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Resumen Para evaluar la experiencia, expresión y control de la ira, Spielberger construyó el Inventario State-Trait Anger Expression Inventory. El presente trabajo se propuso evaluar la validez y confiabilidad de las puntuaciones de la versión española del STAXI-2 para población general y hospitalaria de República Dominicana. Con este fin se analizó su estructura factorial, se evaluó la consistencia interna del instrumento, y se obtuvieron evidencias de validez mediante el contraste de grupo (población general vs. hospitalaria). Para realizar el estudio se trabajó con muestra de total de 1034 participantes, de población general (N = 792) y hospitalaria (N = 242) de la ciudad de Santiago de los Caballeros, República Dominicana. El análisis factorial confirmatorio permitió verificar el ajuste de los modelos originales para todas las escalas de ira (i.e. modelo de tres factores para la escala de ira-estado; modelo de dos factores para la escala de ira-rasgo; y modelo de cuatro factores para la escala de control y expresión de la ira). Todas las dimensiones descritas alcanzaron índices de fiabilidad aceptables y óptimos. Finalmente, las escalas consideradas discriminaron adecuadamente entre población general y hospitalaria, especialmente cuando se consideró la muestra psiquiátrica. En conjunto los resultados permiten concluir que las puntuaciones de la versión española del STAXI-2 son válidas y confiables para medir el estado-rasgo, y control-expresión de la ira en República Dominicana. Abstract To measure the experience, expression and control of anger, Spielberger built the Inventory State-Trait Anger Expression Inventory. This paper under took to evaluate the validity and reliability of the scores of the Spanish version of the STAXI-2 for the general and hospital population of the DR. To this end, the factorial structure was analyzed, the internal consistency of the instrument was evaluated, and evidence of validity was obtained by contrasting groups (general vs. hospital population). To conduct the study, we worked with a sample of 1034 participants from both the general population (N = 792) and hospital population (N = 242) from the city of Santiago de los Caballeros, Dominican Republic. The confirmatory factor analysis allowed to verify the adjustment of the original models for all anger scales (i.e. three-factor model for the anger-state scale, two-factor model for the anger-trait scale, and four-factor model for the scale of control and expression of anger). All the dimensions reached acceptable or optimal reliability indexes. Finally, the scales adequately discriminated between the general and hospital population, especially when the psychiatric sample was considered. Overall, the results allow us to conclude that the scores of the Spanish version of the STAXI-2 are valid and reliable to measure the state trait, and control-expression of anger in the DR.

Background: Major depressive disorder (MDD) is highly prevalent in the Spanish primary care (PC) setting and the leading cause of disability in Spain. The aim of this study was to evaluate several key psychometric properties of the Sheehan Disability Scale (SDS) in patients with or without MDD and varying degrees of symptom severity using the Patient Health Questionnaire-9 (PHQ-9). Method: A total of 1,704 PC patients participating in the PsicAP clinical trial completed the SDS and PHQ-9. We evaluated the factor structure, measurement invariance across gender, internal consistency, and the discriminative and predictive validity. Results: Confirmatory factor analyses revealed a unifactorial model of the SDS containing 4 items (SDS-4) with the best model fit (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). This model contained the three life domain items (work, family, and social life) plus perceived stress (PS) with significant loadings. The internal consistency of the SDS-4 was acceptable in patients with or without MDD, regardless of symptom severity. The SDS-4 also showed good discriminative capacity and acceptable predictive validity in all subsamples. Conclusions: These findings support the use of the SDS-4 to assess depression-related disability in patients at Spanish primary care centres. Antecedentes: el Trastorno Depresivo Mayor (TDM) es muy prevalente en la atención primaria (AP) española y es la principal causa de discapacidad en España. En este trabajo se estudiaron algunas propiedades psicométricas de la Escala de Discapacidad de Sheehan (SDS) en pacientes con o sin TDM y con varios niveles de severidad de síntomas, usando el Patient Health Questionnaire-9 (PHQ-9). Método: 1.704 pacientes de AP que participaron en el ensayo clínico PsicAP cumplimentaron la SDS y el PHQ-9. Se estudió la estructura factorial, medida de invarianza de género, consistencia interna, validez discriminativa y la validez predictiva. Resultados: el análisis factorial confirmatorio mostró un modelo unifactorial con 4 ítems (SDS-4) con un buen ajuste (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). Este modelo contenía los tres ítems de esferas de la vida (trabajo, familia y vida social) más el ítem de estrés percibido con cargas significativas. La consistencia interna de la SDS-4 fue aceptable en pacientes con MDD y con diferente severidad de síntomas depresivos. También se halló una buena validez discriminativa y aceptable validez predictiva. Conclusiones: nuestros hallazgos respaldan el uso de la SDS-4 cuando se evalúe la discapacidad relacionada con la depresión en centros de AP españoles. Agencia Estatal de Investigación (PSI2012-36589). Fundación Española para la Promoción y el Desarrollo Científico y Profesional de la Psicología. Agencia Estatal de Investigación (SI2014-56368-R). 3.890 JCR (2020) Q2, 30/140 Psychology, Multidisciplinary 1.308 SJR (2020) Q1, 42/263 Psychology (miscellaneous) 2,959 IDR (2020) C1, 4/59 Psicología UEV

