Miguel A. Santed

Adverse psychological effects in women attending a second-stage breast cancer screening

OBJECTIVE The purpose of this study was to examine the emotional and psychopathological impact associated with a second-stage screening for breast cancer. METHOD We used a short-term longitudinal design. Interviews were conducted with 1195 women of 45-65 years old in three temporal conditions (premammogram, postmammogram, and follow-up). Participants included women attending for regular breast cancer screening who were recalled for a further mammogram (i.e., second-stage breast cancer screening) and women who were not recalled. Affective-cognitive concerns about cancer (worry, fear, and perceived vulnerability) were rated using a 10-point Likert scale. Psychopathology was assessed using the Hopkins Symptom Check List-Revised (SCL-90-R). RESULTS Women attending the second-stage screening exhibited significantly higher levels of breast cancer worries, fears, and beliefs than women attending for routine screening before obtaining the results of the mammogram. This affective-emotional impact disappeared quickly and was not relevant 2 months following the mammogram. Despite the fact that levels of psychopathological symptoms were higher in the premammogram condition, there were no differences between groups on these measures. CONCLUSION These results provide support for the hypothesis that women recalled for further mammograms tend to experience high levels of affective-cognitive distress but not psychopathological symptoms. Moreover, results do not sustain the prediction that this psychological impact persists beyond receipt of a negative result. Some recommendations to reduce these psychological side effects are suggested.

Differences in negative life events between patients with anxiety disorders, depression and hypochondriasis

This study investigated whether some categories of adverse life events are differentially associated with specific types of emotional disorders. A life self-report measure of major life events was completed by 42 subjects with diagnoses of anxiety disorders, 46 subjects with major depression, 26 subjects with hypochondriasis and 73 nonclinical subjects (controls). As predicted, the onset of anxiety disorders, depression, and hypochondriasis appears to be differentially related with life stress of ‘threat’, ‘loss’, and ‘health’, respectively, previously experienced by the clinical subjects. Also, there were significant differences between clinical and nonclinical subjects on both perceived life stress and number of life events reported. Findings suggest a differential implication of psychosocial stress categories in particular emotional disorders (i.e., anxiety, depressive and hypochondriacal disorders). These results expand previous findings that have demonstrated an association between negative life events and psychopathology.

A factor confirmation and convergent validity of the "areas of worklife scale" (AWS) to Spanish translation

BackgroundPerceived incongruity between the individual and the job on work-life areas such as workload, control, reward, fairness, community and values have implications for the dimensions of burnout syndrome. The “Areas of Work-life Scale” (AWS) is a practical instrument to measure employees´ perceptions of their work environments.AIMS: Validate a Spanish translation of the AWS, and it relationship with Masclach Burnout Inventory dimensions.MethodsThe study was conducted in three medium-sized hospitals and seven rural and urban Primary Care centres (N = 871) in Spain. The “Maslach Burnout Inventory General Survey” (MBI-GS) and AWS were applied. We developed a complete psychometric analysis of its reliability, and validity.ResultsData on the reliability supported a good internal consistency (Cronbach α between .71, and .85). Construct validity was confirmed by a six factor model of the AWS as a good measure of work environments (χ2(352) = 806.21, p < 0.001; χ2/df = 2.29; CFI = 0.935, RMSEA = 0.039); concurrent validity was analysed for its relationship with other measures (opposing dimensions to burnout, and MBI), and each correlation between dimensions and sub-dimensions were statistically significant; as well, predictive validity, by a series of Multiple Regression Analysis examined the resulting patterns of the Confirmatory Factor Analysis (CFA) confirms the relationship between the work-life areas and burnout dimensions.ConclusionsLeiter and Maslach’s AWS has been an important instrument in exploring several work-life factors that contribute to burnout. This scale can now be used to assess the quality of work-life in order to design and assess the need for intervention programs in Spanish-speaking countries.

