Amparo Belloch Fuster

Attentional biases and vulnerability to depression

This study was designed to examine selective processing of emotional information in depression. It focuses on possible attentional biases in depression, and whether such biases constitute a cognitive vulnerability factor to suffer from the disorder or, on the contrary, they reflect a feature associated exclusively with the clinical level of depression. 81 participants were included in the study: 15 with a diagnosis of Major Depression; 17 were diagnosed as Dysthymia; 11 participants scored over 18 in the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979); 15 participants, in whom a sad mood state was induced by an experimental mood induction (Velten technique + music, or biographical recall + music); and 23 participants as a normal-control group. All participants were presented with the emotional Stroop task. The data indicated that attentional bias was only present in the group of patients with Major Depression, so it does not seem to be a cognitive vulnerability factor for this disorder.

Spanish Asthma Patients’ Beliefs About Health and Medicines: Validation of 2 Questionnaires

Abstract Objective We translated 2 health beliefs questionnaires–an instrument based on the health belief model (HBM) containing 19 items in 6 domains and the Beliefs About Medicines Questionnaire (BMQ) containing 18 items divided into a general and a specific section–and then administered and validated them in a group of Spanish patients with asthma. Patients and Methods In 2 clinical visits data were collected on 126 patients with stable asthma of different levels of severity. At the first visit, the patients underwent spirometry and were asked questions about sociodemographic factors and clinical history. At the second visit, they completed the State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Spanish versions of the HBM and BMQ, which had been previously translated and backtranslated. Results The BMQ had adequate internal consistency and content validity but the HBM replicated just 4 of the 6 domains present in the original questionnaire. The reformulated HBM (measuring 4 domains) accounted for 48% of the variance and had Cronbach a levels ranging from 0.63 to 0.75. The 2 questionnaires showed interactions between a) negative beliefs about medicines and asthma and b) awareness of the need for medication and trust in physician and pessimism. Correlations were also found between negative beliefs and anxiety and depression and between awareness of the need for medication and disease severity. Finally, low educational level, female sex, and greater duration of asthma were correlated with beliefs that disease control was driven by chance. Conclusions The reformulated HBM and the BMQ have satisfactory measurement properties and assess similar but not identical aspects of beliefs and value judgments about health and medicine in individuals with asthma. These beliefs were correlated to different degrees with the clinical, sociodemographic, and psychologic variables studied.

Creencias sobre la salud y los medicamentos en la poblacion asmatica española. Validacion de 2 instrumentos para su medida

Objective We translated 2 health beliefs questionnaires—an instrument based on the health belief model (HBM) containing 19 items in 6 domains and the Beliefs About Medicines Questionnaire (BMQ) containing 18 items divided into a general and a specific section—and then administered and validated them in a group of Spanish patients with asthma.OBJECTIVE We translated 2 health beliefs questionnaires-an instrument based on the health belief model (HBM) containing 19 items in 6 domains and the Beliefs About Medicines Questionnaire (BMQ) containing 18 items divided into a general and a specific section-and then administered and validated them in a group of Spanish patients with asthma. PATIENTS AND METHODS In 2 clinical visits data were collected on 126 patients with stable asthma of different levels of severity. At the first visit, the patients underwent spirometry and were asked questions about sociodemographic factors and clinical history. At the second visit, they completed the State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Spanish versions of the HBM and BMQ, which had been previously translated and backtranslated. RESULTS The BMQ had adequate internal consistency and content validity but the HBM replicated just 4 of the 6 domains present in the original questionnaire. The reformulated HBM (measuring 4 domains) accounted for 48% of the variance and had Cronbach #a levels ranging from 0.63 to 0.75. The 2 questionnaires showed interactions between a) negative beliefs about medicines and asthma and b) awareness of the need for medication and trust in physician and pessimism. Correlations were also found between negative beliefs and anxiety and depression and between awareness of the need for medication and disease severity. Finally, low educational level, female sex, and greater duration of asthma were correlated with beliefs that disease control was driven by chance. CONCLUSIONS The reformulated HBM and the BMQ have satisfactory measurement properties and assess similar but not identical aspects of beliefs and value judgments about health and medicine in individuals with asthma. These beliefs were correlated to different degrees with the clinical, sociodemographic, and psychologic variables studied.