Resumen tomado de la publicación Discapacidad y estrés percibido en pacientes de atención primaria con depresión mayor. Antecedentes: el Trastorno Depresivo Mayor (TDM) es muy prevalente en la atención primaria (AP) española y es la principal causa de discapacidad en España. En este trabajo se estudiaron algunas propiedades psicométricas de la Escala de Discapacidad de Sheehan (SDS) en pacientes con o sin TDM y con varios niveles de severidad de síntomas, usando el Patient Health Questionnaire-9 (PHQ-9). Método: 1.704 pacientes de AP que participaron en el ensayo clínico PsicAP cumplimentaron la SDS y el PHQ-9. Se estudió la estructura factorial, medida de invarianza de género, consistencia interna, validez discriminativa y la validez predictiva. Resultados: el análisis factorial confirmatorio mostró un modelo unifactorial con 4 ítems (SDS-4) con un buen ajuste (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). Este modelo contenía los tres ítems de esferas de la vida (trabajo, familia y vida social) más el ítem de estrés percibido con cargas significativas. La consistencia interna de la SDS-4 fue aceptable en pacientes con MDD y con diferente severidad de síntomas depresivos. También se halló una buena validez discriminativa y aceptable validez predictiva. Conclusiones: nuestros hallazgos respaldan el uso de la SDS-4 cuando se evalúe la discapacidad relacionada con la depresión en centros de AP españoles. ESP

Background Somatic symptoms are highly prevalent in primary care although insufficiently understood. The Patient Health Questionnaire (PHQ-15) is a valuable screening test but it has not yet been possible to unequivocally demonstrate its latent structure and measurement invariance. Methods A total of 1,255 patients from 28 primary care centres suffering symptoms of anxiety, depression or somatisation participated in a clinical trial. They completed the PHQ-15 at baseline and 374 retook it at three months. Exploratory structural equation modelling (ESEM) was used to compare three models: 1) a single global factor for somatisation, 2) four specific correlated factors, and 3) a bifactor model integrating the first two models. Results A multi-group invariance analysis of the best-fit model was performed: the bifactor model (χ2=25.17, df=23, p = 0.34, RMSEA=0.009, CFI=1.00, TLI=0.999). Strict invariance was good for both gender (RMSEA = 0.046, CFI = 0.973, TLI = 0.963) and age (RMSEA = 0.048, CFI = 0.964, TLI = 0.962). Configural and metric invariance were confirmed for moment of assessment, but scalar invariance was not. Limitations The two main limitations were the sample (primary care patients with emotional disorders), which was not representative of the general population, and the utilisation of ESEM (vs. confirmatory factor analysis), which did not allow a second-order factor model to be tested. Conclusions PHQ-15 showed a bifactor structure, providing both a single global measure of somatisation and specific measures of pain, gastrointestinal, cardiopulmonary and fatigue factors. Its factor invariance with regard to both gender and age was confirmed.

