RESUMEN
Healthcare workers exposed to emergencies and chronic stressors are at high risk of developing mental health problems. This review synthesized existing studies of group psychological therapy to reduce distress symptoms in healthcare workers (i.e., as complex and heterogeneous emotional states, characterized by the presence of symptoms associated with post-traumatic stress disorder, burnout, anxiety, depression and moral injury). Searches were conducted using PRISMA guidelines and databases such as PubMed, PsycINFO, Medline and Web of Science, along with manual searches of reference lists of relevant articles. The search returned a total of 1071 randomized trials, of which 23 met the inclusion criteria. Of the total studies, nine were mindfulness interventions, seven were cognitive behavioural programmes, one was a programme based on acceptance and commitment therapy, one was an EMDR protocol and two focused on systemic and art therapy. Most studies aimed to reduce burnout, anxiety and depression; only three focused on post-traumatic stress disorder, and no studies were found that addressed moral injury. The results suggested that group interventions could be an effective tool to improve the mental health of healthcare workers and reduce their symptoms of distress, although many of the studies have methodological deficiencies. Limitations and future directions are discussed.
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Personal de Salud , Psicoterapia de Grupo , Humanos , Personal de Salud/psicología , Psicoterapia de Grupo/métodos , Agotamiento Profesional/psicología , Agotamiento Profesional/prevención & control , Agotamiento Profesional/terapia , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Atención Plena/métodos , Terapia Cognitivo-Conductual/métodosRESUMEN
The aim of this work is to determine if relapses can hinder the sequence of psychological recovery and to rebuild this sequence in patients with severe alcohol dependence that seek treatment. The sample was comprised of 159 patients seeking an intensive outpatient treatment of two years duration and who were subject to follow-up during four years after discharge. Patients were grouped according to the presence of relapse during follow-up, resulting in abstainers (n = 80) and relapsers (n = 79). Assessments were carried out in the following periods: baseline, at discharge, and at the second- and fourth-year follow-ups. The measurement variables were avoidance behavior, anxiety, depression, impulsivity and meaning in life (MiL). A control group (n = 74) was evaluated at the same periods as the patients. Results indicate a slower recovery in relapsers in comparison to abstainers in all psychological dimensions and periods assessed. At the second-year follow-up, the abstainers achieved similar scores in depression as the control participants, in addition to higher scores in Meaning in Life at the end of treatment. In patients with severe alcohol dependence, our data supports a sequence of recovery that could continue beyond the four years of follow-up after treatment. This sequence would begin with the avoidance of risk situations and continue with the rest of dimensions (anxiety, depression, impulsivity).
El objetivo de este trabajo es comprobar si las recaídas dificultan la secuencia de la recuperación psicológica y reconstruir la secuencia de la recuperación de pacientes graves que solicitan tratamiento. Los participantes fueron 159 pacientes tratados durante dos años en un programa ambulatorio intensivo y tras ser dados de alta fueron seguidos durante cuatro años. En función de la presencia o no de recaída durante el seguimiento se configuraron dos grupos, el de abstinentes (n = 80) y el de pacientes que recaen (n = 79). Las evaluaciones se realizaron: basal, al alta del tratamiento, al 2.º y 4.º año de seguimiento. Las variables fueron: conductas de evitación, ansiedad, depresión, impulsividad y sentido de la vida. Se incluyó un grupo de control (n = 74) que fue evaluado con la misma cadencia que los pacientes. Los resultados indican una recuperación más lenta en el grupo con recaídas frente a los abstinentes, en todas las dimensiones psicológicas y los períodos estudiados. A los dos años de seguimiento, los pacientes abstinentes obtuvieron puntuaciones en depresión similares a los controles, además de puntuaciones superiores en sentido de la vida (MiL) a partir del final del tratamiento. Al menos en pacientes con dependencia grave del alcohol, nuestros resultados apoyan una secuencia de recuperación que podría continuar más allá de los cuatro años de seguimiento. Se inicia con la evitación de situaciones de riesgo y continúa con el resto de las dimensiones (ansiedad, depresión, impulsividad).
