Psychometric properties of the Pride in Eating Pathology Scale in a Spanish population

BACKGROUND

In its relation to eating disorders, pride is one of the self-conscious emotions least analyzed, and requires valid and reliable instruments for its measurement. This study aimed to examine the factor structure and the psychometric properties of the Pride in Eating Pathology Scale (PEP-S), in the Spanish general population, as well as between-sex differences in PEP-S scores.

METHODS

Of the 1483 participants aged 18 to 34 (M = 21.99; SD = 3.09), 954 were women (65.2%) and the majority were university students (78.8%). Psychometric properties of the scale were tested in a cross-sectional design using cross-validation, i.e., exploratory and confirmatory factor analysis, and estimation of invariance (sex).

RESULTS

The four-factor structure found was similar to the original scale with invariance across sex and internal consistency (ordinal alpha .99) and stability (.85). Evidence of convergent validity and differences between sexes were found. Specifically, women scored higher on all the factors, including the healthier sense of pride.

CONCLUSIONS

The PEP-S scale is an instrument with evidence of validity and reliability in the Spanish population. Although it still has to be tested in a clinical population, it constitutes a promising instrument for the evaluation of the self-conscious emotion, pride.

Childhood and adolescent trauma and dissociation: The mediating role of rumination, intrusive thoughts and negative affect

Dissociation is a complex phenomenon which is present in a wide variety of psychiatric disorders and also in the general population. The objective of this study was to examine the relationship between childhood and adolescent traumas and development of dissociative phenomena in a nonclinical population, emphasizing the potentially mediating role of rumination, intrusive thoughts and negative affect in a population with no psychiatric pathology in adulthood. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.10 years (SD: 14.08). They completed the Juvenile Victimization Questionnaire (JVQ), the Ruminative Response Scale (RRS), the White Bear Suppression Scale (WBSI), the Dissociative Experience Scale, 2d ver. Rev. (DES-II) and the Depression, Anxiety and Stress Scale (DASS-21). The results supported the starting hypotheses showing a positive correlation between childhood and adolescent trauma and dissociation, and between childhood and adolescent trauma and rumination, intrusive thoughts and negative affect, and mediation of these variables between childhood and adolescent trauma and dissociative states. The relationship between trauma in early ages and dissociation in adulthood is complex. Although the design used in this study was cross-sectional, the results are compatible with the starting hypothesis that rumination, intrusive thoughts and negative affect mediate this relationship.

Spanish validation of the Detachment and Compartmentalization Inventory (DCI) in a community and clinical sample. A new instrument for measuring dissociation

INTRODUCTION

Dissociative symptoms are a type of phenomenon which is present in a wide variety of psychopathological disorders. It is therefore necessary to develop scales that measure this type of experience for therapy and research. Starting out from the bipartite model of dissociation, this study intended to adapt and validate the Detachment and Compartmentalization Inventory (DCI) in Spanish.

MATERIAL AND METHODS

For this, 308 participants (268 from the community population and 40 with psychiatric pathology) completed the DCI, the Dissociative Experiences Scale (DES-II), the Somatoform Dissociation Questionnaire (SDQ20) and the Mindfulness Attention Awareness Scale (MAAS).

RESULTS

The results showed that the Spanish version has a two-factor structure similar to the original version and was invariant across participants. The reliability of DCI scores was adequate and acquired evidence of validity related to other instruments.

CONCLUSIONS

It is concluded that the DCI is a valid scale for detecting detachment and compartmentalization dissociative experiences, both in the clinic and research.