Background The Generalized Anxiety Disorder 7-item scale (GAD-7) is commonly used by clinicians and researchers to screen for anxiety disorders and to monitor anxiety symptoms in primary care. However, findings regarding its factor structure are mixed, with most studies reporting a best-fitting for a one-factor structure, whereas others indicate a two-factor model. To be valid for comparisons, the GAD-7 should measure the same latent construct with the same structure across groups and over time. We aimed to examine the best-fit factor structure model of the GAD-7 among primary care patients and to evaluate its measurement invariance. Methods A total of 1255 patients completed the computerized version of GAD-7 and a subsample of 238 cases was assessed at the 3-month follow-up. A confirmatory factor analysis (CFA) was performed and analyses of multiple-group invariance were also conducted to determine the extent to which the factor structure was comparable across various sociodemographic groups and over time. Results The results showed that both a one- and two-factor structure (representing somatic and cognitive-affective components) were invariant across sociodemographic groups and over time. The two-factor structure provided the best model fit. Limitations Results cannot be generalized to all primary care patients, as only patients whose general practitioners consider them to suffer emotional disorders were included. Conclusions Our study supports the reliability and validity of the one- and two-factor model of the GAD-7, both for screening purposes and for monitoring response to treatment.

La eficacia, efectividad y eficiencia de la Terapia Cognitivo-Conductual (TCC) para una amplia variedad de problemas psicológicos, particularmente para los trastornos de ansiedad y la depresión, cuenta con mayor apoyo empírico que ninguna otra forma de intervención psicológica. Sin embargo, sólo una pequeña parte de las personas con trastornos mentales comunes recibe un tratamiento adecuado. La expansión del enfoque transdiagnóstico en los trastornos mentales, especialmente en el contexto de Atención Primaria (AP), donde son tratados la mayor parte de las personas con trastornos mentales comunes, puede servir para facilitar el acceso a los tratamientos psicológicos eficaces. El estudio PsicAP es un ensayo clínico en curso para investigar la eficacia de la TCC transdiagnóstica grupal para tratar trastornos emocionales en el entorno de AP. Los resultados de este ensayo podrían servir para promover el uso de tratamientos psicológicos para los trastornos mentales más prevalentes en AP, según lo recomendado por las guías clínicas basadas en la evidencia.

Introducción y objetivos: la insatisfacción corporal parece estar asociada con los trastornos alimentarios, obesidad, disminución de actividad física y consumo de frutas y verduras. En este estudio se han obtenido los datos psicométricos de un cuestionario para medir la insatisfacción corporal: el cuestionario IMAGEN. Método: las muestras estuvieron compuestas por 538 mujeres de edades entre 11 y 22 años, 494 provenientes de centros educativos y 44 con diagnóstico de trastorno alimentario procedentes de hospitales. Resultados: los resultados del análisis factorial confirmatorio reducen los ítems desde 38 de la versión original a 25. El modelo muestra una estructura pentafactorial de primer orden: a) emocional, con cinco ítems; b) miedo a engordar, con cuatro ítems; c) planteamiento de cambio, con tres ítems; d) perceptivo, con seis ítems; e) comportamental, con cuatro ítems; y un factor de segundo orden (cognitivo-emocional) que incluye a los factores: emocional, miedo a engordar, y planteamiento de cambio. Se analizaron los datos psicométricos siguientes: consistencia interna (alfa entre 0,84-0,92), validez discriminante (diferencias significativas entre grupo clínico y control), y validez convergente (correlaciones significativas con el EDI-2), considerándose adecuados. Además, se establecieron puntos de corte para las subescalas, interpretando que puntuaciones altas en insatisfacción están asociadas con tener trastorno alimentario. Las estimaciones más precisas se obtienen para el factor comportamental (odds ratio 33,2; IC 95% = 15,1-68,3). Conclusión: a partir de los resultados se estima que el cuestionario IMAGEN reducido presenta buenos indicadores psicométricos para evaluar la insatisfacción corporal, aunque se necesitan más investigaciones con diferentes muestras antes de generalizar su uso. Introduction and objectives: Body dissatisfaction seems to be associated with eating disorders, obesity, decreasing levels of physical activity and fruit and vegetable consumption. In this study the psychometric properties of a questionnaire to measure body dissatisfaction, the IMAGEN questionnaire, have been obtained. Method: The samples have been composed of 538 women of ages between 11 and 22 years, 494 out from different schools and 44 out diagnosed of eating disorder from hospital. Results: The confirmatory factor analysis reduces the items from 38 in the original version to 25. The model shows a penta-factor structure: a) emotional, with five items; b) fear to gain weight, with four; c) approach to change, with three; d) perceptive, with six; and e) behavioral, with four items. Besides, it has been obtained a second order factor (cognitive-emotional) that includes the a), b) and c) previous factors. The psychometric properties such as internal consistency (alpha from 0.84 to 0.92), discriminative validity (significant difference by group) and convergent validity (significant statistical relation between IMAGE and EDI-2 factors) have been evaluated and some acceptable results have been obtained. In addition to that, the cut-offs for each questionnaire scale were established, implying that high scores in body dissatisfaction are associated with having an eating disorder. The most accurate estimates correspond to the behavioral factor of dissatisfaction (odds ratio 33.2; IC 95% = 15.1-68.3). Conclusion: From these results it is concluded that the reduced IMAGE questionnaire presents good psychometric properties. However, more research is needed with different samples before generalizing its use.

