Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-03T08:32:42.425Z Has data issue: false hasContentIssue false

Avoidance and Activation as Keys to Depression: Adaptation of the Behavioral Activation for Depression Scale in a Spanish Sample

Published online by Cambridge University Press:  10 January 2013

Jorge Barraca*
Affiliation:
Universidad Camilo José Cela (Spain)
Marino Pérez-Álvarez
Affiliation:
Universidad de Oviedo (Spain)
José Héctor Lozano Bleda
Affiliation:
Universidad Camilo José Cela (Spain)
*
Correspondence concerning this article should be addressed to Jorge Barraca Mairal. Dpto. de Psicología. Facultad de Ciencias de la Salud. Universidad Camilo José Cela. C/. Castillo de Alarcón, 49. Urb. Villafranca del Castillo. 28692 Madrid (Spain). E-mail: [email protected]

Abstract

In this paper we present the adaptation of the Behavioral Activation for Depression Scale (BADS), developed by Kanter, Mulick, Busch, Berlin, and Martell (2007), in a Spanish sample. The psychometric properties were tested in a sample of 263 participants (124 clinical and 139 non-clinical). The results show that, just as in the original English version, the Spanish BADS is a valid and internally consistent scale. Construct validity was examined by correlation with the BDI-II, AAQ, ATQ, MCQ-30, STAI and EROS. Factor analysis justified the four-dimensions of the original instrument (Activation, Avoidance/Rumination, Work/School Impairment and Social Impairment), although with some differences in the factor loadings of the items. Further considerations about the usefulness of the BADS in the clinical treatment of depressed patients are also suggested.

En el artículo se presenta la adaptación en una muestra española de la Escala de Activación Conductual para la Depresión (BADS) desarrollada por Kanter, Mulick, Busch, Berlin, and Martell (2007). Las propiedades psicométricas del instrumento se recabaron con una muestra de 263 participantes (124 clínicos y 139 no clínicos). Los resultados demuestran que, al igual que en la versión inglesa, el BADS adaptado al español es una escala válida y con consistencia interna. La validez de constructo se contrastó por medio de correlaciones con el BDI-II, el AAQ, el ATQ, el MCQ-30, el STAI y el EROS. El análisis factorial confirmó las cuatro dimensiones del instrumento original (Activación, Evitación/Rumia, Afectación del Trabajo/Escolaridad y Afectación de la Vida Social), aunque con algunas diferencias respecto a los pesos factoriales de los ítems. Para terminar, se incluyen algunas consideraciones sobre la utilidad del BADS en el tratamiento clínico de los pacientes depresivos.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Armento, M. E. A., & Hopko, D. R. (2007). The Environmental Reward Observation Scale (EROS): Development, validity, and reliability. Behavior Therapy, 38, 107119. doi:10.1016/j.beth.2006.05.003CrossRefGoogle ScholarPubMed
Barraca, J. (2004). Spanish adaptation of the Activation and Action Questionnaire (AAQ). International Journal of Psychology and Psychological Therapy, 4, 505515.Google Scholar
Barraca, J. (2009). La Activación Conductual (AC) y la Terapia de Activación Conductual para la Depresión (TACD). Dos protocolos de tratamiento desde el modelo de activación conductual. [Behavioral Activation (BA) and Behavioral Activation Treatment for Depression (BATD). Two protocols treatment from the behavioral activation model] EduPsykhé. Revista de Psicología y Educación, 8, 2350.Google Scholar
Barraca, J., & Pérez-Álvarez, M. (2010). Spanish adaptation of the Environmental Reward Observation Scale (EROS). Ansiedad y Estrés, 16, 95106.Google Scholar
Beck, A. T., Epstein, N., Brown, G. & Steer, R. A. (1988). An inventory for measuring anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893897. doi:10.1037/0022-006X.56.6.893CrossRefGoogle ScholarPubMed
