Barriers to access intimate partner violence services in female Romanian immigrants in Spain: A Delphi study.

Immigrant women may be at higher risk of intimate partner violence (IPV) and may seek specialized services less frequently than other populations. In Spain, Romanian origin foreigners comprise the second-highest proportion among immigrant population. This study aimed to identify, from the perspective of experts, (1) the main barriers faced by immigrant women of Romanian origin in accessing specialized services for IPV in Spain; and (2) the most useful strategies to combat these barriers. A Delphi study was conducted with a panel of 23 experts. The coefficient rWG was calculated to established agreement among participants. The results showed 58 barriers and 31 strategies with high agreement among the experts (rWG ≥ 0.80). Barriers in access to services that were considered to be highly influential included: having been in the host country for a short time; lack of language proficiency; job insecurity; difficulty with family-work reconciliation; and fear of the social consequences for help-seeking. The strategies considered most useful were: facilitating access to the job market and decent housing; promoting a social support network; translating material into Romanian; and increasing training among professionals. The findings offer guidelines for the improvement of the accessibility of specialized services to immigrant women of Romanian origin.

Quality of Memories in Women Abused by Their Intimate Partner: Analysis of Traumatic and Nontraumatic Narratives.

Traditional models of posttraumatic stress disorder (PTSD) claim that the high emotional intensity of traumatic events leads to deficits in the voluntary access of traumatic memories. This may result in disorganized narratives, with a high sense of emotional and sensory reliving. Alternatively, the basic mechanisms view suggests that high arousal leads to more available involuntary and voluntary memories. Traumatic narratives would not be impaired; indeed, they would be immersive and rich in detail. To test this perspective, this study compared the trauma narratives of 50 battered women (trauma-exposed group) with narratives about positive experiences and narratives of 50 nonexposed women (controls), and analyzed the relationship between trauma narrative aspects and the severity of PTSD. Results showed that trauma narratives were detailed, oriented, and coherent. Affective process words and emotional tone were related to trauma centrality and anxiety during disclosure, and predicted the severity of PTSD (R2 = .26). These variables, together with the use of present tense verbs, accounted for a significant variance in intrusions (R2 = .34). As hypothesized, narrative aspects related to a sense of reliving and narrative immersion were better predictors of PTSD than aspects reflecting impaired access to voluntary traumatic memories.

Factors associated with anger and anger expression in caregivers of elderly relatives.

OBJECTIVES: Anger is a common feeling among family caregivers of elderly dependents. However, this feeling has received less attention than other emotional effects of caring. This study measures anger in caregivers and analyzes its predictors. METHOD: Trait anger and anger expression (expression-in, expression-out and expression index), caregiver and care recipient features, stressors (e.g. care demands and support), appraisal (e.g. burden) and resources (e.g. coping, self-efficacy) were assessed in 111 caregivers of elderly dependent relatives. Staged stepwise multiple linear regression analyses were carried out for each of the four anger scores. RESULTS: Caregivers presented mild anger levels and showed expression-in rather than expression-out of anger. Stepwise multiple linear regression analyses showed that a bad relationship between caregiver and care recipient, the presence of disruptive behaviors and caregivers' low efficacy to handle them, and mostly the use of emotion-focused coping were the significant predictors of trait anger, anger expression index and anger expression-out. Explained variance for each of these regression models was 38%, 33% and 27%, respectively. Burden was the only significant predictor for internal anger expression (8% explained variance). CONCLUSION: Results highlight that interventions aimed to improve caregivers' strategies to address memory and behavior problems and to promote the use of effective coping strategies could be helpful to prevent anger and expression-out of anger. Reducing burden in caregivers might result in reductions of anger expression-in. Data underscore the need to consider anger feeling and both in-expression and out-expression of anger separately in order to understand anger experience in caregivers.

Quality of memories in battered women: Analysis of positive narratives.

