Desarrollo y validación de la versión II de la escala EMUN

Article information

Resumen

Introducción

La escala EMUN se desarrolló para medir síntomas psiquiátricos en pacientes con trastorno afectivo bipolar. Aunque ha mostrado adecuadas propiedades psicométricas, varios estudios han reportado que la labilidad afectiva, la agresividad y la impulsividad (síntomas no incluidos en la escala) son características importantes del trastorno.

Objetivo

Determinar las propiedades psicométricas de la EMUN al adicionar tres ítems: labilidad afectiva, agresividad e impulsividad.

Métodos

Los datos para el estudio fueron recolectados en 223 pacientes con diagnóstico de episodio maniaco, hipomaniaco o mixto, utilizando una versión modificada de la escala EMUN (EMUN-II), que incluye tres ítems adicionales. Se usó el alfa de Cronbach para evaluar consistencia interna. El contenido se validó usando métodos factoriales y modelamiento con ecuaciones estructurales.

Resultados

Una solución de cuatro factores (activación general, agresividad, activación cognoscitiva y depresión) da cuenta del 96% de la varianza total. Los coeficientes de correlación-concordancia de Lin revelaron valores adecuados para la confiabilidad test-retest. La escala detectó una diferencia significativa entre las medias antes del tratamiento farmacológico y después de este.

Conclusión

La inclusión de tres ítems adicionales mejoró la validez de contenido de la escala EMUN y conservó un instrumento con adecuadas propiedades psicométricas.

Palabras clave:

escalas de valoración psiquiátrica

trastorno bipolar

psicometría

Abstract

Introduction

The EMUN scale has been developed as a psychiatric rating scale for measuring manic symptoms in patients with bipolar disorder. Although the instrument has shown adequate psychometric properties, additional symptoms not included in the scale such as mood lability, aggressiveness, and impulsivity have been reported as important clinical characteristics in several studies.

Objectives

To determine the psychometric properties of the EMUN scale when items measuring mood lability, aggressiveness, and impulsivity are included in the instrument.

Method

Study data was collected from 223 patients with manic, hypomanic or mixed episodes using a modified version of the EMUN scale that includes three additional items (EMUN-II). The CARS-M scale was applied simultaneously to measure concurrent validity. Reliability and sensitivity to change were determined using a repeated measures design.

Results

A four-factors solution (general activation, aggressiveness, cognitive activation, and depression) accounts for 96% of the total variance of the scale. Lin's concordance correlation coefficient revealed adequate scores for test-retest reliability. The scale detected a significant difference between the means before and after pharmacological treatment.

Conclusion

When three additional items are included content validity of the EMUN scale improves. All of the psychometric properties of the original instrument are preserved.

Key words:

Psychiatric status rating scales

bipolar disorder

psychometrics

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