Introduccion y objetivos: la insatisfaccion corporal parece estar asociada con los trastornos alimentarios, obesidad, disminucion de actividad fisica y consumo de frutas y verduras. En este estudio se han obtenido los datos psicometricos de un cuestionario para medir la insatisfaccion corporal: el cuestionario IMAGEN. Metodo: las muestras estuvieron compuestas por 538 mujeres de edades entre 11 y 22 anos, 494 provenientes de centros educativos y 44 con diagnostico de trastorno alimentario procedentes de hospitales. Resultados: los resultados del analisis factorial confirmatorio reducen los items desde 38 de la version original a 25. El modelo muestra una estructura pentafactorial de primer orden: a) emocional, con cinco items; b) miedo a engordar, con cuatro items; c) planteamiento de cambio, con tres items; d) perceptivo, con seis items; e) comportamental, con cuatro items; y un factor de segundo orden (cognitivo-emocional) que incluye a los factores: emocional, miedo a engordar, y planteamiento de cambio. Se analizaron los datos psicometricos siguientes: consistencia interna (alfa entre 0,84-0,92), validez discriminante (diferencias significativas entre grupo clinico y control), y validez convergente (correlaciones significativas con el EDI-2), considerandose adecuados. Ademas, se establecieron puntos de corte para las subescalas, interpretando que puntuaciones altas en insatisfaccion estan asociadas con tener trastorno alimentario. Las estimaciones mas precisas se obtienen para el factor comportamental (odds ratio 33,2; IC 95% = 15,1-68,3). Conclusion: a partir de los resultados se estima que el cuestionario IMAGEN reducido presenta buenos indicadores psicometricos para evaluar la insatisfaccion corporal, aunque se necesitan mas investigaciones con diferentes muestras antes de generalizar su uso.

The Beck Depression Inventory-II (BDI-II) is currently one of the most widely used measures in both research and clinical practice for assessing depression. Although the psychometric properties of the scale have been well established through many studies worldwide, so far there is no study examining the validity and reliability of BDI-II in Republic Dominican. The purpose of the present study was twofold: (a) to examine the latent structure of BDI-II by testing several competing models proposed in the literature; and (b) to provide evidence of validity and reliability of the BDI-II in Republic Dominican. Confirmatory factor analysis indicated that a bifactor model with a general depression factor and three specific factors consisting of cognitive, affective and somatic showed the best fit to the data. Internal reliability was moderate to high for all subscales and for the total scale. Scores on BDI-II discriminated between clinical and general population, supporting for external validity. Practical implications are discussed and suggestions for further research are also made.

The aim of the study was to determine the criterion validity of a computerized version of the General Anxiety Disorder-7 (GAD-7) questionnaire to detect general anxiety disorder in Spanish primary care centers. A total of 178 patients completed the GAD-7 and were administered the Composite International Diagnostic Interview (CIDI) for DSM-IV Axis I Disorders, which was used as a reference standard. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. A cut-off of 10 yielded a sensitivity of .87, a specificity of .78, a positive predictive value of .93, a negative predictive value of .64, a positive likelihood ratio of 3.96 a negative likelihood ratio of .17 and Younden’s Index of .65. The GAD-7 performed very well with a cut-off value of 10, the most frequently used cut-off point. Thus, a computerized version of the GAD-7 is an excellent screening tool for detecting general anxiety disorder in Spanish primary care settings.

