is an important mediator on body dissatisfaction and disordered eating in Mexican girls.

Con el objetivo de examinar el rol de la influencia de pares y de la interiorización del ideal de delgadez sobre la insatisfacción corporal y la alimentación no saludable en una muestra comunitaria, se aplicó el Test de Actitudes Alimentarias, el Cuestionario de Imagen Corporal y el Cuestionario de Influencias del Modelo Estético Corporal a 130 mujeres estudiantes, cuya media de edad fue de 19.44 años. El análisis de datos reveló que la interiorización del ideal de delgadez medió la relación entre la influencia de pares y la insatisfacción corporal (β=0.14, p>.05), así como la relación entre la influencia de pares y la alimentación no saludable (β=0.09, p>.05). Este estudio apoya la hipótesis de que la interiorización del ideal de delgadez es un importante mediador sobre la insatisfacción corporal y la alimentación no saludable en jóvenes mexicanas.

Com o objetivo de examinar o papel da influência de pares e da interiorização do ideal de delgadeza na insatisfação corporal e na alimentação não saudável em uma amostra comunitária, aplicou-se o Teste de Atitudes Alimentares, o Questionário de Imagem Corporal e o Questionário de Influências do Modelo Estético Corporal a 130 mulheres estudantes, cuja média de idade foi de 19.44 anos. A análise de dados revelou que a interiorização do ideal de delgadeza mediou a relação entre a influência de pares e a insatisfação corporal (β=0.14, p>.05), assim como a relação entre a influência de pares e a alimentação não saudável (β=0.09, p>.05). Este estudo apoia a hipótese de que a interiorização do ideal de delgadeza é um importante mediador na insatisfação corporal e na alimentação não saudável em jovens mexicanas.

Disordered eating behaviors and binge drinking in female high-school students: the role of impulsivity / Conductas alimentarias de riesgo y consumo escesivo de alcohol en mujeres estudiantes: el papel de la impulsividad

Introduction It is widely accepted that psychiatric comorbidity can increase the severity, chronicity, and treatment resistance of psychiatric disorders. In various studies worldwide, it has been estimated that the prevalence of alcohol use disorders in women with disordered eating behaviors (DEB) is situated at between 2.9 and 48.6%. It is worth noting that previous studies have not considered the analysis of the variables that could explain the comorbidity between DEB and alcohol use in adolescents, such as impulsivity, which is the key variable for explaining this comorbidity. On the other hand, most studies have addressed the adult population in psychiatric hospitals or people with eating disorders (ED) or alcohol use disorders. It is considered that those subjects have already developed psychiatric comorbid disorders. Impulsivity could be an unspecific trait that aggravates the psychiatric condition of a determined person and it is therefore more likely for that person to seek specialized care. According to the above, the role of impulsivity in the comorbidity of ED and alcohol use might not be similar to that of the general population, mostly among those who have not yet developed a whole clinical syndrome. Therefore, we consider that it is important to clarify the involvement of impulsivity in the comorbidity between disordered eating behaviors (DEB) and binge drinking (BD) in high school students. It is also crucial to analyze the association between impulsivity and the coexistence of DEB and binge drinking (BD) in female students aged between 15 and 19 years at public high schools in the State of Mexico. Methods Data for this study were drawn from the Project entitled "Prevalence and Factors Associated with Disordered Eating Behaviors in Adolescent Women with Different Levels of Urbanization and Migration Intensity" (CONACyT-SEP-2004-46560). The design for this study is cross-sectional and analytical. A sample of 2357 female students at 11 public high schools in the State of Mexico was randomly selected during the 2006-2007 school year. For data collection for this project, a questionnaire was used that included socio-demographic variables, the Plutchik Impulsivity Scale (PIS), the Brief Questionnaire to Measure Risky Eating Behaviors (BQREB), and the questions on alcohol use included in the Questionnaire of Surveys on Substance Use in Students in Mexico (2003 version). Data were analyzed with the STATA version 10 survey function. Results Impulsivity was associated with the coexistence of DEB and BD (U=224427; p<0.01). The 3.5% of female students with impulsivity presented DEB and BD together vs. 0.6% who did not; 19.6% of female students with impulsivity presented one of the two behaviors vs. 7.8% without this trait. Impulsivity was associated positively and significantly with the coexistence of DEB and BD (t=3.8; p<0.01), regardless of socioeconomic variables, such as the father's educational attainment, the mother's educational attainment, and the number of services in the household. Conclusion The results of this paper indicate a statistically significant association between impulsivity and the coexistence of DEB and BD. This means that there is a greater percentage of coexistence of DEB and BD in female high school students considered to be impulsive in comparison with adolescents without this trait. This occurs regardless of socioeconomic variables, such as the father's educational attainment, the mother's educational attainment, and the number of services in the household. Future research should establish the role of other variables such as depression and examine the association of impulsivity with socioeconomic variables.