OBJECTIVES: In recent years, the evidence regarding the characteristics of positive autobiographical memories in the field of posttraumatic stress disorder has gained increasing interest. The objective of this study was to add to the evidence in this area by analyzing the characteristics of positive memories in a specific trauma population, namely victims of intimate partner violence. METHOD: The study compared the narratives of highly positive events of 50 battered women (trauma-exposed group) with those of 50 nonexposed women (controls). RESULTS: The results show that, compared with the narratives of the control group, the narratives of the trauma-exposed group contained fewer references to positive emotions and achievement and more words related to the first person and mistreatment. CONCLUSIONS: The results support the hypothesis that the consequences of trauma can impact the characteristics of positive autobiographical memories. The resulting clinical implications point toward the possible relevance of adding work with positive memories to the clinical approach to trauma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Presentation of the Coding and Assessment System for Narratives of Trauma (CASNOT): Application in Spanish Battered Women and Preliminary Analyses.

This study introduces a new coding system, the Coding and Assessment System for Narratives of Trauma (CASNOT), to analyse several language domains in narratives of autobiographical memories, especially in trauma narratives. The development of the coding system is described. It was applied to assess positive and traumatic/negative narratives in 50 battered women (trauma-exposed group) and 50 nontrauma-exposed women (control group). Three blind raters coded each narrative. Inter-rater reliability analyses were conducted for the CASNOT language categories (multirater Kfree coefficients) and dimensions (intraclass correlation coefficients). High levels of inter-rater agreement were found for most of the language domains. Categories that did not reach the expected reliability were mainly those related to cognitive processes, which reflects difficulties in operationalizing constructs such as lack of control or helplessness, control or planning, and rationalization or memory elaboration. Applications and limitations of the CASNOT are discussed to enhance narrative measures for autobiographical memories.

Alcohol and psychotropic substance use in female Spanish victims of intimate partner violence.

BACKGROUND: Studies show high use of alcohol among American women who are victims of intimate partner violence (IPV), but not in Spanish victims. This study examines hazardous drinking, use of psychotropic substances, and the relationship with psychopathological symptoms in Spanish women who are victims of IPV. METHOD: 50 battered women and 50 control women from general population were assessed. RESULTS: Hazardous drinking in women victims of IPV (18.4% and 24.5%) was higher than in previous Spanish studies, and lower than in controls (no significant difference). Women victims of IPV showed a significantly higher use of psychotropic medication than controls (40% vs. 20%). For women victims of IPV, psychopathological symptoms were not related to use of alcohol, but use of psychotropic medication was related to post-traumatic arousal. CONCLUSIONS: Results suggest that Spanish women victims of IPV may resort to psychotropic medication rather than alcohol to cope with their symptoms.

Memory and narrative of traumatic events: A literature review.

This study presents a literature review of 22 studies published since 2004 that use linguistic procedures to evaluate narratives by persons who had suffered any traumatic event. The aim is to analyze the features of traumatic memories and, thus, how individuals construct and integrate their recall of what happened with other autobiographical memories. It uses cognitive theoretical models of posttraumatic stress disorder (PTSD) and their hypotheses about trauma memories as a framework. Findings reveal that trauma narratives are dominated by sensorial/perceptual and emotional details. The study of other narrative aspects (i.e., fragmentation, length, temporal context, and references to self) provides heterogeneous results. Results are discussed in light of the current state of PTSD research, exploring the principal hypotheses that have been proposed in cognitive theories to explain clinical findings.

Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims.

BACKGROUND: Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. OBJECTIVE: This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. METHOD: Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. RESULTS: Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. CONCLUSIONS: The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed.

Narrative Length and Speech Rate in Battered Women.

Narrative length and speech rate of traumatic recollections have been previously associated with different emotions and adjustment trajectories after trauma. However, the evidence is limited and the results are mixed. The present study aimed to evaluate length (i.e., word count) and speech rate (i.e., words per minute) in narratives of events with different valence (i.e., neutral, positive, and negative/traumatic) by 50 battered women (trauma group) and 50 non-traumatized women (controls). The results showed that traumatic narratives by the trauma group were longer than those by the control group. Moreover, they were inversely related to time since the event and anxiety during disclosure, whereas the speech rate was also inversely associated with anxiety, as well as with peritraumatic dissociation and avoidance. The shorter narratives for positive events and a decelerated speech pattern for traumatic experiences predicted psychological symptoms. Additionally, the individual's emotional state predicted narrative aspects, with bidirectional effects. Our findings showed that linguistic characteristics of traumatic narratives (but also of narratives of positive events) revealed information about how the victims elaborated autobiographical memories and coped with the trauma.

