Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population.

OBJECTIVES: To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. METHODS: n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. RESULTS: The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. CONCLUSIONS: This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D.

Development and validation of the openness to the future scale: a prospective protective factor.

BACKGROUND: Most of the research on psychopathology has provided an incomplete picture of mental health by focusing on vulnerability factors and omitting the transversal processes that may explain human adapted functioning. Moreover, research has not sufficiently addressed prospective protective factors for mental health. New theoretical and empirical endeavors aim to incorporate this perspective, particularly in the realm of emotional disorders. A positive view of the future is an indispensable process in attaining desired goals and wellbeing. Openness to the Future is a construct characterized by positive affectivity towards the future, which can be a protective factor for mental health. Although some scales assess future orientations, the complexity of this concept has not yet been captured; therefore, there is a need for new instruments. This study presents the development and validation of a scale for measuring Openness to the Future in clinical (n = 412) and community (n = 890) samples. METHODS: Psychometric properties of the OFS were analyzed using Confirmatory Factor Analysis (CFA) and Item Response Theory (IRT) analyses, establishing cut-off points to better classify these two groups. Moreover, convergent and discriminant validity were examined by correlating the OFS with theoretically related constructs. RESULTS: Results support a unidimensional structure and indicate that the items function similarly across clinical and community samples. Moreover, the Openness to the Future scale shows good convergent and discriminant validity. CONCLUSIONS: These findings suggest that the Openness to the Future scale is a valid and brief measure of openness to the future for use with clinical and community samples, and it could help to fill a gap in the literature regarding attitudes towards the future and their implications. Openness to the Future is presented as an empirically feasible and theoretically consistent construct that includes both prospective and protective factors in the psychopathological chart.

Psychometric properties of the General Self Efficacy-12 Scale in Spanish: general and clinical population samples.

The General Self Efficacy Scale (GSES-12) is a short version of the Sherer's Self-Efficacy Scale, and evaluates a general dimension and three aspects of self-efficacy: initiative, persistence and effort. The aim of this study is to explore the factorial structure, reliability, and criterion validity of the Spanish adaptation of the GSES-12 in general and clinical populations. The sample was composed of 714 volunteers (332 from the clinical population). Results of the principal components analysis yielded a 3-factor structure that was later confirmed through Confirmatory Factor Analysis. Moreover, this study shows good internal consistency and test-retest values, and differences in self-efficacy scores between the clinical and non-clinical groups. The present study demonstrates that the Spanish version of the GSES-12 is a valid and reliable measure, and it adds relevant information to the debate about the dimensional structure of general self-efficacy.

Efficacy and acceptability of an Internet platform to improve the learning of nutritional knowledge in children: the ETIOBE Mates.

Possessing sufficient nutritional knowledge is a necessary component in the prevention and treatment of obesity. A solid understanding of nutrition can help people make appropriate food selections and can also help correct irrational ideas or myths people may believe about food. It is a challenge to provide this information to children in ways that are exciting. Thus, we propose an online video game platform to deliver the information. The objective of this study was to study the efficacy and acceptability of an online game called 'ETIOBE Mates' that was designed to improve children's nutritional knowledge; furthermore, we compare it with the traditional paper-pencil mode of information delivery. A sample of 228 children participated in the study. Participants were divided into two groups: an experimental group (who used ETIOBE Mates) and a control group (who were given a pamphlet). Both groups increased their scores for nutritional knowledge. The interaction between group × time was also statistically significant; it indicated that acquisition of nutritional knowledge was superior in the experimental group. The children considered the serious games platform to be a useful medium for improving their nutritional knowledge. Online games can be an effective method of delivery for preventive and treatment tasks that are otherwise tedious for children.

The social phobia and anxiety inventory: psychometric properties in a Spanish sample.

This study is a validation of the Spanish version of the Social Phobia and Anxiety Inventory using a nonclinical sample (198 participants) and a clinical sample (72 participants with social phobia). The factor structure and concurrent validity with Fear of Negative Evaluation and Social Avoidance and Distress scales were analyzed. The Social Phobia and Anxiety Inventory demonstrated good concurrent validity, showing statistically significant relationships with Fear of Negative Evaluation and Social Avoidance and Distress. Results confirmed the rationale for the division of the SPAI into two subscales. Results also demonstrated the utility of the Social Phobia and Anxiety Inventory for differentiating between a nonclinical sample and participants with a social phobia, and its adequate reliability.

Mixing realities? An application of augmented reality for the treatment of cockroach phobia.

