Patients With Depression, Somatoform Disorders, and Eating Disorders on the Stages of Change: Validation of a Short Version of the URICA

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The study aimed at constructing a time-efficient short version of the University of Rhode Island Change Assessment (URICA), and at exploring differences in the stages of change between patients with depression, somatoform disorders, and eating disorders across the course of therapy. The URICA and diverse outcome measures were administered to 253 patients in early-, middle-, and late stages of inpatient therapy. The factor structure of the short form of the URICA (URICA-S) was excellent as shown by (1) an exploratory factor analysis on a randomized one-half of the sample, (2) a confirmatory factor analysis on the other half of the sample, and (3) a stable factor structure over a 6-week interval. The resulting factors of the URICA-S were called precontemplation, contemplation, action, and maintenance. The internal consistencies of the URICA-S factors were sufficient to excellent. Supporting the criterion-related validity, the URICA-S predicted relevant outcome measures. Analyses of variance showed that the ratings on the action and the maintenance factors were differentially associated with outcome in patients with depression, somatoform disorders, and eating disorders. These findings implicate that a disorder-specific combination of action and relapse-prevention–oriented interventions might optimize outcome in inpatients with different psychiatric disorders.

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