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.

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.

Abstract The purpose of this work was to identify characteristics associated with risky eating behaviors (REB) in university students. Participants were 781 women and 570 male students of a public university, with an average age of 20.1 years (SD = 2.7) and 21.2 years (SD = 3.3), respectively. The participants completed a set of self-report questionnaires, and their weight and height were measured. The prevalence of moderate frequency REB among women was 23.0% and high frequency 10.1%, while among men it was 22.3% and 6.7%, respectively (p = 0.07). Among women, the characteristics that increased the risk to present REB were: body dissatisfaction (OR = 5.4), negative affect (OR = 3.8), internalization of the ideal of thinness (OR = 3.6), and practicing some sport (OR = 2.8). Among men, these characteristics were: having being teased (OR = 10.3), drive for muscularity (OR = 3.4), body mass index (OR = 3.5) and practicing some sport (OR = 3.1). Given the different characteristics that increase the probability of presenting REB among university students and men, it is necessary to establish models that describe the specific risk conditions according to sex, as well as, to develop appropriate instruments and interventions.

Resumen El objetivo de este trabajo fue identificar características asociadas a conductas alimentarias de riesgo (CAR) en estudiantes universitarios. Participaron 781 mujeres y 570 hombres estudiantes de una universidad pública, con edad promedio de 20.1 años (DE = 2.7) y 21.2 años (DE = 3.3), respectivamente. Los participantes completaron una batería de cuestionarios de autoinforme y se registró su peso y talla. La prevalencia de CAR de frecuencia moderada entre las mujeres fue 23.0% y de frecuencia alta 10.1%, mientras que entre los hombres fue 22.3% y 6.7%, respectivamente (p = 0.07). Entre las mujeres, las características que aumentaron el riesgo para presentar CAR fueron: insatisfacción corporal (OR = 5.4), afecto negativo (OR = 3.8), interiorización del ideal de delgadez (OR = 3.6) y practicar algún deporte (OR = 2.8). Entre los hombres, estas características fueron: haber recibido burlas (OR = 10.3), motivación por la musculatura (OR = 3.4), índice de masa corporal (OR = 3.5) y practicar algún deporte (OR = 3.1). Ante las diferentes características que aumentan la probabilidad para presentar CAR entre mujeres y hombres universitarios, es necesario plantear modelos que describan las condiciones específicas de riesgo según sexo, así como desarrollar instrumentos e intervenciones apropiadas.

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.

Abstract The sociocultural pressure on university students, and particularly those studying Nutrition, negatively influences their body image (BI), which favors the adoption of risky eating behaviors (REB), regardless of their nutritional status (NS). The purpose of this study was to describe the relationship between body dissatisfaction (BD), NS and REB in Nutrition students. A total of 370 students from a private university participated (93.5% women), with a mean age of 19.5 years (SD = 2.5). Although 81% of the students were normal weight, 72.3% had BD. Participants with obesity, overweight or normal weight had moderate risk of REB (p < .05), but not those who were satisfied with their BI (p < .05). Specifically, students who wished to have a thinner silhouette showed greater risk of REB (OR = 2.97, p < .05) vs. those who wished to have a robust silhouette (p = . 76). In addition, the higher body mass index, the more exercise to lose weight, restrictive diets, binge eating and loss of control when eating (p < .05). It is necessary to develop interventions aimed at improving body satisfaction to prevent REB among university students, with greater emphasis on those who choose Nutrition as a professional career.

Resumen La presión sociocultural sobre los estudiantes universitarios, y en particular los que estudian nutrición, influye de manera negativa en su imagen corporal (IC), lo que favorece la adopción de conductas alimentarias de riesgo (CAR), independientemente de su estatus nutricional (ETN). El propósito del presente trabajo fue analizar la relación entre insatisfacción corporal (INC), ETN y CAR en estudiantes de nutrición. Participaron 370 estudiantes de una universidad privada (93.5% mujeres), con edad promedio de 19.5 años (DE = 2.5). Aunque 81% de los estudiantes era normopeso, 72.3% presentaron INC. Los participantes con obesidad, sobrepeso o normopeso presentaron riesgo moderado de presentar CAR (p < .05), pero no aquellos que estaban satisfechos con su IC (p < .05). Específicamente, los estudiantes que desearon tener una silueta más delgada mostraron mayor riesgo de presentar CAR (OR = 2.97, p < .05) vs. quienes deseaban tener una más robusta (p = .76). Además, a mayor índice de masa corporal, mayor práctica de ejercicio para bajar de peso, dietas restrictivas, atracones y pérdida de control al comer (p < .05). Es necesario desarrollar intervenciones orientadas a mejorar la satisfacción corporal para prevenir CAR entre estudiantes universitarios, y con mayor énfasis en aquellos que optan por cursar la carrera de nutrición.

