Predictors of anxiety and depression among newly diagnosed people living with HIV: A longitudinal study.

This longitudinal study examined whether past resilience and internalized stigma predicted anxiety and depression among newly diagnosed Spanish-speaking people living with HIV (PLWH). We also analyzed whether coping strategies mediated this relationship. Data were collected at two time points from 119 PLWH. Approximately a third of participants had scores indicative of anxiety symptoms, the same result was found for depressive symptoms. Structural equations modeling revealed that 61% of the variance of anxiety and 48% of the variance of depression 8 months after diagnosis was explained by the proposed model, which yielded a good fit to data. Anxiety and depressive symptoms were significantly and negatively predicted by positive thinking, thinking avoidance, and past resilience, and positively predicted by self-blame. Additionally, anxiety was positively predicted by internalized stigma. Past resilience negatively predicted internalized stigma, self-blame, and thinking avoidance and it positively predicted positive thinking. Internalized stigma positively predicted self-blame. Moreover, internalized stigma had a significant indirect effect on anxiety symptoms through self-blame, and past resilience had significant indirect effects on anxiety symptoms and depressive symptoms through internalized stigma and coping. The results point to the need for clinicians and policy makers to conduct systematic assessments and implement interventions to reduce internalized stigma and train people living with HIV to identify and use certain coping behaviors.

Are Pediatric Critical Personnel Satisfied With Their Lives? Prediction of Satisfaction With Life From Burnout, Posttraumatic Stress, and Posttraumatic Growth, and Comparison With Noncritical Pediatric Staff.

OBJECTIVES: Staff in PICUs shows high burnout, posttraumatic stress disorder symptoms, and posttraumatic growth levels. However, their levels of satisfaction with life and how positive and negative posttrauma outcomes relate to each other and contribute to predict satisfaction with life remain unknown. Thus, we attempted to explore these aspects and to compare the findings with data from pediatric professionals working in noncritical units. DESIGN: This is an observational multicentric, cross-sectional study. SETTING: The PICU of nine hospitals in Spain, and other pediatric units in the same hospitals. SUBJECTS: Two hundred ninety-eight PICU workers (57 physicians, 177 nurses, and 64 nursing assistants) and 189 professionals working in noncritical pediatric units (53 physicians, 104 nurses, and 32 nursing assistants). INTERVENTION: Participants completed the Maslach Burnout Inventory, the Trauma Screening Questionnaire, the Posttraumatic Growth Inventory, and the Satisfaction With Life Scale. MEASUREMENTS AND MAIN RESULTS: Of PICU staff, 16.4% were very satisfied with their lives, 34.2% were satisfied, 34.6% showed average satisfaction with life, and 14.8% were below average. No differences were found between PICU and non-PICU workers. Women reported lower satisfaction with life than men, and physicians reported higher satisfaction with life than other professional groups. The correlation between posttraumatic stress disorder and posttraumatic growth was low, but significant and positive. According to the path analysis with latent variables, 20% of the variance satisfaction with life could be predicted from burnout, posttraumatic stress disorder symptoms, and posttraumatic growth. Higher distress was inversely associated to satisfaction with life, whereas posttraumatic growth contributed to higher satisfaction with life. CONCLUSIONS: Posttraumatic growth can moderate the negative effect of traumatic work-related experiences in satisfaction with life. PICU and non-PICU workers were equally satisfied with their lives. Positive and negative impact of work-related potentially traumatic events can coexist in the same person. Interventions aimed at reducing distress and fostering posttraumatic growth could impact in an improvement in pediatric health professionals' satisfaction with life.

Predicting Posttraumatic Growth in Mothers and Fathers of Critically Ill Children: A Longitudinal Study.

