Using an Overlapping Time Interval Strategy to Study Diagnostic Instability in Mild Cognitive Impairment Subtypes.

(1) Background: Mild cognitive impairment (MCI) is a diagnostic label in which stability is typically low. The aim of this study was to examine temporal changes in the diagnosis of MCI subtypes by using an overlapping-time strategy; (2) Methods: The study included 435 participants aged over 50 years with subjective cognitive complaints and who completed at least one follow-up evaluation. The probability of transition was estimated using Bayesian odds ratios; (3) Results: Within the different time intervals, the controls with subjective cognitive complaints represented the largest proportion of participants, followed by sda-MCI at baseline and in the first five intervals of the follow-up, but not in the last eight intervals. The odds ratios indicated higher odds of conversion to dementia in sda-MCI and mda-MCI groups relative to na-MCI (e.g., interval 9-15 months-sda-MCI OR = 9 and mda-MCI OR = 3.36; interval 27-33-sda-MCI OR = 16 and mda-MCI = 5.06; interval 42-48-sda-MCI OR = 8.16 and mda-MCI = 3.45; interval 45-51-sda-MCI OR = 3.31 and mda-MCI = 1); (4) Conclusions: Notable patterns of instability consistent with the current literature were observed. The limitations of a prospective approach in the study of MCI transitions are discussed.

Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity.

Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n = 54) and the other with BED (OB-BED, n = 48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy.

Antecedentes/Objetivos: El trastorno por Atracón (TA) es un trastorno de la conducta alimentaria asociado frecuentemente con la obesidad. Con el objetivo de identificar las variables que permiten detectar mejor la presencia de TA se compararon personas con malnutrición por exceso con y sin TA respecto a la presencia de conflictos cognitivos, sintomatología alimentaria y sintomatología ansioso-depresiva. La inclusión de los conflictos cognitivos había resultado relevante en estudios con bulimia pero no habían sido investigados con respecto al TA. Método: Se evaluó a dos grupos con obesidad, uno sin TA (OB, n = 54) y otro con TA (OBTA, n = 48), utilizando un cuestionario sociodemográfico, una entrevista semiestructurada para evaluar TA, cuestionarios (DASS-21, EDE-Q, EEQ) y la Técnica de la Rejilla. Se realizaron análisis de comparación de grupos y de regresión logística. Resultados: El grupo OBTA presentó más conflictos y más sintomatología. El modelo que mejor diferenció entre los grupos incluyó la alimentación emocional y el nivel de conflictos cognitivos, clasificando correctamente al 91,4% de la muestra. Conclusiones: Estos resultados resaltan el rol que juegan los conflictos cognitivos y la alimentación emocional como aspectos diferenciadores entre OB y OBTA, con un alto nivel de precisión predictiva.

Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity / Alimentación emocional y conflictos cognitivos como predictores del trastorno por atracón en pacientes con obesidad

Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n = 54) and the other with BED (OBBED, n = 48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy (AU)

Antecedentes/Objetivos: El trastorno por Atracón (TA) es un trastorno de la conducta alimentaria asociado frecuentemente con la obesidad. Con el objetivo de identificar las variables que permiten detectar mejor la presencia de TA se compararon personas con malnutrición por exceso con y sin TA respecto a la presencia de conflictos cognitivos, sintomatología alimentaria y sintomatología ansioso-depresiva. La inclusión de los conflictos cognitivos había resultado relevante en estudios con bulimia pero no habían sido investigados con respecto al TA. Método: Se evaluó a dos grupos con obesidad, uno sin TA (OB, n = 54) y otro con TA (OBTA, n = 48), utilizando un cuestionario sociodemográfico, una entrevista semiestructurada para evaluar TA, cuestionarios (DASS-21, EDE-Q, EEQ) y la Técnica de la Rejilla. Se realizaron análisis de comparación de grupos y de regresión logística. Resultados: El grupo OBTA presentó más conflictos y más sintomatología. El modelo que mejor diferenció entre los grupos incluyó la alimentación emocional y el nivel de conflictos cognitivos, clasificando correctamente al 91,4% de la muestra. Conclusiones: Estos resultados resaltan el rol que juegan los conflictos cognitivos y la alimentación emocional como aspectos diferenciadores entre OB y OBTA, con un alto nivel de precisión predictiva (AU)