Antifat attitudes in a sample of women with eating disorders

INTRODUCTION One of the main problems of patients with eating disorders is their body dissatisfaction. Although these individuals usually are not satisfied with their bodies there are not many investigations that focus on how these patients see people with real weight problems. For this reason, in this study it is analyzed how women with eating disorders see obese people. METHODS A total of 104 participants (35 with anorexia nervosa, 28 with bulimia nervosa, 16 with eating disorder not otherwise specified and 25 controls) were selected to conduct the study. To measure anti-fat attitudes the Spanish version of the Antifat Attitudes Questionnaire was used. To measure if participants had body dissatisfaction it was used the Spanish versions of the Body Shape Questionnaire. Finally, anthropometric measures (height and weight) were taken in order to calculate the BMI (kg/m(2)), as well as some socio-demographic information. RESULTS It was found that participants with bulimia nervosa showed scores higher on antifat attitudes than the rest of the participants. Additionally, it was found that this result was influenced by the body dissatisfaction of the participants. DISCUSSION These results suggest that negative attitudes toward obese people may influence an individuals body image. One way of maintaining a positive body image (especially, the subjective dimension, body satisfaction) is to compare oneself with those perceived as physically inferior (people with weight problems), a strategy that is especially relevant when the mass media insists in depict extreme thin women.

Experimental induction of thought-shape fusion in eating disorder patients: the role of coping strategies

OBJECTIVE The aim was to induce the thought-shape fusion (TSF) distortion experimentally, testing: a) Whether the TSF distortion could be induced by anxiety in general or if it had a specific relationship with thoughts related to the intake of fattening foods; b) Whether the TSF could be induced in non-clinical participants as well as in the eating disorder patients; c) Whether participants with more appropriate coping strategies would experience less TSF than those who showed inadequate coping strategies; and d) That TSF could have behavioural effects (e.g., neutralization of TSF and food intake) related to emotions. METHODS The sample comprised two groups (eating disorder patients and students), with 45 participants each, aged between 18 and 25 years, 92.50% and 86.7% of women in the eating disorders group and the students group respectively. The two groups underwent three experimental conditions (TSF, anxiety, and control), measuring the results with regards to the emotional and behavioural responses. RESULTS Participants in the TSF induction condition reported more guilt, more feelings of fatness, more likelihood of weight gain, and higher degree of moral wrong-doing compared with participants in both the anxiety and control induction conditions. The effect of the adequate coping strategies in decreasing the strength of the TSF bias was confirmed in both eating disorder patients and non-clinical participants. DISCUSSION The study of the TSF distortion may have relevant implications in terms of treatment and prognostic of eating disorders. This distortion may be involved in the development and maintenance of eating disorder psychopathology.

A confirmatory factor-analytic validation of the tripartite model of depression and anxiety among undergraduates in Spain

The tripartite model of depression and anxiety proposes that low positive affect is a specific indicator of depression, whereas high physiological hyperarousal is a specific marker of anxiety. High negative affect, while common to both syndromes, is specific to neither. To test the validity of the tripartite model, we administered self-report scales on positive affect, negative affect, and physiological hyperarousal to 388 undergraduates in Spain. LISREL confirmatory factor analytic techniques were used. Consistent with the predictions of the tripartite view and with previous work on North American samples (e.g., Joiner, 1996), a three-factor model with Positive Affect, Physiological Hyperarousal, and Negative Affect as factors, provided the best fit for the observed data. These findings contribute to an emerging literature on the validity of the tripartite model, and, furthermore, are the first to indicate that the model and its implications may be applied cross-culturally.