Abstract The purpose of this study was to identify and comprehend the family aspects associated to the development of an eating disorder (ED), from the point of view of parents with daughters diagnosed with an ED and women diagnosed with an ED. It is a qualitative study where a semi structured interview was used that gathered information about familial support, emotional expression, familial cohesion, problem solving, stressful life events and life cycle transitions, criticism about eating, body shape and weight. The sample comprised nine participants: five parents with daughters diagnosed with an ED, and four women with an ED. A content analysis derived two categories: Difficulties in rearing practices, and Parent’s negative attitudes towards daughters eating, shape and weight. Parents showed difficulty with rearing practices during their daughter’s childhood and adolescence that hindered the identification of the beginning of the ED. Parents also demonstrated affect by expressing approbation words when their daughters were slim and skipped this same expression for those who weren’t. Both aspects were related to the development of an ED. In conclusion, it is highlighted the importance of considering familial aspects in the prevention of ED.

Resumen El objetivo de este trabajo fue identificar y comprender los aspectos familiares (AF) asociados al desarrollo de un trastorno de la conducta alimentaria (TCA), a partir de la percepción de padres con hijas diagnosticadas con TCA y de mujeres con diagnóstico de TCA. Este estudio cualitativo, con base a una entrevista semi-estructurada, abordó temas como: apoyo familiar, expresión de emociones, cohesión familiar, solución de problemas, situaciones de vida estresantes y de transición en el ciclo vital de la familia, burlas y comentarios negativos hacia la alimentación, la forma y el peso corporal. La muestra constó de nueve participantes: cinco padres de hijas diagnosticadas con TCA y cuatro mujeres con diagnóstico de TCA. El análisis de contenido derivó dos categorías: Dificultades en las prácticas parentales y Actitudes negativas de los padres hacia la alimentación, la forma y el peso de sus hijas. Los padres mostraron dificultades en las prácticas de crianza durante la infancia y la adolescencia de su hija, lo que obstaculizó la identificación del inicio del TCA. Además, los padres expresaban su afecto emitiendo palabras de aprobación cuando sus hijas eran delgadas y omitían expresarlo a las que no lo eran. Ambos aspectos relacionados con el desarrollo del TCA. En conclusión, destaca la importancia de considerar los AF en la prevención de los TCA.

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.

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.

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.

Objetivo. La crianza de los hijos es una de las funciones de carácter universal más importantes de la familia. Este estudio aborda la perspectiva y la valoración de los hijos en este proceso, en el que participan activamente. El objetivo del estudio fue construir y validar una escala para medir la percepción de jóvenes estudiantes con respecto a la crianza parental en el ámbito familiar. Método. Se trabajó con una muestra estratificada por área de conocimiento de 727 estudiantes de la Universidad Autónoma del Estado de México en la ciudad de Toluca, aplicando el instrumento de manera colectiva en los salones de clase, con la colaboración anónima y voluntaria de los participantes. Resultados. Como resultado del análisis factorial con rotación varimax, la versión final de la escala quedó estructurada con 32 reactivos agrupados en tres factores: mostrar interés en las actividades del hijo, apoyo hacia el hijo y orientación al hijo. La escala obtuvo un Alfa de Cronbach de 0.91, explicando el 41% de la varianza. Los resultados muestran que entre los jóvenes predomina una evaluación positiva de la frecuencia con la que los padres desempeñan las actividades de crianza, considerando que éstos cumplen con su función socializadora. Conclusión. Se concluye que es importante realizar más investigaciones sobre la perspectiva y las experiencias que tienen los hijos en el proceso de crianza y en la interacción con sus padres.

Objective. The raising of children is universally one of the most important functions of a family. This study deals with the perspective and the valuation of children in this process in which they actively participate. The objective was the construction and validation of a scale with which to measure the perception of young students regarding parental upbringing in the familial environment. Method. A stratified sample according to areas of knowledge was identified. The instrument was applied collectively in classrooms, anonymously and voluntarily, to 727 Universidad Autónoma students from the Estado de México in the city of Toluca. Results. As a result of the factor analysis with varimax rotation, the final version of the scale was structured with 32 items grouped according to three factors: interest shown in the activities of the child, support given the child, and orientation given the child. The scale obtained a Cronbach Alfa of 0.91, explaining 41% of the variance. The results show that, among the young people, a positive evaluation predominates regarding the frequency with which parents assume activities related to upbringing, thus leading to the consideration that they fulfill their socializing function. Conclusion. In conclusion it is important to do more research on the perspective and the experiences which children have with the process of upbringing and their interaction with their parents.

Escopo. A criança dos filhos é uma das funções principais de caráter universal mais importantes da família. Em este estudo é abordada a perspectiva e a valoração dos filhos em este processo, no que eles participam ativamente. Metodología. O escopo do estudo foi construir e validar uma escala para medir a percepção dos jovens estudantes sobre a criança parental no âmbito familiar. Material e metodologia. No trabalho foi usada uma mostra estratificada por área de conhecimento de 727 estudantes da Universidade Autónoma do Estado de México na cidade de Toluca, e foi aplicado o instrumento de maneira coletiva nas aulas de classe, com colaboração anónima e voluntaria dos participantes. Resultados. Como resultados da análise fatorial com rotação varimax, na versão final a escala quedou estruturada con 32 reativos agrupados em três fatores: mostrar o interesse nas atividades do filho, apoio para o filho e orientação ao filho. A escala teve um Alfa de Cronbach de 0.91, explicando o 41% da variação. Os resultados mostram que entre os jovens predomina uma avaliação positiva da frequência com a de os pais desenvolvem nas atividades de criança, considerando que estes tem com sua função socializadora. Conclusão. A conclusão é ressaltar a importância a realização de mais pesquisas sobre a perspectiva e as experiências que tem os filhos no processo de criança e na interação com seus pais.

