Breastfeeding and maternal attachment: The moderating roles of maternal stress and child behavior.

PURPOSE: This study examined the effect of breastfeeding on maternal attachment, and explored the moderating role of maternal stress and child behavior in this relationship, in a sample of Spanish mothers with children aged between 2 and 7 years. DESIGN AND METHODS: A total of 432 mothers participated in a cross-sectional online survey. A three-way interaction model was used to test the moderating role of maternal stress and child behavioral problems in the relationship between breastfeeding and maternal attachment. RESULTS: The full model accounted for 19% of the variance of maternal attachment. Breastfeeding was significantly associated with mother-rated attachment, and the moderated moderation analysis confirmed the moderating effects of maternal stress and child behavior on the relationship between breastfeeding and maternal attachment. CONCLUSIONS: This study adds to the existing literature that supports the contribution that breastfeeding makes in enhancing maternal attachment, and may help to clarify the role of breastfeeding in shaping maternal attachment. Our findings suggest that breastfeeding is a factor in enhancing maternal attachment, and also identify maternal stress and child behavior as moderators of this relationship. PRACTICE IMPLICATIONS: Understanding the mechanisms by which breastfeeding affects maternal attachment will help generate recommendations to improve breastfeeding and maternal attachment.

Development and validation of a short version of the questionnaire of stressful life events (QSLE).

Stressful life events (SLE) tend to occur before the onset of psychosis, this highlights the importance of its detection and evaluation in these patients. The need to have instruments that assess SLE easily and quickly underpins the objective of this study, which is to validate a short version of the questionnaire of stressful life events (QSLE). 124 patients with first-episode psychosis and 218 healthy controls aged between 11 and 52 years were recruited. The QSLE scale underwent discrimination analysis, which revealed 18 items had good SLEs discriminability between the two samples. These 18 items were then used to create the shorter QSLE-SV. The QSLE-SV showed good internal consistency (Cronbach's alpha = 0.749). An AUC of 0.830 was observed, suggesting that the predictor was good. Using 2 as the cut-off score to predict an individual as a patient would yield a sensitivity of 91.1% and a specificity of 51.6%, and using a cut-off point of 3, the sensitivity was 77.4% and the specificity was 72.5%. QSLE-SV displayed satisfactory psychometric properties in a Spanish population. The QSLE-SV allows for investigating childhood, adolescent and adult life events by measuring current stress and age on a continuous scale in a quick and easy way.

Symptoms and functioning: a content analysis of the PANSS under the ICF framework.

PURPOSE: The study aimed to compare the content of the Positive and Negative Syndrome Scale (PANSS) with that of the International Classification of Functioning, Disability, and Health (ICF) and to examine the extent to which PANSS items are represented in the ICF Core Sets (ICF-CS) for schizophrenia. METHODS: The 30 items of the PANSS were linked to the ICF using established rules by two health professionals experienced in applying the ICF conceptual framework. RESULTS: PANSS items were linked to 42 unique ICF categories, corresponding mainly to the Body functions component; categories b160 Thought functions and b152 Emotional functions from this component were the most frequently linked. Regarding the Activities and participation component, the second-level category d720 Complex interpersonal interactions was the most frequently linked to PANSS items. Overall, PANSS items covered 18% and 40% of the categories included, respectively, in the Comprehensive and Brief versions of the ICF-CSs for schizophrenia. No PANSS items were linked to categories from the Body structures or Environmental factors components. CONCLUSIONS: The PANSS broadly covers the content of the ICF, especially as regards mental and movement-related functions, although it also covers some aspects of interpersonal relationships.

Effectiveness of a recovery workshop implemented in community mental health services in Catalonia (Spain): study protocol for a non-randomized controlled trial.

