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SUMMARY women (average age 19.1 years, SD=3.8), high school and college
students at public and private schools in Mexico City. The study
The main purpose of this paper was to present the construct was carried out in two phases: in the first, the individual (eating
validity of an instrument for the detection of risk factors for behaviors, body weight history, curriculum, dating and violence),
eating disorders in Mexican adolescents and young psychosocial (self-esteem, body image, depression, personality
women, such that professionals in this area have a reliable and traits, identity and sexuality) and sociocultural (interpersonal
valid instrument for the detection of risk factors with qualitative relationships, career choice and values towards the body) factors
and quantitative specifications, for the discrimination of risk associated with the development of eating disorders were assessed
severity in conjunction with decision-making related to prevention using a qualitative methodology (in-depth interviews) with 10
and treatment. This has been a theoretical and practical issue Mexican eating disordered patients in treatment at the Eating
lacking issue in our present socio-cultural context. As systematic Disorders Unit of the National Institute of Psychiatry Ramn
research on eating disorders is recent in Mexico, and because the del Fuente in Mexico City.
low prevalence of these diseases has limited the access to clinical The data obtained from the first phase, was used to identify
populations, their cause may be explained based on other cultural the most important issues reported by patients, and questions
contexts research findings. Therefore it has become an important were developed to assess the different areas; this resulted in the
task to enrich such information with the Mexican eating disordered development of a 273 question self-report instrument. The
womens experience, related to cultural issues. It may appear instrument included two types of measurements: questions
reiterative to develop new assessment instruments for this purpose, specifically implemented for this study, and scales previously
considering that international workings are abundant and some validated in Mexican populations, such as the CES-D, suicidal
of them have been already validated with Mexican populations, ideation scale, and the relationship with mother/father scale, the
for instance the Eating Attitudes Test, a self-report screening test Pope self-esteem scale, and the Eating Disorders Inventory
of the symptoms and concerns characteristic of eating disorders, perfectionism, maturity fears and body dissatisfaction scales. The
and the Eating Disorders Inventory, that measures traits and instrument was initially assessed with a pilot study to determine
symptom clusters presumed to have relevance for the the correct comprehension of the items and its statistical
understanding and treatment of eating disorders. However, it is discrimination, with 31 women diagnosed with eating disorders
important to highlight the cultural differences of a particular in treatment at the Eating Disorders Unit, and 30 normal controls
culture and their relationship to psychopathology. The results with similar ages (X=22.5, SD=7.7), similar schooling curriculum
obtained in different cultures, question the universal meanings in years (X=12.5, DE=3.3) and BMI (X=22.3, SD=3.6). To
for psychological disorders challenging the validity of achieve these goals, independent samples t-tests were conducted
standardization for non-occidental cultures. These views support between groups, considering as valid those items that were
the development of appropriate assessment instruments in different at a .05 level. After the pilot study the instrument
different cultures. The main contribution of this instrument is included 14 areas and 216 questions associated with the
that it was developed based on the information provided by development of eating disorders; nevertheless, in this paper only
Mexican eating disordered patients in relation to the development the results from the validation analyses of the 8 Likert scales that
of their illness. comprise the instrument will be reported: depressive symptoms,
Risk factors associated with the development of eating disorders suicidal ideation, self-esteem, psychological characteristics,
were assessed in a sample of 332 Mexican adolescents and young relationships with brothers and sisters, with males, with mother
*
Trabajo presentado en la 2003 Conference of the Academy for Eating Disorders, Denver, Colorado, mayo 2003.
**Investigador de tiempo completo. Direccin de investigaciones Epimiolgicas y Psicosociales. Instituto Nacional Psiquiatra Ramn de la Fuente.
Correo electrnico unikels@imp.edu.mx.
***Divisin de Estudios de Posgrado. Facultad de Psicologa, UNAM.
Correspondencia: Mtra. Claudia Unikel. Calz. Mxico-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, 14370 Mxico, D.F.
