Silvia Rosado

Spanish version of the Dimensional Obsessive–Compulsive Scale (DOCS): Psychometric properties and relation to obsessive beliefs

OBJECTIVES Our main goal was to provide the psychometric properties of the Spanish version of the Dimensional Obsessive-Compulsive Scale (DOCS) in a non-clinical sample (n = 237) and in adult patients with Obsessive-Compulsive Disorder (OCD) (n = 110). We also examined the association between OC symptom dimensions and obsessive beliefs. METHODS The psychometric properties involved four steps: reliability, structural validity, convergent and discriminant validity and diagnostic sensitivity. Linear regression analyses were used to assess the associations between OC symptoms and obsessive beliefs. RESULTS Exploratory and confirmatory factor analyses replicated the original four-factor structure in both samples. The DOCS showed good performance in terms of internal consistency, test-retest reliability and convergent validity in both samples. The DOCS showed better diagnostic sensitivity than another self-report instrument of OC symptoms, the Obsessive-Compulsive Inventory Revised. Findings of the relationship between obsessive beliefs and OC symptoms revealed that certain obsessive beliefs predicted specific OC symptom dimensions. CONCLUSIONS The Spanish version of the DOCS has similar psychometric properties than the original English instrument, although its performance is somewhat better in OCD patients than in students. It will be important to ascertain its ability to discriminate OCD from other associated disorders.

Joint hypermobility, fears, and chocolate consumption.

Our purpose was to evaluate joint hypermobility, an inherited disorder of the connective tissue significantly associated with anxiety disorders, in a sample of nonclinical students in relation to the frequency of severe fears and consumption of chocolate, coffee, cigarettes, and alcohol. One hundred fifty students completed the Hakim and Grahame Simple Questionnaire to detect hypermobility and the self-administered modified Wolpe Fear Scale (100 items). Severe fears and daily consumption of cigarettes, alcohol, coffee, and chocolate were compared with the hypermobility scores. We found significant differences when comparing severe fears between the groups with and without hypermobility (7.6 vs. 11; p = 0.001), reinforcing the hypothesis that the intensity of fears is greater in subjects with hypermobility. Only the frequency of chocolate intake was significantly higher among subjects with hypermobility (31.2% vs. 51.2%; p = 0.038) and may correspond to attempts of self-treatment of the collagen condition.

Self-reported screening questionnaire for the assessment of Joint Hypermobility Syndrome (SQ-CH), a collagen condition, in Spanish population

Background and Objectives: To develop a self-assessment screening ques- tionnaire (SQ-CH), with image illustrated criteria to easily identify collagen anomalies and to assist Hypermobility�s evaluation in a Spanish sample. Methods: One hundred ninety one participants were recruited form an anxiety outpa- tient unit of a general university hospital and from a primary care setting, underwent a complete and rigorous evaluation of hypermobility. First, all participants completed the self-reported measures for the screening of Hypermobility Syndrome, the 7 self-reported items in y/n format aiming to validate (SQ-CH) and the 5 item self-reporting questionnaire of Hakim and Grahame (2003). Secondly, each of the participants was individual assessed by a trained clinician on the Beighton and Hospital del Mar evaluation for the diagnosis of Joint Hypermobility Syndrome. Results : Significant correlations were found between the SQ-CH and the Beighton and Hospital del Mar scales as well as with the 5-item self-reporting questionnaire. Results on temporal stability, specificity and sensitivity of the SQ-CH were satisfactory, and the best cut-off point was set at 3 positive items (i.e. answered affirmatively). Conclusions: The developed screening questionnaire for hypermobility (SQ-CH) is, to our knowledge, the first self-assessment questionnaire to evaluate the symptoms of the joint hypermobility syndrome in a Spanish population. It has shown good validity and good reliability and is therefore ready for its use as a screening tool to assess this collagen condition in all sort of potential suffers, particularly, patients suffering from anxiety.