Impact of Baseline and Induced Dyspnea on the Quality of Life of Patients With COPD

Objective Dyspnea is the main symptom of chronic obstructive pulmonary disease (COPD) and as such is an important determinant of health-related quality of life. It is, however, weakly correlated to severity of obstruction and there is little information available on how it exercises its effect on health-related quality of life. The aims of this study were to identify the determinants of baseline dyspnea and to ascertain how that factor influences the health-related quality of life of patients with COPD. Patients and methods A total of 101 patients with COPD were studied. Tests included full lung function assessment, the bronchial provocation test (n=70), and the 6-minute walk test. The following variables were measured: baseline dyspnea, bronchoconstriction-induced dyspnea, exertional dyspnea, health-related quality of life, and levels of anxiety and depression. Results Determinants of baseline dyspnea were anxiety (explained variance, 17%), maximum inspiratory pressure (4%), and PaO 2 (4%). In patients with mild to moderate COPD (forced expiratory volume in 1 second, >50% of predicted), the main determinant of health-related quality of life was anxiety (explained variance, 43%). Other determinants were the number of meters walked in the 6-minute-walk test, age, and baseline dyspnea (variance explained by both factors, 26%). Baseline dyspnea and bronchoconstriction-induced dyspnea were both identified as independent determinants of health-related quality of life (on the activity and impact subscales of the St Georges Respiratory Questionnaire, respectively). The main determinant of health-related quality of life in patients with severe COPD (forced expiratory volume in 1 second, >50% of predicted) was baseline dyspnea. Finally, the main determinants of anxiety were exertional dyspnea (variance, 42%) and baseline dyspnea (6%). Conclusions Anxiety is the main determinant of health-related quality of life in patients with COPD, and it is triggered mainly by baseline dyspnea and exertional dyspnea.

OriginalCreencias sobre la salud y los medicamentos en la población asmática española. Validación de 2 instrumentos para su medidaSpanish Asthma Patients’ Beliefs About Health and Medicines: Validation of 2 Questionnaires

Objective We translated 2 health beliefs questionnaires—an instrument based on the health belief model (HBM) containing 19 items in 6 domains and the Beliefs About Medicines Questionnaire (BMQ) containing 18 items divided into a general and a specific section—and then administered and validated them in a group of Spanish patients with asthma.OBJECTIVE We translated 2 health beliefs questionnaires-an instrument based on the health belief model (HBM) containing 19 items in 6 domains and the Beliefs About Medicines Questionnaire (BMQ) containing 18 items divided into a general and a specific section-and then administered and validated them in a group of Spanish patients with asthma. PATIENTS AND METHODS In 2 clinical visits data were collected on 126 patients with stable asthma of different levels of severity. At the first visit, the patients underwent spirometry and were asked questions about sociodemographic factors and clinical history. At the second visit, they completed the State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Spanish versions of the HBM and BMQ, which had been previously translated and backtranslated. RESULTS The BMQ had adequate internal consistency and content validity but the HBM replicated just 4 of the 6 domains present in the original questionnaire. The reformulated HBM (measuring 4 domains) accounted for 48% of the variance and had Cronbach #a levels ranging from 0.63 to 0.75. The 2 questionnaires showed interactions between a) negative beliefs about medicines and asthma and b) awareness of the need for medication and trust in physician and pessimism. Correlations were also found between negative beliefs and anxiety and depression and between awareness of the need for medication and disease severity. Finally, low educational level, female sex, and greater duration of asthma were correlated with beliefs that disease control was driven by chance. CONCLUSIONS The reformulated HBM and the BMQ have satisfactory measurement properties and assess similar but not identical aspects of beliefs and value judgments about health and medicine in individuals with asthma. These beliefs were correlated to different degrees with the clinical, sociodemographic, and psychologic variables studied.