Introducción En términos generales, se acepta que la comorbilidad psiquiátrica puede incrementar la gravedad, la cronicidad y la resistencia al tratamiento de los trastornos psiquiátricos. En diversos estudios en todo el mundo se ha estimado que la prevalencia de trastornos por consumo de alcohol en mujeres con conductas alimentarias de riesgo (CAR) se sitúa entre el 2.9 y el 48.6%. Es importante señalar que los estudios anteriores no han considerado el análisis de las variables que podrían explicar la comorbilidad entre las CAR y el consumo de alcohol en los adolescentes, tales como la impulsividad, que es la variable considerada como la más importante para explicar dicha comorbilidad. Por otro lado, la mayor parte de la literatura ha estudiado a población adulta en hospitales psiquiátricos o a sujetos que ya han cumplido con los criterios diagnósticos de los trastornos de la conducta alimentaria (TCA) y de los trastornos por uso de alcohol. Se ha considerado que dichas poblaciones ya han desarrollado trastornos psiquiátricos comórbidos y que la impulsividad puede ser un rasgo inespecífico que agrava la situación psiquiátrica de una persona y que de esa forma sea más probable que acuda a una institución hospitalaria. Por lo tanto, es posible que la participación de la impulsividad en la comorbilidad entre los TCA y el consumo de alcohol no sea similar en la población general, sobre todo en la que no ha desarrollado los trastornos aún. Por lo tanto, consideramos importante aclarar la participación de la impulsividad en la comorbilidad entre las conductas alimentarias de riesgo (CAR) y el consumo excesivo de alcohol (CEA) en la población general y especialmente en aquellos sujetos en riesgo de presentar estos trastornos. Para ello se consideró importante analizar la asociación entre la impulsividad y la coexistencia de las conductas alimentarias de riesgo y el consumo excesivo de alcohol en estudiantes de sexo femenino de entre 15 y 19 años en escuelas públicas del Estado de México. Método Los datos para este estudio fueron obtenidos del Proyecto "Preva-lencia y Factores Asociados a Conductas Alimentarias de Riesgo en Mujeres Adolescentes en Localidades con diferente Nivel de Urbanización e Intensidad de Migración" (CONACyT-SEP-2004-46560). El diseño del estudio es transversal-analítico. La unidad de análisis fueron las estudiantes de sexo femenino entre 15 y 19 años de edad en instituciones educativas públicas de nivel medio superior en el Estado de México. Para la selección de las estudiantes, se utilizó un muestreo aleatorio estratificado. La muestra consistió en 2357 estudiantes de 11 escuelas públicas en el Estado de México durante el año escolar 2006-2007. Para la recolección de datos se empleó un cuestionario que incluía variables sociodemográficas, la Escala de Impulsividad Plutchik, el Cuestionario Breve de Conductas Alimentarias de Riesgo, y las preguntas sobre el consumo de alcohol, incluidas en el cuestionario de estudiantes (versión 2003) de las encuestas sobre consumo de sustancias en estudiantes de México. Los datos fueron analizados con la función survey del programa estadístico STATA versión 10 con una ponderación de la muestra que correspondió a la probabilidad de selección debido al nivel de marginación y estatus migratorio. Para determinar la asociación entre la impulsividad y la coexistencia entre las CAR y el CEA, se realizó un análisis de regresión ordinal. Resultados La impulsividad se asoció con la coexistencia entre las conductas alimentarias de riesgo y el consumo excesivo de alcohol (U=224427, p<0.01). El 3.5% de las estudiantes con impulsividad presentaron CAR y CEA de manera conjunta vs. el 0.6% que no cumplieron con dicha definición, mientras que el 19.6% de las estudiantes con impulsividad presentaron una de las dos conductas vs. 7.8% sin dicho rasgo. La impulsividad se asoció de manera positiva y significativa con la coexistencia CAR & CEA (t=3.83; p<0.01), de manera independiente a las variables socioeconómicas como la escolaridad del padre, la escolaridad de la madre y el número de servicios en la vivienda. Conclusión Los resultados de este trabajo indican una asociación estadísticamente significativa entre la impulsividad y la coexistencia de CAR y CEA. Lo anterior significa que hay un porcentaje mayor de la coexistencia de CAR y CEA en las estudiantes que cumplieron la definición operacional de impulsividad en comparación con las estudiantes sin dicho rasgo, de manera independiente a las variables socioeconómicas como la escolaridad del padre, la escolaridad de la madre y el número de servicios en la vivienda. Los resultados del presente estudio muestran que la impulsividad está asociada con una serie de conductas que pueden incrementar el desarrollo de un TCA comórbido con un trastorno por consumo de alcohol, y por lo tanto, sugieren un peor pronóstico para las adolescentes incluidas en el estudio. Lo anterior plantea la necesidad de detectar a los sujetos en riesgo de desarrollar ambos trastornos y su canalización a los servicios de salud especializados. Queda pendiente establecer el papel de otras variables como la depresión, y estudiar la asociación entre la impulsividad con las variables socioeconómicas mencionadas.