BACKGROUND: Many countries today are undergoing a paradigm shift in mental health policies towards a recovery-oriented and rights-based approach. From this perspective, self-determination and self-management are fundamental factors for recovery. Despite this shift, there is still a lack of evidence on the effectiveness of training programmes aimed at promoting self-determination and self-management in recovery processes implemented in southern European or Spanish-speaking countries. The aim of this paper is to present a study protocol that evaluates the effectiveness of a 12-session recovery workshop implemented in community mental health services in Catalonia (Spain). METHODS/DESIGN: This is a 12-week follow-up multi-centre non-randomized controlled trial design. At least 160 users will be recruited from 13 Community Rehabilitation Services (CRS) in Catalonia. Eligible participants are adult (≥ 18 years old) users of a CRS, who sign a written consent to participate. The experimental group participates in a recovery workshop, in which people learn to develop and implement their own plan of personal recovery, which includes a Wellness Toolbox, a Maintenance Toolkit, a Personal Growth Plan, a Mirror of Relapses, a Crisis Plan, and a Learning Agenda. The control group participates in the usual activities of the CRS. Data is collected using a questionnaire of sociodemographic characteristics, personal recovery, empowerment, hope and perceived social support. The users' measurements are taken at the baseline and one week after the end of the workshop. The primary outcome measures include the Self-Identified Stage of Recovery and the Maryland Assessment of Recovery in Serious Mental Illness Scale (short version). The secondary outcome measures include the Netherlands Empowerment List, Dispositional Hope Scale, and Multidimensional Scale of Perceived Social Support. Descriptive statistics for characterizing the sample size will be performed. Multivariate analyses for repeated measures designs will be used to evaluate the primary and secondary outcomes. Between-group and within-subject comparisons will be conducted. DISCUSSION: The results of the study will provide information on the usefulness of recovery workshops in a Mediterranean cultural context. Additionally, if this workshop is effective, it will be proposed for inclusion within the portfolio of community mental health services in Catalonia. TRIAL REGISTRATION: ISRCTN11695542 (Registration date: 5 July 2022).

The psychometric properties of the parenting scale for Spanish mothers with children aged between 2 and 7 years.

PURPOSE: This study aimed to evaluate the psychometric properties of the Spanish version of the Parenting Scale in a large sample of Spanish mothers. DESIGN AND METHODS: A two-stage cross-sectional study of the adaptation and cultural validation of the Parenting Scale in a Spanish-speaking environment. In Stage I, the Parenting Scale was translated and back-translated and its semantic, linguistic and contextual equivalence was assessed. In Stage II, the Spanish-language version was validated after its application to 662 Spanish mothers with healthy children aged between 2 and 7 years. Several factor structure models of the Parenting Scale were compared by confirmatory factor analysis. Convergent validity, internal consistency and test-retest reliability were also examined. RESULTS: The model of Irvine et al. (1999) presented the best fit to our data. This model demonstrated adequate reliability (internal consistency and stability). The total score and each factor of the Parenting Scale correlated positively with perceived stress in mothers, difficulties in mother-child bonding and child hyperactivity, and negatively with child prosocial behavior. CONCLUSIONS: The Spanish version of the Parenting Scale is a valid and reliable measure that can be used by healthcare professionals and scientists to assess dysfunctional parenting in Spanish mothers of children aged 2 to 7 years. PRACTICE IMPLICATIONS: This study will allow the use of the Parenting Scale in epidemiological and cross-cultural studies in a variety of applied contexts. Additionally, health professionals who work with families in Spain will have access to a valid and reliable instrument for the assessment of mothers' parenting styles.

The Maternal Attachment Inventory: Development and validation of a short form.

AIMS: To translate and adapt the Maternal Attachment Inventory (MAI) into Spanish; to develop a short form of the instrument that can be used during early childhood; and to test its psychometric properties in a large sample of Spanish mothers. DESIGN: Cross-sectional study of adaptation and cultural validation of instruments. METHODS: Data were collected between February and September 2018. In Stage I, the instrument was culturally adapted using a standardized translation and back-translation method. In Stage II, the factor structure of the Spanish version was tested in a sample of 300 mothers with children aged between 2 and 7 years, and on the basis of the findings a short form of the instrument was developed. Finally, in Stage III, in a second sample of 356 mothers, confirmatory factor analyses of first-, second-order and bi-factor structure were conducted to find the optimal factor structure of the short form of the Spanish MAI. Convergent validity, internal consistency and test-retest reliability were also examined. RESULTS: A bi-factor structure with four sub-scales and 17 items emerged from the factor analyses conducted in Stages II and III. Scores on the short form were negatively correlated with mother-to-infant bonding disorders. The short form presented adequate internal consistency and test-retest reliability. CONCLUSIONS: The Spanish MAI short form is a valid and reliable measure for assessing maternal attachment in mothers of children aged between 2 and 7 years. IMPACT: We present a short version of the MAI for healthcare professionals, adapted for application in a new age range and validated for use with Spanish mothers.