OBJECTIVE: Determine the relationship between the variables of self-esteem (SE), body dissatisfaction (BD), and body mass index (BMI) in a continuum of risky eating behaviors (REB) that ranges from normal behavior to the risk of eating disorders (ED), thus facilitating early detection of adolescents with ED symptomatology and the degree to which such variables have an influence. METHODS: A total of 1 982 young women aged 15-19 were selected through stratified random sampling. Self-esteem (Pope, McHale, and Craighead scale), body dissatisfaction (Stunkard's Figure Rating Scale), and body mass index were measured. A brief REB questionnaire was administered. Three categories of REB were defined: no risk, moderate risk, and high risk. A multiple regression analysis was performed. RESULTS: A direct relationship was found between risk of REB and BD, with significant differences between the groups (P < 0.001): no risk (83.6% of sample), 54.1% had BD; moderate risk (11.9% of sample), 84.8% had BD; and high risk (4.5% of sample), 89.9% had BD. There were significant differences in SE and BMI only between the group with no risk and each of the risk groups. Self-esteem played a role in predicting REB in all the regression models evaluated, whereas BMI did not. CONCLUSIONS: It is essential to identify adolescents at moderate risk of REB who have prodromic features of ED such as low SE and BD. When these features occur simultaneously, they can mediate a negative effect of BMI on REB

OBJETIVO: Determinar las relaciones existentes entre las variables autoestima (AU), insatisfacción corporal (IC) e índice de masa corporal (IMC) en un continuo de conductas alimentarias de riesgo (CAR) que abarque desde la normalidad hasta el riesgo de trastornos de conducta alimentaria (TCA), facilitando así la detección temprana de adolescentes con manifestaciones de TCA y el grado en que influyen dichas variables. MÉTODOS: Se seleccionaron 1 982 mujeres de 15 a 19 años de edad, de acuerdo con un muestreo aleatorio estratificado. Se midió la AU (escala de Pope, McHale y Craighead), la IC ("Escala análoga de figuras corporales" de Stunkard) y el IMC. Se administró un cuestionario breve de CAR. Se definieron tres categorías de CAR: sin riesgo, riesgo moderado y riesgo alto. Se realizó la prueba de regresión multinomial. RESULTADOS: Se encontró una relación directa entre el riesgo de CAR y la IC, con diferencias significativas entre grupos (P < 0,001): sin riesgo (83,6% de la muestra) 54,1% presentaron IC; con riesgo moderado (11,9% de la muestra) 84,8% presentaron IC, y de riesgo alto (4,5% de la muestra) 89,9% presentaron IC. En AU e IMC solo hubo diferencias significativas entre el grupo sin riesgo y cada uno de los grupos de riesgo. La AU participó en la predicción de CAR en todos los modelos de regresión evaluados, mientras que el IMC no lo hizo. CONCLUSIONES: Es perentorio identificar adolescentes en riesgo moderado de CAR que revelen características prodrómicas de TCA, como baja AU e IC, las cuales, cuando se presentan de forma conjunta, pueden mediar un efecto negativo del IMC sobre las CAR

The aim of this study was to validate the instrument Body Shape Questionnaire (BSQ) in female Mexican population, created to assess body dissatisfaction. 472 women participated, 256 were students and formed the control group (x‾ = 15.9, DE = 3.2) and 216 patients with Eating Disorders (ED) (x‾ = 20.5, DE = 3.9) with an age range of 13 to 30 years. The results showed excellent internal consistency (a = .98) and a 2-factor structure that explained 63.8% of the total variance. These were: 1) normative body uncomfort (α=.95), and 2) pathological body uncomfort (α=.94). Regarding the discriminant and predictive validity, the BSQ showed good ability to classify individuals with eating disorders, depending on body dissatisfaction, noting that such capacity is greater when discriminating between Anorexia, Bulimia and control (λ de Wilks = .485, χ2(gl=1)= 278.830, p≤ .001). Finally we explored 6 different cut off points, of which the 110-was proved to be the most appropriate according to their values of sensitivity (84.3%) and specificity (84.4%). In conclusion, the BSQ is a useful questionnaire to detect body dissatisfaction in Mexican women.

