The role of resilience and coping strategies as predictors of well-being in breast cancer patients.

PURPOSE: This study investigated the role of resilience and coping strategies on breast cancer patients' well-being using a structural equation model. To achieve this objective, a model previously developed by Mayordomo's group was partially replicated using a longitudinal study design in an oncological sample. METHODS: The study was a longitudinal observational survey. Patients with breast cancer were recruited (N = 166). Resilience was measured with the Mexican Resilience Measurement Scale, coping strategies with the Forms of Coping and Dimensions Scale and perception of the psychological well-being with a short-form of Ryff's Scales of Psychological Well-Being at the start and end of adjuvant chemotherapy (T1 and T2 respectively). RESULTS: The results showed stability in the variables over time and revealed differences with respect to Mayordomo's model. The best predictor of well-being at T2 was well-being at T1. In addition, the model indicated that resilience had a direct impact on well-being through problem-focused coping. Indeed, resilience and problem-focused coping best explained well-being at T2. CONCLUSIONS: Both at the start and end of adjuvant chemotherapy for breast cancer, problem-focused coping positively predicted resilience, which in turn was a positive predictor of well-being. On the other hand, emotion-focused coping showed no association with resilience or well-being. As part of the multidisciplinary cancer team, oncology nurses have a key role to play in promoting resilience and problem-focused coping as an important goal of psychosocial interventions in breast cancer patients.

The role of personal recovery and internalised stigma on the expression of symptomatology in severe mental disorders: Mediating and moderating effects.

OBJECTIVE: Given the relevance of internalised stigma in people suffering from a mental disorder, in the present study, the possible mediating and moderating role of self-stigma in the relationship between personal recovery and symptomatology has been studied. METHOD: 265 participants with severe mental disorder completed the following instruments: ISMI (self-stigma), REE (personal recovery) and HoNOS, CGI, GAF and EuroQol (symptomatology). RESULTS: both the mediation and moderation analyses show significant results, which would indicate that internalised stigma has an effect on the relationship between personal recovery and symptomatology. Also, people with lower level of personal recovery and greater self-stigma have greater symptomatology than those who are in more advanced personal recovery processes and have a lower perception of internalised stigma. DISCUSSION: the findings of this study suggest that self-stigma has an effect, and the improvement at personal recovery and symptomatology is accentuated when people with a severe mental disorder have a better management of internalised stigma. Therefore, it may be interesting to include this variable in recovery interventions.

Outcomes Assessment in Psychological Treatment: Spanish adaptation of OQ-45 (Outcome Questionnaire) / Evaluación de resultados en el tratamiento psicológico: adaptación española del OQ-45 (Outcome Questionnaire)

Abstract Introduction: The Lambert's Outcomes Questionnaire (OQ-45) is a 45-item self-administered instrument used to measure clinical outcomes in psychotherapy. It measures functioning through three areas: symptoms distress, interpersonal relations and social role. The objective of this paper is to assess the reliability and the validity of its Spanish version. Method: A sample of 639 subjects, non-clinical and clinical, completed the instrument. Results: The psychometric evidences of the questionnaire showed an adequate internal consistency (.97 and .91) and acceptable convergent validity with the BDI, STAI, PSS and SF-12. The Confirmatory Factor Analyses suggested a bifactor structure. The cut-off points have been established for the subscales and total score (54.5), considering the clinical criterion, which means, prioritizing slightly the sensibility over the specificity. The RCI was 3.80 and Minimum Change Score 17.56. Conclusion: The OQ-45 showed acceptable psychometric properties, providing support for using this version of the questionnaire to assess Spanish's functionality. Given these findings, this tool could help clinicians evaluate treatment efficacy and establish psychotherapy goals.