Occupational Therapists' Perspective on the International Classification of Functioning, Disability and Health Core Sets (ICF-CS) for Schizophrenia.

IMPORTANCE: The International Classification of Functioning, Disability and Health (ICF) Core Sets (CSs) for schizophrenia are sets of ICF categories that are relevant specifically to the functioning and disability of people with schizophrenia. OBJECTIVE: To identify the problems occupational therapists commonly encounter when treating people with schizophrenia and to validate the ICF-CSs for schizophrenia from their perspective. DESIGN: Three-round Delphi study using online surveys distributed to occupational therapists worldwide. Participants were asked which problems with functioning they considered most relevant when treating people with schizophrenia. PARTICIPANTS: Occupational therapists experienced in the treatment of people with schizophrenia. MEASURES: Responses were linked to the ICF categories by two trained health professionals, and a statistical measure of agreement and κ coefficient were calculated. RESULTS: Ninety-two occupational therapists from 29 countries in all six World Health Organization regions named 2,527 meaningful concepts. After the linking process, 121 ICF categories and 31 Personal Factors were presented to the expert panel, who reached consensus (agreement of ≥75%) on 97 ICF categories and 27 Personal Factors. Consensus was reached on the 25 categories in the Brief ICF-CS for schizophrenia and 89 of the 97 categories in the Comprehensive ICF-CS for schizophrenia. CONCLUSIONS AND RELEVANCE: The ICF Core Sets for schizophrenia were validated from the perspective of occupational therapists and are potentially useful tools for clinical practice because they cover a wide variety of problems that occupational therapists deal with in interventions with people with schizophrenia. WHAT THIS ARTICLE ADDS: The ICF-CSs for schizophrenia are useful guides for describing and classifying functioning, disability, and health to aid occupational therapy intervention with people with schizophrenia. Occupational therapists are essential in the rehabilitation of this client population, and their perspective has contributed to the development and enrichment of the ICF-CSs for schizophrenia.

Translation and validation of Baron Cohen’s face test in a general population from Spain.

Facial emotion recognition is considered the foundation of effective social functioning, but it has been found impaired in several clinical populations. How- ever, there are few validated tests to measure the ability. To the best of our knowledge, there is no validated measure in a Spanish population. We translated and validated Baron Cohen’s Face Test in a general Spanish population.

Employment Support Needs of People with Schizophrenia: A Scoping Study.

Purpose People with schizophrenia continue to encounter barriers to employment acquisition. The aim of this scoping study was to identify and synthesize existent evidence about the employment support needs of people diagnosed with schizophrenia. Methods Five relevant databases were used: CINAHL, Medline, PsycINFO, SCOPUS, and Web of Science. Additional material of potential interest was identified through the references of the retrieved articles. A manual search for publications from the 3 months immediately prior to the electronic search was carried out in specialized journals. Searches covered the period between 1945 and August 30, 2017 without language restrictions. Two approaches were used to display the data: descriptive analysis and thematic analysis. Results Twelve articles met the inclusion criteria, most of which discussed experiences of participation in individual placement and support programmes. Thematic analysis identified four support needs: developing skills, vocational intervention, support and encouragement, and a supportive work environment. Conclusions There is a paucity of literature examining and evaluating employment support needs from the perspectives of people with schizophrenia. Future research must look beyond individual factors affecting employment outcomes to consider societal attitudes, stigma and work-related legislation.

The Relationship Between Religiosity and Anxiety: A Meta-analysis.