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the BDI-II. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.CrossRefGoogle ScholarPubMed
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238246. doi:10.1037/0033-2909.107.2.238CrossRefGoogle ScholarPubMed
Bentler, P. M. (2005). EQS 6 structural equations program manual. Encino, CA: Multivariate Software.Google Scholar
Bollem, K. A. (1989). Structural equations with latent variables. Oxford: Wiley.CrossRefGoogle Scholar
Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In Bollen, K. A. & Long, J. S. (Eds.), Testing structural equation models (pp. 136–61). Newbury Park, CA: Sage.Google Scholar
Cano-García, F. J., & Rodríguez-Franco, L. (2002). Evaluación del lenguaje interno ansiógeno y depresógeno en la experiencia de dolor crónico [Assessment of the ansioux and depressive self-statements in the chronic pain experience]. Apuntes de Psicología, 20, 329346.Google Scholar
Cuijpers, P., van Straten, A., & Warnerdam, L. (2007). Behavioral activation treatments of depression: a meta-analysis. Clinical Psychology Review, 27, 318326. doi:10.1016/j.cpr.2006.11.001CrossRefGoogle ScholarPubMed
Cullen, J. M., Spates, C. R., Pagoto, S., & Doran, N. (2006). Behavioral activation treatment for major depressive disorder: a pilot investigation. The Behavior Analyst Today, 7, 151166.CrossRefGoogle Scholar
Daughters, S. B., Braun, A. R., Sargeant, M., Reynolds, E. R., Hopko, D., Blanco, C., & Lejuez, C. W. (2008). Efficacy of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: the Life Enhancement Treatment for Substance Use (LETS ACT). Journal of Clinical Psychiatry, 69, 122129.CrossRefGoogle ScholarPubMed
Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., … Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adult. Journal of Consulting and Clinical Psychology, 74, 658670. doi:10.1037/0022-006X.74.4.658CrossRefGoogle Scholar
Dodson, K. S., Hollon, S. D., Dimidjian, S., Schmaling, K. B., Kohlenberg, R. J., Gallop, R. J., … Jacobson, N. S. (2008). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of Consulting and Clinical Psychology, 76, 468477. doi:10.1037/0022-006X.76.3.468Google Scholar
Edwards, A. L. (1957). Techniques of attitude scale construction. New York, NY: Appleton Century-Crofts.CrossRefGoogle Scholar
Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 857870. doi:10.1037/h0035605CrossRefGoogle Scholar
Flaherty, J. A., Gaviria, M., Pathak, D., Mitchell, T., Wintrob, R., Richman, J., & Birz, S. (1988). Developing instruments for cross-cultural psychiatric research. The Journal of Nervous and Mental Disease, 176, 260263.CrossRefGoogle ScholarPubMed
García-Montes, J. M., Pérez-Alvarez, M., Soto, C., Perona, S., & Cangas, A. (2006). Metacognitions in patients with hallucinations and obsessive-compulsive disorder: The superstition factor. Behavior Research and Therapy, 44, 10911104. doi:10.1016/j.brat.2005.07.008CrossRefGoogle ScholarPubMed
Hambleton, R. K., & Kanjee, A. (1995). Increasing the validity of cross-cultural assessments: Use of improved methods for test adaptations. European Journal of Psychological Assessment, 11, 147157. doi:10.1027/1015-5759.11.3.147CrossRefGoogle Scholar
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press.Google Scholar
Hayes, S. C., Strosahl, K. D., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., … McCurry, S. M. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54, 553578.CrossRefGoogle Scholar
Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire. Cognitive Therapy and Research, 4, 383395. doi:10.1007/BF01178214CrossRefGoogle Scholar