Resumen Introducción: El instrumento Outcome Questionnaire (OQ-45) desarrollado por Lambert, se trata de una escala auto-administrada de 45-ítems que se utiliza para medir los resultados clínicos en psicoterapia. Esta herramienta evalúa el funcionamiento por medio de tres áreas: síntomas de malestar, relaciones interpersonales y rol social. El objetivo de este artículo es evaluar la fiabilidad y la validez de la versión española. Método: Una muestra de 639 personas, clínica y no clínica, cumplimentaron dicho instrumento. Resultados: Las evidencias psicométricas del cuestionario mostraron una consistencia interna adecuada (.97 y .91) y una validez convergente aceptable con las siguientes escalas: BDI, STAI, PSS y SF-12. Los análisis factoriales confirmatorios han sugerido una estructura bifactorial. Los puntos de corte se han establecido para las subescalas y la puntuación total (54.5), teniendo en cuenta el criterio clínico, lo que significa que se ha priorizado ligeramente la sensibilidad sobre la especificidad. El RCI ha sido de 3.80 y la puntuación mínima de cambio de 17.56. Conclusión: El OQ-45 ha mostrado propiedades psicométricas aceptables, que apoyan el uso de esta versión para valorar la funcionalidad de los españoles y, como consecuencia, podría ayudar a los clínicos a evaluar la eficacia del tratamiento y establecer objetivos en psicoterapia.

Design and evaluation of a positive intervention to cultivate mental health: preliminary findings

Abstract The past two decades have witnessed a proliferation of positive psychological interventions for clinical and nonclinical populations, and recent research, including meta-analyses, is providing evidence of its effectiveness. Most interventions have focused on increasing life satisfaction, positive affect, and psychological well-being. Manualized, multi-component interventions based on a comprehensive theory are scarce. Keyes' concept of mental health and flourishing (subjective, psychological, and social well-being) is an overarching theoretical framework to guide the design of a multi-component psychological intervention to cultivate well-being and personal development. Therefore, the purpose of this study was to design a theory-driven positive intervention and to pilot test the intervention. The manual presents an 8-week group program that includes homework activities. A sample of 56 young adults completed the intervention. Participants were assessed at base line, after termination, and at a 6-month follow-up session. Standardized instruments were used to assess the dimensions of mental health proposed by Keyes. Pre- and post-test measures of subjective, psychological, and social well-being showed significant differences, as did the total mental health scores. At 6-month follow-up, differences remained in subjective and psychological well-being and in positive mental health, with smaller effect sizes. Limitations of these preliminary findings as well as future lines of research and improvements in this manualized intervention are proposed in the light of current research on positive interventions.

Desarrollo de una Escala de Autoinforme para la valoración del TDAH en la infancia (EA-TDAH): Estudio Delphi y datos de adecuación psicométrica / Development of a self reported scale for ADHD in childhood (EA-ADHD): Delphi study and preliminary psychometric data

Eli objetivo del presente estudio es desarrollar una escala de evaluación del TDAH en la infancia, diseñada específicamente para ser respondida por los propios menores. Se generó una escala preliminar (IM1) basada en los criterios DSM-IV para el TDAH, incluyendo otros signos y síntomas relacionados. Se utilizó el método Delphi para analizar la validez aparente y de contenido. Asimismo se llevó a cabo un pilotaje de la versión final del instrumento (IM2) con una muestra normativa de 384 escolares de entre nueve y 17 años. El EA-TDAH fue valorado por los expertos como clínicamente útil y obtuvo una alta consistencia interna (α=.86) así como una validez estructural adecuada. El instrumento mostró validez discriminante en tanto que el grupo clasificado como 'No TDAH' mostró puntuaciones más bajas que el grupo 'Probable TDAH' (13.8%). Aunque se requiere ampliar el estudio incorporando muestras clínicas, la EA-TDAH parece ser una escala adecuada para valorar signos y síntomas de TDAH.

The purpose of this study is to develop a self reported scale specifically designed to assess ADHD symptoms and signs (EA-TDAH). Methods: A preliminary scale was generated based on DSM-IV criteria for ADHD and related signs. The Delphi technique was used due to analyze content and apparent validity. A pilot study was conducted using a normative sample compound by 382 children and adolescents aged nine to 17. The EA-TDAH scale was rated by experts as clinically useful, and it showed high internal consistency (α=.86) and an adequate structural validity with two components. According to YSR's DSM correspondences, participants were classified as possible ADHD cases (13.8%) and not ADHD cases, it was the first group that showed higher ratings in the new scale. Although further investigation with clinical samples is needed, EA-TDAH seems to be an adequate scale for assessing ADHD symptoms and signs.