Research on parental psychological effects related to a child's critical illness has focused on studying negative outcomes, while the possibility of posttraumatic growth (PTG), defined as the perception of positive changes after a traumatic event, has been overlooked. This study explores the degree of parental PTG after a child's hospitalization in a pediatric intensive care unit (PICU) and the role of resilience, emotions, perceived severity of the child's condition and stress in predicting PTG. In the first 48 h after their child's discharge from a PICU, N = 196 parents were assessed for resilience, emotions, perceived stress, and the degree to which they perceived their child's condition as severe. 6 months later N = 143 parents were assessed PTG. 6 months post discharge, 37.1% of parents reported PTG at least to a medium degree. Path analyses with latent variables showed that the psychological variables assessed at discharge predicted between 20 and 21% of the total variance in PTG. Resilience affected PTG indirectly, through the bias of positive emotions. PTG is a frequent phenomenon. Psychological interventions aimed at encouraging parental PTG after a child's critical admission should focus on boosting resilience and positive emotions.

Burnout and posttraumatic stress in paediatric critical care personnel: Prediction from resilience and coping styles.

INTRODUCTION: Our aims were (1) to explore the prevalence of burnout syndrome (BOS) and posttraumatic stress disorder (PTSD) in a sample of Spanish staff working in the paediatric intensive care unit (PICU) and compare these rates with a sample of general paediatric staff and (2) to explore how resilience, coping strategies, and professional and demographic variables influence BOS and PTSD. MATERIALS AND METHODS: This is a multicentre, cross-sectional study. Data were collected in the PICU and in other paediatric wards of nine hospitals. Participants consisted of 298 PICU staff members (57 physicians, 177 nurses, and 64 nursing assistants) and 189 professionals working in non-critical paediatric units (53 physicians, 104 nurses, and 32 nursing assistants). They completed the Brief Resilience Scale, the Coping Strategies Questionnaire for healthcare providers, the Maslach Burnout Inventory, and the Trauma Screening Questionnaire. RESULTS: Fifty-six percent of PICU working staff reported burnout in at least one dimension (36.20% scored over the cut-off for emotional exhaustion, 27.20% for depersonalisation, and 20.10% for low personal accomplishment), and 20.1% reported PTSD. There were no differences in burnout and PTSD scores between PICU and non-PICU staff members, either among physicians, nurses, or nursing assistants. Higher burnout and PTSD rates emerged after the death of a child and/or conflicts with patients/families or colleagues. Around 30% of the variance in BOS and PTSD is predicted by a frequent usage of the emotion-focused coping style and an infrequent usage of the problem-focused coping style. DISCUSSION AND CONCLUSIONS: Interventions to prevent and treat distress among paediatric staff members are needed and should be focused on: (i) promoting active emotional processing of traumatic events and encouraging positive thinking; (ii) developing a sense of detached concern; (iii) improving the ability to solve interpersonal conflicts, and (iv) providing adequate training in end-of-life care.

Internalized HIV Stigma and Disclosure Concerns: Development and Validation of Two Scales in Spanish-Speaking Populations.

Internalized stigma and disclosure concerns are key elements for the study of mental health in people living with HIV. Since no measures of these constructs were available for Spanish population, this study sought to develop such instruments, to analyze their reliability and validity and to provide a short version. A heterogeneous sample of 458 adults from different Spanish-speaking countries completed the HIV-Internalized Stigma Scale and the HIV-Disclosure Concerns Scale, along with the Hospital Anxiety and Depression Scale, Rosenberg's Self-esteem Scale and other socio-demographic variables. Reliability and correlation analyses, exploratory factor analyses, path analyses with latent variables, and ANOVAs were conducted to test the scales' psychometric properties. The scales showed good reliability in terms of internal consistency and temporal stability, as well as good sensitivity and factorial and criterion validity. The HIV-Internalized Stigma Scale and the HIV-Disclosure Concerns Scale are reliable and valid means to assess these variables in several contexts.

Predictors of Resilience and Posttraumatic Growth Among People Living with HIV: A Longitudinal Study.

This longitudinal study investigated the predictors of HIV-related resilience (HR) and posttraumatic growth (PTG) among Spanish-speaking HIV-positive people. Perceived past resilience, internalised stigma, and coping strategies were hypothesised as possible predictors. Data were collected at two time points from 119 HIV-positive people. Path analyses with latent variables revealed that half of HR 8 months after diagnosis was predicted by rumination, emotional expression, positive thinking, internalised stigma, and perceived past resilience. The latter three, along with isolation, self-blame, thinking avoidance, and help seeking predicted some PTG dimensions 8 months after diagnosis. The results highlight the importance of internalised stigma associated with HIV infection and of the differential use of coping strategies, and point to the need for clinicians and policy makers to implement stigma reduction and appropriate coping strategies interventions.

