Exploring the structure of the GAD-7 scale in primary care patients with emotional disorders: A network analysis approach.

OBJECTIVE: Anxiety symptoms are one of the most frequent manifestations in people attending primary care, although how the symptoms are associated is unclear. This study aimed to establish the symptom structure of the Generalized Anxiety Disorder scale (GAD-7) using a novel network approach in combination with traditional analytical tools. METHODS: A sample of 1704 primary care patients with emotional disorders (i.e., anxiety, depression, and/or somatization) completed the GAD-7 to report their anxiety symptoms. We examined the GAD-7 structure using exploratory graph analysis (EGA) compared to exploratory factor analysis (EFA) and confirmatory factor analysis. RESULTS: The EFA results showed a one-factor solution, but EGA revealed a two-factor solution (cognitive-emotional and somatic). "Worrying too much" and "difficulty relaxing" were the most relevant symptoms. CONCLUSIONS: The results support the possible distinction between the somatic and cognitive-emotional components of the GAD-7, thus permitting more specific screening in primary care settings.

A modern network approach to revisiting the Positive and Negative Affective Schedule (PANAS) construct validity.

INTRODUCTION: The factor structure of the Positive and Negative Affective Schedule (PANAS) is still a topic of debate. There are several reasons why using Exploratory Graph Analysis (EGA) for scale validation is advantageous and can help understand and resolve conflicting results in the factor analytic literature. OBJECTIVE: The main objective of the present study was to advance the knowledge regarding the factor structure underlying the PANAS scores by utilizing the different functionalities of the EGA method. EGA was used to (1) estimate the dimensionality of the PANAS scores, (2) establish the stability of the dimensionality estimate and of the item assignments into the dimensions, and (3) assess the impact of potential redundancies across item pairs on the dimensionality and structure of the PANAS scores. METHOD: This assessment was carried out across two studies that included two large samples of participants. RESULTS AND CONCLUSION: In sum, the results are consistent with a two-factor oblique structure.

Psychometric Analysis of Two Brief Versions of the CERQ in the Argentinean Population: CERQ-18 and CERQ-27.

Background: Emotion Regulation (ER) involves any explicit or implicit process that may alter the emotion felt, its duration and expression, and is a transdiagnostic factor of vulnerability involved in the etiology and maintenance of different emotional disorders. The Cognitive Emotion Regulation Questionnaire (CERQ) assesses nine cognitive strategies involved in ER and is a valuable tool. Its popularity and wide use led to the development of two abbreviated versions: a version with 18 items (two items per factor) and a 27-item version (three items per factor). Objective: To analyze the psychometric properties of both versions in the Argentinean population. Design: The research design was instrumental. The factor structure of the CERQ-18 and CERQ-27 as well as the reliability of the scores and the construct of each dimension were evaluated. In addition, we gathered validity evidence for its relationship with other variables by associating the CERQ scores with Difficulties in Emotion Regulation Scale (DERS) scores. Results: The CERQ-18 presented more consistent evidence regarding its internal structure (adequate fit indices and factor loadings of moderate magnitude) and reliability. Given that the association of the two versions with the DERS is similar, we recommend that the 18-item version be used. Conclusion: The CERQ-18 has quite similar psychometric properties to the CERQ-27 in the general population of Argentina and the findings contribute to an understanding of its internal structure.

Cost-effectiveness of transdiagnostic group cognitive behavioural therapy versus group relaxation therapy for emotional disorders in primary care (PsicAP-Costs2): Protocol for a multicentre randomised controlled trial.