Perceived parental child rearing and attachment as predictors of anxiety and depressive disorder symptoms in children: The mediational role of attachment

The present study aimed to examine (a) the relative contribution of perceived parental child-rearing behaviors and attachment on anxiety and depressive symptoms, and (b) the role of attachment as a possible mediator of the association between parental rearing and anxiety and depression. A sample of 1002 children (aged 9-12 years) completed a booklet of self-report questionnaires measuring parental rearing behaviors, attachment towards peers, and DSM anxiety and depressive disorder symptoms. We found that parental aversiveness, parental neglect, and fearful/preoccupied attachment, each accounted for a significant amount of the variance in both anxiety and depressive symptoms. In addition, parental overcontrol was found to account for unique variance in anxiety whereas communication/warmth accounted for a significant proportion of the variance in depression. A relevant finding was that fearful/preoccupied attachment was found to mediate the association between parental rearing behaviors and both anxiety and depression. Parental rearing behaviors and attachment to peers may act as risk factors to the development and/or maintenance of anxiety and depressive symptomatology in children. Findings may contribute to outline preventive and/or treatment programs to prevent or reduce both clinical anxiety and depression during childhood.

Absence of seasonal pattern of birth in patients with anorexia nervosa

OBJECTIVE An excess of spring births has been suggested in patients with anorexia nervosa (AN), especially in the restricting subtype, but most of the research has been carried out inside the United Kingdom. The aim of this study was to assess whether there is a seasonal pattern of birth in a representative sample of patients with AN in a different latitude in the northern hemisphere. METHOD We examined the month of birth in a sample of 210 female patients with a DSM-IV diagnosis of AN at first presentation to a specialized eating disorders service in Spain. RESULTS We found no evidence of significant variation in month or season of birth in AN when compared to general population. DISCUSSION There is not enough evidence of a season of birth bias under the latitude of the United Kingdom in the risk of developing AN.

Impact of functional dyspepsia on quality of life in eating disorder patients: the role of thought-shape fusion.

OBJECTIVE The study begins by analysing the psychometric properties of the Nepean Dyspepsia Index-Short Form (NDI-SF), before moving on to study quality of life in patients with functional dyspepsia (FD) and the psychopathological features that underlie the disorder in three groups of subjects: patients with eating disorders (ED), psychiatric patients (non-ED), and a group of students, all of whom fulfilled Rome III criteria for FD. The analysis specifically focused on the relationship between thought-shape fusion (TSF) and functional dyspepsia, and hence on the potential repercussions this could have on the quality of life of patients with eating disorders. METHODS The sample comprised 78 ED outpatients, 77 non-ED outpatients, and 90 university students, all of them with associated FD (Rome III criteria). The mental disorders (ED and non-ED) fulfilled the diagnostic criteria of DSM IV-RT. In all cases, the symptoms of dyspepsia, the related quality of life, anxiety, depression, and TSF were determined. RESULTS Satiation and bloating were significantly higher in ED patients. Correlations between dyspepsia and TSF were initially positive and significant in all cases, but significance was only maintained in the group of ED patients after controlling for the other psychopathological variables. Regarding the ED group, the regression analysis revealed the following predictors of quality of life: dyspepsia, depressive symptomatology, TSF-conceptual, TSF-interpretative and total TSF. DISCUSSION The cognitive distortion of TSF appears to constitute a general bias common to all eating disorders, with specific effect on the characteristic symptoms of FD.

Perfil psicológico diferencial entre dolor torácico de causa no cardiológica y enfermedad coronaria: un estudio controlado

El objetivo del trabajo es identificar variables que permitan diferenciar el dolor toracico de causa no cardiologica (DTCNC) de la enfermedad coronaria (EC). Se realizo un estudio observacional, de casos (pacientes con DTCNC, n = 40) y controles (pacientes con EC, n = 40). Se analizaron variables sociodemograficas, medicas y psicologicas. No existian diferencias en personalidad, excepto en el rasgo «control emocional», menor en DTCNC. Estos enfermos presentaron mayor alexitimia y empleaban mas frecuentemente dos estrategias de afrontamiento: la religion y la busqueda de ayuda medica. Cuando se realizo un analisis multivariable, el modelo compuesto por las siguientes cuatro variables: alexitimia, calidad de vida y afrontamientos basados en la religion y en la busqueda de ayuda medica muestra una sensibilidad del 85,4% y una especificidad del 80%. Este modelo predictivo podria emplearse como test de screening para diferenciar ambos trastornos.