Hopko, D. R., Lejuez, C. W., LePage, J. P., Hopko, S. D., & McNeil, D. W. (2003). A brief behavioral activation treatment for depression: a randomized trial within an inpatient psychiatric hospital. Behavior Modification, 27, 458469. doi:10.1177/0145445503255489CrossRefGoogle ScholarPubMed
Hopko, D. R., Lejuez, C. W., Ruggiero, K. J., & Eifert, G. H. (2003). Contemporary behavioral activation treatments for depression: Procedures, principles, and progress. Clinical Psychology Review, 23, 699717. doi:10.1016/S0272-7358(03)00070-9CrossRefGoogle Scholar
Hopko, D. R., Robertson, S. M. C., & Lejuez, C. W. (2006). Behavioral activation for anxiety disorders. The Behavior Analyst Today, 7, 212232. doi:10.1177/1534650103258969CrossRefGoogle Scholar
Hoyle, R. H. (1995). Structural equation modeling: Concepts, issues, and applications. Thousand Oaks, CA: Sage.Google Scholar
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 155. doi:10.1080/10705519909540118CrossRefGoogle Scholar
Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: returning to contextual roots. Clinical Psychology: Science and Practice, 8, 255270. doi:10.1093/clipsy.8.3.255Google Scholar
Kanter, J. W., Mulick, P. S., Busch, A. M., Berlin, K. S., & Martell, C. R. (2007). The Behavioral Activation for Depression Scale (BADS): Psychometric properties and factor structure. Journal of Psychopathology and Behavioral Assessment, 29, 191202. doi:10.1007/s10862-006-9038-5CrossRefGoogle Scholar
Kanter, J. W., Rusch, L. C., Busch, A. M., & Sedivy, S. K. (2009). Validation of the Behavioral Activation for Depression Scale (BADS) in a community sample with elevated depressive symptoms. Journal of Psychopathology and Behavioral Assessment, 31, 3642. doi:10.1007/s10862-008-9088-yCrossRefGoogle Scholar
Kanter, J., Manos, R. C., Bowe, W. M., Baruch, D. E., Busch, A. M., & Rusch, L. C. (2010). What is behavioral activation? A review of the empirical literature. Clinical Psychology Review, 30, 608620. doi:10.1016/j.cpr.2010.04.001CrossRefGoogle ScholarPubMed
Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York, NY: The Guilford Press.Google Scholar
Lejuez, C., Hopko, D., & Hopko, S. (2001). A brief behavioral activation treatment for depression: Treatment manual. Behavior Modification, 25, 255286. doi:10.1177/0145445501252005CrossRefGoogle ScholarPubMed
Mardia, K. V. (1970). Measures of multivariate skewness and kurtosis with applications. Biometrika, 57, 519530. doi:10.1093/biomet/57.3.519CrossRefGoogle Scholar
Mardia, K. V. (1974). Applications of some measures of multivariate skewness and kurtosis in testing normality and robustness studies. Sankhya B The Indian Journal of Statistics, 36, 115128.Google Scholar
Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. New York, NY: Norton.Google Scholar
Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115121. doi:10.1037/0022-3514.61.1.115CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S., Parker, L. E., & Larson, J. (1994). Ruminative coping with depressed mood following loss. Journal of Personality and Social Psychology, 67, 92104. doi:10.1037/0022-3514.67.1.92CrossRefGoogle ScholarPubMed
Ottenbreit, N. D., & Dobson, K. S. (2004). Avoidance and depression: The construction of the Cognitive-Behavioral Avoidance Scale. Behaviour Research and Therapy, 42, 293313. doi:10.1016/S0005-7967(03)00140-2CrossRefGoogle ScholarPubMed
Pérez-Álvarez, M. (2008). Hyperreflexivity as a condition in mental disorders: a clinical and historical perspective. Psicothema, 20, 181187.Google ScholarPubMed
Porter, J. F., Spates, C. R., & Smithan, S. (2004). Behavioral Activation group therapy in public mental health setting: a pilot investigation. Professional Psychology: Research and Practice, 35, 297301. doi:10.1037/0735-7028.35.3.297CrossRefGoogle Scholar
