Reprinted from Eating Disorders Review
July/August 2004 Volume 15, Number 4
©2004 Gürze Books
Anorexia nervosa patients often have an ambivalent attitude toward recovery, which may pose challenges for healthcare professionals who are trying to establish a good therapeutic alliance with these patients. Prochaska and DiClemente (Psychotherapy: Theory, Research, and Practice 1982; 19:276) developed a stages-of-change model to help explain the process toward a real willingness on the part of the patient to change. In its most recent version, six stages are identified: precontemplation, contemplation, preparation, action, maintenance, and termination.
Physicians in Barcelona, Spain, have tested and validated a Spanish version of the Anorexia Stages of Change Questionnaire (ANSOCQ), developed by Reiger et al. in 2001 (Psychology and Psychotherapy Theory, Research and Practice 2004;77:91). Dr. E. Serrano and colleagues at the University of Barcelona administered the ANSCOQ, the Eating Disorders Inventory (EDI-2), the Beck Depression Inventory (BDI) to 70 anorexia nervosa patients with a mean age of 15.6 years who were being treated at a specialized eating disorder clinic and who had reached different stages of treatment.
The authors reported that their results support the psychometric properties of the Spanish version of the ANSCOQ. Significant negative correlations were obtained between the ANSCOQ and both the BDI and EDI-2 subscales (especially the drive for thinness, body dissatisfaction, ineffectiveness, interoceptive awareness, asceticism and social insecurity subscales). Their work also adds to previous research because their study population was younger than previous groups and included patients attending a day program and outpatient programs rather than inpatient. The percentage of patients in each stage of change lent further support to the validity of the ANSCOQ. In comparison to the study of Reiger et al (Int J Eat Disord 2002;32:24), in Australia, patients in the current study were more often in the preparation and action stages. The authors explain that the patients in the Australian study were all evaluated during admission to an inpatient unit, whereas the participants were patients undergoing inpatient, day program, or outpatient treatment. The Spanish version of the ANSCOQ was found to be reliable and consistent. According to the authors, it is likely to be a useful instrument for clinical and research work on anorexia nervosa in Spanish-speaking populations.