José H. Marco

Meaning in Life Buffers the Association Between Risk Factors for Suicide and Hopelessness in Participants With Mental Disorders.

OBJECTIVE Hopelessness is a proximal risk factor of suicide. Meaning in life has been found to be a protective factor against suicidal ideation; however, the majority of studies that have explored the role of meaning in life in the context of suicidality have been conducted in nonclinical populations. The aim of this study was to investigate whether meaning in life can moderate and buffer the association between suicide risk factors and hopelessness in a clinical sample with a heightened risk of suicide. METHOD A total of 224 participants diagnosed with mental disorders completed self-report measures of suicide risk factors, hopelessness, and meaning in life. RESULTS The main result from this study was that meaning in life moderated the association between suicide risk factors and hopelessness. CONCLUSION Meaning in life is an important variable in the prevention and treatment of people at risk of suicide.

Meaning in life and non-suicidal self-injury: A follow-up study with participants with Borderline Personality Disorder

Non-suicidal self-injury (NSSI) is considered one of the defining features of people diagnosed with Borderline Personality Disorder (BPD). Longitudinal studies are needed to identify factors predicting future NSSI in BPD participants. Several studies have shown that low meaning in life is associated with mental health problems, addiction problems, depression, hopelessness, and suicide. The purpose of this paper is to examine whether meaning in life predicts the frequency of NSSI behaviors during the one-year follow-up. The sample was composed up of 80 participants with a BPD diagnosis. We assessed the frequency of NSSI behaviors over a 12-month follow-up period. The results suggest that the participants who had low meaning in life had more frequency of NSSI, depression, and hopelessness at baseline, and more frequency of NSSI during the follow-up, than participants with high meaning in life. The predictor variables: Frequency of NSSI at base line, depression, hopelessness, and meaning in life, significantly predicted the frequency of NSSI during the one-year follow-up. Therefore, meaning in life was the only predictor of NSSI during the follow-up period.

Confirmatory factor analysis and psychometric properties of the Spanish version of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales.

The Multidimensional Body-Self Relations Questionnaire (MBSRQ) is the most comprehensive instrument to assess body image. The MBSRQ-Appearance Scales (MBSRQ-AS) is a reduced version that has been validated in other languages. The main aim of the present study was to confirm the factor structure of the Spanish version of the MBSRQ-AS and analyze its psychometric properties in 1041 nonclinical individuals. Confirmatory factor analysis showed excellent goodness of fit indices for the five-factor structure (Appearance Evaluation, Appearance Orientation, Body Areas Satisfaction, Overweight Preoccupation, and Self-Classified Weight). Factors possessed adequate scale score reliability indices. Some of the factors showed significant associations with the Eating Attitudes Test. Significant differences were found between boys/men and girls/women, and among age groups. The Spanish version of the MBSRQ-AS is a valid instrument for use in nonclinical population settings in people from 15 to 46 years old.

Dialectical behavioural therapy for oppositional defiant disorder in adolescents: a case series

BACKGROUND Oppositional defiant disorder (ODD) is characterised as a recurrent pattern of defiant behaviour towards authority figures, irritability and difficulties in regulating emotions. ODD in adolescents presents similar symptomatology to borderline personality disorder (BPD). A treatment programme that has been shown to be effective for treating problems related to emotion dysregulation such as BPD is dialectical behavioural therapy (DBT). The aim of this article is to outline a case series in which we applied DBT to two adolescents diagnosed with ODD, in addition to psychiatric comorbidity and parasuicidal behaviours. METHOD We applied a training programme of 24 sessions in DBT skills, along with individual therapy. RESULTS The results showed a decrease in impulsive behaviours, maladaptive behaviours to regulate affect, self-mutilation behaviour, number of hospitalisations, anger and depressive symptoms. The data also showed an increase in positive emotions. CONCLUSION These results suggest that DBT can be an alternative for the treatment of ODD in adolescents with psychiatric comorbidity and parasuicidal behaviours.

Meaning in Life in People with Borderline Personality Disorder.

Low feelings of meaning in life are associated with depression, hopelessness and suicide, substance abuse and emotional dysregulation. The aim of this study is to offer results about the importance of the construct meaning in life in the psychopathology of BPD. In study 1, the sample was made up of 223 participants, 141 participants with BPD and 82 participants with another mental disorder but without BPD. In study 2, the sample was made up of 80 participants with BPD. Study 1 indicated that the participants with BPD had a lower feeling of meaning in life than the participants with mental disorders but without a BPD. Study 2 indicated that meaning in life was highly negatively correlated with the symptoms of BPD. The model composed of emotional dysregulation, and meaning in life was significantly associated with BPD psychopathology. The present study supports the association between meaning in life with the psychopathology of BPD. Copyright

Comparison of clinical and demographic characteristics among borderline personality disorder patients with and without suicidal attempts and non-suicidal self-injury behaviors.

