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Development and Validation of the Resilience in Eating Disorders Scale (RED-5)

  • Carlota Las-Hayas [1] ; Odin Hjemdal [3] ; Pedro-José Muñoz [4] ; Jesús-Ángel Padierna Acero [5] ; Luis Beato-Fernandez [2] ; Andrés Gómez-del-Barrio [6] ; Diana M. Pérez-Valencia [1] ; Amaia Pikatza-Huerga [1] ; Aitor Almeida [1]
    1. [1] Universidad de Deusto

      Universidad de Deusto

      Bilbao, España

    2. [2] Hospital Quironsalud Ciudad Real

      Hospital Quironsalud Ciudad Real

      Ciudad Real, España

    3. [3] Department of Psychology, Norwegian University of Sciences and Technology, 7034 Trondheim, Norway
    4. [4] Psychiatry Service, Ortuella Mental Health Center, 48530 Bizkaia, Spain
    5. [5] Psychiatry Service, Galdakao-Usansolo Hospital, 48960 Bizkaia, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 48960 Bizkaia, Spain
    6. [6] Valdecilla Biomedical Research Institute (IDIVAL), 39011 Santander, Spain; Eating Disorders Unit, Department of Psychiatry, Hospital Universitario Marqués Valdecilla, 39002 Cantabria, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
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  • Localización: Actas españolas de psiquiatría, ISSN 1139-9287, Vol. 54, Nº. 1, 2026, págs. 1-16
  • Idioma: inglés
  • DOI: 10.62641/aep.v54i1.2008
  • Enlaces
  • Resumen

    • Background: A resilience scale tailored for individuals with eating disorders (EDs) could significantly enhance our understanding and treatment of EDs. Therefore, we developed and psychometrically evaluated a new Resilience in Eating Disorders scale (RED) following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.

      Method: Informed by prior qualitative interviews, the new RED scale underwent an initial pilot test among patients with EDs (n = 52) and field tests among patients with EDs (n = 169), ED-recovered individuals (n = 61), and a normative sample of the general population (n = 349), all aged between 27.9 and 29.8 years and residing in Spain. In this study, the participants completed the RED scale, Resilience Scale-25 (RS-25), Eating Attitudes Test-26 (EAT-26), World Health Organisation Quality of Life Scale – Brief Version (WHOQOL-BREF), and Hospital Anxiety and Depression Scale (HADS). Data were collected at baseline and after 1 year. Alongside machine learning techniques, exploratory and confirmatory analyses were employed to evaluate the reliability, construct validity, convergent validity, known-groups validity, predictive validity and responsiveness of the RED scale.

      Results: The original 52-item version of the RED scale was refined to 44 items following the pilot phase, and ultimately reduced to a 5-item version (RED-5) after field testing and psychometric evaluation. The RED-5 demonstrated strong psychometric properties, with excellent model fit indices (Root Mean Square Error of Approximation (RMSEA) = 0.03, and Comparative Fit Index (CFI) = 0.99) and acceptable internal consistency (Cronbach's alpha = 0.71). Additionally, the RED-5 scale effectively predicted quality of life, anxiety, depression, and ED symptomatology over a 1-year period.

      Conclusions: The RED-5 is a concise, psychometrically robust scale specifically developed to assess resilience in patients with EDs. It significantly predicts ED symptoms and quality-of-life outcomes, making it a valuable tool for both clinical practice and research. The RED-5 allows for quick administration and easy scoring. It provides mental health professionals with a tool to guide resilience-informed assessment and more personalized treatment planning.

