Functional Impairment in Borderline Personality Disorder: The Mediating Role of Perceived Social Support.

Borderline personality disorder (BPD) is characterized by instability in relationships, mood fluctuations, and erratic behavior. This study investigates the relationship between pathological personality traits and functional disability, the status of perceived social support in BPD, as well as its mediating role in this relationship. In this cross-sectional study, 192 Spanish women (BPD group, N = 97; healthy control group, N = 95) completed, through two online platforms, a battery of tests including: the Personality Inventory for DSM-5 Brief Form (PID-5-BF), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Perceived Social Support subscale of the Quality of Life Questionnaire (QLQ). The results show that perceived social support was significantly lower in the BPD group, which also presented a significantly higher disability score than the control group. Pathological personality traits affected functionality both directly and indirectly through perceived social support, as this variable was a significant mediator in both groups. We conclude that perceived social support is impaired in BPD patients, and enhancing it as a complementary therapy to evidence-based treatments could help preserve the functionality of patients while pathological traits are regulated. This study also encourages future research to delve into the relevance of other psychosocial variables on the functionality of subjects with BPD, and the need of enhancing them in therapy.

A Randomised Trial of a Positive Intervention to Promote Well-Being in Cardiac Patients.

BACKGROUND: Negative emotions are linked to the onset and development of coronary heart diseases (CHD), whereas positive emotions are associated with better health and lower mortality rates among patients with these diseases. The objective of this randomised trial was to improve cardiac patients' emotional states using a Programme to Improve Well-being (PIW) based exclusively on positive interventions (those that promote intentional behaviours and thoughts to improve well-being). METHODS: Cardiac patients (n = 108) were randomly assigned to two parallel groups. In the control group, they participated in only a Cardiac Rehabilitation Programme (CRP group), whereas the intervention group also participated in the PIW (CRP+PIW group). Physical functional capacity, depressive symptoms, hostility, and negative and positive affect were assessed at T1 (baseline) and T2 (8 weeks later). RESULTS: At T2, after controlling for functional capacity, the CRP+PIW group reported a significantly less negative affect than the CRP group. Moreover, the CRP group did not change from T1 to T2, whereas the CRP+PIW group reported more positive emotions and fewer negative emotions and hostility at T2 than at T1. CONCLUSIONS: Positive interventions effectively improve the emotional state of cardiac patients. We suggest that specific modules should be included in the CRP to improve well-being.

Subjective well-being in heart failure patients: influence of coping and depressive symptoms.

BACKGROUND: Psychological factors play a crucial role in the well-being of chronically ill patients. PURPOSE: This research examined coping, depressive symptoms and subjective well-being (SWB) in patients with heart failure (HF). The study also analysed whether depressive symptoms mediated the association between coping strategies and SWB. METHOD: Participants (N = 60, 68.3 % men, aged between 40 and 89 years old) diagnosed with HF were recruited from the cardiology service of a general hospital. Coping strategies were assessed with 16 items of the Brief COPE Scale. The items were organised, according to theoretical and empirical data, into four types of coping: task-focused, seeking social support, maladaptive emotion-focused and acceptance coping. Depressive symptoms were assessed with the corresponding subscale of the Hospital Anxiety and Depression Scale. SWB was assessed considering the Satisfaction with Life Scale and the Positive and Negative Affect Schedule. RESULTS: The multiple regression analyses carried out indicated that SWB was positively associated with task-focused coping and inversely related to maladaptive strategies and depressive symptoms. Gender was also a significant predictor of SWB, with male patients reporting higher well-being than female patients. The mediational analysis showed that depressive symptoms partially mediated the relationships between task-focused coping and SWB. CONCLUSION: Results were discussed in the light of the importance of gender, depression and coping in patients with HF since these factors may affect subjective well-being and contribute to severe physical impairment.

[Spanish adaptation of Hobfoll's Strategic Approach to Coping Scale (SACS)]. / Adaptación española de la Escala Multiaxial de Afrontamiento Estratégico (SACS) de Hobfoll.

The present research adapted the Strategic Approach to Coping Scale (SACS), developed by Hobfoll and colleagues, to the Spanish population. SACS is an instrument derived from Hobfoll's Conservation of Resources Theory, which emphasises the contribution of social factors to coping processes. This instrument assesses coping strategies in 9-subscales, organised in three dimensions: orientation to the problem (active/passive), use of social resources (prosocial/antisocial), and orientation to others involved (direct/indirect). The Spanish version, administered to a non-clinical sample (N= 767), found 7-subscales structured in prosocial/antisocial, active/passive and reflexive/intuitive dimensions, with adequate reliability and construct validity. To conclude, the Spanish SACS is a potentially useful and reliable instrument for research and clinical purposes, mainly in areas in which social components need to be explicitly considered.