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Alcoholismo , Humanos , Estudios de Seguimiento , Alcoholismo/terapia , Alcoholismo/psicología , Pacientes Ambulatorios , Ansiedad/terapia , Trastornos de Ansiedad , RecurrenciaRESUMEN
Attachment theory is considered an important theoretical framework for understanding the ontogenesis of psychopathology. In this regard, insecure attachment styles have been associated with the development and maintenance of paranoid and depressive symptoms. Furthermore, different psychological processes (i.e., self-esteem and experiential avoidance) have been identified as mediating mechanisms between the relationship of insecure attachment and these symptoms. Nowadays, there is a more positive view in psychology focusing on factors that contribute to well-being, although little is known about the role of these psychological well-being variables as mediators between insecure attachment and psychopathology. For thus, the aim of this study was to test one explorative structural equation model of insecure attachment on paranoid and depressive symptoms through psychological mediating mechanisms to elucidate the processes involved in each of them. To evaluate the model, 141 individuals with severe psychiatric conditions participated in the study. The results revealed good model fit, highlighting that avoidant attachment has a direct and indirect effect on the symptoms, while anxious attachment has only an indirect effect through mediating mechanisms. On the other hand, lower levels of self-acceptance and environmental mastery have been identified as important processes associated with paranoid and depressive symptoms. However, less positive relationships were a significant mediating mechanism only for paranoid ideation symptoms. These results have important clinical implications by shedding light on the relationship between insecure attachment, paranoid and depressive symptoms, and the psychological mediating mechanisms involved in this relationship, which may be considered key variables in clinical treatments.
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Depresión , Apego a Objetos , Ansiedad/psicología , Depresión/psicología , Humanos , Autoimagen , Encuestas y CuestionariosRESUMEN
OBJECTIVE: The aim of this study was to examine the efficacy and effectiveness of a theory-driven multicomponent positive psychology intervention to improve well-being for individuals with severe psychiatric conditions (SPCs) in comparison with treatment as usual (TAU). This intervention moves away from the traditional psychiatric perspectives that focused on symptoms and deficits, promoting a broader view of outcomes such as noncritical self-acceptance, strengths, and positive relationships with others, among other things. METHOD: A two-arm randomized and outcome-blinded trial with pre-post and 6-month follow-up evaluations was conducted to assess the intervention. A total of 141 participants were allocated to either the experimental condition or the waiting list group receiving their TAU. A mixed-effect model was used to examine the efficacy of the intervention and a repeated-measures Student's t-test for the follow-up effectiveness analysis. RESULTS: The intervention protocol was highly acceptable for participants, showing very high participant satisfaction as well as good attendance and adherence rates. At the end of the group therapy, participants reported a significant improvement in self-acceptance and environmental mastery and, these changes were maintained in the follow-up assessment after 6 months. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The results of this randomized control trial provide further evidence supporting that positive psychology approaches can be a powerful complementary strategy to promote more comprehensive psychiatric rehabilitation services for people with SPCs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Trastornos Mentales , Psicología Positiva , HumanosRESUMEN
Background : Self-concepts are being intensively investigated in relation to paranoia, but research has shown some contradictory findings. Studying subclinical phenomena in a non-clinical population should allow for a clearer understanding given that clinical confounding factors are avoided. We explored self-esteem, self-schemas, and implicit/explicit self-esteem discrepancies in three non-clinical groups with different psychopathological traits and a control group. Methods: Participants with elevated trait-paranoia (n = 41), depressive symptoms (n = 34), a combination of both traits (n = 32), and a control group (n = 71) were assessed on implicit and explicit self-esteem, self-schemas, depression, and paranoia. A dimensional approach with the total sample (n = 208) was also used to complement the information provided by the group approach. Results: All groups presented similar and positive levels of implicit self-esteem. Trait-paranoia participants had similar levels of explicit self-esteem and self-schemas compared with the control group. However, the group with a combination of trait-paranoia and depressive symptoms showed the lowest levels of positive self-schemas and self-esteem. Furthermore, this group and the control group displayed implicit/explicit self-esteem discrepancies, although in opposite directions and with different implications. The dimensional approach revealed associations of trait-paranoia and depressive symptoms with poor explicit self-esteem and self-schemas but not with implicit self-esteem. Conclusions: Trait-paranoia participants showed different self-representations depending on whether depressive symptoms were present or not. The interaction between subclinical neurotic and psychotic traits entailed a detrimental self-representation that might increase the risk for psychopathology.