Recibido primera versin: 23 de abril de 2003. Recibido segunda versin: 4 de septiembre de 2003. Aceptado: 20 de octubre de 2003
CUADRO 3
Anlisis Factorial. Autoestima
56% de la varianza total explicada. Los valores de con- j 5 factores puros en 19 iteraciones, que explicaron
sistencia interna alpha de Cronbach de los factores fluc- 57.4% de la varianza total. Los valores de consistencia
tuaron entre .63 y .94 (cuadro 7). El factor 1 agrup interna alpha de Cronbach fluctuaron entre .60 y .93
11 reactivos relacionados con la manifestacin de afec- para cada uno de los factores (cuadro 8). Los factores
to y comunicacin con el padre. El factor 2 agrup 8 Maltrato emocional, Afecto positivo y Crtica,
preguntas relacionadas con las prcticas de control del hacen referencia a los mismos conceptos ya explica-
padre hacia la hija. El factor 3, se form con 3 reactivos dos para la escala de Relacin con pap, pero a di-
relacionados con la preocupacin del padre por man- ferencia de stos, en la escala de relacin con mam se
tener cubiertas las necesidades bsicas de su hija. El form un factor que fue denominado Vala y que
factor 4 agrup preguntas sobre hacer crticas o com- incluy 4 reactivos elaborados para la presente investi-
paraciones del cuerpo de la hija, y el factor 5 se form gacin: dos de ellos hacen referencia a la percepcin,
con 9 reactivos de los cuales 2 compartieron su carga por parte de la hija, de las exigencias de su madre con
factorial con el factor 2 y se refiere al maltrato emo- ella, y dos reactivos que se refieren a la percepcin de
cional ejercido por parte del padre hacia la hija. la hija sobre la apreciacin de la madre respecto a ella.
La escala Relacin con mam obtuvo un valor de El factor 4, Decepcin hija-madre, incluy 4 pre-
consistencia interna alpha de Cronbach de .93 una vez guntas relacionadas con la percepcin de la hija con
eliminados los 10 reactivos que obtuvieron correlacio- respecto a las expectativas que su madre tiene respecto
nes tem-total menores a .30. El anlisis factorial arro- a ella.
Factor 1 Factor 1
Varianza total explicada = 48.6% Varianza total explicada = 61.1%
Valor Eigen = 3.4 Valor Eigen = 4.8
Alpha de Cronbach = .80 Alpha de Cronbach = .90
cin o incluso se ha encontrado una correlacin nega- conceptual y valores de consistencia interna de mode-
tiva (5). Es posible sin embargo, que cuando el rada a alta (.77 y .72 respectivamente). La seccin so-
perfeccionismo interacciona con otras variables, acte bre insatisfaccin con la figura corporal se subdividi
como factor de riesgo (32). En un estudio previo rea- en dos partes, una relacionada con la influencia del
lizado con muestras de estudiantes mexicanas de nivel modelo esttico corporal actualmente predominante,
bachillerato y licenciatura (3), se encontr una correla- que se manifiesta a travs de creencias y actitudes hacia
cin significativa pero dbil entre el perfeccionismo y la obesidad, y la otra relacionada con la discrepancia
la conducta alimentaria, ambos medidos con el EDI entre una figura real e ideal, que genera insatisfaccin
(14). En la presente investigacin, la forma de medi- con la totalidad del cuerpo o con partes del mismo.
cin de este constructo no mostr la fuerza necesaria Estos dos aspectos han sido considerados como varia-
para permanecer en la escala; mientras que las otras bles moderadoras para el desarrollo de trastornos
dos subescalas propuestas (miedo a madurar e insatis- alimentarios en personas cuyo autoconcepto se basa de
faccin con la figura corporal), mostraron coherencia manera importante en la forma y el peso corporal (33).
El anlisis de las escalas relacin con hermanos y cuanto a la manifestacin de afecto e inters por las
relacin con hombres, ambas propuestas originales actividades de la hija.
de la presente investigacin, mostr valores de consis-
tencia interna elevados (alpha= .90 y .80 respectiva-
mente). Ambas escalas arrojaron un solo factor con REFERENCIAS
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