Psychometric properties of the Modified Tonic Immobility Scale / Propiedades psicométricas de la Escala Modificada de Inmovilidad Tónica

The Tonic Immobility Scale has been only studied in abuse and/or sexual assault survivors, but tonic immobility (TI) also occurs after other types of traumatic events. Consequently, we modified the scale for this purpose and studied its factor structure, internal consistency, and convergent, divergent and discriminant validity in 392 university students, most of whom had suffered one or more traumatic events of various kinds. The Fear subscale of the Modified Tonic Immobility Scale (MTIS)showed very low internal consistency, and must be eliminated or reformulated. Discrimination indices of items 5 and 8 were very low, and these items must be reformulated or removed. After removing the five previous items, the shortened version of the MTIS had a one-factor structure, although model fit was not completely satisfactory. This scale showed acceptable levels of reliability, convergent validity with post-traumatic symptomatology, divergent validity with measures of depression and anxiety, and discriminant validity differentiating between groups that had and had not experienced traumatic events. The psychometric properties of the shortened version of the MTIS should be studied further. It may also be advisable to add new items of TI in order to establish whether this is a construct with more than one dimensión

La Escala de Inmovilidad Tónica ha sido estudiada sólo en víctimas de abusos y/o agresiones sexuales, pero la inmovilidad tónica (IT) puede darse ante otros eventos traumáticos. En consecuencia, nos propusimos modificar la escala con este fin y estudiar su estructura factorial y otras propiedades psicométricas (consistencia interna y validez convergente, divergente y discriminante) en 392 universitarios, la mayoría de los cuales había padecido uno o más eventos traumáticos de distintos tipos. La subescala de miedo de la Escala Modificada de Inmovilidad Tónica (EMIT) mostró una consistencia interna muy baja y debe ser eliminada o reformulada. Los índices de discriminación de los ítems 5 y 8 fueron muy bajos y dichos ítems deben ser reformulados o eliminados. Después de eliminar los cinco ítems anteriores, la versión abreviada de la EMIT tuvo una estructura unifactorial, aunque el ajuste del modelo no fue totalmente satisfactorio. Esta escala mostró niveles aceptables de fiabilidad, validez convergente con sintomatología postraumática, validez divergente con medidas de depresión y ansiedad, y validez discriminante al diferenciar entre grupos que habían experimentado o no eventos traumáticos. Las propiedades psicométricas de la versión abreviada de la EMIT deben ser más estudiadas. Puede ser aconsejable añadir nuevos ítems de IT para determinar si este es un constructo con más de una dimensión

Factor structure of the adolescent coping orientation for problem experiences in Spanish adolescents.

The present study aimed to identify the best structure of the Adolescent Coping Orientation for Problem Experiences when applied to Spanish adolescents. A confirmatory factor analysis of five previous factor structures was conducted. As the data did not fit previous factor models, two exploratory factor analyses (first- and second-order) were carried out to identify the structure for Spanish adolescents and to analyse its criterion validity in relation to mental health, which was assessed by means of the Youth Self-Report. A first-wave sample of 1,152 secondary education pupils (645 boys, 56%; 507 girls, 44%; M age = 14.4 yr., SD = 1.4) was involved in the confirmatory and exploratory factor analyses. A second-wave sample of = 374 secondary education pupils (188 boys, 50.5%; 186 girls, 49.5%; M age = 15.4 yr., SD = 1.1) was used to assess criterion validity. The results yielded eight first-order factors with Cronbach's alpha ranging from .63 to .79, and two second-order factors that replicated the Approach and Avoidance focus of coping. The paper discusses both the content of the extracted factors and mental health issues.

Factorial structure and validity of the Multicultural Quality of Life Index.