Measurement of depressive comorbidity in drug dependents: Validity and diagnostic efficiency of Beck's Depression Inventory (BDI-II) in Dominicans with multiple substance consumption. The present study proposed two main objectives, a) evaluate the validity of BDI-II for the identification of comorbid depressive symptoms in people with multiple substance abuse (i.e. Known-Groups Validity); and b) verify the diagnostic efficacy of the inventory for the distinction between general population and clinical drug dependents. From a two-stage sampling, a total of 116 Dominicans was selected, of whom 50% were drug-dependent. Analysis of differences between groups and analysis of COR curves were applied. The results show statistically significant and large effect size differences in depression levels in favor of the substance abuse group. In addition, COR curve analyses indicate that depression scores derived from BDI-II have adequate diagnostic performance indices. In short, evidence is provided in favor of the appropriateness and validity of the BDI-II to be applied in a population of drug dependents. Keywords: Drug dependents; depression; BDI-II; comorbidity; known-groups validity; COR curves; Dominican Republic. Resumen: El presente estudio se propuso como objetivos, a) evaluar la validez del BDI-II para la identificación de sintomatología depresiva comórbida en personas con múltiple abuso de sustancias (i.e. Known-Groups Validity); y b) verificar la eficacia diagnóstica del inventario para la distinción entre población general y drogodependientes clínicos. A partir de un muestreo bietapico, se seleccionó un total de 116 dominicanos de los cuales el 50% era drogodependiente. Se aplicaron análisis de diferencias entre grupos y análisis de curvas COR. Los resultados muestran diferencias estadísticamente significativas, y de tamaño del efecto grande, en los niveles de depresión en favor del grupo de personas con problemática de abuso de sustancias. Además, los análisis de curvas COR indican que los puntajes de depresión derivados del BDI-II presentan índices de rendimiento diagnóstico adecuados. En suma, se aporta evidencia a favor de la adecuación y validez del BDI-II para ser aplicado en población de drogodependientes. Palabras clave: Drogodependencia; depresión; BDI-II; comorbilidad; known-groups validity; curvas COR; República Dominicana.

espanolEl objetivo de la investigacion fue comparar las manifestaciones de ansiedad entre estudiantes de medicina dominicanos y espanoles. La muestra total estuvo conformada por 160 estudiantes de ambos paises, 40 mujeres y 40 hombres en cada uno de los grupos, todos con una edad de 18 anos, seleccionados de manera no probabilistica de tipo intencional y teniendo como criterio de inclusion no haber sido diagnosticados por algun trastorno de ansiedad. Como instrumento de medicion se aplico el Inventario de Situaciones y Respuestas de Ansiedad-ISRA. Los datos fueron analizados mediante un ANOVA de dos factores (sexo y nacionalidad) el cual permitio hallar como resultado diferencias estadisticamente significativas por sexo para el sistema de respuesta cognitivo, fisiologico y nivel general de ansiedad, asi como en areas situacionales de ansiedad de evaluacion y ansiedad en situaciones cotidianas. No se hallaron diferencias significativas por nacionalidad entre ambos grupos. EnglishThe aim of this study was to compare the manifestations of anxiety in Dominican and Spanish medical students. The total sample consisted of 160 students of both nationalities (80 students per group divided into 40 men and 40 women per group). All participants were more than 18 years old and were selected using a non-probabilistic intentional sampling method. The inclusion criterion was not having been previously diagnosed with an anxiety disorder. The assessment instrument used was the Inventory of Situations and Responses of Anxiety (ISRA). Data were analysed using ANOVA to determine statistically significant differences by gender and nationality. Differences by gender were found in cognitive and physiological responses, overall level of anxiety, and situational areas of anxiety assessment and anxiety in everyday situations. No significant differences were found by nationality.