Several research studies from the USA and Western industrialized countries have reported a negative association between religiosity and anxiety. However, Arabic studies using mainly Muslim samples are limited. The objective of the present study was to apply meta-analysis statistical techniques to 10 Arabic studies of this association. All of the respondents were Arab citizens, ranging in age between 14 and 43 years, and the vast majority of them were Muslims. Religiosity and anxiety were assessed with seven different scales. In all of the studies, the administration of the scales was in small group sessions and in the Arabic language. Pearson correlation coefficients were calculated between the religiosity and anxiety scale scores. All the correlations were negative. All but one were statistically significant, ranging from - 0.16 to - 0.43. The mean effect size was - 0.22, and the impact of age and gender on the correlation was not significant. This result suggests that religiosity may affect anxiety by providing buffering and coping mechanisms.

The Relationship of Motivation and Neurocognition with Functionality in Schizophrenia: A Meta-analytic Review.

The role that neurocognition plays in functionality in schizophrenia has been widely examined, although in recent years increasing attention has been paid to the influence of motivation instead. This study provides a review of the relationship of neurocognition and motivation with functionality in schizophrenia, taking into account objective/subjective functionality assessment, demographic variables, and the different terms used when referring to motivation. A search of electronic databases identified 34 studies that met the inclusion criteria for review. Correlation coefficients between motivation and functionality and between neurocognition and functionality were extracted. For a better understanding, potential moderator variables were also extracted. Meta-analysis showed that both motivation and neurocognition assessments were strongly associated with functioning, with correlations between motivation and functional outcomes being stronger. However, more than three-quarters of the variance in outcome remained unexplained by the moderating factors examined. The paper concludes with recommendations for clinical practice and future research.

Spanish Adaptation of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-S) in Nursing Undergraduates.

The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) is designed to assess the attitudes of professionals and trainees toward caring for the dying patient and their family members. In this study the main aim is to adapt the FATCOD to a Spanish context (FATCOD-S). In addition, the relations between FATCOD-S, sociodemographic variables, emotional intelligence, and death attitudes have been analyzed. A sample of 669 Spanish nursing students from four Universities responded to a questionnaire. The exploratory factor analysis (EFA) concludes a structure composed of two significant factors. A confirmatory factor analysis (CFA) was carried out. The CFA supported a two-factor model. Students with past experience of death and those who had received training in palliative care scored significantly higher on both factors of the FATCOD-S ( p < 0.01). The FATCOD-S is an effective and valid tool for measuring the attitudes of Spanish nursing students toward caring for patients at the end of life.

Clinical case management for patients with schizophrenia with high care needs.

The aim of this study is to establish the effectiveness of a clinical case management (CM) programme compared to a standard treatment programme (STP) in patients with schizophrenia. Patients for the CM programme were consecutively selected among patients in the STP with schizophrenia who had poor functioning. Seventy-five patients were admitted to the CM programme and were matched to 75 patients in the STP. Patients were evaluated at baseline and at 1 year follow-up. At baseline, patients in the CM programme showed lower levels of clinical and psychosocial functioning and more care needs than patients in the STP. Both treatment programmes were effective in maintaining contact with services but the CM programme did not show advantages over the STP on outcomes. Differences between groups at baseline may be masking the effects of CM at one year follow-up. A longer follow-up may be required to evaluate the real CM practices effects.

Perceived emotional intelligence in nursing: psychometric properties of the Trait Meta-Mood Scale.

AIMS AND OBJECTIVES: To examine the psychometric properties of the Trait Meta-Mood Scale in the nursing context and to determine the relationships between emotional intelligence, self-esteem, alexithymia and death anxiety. BACKGROUND: The Trait Meta-Mood Scale is one of the most widely used self-report measures for assessing perceived emotional intelligence. However, in the nursing context, no extensive analysis has been conducted to examine its psychometric properties. DESIGN: Cross-sectional and observational study. METHODS: A total of 1417 subjects participated in the study (1208 nursing students and 209 hospital nurses). The Trait Meta-Mood Scale, the Toronto Alexithymia Scale, the Rosenberg Self-Esteem Scale and the Death Anxiety Inventory were all applied to half of the sample (n = 707). A confirmatory factor analysis was carried out, and statistical analyses examined the internal consistency and test-retest reliability of the Trait Meta-Mood Scale, as well as its relationship with relevant variables. RESULTS: Confirmatory factor analysis confirmed the three dimensions of the original scale (Attention, Clarity and Repair). The instrument showed adequate internal consistency and temporal stability. Correlational results indicated that nurses with high scores on emotional Attention experience more death anxiety, report greater difficulties identifying feelings and have less self-esteem. By contrast, nurses with high levels of emotional Clarity and Repair showed less death anxiety and higher levels of self-esteem. CONCLUSIONS: The Trait Meta-Mood Scale is an effective, valid and reliable tool for measuring perceived emotional intelligence in the nursing context. Training programmes should seek to promote emotional abilities among nurses. RELEVANCE TO CLINICAL PRACTICE: Use of the Trait Meta-Mood Scale in the nursing context would provide information about nurses' perceived abilities to interpret and manage emotions when interacting with patients.