El objetivo de la presente investigación fue validar el instrumento en población mexicana femenina Body Shape Questionnaire (BSQ), creado con la finalidad de evaluar la insatisfacción corporal. Participaron 472 mujeres, 256 eran estudiantes (x‾ = 15.9, DE = 3.2) y conformaron el grupo control y 216 pacientes con Trastorno del Comportamiento Alimentario (TCA) (x‾ = 20.5, DE = 3.9) con un rango de edad de 13 a 30 años. Los resultados mostraron una excelente consistencia interna (a = .98), así como una estructura de 2 factores que explicaron el 63.8% de la varianza total. Estos fueron: 1) Malestar corporal normativo (α=.95) y 2) Malestar corporal patológico (α=.94). Respecto a la validez discriminante y predictiva, el BSQ mostró una buena capacidad de clasificar a individuos con TCA, en función de la insatisfacción corporal, y se observó que dicha capacidad es mayor cuando discrimina entre Anorexia, Bulimia y control (λ de Wilks = .485, χ²(gl=1)= 278.830, p≤ .001). Finalmente se exploraron 6 diferentes puntos de corte, de los cuales 110 fue el que demostró ser el más apropiado, de acuerdo a sus valores de sensibilidad (84.3%) y especificidad (84.4%). En conclusión el BSQ es un cuestionario de gran utilidad para detectar la insatisfacción corporal en mujeres mexicanas.

Introduction Body image is a concept which involves the feelings, attitudes and perceptions people have about their own body, and is influenced by the adoption of social standards. Body image studies are used in the field of eating disorders research in order to analyze the degree of body dissatisfaction. However, most of the scales proposed to assess body image have been developed in Anglo-Saxon and European countries. Therefore, research on this topic in other socio-cultural contexts requires the standardization and validation of culturally adapted instruments. The aim of the present study was to determine and discuss the reliability and validity of a Mexican scale which measures body image. Additionally, comparisons regarding body dissatisfaction, internalization of the aesthetic ideal of thinness, social influence, age and Body Mass Index (BMI) were made between groups of female college students with and without disordered eating. Materials and methods The sample of this study comprised 508 female college students from the Universidad Autónoma del Estado de México, selected by means of a probabilistic stratification procedure taking into account the proportion of female students enrolled in each academic area of the university. Their average age was 20.1 years; their mean weight was 57.2 kg with an average height of 1.58 m, whereas the average BMI was 22.8. Based on the theoretical assumptions, three indicators were defined to structure the Body Image Scale: body dissatisfaction, social influence and the internalization of the aesthetic ideal of thinness, measured by a five-point Likert-type scale ranging from never (1) to always (5). A pilot study was carried out in a population of 100 college women; as a result, some adjustments were made in the instructions and in the order of the items. Additionally, a content validation was conducted through the judgments of four professional experts in the clinical mental health area. The scale contains thirty-three items; six of them refer to criticism and family pressure to maintain a slim silhouette and twelve address body dissatisfaction. The remaining fifteen items were taken from the Attitudes Towards Body Figure Questionnaire developed by Unikel, Gomez Peresmitré and Juarez. Results After using Kaiser-Meyer-Olkin's (KMO) and Bartlett's tests for establishing the factor structure of the instrument and obtaining a value of 0.94 (p<0.001), the composition of the final version of the scale consisted of twenty-six items grouped into three factors: Factor I: Body dissatisfaction, containing 10 items, with a mean of 3.1 (s.d. = 0.8), accounting for 17.9% of the variance and with a value of Cronbach's Alpha of .84. Factor II: Internalization of the aesthetic ideal of thinness, including 10 items with a mean of 3.5 (s.d.=0.9) which explained 15.2% of the variance and with a value of Cronbach's Alpha of .89. Factor III: Social influence consisted of 6 items with a mean of 3.8 (s.d.=0.8), and accounted for 9.9% of the variance and with a value of Cronbach's Alpha of .82. A discriminant analysis was performed in order to determine if there were any differences according to body image and disordered eating and to establish the predictive validity of the scale. The results indicated that 13 of the 26 items correctly classified the body image scale in 98.2% of the original grouped cases and 97.4% of the cases grouped by cross-validation. A comparative analysis using Student's t-test was conducted among students who had high and low scores in BCCAR (Brief Questionnaire to measure Risky Eating Behaviors), yielding significant differences in their scores on all three factors of the scale. This indicates that women with disordered eating show significantly higher degrees of body dissatisfaction, internalization of the aesthetic ideal of thinness and social influence than women without disorder. Discussion The results of the study showed that the Body Image Scale has acceptable levels of validity and reliability, making it an adequate instrument for differentiating between women with and without disordered eating. The results reveal that high levels of body dissatisfaction were expressed in the majority of the sample, which is consistent with a previous study performed by Baile, Raich and Garrido in Spain, where 80% of the teenage girls expressed dissatisfaction with their body image. Lamerias et al. also found that 85% of the Spanish female college students were dissatisfied with their weight. A considerable degree of internalization of the aesthetic thin body ideal was observed in the sample, as a significant percentage of the participants with body dissatisfaction referred that body weight is important for getting nice clothes and that they are willing to do anything for a slimmer body shape. Also, physical appearance and body weight are deemed necessary for feeling fine. As the difference in body image in terms of eating behaviors risk is concerned, women presenting more risk obtained higher mean scores on the body dissatisfaction, internalization of the aesthetic thin body ideal and social influence factors, which could be a consequence of their perception of disapproval and body disgust. Troisi et al. also reported having found significant negative correlations between body image satisfaction and the presence of eating disorders. The findings of the comparison between body image dissatisfaction in terms of BMI showed that women with low weight are the least satisfied, followed by the ones who present obesity. This suggests that individuals with extreme thinness tend to have greater body image dissatisfaction, whereas Mirza, Davis and Yanovsi found that persons who are overweight or obese are the most dissatisfied. Regarding the internalization of the aesthetic thin body ideal and BMI, the highest scores were obtained in underweight women, followed by the obese ones. This is consistent with what Unikel et al. refer, mentioning that a thin body is socially perceived as more attractive, and also eating less is considered to be more feminine. It is concluded that, according to the results of the study, the proposed scale constitutes an adequate instrument for measuring body image in Mexican samples. Taking some items from already validated instruments proved to be useful for integrating all dimensions of the construct. However, it is considered necessary to obtain data on concurrent validity, sensitivity and specificity values in other samples and to determine cut-off points, in order to confirm its usefulness for research on body image.