Research has shown that both suicidal and Non-Suicidal Self-Injury (NSSI) behaviors are co-morbid phenomena that are present in BPD patients, considered phenomenologically distinct, and associated with different methods, motives, frequency, and severity of psychopathology. This study is aimed at extending previous research by examining differences in demographical, clinical and psychological characteristics of BPD patients with or without a history of Suicide Attempts (SAs) and/or NSSI behaviors. Our sample included 89 outpatients with a BPD diagnosis assessed through clinical, structured interviews, and self-reports. The major findings showed that patients with a history of suicide attempts and non-suicidal self-injury were characterized by major number of lifetime suicide attempts and more severe feelings of hopelessness than patients with NSSI. Additionally, more violent thoughts towards others were observed in patients with NSSI. These results support a relatively more severe profile inherent in patients with SA and NSSI and allow us to differentiate NSSI from suicide attempts, highlighting the importance of evaluating and treating hopelessness and exploring the tendency to have violent thoughts towards others in this clinical population.

Psychopathological Differences Between Suicide Ideators and Suicide Attempters in Patients with Mental Disorders

BACKGROUND Although suicide is one of the leading causes of death worldwide, there is a need for studies to identify variables that can differentiate patients with suicide ideation at risk of transitioning to an attempt. METHOD In this study, we assessed suicide ideation and attempts, non-suicidal self-injury (NSSI), hopelessness, borderline symptoms and meaning in life in a sample of 348 patients with different diagnoses of mental disorders. We divided the sample into four subgroups: patients without suicide ideation or suicide attempts; patients with current suicide ideation; patients with lifetime suicide attempts and patients with a suicide attempt in the previous year. RESULTS The group with suicide attempts in the previous year showed higher levels of hopelessness, borderline symptoms and NSSI, and lower levels of meaning in life than the other groups. LIMITATIONS Groups were composed of unequal numbers of patients, and in some of them, the sample size was small. The sample was composed mainly of women with eating disorders. The study design was retrospective, and so the results must be considered in terms of correlates. CONCLUSIONS Our results suggest that hopelessness, borderline symptoms-including NSSI-and meaning in life play a key role in suicide attempts. Thus, psychotherapeutic interventions should focus on managing NSSI, searching for meaning and managing emptiness, loss of control and feelings such as self-contempt in patients with suicide ideation. Copyright

The buffer role of meaning in life in hopelessness in women with borderline personality disorders

Meaning in life has been found to be a protective factor against suicidal ideation. The aim of this study was to investigate whether meaning in life can moderate and buffer the association between suicide risk factors and hopelessness in women with borderline personality disorders. One hundred twenty-four women diagnosed with borderline personality disorder completed self-report measures of suicide risk factors, hopelessness, and meaning in life. The main result from this study was that meaning in life moderated the association between suicide risk factors and hopelessness. Meaning in life is an important variable in the prevention and treatment of risk of suicide in women with borderline personality disorder.

PDA self-register system for eating disorders: a study on acceptability and satisfaction.

Self-monitoring techniques, such as the use of dietary registers, are considered to be central to cognitive-behavioral treatment of Eating Disorders (ED). This information allows the clinician to identify the triggers of the behaviors associated to ED as purges and/or binges, and the associated thoughts and emotions, helping to carry out a more accurate assessment. Traditionally these registers are made with paper and pencil mode, where the patient has to register every eating and the emotions/thoughts associated; but this system has some problems, as low portability, low adherence or methodological difficulties. The use of PDA for self-registers can help to solve these problems. The aim of this study is to study the levels of acceptability and satisfaction with PDAs self-register system specifically designed for assessment and treatment of ED. Samples of 30 subjects diagnosed with ED are receiving a PDA with software specifically designed for recording type and amount of food, emotions before and after eating and other behaviors. The participants are completing self-register daily during a week, and afterwards answer an acceptance and satisfaction questionnaire. This work is in progress at the moment. It is expected that the PDA system will show high levels of acceptance and satisfaction.

Purpose-in-Life Test: Comparison of the Main Models in Patients with Mental Disorders

The aim of this study was to compare the main proposed models for the Purpose-In-Life Test, a scale for assessing meaning in life, in 229 Spanish patients with mental disorders (195 females and 34 males, aged 13-68, M = 34.43, SD = 12.19). Confirmatory factor-analytic procedures showed that the original model of the Purpose-In-Life Test, a 20-item unidimensional scale, obtained a better fit than the other analyzed models, SBχ2(df) = 326.27(170), SBχ2/df = 1.92, TLI = .93, CFI = .94, IFI = .94, RMSEA = .063 (90% CI [.053, .074]), CAIC = -767.46, as well as a high internal consistency, (α = .90). The main conclusion is that the original version of the Purpose-In-Life shows a robust construct validity in a clinical population. However, authors recommend an in-depth psychometric analysis of the Purpose-In-Life Test among clinical population. Likewise, the importance of assessing meaning in life in order to enhance psychotherapeutic treatment is noted.