Dissociation as a Mediator of Traumatic Childhood Experiences and Ideas of Reference

Ideas of reference (IR) - self-attributions about what happens in the social environment are a frequent phenomenon present in a wide variety of people with mental health disorders as well as in the nonclinical population. The purpose of this study was to find out the relationship between traumatic childhood experiences, IR and dissociative states in the nonclinical population, emphasizing the potential mediating role of dissociation between traumatic experiences and IR. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.20 years (SD = 14.08). They filled in the Juvenile Victimization Questionnaire (JVQ), the Dissociative Experiences Scale-II (DES-II) and the Referential thinking Scale (REF). The results supported the original hypotheses and showed that the participants with higher frequency of IR reported more childhood traumatic (χ² (2) = 64.33, p < .001, f = .39, 1- β = .99) and dissociative experiences (χ² (2) = 50,414, p < .001, f = .38, 1- β = .99), and that dissociative states (β = .12, p < .05; 95%CI [.07, .19]; c´ = .26, p < .001), specifically absorption (β = .09, p < .05; 95% CI [.03, .15]; c´ = .26, p < .001), mediated between traumatic childhood experiences and referential thinking. It was concluded that the relationship between traumatic experiences and IR is complex and may be mediated by variables such as dissociation.

The first session is the one that counts: An exploratory study of therapeutic alliance

Background

The controversy about whether psychotherapy outcome is the consequence of the techniques themselves, common factors or both is still current. The importance of common factors has been demonstrated, although it is also known that they alone are insufficient. At the present time, the contextual model grants heavy weight to the therapeutic alliance in the first sessions and seems to predict positive final results. Furthermore, monitoring sessions has demonstrated that this alliance improves.

Objectives

To analyze the relationship between the therapeutic alliance and patient's perceived improvement during the first five sessions of therapy, and find out whether the therapeutic alliance is maintained or unstable within that timeframe.

Methods

Thirty-four patients at a university psychological care service who had had at least five therapy sessions participated. Of these, 70.46% were women (Mage = 24.24, SD = 6.73). The patients filled out the Outcome Rating Scale and Session Rating Scale the week before each session. Data were analyzed by the Dual STATIS method.

Results

The compromise matrix explained 77.36% of the variability. The position of the vectors and the distribution of the position of the patients on the graph show that as their perception increased, therapeutic alliance remained stable. Moreover, the position of the vectors shows that the therapeutic alliance was forged in the first session and remained stable during the following sessions.

Conclusion

This exploratory study demonstrated the importance of the first session in establishing the therapeutic alliance, and for it to remain stable, regardless of whether the rest of the therapeutic process has variations or changes. Novel use of the STATIS method for analyzing measurements in the first five sessions, showed that beginning the therapeutic intervention with a strong alliance, produced the favorable, lasting effects necessary for development of the intervention.

Validation of the aberrant salience inventory in a general and clinical Spanish population

BACKGROUND

The concept of aberrant salience is related to the onset of psychosis. Its study is important for early identification and possible intervention in processes activating later positive symptoms.

OBJECTIVES

This study validated the Spanish Aberrant Salience Inventory (ASI) for adult and clinical populations.

METHODS

The sample consisted of 6178 participants, of whom 4523 were adolescents, 1292 were general population adults and 363 were patients with a psychopathology.

RESULTS

The evidence provided validates the instrument's structure. Invariance of measurement suggests that both men and women, patients and nonclinical population (adults and adolescents) interpreted the items on the ASI similarly. The distribution of scores by age also suggests stabilization of the trend at about 19 years of age, showing a developmental change in motivational response. The hypothesis that patients, and in particular, those diagnosed with schizophrenia and other psychotic disorders and bipolar disorders would have the highest average scores in aberrant salience was met.

CONCLUSIONS

This is a valuable instrument for evaluating a complex process related to abnormal motivation in the development of schizophrenia.

Spanish adaptation and validation of the Peer Mental Health Stigmatization Scale (PMHSS-24)

INTRODUCTION

There is currently a growing interest in interventions aimed at the reduction of stigma towards people with emotional difficulties in adolescents. Unfortunately, the number of scales available in Spanish to assess stigma at these ages is limited. This paper aims to adapt and validate the scale of stigmatizing attitudes towards mental health among peers (Peer Mental Health Stigmatization Scale PMHSS-24).