The main objective of the present research was the standardization and validation of the Inventory of Situations and Responses of Anxiety ISRA (Miguel - Tobal & Cano -Vindel, 2002) in the population of the Dominican Republic. Additionally, to verify if the ISRA distinguish between healthy individuals and patients diagnosed with bronchial asthma was a key objective too. The total sample of 1074 subjects aged 18 to 69 years was composed by 986 healthy subjects (students and the general population) and 88 individuals with bronchial asthma, to whom we applied the Inventory of Situations and Responses of Anxiety (ISRA; Miguel - Tobal & Cano -Vindel, 2002), and the Spanish version of the State-Trait Inventory (STAI, Spielberger, Edwards, Lushene, Montuori & Platzek, 1970). The data were analyzed by two-way ANOVA, showing significant differences between anxiety levels of the groups assessed. APEs confirm the existence of three sets of responses (cognitive, physiological and motor) and 3 situational areas (assessment, interpersonal, phobic and everyday life). High reliability was evidenced by Cronbach’s alpha and test-retest. Significant positive correlations between the ISRA and the STAI for concurrent validity were obtained. These results show that ISRA is a reliable and valid instrument to assess anxiety.

Panic attacks frequently lead to psychopathological disorders, including panic disorder. Even though panic disorder is a highly comorbid and disabling mental health problem associated with stressful life or traumatic events, perievent panic attacks and their association with panic disorder have hardly been investigated as a central topic after mass trauma. Using data from a longitudinal population-based assessment of Madrid residents after the March 11, 2004 train bombings (N = 1,589), with assessments conducted 1, 6, and 12 months after the attacks, the rate of perievent panic attacks was 10.9%. Level of exposure, previous life stressors, and negative emotionality were associated with perievent panic attacks (β = .12, .15, and .10, respectively), which in turn mediated the relationship between exposure to the terrorist event and panic disorder in the following year. Previous life stressors (β = .15) and low social support (β = -.14) were directly associated with panic disorder during the subsequent year. The most vulnerable individuals who experienced perievent panic attacks were 3.7 times, 95% confidence interval [CI] = [2.1, 6.4], more likely to suffer from panic disorder in the following year. Results suggest that early identification of perievent panic attacks following mass trauma may be helpful for reducing panic disorder.

Background The prevalence of major depressive disorder (MDD) in Spanish primary care (PC) centres is high. However, MDD is frequently underdiagnosed and consequently only some patients receive the appropriate treatment. The present study aims to determine the utility of the Patient Health Questionnaire-9 (PHQ-9) to identify MDD in a subset of PC patients participating in the large PsicAP study. Methods A total of 178 patients completed the full PHQ test, including the depression module (PHQ-9). Also, a Spanish version of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was implemented by clinical psychologists that were blinded to the PHQ-9 results. We evaluated the psychometric properties of the PHQ-9 as a screening tool as compared to the SCID-I as a reference standard. Results The psychometric properties of the PHQ-9 for a cut-off value of 10 points were as follows: sensitivity, 0.95; specificity, 0.67. Using a cut-off of 12 points, the values were: sensitivity, 0.84; specificity, 0.78. Finally, using the diagnostic algorithm for depression (DSM-IV criteria), the sensitivity was 0.88 and the specificity 0.80. Conclusions As a screening instrument, the PHQ-9 performed better with a cut-off value of 12 versus the standard cut-off of 10. However, the best psychometric properties were obtained with the DSM-IV diagnostic algorithm for depression. These findings indicate that the PHQ-9 is a highly satisfactory tool that can be used for screening MDD in the PC setting. Trial registration Current Controlled Trials ISRCTN58437086 . Registered 20 May 2013.