PURPOSE: To study the internal structure and the convergent and divergent validity of the Multicultural Quality of Life Index (MQLI) in a Spanish sample. METHODS: The MQLI, along with another quality of life instrument--the World Health Organization Quality of Life, brief version (WHOQOL-BREF)--and the Depression, Anxiety and Stress Scales (DASS-21), was administered to 356 students, 159 people from the general population and 65 psychiatric patients. RESULTS: The value of Cronbach's a was .90. The confirmatory factor analysis showed a good fit for both the one- and two-factor structures. The overall mean score of the MQLI correlated between .61 and .78 with the domains of the WHOQOL-BREF and between -.55 and -.70 with the DASS-21 scales. CONCLUSIONS: The MQLI has high internal consistency, can be interpreted in terms of a single factor, and has an adequate convergent validity, although its absolute correlations with depression and with the WHOQOL-BREF were equally high.

Dimensional structure of the Brief Symptom Inventory with Spanish college students / Estructura dimensional del Brief Symptom Inventory con universitarios españoles

The Brief Symptom Inventory is designed to assess symptoms of psychological disorders in adolescents and adults. The dimensional structure of the inventory, using exploratory and confirmatory factor analyses, was examined with a cross-sectional design in a Spanish sample of college students (N = 1,033, aged between 18 and 30 years old). Two hypotheses were tested: the original distribution of the items in nine factors, and the unidimensionality of the inventory. According to the results, a nine-factor structure seemed to be confirmed, although the strong intercorrelations found among the subscales indicated that these were measuring closely related constructs. The importance of cultural influences when assessing psychological symptoms and the need to develop national and sex norms for instruments that assess psychopathology, are also discussed (AU)

El Brief Symptom Inventory es un autoinforme que permite evaluar síntomas de trastornos psicológicos en jóvenes y adultos. En el presente estudio se analizó la estructura dimensional del cuestionario mediante análisis factorial confirmatorio. La muestra utilizada fueron 1.033 estudiantes universitarios de entre 18 y 30 años, pertenecientes a distintas facultades y centros adscritos de la Universidad de Barcelona. Se testaron dos hipótesis: la distribución original de los ítems en nueve factores y la unidimensionalidad del cuestionario. Los resultados obtenidos parecen confirmar la estructura de nueve factores, si bien las fuertes correlaciones entre las subescalas indican que éstas evalúan constructos muy relacionados. Se discuten también la importancia de las diferencias culturales al evaluar síntomas psicológicos y la necesidad desarrollar datos normativos en función del país y del sexo (AU)

Dimensional structure of the Brief Symptom Inventory with Spanish college students.

The Brief Symptom Inventory is designed to assess symptoms of psychological disorders in adolescents and adults. The dimensional structure of the inventory, using exploratory and confirmatory factor analyses, was examined with a cross-sectional design in a Spanish sample of college students ( N = 1,033, aged between 18 and 30 years old). Two hypotheses were tested: the original distribution of the items in nine factors, and the unidimensionality of the inventory. According to the results, a nine-factor structure seemed to be confirmed, although the strong intercorrelations found among the subscales indicated that these were measuring closely related constructs. The importance of cultural influences when assessing psychological symptoms and the need to develop national and sex norms for instruments that assess psychopathology, are also discussed.

Multi-episode survival analysis: an application modelling readmission rates of heroin dependents at an inpatient detoxification unit.

The purpose of this study is to describe the characteristics of a statistical technique appropriate for analysing multi-episode data (multi-episode survival analysis), and to show its application in modelling the flow of readmissions at an inpatient detoxification unit. Data are from 784 opioid-dependent patients admitted at an inpatient detoxification unit, who totalled 1,255 admission episodes. Information stored prospectively at the unit database was reviewed for the following variables at the time of each patient discharge: episode serial number, sex, route of heroin administration, reason for discharge, time of discharge, and transition time (re-entry into the inpatient detoxification unit). Cox's semi-parametric regression model seems the most appropriate for describing the series of episodes. Amongst the parametric models, most noteworthy was the superior fit of the Gompertz-Makeham model, suggesting that the transition rate decreases monotonically with time. The influence of the variables assessed differed based on the serial number of the episode. The results suggest that multi-episode survival analysis is a statistical method that can fully address the long-term perspective on treatment utilization.