Academic journal article International Journal of Clinical and Health Psychology

Validity Evidence of the Behavioral Activation for Depression Scale-Short Form among Depressed Smokers

Academic journal article International Journal of Clinical and Health Psychology

Validity Evidence of the Behavioral Activation for Depression Scale-Short Form among Depressed Smokers

Article excerpt

Smoking produces a heavy economic burden worldwide, especially in Europe and North America where the tobacco epidemic accounts for 5.7% of global health expenditures (Goodchild, Nargis, & Tursan d'Espaignet, 2018). In Spain, despite there having been a slight decrease in the percentage of daily smokers over the last decade (from 32.5% in 2005 to 30.8% in 2015) (National Plan of Drugs, 2017), depression seems to have increased in this population (Becoña, López-Durán, Fernández del Río, & Martínez, 2014). This comorbidity leads not only to poor cessation outcomes (Weinberger et al., 2016), but also causes poor quality of life as evidenced by a high number of hospitalizations (Baker, 2017).

Against this background, research into smoking and depression is currently focused on the development of effective strategies to promote abstinence (López-Núnez, Martínez-Loredo, Weidberg, Pericot-Valverde, & SecadesVilla, 2016; Secades-Villa et al., 2015). In particular, behavioral activation (BA) as an adjunct to smoking cessation treatments has been recently recognized as a promising intervention in terms of mood improvement and cessation rates (MacPherson, Collado, Lejuez, Brown, & Tull, 2016; MacPherson et al., 2010; Pérez-Álvarez, 2012; Ross et al., 2016; van der Meer, Willemsen, Smit, Cuijpers, & Schippers, 2010). Treatments based on BA emphasize the importance of reengaging individuals with pleasant and adaptive activities while overcoming avoidance patterns as the main therapy component (Barraca, 2012; Chan, Sun, Tam, Tsoi, & Wong, 2017). Consequently, evaluating changes in activation and avoidance patterns is of great interest.

Accordingly, the Behavioral Activation Scale (BADS) has been developed as an instrument to assess frequency of activation, escape and avoidance behaviors throughout BA therapy (Kanter, Mulick, Busch, Berlin, & Martell, 2006). Although this scale originally consisted of 29 items, a 9-item short version has been recently cross-culturally validated (Manos, Kanter, & Busch, 2010; Manos, Kanter, & Luo, 2011; Wagener, Van der Linden, & Blairy, 2015). The abbreviated version of BADS (BADS-SF) allows health providers to swiftly and effectively monitor BA changes in-treatment; especially when added to other smoking-related and sociodemographic measurements. Research has reported that BADS-SF possesses adequate psychometric properties across both non-clinical (Raes, Hoes, Van Gucht, Kanter, & Hermans, 2010; Wagener et al., 2015) and clinically depressed individuals (Fuhr, Hautzinger, Krisch, Berking, & Ebert, 2016). Interestingly, it has shown good construct validity through high correlations with measures of depression and predictive validity over a one-week period (Manos et al., 2011).

Notwithstanding this, the BADS-SF has not yet been validated in the context of Spanish-speaking depressed smokers. Given that Spanish is the third most widely spoken language worldwide, and because of the increasing migratory movements of this population to the US, having adequate assessment tools for BA monitoring becomes essential in order to yield evidence on treatment efficacy for this particular group. Despite the existence of a validated version of the 25-item BADS scale in Spanish (Barraca, Pérez-Álvarez, & Lozano Bleda, 2011), the adaptation of BADS to a shorter format offers health providers a more efficient tool for monitoring activation levels in each therapy session.

This study sought to adapt the BADS-SF to a sample of Spanish depressed smokers and examine whether support for its psychometric properties is achieved in this population. We examined for reliability and validity evidence based on its internal structure and relation to other variables.

Method

Participants

The data set comprised 169 smokers (72.2% female) with moderate to severe depressive symptoms (BDI = 28.70, SD = 9.31). Most participants had a current depression diagnosis (73. …

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