Ectomorphic somatotype and joint hypermobility are linked in panic and agoraphobic patients: A case-control study

Abstract Objective. To test whether there is an association between somatotype measures, joint hypermobility (JH), and panic and/or agoraphobia (PA). Method. Sociodemographic characteristics, somatotype, and JH status were assessed in 60 patients (30 men and 30 women) with PA and 60 non-clinical controls, matched by age and gender. Results. Patients and controls categorized by gender did not differ in terms of age, educational degree, marital status, or labour situation. There were significant differences between mean somatotype groups both in men and women. Men and women somatotype patients were significantly less endomorphic and more ectomorphic than controls. Hypermobility was significantly more frequent in both male and female patients. In the entire sample, 38.3% of patients and 13.3% of controls were categorized as ectomorphic (χ2 = 8.5, p = 0.004). After adjusting for age and sex, ectomorphic somatotype was independently related to JH status [OR = 3.25, 95% CI 1.35–7.8, p = 0.008]. Conclusions. Since PA may be associated with JH, it is suggested that the relationship found between panic and ectomorphic somatotype might be mediated through JH.

Psychometric Properties of the Spanish Version of the Panic Disorder Severity Scale

The Panic Disorder Severity Scale (PDSS) is a well-established measure of panic symptoms but few data exist on this instrument in non north-American samples. Our main goal was to assess the psychometric properties (internal consistency, test re-test reliability, inter-rater reliability, convergent and divergent validity) and the factor structure of the Spanish version. Ninety-four patients with a main diagnosis of panic disorder were assessed with the Spanish version of PDSS, the Anxiety Sensitivity Index-3 (ASI-3), the Panic and Agoraphobia Scale (PAS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II) the PDSS self-rating form and the Clinical Global Impression-Severity scale (CGI). The Spanish PDSS showed acceptable internal consistency (α = .74), excellent test-retest (total score and items 1-6: α > .58, p .90) and medium to large convergent validity (r = .68, 95% CI [.54, .79], p < .01; r = .80, 95% CI [.70, .87], p < .01; r = .48, 95% CI [.28, .67], p < .01; BAI, PAS and ASI-3 total scores respectively). Data on divergent validity (BDI-II total score: r = .52, 95% CI [.34, .67], p < .01) suggest some need for refinement of the PDSS. The confirmatory factor analysis suggested a two-factor modified model for the scale (nested χ2 = 14.01, df = 12, p < .001). The Spanish PDSS has similar psychometric properties as the previous versions and is a useful instrument to assess panic symptoms in clinical settings in Spanish-speaking populations.

Joint Hypermobility, Anxiety, and Psychosomatics — The New Neuroconnective Phenotype

In this chapter, after summarizing the concept and diagnosis of the Joint Hypermo‐ bility (Hyperlaxity), we review case control studies in two directions: Anxiety in Joint Hypermobility and Joint Hypermobility in Anxiety disorders, studies in non‐ clinical samples, review papers, and one incidence study. Collected evidence tends to confirm the strength of the association described two and a half decades ago. Common mechanisms involved include genetics, autonomic nervous system dys‐ functions, and interoceptive and exteroceptive processes. Considering clinical and nonclinical data, pathophysiological mechanisms, and present nosological status, we suggest a new Neuroconnective phenotype in which together around a common core Anxiety-Collagen hyperlaxity, it includes five dimensions: behavioral, psycho‐ pathology, somatic symptoms, somatosensory symptoms, and somatic illnesses. So‐ matic illnesses include irritable bowel, dysfunctional esophagus, multiple chemical sensitivity, dizziness or unsteadiness (central vestibular pattern), chronic fatigue, fi‐ bromyalgia, glossodynia, vulvodynia, hypothyroidism, asthma, migraine, temporo‐ mandibular dysfunction, and intolerances or food and drug hypersensitivity. It is envisaged that new descriptions of anxiety disorders and also of some psychoso‐ matic conditions will emerge and different nosological approaches will be required.