Introducción La imagen corporal es la representación mental del cuerpo que cada individuo construye en términos de sentimiento y actitudes hacia el propio cuerpo. El propósito de este estudio es: desarrollar, validar y encontrar el grado de confiabilidad de una escala para medir la imagen corporal en dos grupos de mujeres estudiantes de nivel universitario, uno con conductas alimentarias de riesgo (CAR) y otro sin ellas, así como establecer comparaciones respecto a la edad y al índice de masa corporal (IMC). Material y método El trabajo se realizó en una muestra probabilística estratificada de 508 mujeres que estudian en la Universidad Autónoma del Estado de México. Para realizar la integración del constructo de imagen corporal se definieron tres indicadores: insatisfacción corporal, influencia social e interiorización del ideal estético de delgadez. Primero se piloteó la escala de imagen corporal compuesta por 40 reactivos aplicándose a una muestra de tipo intencional en 100 mujeres universitarias de nivel superior. Una vez modificada la escala se llevó a cabo una validación de contenido a través del método de expertos. Asimismo, para medir las conductas alimentarias de riesgo se utilizó el Cuestionario Breve para medir Conductas Alimentarias de Riesgo (CBCAR) de Unikel, Bojórquez y Carreño. Para el procesamiento de los datos se llevaron a cabo análisis de consistencia interna (Alfa de Cronbach) y análisis factorial de componentes principales con rotación varimax. Para la comparación de medias se utilizó la t de Student y para la exploración de la diferencia entre las variables de imagen corporal, una prueba de análisis de varianza (Anova de una vía) y la prueba a posteriori de Scheffé para la diferenciación entre imagen corporal, edad e IMC. Resultados La composición de la versión final de la prueba fue de 26 reactivos, integrados en tres factores: El factor I se denominó insatisfacción corporal, consta de 10 reactivos con una media de 3.1 (d.e.=0.8), un total de la varianza explicada de 17.9% y un Alfa de Cronbach de 0.84. El factor II se denominó interiorización del ideal estético de delgadez, se formó por 10 reactivos, con una media de 3.5 (d.e.=0.9), varianza explicada de 15.2% y un Alfa de Cronbach de 0.89. El factor III se denominó influencia social, se formó de seis reactivos, con una media de 3.8 (d.e =0.8), varianza explicada de 9.9% y un alfa de Cronbach de 0.82. Para observar el nivel de confiabilidad total del instrumento se realizó un análisis de consistencia interna de los 26 reactivos restantes con el cual se obtuvo un valor alfa de Cronbach de 0.94. Se llevó a cabo un análisis de comparación con la prueba t de Student la cual indicó que las mujeres con CAR mostraron mayor insatisfacción corporal, interiorización del ideal estético de la delgadez e influencia social. No se presentaron diferencias estadísticamente significativas respecto a la comparación por edad, mientras que resultaron significativas las comparaciones entre el IMC y los factores de insatisfacción corporal e interiorización del ideal estético de delgadez. Discusión La evidencia indica que la escala de medición de imagen corporal cuenta con valores de validez y confiabilidad adecuados. De la misma manera se observó una validez predictiva aceptable que permitió clasificar correctamente una elevada proporción de los casos (97.4%). Estos resultados pusieron de manifiesto que la insatisfacción corporal es un factor presente en la mayoría de la muestra estudiada. Respecto a la diferencia de medias de la imagen corporal entre mujeres que presentan CAR y las que no, se encontró que en las primeras las puntuaciones fueron mayores. En cuanto a la insatisfacción corporal y el IMC, se observó que los grupos con mayor grado de insatisfacción fueron los de las mujeres con bajo peso seguidos de las mujeres con obesidad.