Several randomised controlled trials (RCT) have demonstrated the superiority of transdiagnostic group cognitive-behavioural therapy (TD-CBT) to treatment as usual (TAU) for emotional disorders in primary care. To date, however, no RCTs have been conducted to compare TD-CBT to another active intervention in this setting. Our aim is to conduct a single-blind RCT to compare group TD-CBT plus TAU to progressive muscle relaxation (PMR) plus TAU in adults (age 18 to 65 years) with a suspected emotional disorder. We expect that TD-CBT + TAU will be more cost-effective than TAU + PMR, and that these gains will be maintained at the 12-month follow-up. Seven therapy sessions (1.5 hours each) will be offered over a 24-week period. The study will be carried out at four primary care centres in Cantabria, Spain. The study will take a societal perspective. Psychological assessments will be made at three time points: baseline, post-treatment, and at 12-months. The following variables will be evaluated: clinical symptoms (anxiety, depression, and/or somatic); functioning; quality of life (QoL); cognitive-emotional factors (rumination, worry, attentional and interpretative biases, emotion regulation and meta-cognitive beliefs); and satisfaction with treatment. Data on health service use, medications, and sick days will be obtained from electronic medical records. Primary outcome measures will include: incremental cost-effectiveness ratios (ICER) and incremental cost-utility ratios (ICURs). Secondary outcome measures will include: clinical symptoms, QoL, functioning, and treatment satisfaction. Bootstrap sampling will be used to assess uncertainty of the results. Secondary moderation and mediation analyses will be conducted. Two questionnaires will be administered at sessions 1, 4, and 7 to assess therapeutic alliance and group satisfaction. If this trial is successful, widespread application of this cost-effective treatment could greatly improve access to psychological treatment for emotional disorders in the context of increasing demand for mental healthcare in primary care. Trial registration: ClinicalTrials.gov: Cost-effectiveness of a Transdiagnostic Psychological Treatment for Emotional Disorders in Primary Care (PsicAP). NCT05314920.

Contribution of Academic Satisfaction Judgments to Subjective Well-Being.

The role of academic satisfaction (AS) on persistence and successful academic behavior has been the focus of research for decades. Nevertheless, driven by positive educational psychology, subjective well-being has been highlighted as another central feature in the academic path of students. Studies aimed at identifying the variables that contribute to explain different aspects of academic performance have been widely investigated, although studies aimed at identifying the determinants of subjective well-being are still limited. The present paper examined the contribution of AS judgments on subjective well-being (SWB). To this end, it was hypothesized that SWB levels depend on the balance between positive/negative emotions and life satisfaction judgments. Furthermore, it was stipulated that AS has an indirect contribution on SWB, through life satisfaction, whereas the balance of emotions influences both AS judgments and life satisfaction. Using an analysis strategy based on structural equation modeling, the results indicated that the model fitted satisfactorily, explaining 32% of the variance of SWB. Particularly, it was observed that AS judgments contributed to life satisfaction judgments (ß = 0.34). Although no direct contribution of AS on SWB was reported, a total contribution partially mediated by life satisfaction judgments was revealed (total ß = 0.19). These findings support the importance of academic satisfaction judgments, not only because of their importance in academic terms, but also because of their impact on university students' subjective well-being and health.

Improving Access to Psychological Therapies in Spain: From IAPT to PsicAP.

BACKGROUND: Anxiety and depression are very prevalent in primary care, with high rates of chronic cases, comorbidity and lost quality of life, along with huge economic costs. The Improving Access to Psychological Therapies (IAPT) project, launched in the United Kingdom in 2007, has become an international benchmark for the treatment of common mental disorders. In Spain, Psicofundación developed the PsicAP clinical trial, following the precedent set by the IAPT. METHOD: This study reviews and compares and contrasts the methods, results, and contributions of the IAPT and PsicAP. RESULTS: The IAPT is a project for the pragmatic implementation of evidence-based psychological therapies in primary care. PsicAP is a randomized clinical trial whose results demonstrated that adding a psychological treatment (seven group sessions of transdiagnostic cognitive-behavioural therapy) to treatment-as-usual (TAU) for anxiety and depression in the primary care setting was more effective and cost-effective than TAU alone. The therapeutic gains and the cost-effectiveness were maintained at a 12 months follow-up. Moreover, the percentage of reliably recovered patients was comparable to the numbers from the IAPT. CONCLUSIONS: This brief psychological treatment should be implemented in the Spanish public health system, similar to the precedent set by the IAPT initiative.

Psychometric properties of the Mindful Attention Awareness Scale (MAAS) in a first-episode psychosis sample.