BACKGROUND Demand for primary care (PC) services in Spain exceeds available resources. Part of this strong demand is due to the high prevalence of emotional disorders (EDs)-anxiety, depression, and somatic symptom disorders-and related comorbidities such as pain or chronic illnesses. EDs are often under- or misdiagnosed by general practitioners (GPs) and, consequently, treatment is frequently inadequate. OBJECTIVE We aim to compare the short- and long-term effectiveness of group-delivered transdiagnostic cognitive behavioral therapy (TD-CBT) versus treatment as usual (TAU) in the treatment of EDs in the PC setting in Spain. We also aim to compare the effect of these treatments on disability, quality of life, cognitive-emotional factors, and treatment satisfaction. METHODS Here we present the study design of a two-arm, single-blind, randomized controlled trial (N=1126) to compare TAU to TD-CBT for EDs. TAU will consist primarily of pharmacological treatment and practical advice from the GP while TD-CBT will be administered in seven 90-minute group sessions held over a period ranging from 12 to 14 weeks. Psychological assessments are carried out at baseline (ie, pretreatment); posttreatment; and at 3-, 6-, and 12-month follow-up. The study is conducted in approximately 26 PC centers from the National Health System in Spain. RESULTS This study was initiated in December 2013 and will remain open to new participants until recruitment and follow-up has been completed. We expect all posttreatment evaluations to be completed by December 2017, and follow-up will end in December 2018. CONCLUSIONS We expect the TD-CBT group to have better results compared to TAU on all posttreatment measures and that this improvement will be maintained during follow-up. This project could serve as a model for use in other areas or services of the National Health System in Spain and even in other countries. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN): 58437086; http://www.isrctn.com/ISRCTN58437086 (Archived by WebCite at http://www.webcitation.org/6mbYjQSn3).

Body dissatisfaction seems to be associated with eating disorders, obesity, decreasing levels of physical activity and fruit and vegetable consumption. In this study the psychometric properties of a questionnaire to measure body dissatisfaction, the IMAGEN questionnaire, have been obtained.The samples have been composed of 538 women of ages between 11 and 22 years, 494 out from different schools and 44 out diagnosed of eating disorder from hospital.The confirmatory factor analysis reduces the items from 38 in the original version to 25. The model shows a penta-factor structure: a) emotional, with five items; b) fear to gain weight, with four; c) approach to change, with three; d) perceptive, with six; and e) behavioral, with four items. Besides, it has been obtained a second order factor (cognitive-emotional) that includes the a), b) and c) previous factors. The psychometric properties such as internal consistency (alpha from 0.84 to 0.92), discriminative validity (significant difference by group) and convergent validity (significant statistical relation between IMAGE and EDI-2 factors) have been evaluated and some acceptable results have been obtained. In addition to that, the cut-offs for each questionnaire scale were established, implying that high scores in body dissatisfaction are associated with having an eating disorder. The most accurate estimates correspond to the behavioral factor of dissatisfaction (odds ratio 33.2; IC 95% = 15.1-68.3).From these results it is concluded that the reduced IMAGE questionnaire presents good psychometric properties. However, more research is needed with different samples before generalizing its use.INTRODUCCIÓN Y OBJETIVOS: la insatisfacción corporal parece estar asociada con los trastornos alimentarios, obesidad, disminución de actividad física y consumo de frutas y verduras. En este estudio se han obtenido los datos psicométricos de un cuestionario para medir la insatisfacción corporal: el cuestionario IMAGEN. MÉTODO: las muestras estuvieron compuestas por 538 mujeres de edades entre 11 y 22 años, 494 provenientes de centros educativos y 44 con diagnóstico de trastorno alimentario procedentes de hospitales. RESULTADOS: los resultados del análisis factorial confirmatorio reducen los ítems desde 38 de la versión original a 25. El modelo muestra una estructura pentafactorial de primer orden: a) emocional, con cinco ítems; b) miedo a engordar, con cuatro ítems; c) planteamiento de cambio, con tres ítems; d) perceptivo, con seis ítems; e) comportamental, con cuatro ítems; y un factor de segundo orden (cognitivo-emocional) que incluye a los factores: emocional, miedo a engordar, y planteamiento de cambio. Se analizaron los datos psicométricos siguientes: consistencia interna (alfa entre 0,84-0,92), validez discriminante (diferencias significativas entre grupo clínico y control), y validez convergente (correlaciones significativas con el EDI-2), considerándose adecuados. Además, se establecieron puntos de corte para las subescalas, interpretando que puntuaciones altas en insatisfacción están asociadas con tener trastorno alimentario. Las estimaciones más precisas se obtienen para el factor comportamental (odds ratio 33,2; IC 95% = 15,1-68,3). CONCLUSIÓN: a partir de los resultados se estima que el cuestionario IMAGEN reducido presenta buenos indicadores psicométricos para evaluar la insatisfacción corporal, aunque se necesitan más investigaciones con diferentes muestras antes de generalizar su uso.