The term <<eating behavior>> is immediately related to food consumption. However, eating is a complex behavior mediated by external factors. Eating is not exclusively related to satisfying individual's needs or nutritional requirements. Eating behavior alteration has originated disordered eating (DE) and eating disorders (ED), such as anorexia nervosa, bulimia nervosa and binge eating syndrome, where patterns of food ingestion are altered and people forget the importance of maintaining a balance between caloric ingestion and caloric expenditure, with repercussions in the nutritional status and in the individual's health. Recent studies carried out in Mexican population have confirmed the presence of DE, particularly among adolescents and young adults, and predominantly in females. Data from a representative sample of students with a mean age of 14.5 years reported an increase in the proportion of DE between the 1997 and the 2003 assessments (1.3% in males and 3.4% in females) compared to the 3.8% in males and 9.6% in females registered in 2003. More recent data from the National Nutrition and Health Survey 2006, in a representative sample of adolescents 10 to 19 years of age, indicated a prevalence of 0.8% (1% in females and 0.4% in males), with higher scores in the north and center-west areas of the country, followed by the central and south-south-east areas, with almost two-fold percentages in the urban settings compared to the rural ones. The multifactorial origin of ED is well known and among the most studied risk factors are: eating behaviors, high body mass index (BMI) and body thin-ideal internalization. Research findings indicate that overweight and obese adolescents are at more risk for body dissatisfaction, as their physical appearance is farther away from being as the one promoted by society and the media. The sociocultural pressure to be thin has promoted the internalization of the idea that being thin is synonymous to success, greater social acceptance, femininity (among females), self-control, and self-esteem. Based on the above, the main purpose of this paper was to evaluate the prevalence of DE and its relationship to body thin-ideal internalization and BMI in high school and college male and female students from an urban setting. An additional objective was to provide data on reliability and validity of the scales used in a sample of males, as well as additional validity data in females. Data analyzed in this research come from a larger study on risky factors associated to ED carried out in high-school and college students in the city of Pachuca, Hidalgo, during the 2007-2008 school years. After censing the school, a sample of 845 students was selected (381 males, 464 females), 45.1% was from high school, with a range of 15 to 17 years(× =15.82; D.E.=0.78), and 54.9% from college with a range of 18 to 23 years(× =19.81; D.E.=1.41) and that completed the questionnaires adequately. Two previously validated questionnaires in Mexican samples were used to assess DE and body thin-ideal internalization: the Brief Questionnaire for Risky Eating Behaviors and the Attitudes toward Body Figure Questionnaire. Cutoff points for these questionnaires were used to determine the prevalence rates. BMI was obtained by measuring each subject's weight and height by standardized experts and divided in categories according to NCHS those under 18 years old, and to the World Health Organization Experts Committee for those above 18. Self-reported questionnaires were applied to students after verbal consent was received from the school authorities and students, who were previously informed about the voluntary, anonymous, and confidential nature in the study. The protocol was revised by the Ethics Committee of the institution were the field work was carried out. Descriptive analyses were held, as well as Student t tests for comparisons between groups, and a logistic regression analysis to estimate the risk for DE. Results showed that 70% of the women had a normal weight, and there were fewer students in the very underweight and underweight categories (high-school 2.9% and 8.7% college) than those in the overweight and obese categories (high-school 15.2% and 8.3% vs. 18.6% and 6.6% in college). Among the males, a similar distribution was found, 71.3% of the high-school and 58.2% of college students have normal weight, 2.7% and 4.8% low weight, 19.1% and 26.1% were overweight, and 6.9% and 10.9% were obese, respectively. The prevalence of DE was 8.4% in females (9.0% in high school and 7.9% in college), and 2.9% in males (1.6% in high school and 4.2% in college). DE was more prevalent among females, with the exception of binge eating and lack of control while eating. The analysis by BMI showed that neither females nor males with very low or low weight scored high on DE. The higher percentages were obtained for the overweight students of both sexes, and obese males obtained the higher percentages of all. From the total of females with DE, the 84.2% of high-school and 80% of college students also scored high on body thin-ideal internalization, while in males the results were 33.3% and 62.5%, respectively. The regression analysis indicated that the two variables associated with DE were body thin-ideal internalization (OR=27.27) and sex <<being female>> (OR=2.33). The model correctly classified 94.5% of the cases and explained 35% of the DE occurrence. The DE scale yielded a reliability score of 0.72 in females and of 0.63 in males. For both males and females, the scale yielded 3 factors with a congruent conceptual structure. The Attitudes toward Body Figure Questionnaire had a reliability of 0.94 in females and of 0.89 in males. In the case of females, the structure obtained nearly replicated the one obtained in Mexico City's students, but in the case of the male's questionnaire, three questions were eliminated leaving a two-factor structure. From the present data, it can be concluded that DE is present in the sample studied, mainly in females. It was also found that the preoccupation with gaining weight, dieting, and excessive exercising with the purpose of losing weight are also present in a high percentages in Mexican youths not only from the largest metropolis, but also in other urban settings such as Pachuca, Hidalgo. The prevalence found was similar to the one from the Student Survey from Mexico City in adolescents. A positive relationship between DE, educational status, and age was also found; overweight women and obese men were the ones that obtained the higher percentages of DE. The fact that obese men displayed the higher percentages is an important finding regarding the development of future preventive interventions, as it has been so far a neglected population in relation to this topic. The psychometric properties of the validated questionnaires in females were adequate and factorial structures were conceptually congruent. Nevertheless, in the case of males, it is important to continue working in the development of screening questionnaires sensible to their conceptions, beliefs, and attitudes regarding eating, weight control, and beauty ideal, in a way to count with reliable and valid instruments for the detection of DE and body thin-ideal internalization, so we recommend to use caution in interpreting the use of these scales in male populations.