Despite the considerable growth in mindfulness-based research in the field of psychosis, few attempts have been made to validate mindfulness instruments in this population. This study aimed to evaluate the factorial structure, internal consistency, construct validity, and longitudinal measurement invariance of the Mindful Attention Awareness Scale (MAAS) in a sample of individuals with first-episode psychosis (FEP). In a sample of 150 individuals with remitted FEP, the present study explored the factor structure, measurement invariance, reliability, convergent and discriminant validity of the MAAS. Confirmatory factor analysis supported a single-factor solution, which showed temporal stability, excellent internal consistency reliability (Cronbach's α = .92; McDonald's ω = .93), and theoretically coherent convergent and discriminant validity with measures of well-being, satisfaction with life, savoring, self-compassion, depression, anxiety, stress, and positive symptoms. Overall, the psychometric properties of the MAAS were similar to those described in previous validation studies, thus supporting the value of this instrument to assess the dimension of attention and awareness to the present moment in individuals with FEP. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of social relatedness and self-beliefs in social functioning in first-episode psychosis: Are we overestimating the contribution of illness-related factors?

OBJECTIVE: Numerous research studies have demonstrated an association between higher symptom severity and cognitive impairment with poorer social functioning in first-episode psychosis (FEP). By contrast, the influence of subjective experiences, such as social relatedness and self-beliefs, has received less attention. Consequently, a cohesive understanding of how these variables interact to influence social functioning is lacking. METHOD: We used structural equation modeling to examine the direct and indirect relationships among neurocognition (processing speed) and social cognition, symptoms, and social relatedness (perceived social support and loneliness) and self-beliefs (self-efficacy and self-esteem) in 170 individuals with FEP. RESULTS: The final model yielded an acceptable model fit (χ2 = 45.48, comparative fit index = 0.96; goodness of fit index = 0.94; Tucker-Lewis index = 0.94; root mean square error of approximation = 0.06) and explained 45% of social functioning. Negative symptoms, social relatedness, and self-beliefs exerted a direct effect on social functioning. Social relatedness partially mediated the impact of social cognition and negative symptoms on social functioning. Self-beliefs also mediated the relationship between social relatedness and social functioning. CONCLUSIONS: The observed associations highlight the potential value of targeting social relatedness and self-beliefs to improve functional outcomes in FEP. Explanatory models of social functioning in FEP not accounting for social relatedness and self-beliefs might be overestimating the effect of the illness-related factors.

Cognitive processes of emotional regulation, burnout and work engagement.

BACKGROUND: Workers constantly resort to cognitive processes of emotion regulation to deal with emotions they experience in the workplace. These processes belong either to the "automatic" (preconscious and fast) or the "elaborative" (conscious and slow) mode. This study aims to determine the role of these variables in the work setting and to analyze their relationship with positive and negative affect, engagement and burnout. METHOD: 350 employees (54.8% men and 45.2% women) were presented with several instruments measuring burnout, engagement, affect and cognitive emotion regulation strategies in a prospective study. An explanatory model was tested through structural equation modeling analysis. RESULTS: Acceptable fit indices and a significant explanatory value both for burnout (61%) and engagement (58%) were obtained. The use of "automatic" cognitive regulation strategies was associated with the presence of negative affect and burnout whereas "elaborative" processes were associated with positive affect and engagement. CONCLUSIONS: Our findings underscore the importance of the role of cognitive emotion regulation in organizational settings.

Cost-Effectiveness and Cost-Utility Analysis of the Treatment of Emotional Disorders in Primary Care: PsicAP Clinical Trial. Description of the Sub-study Design.

Introduction: In the primary care (PC) setting in Spain, the prevalence of emotional disorders (EDs) such as anxiety, depression and somatoform disorder is high. In PC patients, these disorders are not always managed in accordance with the recommendations provided by clinical practice guidelines, resulting in major direct and indirect economic costs and suboptimal treatment outcomes. The aim is to analyze and compare the cost-effectiveness and cost-utility of group-based psychological therapy versus treatment as usual (TAU). Methods: Multicenter, randomized controlled trial involving 300 patients recruited from PC centers in Madrid, Spain, with symptoms or possible diagnosis of anxiety, mood (mild or moderate), or somatoform disorders. Patients will be randomized to one of two groups: an experimental group, which will receive group-based transdiagnostic cognitive-behavioral therapy (TD-CBT); and a control group, which will receive TAU (mainly pharmacological interventions) prescribed by their general practitioner (GP). Clinical assessment will be performed with the Patient Health Questionnaire (PHQ). Direct and indirect costs will be calculated and relevant socio-demographic variables will be registered. The Spanish version of the EuroQol 5D-5L will be administered. Patients will be assessed at baseline, immediately after treatment finalization, and at 6 and 12 months post-treatment. Discussion: To our knowledge, this is the first study to compare TD-CBT to TAU in the PC setting in Spain. This is the first comparative economic evaluation of these two treatment approaches in PC. The strength of the study is that it is a multicenter, randomized, controlled trial of psychotherapy and TAU for EDs in PC. Trial registration: Protocol code: ISCRCTN58437086; 20/05/2013.                                        EUDRACT: 2013-001955-11.                                        Protocol Version: 6, 11/01/2014.