RESUMEN
BACKGROUND: Network analysis (NA) is an analytical tool that allows one to explore the map of connections and eventual dynamic influences among symptoms and other elements of mental disorders. In recent years, the use of NA in psychopathology has rapidly grown, which calls for a systematic and critical analysis of its clinical utility. METHODS: Following PRISMA guidelines, a systematic review of published empirical studies applying NA in psychopathology, between 2010 and 2017, was conducted. We included the literature published in PubMed and PsycINFO using as keywords any combination of "network analysis" with the terms "anxiety," "affective disorders," "depression," "schizophrenia," "psychosis," "personality disorders," "substance abuse" and "psychopathology." RESULTS: The review showed that NA has been applied in a plethora of mental disorders in adults (i.e., 13 studies on anxiety disorders; 19 on mood disorders; 7 on psychosis; 1 on substance abuse; 1 on borderline personality disorder; 18 on the association of symptoms between disorders), and 6 on childhood and adolescence. CONCLUSIONS: A critical examination of the results of each study suggests that NA helps to identify, in an innovative way, important aspects of psychopathology like the centrality of the symptoms in a given disorder as well as the mutual dynamics among symptoms. Yet, despite these promising results, the clinical utility of NA is still uncertain as there are important limitations on the analytic procedures (e.g., reliability of indices), the type of data included (e.g., typically restricted to secondary analysis of already published data), and ultimately, the psychometric and clinical validity of the results.
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Trastornos Mentales/fisiopatología , Trastornos Mentales/psicología , Psicopatología/métodos , Interpretación Estadística de Datos , Humanos , Evaluación de Síntomas/métodosRESUMEN
Well-being is a critical outcome in the recovery from psychosis and the prevention of symptoms. Previous reviews of the effectiveness of psychological interventions have focused on psychotic symptoms and general psychopathology, not recognising well-being as an essential outcome. This study conducted a meta-analysis of the effects of psychological interventions on the well-being and quality of life (QoL) of people with schizophrenia and analysed some critical moderating factors. A systematic literature search was conducted yielding 12986 published reports, 2043 of which were clinical trials. After a detailed review, 36 articles were included in the analyses. Measures of related concepts, well-being and quality of life were included in the present meta-analysis to reflect the current state of the literature and to ensure the representativeness of RCTs that have evaluated the effect of psychological interventions on the extent to which people with schizophrenia experience a good life. Our findings reflect a significant, small, treatment effect on the outcomes of well-being. Subgroup analysis also suggested a significant moderating effect when the primary aim of the intervention was well-being. These findings suggest that symptom or functional improvement does not necessarily lead to an improvement in well-being and would imply the need to focus specifically on those. We recommend psychological interventions that target well-being as a complementary strategy in mental health promotion and treatment. In addition, we stress the need to include well-being outcome measure in RCT as well as to clearly identify the different domains of well-being being measured.
