Aberrant Salience and Disorganized Symptoms as Mediators of Psychosis.

Introduction: Ideas of reference (IR) are frequent in psychopathology, mainly in psychotic disorders. The frequency of IR and preoccupation about them are related to the psychotic dimension, and to a lesser extent, to negative or emotional disorganized dimensions. Aberrant salience (AS), has been proposed as an indicator of the onset of psychosis, particularly of schizophrenia. This study analyzed the mediating role of AS, disorganized symptoms and preoccupation about IR in the relationship between IR and the psychotic dimension. Method: The sample consisted of 330 participants (116 university students and 214 clinically active patients), 62.4% of whom were women aged 18-79. The Referential Thinking Scale, the Aberrant Salience Inventory, and the Brief Psychiatric Rating Scale were administered. Results: Evidence of a partial mediation model showed that the relationships between IR and the psychotic dimension were mediated jointly by AS and the disorganized dimension, and preoccupation about IR no longer had a role. This relationship was significantly influenced by participant age. The variables in the model explained 54.16% of the variance. Conclusion: The model proposed enabled a set of vulnerabilities (unusual thought content) to be predicted that could lead to a high-risk general pathological state and proneness to psychosis in particular. These findings are discussed with regard to early detection and prevention of psychosis.

A Mediation Model for Ideas of Reference.

Ideas of reference are common in human beings, but they are frequent in certain psychopathological disorders, mainly those concerning the psychotic spectrum. The purpose of this study was to attempt to construct a model predicting the appearance of ideas of reference and to test the relationship of personality (based on the Gray model), emotional, and self-consciousness variables. Five-hundred and seventy-four participants (287 patients with several different psychopathological diagnoses) filled in the Referential Thinking Scale (REF), the GHQ-28, the Self-Consciousness Scale (SCS-R), and the SPSRQ Scale. The resulting model found full mediation of sensitivity to punishment, sensitivity to reward, depression, and public self-consciousness between anxiety and ideas of reference, regardless of the group they were in (patients vs. nonpatients). This result, based on the appearance of anxiety symptomatology, explains 43% of the variance in scores, showing the presence of ideas of reference and therefore enables prediction of a set of vulnerabilities (established with self-reports) which could lead to a psychological state of high general pathological risk and proneness to psychosis in particular.

The mediating role of emotional symptomatology between anticipatory fatigue and the perception of fatigue.

BACKGROUND: Clinical research stresses the importance of cognitive variables for predisposition, onset, and especially, perpetuation of perceived fatigue. The aim was to analyze the mediating effects of emotional symptomatology (somatic, depressive and anxiety) between anticipatory fatigue and perception of physical and cognitive fatigue. METHODS: The sample was composed of 317 participants (29% from a clinical population) aged 18 to 76. Anticipatory fatigue and perception of fatigue were measured by fatigue scales. Emotional symptoms were assessed by the General Health Questionnaire, GHQ-28.  Results : Depressive symptomatology mediated the relationship between anticipatory fatigue and cognitive fatigue in both groups, and also somatic symptoms/somatization in patients. The indirect effect of physical fatigue was observed only in the clinical group, with depressive symptoms partially mediating the anticipatory fatigue and cognitive fatigue relationship. CONCLUSIONS: Anticipatory fatigue has a partial indirect effect on total physical fatigue, and full indirect effect on cognitive fatigue, mediated by depressive and somatic symptoms. Anticipatory fatigue is a relevant cognitive factor in the design of psychological intervention for improvement of cognitive and physical fatigue.

Perceived Experience of Fatigue in Clinical and General Population: Descriptors and Associated Reactivities.

The aim of this study is the analysis of different descriptors and reactions related to the experience of fatigue. Two groups were compared: a clinical sample (n = 92, 31 males, mean age = 38.87) and a non-clinical (n = 225, 135 males, mean age = 32.45) sample. The total sample was composed of 317 participants (52% males), ranging in age from 18 to 76 years. Findings show the experience of fatigue was mainly related to somatic terms (76% of the total sample). Specific results were found only for the clinical group: (a) significant relationships between fatigue and anxiety, χ2(1) = 34.71, p < .01; tension, χ2(1) = 16.80, p < .01; and sadness, χ2(1) = 24.59, p < .01; (b) higher intensity of fatigue (F = 84.15, p = .001), and predominance of the cognitive components of fatigue. Results showed that fatigue in subjects with a clinical disorder (versus those without) was associated both, to negative emotional states, and to a higher intensity of fatigue, especially in its cognitive elements. Important clinical implications for its assessment and intervention are discussed.

The effects of anticipatory fatigue and emotional symptomatology on perceived physical and cognitive fatigue / Efectos de la fatiga anticipatoria y la sintomatología emocional en la percepción de fatiga física y cognitiva

The two fold aim of this study was first, to analyze the effects of anticipatory fatigue, emotional symptomatology and belonging to a clinical group on the physical and cognitive perception of fatigue, and second, to explore the potential moderating effect of anticipatory fatigue on the relationship between symptomatology or clinical condition and perceived fatigue. The conditional and partial effects of independent variables were analyzed by hierarchical regression in an ex-post-facto correlational design. The sample was composed of 317 participants (29% from a clinical population). Anticipatory fatigue (by an ad hoc scale), and perception of fatigue (by the Chalder Fatigue Scale) were measured. Emotional symptoms were assessed by Goldberg’s GHQ-28 questionnaire. Anticipatory fatigue and emotional symptoms (mainly depressive) had significant effects on cognitive and physical fatigue. Belonging to the clinical group significantly and exclusively predicted cognitive fatigue. Furthermore, anticipatory fatigue moderated between-group effects (clinical versus general) and cognitive fatigue. In brief, emotional symptoms (mainly depressive) and anticipatory fatigue significantly predicted perceived cognitive and physical fatigue. Anticipation of fatigue moderated the effect of clinical group on cognitive fatigue after controlling for depressive symptomatology (AU)