Posttraumatic growth inventory: factor structure in Spanish-speaking people living with HIV.

This cross-sectional study analyzed the factorial structure of the Posttraumatic Growth Inventory (PTGI) in a sample of 304 Spanish-speaking HIV-positive adults. Participants completed the PTGI and a socio-demographic questionnaire. Exploratory factor analysis (EFA) was carried out through structural equations modeling, with a Varimax rotation. Factors with eigenvalues greater than 1 were extracted, and items with loadings higher than .5 on a factor and lower than .4 on the rest were retained. Two confirmatory factor analyses (CFA) were performed to test a hierarchical model and a bifactor model. Reliability analyses were conducted. EFA suggested a three-factor model keeping 11 of the original 21 items. The three factors that emerged were changes in philosophy of life, in the self and in interpersonal relationships. CFAs suggested that only the bifactor model fitted the data. The three factors as well as the global scale showed good reliability. The factor structure of PTGI's scores in our data is consistent with the three dimensions theorized by Tedeschi and Calhoun, which speaks in favor of the construct validity of this measure.

Development of a screening measure of stress for parents of children hospitalised in a Paediatric Intensive Care Unit.

BACKGROUND: Having a child admitted to intensive care is a highly stressful experience for parents; however there is a lack of screening instruments of parental stress in that context, which would be useful for both, research and clinical purposes. OBJECTIVES: (1) To validate a brief measure of parental stress based on the Parental Stressor Scale: Paediatric Intensive Care Unit (PSS:PICU), (2) to study which environmental factors of the PICU are more stressful in a sample of Spanish parents, and (3) to study which variables are related to higher levels of stress among this group. METHOD: 196 Spanish parents completed the Abbreviated PSS: PICU (A-PSS:PICU) and a general stress scale (the Perceived Stress Scale) upon their child's discharge to test the convergent validity of the tool. Three months later, they were assessed anxiety and depression using the Hospital Anxiety and Depression Scale, and posttraumatic stress with the Davidson Trauma Scale in order to test the predictive validity of the A-PSS:PICU. RESULTS: Two factors emerged from Confirmatory Factor Analyses, (1) stress due to child's condition and (2) stress related to PICU's staff. The A-PSS:PICU showed adequate reliability and convergent and predictive validity. The most stressful aspects were the behaviours and emotional responses of their child and the loss of their parental role. Age, gender, child's condition, length of admission, spiritual beliefs, and mechanical ventilation were associated to parental stress scores. CONCLUSION: The A-PSS:PICU is a reliable and valid measure. Parental stress should be screened during a child's PICU admission to identify parents at risk of post-discharge distress.

Differences between immigrant and national students in motivational variables and classroom-motivational-climate perception.

The objective of this study is to see whether Immigrant (IM) and Spanish (National) students (SP) need different kinds of help from teachers due to differences in motivation, family expectancies and interests and classroom-motivational-climate perception. A sample of Secondary Students -242 Spanish and 243 Immigrants- completed questionnaires assessing goal orientations and expectancies, family attitudes towards academic work, perception of classroom motivational climate and of its effects, satisfaction, disruptive behavior and achievement. ANOVAs showed differences in many of the motivational variables assessed as well as in family attitudes. In most cases, Immigrant students scored lower than Spanish students in the relevant variables. Regression analyses showed that personal and family differences were related to student's satisfaction, achievement and disruptive behavior. Finally, multi-group analysis of classroom-motivational-climate (CMC) showed similarities and differences in the motivational value attributed by IM and SP to each specific teaching pattern that configure the CMC. IM lower self-esteem could explain these results, whose implications for teaching and research are discussed.

On the nature of motivational orientations: implications of assessed goals and gender differences for motivational goal theory.

