Academic journal article The Spanish Journal of Psychology

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

Academic journal article The Spanish Journal of Psychology

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

Article excerpt

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.

Keywords: behavioral activation, depression, psychotherapy, test validation, Spain.

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.

Palabras clave: activación conductual, depresión, psicoterapia, validación de test, España.

Behavioral activation (BA) is a functional analytic therapy deeply rooted on Skinner's applied behavior analysis (Skinner, 1953). BA therapy is also based on previous behavioral approaches to depression as Fester's functional analysis (Fester, 1973) and Lewinsohn's model of depression, the latter essentially focused on pleasant events scheduling to increase rates of response-contingent positive reinforcement (Zeiss, Lewinsohn, & Munoz, 1979). Therapies based on behavioral activation have recently appeared as some of the most efficacious and efficient treatments for depression (Cuijpers, van Straten, & Warnerdam, 2007; Cullen, Spates, Pagoto, & Doran, 2006; Daughters et al., 2008; Dimidjian et al., 2006; Dodson et al., 2008; Hopko, Lejuez, LePage, Hopko, & McNeil, 2003; Porter, Spates, & Smithan, 2004). The current intervention of Behavioral Activation (Jacobson, Martell, & Dimidjian, 2001; Martell, Addis, & Jacobson, 2001) is a therapy expressly directed at helping the person to increase activation in such a way that he can experience greater contact with the sources of reward and solve the problems in his/her life.

Currently there are two different versions of BA, one by Martell et al. (2001) and one by Lejuez, Hopko, & Hopko (2001), the last one referred to as behavioral activation treatment of depression (BATD). Both target activation but have slightly different techniques (see Barraca, 2009, and Hopko, Lejuez, Ruggiero, & Eifert, 2003 for a more extended discussion).

The therapy focuses on activating clients to contact positive reinforcement. This is done by assigning activities, identifying and blocking avoidance behaviors that might interfere with activation, and a variety of other strategies (Kanter et al., 2010). The procedure consists of studying the case according to a functional behavior analysis. BA is a structured therapy with one clear target: promoting activation, frequently by reducing the avoidance patterns (Martell et al. …

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