This study aimed to evaluate the preliminary psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in a community sample of adults living with a spinal cord injury (SCI). A cross-sectional design was used with 963 people living in the community with an SCI. Participants were recruited via three spinal centres in the United Kingdom. They completed the HADS and the Life Satisfaction Questionnaire. Psychometric analyses were conducted for the whole sample, by gender and level of injury. The HADS demonstrated good internal consistency, with promising content validity. Two factors, approximating to anxiety and depression were extracted via factor analysis for the whole sample, by gender and level of injury. In line with existing literature, females scored significantly higher than males on the anxiety subscale. Item 7 ("I can sit at ease and feel relaxed") was found to be a complex item, with a potentially different meaning within this population. This study presents preliminary findings, which support the psychometric integrity of the HADS within an outpatient population with SCI. Items that included potential somatic components revealed a more complex factor loading profile. Recommendations are made to further investigate this measure with amendments to such items, incorporating inpatients and independent measures of anxiety and depression to address validity directly.

This paper describes the development of two measures. The first is designed to assess eating disorder-related automatic thoughts; the second is designed to assess a wide range of eating disorder-related behaviors. Principal components analysis identified three dimensions of thoughts: positive thoughts about eating, negative thoughts about eating, and permissive thoughts. Principal components analysis also identified six dimensions of behavior related to: shape and weight, bingeing, dieting, food, eating, and overeating. Both measures possess promising psychometric properties, including good construct and criterion-related validity. Both successfully discriminated eating disorder patients from dieting and non-dieting groups. The two measures may be useful additions to those currently available to researchers (and clinicians) interested in eating disorders.

It is suggested that metacognitive activity may play a role in the maintenance of AN, particularly in reinforcing negative self-evaluations.

Objective: The study explored the semantic content and origins of negative selfbeliefs, and their functional links to "not eating enough" and other behaviors, in participants with anorexia nervosa (AN). Method: Fifteen women meeting DSM-IV criteria for AN were compared with 17 dieting and 18 non-dieting women matched on age and number of years of education. The main outcome measure was a semi-structured interview. Results: Six themes were identified in the beliefs of participants with AN. These were, in order of decreasing frequency, powerlessness (present in all but three AN participants), failure, defectiveness, unattractiveness, worthlessness and emptiness. Importantly, powerlessness and failure beliefs were consistently present independent of Beck Depression Inventory-II scores. The negative early life experiences associated with these beliefs had high distress and responsibility ratings. Participants with AN reported that they employed specific behaviors, particularly 'not eating enough,' and 'placating others,' to try to reduce the cognitive and emotional impact of their negative self-beliefs. Discussion: The findings are discussed in relation to the role of powerlessness and the function of "not eating enough" in cognitive theory and therapy for AN.

This pilot study aimed to investigate the prevalence of maternal posttraumatic stress (PTSD), anxiety and depressive symptoms and what aspects of having a child with anorexia nervosa (AN) are perceived as traumatic by the mothers. Thirty-one mothers of daughters with AN completed a range of self-report questionnaires and a structured clinical interview. Higher rates of anxiety, depression and PTSD symptoms were found in mothers than in the general UK population. Mothers reported acute traumatic stressors during the course of AN, such as 'thinking their daughter was about to die or dead', 'seeing or consenting to their daughter being tube-fed'. We also found that mothers rated chronic aspects of their daughter's AN as very severely distressing, such as 'worrying about permanent damage to daughter's health'. Results suggest that maternal mental health should be kept in mind during assessments of individuals with eating disorders and referral for a service in their own right might be indicated.

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