[Resilience in caregivers of patients with dementia: A preliminary study]. / Resiliencia en cuidadores de personas con demencia: estudio preliminar.

INTRODUCTION: Caring for a relative with dementia often has negative effects on the caregiver's physical and psychological health. However, many caregivers successfully cope with the stress factors arising from care, and even have uplifts during their experience, showing high resilience levels. This study presents a preliminary analysis of resilience in caregivers of patients with dementia, exploring its relationship with different variables. MATERIAL AND METHODS: Resilience was assessed (by CD-RISC) in 53 family caregivers of patients with dementia. Resilience was correlated to the following variables: caregiving context, stressors (e.g., cognitive impairment), appraisals (e.g., burden), moderators (e.g., personality traits and resources), and caregiving consequences (physical and psychological health). RESULTS: The participants showed moderate scores on resilience. Resilience was associated with poor emotional and physical status (significant inverse correlations with anxiety, depression, psycho-active drug use, health habits…). High resilience scores were significantly correlated to burden, neuroticism and extraversion, self-efficacy, self-esteem and less use of emotion focused coping strategies. CONCLUSIONS: Higher resilience relates to a good emotional and physical status in caregivers. Moreover, resilience is more associated with caregiver variables (e.g., appraisal and coping with care, personality features), than to situational variables. The data highlight the strengthening of these types of appraisal and coping as a way to improve caregivers' resilience and, consequently, their health.

Resiliencia en cuidadores familiares de personas mayores dependientes / Resilience in caregivers of elderly dependent relatives

El presente trabajo analiza la distribución de los niveles de resiliencia en cuidadores no profesionales (familiares) de personas mayores dependientes, y explora las características que poseen los cuidadores altamente resilientes. Para ello se administró la escala CD-RISC a una muestra de 111 cuidadores. En función de las puntuaciones obtenidas, se distinguieron dos grupos: alta vs. moderada o baja resiliencia. Se analizaron las diferencias entre ambos grupos en las diversas variables que afectan al estrés del cuidador. Aunque hubo diferencias en el estado cognitivo del receptor de cuidado, las mayores diferencias se obtuvieron en las denominadas variables mediadoras, observando en los cuidadores con alta resiliencia mayores puntuaciones en: satisfacción con el apoyo social recibido, autoeficacia para controlar los pensamientos negativos, autoestima, autocuidado y extraversión; y siendo estas diferencias estadísticamente significativas. Asimismo los cuidadores altamente resilientes tendieron a manifestar una menor preocupación por los problemas del mayor, y presentaron menores niveles de sintomatología depresiva y ansiosa. Este estudio pone de manifiesto la importancia de la resiliencia como factor de protección en el ámbito del estrés crónico, incorporando aspectos positivos de la adaptación a los modelos teóricos de cuidado, los cuales tradicionalmente se han venido centrando en el desarrollo de sintomatología

The present study analyzes resilience levels in caregivers of elderly dependent relatives and explores the characteristics of highly resilient caregivers. With this aim, the CD-RISC was selected to assess a sample of111 caregivers. According with CD-RISC scores, two groups of subject were established: high vs. moderate or low resilience. Differences between both groups were examined. Although there were differences in the cognitive status of care recipient, the more relevant differences were found inmediator variables. So, highly resilient group reported greater levels of: satisfaction with social support, self-efficacy to control negative thoughts, extraversion and self-care; being these differences statistically significant. Moreover resilient caregivers tended to show less reaction to patient behavioral disturbance, and they had lower levels of depression and anxiety symptoms. These findings emphasize the relevance of resilience as a protective factor in chronic stress situations. This involves the incorporation of positive aspects to theoretical models of caregiving, which traditionally have focused on the development of symptoms

Presentation of the Coding and Assessment System for Narratives of Trauma (CASNOT): Application in Spanish Battered Women and Preliminary Analyses