[Emotional responsiveness of substance abusers under outpatient treatment]. / Respuesta emocional en adictos a sustancias en tratamiento ambulatorio.

The emotions predispose to action providing information from both internal and external environment. There is evidence indicating that the emotional response in drugdependent patients is different from that of the not consuming population. The present work analyzed the emotions of drugdependent under ambulatory treatment (N=57), following the Lang's theory of emotion, considering the dimensions of valence, arousal and dominance or control, across the International Affective Picture System (IAPS), individually applied. The results were contrasted with a control group of not consuming persons (N=44) of similar age, since this variable concerns emotional experience. The influence of sex was also analyzed, considering the possible differences between men and women in emotional experience. The results can be summarized in the following points: (1) There were significant differences between substance abusers and not consumers in the dimension of valence, valuing the consumers the emotional stimuli of the most extreme form (the agreeable ones as better, and the disagreeable ones as worse); (2) there were no differences between both groups in the arousal and dominance dimensions; and (3) women reported more arousal before aversive images, and less before the sexual ones, than males, independently of they were or not substance abusers. Finally, it is suggested the need to deep into the analysis of sex differences and into the images selected, as well as into the usefulness of the emotion centred therapies for the treatment of drugdependency.

[Cardiovascular health in women: the role of anger and its expression]. / Salud cardiovascular en la mujer: el papel de la ira y su expresión.

The relationships between anger expression (in, out, and control) and cardiovascular health (emotional distress, cardiovascular symptoms reported, and preventive health behaviors) were analyzed in 327 women (range 17-60 years). The same criteria (N= 218), as well as blood pressure (BP) registered in medical checkups (N= 90) were recorded one year later. Four groups according to anger-in and anger-control scores, going from the most hostile (high anger-in and low anger-control) to the least hostile (low anger-in and high anger-control) were considered. The results indicated that the most hostile group, with the least adaptive anger expression, presented worst cardiovascular health than the other three groups, at both temporal moments. Furthermore, the presence of women with pathological BP levels was higher in the groups of high anger-in. These data ratify the role of anger expression, especially its repression (anger-in) and the lack of adequate canalization or control in women's cardiovascular health from a prospective design. Appropriate management of anger feelings and the practice of preventive health behaviors can protect women from cardiovascular problems.

Relations between life satisfaction, adjustment to illness, and emotional distress in a sample of men with ischemic cardiopathy.

Fifty-two men who had suffered a first episode ischemic heart disease reported their degree of life satisfaction, the strategies they used to adjust to the illness, and the symptoms of anxiety and depression they felt. The multiple regression analyses carried out indicated that emotional distress was associated with a lower level of life satisfaction. In the analyses of anxiety symptoms, the use of negative adjustment strategies was also a significant predictor. Lastly, a significant Life Satisfaction x Type of Adjustment interaction was obtained. According to this, the patients who felt more satisfaction with their lives used more positive strategies to adjust to the illness and fewer negative ones, than the group of patients who were less satisfied. In conclusion, life satisfaction predicts emotional wellbeing of patients with ischemic heart disease and it enhances the implementation of appropriate strategies to cope with the disease. Moreover, although life satisfaction has been considered a stable measure, we suggest it may change as the experience of illness limits individuals' important goals.

Gender and social support in the context of cardiovascular disease.

OBJECTIVE: Gender and social support (SS) can affect the level of adjustment to cardiovascular disease (CVD). In this study we attempted to determine the effects of both factors on negative mood state, quality of life (QOL) and perceived health control (PHC) in patients at high CVD risk or with CVD. We also tested for an interactive effect of gender and SS. METHOD: One hundred and fifty-three chronic outpatients (89 females and 60 males; 4 provided no information on gender) were assessed. Levels of social support were measured. Other psychosocial variables included were negative mood state, domains of QOL (satisfaction and free time) and PHC. RESULTS: The results, as expected, indicated main effects of gender and social support. Females experienced higher negative mood state and lower PHC in comparison with males. Patients with low SS reported less satisfaction, free time and PHC and had more negative mood state. No interaction of gender by social support was found. CONCLUSIONS: Levels of social support and gender are important aspects that influence emotional and psychological functioning in patients with CVD. Specific interventions designed for females and individuals with poor emotional and instrumental support may contribute to positive changes in their adjustment.