El objetivo de este estudio fue doble, primero, analizar los efectos de la fatiga anticipatoria, la sintomatología emocional y la pertenencia a un grupo clínico sobre la percepción de fatiga física y mental; segundo, explorar el potencial efecto moderador de la anticipación de la fatiga en las relaciones entre la sintomatología o la condición clínica y la sensación percibida de fatiga. Se analiza mediante un diseño ex post facto y correlacional los efectos parciales y condicionados de las variables predictivas mediante diferentes análisis de regresión jerárquica. Participaron 317 sujetos (29% procedentes de población clínica). Se evaluó la fatiga anticipatoria (Escala elaborada ad hoc), la experiencia percibida de fatiga (Escala de Fatiga de Chalder et al., 1993), y la sintomatología emocional (GHQ-28 de Goldberg, 1996). Los resultados mostraron efectos significativos de la fatiga anticipatoria y la sintomatología emocional, predominantemente de la sintomatología depresiva sobre la percepción de fatiga física y mental. La pertenencia a un grupo clínico predecía de forma significativa y exclusiva la fatiga cognitiva. Además, la fatiga anticipatoria moderaba el efecto del grupo (clínico versus general) sobre la fatiga cognitiva. En conclusión, la sintomatología, principalmente la depresiva, y la fatiga anticipatoria, tienen un valor predictivo significativo en la experiencia percibida de la fatiga física y mental. La anticipación de fatiga moderaba el efecto del grupo clínico sobre la experiencia de fatiga cognitiva una vez controlada la sintomatología depresiva (AU)

The mediating role of emotinal symptomatology between anticipatory fatigue ad the perception of fatigue / El papel mediador de la sintomatología emocional entre la fatiga anticipatoria y la percepción de la fatiga

BACKGROUND: Clinical research stresses the importance of cognitive variables for predisposition, onset, and especially, perpetuation of perceived fatigue. The aim was to analyze the mediating effects of emotional symptomatology (somatic, depressive and anxiety) between anticipatory fatigue and perception of physical and cognitive fatigue. METHODS: The sample was composed of 317 participants (29% from a clinical population) aged 18 to 76. Anticipatory fatigue and perception of fatigue were measured by fatigue scales. Emotional symptoms were assessed by the General Health Questionnaire, GHQ-28. RESULTS: Depressive symptomatology mediated the relationship between anticipatory fatigue and cognitive fatigue in both groups, and also somatic symptoms/somatization in patients. The indirect effect of physical fatigue was observed only in the clinical group, with depressive symptoms partially mediating the anticipatory fatigue and cognitive fatigue relationship. CONCLUSIONS: Anticipatory fatigue has a partial indirect effect on total physical fatigue, and full indirect effect on cognitive fatigue, mediated by depressive and somatic symptoms. Anticipatory fatigue is a relevant cognitive factor in the design of psychological intervention for improvement of cognitive and physical fatigue

ANTECEDENTES: la investigación clínica resalta la importancia de variables cognitivas en la predisposición, inicio y mantenimiento de la fatiga percibida. Se analizan los efectos de mediación de la sintomatología emocional entre la fatiga anticipatoria y la percepción de la fatiga física y cognitiva. MÉTODOS: la muestra se compone de 317 participantes (29% de población clínica) de 18 a 76 años. La fatiga anticipatoria y la percepción de la fatiga se midieron a través de escalas de fatiga y los síntomas emocionales a través del Cuestionario GHQ-28. RESULTADOS: la sintomatología depresiva media la relación entre fatiga anticipatoria y la fatiga cognitiva en ambos grupos, y también para el grupo de pacientes cuando además los síntomas son somáticos. En el caso de la fatiga física, el efecto indirecto se da solo para el grupo clínico, siendo la sintomatología depresiva la variable que media parcialmente la relación. CONCLUSIONES: la fatiga anticipatoria tiene un efecto indirecto parcial sobre la fatiga física e indirecto total sobre la fatiga cognitiva, mediado por los síntomas depresivos y somáticos. Este factor cognitivo es relevante en el diseño de la intervención psicológica para la disminución de la fatiga cognitiva y física

Perceived experience of fatigue in clinical and general population: descriptors and associated reactivities

The aim of this study is the analysis of different descriptors and reactions related to the experience of fatigue. Two groups were compared: a clinical sample (n = 92, 31 males, mean age = 38.87) and a non-clinical (n = 225, 135 males, mean age = 32.45) sample. The total sample was composed of 317 participants (52% males), ranging in age from 18 to 76 years. Findings show the experience of fatigue was mainly related to somatic terms (76% of the total sample). Specific results were found only for the clinical group: (a) significant relationships between fatigue and anxiety, χ2(1) = 34.71, p < .01; tension, χ2(1) = 16.80, p < .01; and sadness, χ2(1) = 24.59, p < .01; (b) higher intensity of fatigue (F = 84.15, p = .001), and predominance of the cognitive components of fatigue. Results showed that fatigue in subjects with a clinical disorder (versus those without) was associated both, to negative emotional states, and to a higher intensity of fatigue, especially in its cognitive elements. Important clinical implications for its assessment and intervention are discussed (AU)

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