This study introduces a new coding system, the Coding and Assessment System for Narratives of Trauma (CASNOT), to analyse several language domains in narratives of autobiographical memories, especially in trauma narratives. The development of the coding system is described. It was applied to assess positive and traumatic/ negative narratives in 50 battered women (trauma-exposed group) and 50 nontrauma-exposed women (control group). Three blind raters coded each narrative. Inter-rater reliability analyses were conducted for the CASNOT language categories (multirater Kfree coefficients) and dimensions (intraclass correlation coefficients). High levels of inter-rater agreement were found for most of the language domains. Categories that did not reach the expected reliability were mainly those related to cognitive processes, which reflects difficulties in operationalizing constructs such as lack of control or helplessness, control or planning, and rationalization or memory elaboration. Applications and limitations of the CASNOT are discussed to enhance narrative measures for autobiographical memories (AU)

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Resiliencia, Personalidad Resistente y Crecimiento en Cuidadores de Personas con Demencia en el Entorno Familiar: Una Revisión / Resilience, Hardiness and Growth in Dementia Patients' Family Caregivers: A Review

La investigación en torno al cuidado no profesional de mayores con demencia ha proliferado a lo largo de los últimos años, constatando muchos autores que, del mismo modo en que el cuidado se asocia a un buen número de consecuencias negativas, diversos efectos positivos pueden derivarse de esta experiencia. Sin embargo, y a pesar del impacto de la corriente positiva en la actualidad, son muy escasos los estudios que valoran la personalidad resistente (hardiness), la resiliencia y el crecimiento personal en cuidadores. El presente artículo hace una revisión sistemática de las contribuciones más relevantes a este campo, a partir del análisis de nueve publicaciones. Todos estos trabajos evalúan, de un modo cuantitativo, la resiliencia, el hardiness o el crecimiento en familiares de personas con demencia. Las características y resultados de dichos trabajos serán valoradas, teniendo en consideración sus implicaciones para el estudio y la atención a los cuidadores (AU)

In the last few years, research into non professional caregiving for dementia patients has increased, and has shown that such caregiving carries both negative and positive effects. Nevertheless, in spite of the growing influence of positive psychology, studies focused on resilience, hardiness and personal growth in caregivers remain fairly scarce. The present article aimed to systematically review the existing studies on this topic, analyzing nine studies that assess resilience, hardiness or growth in dementia patients' family caregivers. The features and results of these studies will be discussed, considering their implications for the study of, and attention to, caregivers (AU)

Adaptación española de la "Escala de resiliencia de Connor-Davidson" (CD-RISC) en situaciones de estrés crónico / Spanish version of the Connor-Davidson Resilience Scale (CD-RISC) for chronic stress situations

El objetivo del estudio fue evaluar las propiedades psicométricas de la adaptación española de la "Escala de resiliencia de Connor-Davidson" (CD-RISC) en situaciones de estrés crónico, con 111 cuidadores familiares de personas mayores dependientes. Al calcular la fiabilidad de la escala y la correlación ítemescala se encontró que cuatro ítems afectaban negativamente su fiabilidad y fueron eliminados. La versión reducida de 21 ítems mostró una elevada fiabilidad (alfa= 0,90). El análisis factorial exploratorio arrojó cuatro factores (55,31% varianza explicada): afrontamiento y persistencia ante situaciones de estrés; capacidad de superación y logro de objetivos; valoración positiva y confianza. Los tres primeros factores mostraron una adecuada fiabilidad (alfa = 0,75-0,86); no así el cuarto, compuesto sólo por dos ítems. Respecto a la validez convergente y divergente, las puntuaciones globales de la CD-RISC mostraron correlaciones directas y significativas con medidas de autoestima y de percepción de autoeficacia del cuidador e inversas y significativas con depresión, ansiedad y carga del cuidador. En conclusión, esta nueva versión de la CD-RISC posee una fiabilidad y validez que permite su utilización en cuidadores