MATERIAL AND METHODS

A total of 443 adolescents (46.6% female and 53.7% male) between 13 and 17 years of age participated (M_age = 14.64; SD = 0.83) in the 3rd and 4th grades of Obligatory Secondary Education. The internal consistency of the test was calculated, an exploratory factorial analysis (EFA) was performed with half of the sample and a confirmatory one (CFA) with the other half, and the invariance of measurement of the scale through sex was found.

RESULTS

The EFA showed a two-factor structure for the negative scale (53% of the variance explained) and another 2 for the positive scale (62% of the variance explained). The CFA corroborated the factor structure with appropriate goodness-of-fit indicators (CFI > 0.95; NNFI > 0.95, SRMR < 0.08, RMSEA < 0.08). Factor loads ranged from 0.49 to 0.89, with α factor correlation between r = 0.53 and 0.45. Both subscales exhibited optimal alpha values (negative 0.94 and positive 0.81). The scale was invariant between the sexes.

CONCLUSIONS

The data suggest that PMHSS-24 may be a useful scale for the initial screening of the stereotypes exhibited by adolescents toward people with mental illness.

Aberrant Salience and Disorganized Symptoms as Mediators of Psychosis

Introduction

Ideas of reference (IR) are frequent in psychopathology, mainly in psychotic disorders. The frequency of IR and preoccupation about them are related to the psychotic dimension, and to a lesser extent, to negative or emotional disorganized dimensions. Aberrant salience (AS), has been proposed as an indicator of the onset of psychosis, particularly of schizophrenia. This study analyzed the mediating role of AS, disorganized symptoms and preoccupation about IR in the relationship between IR and the psychotic dimension.

Method

The sample consisted of 330 participants (116 university students and 214 clinically active patients), 62.4% of whom were women aged 18-79. The Referential Thinking Scale, the Aberrant Salience Inventory, and the Brief Psychiatric Rating Scale were administered.

Results

Evidence of a partial mediation model showed that the relationships between IR and the psychotic dimension were mediated jointly by AS and the disorganized dimension, and preoccupation about IR no longer had a role. This relationship was significantly influenced by participant age. The variables in the model explained 54.16% of the variance.

Conclusion

The model proposed enabled a set of vulnerabilities (unusual thought content) to be predicted that could lead to a high-risk general pathological state and proneness to psychosis in particular. These findings are discussed with regard to early detection and prevention of psychosis.

Trends of Sedentary Time and Domain-Specific Sedentary Behavior in Spanish Schoolchildren

Purpose: To examine the temporal trends of accelerometer-based total daily sedentary time (ST) and self-reported domain-specific sedentary behavior (SB) on weekdays and weekends in Spanish children. Method: A total of 560 (50.53% girls) children (4th graders) in 2011/12 from 23 Spanish schools and 462 (48.70% girls) children (4th graders) in 2017/18 from 19 schools across Cadiz participated. Hip-worn accelerometers and questionnaires were used to assess total daily ST and self-reported time in SB modalities, respectively. Results: The objectively measured total daily ST tended to increase in boys on weekdays and weekends. Time spent watching television (TV) decreased during the week and weekend days, while time surfing on the internet increased on weekdays and weekends. Playing video-games increased in boys during the weekends. The trend to increase the time spent on educational activities with a computer during the weekdays and weekends was accompanied by a reduction of the same activities without using a computer. There was a trend to increase reading for fun, talking on the phone and total time in other SB, on weekdays and weekends in boys and girls. Conclusion(s): Spanish boys tended to increase objectively measured total daily ST. Moreover, SB modalities have changed in recent years in children, replacing TV viewing by computer use for both educational and non-educational purposes, as well as by the use of smartphones or other sedentary activities that does not imply the presence of a screen. These findings highlight the need to promote interventions to decrease total daily ST and reduce SB activities.