El término <<conducta alimentaria>> se asocia de manera inmediata con el hecho de ingerir alimentos; sin embargo, es una conducta compleja mediada por factores externos a la persona y no exclusivamente porque los individuos quieran satisfacer sus necesidades alimentarias y sus requerimientos nutricios. La alteración de esta conducta ha dado origen a lo que se conoce como trastornos de la conducta alimentaria (TCA) tales como la anorexia nervosa, la bulimia nervosa y <<el trastorno por atracón>>, en los cuales se ven distorsionados los patrones de la ingestión de alimentos, olvidándose la importancia de mantener un balance entre ingestión y gasto de energía, lo que repercute de manera importante en el estado nutricio y por ende en la salud del individuo. Es bien sabido el origen multifactorial de los TCA, y dentro de los factores de riesgo más estudiados están: las conductas alimentarias, el Índice de Masa Corporal (IMC) y las actitudes hacia el cuerpo provenientes de la interiorización de una figura corporal delgada. El objetivo principal de este estudio fue conocer la prevalencia de las conductas alimentarias de riesgo (CAR) y su relación con la interiorización del ideal estético de delgadez y con el IMC, en estudiantes de ambos sexos de nivel preparatoria y licenciatura en una escuela privada de la ciudad de Pachuca, Hidalgo. Un objetivo adicional fue el de proporcionar datos de confiabilidad y validez de las escalas utilizadas en una muestra de hombres, así como datos adicionales de validez en las mujeres. Se trabajó con una muestra de 845 sujetos (381 hombres y 464 mujeres) de los cuales 45.1% eran de nivel preparatoria con un rango de edad de 15 a 17 años (× =15.82; D.E.=.78) y 54.9% de nivel licenciatura en un rango de edad de 18 a 23 años (× =19.81; D.E.=1.41). Se aplicaron el Cuestionario Breve de Conductas Alimentarias (CBCAR) y el Cuestionario de Actitudes hacia la Figura Corpora l. El IMC se obtuvo partir de la medición del peso y la estatura de cada sujeto. La distribución por categorías del IMC por nivel escolar mostró que el 70% de las mujeres tiene peso normal, y que el porcentaje de las que se encuentran en las categorías de peso muy bajo y bajo (preparatoria 2.9% y licenciatura 8.7%) es mucho menor que las que se hallan en sobrepeso y obesidad (preparatoria 15.2% y 8.3% vs. licenciatura 18.6% y 6.6%). En los hombres se encontró una distribución similar: 71.3% de los de preparatoria y 58.2% de los de licenciatura tienen peso normal, 2.7% y 4.8% bajo peso, 19.1% y 26.1% sobrepeso, y 6.9% y 10.9% obesidad, respectivamente. La prevalencia de CAR en mujeres fue de 8.4% (9.0% en preparatoria; 7.9% en licenciatura) y de 2.9% en hombres (1.6% en preparatoria; 4.2% en licenciatura). <<Los porcentajes de preocupación por engordar, sensación de falta de control al comer, vómito auto-inducido, ayunos, dietas, pastillas, diuréticos y laxantes fueron mayores en las mujeres>>. Del total de mujeres con CAR elevadas, el 84.2% de preparatoria y el 80% de licenciatura también obtuvo puntuaciones altas en el cuestionario sobre interiorización del ideal estético de delgadez, en tanto que en los hombres fue el 33.3% y el 62.5%, respectivamente. La escala CBCAR en mujeres arrojó un alfa de Cronbach de 0.72 y de 0.63 en hombres. El instrumento de actitudes alcanzó valores de confiabilidad de 0.94 para mujeres y de 0.89 para hombres. Se puede concluir que en la población estudiada están presentes las CAR características de los TCA, y que a mayor interiorización de una figura delgada mayor aparición de dichas conductas, principalmente entre las mujeres. Igualmente se comprobó que la práctica de dietas y de ejercicio para bajar de peso, aunadas a la preocupación por engordar, se presentan en porcentajes importantes en estudiantes del Estado de Hidalgo, lo que confirma que esta problemática no es exclusiva de las grandes urbes.