Augmented reality (AR) refers to the introduction of virtual elements in the real world. That is, the person is seeing an image composed of a visualization of the real world, and a series of virtual elements that, at that same moment, are super-imposed on the real world. The most important aspect of AR is that the virtual elements supply to the person relevant and useful information that is not contained in the real world. AR has notable potential, and has already been used in diverse fields, such as medicine, the army, coaching, engineering, design, and robotics. Until now, AR has never been used in the scope of psychological treatment. Nevertheless, AR presents various advantages. Just like in the classical systems of virtual reality, it is possible to have total control over the virtual elements that are super-imposed on the real world, and how one interacts with those elements. AR could involve additional advantages; on one side it could be less expensive since it also uses the real world (this does not need to be modeled), and it could facilitate the feeling of presence (the sensation of being there), and reality judgment (the fact of judging the experience as real) of the person since the environment he or she is in, and what he or she is seeing is, in fact the "reality." In this paper, we present the data of the first case study in which AR has been used for the treatment of a specific phobia, cockroaches phobia. It addresses a system of AR that permits exposure to virtual cockroaches super-imposed on the real world. In order to carry out the exposure, the guidelines of Ost with respect to "one-session treatment" were followed. The results are promising. The participant demonstrated notable fear and avoidance in the behavioral avoidance test before the treatment, and not only was an important decrease in the scores of fear and avoidance observed after the treatment, but also the participant was capable of approaching, interacting, and killing live cockroaches immediately following the treatment. The results are maintained in a follow-up conducted 1 month after the termination of the treatment.

Explicit and implicit memory biases in depression and panic disorder.

The purpose of the present study was to investigate the presence of a bias for emotional information (panic-related, depression-related, positive and neutral) in explicit memory and implicit memory (by means of free recall and word-stem completion tasks, respectively) among depressed (N=20) and panic (N=20) patients. Three different encoding conditions (graphemic, semantic and self-reference) were used. The results of this study failed to show the existence of a mood-congruent memory bias for both implicit and explicit memory in these emotional disorders. According to the correlational analyses performed, differences among categories of emotional words meant less than the difference among various types of encoding and memory bias in order to differentiate among groups.

Virtual reality treatment of claustrophobia: a case report.

The efficacy of a treatment for claustrophobia using only Virtual Reality (VR) exposure was examined. The subject was a 43-year-old female who suffered from clinically significant distress and impairment and sought psychological therapy. Eight individual VR graded exposure sessions were conducted. All self-report measures were reduced following VR exposure and were maintained at one month follow-up. The necessity of a theoretical framework for this new medium for exposure therapy is discussed.

Virtual reality and psychopathology.

Progress in the development of Virtual Reality (VR) is faster than has been forecast, which makes deep reflection on its potential uses and abuses absolutely necessary. The current article focuses on the analysis of some of the applications and implications of VR on psychopathology. It is obvious that they could be many, but we are only focusing on: (a) VR as a model to answer some central questions that traditionally have intrigued psychopathologists; and (b) VR and possible psychopathological experiences. We believe that VR has the potential of becoming a tool that will allow psychopathology to challenge and modify theoretical positions already established, and to pose new ones. This new way of experience can help us to find the answers to old question, and, at the same time, it can make new answers arise on the psychopathological and psychological horizon. Such answers are not only related to empirical and theoretical issues, but to moral ones as well. This road of research has just started.

Immersion and emotion: their impact on the sense of presence.

The present study is designed to test the role of immersion and media content in the sense of presence. Specifically, we are interested in the affective valence of the virtual environments. This paper describes an experiment that compares three immersive systems (a PC monitor, a rear projected video wall, and a head-mounted display) and two virtual environments, one involving emotional content and the other not. The purpose of the experiment was to test the interactive role of these two media characteristics (form and content). Scores on two self-report presence measurements were compared among six groups of 10 people each. The results suggest that both immersion and affective content have an impact on presence. However, immersion was more relevant for non-emotional environments than for emotional ones.

Virtual reality: a new clinical setting lab.

Virtual Reality (VR) is a new technology halfway between television and computer. It constitutes another step in the evolution of our use of a tool that allows us to see, to hear and to feel in a world created graphically in three dimensions, and to interact with it. VR is, mainly, a mental experience which makes the user believe that "he is there", that he is present in the virtual world. With this new tool, the user is no longer a mere observer of that which is happening on a screen, but he "feels" that he is immersed in that world and participates in it, in spite of the fact that they are spaces and objects that only exist in the memory of the computer and in the user's mind. This chapter seeks to carry out different reflections at different levels. First, we will analyze the relationships between VR and Psychology, one of the disciplines that has made more efforts in order to understand how we obtain knowledge from the world and from ourselves. We will also analyze the impact VR can have in one of the applied disciplines of Psychology, which is Clinical Psychology. With regard to this application environment, VR becomes a tool which can generate useful models for Psychology (both normal and abnormal), and it is offered as a research context for Clinical Psychology; as a "realistic" laboratory where we can study behaviours, emotions, thoughts, etc.; and a new means to develop psychological treatments.