In a historical revision of the achievement goal construct, Elliot (2005) recognized that there is little consensus on whether the term "goal" in "achievement goal orientations" (GO) is best represented as an "aim", as an overarching orientation encompassing several "aims", or as a combination of aims and other processes -self-regulation, etc.-. Elliot pointed also that goal theory research provides evidence for different models of GO. As there were no consensus on these issues, we decided to get evidence about the nature and structure of GO, about the role of gender differences in the configuration of such structure, and about relations between GO, expectancies, volitional processes and achievement. A total of 382 university students from different faculties of two public universities of Madrid (Spain) that voluntarily accepted to fill in a questionnaire that assessed different goals, expectancies and self-regulatory processes participated in the study. Scales reliability, confirmatory factor analyses, multiple-group analyses, and correlation and regression analyses were carried out. Results support the trichotomous model of GO, the consideration of GO as a combination of aims and other psychological processes, showed some gender differences and favour the adoption of a multiple goal perspective for explaining students' motivation.

Development and initial validation of the Classroom Motivational Climate Questionnaire (CMCQ).

Research on classroom goal-structures (CGS) has shown the usefulness of assessing the classroom motivational climate to evaluate educational interventions and to promote changes in teachers' activity. So, the Classroom Motivational Climate Questionnaire for Secondary and High-School students was developed. To validate it, confirmatory factor analysis and correlation and regression analyses were performed. Results showed that the CMCQ is a highly reliable instrument that covers many of the types of teaching patterns that favour motivation to learn, correlates as expected with other measures of CGS, predicts satisfaction with teacher's work well, and allows detecting teachers who should revise their teaching.

Prediction of parental posttraumatic stress, anxiety and depression after a child's critical hospitalization.

OBJECTIVE: To study the role of parental resilience, emotions accessed during admission and perceived stress in predicting the degree of parental posttraumatic stress disorder (PTSD), anxiety and depression symptoms after a child's treatment in intensive care. METHODS: This was prospective longitudinal cohort study. A total of 196 parents of pediatric intensive care survivors completed questionnaires assessing resilience, perceived stress, emotions experienced during admission, 48h post-discharge (T0). Sociodemographic and medical data were also collected. Main outcomes were anxiety, depression and PTSD, three (T1) and six (T2) months later. RESULTS: At T2, 23% of parents reported clinically significant levels of symptoms of PTSD, 21% reported moderate-severe anxiety, and 9% reported moderate-severe depression. These rates were not statistically different to rates at T1. Path analyses indicated that 47% of the variance in psychopathology symptoms at T2 could be predicted from the variables assessed at T0. Resilience was a strong negative predictor of psychopathology symptoms, but this effect was mostly indirect, mediated by the stress that parents perceive during their child's critical hospitalization. CONCLUSIONS: Mobilizing coping in order to maintain resilience and to decrease their perceived stress levels could improve parents' mental health outcomes following their child's intensive care treatment.

Evaluating Resilience: Development and Validation of the Situated Subjective Resilience Questionnaire for Adults (SSRQA).

Although resilience varies depending on the specific type of adverse situation faced by the individual, to date resilience questionnaires do not consider its situational character. This study aims to develop and validate the Situated Subjective Resilience Questionnaire for Adults (SSRQA), which assesses resilience in five different adverse contexts. A total of 584 Spanish adults (including general population and clinical samples individuals) completed the SSRQA and other measures of resilience, optimism, and self-efficacy. Confirmatory factor analysis showed that the SSRQA structure fitted the situational model better (χ2/df = 1.90; CFI = .96; TLI = .95; RMSEA = .07) than the non-situational version (χ2/df = 4.99; CFI = .79; TLI = .76; RMSEA = .15). The SSRQA was shown to be reliable (α = .90) and to be significantly and positively correlated with other resilience measures (p < .001) and, to a lower degree, with optimism and self-efficacy (p < .001). Degree of exposure to each adverse situation was negatively correlated with resilience in the face of that situation (p < .05), supporting a vulnerability to stress model. The SSRQA has been demonstrated to be a reliable and valid situated measure for resilience towards different adverse contexts.

Learning-related motives and the perception of the motivational quality of the learning environment.