The Role of Negative Affect in Emotional Processing of Food-Related Images in Eating Disorders and Obesity

The aim of the present study was to analyze differences in the emotional processing (valence, arousal, and dominance) of food-related information in patients with eating disorders (ED), patients with obesity, and healthy women. Moreover, the mediator role of negative affect and the moderating role of the diagnostic group (ED vs. non-ED) were analyzed.

METHOD

The sample consisted of 94 women (39 with eating disorders, 19 with obesity, and 36 healthy participants).

MEASURES

International Affective Picture System (IAPS) food picture exposure task; Self-Assessment Manikin Analog-Visual Scale (SAM) appraising Arousal, Valence, and Dominance; Eating Attitudes Test (EAT-26); Positive and Negative Affect Schedule (PANAS).

RESULTS

Patients with purging symptomatology rated food images as more unpleasant than healthy women. Patients with purging and restrictive eating symptomatology showed higher levels of arousal and less dominance over the emotions experienced, compared to patients with obesity and healthy women. The mediation analysis showed that negative affect mediated the relationship between eating symptomatology (EAT-26) and the Valence of food images, as well as the control over the emotions experienced when viewing food images (Dominance). For the moderation analysis participants were regrouped into two groups (ED patients vs. non-ED patients). The direct relationship between eating symptomatology and food image valence was moderated by the diagnostic group. However, the group did not moderate the direct relationship between the EAT-26 and dominance over experienced emotions, or the indirect effect on eating symptomatology through negative affect. These results show the relevance of negative affect in the emotional processing of food-related information, and they support an eating disorder-disordered eating dimensional perspective.

Hallucinations and Delusions as Low-Quality Attributions: Influencing Factors and Proposal for Their Analysis

Hallucinations and delusions, in keeping with the distress accompanying them, are major features in the diagnosis of psychosis in international classifications. In spite of their human and clinical importance, the concepts are unclear. The distinction between hallucinations and delusions in terms of perception-thought is not precise enough, causing problems in analyzing the patient's words. Nor are the differentiations or variations within each precise enough. Continuing the long clinical tradition discussing the distinction between hallucinations and delusions while assuming their similarities, this study poses a concept integrating the two phenomena as attributions people make about themselves and their settings. Then the elements of any attribution can be used as guides for structuring significant literature on both, and reduce analytical ambiguity. Such attributions make more sense within the structure of two-way relationships with factors in a person's own framework and setting. This structure is described with its variables and relationships as a guide to assessment, follow-up, and intervention. Two checklists are provided for orientation.

The dark side of Instagram: Predictor model of dysmorphic concerns

Dysmorphic concern are excessive preoccupation about one or several physical characteristics perceived as defects, usually unnoticeable by others. This study was intended to explore the relationship between Instagram use and dysmorphic concerns through appearance-related comparisons, ideas of reference and problems with emotion regulation, and find out whether this relationship is moderated by gender.

METHOD

The sample was comprised of 796 participants (Mage  = 22.49; SD = 3.56; 54% women).

RESULTS

The results showed a non-significant direct effect between Instagram use and dysmorphic concerns. However, the relationship between these variables was statistically significant through appearance-related comparisons, ideas of reference about "laughing, commenting" and difficulties in emotion regulation. Gender did not moderate any relationship.

CONCLUSIONS

Men and women who made the most use of Instagram were equally vulnerable to dysmorphic concerns when they tended to compare their appearance with other users, had problems regulating their emotions, and showed interpretative biases related to the belief that others could make comments about them or laugh at them because of their imperfections. The implications of the study are discussed.

Spanish adaptation and validation of the Peer Mental Health Stigmatization Scale (PMHSS-24)

INTRODUCTION

There is currently a growing interest in interventions aimed at the reduction of stigma towards people with emotional difficulties in adolescents. Unfortunately, the number of scales available in Spanish to assess stigma at these ages is limited. This paper aims to adapt and validate the scale of stigmatizing attitudes towards mental health among peers (Peer Mental Health Stigmatization Scale PMHSS-24).