Neurodevelopment or neurodegeneration: review of theories of schizophrenia.

Many hypothesis have tried to explain the aetiology of schizophrenia, the abnormal neurodevelopmental hypothesis is one of the most widely acknowledged and is based on the presence of both prenatal and perinatal disorders, differences in IQ or the existence of genetic abnormalities, which, with the interaction of certain environmental factors, schizophrenia could occur at some point in the development. This hypothesis provides a good account of how these factors result in an alteration in the normal development and how they can lead to a disorder of schizophrenia. On the other hand, a smaller but not insignificant number of studies based on variables such as the presence of neurotoxicity in the brains of individuals with schizophrenia, alterations at the structural and brain connectivity, suggest the existence of a degenerative process in the course of this disease. In this work, we review the different factors underlying both hypotheses, some of which are difficult to categorize in either approach given the controversy and lack of consensus in their interpretation of the available data. Finally, we discuss the need for a non-exclusive alternative model to help understand the available evidence on the origin, course and consequences of the disease.

Testing the latent structure, factorial equivalence, and external correlates of the brief self-control scale in a community sample of Spanish adults.

The Brief Self-Control Scale (BSCS) is a 13-item personality measure capturing how people differ in their capacity to exert self-control. Although the BSCS was originally regarded as a one-dimensional scale, subsequent psychometric studies have provided support for the empirical distinction of two and four interrelated but distinct components of self-control. Using a large sample of Spanish adults (n = 1,558; 914 female, 58.7%), we performed a comprehensive data-driven comparison of the most well-established item-level latent structures for the BSCS. Results showed that the differentiation between general self-discipline and impulse control offered a better fit to the observed data than did the unidimensional representation of self-control. This two-dimensional structure for the BSCS scores was also supported in terms of its internal consistency, measurement invariance across gender and age groups, and meaningful correlations with wellbeing-related indicators and Big Five personality traits. Plausible implications of these findings are discussed.

Evidence of Validity and Reliability for the Spanish Version of the Self-Identified Stage of Recovery.

BACKGROUND: The Self-Identified Stage of Recovery (SISR) () is a scale used to assess both the stage of recovery (SISR-A) and the components of the process of personal recovery (SISR-B). This study aimed to develop the Spanish version of the SISR and obtain evidence of validity and reliability in a sample of 230 users of community mental health services. METHOD: The Spanish version of the SISR was developed following the translation-back translation procedure, with the support of a committee of experienced experts. The SISR was examined in terms of dimensional structure, internal consistency, relationships with other variables (i.e., the Maryland Recovery Assessment Scale [MARS-12] and the Dispositional Hope Scale [DHS]), and temporal stability (n = 66). Differential item functioning (DIF) by gender was analysed. RESULTS: The study confirmed the unidimensionality of the SISR-B and suitable internal consistency of its scores (ω = .83, α = .83). Scores from both SISR-A and SISR-B showed good temporal stability and the SISR-B displayed strong correlations with the MARS-12 (rs = .78) and the DHS (rs = .67). No DIF was found. CONCLUSIONS: This study supports the validity and reliability of the scores of the Spanish version of the SISR.

Relationship between emotional awareness, symptoms, and protective factors in children exposed to intimate partner violence.