Psychometric characteristics in normal and social phobic samples for a Spanish version of the Rosenberg Self-Esteem Scale.

The present paper had three purposes: (a) presenting normative data for the Rosenberg Self-esteem Scale in a Spanish sample, (b) studying whether there are significant sex or age differences in self-esteem, and (c) studying whether there are significant differences between a Control group with no psychological diagnosis and a group of social phobics. Of the total sample of 266 persons, 214 belonged to the Control group and 52 to the Social Phobic group. Item-total score correlations and alpha reliabilities supported the internal consistency of the scale. There were statistically significant differences between the Control and Social Phobic groups, but not by sex or age.

Self-consciousness Scale: a study of Spanish housewives.

The purpose of this study was to examine the applicability with 93 Spanish housewives of the translated Self-consciousness Scale. We present reliability measures and normative data, and we also include data for two clinical samples (31 depressive and 31 asthmatic women patients).

Ecological momentary assessment for chronic pain in fibromyalgia using a smartphone: a randomized crossover study.

BACKGROUND: Daily diaries are a useful way of measuring fluctuations in pain-related symptoms. However, traditional diaries do not assure the gathering of data in real time, not solving the problem of retrospective assessment. Ecological momentary assessment (EMA) by means of electronic diaries helps to improve repeated assessment. However, it is important to test its feasibility in specific populations in order to reach a wider number of people who could benefit from these procedures. METHODS: The present study compares the compliance and acceptability of an electronic diary running on a smartphone using a crossover design for a sample with a specific pain condition, fibromyalgia and low familiarity with technology. Forty-seven participants were randomly assigned to one of two conditions: (1) paper diary - smartphone diary and (2) smartphone diary - paper diary, using each assessment method for 1 week. RESULTS: The findings of this study showed that the smartphone diary made it possible to gather more accurate and complete ratings. Besides, this method was well accepted by a sample of patients with fibromyalgia referred by a public hospital, with an important proportion of participants with low level of education and low familiarity with technology. CONCLUSIONS: The findings of this study support the use of smartphones for EMA even in specific populations with a specific pain condition, fibromyalgia and with low familiarity with technology. These methods could help clinicians and researchers to gather more accurate ratings of relevant pain-related variables even in populations with low familiarity with technology.

Validation of the Dutch Eating Behavior Questionnaire for Children (DEBQ-C) for use with Spanish children.

INTRODUCTION: The Dutch Eating Behaviour Questionnaire for children was developed by Van Strien and Oosterveld (2008) to measure three different eating behaviors (emotional eating, restrained eating and external eating); it is an adaptation of the DEBQ for adults. OBJECTIVE: The purpose of this study is to analyze the psychometric properties of the Dutch Eating Behavior Questionnaire for Children (DEBQ-C) with a Spanish sample. METHOD: The DEBQ-C was administered to 473 children (240 boys and 233 girls), from 10 to 14 years old. The sample included a Clinical Overweight Group (COG; n = 81) comprising children who were receiving weight loss treatments, a Non Clinical Overweight Group (NCOG, n = 31) comprising children who were overweight but not in treatment, and a Normal Weight Group (NWG, n = 280). RESULTS: Results showed that the DEBQ-C had acceptable internal consistency (a = 0.70). Temporal stability was good for "External Eating" and "Restrained Eating" scales. Confirmatory factor analysis showed that the three-factor solution had good fit indices. Furthermore, the clinical overweight participants scored significantly higher on "External Eating" and "Restrained Eating" compared to the normal weight children. CONCLUSION: The DEBQ-C proved to be an effective instrument for researching children's eating behaviors.

An Internet-based self-help treatment for fear of public speaking: a controlled trial.

This study offers data about the efficacy of "Talk to Me," an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.

Detection and distraction effects for threatening information in social phobia and change after treatment.

This work examines differences in the detection and distraction by social-threat-related information between a social phobia group (SP; N=33) and a normal control group (NC; N=32). The change obtained after psychological treatment is also studied for the SP group. A paper-and-pencil visual search task is used, in which the emotional valence of the "target" (social threat, physical threat, and neutral words) and "distractor" (social threat, physical threat, neutral, and nonsense words) verbal stimuli is manipulated. Results indicate that there are no differences in the detection of social-threat targets between SP and NC participants. However, the performance of SP individuals is more impaired when distractor stimuli related to social threat are presented, regardless of the target valence. This increased distraction by social-threat-related stimuli is reduced after psychological treatment, and this decrease is maintained at 6-month follow-up.