MATERIAL AND METHODS

A total of 443 adolescents (46.6% female and 53.7% male) between 13 and 17 years of age participated (Mage=14.64; SD=.83) in the 3rd and 4th grades of Obligatory Secondary Education. The internal consistency of the test was calculated, an exploratory factorial analysis (EFA) was performed with half of the sample and a confirmatory one (CFA) with the other half, and the invariance of measurement of the scale through sex was found.

RESULTS

The EFA showed a two-factor structure for the negative scale (53% of the variance explained) and another 2for the positive scale (62% of the variance explained). The CFA corroborated the factor structure with appropriate goodness-of-fit indicators (CFI>.95; NNFI>.95, SRMR<.08, RMSEA<.08). Factor loads ranged from .49 to .89, with α factor correlation between r=.53 and .45. Both subscales exhibited optimal alpha values (negative .94 and positive .81). The scale was invariant between the sexes.

CONCLUSIONS

The data suggest that PMHSS-24 may be a useful scale for the initial screening of the stereotypes exhibited by adolescents toward people with mental illness.

Interpersonal Violence and Psychotic-Like Experiences: The Mediation of Ideas of Reference, Childhood Memories, and Dissociation

Previous studies have demonstrated the relationship between the accumulation of situations involving interpersonal violence (IV) and psychotic-like experiences. This study explored whether IV is related to aberrant salience (AS), using a sequential mediation model that included memories of relationship with parents (submission, devaluation, and threat; Early Life Experiences Scale (ELES)), ideas of reference (IR), and dissociative symptoms (absorption and depersonalization), and whether the patient/nonpatient condition moderated this effect. The sample was made of 401 participants (including 43 patients with psychotic disorders) aged 18 to 71 years (Mage = 30.43; SD = 11.19). Analysis of a serial multiple mediator model revealed that IR, ELES, absorption, and depersonalization fully mediated the effect of IV on AS, explaining 39% of the variance, regardless of the patient/nonpatient condition. The indirect paths, which place IR and dissociation (especially absorption, the variable to which the IR and ELES lead) in a primordial position for being related to AS, are discussed. This continuum model could be useful for understanding processes related to the onset of psychosis unmoderated by the patient/nonpatient condition.

Factor structure and psychometric properties of the Spanish version of the Body Image Avoidance Questionnaire (BIAQ)

PURPOSE

The main objective of this study was to analyse the factor structure and psychometric properties of a Spanish validation of the Body Image Avoidance Questionnaire (BIAQ) in a community sample of adolescents.

METHODS

A total of 4283 people (55.9% girls, aged 12-18) participated.

RESULTS

Confirmatory factor analysis corroborated four first-order factors related to a second-order factor including the total BIAQ score, with excellent fit and invariance across sex. The total internal consistency of the questionnaire was adequate, although two factors showed low reliability. Strong relationships were found with scales evaluating preoccupation with weight and dysmorphic concerns, and moderate correlations with dissatisfaction and investment in appearance. It was found that 24.06% of adolescents with body image disturbance could be at risk of developing a body image disorder.

CONCLUSIONS

The results of this study support the use of the Spanish translation of the BIAQ for assessing behavioural characteristic of body image disturbance.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study.

Spanish validation of the Aberrant Salience Inventory in a general adolescent population

BACKGROUND

Aberrant salience (AS), related to classical delusional mood and self-disturbances, may be one of the keys to early detection of psychosis, before abnormal assignment of significance. As adolescence is a critical period in development of the self and there are few instruments for evaluating AS, validation of the Aberrant Salient Inventory (ASI) is proposed for use in the general adolescent population.

METHODS

A sample of 4,523 participants, 53.6% women, from 11 to 18 years of age (M = 14.31, SD = 1.66), from 29 schools in Western Andalusia (Spain) were evaluated collectively.

RESULTS

Good fit was found in the answers, and the original five-factor structure of the inventory was replicated. Reliability (ordinal alpha) was adequate both for the total (.95) and for the factors (.74. to .85). Invariance across sex, adequate indicators of concurrent (ideas of reference) and divergent (negative symptoms) validity, and sensitivity of .88 were found.