OBJECTIVE: This study was designed to analyze the associations between emotional awareness (EA) and internalizing and externalizing symptoms, and mood states in children ages 8-12 who were previously exposed to intimate partner violence (EIPV). The study also aimed to explore the association between EA and external and internal protective factors of resilience. METHOD: A descriptive design study was used; participants were 61 children (M = 10 years, 52.5% girls) who were EIPV patients from three Child and Adolescent Mental Health Centers in the Barcelona metropolitan area, Spain. The hypotheses of this study were that (a) an increased capacity for EA would be associated with less severity of internalizing and externalizing symptoms in children EIPV and (b) an increased capacity for EA would correlate with greater resilience. RESULTS: Lower EA was found to be associated with more symptoms, specifically trait anxiety, depression, somatic complaints, total externalizing and internalizing symptoms, and increased feelings of anger and sadness. Greater EA was linked to improved social skills, higher self-esteem, empathy, humor, and both external and internal resilience, as well as with reduced aggressiveness/antisocial behavior and loneliness/social anxiety. The variables that best explained the EA factors were trait anxiety, dysphoria, problem attention, sadness, humor, self-esteem, internal and external protective factors, appropriate social skills, and friendship. CONCLUSION: This study highlights the relevance of EA for children EIPV. Lower EA was associated with higher symptom severity, while higher EA was linked to better self-esteem, social skills, and resilience. The findings suggest the significance of addressing EA in therapeutic interventions for this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Cornell-Brown scale for quality of life in dementia: Spanish adaptation and validation.

The objective of this study was to validate a Spanish version of the Cornell-Brown Scale (CBS) for quality of life (QoL) in dementia. One hundred persons with mild-to-moderate dementia (Diagnostic and Statistical Manual of the American Psychiatric Association, 4th edition) were recruited and interviewed at 5 Spanish centers to obtain sociodemographic information, health perceptions, depressive symptoms (Geriatric Depression Scale 15-item version), functional ability (Barthel Index), dementia severity (Mini-Mental State Examination), specific QoL (CBS), and generic QoL (World Health Organization Quality of Life-BREF version). Analysis was carried out using classical psychometric methods. Internal consistency reliability for the CBS was good (0.87). A priori hypotheses about the relationship between CBS and the World Health Organization Quality of Life-BREF version psychological domain and Geriatric Depression Scale 15-item version were confirmed, indicating good construct validity. Regarding contrasting groups' differences, CBS scores significantly differentiated between healthy and unhealthy and depressed and nondepressed participants but not between those with mild and moderate dementia. The exploratory factor analysis showed a 5-factor solution, which accounted for 63.9% of the total variance of CBS. This study is the first to report the factor structure of the CBS. These results indicate that CBS is a useful tool in assessing persons with dementia. Replication of these results with larger samples is advised. The Spanish version of the CBS is reliable and valid in persons with mild/moderate dementia who are living at home and with a known caregiver.

The screen for cognitive impairment in psychiatry: diagnostic-specific standardization in psychiatric ill patients.

BACKGROUND: The Screen for Cognitive Impairment in Psychiatry (SCIP) is a simple and easy to administer scale developed for screening cognitive deficits. This study presents the diagnostic-specific standardization data for this scale in a sample of schizophrenia and bipolar I disorder patients. METHODS: Patients between 18 and 55 years who are in a stable phase of the disease, diagnosed with schizophrenia, schizoaffective disorder, schizophreniform disorder, or bipolar I disorder were enrolled in this study. RESULTS: The SCIP-S was administered to 514 patients (57.9% male), divided into two age groups (18-39 and 40-55 years) and two educational level groups (less than and secondary or higher education). The performance of the patients on the SCIP-S is described and the transformed scores for each SCIP-S subtest, as well as the total score on the instrument, are presented as a percentile, z-score, T-scores, and IQ quotient. CONCLUSIONS: We present the first jointly developed benchmarks for a cognitive screening test exploring functional psychosis (schizophrenia and bipolar disorder), which provide increased information about patient's cognitive abilities. Having guidelines for interpreting SCIP-S scores represents a step forward in the clinical utility of this instrument and adds valuable information for its use.