Abstract: The Eating Disorder Inventory (EDI) is a psychometric instrument developed by Garner et al. for the evaluation of psychological traits in patients with eating disorders. The questionnaire offers an integral evaluative approach that includes other psychological characteristics besides those of fear of fatness. It consists of 64 items in 8 subscales: 1) Drive for Thinness, 2) Bulimia, 3) Body Dissatisfaction, 4) Ineffectiveness, 5) Perfectionism, 6) Interpersonal Distrust, 7) Interoceptive Awareness, 8) Maturity Fears. The EDI is an instrument widely used for the exploration of eating disorders (ED). Nevertheless, the use of psychometric scales in a population other than the one in which they were originally developed, requires careful adaptation. Items should be phrased in a culturally significant way, and even after that, constructs still could have different meanings in different contexts. The factorial grouping of the EDI in open populations has been reported as different from the results in clinical samples. Also, Lee and cols. reported a low correlation of the EDI subscales that measure weight preoccupation and the General Health Questionnaire - 12, concluding that fear of fatness is not related with emotional distress in their sample. In Mexico City, Alvarez and Franco conducted a validation study, finding good reliability and discriminative power, and a factorial grouping close to the original. On the other hand, in a sample of teenage girls from a semi-rural area, the factorial grouping was very different. Although we already have data about the EDI's specificity and sensitivity in Mexican ED patients, there are no studies of the validity and reliability of the test in this population. Therefore, our main objective in this work was to validate the EDI in a sample of Mexican ED patients. Also, the score information provided could be used for comparison purposes with other clinical samples. A non-probabilistic sample was obtained of all subsequent patients attending the ED Clinic at the National Institute of Psychiatry Ramón de la Fuente (INPRF) in the period 1997 2002 (n=523). Patients were diagnosed according to DSM-IV criteria in a clinical interview. They also completed other questionnaires, such as the Symptom Check List (SCL90) and the Coopersmith's Self-esteem Inventory. According to diagnosis, the sample was composed of compulsive/purging type anorexia nervosa, 5.7%; restrictive anorexia nervosa, 8%; purging type bulimia nervosa 45.1% and eating disorders not otherwise specified 41.3%. Mean age was 19.9 years (s.d.=3.9), within a rank of 13 to 39 years. Mean age at the beginning of ED was 16 years (s.d.=3.1). Mean educational level was 12 years (s.d.=3), i.e. high-school level. The sample included single women 93.9%, married 4.8% and divorcees, 1.4%. Mean Body Mass Index was 21 (s.d. = 5.5). Participants completed the EDI, SCL90, and Coopersmith's self-esteem inventory during their first visit to the Clinic. They were assured of the voluntary nature and confidentiality of their participation. Completing the tests took them about 60 minutes. An internal reliability analysis was conducted, followed by a factorial analysis of main components with Varimax rotation. Pearson correlations were made to assess the concurrent validity of EDI and other instruments. Analysis of variance was employed to compare between diagnostic groups. Data were captured and analysed in the SPSS software, versión 10.0. The first step of the analysis was the item-total correlation, considering as valid correlations equal or over 0.28. This step eliminated 12 items that were not included in further analyses. Cronbach's alpha was 0.93. Most of the items in the Perfectionism subscale disappeared in this step. Second step was factorial analysis. We found 6 factors with a minimum of 3 items included with factorial charges equal or over .40. Then a second analysis was conducted with only the 40 items that had been grouped in the 6 factors. Factor 1 included items from Bulimia and Interoceptive Awareness; factor 2, from Drive for Thinness and Body Dissatisfaction; factor 3, from Interoceptive Awareness; factor 4, from Ineffectiveness; factor 5, from Maturity Fears; and factor 6, from Body Dissatisfaction. The resulting factorial structure explained 56% of total variance. Cronbach's alpha of the final version was 0.92. Correlation analysis showed a positive and significant correlation of EDI with SCL-90, and a negative and significant correlation of EDI with Coopersmith's self-esteem inventory. Comparisons between diagnostic groups showed that bulimia nervosa patients had the highest scores in the EDI. Patients with restrictive AN had the lowest scores in all sub-scales except for Maturity Fears. Bulimia nervosa and compulsive/purging type AN patients were different from restrictive AN and EDNOS patients in the total score of Interoceptive Awareness and Ineffectiveness subscales. Bulimia nervosa was different from the other groups in Bulimia and Drive for Thinness subscales. The results show that, in this sample, many of the EDI items have a poor correlation with the scale, and factorial grouping is different from the original. However, once non-correlated items are eliminated, a version of the EDI remains that is valid and reliable. Items from the Perfectionism subscale were eliminated because of low correlation with the rest of the EDI. This supports the findings in Bulgaria, rural Mexico, and Mexico City. Maturity Fears, which also had dubious results in other studies, grouped correctly in this sample, although it did not distinguish among diagnostic groups. Analysis of variance showed that subscales were able to differentiate the Bulimia nervosa patients. Also, most of the variance explained corresponded to the Bulimia subscale, suggesting that EDI can detect bulimic attitudes, and so is a useful complement to instruments that are more capable of detecting anorexia nervosa, such as the Eating Attitudes Test. However, this could also be an effect of the sample's composition, with more than half of it being bulimic patients. Another important segment of variance was explained by Interoceptive Awareness, Ineffectiveness and Maturity Fears subscales, psychological traits that are not necessarily related to ED. In this sample, psychological subscales correlated with eating and weight attitude subscales, showed that Mexican patients do present ED according to the way they are conceptualized in the DSM-IV. Our results show that the EDI is adequate for the evaluation of psychological traits of ED patients in Mexico. Perfectionism and Interpersonal Distrust subscales are an exception, that requires further investigation.

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