How can university students' motivation to learn be enhanced? To achieve this, first we should know: What motivational value do students attribute to each particular component of learning environments? To which degree is this value mediated by students' motivational orientations? To respond to these questions, 1,166 university students were administered two questionnaires, one for assessing their motivational orientations and the other, their perceptions of the characteristics of their learning environment. Descriptive and multiple-regression analyses were performed to respond to the questions. Results support predictions concerning both questions, suggesting that motivation modulates the motivational effect of learning environments.

Relation between parental psychopathology and posttraumatic growth after a child's admission to intensive care: Two faces of the same coin?

OBJECTIVES: Confronted with the potentially traumatic experience of a child's admission to a paediatric intensive care unit, parents may experience psychopathological post-trauma symptoms as well as posttraumatic growth. The aim of this cross-sectional study was to explore the relation between psychopathology symptoms, namely, posttraumatic stress disorder), anxiety and depression, as well as post traumatic growth in parents following their child's hospitalisation in a paediatric intensive care unit. METHODS: Six months after their child's discharge, 143 parents completed the questionnaire, which assessed post traumatic growth (Posttraumatic Growth Inventory), post traumatic stress disorder (Davidson Trauma Scale), depression and anxiety (Hospital Anxiety and Depression Scale). RESULTS: Of the 143 parents, 23.1% reported symptoms of post traumatic stress disorder, 21% reported symptoms of moderate to severe anxiety, 9.1% reported symptoms of moderate to severe depression and 37.1% reported at least a medium degree of post traumatic growth. There was a moderate, direct association between post traumatic stress disorder, depression and anxiety with post traumatic growth. Higher scores in anxiety, depression and post traumatic stress disorder were associated with higher levels of post traumatic growth, contradicting the notion of an inverted U-shaped relationship between psychopathology symptoms and post traumatic growth. CONCLUSIONS: Given that positive and negative outcomes after a child's critical admission tend to co-occur, it is surmised that parents who indicate post traumatic growth do not deny the difficulties. While not negating the negative impact on the mental health of a parent with a child admitted to intensive care, including the assessment of post traumatic growth as an outcome following this event has important implications for research and clinical practice.

Social Support in Newly Diagnosed People living With HIV: Expectations and Satisfaction Along Time, Predictors, and Mental Health Correlates.

Social support usually decreases following HIV diagnosis, and decreased support is related to worsening mental health. We investigated the evolution of social support after HIV diagnosis and its relationship to anxiety, depression, and resilience, and sought to develop a social support prediction model. There were 119 newly diagnosed Spanish speakers who participated in this longitudinal study, completing measures of social support, internalized stigma, disclosure concerns, degree of disclosure, coping, anxiety, depression, and resilience. Bivariate associations and multiple regression analyses were performed. Results showed that the highest levels of support arose from friends, health care providers, and partners, and that social support decreased following diagnosis. Subsequent social support was negatively predicted by avoidance coping and positively by approach coping, steady partnership, and disclosure. It was significantly associated with decreased anxiety and depression and higher resilience. Interventions should seek to promote mental health in people living with HIV by increasing social support.

School Climate and Teachers’ Motivational Variables: Effects on Teacher Satisfaction and Classroom Motivational Climate Perceived by Middle School Students. A Cross-cultural Study / Clima escolar y variables motivacionales del profesorado: efectos sobre la satisfacción de los docentes y el clima motivacional del aula percibido por los estudiantes de secundaria. Un estudio transcultural

This paper seeks two objectives. First, to study the potential effect of teachers’ perception of school climate and teachers’ motivational variables related to students on teachers’ satisfaction with school, and classroom motivational climate (CMC). Second, to validate a battery of questionnaires for assessing different teachers’ motivational variables related to students: motivational knowledge, teachers’ focus on students’ grades and emotional needs, and expectancies. In total, 441 teachers and 5,380 students from Spain and Costa Rica participated in the study. Confirmatory factor analyses showed the adequacy of each questionnaire structure. Besides, results on correlation and regression analyses showed, first, that school climate perception, together with teachers’ expectancies are the main factors potentially influencing teachers’ satisfaction with school. Second, that CMC does not depend on teachers’ satisfaction, but only on two components of school climate – teacher’s mutual support and students’ attitudes –, and on self-efficacy expectancies. In both regression analyses – satisfaction and CMC –, cross-cultural differences were found.