CONCLUSIONS

The results suggest the ASI for use in the general adolescent population, and show that 7% of the sample could be at risk of beginning psychosis.

The relationship with the voices as a dialogical experience: The role of self-focused attention and dissociation

OBJECTIVE

The purpose of this article was to study the relationship of self-focused attention and dissociation with the dialogical relationship persons diagnosed with psychosis have with their voices.

METHOD

The DAIMON Scale was applied to 62 persons diagnosed with psychosis to measure the dialogical relationship with their voices, and the Cambridge depersonalization scale, the Tellegen absorption scale, and the self-focused attention scale.

RESULTS

The results showed that the dialogical relationship with the voices was associated with high levels of self-focused attention (private and public), depersonalization, and absorption. It was also found that absorption mediated significantly between public self-focused attention and the dialogical relationship with the voices.

CONCLUSIONS

The role of dissociation and self-focused attention in forming the dialogical relationship a person with psychosis has with the voices is discussed and approaches to treatment are suggested.

Spanish validation of the self-evaluation of negative symptoms scale SNS in an adolescent population

BACKGROUND

Negative symptoms (NS) may be observed in the general population in an attenuated form and in high-risk mental states. However, they have been less studied in the general population than positive symptoms, in spite of their importance at the insidious onset of schizophrenia and their appearance before positive symptoms. This study aimed to analyze the empirical structure of the Spanish version of the Self-Evaluation of Negative Symptoms (SNS) Scale and find its psychometric properties and invariance of measurement across sex and age in a sample of adolescents.

METHODS

The sample consisted of 4521 adolescents (53.6% female) from 11 to 18 years of age.

RESULTS

Confirmatory Factor Analysis of the SNS confirmed an internal structure of five first-order factors by the characteristic dimensions of NS: avolition, social withdrawal, diminished emotional range, anhedonia, alogia, and one second-order factor which includes the total NS score. Multi-group confirmatory factor analysis showed that the scale was invariant across sex and age. Total scale reliability was adequate. A strong relationship was found between the SNS with depressive symptomatology, moderate with ideas of reference and low with aberrant salience.

CONCLUSION

The results back use of the Spanish version of the SNS scale for detection of NS in the general population of adolescents.

Examining the structure of ideas of reference in clinical and community samples

AIMS

This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis.

METHODS

A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses-154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84.

RESULTS

Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the "causal explanations", "Songs, newspapers, books" and "laughing and commenting" REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders.

CONCLUSIONS

The results provide satisfactory that the REF scale could be used to study psychosis.

Childhood memories of threatening experiences and submissiveness and its relationship to hallucination proneness and ideas of reference: The mediating role of dissociation

Recent studies have emphasized the importance of childhood memories of threatening experiences and submissiveness in a diversity of psychological disorders. The purpose of this work was to study their specific relationship with hallucination proneness and ideas of reference in healthy subjects. The ELES scale for measuring memory of adverse childhood experiences, the DES-II scale for measuring dissociation, the LSHS-R scale for measuring hallucination proneness, and the REF for ideas of reference were applied to a sample of 472 subjects. A positive association was found between childhood memories of adverse experiences and hallucination proneness and ideas of reference, on one hand, and dissociation on the other. A mediation analysis showed that dissociation was a mediator between the memory of adverse childhood experiences and hallucination proneness on one hand, and ideas of reference on the other. When the role of mediator of the types of dissociative experiences was studied, it was found that absorption and depersonalization mediated between adverse experiences and hallucination proneness. However, this mediating effect was not found between adverse experiences and ideas of reference. The relationship between these last two variables was direct. The results suggest that childhood memories of adverse experiences are a relevant factor in understanding hallucination proneness and ideas of reference. Similarly, dissociation is a specific mediator between adverse childhood experiences and hallucination proneness.