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Evaluación de Resultado en la Atención de Salud , Satisfacción Personal , Psicoterapia , Trastornos Psicóticos/terapia , Calidad de Vida , Esquizofrenia/terapia , HumanosRESUMEN
There is a need to develop novel interventions for psychosis, targeted at specific psychological mechanisms. We used a classical conditioning paradigm to a) modify implicit self-esteem and b) examine subsequent effects on subclinical psychotic symptoms measured by the Experience Sampling Methodology. This study is a proof-of-concept pilot investigation conducted with 28 students with high paranoia levels, assessing variations in their self-esteem, paranoid beliefs, and subclinical psychotic symptoms daily. After 2 days, participants were randomized to receive either a positive conditioning task (repeatedly pairing self-relevant words with an image of a smiling face) or a neutral conditioning task (repeatedly pairing self-relevant words with random smiling, angry, or neutral faces). After the intervention, the positive conditioning participants showed significantly higher levels of implicit self-esteem and lower subclinical psychotic symptoms than the control condition participants. This study demonstrated that implicit self-esteem can be increased by using a classical conditioning task.
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Condicionamiento Clásico , Trastornos Psicóticos/psicología , Autoimagen , Adolescente , Adulto , Ira/fisiología , Evaluación Ecológica Momentánea , Femenino , Humanos , Masculino , Trastornos Paranoides/psicología , Trastornos Psicóticos/terapia , Resultado del Tratamiento , Adulto JovenRESUMEN
Adversity has been identified as an important factor in models of psychopathology and can help in understanding persecutory ideation, although potential moderators and mediators for adult psychopathology have not been sufficiently examined. Experiential avoidance (EA) and Self-esteem (SE) are relevant factors to understand how adversity leads to persecutory ideation. This study hypothesized that adversity would be associated with persecutory ideation through heightened EA, and that this association would be strengthened in individuals with a discrepant high SE. Participants with persecutory ideation (n = 52), with depression (n = 35) and healthy controls (n = 51) were assessed with the Trauma History Screen, the Paranoia and Deservedness Scale, and the Beck Depression Inventory. A SE discrepancy index was calculated subtracting the normalized explicit SE score from the normalized implicit SE score (measured by a version of a Go/No-go association task). Our analysis revealed that adversity was associated with higher levels of paranoia and was mediated by EA. In addition, we found that the relationship between adversity and EA was moderated by SE discrepancy. Identification of moderating and mediating variables allows for increased understanding of persecutory ideation and the processes that should be targeted in the course of recovery.
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Trastornos Paranoides/psicología , Adulto , Depresión/complicaciones , Femenino , Humanos , Masculino , Trastornos Paranoides/complicaciones , Escalas de Valoración Psiquiátrica , Psicopatología , Autoimagen , Encuestas y Cuestionarios , PensamientoRESUMEN
INTRODUCTION: Persecutory delusions are a very common symptom in psychotic disorders and represent a considerable cost for both patients and for society. The way in which a person faces their psychotic disorder (i.e., recovery style) has impact on their recovery. The impact of coping style as a moderator in the course of their illness has not been studied sufficiently in persecutory delusions. In addition, internalised stigma is a common process in psychosis that not only might affect emotional distress, but might also shape recovery style. The goal of this study was to examine the moderator role of recovery style between internalised stigma and emotional distress in people with persecutory delusions. METHODS: All 50 people with persecutory beliefs were assessed by the Recovery Style Questionnaire, the Beck Anxiety Inventory, Beck Depression Inventory, Second Edition, and Internalised Stigma of Mental Illness. RESULTS: Moderation analysis showed that participants with a sealing-over recovery style had high levels of depression when they experienced internalised stigma and low levels of depression only when internalised stigma was low. However, participants with an integration recovery style presented similar levels of depression regardless of the level of their internalised stigma. CONCLUSIONS: Findings suggest the moderator role of recovery style between internalised stigma and depression in people with persecutory delusions.