Este trabajo persigue dos objetivos. En primer lugar, estudiar el efecto potencial de la percepción del clima escolar por parte de los profesores y de las variables motivacionales de estos relacionadas con los estudiantes en la satisfacción de los profesores con la escuela y el clima motivacional del aula (CMC). En segundo lugar, validar una batería de cuestionarios para evaluar las diferentes variables motivacionales de los docentes relacionadas con los estudiantes: conocimiento motivacional, enfoque de los docentes en las calificaciones y necesidades emocionales de los estudiantes y expectativas. En total, 441 profesores y 5,380 estudiantes de España y Costa Rica participaron en el estudio. Los análisis factoriales confirmatorios mostraron la adecuación de la estructura de cada cuestionario. Además, los resultados de los análisis de correlación y regresión mostraron, en primer lugar, que la percepción del clima escolar, junto con las expectativas de los profesores, son los principales factores que pueden influir en la satisfacción de los profesores con la escuela. En segundo lugar, que el CMC no depende de la satisfacción de los profesores, sino solo de dos componentes del clima escolar, el apoyo mutuo de los profesores y las actitudes de los estudiantes, y de las expectativas de autoeficacia. En ambos análisis de regresión, satisfacción y CMC, se encontraron diferencias transculturales.

Assessment of Goal Orientations from the “Person-Situation Interaction” Perspective / Evaluación de las orientaciones a metas desde la perspectiva de la “interacción persona-situación”

The objective of this study is twofold: to analyze the role of different task situations in the activation of goals and goal orientations and, to make it possible to achieve such an objective to support theoretically, develop, and previously validate the Situated Goals Questionnaire for secondary and high school students (SGQ-SHS). A total of 1,010 Secondary and High School Students from Madrid (Spain) participated in the study. Data analysis using confirmatory techniques, as well as ANOVA and regression techniques, showed the effect of the type of task on the degree to which students declare to pursue different goals – as suggested by the person-situation interaction model –, the relationship between goals, expectancies, and self-regulation styles, as well as the validity of the measures developed for predicting achievement (self-estimated mean grade).

El objetivo de este estudio es doble: estudiar el papel de las situaciones definidas por las diferentes tareas en la activación de metas y de orientaciones a metas por objetivos y, para hacer posible la consecución de dicho objetivo, apoyar teóricamente, desarrollar y validar previamente el Cuestionario de Metas Situadas para Estudiantes de Secundaria y Bachillerato (MESI-SB). Un total de 1,010 estudiantes de Secundaria de Madrid (España) participaron en el estudio. Los datos analizados mediante técnicas confirmatorias, así como técnicas de ANOVA y regresión, pusieron de manifiesto que el efecto del tipo de tarea influye en el grado en que los estudiantes declaran perseguir diferentes objetivos –como sugiere el modelo de interacción persona-situación–, la relación entre los objetivos, las expectativas y los estilos de autorregulación, así como la validez de las medidas desarrolladas para predecir el logro (calificación media autoestimada).

Personal Factors Underlying Resilience in Adolescence: Cross-Cultural Validity of the Prince-Embury Model.

Resiliency personality factors are supposed to underlie resilience. To get evidence on this supposition, the Prince-Embury scales (PES) for adolescents were adapted to the Spanish population. Then, the relationship between the resiliency variables sense of mastery, sense of relatedness and emotional reactivity -assessed with the PES- with resilience -assessed with the Subjective Resilience Questionnaire (SRQ)- were analyzed, as well as the role of social integration within this relationship. Data from 1083 adolescents were analyzed using confirmatory techniques (CFA, PALV). CFA of PES displayed a good fit to the model (CFI: .95). Path-analysis showed that sense of mastery and emotional reactivity predict resilience as expected, but also that, contrary to expectations based on Prince-Embury's theory, sense of relatedness and resilience are not related, either directly, or through social integration. Being related and socially integrated probably favors well-being, but it may not favor resilience unless associated to Sense of Mastery, at least in adolescence.