  • Referencias bibliográficas
    • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). American...
    • American Psychiatric Association. DSM-5: Diagnostic and Statistical Manual of Mental Disorders (5th Edition). American Psychiatric Association:...
    • Calvete E, Las Hayas C, Gómez Del Barrio A. Longitudinal associations between resilience and quality of life in eating disorders. Psychiatry...
    • Castro J, Toro J, Salamero M, Guimerá E. The Eating Attitudes Test: Validation of the Spanish version. Evaluación Psicológica. 1991; 7:175–189.
    • Cattell RB. The Scree Test For The Number Of Factors. Multivariate Behavioral Research. 1966; 1: 245–276. https://doi.org/10.1207/s15327906mbr0102_10.
    • Cohen J. Statistical power analysis for the behavioural sciences. rev. ed. Academic Press: New York. 1977.
    • Connor KM, Davidson JRT. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety. 2003;...
    • Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951; 16: 297–334. https://doi.org/10.1007/BF02310555.
    • Denckla CA, Cicchetti D, Kubzansky LD, Seedat S, Teicher MH, Williams DR, et al. Psychological resilience: an update on definitions, a critical...
    • Doorley JD, Goodman FR, Kelso KC, Kashdan TB. Psychological flexibility: What we know, what we do not know, and what we think we know. Social...
    • Eddy KT, Tabri N, Thomas JJ, Murray HB, Keshaviah A, Hastings E, et al. Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up....
    • Ellis A, Gillespie K, McCosker L, Hudson C, Diamond G, Machingura T, et al. Meal support intervention for eating disorders: a mixed-methods...
    • Espinoza I, Osorio P, Torrejón MJ, Lucas-Carrasco R, Bunout D. Validation of the WHOQOL-BREF quality of life questionnaire among Chilean older...
    • Fava GA, Tomba E. Increasing psychological well-being and resilience by psychotherapeutic methods. Journal of Personality. 2009; 77: 1903–1934....
    • Folkman S, Lazarus RS. An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior. 1980; 21: 219–239.
    • Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychological Medicine....
    • Gross JJ. The emerging field of emotion regulation: An integrative review. Review of General Psychology. 1998; 2: 271–299. https://doi.org/10.1037/1089-2680.2.3.271.
    • Hatcher L, Stepanski EJ. A Step-by-Step Approach to Using the SAS System for Univariate and Multivariate Statistics (pp. xiv, 552). SAS Institute:...
    • Hildon Z, Montgomery SM, Blane D, Wiggins RD, Netuveli G. Examining resilience of quality of life in the face of health-related and psychosocial...
    • Hosmer DW, Lemeshow S. Applied logistic regression. John-Wiley & Sons, INC: New York. 2000.
    • Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural...
    • Jáuregui Lobera I, Estébanez S, Santiago Fernández MJ, Alvarez Bautista E, Garrido O. Coping strategies in eating disorders. European Eating...
    • Jo D, Pyo S, Hwang Y, Seung Y, Yang E. What makes us strong: Conceptual and functional comparisons of psychological flexibility and resilience....
    • Kabat-Zinn J. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. Hachette Books: New York, NY. 1994.
    • Las Hayas C, Calvete E, Gómez del Barrio A, Beato L, Muñoz P, Padierna JÁ. Resilience Scale-25 Spanish version: validation and assessment...
    • Las Hayas C, Padierna JA, Muñoz P, Aguirre M, Gómez Del BarrioA, Beato-Fernández L, et al. Resilience in eating disorders: A qualitative study....
    • Leahy R. A model of emotional schemas. Cognitive and Behavioral Practice. 2002; 9: 177–190. https://doi.org/10.1016/S1077-7229(02)80048-7.
    • Mallorquí-Bagué N, Vintró-Alcaraz C, Sánchez I, Riesco N, Agüera Z, Granero R, et al. Emotion Regulation as a Transdiagnostic Feature Among...
    • Marr NS, Zainal NH, Newman MG. Focus on and venting of negative emotion mediates the 18-year bi-directional relations between major depressive...
    • Mokkink L, Prinsen CA, Patrick DL, Alonso J, Bouter LM, de Vet HC, et al. COSMIN study design checklist for patient-reported outcome measurement...
    • Muthén LK, Muthén BO. Mplus User’s Guide (Eighth Edition.). Muthén & Muthén: Los Angeles, CA. 1998.
    • Nils F, Rimé B. Beyond the myth of venting: Social sharing modes determine the benefits of emotional disclosure. European Journal of Social...
    • Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard...
    • Osborne EL, Ainsworth B, Chadwick P, Atkinson MJ. The role of emotion regulation in the relationship between mindfulness and risk factors...
    • Peluso PR, Freund RR. Therapist and client emotional expression and psychotherapy outcomes: A meta-analysis. Psychotherapy (Chicago, Ill.)....
    • Pikatza-Huerga A, Las Hayas C, Zulaika U, Almeida A. Predictive assessment of eating disorder risk and recovery: Uncovering the effectiveness...
    • Prefit AB, Cândea DM, Szentagotai-Tătar A. Emotion regulation across eating pathology: A meta-analysis. Appetite. 2019; 143: 104438. https://doi.org/10.1016/j.appet.2019.104438.
    • Quintana JM, Padierna A, Esteban C, Arostegui I, Bilbao A, Ruiz I. Evaluation of the psychometric characteristics of the Spanish version of...
    • Robert M, Shankland R, Andreeva VA, Deschasaux-Tanguy M, Kesse-Guyot E, Bellicha A, et al. Resilience Is Associated with Less Eating Disorder...
    • Skevington SM, Lotfy M, O’Connell KA, WHOQOL Group. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties...
    • Stice E, Marti CN, Rohde P. Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective...
    • Trần V, Szabó Á, Ward C, Jose PE. To vent or not to vent? The impact of venting on psychological symptoms varies by levels of social support....
    • Treasure J, Duarte TA, Schmidt U. Eating disorders. Lancet (London, England). 2020; 395: 899–911. https://doi.org/10.1016/S0140-6736(20)30059-3.
    • Troy AS, Willroth EC, Shallcross AJ, Giuliani NR, Gross JJ, Mauss IB. Psychological Resilience: An Affect-Regulation Framework. Annual Review...
    • Ungar M, Theron L. Resilience and mental health: how multisystemic processes contribute to positive outcomes. The Lancet. Psychiatry. 2020;...
    • van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry....
    • van Hoeken D, Hoek HW. Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden. Current...
    • Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement. 1993; 1: 165–178.
    • Ware JE, Jr, Gandek B, Guyer R, Deng N. Standardizing disease-specific quality of life measures across multiple chronic conditions: development...
    • Wathen CN, MacGregor JCD, Hammerton J, Coben JH, Herrman H, Stewart DE, et al. Priorities for research in child maltreatment, intimate partner...
    • Windle G. What is resilience? A review and concept analysis. Reviews in Clinical Gerontology. 2011; 21: 152–169. https://doi.org/10.1017/S0959259810000420.
    • Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983; 67: 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x.
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