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Adaptación Psicológica , Deluciones/psicología , Depresión/psicología , Trastornos Psicóticos/psicología , Recuperación de la Función , Estigma Social , Adulto , Trastorno Depresivo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios , Adulto JovenRESUMEN
It is known that patients with schizophrenia show a deficiency in the prepulse inhibition reflex (PPI). These patients display abnormalities in autonomic nervous system and hypothalamic-pituitary-adrenal function and may have an altered sensitivity to stress. To date, no studies have been carried out to determine the effect of acute stress on the PPI. We investigated whether there was a differential response in reactivity to acute stress caused by the socially evaluated cold-pressor test (SECPT) in a sample of 58 chronic male patients with schizophrenia and 28 healthy control subjects. PPI, salivary cortisol and heart rate (HR) were measured. The patients were evaluated in two sessions (with and without the SECPT) 72 h apart and basal measurements were carried out and 30 min post-startle probe. We found an increase in salivary cortisol levels and the HR with SECPT condition in both groups and a significantly lower PPI% in patients with schizophrenia. The most relevant findings of this study are that the impairment of the PPI is increased by stress. Stress-induced increase in cortisol in both groups, mainly in healthy control group which allows us to hypothesize that at least such deterioration may be due to the hypercortisolemia caused by the SECPT.
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Respuesta al Choque por Frío/fisiología , Sistema Hipotálamo-Hipofisario/metabolismo , Inhibición Prepulso/fisiología , Reflejo de Sobresalto/fisiología , Esquizofrenia/complicaciones , Filtrado Sensorial/efectos de los fármacos , Estrés Psicológico/metabolismo , Adulto , Anticipación Psicológica/fisiología , Antipsicóticos/uso terapéutico , Estudios de Casos y Controles , Frío , Haloperidol/uso terapéutico , Frecuencia Cardíaca/fisiología , Humanos , Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisario/fisiología , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Psicopatología , Saliva/metabolismo , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Filtrado Sensorial/fisiología , Estrés Psicológico/fisiopatologíaRESUMEN
Evidence suggests that insight in psychosis has been related to treatment adherence, recovery and good prognosis, but also to depression, low self-esteem, and diminished quality of life. Thus, insight might not be advantageous under all circumstances. Internalized-stigma (i.e. self-acceptance of stigmatizing images of illness) and experiential avoidance (i.e. unwillingness to experience negative private events) have been proposed as moderating variables between insight, and psychological health variables and/or distress. We investigated the patterns of association of insight with satisfaction with life, self-esteem, depression, anxiety and psychotic psychopathology as moderated by self-stigmatizing beliefs and experiential avoidance, in a sample of 47 participants with persecutory beliefs and diagnosed with schizophrenia or other psychotic disorder. Moderation analyses confirm the importance of internalized-stigma and experiential avoidance. The presence of insight was associated with more depression when there were high levels of self-stigma. Whereas, the absence of insight was associated with a greater life satisfaction when there were high levels of experiential avoidance. To summarize, our results help understand the complex relationship between insight, psychological health variables and emotional distress, pointing to a differential pattern of moderation for negative and positive outcomes. We discuss the implications of these results for research and treatment of paranoia.
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Trastornos Paranoides/complicaciones , Trastornos Paranoides/psicología , Esquizofrenia/complicaciones , Psicología del Esquizofrénico , Autoimagen , Estigma Social , Adulto , Depresión/etiología , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios , Adulto JovenRESUMEN
This study was aimed to explore the distinct pathways that lead to depression and paranoia. We first examined the association of dysfunctional parenting experiences and negative self-evaluations in depression and paranoia. Furthermore, we also examined whether different self-evaluative beliefs could mediate the relationships between dysfunctional parenting experiences (i.e. parental overprotection or lack of care) and the development of depression and paranoia. A sample composed of 55 paranoid patients, 38 depressed patients and 44 healthy controls completed the Parental Bonding Instrument (PBI), the Evaluative Beliefs Scale (EBS) and some clinical scales. Our analyses revealed that lack of parental care and negative self-self evaluations were associated with depression symptoms. Analyses also revealed that parental overprotection and negative other-self evaluations were associated with paranoid symptoms. Furthermore, negative self-self and other-self evaluations fully mediated the relationship of parental overprotection and paranoia, whereas negative self-self evaluations partially mediated the relationship between lack of parental care and depression. These findings suggest that distinct patterns of parental practices may contribute to the development of different dysfunctional schemas which in turn may lead to either depression or paranoia.
