Validez de constructo de un instrumento para la detección de factores de riesgo en los trastornos de la conducta alimentaria en mujeres mexicanas

SUMMARY The main purpose of this paper was to present the construct validity of an instrument for the detection of risk factors for eating disorders in Mexican adolescents and young women, such that professionals in this area have a reliable and valid instrument for the detection of risk factors with qualitative and quantitative specifications, for the discrimination of risk severity in conjunction with decision-making related to prevention and treatment. This has been a theoretical and practical issue lacking issue in our present socio-cultural context. As systematic research on eating disorders is recent in Mexico, and because the low prevalence of these diseases has limited the access to clinical populations, their cause may be explained based on other cultural context’s research findings. Therefore it has become an important task to enrich such information with the Mexican eating disordered women’s experience, related to cultural issues. It may appear reiterative to develop new assessment instruments for this purpose, considering that international workings are abundant and some of them have been already validated with Mexican populations, for instance the Eating Attitudes Test, a self-report screening test of the symptoms and concerns characteristic of eating disorders, and the Eating Disorders Inventory, that measures traits and symptom clusters presumed to have relevance for the understanding and treatment of eating disorders. However, it is important to highlight the cultural differences of a particular culture and their relationship to psychopathology. The results obtained in different cultures, question the universal meanings for psychological disorders challenging the validity of standardization for non-occidental cultures. These views support the development of appropriate assessment instruments in different cultures. The main contribution of this instrument is that it was developed based on the information provided by Mexican eating disordered patients in relation to the development of their illness. Risk factors associated with the development of eating disorders were assessed in a sample of 332 Mexican adolescents and young women (average age 19.1 years, SD=3.8), high school and college students at public and private schools in Mexico City. The study was carried out in two phases: in the first, the individual (eating behaviors, body weight history, curriculum, dating and violence), psychosocial (self-esteem, body image, depression, personality traits, identity and sexuality) and sociocultural (interpersonal relationships, career choice and values towards the body) factors associated with the development of eating disorders were assessed using a qualitative methodology (in-depth interviews) with 10 Mexican eating disordered patients in treatment at the Eating Disorders Unit of the National Institute of Psychiatry Ramon del Fuente in Mexico City. The data obtained from the first phase, was used to identify the most important issues reported by patients, and questions were developed to assess the different areas; this resulted in the development of a 273 question self-report instrument. The instrument included two types of measurements: questions specifically implemented for this study, and scales previously validated in Mexican populations, such as the CES-D, suicidal ideation scale, and the relationship with mother/father scale, the Pope self-esteem scale, and the Eating Disorders Inventory perfectionism, maturity fears and body dissatisfaction scales. The instrument was initially assessed with a pilot study to determine the correct comprehension of the items and its statistical discrimination, with 31 women diagnosed with eating disorders in treatment at the Eating Disorders Unit, and 30 normal controls with similar ages (X=22.5, SD=7.7), similar schooling curriculum in years (X=12.5, DE=3.3) and BMI (X=22.3, SD=3.6). To achieve these goals, independent samples t-tests were conducted between groups, considering as valid those items that were different at a . 05 level. After the pilot study the instrument included 14 areas and 216 questions associated with the development of eating disorders; nevertheless, in this paper only the results from the validation analyses of the 8 Likert scales that comprise the instrument will be reported: depressive symptoms, suicidal ideation, self-esteem, psychological characteristics, relationships with brothers and sisters, with males, with mother