Brazilian Portuguese translation, cross-cultural adaptation, and apparent validation of the Trauma and Attachment Belief Scale / Tradução para o Português brasileiro, adaptação transcultural e validação aparente da Trauma and Attachment Belief Scale

Abstract Objective This article concerns the translation, cross-cultural adaptation, and apparent validation of the Trauma and Attachment Belief Scale (TABS), an instrument used to assess the psychological effects of traumatic life experiences and vicarious trauma. Methods This study involved literature review and evaluation of conceptual and item equivalences involving expert discussion groups focused on the existence and pertinence of the underlying theoretical concepts and corresponding items in a Brazilian context. Two translations and respective back-translations were performed during the evaluation of semantic equivalence, as well as an evaluation considering the referential and general equivalences between the original TABS and each version. Twenty-eight psychiatrists and psychologists completed a pretest. The final version was tested for reliability through the Cronbach's alpha and for verbal comprehension through the adapted verbal-numeric scale (ranging from 0 [I didn't understand anything] to 5 [I understood perfectly and I had no doubt]) in another 64 health professionals. Results The cross-cultural adaptation demonstrated high semantic equivalence for both the general (>95.0%) and the referential (>90.0%) meaning. The total Cronbach's alpha was 0.9173. All 84 items were maintained, and they favorably contributed to the internal consistency of the scale. The mean values of the adapted verbal-numeric scale for verbal comprehension obtained from health professionals varied from 4.2 to 4.9. Conclusion The Brazilian version of the TABS demonstrated high-quality conceptual, item, and semantic equivalence with the original instrument, as well as high acceptability, internal consistency, and verbal comprehension. The scale is now available for use.

Resumo Objetivo Este artigo se refere à tradução, adaptação transcultural e validação aparente da Trauma and Attachment Belief Scale (TABS), instrumento utilizado para avaliar os efeitos psicológicos das experiências de vida traumáticas e do trauma vicário. Métodos Este estudo envolveu uma revisão de literatura e avaliação da equivalência conceitual e dos itens, empregando grupos de discussão de especialistas, focando na existência e pertinência dos conceitos teóricos subjacentes e na correspondência dos itens dentro de um contexto brasileiro. Duas traduções e respectivas retrotraduções foram realizadas durante a avaliação da equivalência semântica, bem como foi feita uma avaliação considerando a equivalência referencial e geral entre a TABS original e cada versão. Vinte e oito psiquiatras e psicólogos completaram um pré-teste. A versão final foi testada para confiabilidade através do alfa de Cronbach e para compreensão verbal através de uma escala verbal-numérica adaptada [variando de 0 (Eu não entendi nada) a 5 (Eu entendi perfeitamente e não tive qualquer dúvida)] em outros 64 profissionais de saúde. Resultados A adaptação transcultural demonstrou alta equivalência semântica, tanto para o significado geral (>95,0%) quanto referencial (>90,0%). O alfa de Cronbach total foi de 0,9173. Todos os 84 itens foram mantidos e contribuíram favoravelmente para a consistência interna da escala. Os valores médios da escala verbal-numérica adaptada para a compreensão verbal obtidos dos profissionais de saúde variaram de 4,2 a 4,9. Conclusão A versão brasileira da TABS demonstrou equivalência conceitual, de itens e semântica de alta qualidade com o instrumento original, bem como elevada aceitabilidade, consistência interna e compreensão verbal. A escala está atualmente disponível para uso.

Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Objective: To evaluate the frequency of risk behaviors for eating disorder (ED) in patients with type 1 diabetes (T1D) and their association with gender, nutritional status, variables related to T1D, and body satisfaction. Method: 189 individuals with T1D (12-56 years old) answered the Bulimic Investigation Test (BITE), the Eating Attitude Test (EAT), the Binge Eating Scale (BES), Stunkard's Figure Rating Scale, and questions regarding control of T1D. Association between ED risk behaviors and the selected variables was assessed with the chi-square test and Student's t-test; factors that influenced the risk of ED were identified by means of logistic regression. Results: Of the patients with T1D, 58.7% were at risk of ED (45, 40, and 16% according to the EAT, BITE and BES, respectively). There were significant differences between groups with and without risk for ED related to BMI (p = 0.009), gender (p = 0.001), insulin omission (p = 0.003), use of the carbohydrate counting method (p = 0.019), and body dissatisfaction (p = 0.001). The risk of ED was nine times higher in patients who reduced or omitted insulin (p = 0.036). Conclusions: Patients with T1D demonstrated a high frequency of body dissatisfaction and ED risk behaviors; the omission or reduction of insulin was an important risk factor. .