The aim of this study was to evaluate the psychometric properties of the Spanish adaptation of the Connor-Davidson Resilience Scale (CD-RISC) in chronic stress situations. The scale was administered to 111 non-professional caregivers of elderly dependent relatives. When calculating the reliability of the scale and the correlation item-scale, it was found that four items were affecting its reliability negatively and were removed. The reduced 21-item version showed good reliability (alfa = .90). Exploratory factor analysis yielded four factors (55.31% explained variance): coping and persistence in stress situations; strengthening effect of stress and orientation to targets; positive appraisal; and confidence. Factors 1-3, but not factor 4 (with only 2 items) showed adequate reliability (alfa = .75-.86). Regarding convergent and divergent validity, CD-RISC global scorings showed significant, direct correlations with self-esteem and perceived self-efficacy as caregiver measurements; and significant, inverse correlations with depression, anxiety and caregiver’s burden. In conclusion, this new CD-RISC version offers a reliability and validity that enables its use in caregivers

Resiliencia en cuidadores de personas con demencia: estudio preliminar / Resilience in caregivers of patients with dementia: a preliminary study

Introducción. La asistencia a un familiar con demencia a menudo tiene efectos negativos sobre la salud física y psicológica del cuidador. Sin embargo, muchos cuidadores se enfrentan con éxito a los estresores derivados del cuidado, e incluso obtienen beneficios de su experiencia, mostrándose resilientes. El estudio lleva a cabo un análisis preliminar de la resiliencia en cuidadores de personas con demencia y de las variables con las que se asocia. Material y métodos. Se evaluó la resiliencia (mediante CD-RISC) en 53 cuidadores no profesionales de personas con demencia. Se establecieron relaciones entre resiliencia y las siguientes variables: contexto del cuidado, estresores (p. ej., nivel de deterioro cognitivo del mayor), valoración de los estresores (p. ej., sobrecarga del cuidador), mediadores (p. ej., características de personalidad y recursos del cuidador), y consecuencias del cuidado (estado físico y emocional del cuidador). Resultados. Los participantes alcanzaron puntuaciones moderadas en resiliencia, llegando un 24,5% a altos niveles de resiliencia. La resiliencia se asoció de manera significativa a un peor estado emocional y físico del cuidador (correlaciones inversas significativas con ansiedad, depresión, consumo de psicofármacos, hábitos saludables,...). Puntuaciones altas en resiliencia correlacionaron significativamente con sobrecarga, niveles de neuroticismo y extraversión, percepción de autoeficacia, autoestima y menor utilización de estrategias de afrontamiento centradas en las emociones. Conclusiones. Una mayor resiliencia se asocia a un mejor estado emocional y físico de los cuidadores. Además, la resiliencia se asocia fundamentalmente a variables propias del cuidador (p. ej., percepción y afrontamiento de la situación, características de personalidad), más que a variables situacionales. Los datos ponen de manifiesto la posibilidad de potenciación de estos tipos de valoración de la situación de cuidado y de afrontamiento, para la mejora de la resiliencia y por ende de la salud de los cuidadores(AU)

Introduction. Caring for a relative with dementia often has negative effects on the caregiver's physical and psychological health. However, many caregivers successfully cope with the stress factors arising from care, and even have uplifts during their experience, showing high resilience levels. This study presents a preliminary analysis of resilience in caregivers of patients with dementia, exploring its relationship with different variables. Material and methods. Resilience was assessed (by CD-RISC) in 53 family caregivers of patients with dementia. Resilience was correlated to the following variables: caregiving context, stressors (e.g., cognitive impairment), appraisals (e.g., burden), moderators (e.g., personality traits and resources), and caregiving consequences (physical and psychological health). Results. The participants showed moderate scores on resilience. Resilience was associated with poor emotional and physical status (significant inverse correlations with anxiety, depression, psycho-active drug use, health habits...). High resilience scores were significantly correlated to burden, neuroticism and extraversion, self-efficacy, self-esteem and less use of emotion focused coping strategies. Conclusions. Higher resilience relates to a good emotional and physical status in caregivers. Moreover, resilience is more associated with caregiver variables (e.g., appraisal and coping with care, personality features), than to situational variables. The data highlight the strengthening of these types of appraisal and coping as a way to improve caregivers’ resilience and, consequently, their health(AU)