Raes, F., Hoes, D., Van Gucht, D., Kanter, J. W., & Hermans, D. (2010). The Dutch version of the Behavioral Activation for Depression Scale (BADS): Psychometric properties and factor structure. Journal of Behavior Therapy and Experimental Psychiatry, 41, 246250. doi:10.1016/j.jbtep.2010.02.001CrossRefGoogle ScholarPubMed
Raykov, T., & Widaman, K. F. (1995). Issues in structural equation modeling research. Structural Equation Modeling, 2, 289318. doi:10.1080/10705519509540017CrossRefGoogle Scholar
Sanz, J., García-Vera, M. P., Espinosa, R., Fortún, M., & Vázquez, C. (2005). Adaptación española del Inventario para la Depresión de Beck-II (BDI-II): 3. Propiedades psicométricas en pacientes con trastornos psicológicos [Spanish adaptation of the Beck Depression Inventory-II (BDI-II): 3. Psychometric features in patients with psychological disorders]. Clínica y Salud, 1, 121142.Google Scholar
Sanz, J., Navarro, M. E., & Vázquez, C. (2003). Adaptación española del Inventario para la Depresión de Beck-II (BDIII): 1. Propiedades psicométricas en estudiantes universitarios [Spanish adaptation of the Beck Depression Inventory-II (BDIII): 1. Psychometric features in university students]. Análisis y Modificación de Conducta, 29, 239288.Google Scholar
Sanz, J., Perdigón, A. L., & Vázquez, C. (2003). Adaptación española del Inventario para la Depresión de Beck-II (BDIII): 2. Propiedades psicométricas en población general [Spanish adaptation of the Beck Depression Inventory-II (BDI-II): 2. Psychometric features in general population]. Clínica y Salud, 14, 249280.Google Scholar
Satorra, A., & Bentler, P. M. (1988). Scaling corrections for chi-square statistics in covariance structure analysis. In American Statistical Association 1988 proceedings of the business and economics section (pp. 308313). Alexandria, VA: American Statistical Association.Google Scholar
Satorra, A., & Bentler, P. M. (1994). Corrections to test statistics and standard errors in covariance structure analysis. In Eye, A. von & Clogg, C. C. (Eds.), Latent variables analysis: Applications for developmental research (pp. 399419). Thousand Oaks, CA: Sage.Google Scholar
Skinner, B. F. (1953). Science and human behavior. Oxford, UK: Macmillan.Google Scholar
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1982). STAI. Cuestionario de Ansiedad Estado/Rasgo. [STAI. State-Trait Anxiety Inventory]. Madrid, Spain: TEA Ediciones.Google Scholar
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). State-Trait Anxiety Inventory Manual. Palo Alto, CA: Consulting Psychologist Press.Google Scholar
Steiger, J. H., & Lind, J. C. (1980, May). Statistically based tests for the number of common factors. Paper presented at the Psychometric Society annual meeting, Iowa City, IA.Google Scholar
Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38, 110. doi:10.1007/BF02291170CrossRefGoogle Scholar
Wells, A., & Cartwright-Hatton, S. (2002). A short form of the metacognitions questionnaire: properties of the MCQ-30. Behaviour Research and Therapy, 42, 385396.doi:10.1016/S0005-7967(03)00147-5CrossRefGoogle Scholar
West, S. G., Finch, J. F., & Curran, P. J. (1995). Structural equation model with non-normal variables: Problems and remedies. In Hoyle, R. H. (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 5675). Thousand Oaks, CA: Sage.Google Scholar
Youngren, M. A., & Lewinsohn, P. M. (1980). The functional relationship between depressed and problematic interpersonal behavior. Journal of Abnormal Psychology, 89, 333341. doi:10.1037/0021-843X.89.3.333CrossRefGoogle Scholar
Zeiss, A. M., Lewinsohn, P. M., & Muñoz, R. F. (1979). Nonspecific improvement effects in depression using interpersonal skills training, pleasant activity schedules, or cognitive training. Journal of Consulting and Clinical Psychology, 47, 427439. doi:10.1037/0022-006X.47.3.427CrossRefGoogle ScholarPubMed