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Cultura , Depresión/psicología , Trastorno Depresivo/psicología , Apego a Objetos , Trastornos Paranoides/psicología , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Padres/psicología , Autoevaluación (Psicología) , Adulto JovenRESUMEN
OBJECTIVE: Obtaining an accurate blood pressure (BP) reading is vital for diagnosing hypertension. However, BP measures taken in the physician's clinic (CBP) are subject to the 'white coat' bias. Measurements taken outside the office using ambulatory (ABP) and home (HBP) monitoring are superior predictors of cardiovascular diseases compared with CBP, but ABP remains underutilized because of the effort and expense involved. Unfortunately, HBP has limitations, including questionable device validity and patient compliance. Thus, it is important to identify feasible alternative techniques to measure BP in the office that will increase the accuracy of the diagnosis. METHODS: Auscultatory BP was measured in 249 patients in a nonclinical setting by trained technicians (NCBP); on the following day, patients were taken to their physician (CBP). They were also given an HBP monitor, and a 36 h ABP monitoring. Because ABP is considered the gold standard for prediction of cardiovascular disease, these readings were used as the criterion in a statistical model in which CBP, HBP, and NCBP were entered as predictors. The level of agreement between measurements was estimated. RESULTS: Multiple regression analysis showed that HBP and NCBP (P < 0.001) explained 94 and 87% of the variance in systolic and diastolic ABP, respectively. The agreement between NCBP and ABP was greater than that between CBP and ABP or between HBP. CONCLUSION: When ABP monitoring and HBP monitoring are not options, the NCBP at the clinic can avoid the white coat bias and therefore improve diagnosis.
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Determinación de la Presión Sanguínea/métodos , Hipertensión/diagnóstico , Hipertensión de la Bata Blanca/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Presión Sanguínea/fisiología , Monitoreo Ambulatorio de la Presión Arterial , Diástole , Femenino , Humanos , Masculino , Persona de Mediana Edad , Consultorios Médicos , Reproducibilidad de los Resultados , SístoleRESUMEN
In schizophrenia, poor insight has been associated with negative outcome. In fact, some studies have found insight to be associated with greater treatment adherence and lower levels of symptomatology, as well as better psychosocial functioning. However, others have found that insight into illness is associated with an increase in depression, low self-esteem, and possibly higher risk of suicide. We investigated the relationship between insight and well-being in a sample of 40 people presenting paranoid symptoms and diagnosed with schizophrenia or other psychotic disorder. Independent-samples t-tests revealed that compared to a paranoid group with high insight, paranoid participants with low insight had more self-acceptance, higher sense of autonomy and personal growth, and greater orientation towards gratification. Moderation analyses showed that when experiential avoidance was high, insight into paranoia had a detrimental effect on self-acceptance. Overall, our results support the need to explore which psychological variables moderate insight in patients with persecutory beliefs. We discuss the implications of these results for the research of paranoia.
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Trastornos Paranoides/diagnóstico , Trastornos Paranoides/psicología , Autoimagen , Femenino , Humanos , Masculino , Satisfacción Personal , Valor Predictivo de las Pruebas , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Encuestas y CuestionariosRESUMEN
The main purpose of the present study was to examine implicit and explicit self-esteem (SE) in patients with persecutory delusions. In samples of paranoid patients, depressed patients, and healthy controls, implicit SE was assessed using the experimental go/no-go association task, whereas explicit SE was measured using 2 self-reporting questionnaires: the self-worth subscale of the World Assumption Scale (Janoff-Bulman, 1989) and the self-acceptance subscale of the Scales of Psychological Well-Being (Ryff & Keyes, 1995). Our analysis revealed that depressed patients showed lower explicit SE than did paranoid and healthy control participants. However, participants with persecutory delusions had significantly lower implicit SE scores than did healthy controls. We interpret the discrepancies observed between overt and covert measures in the paranoid group as psychological defense mechanisms. The present study stresses the clinical and theoretical importance of the use of implicit measures in psychopathology.