Validation of Spanish Language Evaluation Instruments for Body Dysmorphic Disorder and the Dysmorphic Concern Construct

Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in physical appearance with social avoidance and behavior directed at controlling the defect in appearance. This study attempted to adapt the factor structure of two instruments that cover the DC construct, the Dysmorphic Concern Questionnaire (DCQ) and the Body Dysmorphic Disorder Examination Self-Report (BDDE-SR), to Spanish and establish their psychometric properties. A total of 920 subjects (62.7% women, M_age = 32.44 years) participated. Exploratory and Confirmatory Factor Analysis of both scales found adequate goodness of fit indices. A one-dimensional structure was found for the DCQ and two first-order factors (dissatisfaction/preoccupation with body image (BI) and BI avoidance behavior) were identified for the BDDE-SR. The psychometric test–retest reliability and validity properties (content, convergent, and discriminant) were satisfactory. It is suggested that the DC construct includes both cognitive and behavioral aspects and may represent a continuum of severity with Body Dysmorphic Disorder at the end.

Leiden Index of Depression Sensitivity-Revised (LEIDS-R): Spanish validation proposal

To adapt and validate the Leiden Index of Depression Sensitivity-Revised for evaluating cognitive reactivity to depressive mood to Spanish and validate this Spanish version. To find the scale's factor structure and psychometric properties. The sample consisted of 600 participants (103 patients and 497 subjects from the general population). A four-factor structure was found, a general factor evaluating cognitive reactivity was proposed and ten items were eliminated. A brief version of the (LEIDS-R24) scale is proposed. The factors and the overall scale have adequate internal consistency, and the results of validation show that all the factors on the scale predict depressive symptomatology (BDI-II) adequately, and are highly correlated with the Dysfunctional Attitudes Scale and BDI-II scales. The complete scale adequately discriminated depressive symptomatology in general population subjects and patients with anxiety and depressive disorders. No significant differences were found in the LEIDS-R24 measurement between subjects with anxiety and depressive disorder. The LEIDS-R24 scale may be a useful brief measure for evaluating cognitive reactivity to depressive mood and analyzing the vulnerability which could be common to persons with anxiety and depressive disorders.

A Mediation Model for Ideas of Reference

Ideas of reference are common in human beings, but they are frequent in certain psychopathological disorders, mainly those concerning the psychotic spectrum. The purpose of this study was to attempt to construct a model predicting the appearance of ideas of reference and to test the relationship of personality (based on the Gray model), emotional, and self-consciousness variables. Five-hundred and seventy-four participants (287 patients with several different psychopathological diagnoses) filled in the Referential Thinking Scale (REF), the GHQ-28, the Self-Consciousness Scale (SCS-R), and the SPSRQ Scale. The resulting model found full mediation of sensitivity to punishment, sensitivity to reward, depression, and public self-consciousness between anxiety and ideas of reference, regardless of the group they were in (patients vs. nonpatients). This result, based on the appearance of anxiety symptomatology, explains 43% of the variance in scores, showing the presence of ideas of reference and therefore enables prediction of a set of vulnerabilities (established with self-reports) which could lead to a psychological state of high general pathological risk and proneness to psychosis in particular.

Relationship between inner dialog and ideas of reference and the mediating role of dissociation

Recent lines of research have begun to concentrate on internal dialogue and its relationship to a diversity of psychopathological phenomena present in psychotic disorders. This study was intended as a preliminary exploration of the relationship of internal dialogue, dissociation and ideas of reference. To do this, a sample of 318 students filled in an internal dialogue scale (the VISQ, McCarthy-Jones & Fernyhough), one for dissociation (DES-II, Carlson & Putnam) and another for ideas of reference (REF, Lenzenweger, Bennett & Lilenfeld). The results confirm the hypothesis posed in the sense that internal dialogue was positively associated with dissociation and with ideas of reference. A partial mediation effect of dissociation was also found between inner speech and ideas of reference. Lines of future research this study opens and its possible integration in a model on ideas of reference are discussed.