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Trastorno Depresivo/psicología , Trastornos Paranoides/psicología , Autoimagen , Adulto , Mecanismos de Defensa , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración PsiquiátricaRESUMEN
The aim of this study was to examine the contents of world views held by patients with current persecutory beliefs. We examined whether these beliefs in a just world (BJW) were associated with the severity of psychopathology of participants. Our results showed that, compared with a healthy control group, the current persecutory beliefs group had weaker beliefs in a just world related to themselves (BJW-P), but there were no differences between both groups in their beliefs in general justice in the world (BJW-G). Regression analyses showed that BJW, particularly weaker beliefs in personal justice, significantly associated with more severe symptoms of depression and paranoia as well as with lower scores of psychological well-being. Our results support the relevance of the BJW framework in exploring world views in patients with persecutory beliefs. We discuss the implications of these results for the research and treatment of paranoid ideation.
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Cultura , Trastornos Paranoides/psicología , Justicia Social , Adulto , Deluciones/diagnóstico , Deluciones/psicología , Trastorno Depresivo/psicología , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Satisfacción Personal , Inventario de Personalidad/estadística & datos numéricos , Servicio de Psiquiatría en Hospital , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Psicometría , Autoimagen , España , Adulto JovenRESUMEN
This study was aimed at determining whether there are differences in emotional personality traits and psychosocial stress between hypertension and normotension. From a large community sample of adults, 14 individuals having hypertension and showing clinic blood pressures (BP) >or=140/90 mm Hg and self-measured BPs >or=135/85 mm Hg (sustained hypertensives) were selected and compared with a sex- and age-matched group of 14 individuals with normotension (clinic BPs <140/90 mm Hg and self-measured BPs <135/85 mm Hg) on measures of trait anxiety, trait depression, trait anger and stress derived from standardized questionnaires. There were no significant differences between hypertensives and normotensives on trait anger, but, in line with hypotheses, the sustained hypertensive group showed higher levels of trait anxiety, trait depression and stress than did the normotensive group. A discriminant analysis revealed that trait depression was the most important psychological variable to discriminate between sustained hypertension and normotension. Results provide support to the hypothesized relationship of emotional personality traits and stress with hypertension, and underscore the need to define hypertension on the basis of both clinic and home/ambulatory BP measurements and to simultaneously evaluate all relevant negative emotional constructs, when conducting research on psychological factors in hypertension.
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Emociones , Hipertensión/psicología , Personalidad , Estrés Psicológico/psicología , Anciano , Ansiedad/fisiopatología , Ansiedad/psicología , Presión Sanguínea/fisiología , Estudios de Casos y Controles , Estudios Transversales , Depresión/fisiopatología , Depresión/psicología , Femenino , Encuestas Epidemiológicas , Humanos , Hipertensión/fisiopatología , Masculino , Estrés Psicológico/fisiopatologíaRESUMEN
Only one-third of patients with hypertension under pharmacological treatment achieve the recommended blood pressure goals. Psychological factors could partially account for poor hypertension control through the existence of personality traits related to treatment compliance (e.g., self-discipline, deliberation, impulsiveness), and the fact that stress and some personality traits (e.g., anxiety, depression, anger expression, Type A) are involved in the etiology of some hypertension cases. This study was aimed at examining the differences in personality and stress between patients taking antihypertensive medications with controlled and uncontrolled hypertension. Results revealed that after controlling sex, age, and traditional variables associated with poor hypertension control, the uncontrolled hypertension group showed higher scores on impulsiveness, depression, anger expression-out, and stress, with differences ranging between medium and large (Hedges' g effect size = 0.77 to 1.08). These results support the hypothesized relationship between psychological factors and poor hypertension control.