Análisis psicométrico del Cuestionario de ción Conductual de las Emociones en universitarios peruanos / Psychometric analysis of the Behavioral Regulation of Emotions Questionnaire in Peruvian university students

Resumen La presente investigación tuvo como objetivo traducir e identificar las propiedades psicométricas del Behavioral Emotion Regulation Questionnaire (BERQ) en 315 universitarios de Lima, Perú, entre los 16 y 44 años (M edad = 21.31; DE edad = 3.39; 59.7 % hombres). Para la evaluación se aplicó el BERQ y el Inventario Multicultural de Depresión Estado Rasgo (IMÜDER), y las evidencias de validez de la estructura interna se obtuvieron por medio de un análisis factorial confirmatorio y un modelamiento exploratorio de ecuaciones estructurales, mientras que las evidencias de validez en relación con otras variables se obtuvieron a través de un análisis de regresión lineal. Los resultados indican que la estructura pentafactorial se replica en la muestra peruana, que las estrategias adaptativas predicen significativamente el eutrés, y que las estrategias desadaptativas predicen el distrés; además, los valores de confiabilidad fueron aceptables. Al final se discuten aspectos teóricos y prácticos de los hallazgos y la importancia de continuar brindando evidencia para su utilización en diferentes poblaciones y contextos, teniendo en cuenta que esta la primera vez que se analiza una versión en español del BERQ.

Abstract The present study aimed to translate and identify the psychometric properties of the Behavioral Emotion Regulation Questionnaire (BERQ) in 315 university students from Lima, Peru, aged 16 to 44 years (Mage = 21.31; SD = 3.39; 59.7% male). The BERQ and the Multicultural Inventory of Trait State Depression (IMUDER) were administered for the assessment. Evidence of internal structure validity was obtained through confirmatory factor analysis and exploratory structural equation modeling, while evidence of validity in relation to other variables was obtained through linear regression analysis. The results indicate that the pentafactorial structure is replicated in the Peruvian sample; that adaptive strategies significantly predict eutres, and that maladaptive strategies predict distress; in addition, reliability values were acceptable. At the end, theoretical and practical aspects of the findings and the importance of continuing to provide evidence for its use in different populations and contexts are discussed, taking into account that this is the first time that a Spanish version of the BERQ has been analyzed.

Intolerancia a la frustración y estrategias cognitivas de regulación emocional en la predicción de la agresividad / Frustration intolerance and cognitive strategies of emotional regulation in the prediction of aggressiveness

Resumen La conducta agresiva constituye un problema que afecta a los individuos y a la so ciedad. El Modelo de Agresión General integra un conjunto de variables que influyen en la pro babilidad de exhibir una conducta agresiva entre las cuales está la regulación emocional y la frustración. Esta investigación evalúa las relaciones entre la regulación emocional cognitiva y la intolerancia a la frustración. A 419 sujetos adultos se les administraron la Escala de Intoleran cia a la Frustración, la Escala de Regulación Emocional Cognitiva y el Cuestionario de Agresión. Se hallaron relaciones positivas en la mayoría de las estrategias desadaptativas cognitivas de regulación emocional y relaciones negativas entre la mayoría de las estrategias cognitivas adap tativas de regulación emocional con la conducta agresiva, y relaciones positivas entre todas las dimensiones de la intolerancia a la frustración y la conducta agresiva. El Análisis de Regresión Múltiple muestra que las variables que producen un cambio significativo en la agresividad son la catastrofización y culpar a otros, así como la intolerancia a la frustración referida a derechos. Mediante path análisis se verificó que estas tres variables mencionadas permiten explicar un 41% de la variabilidad en la agresividad.

Abstract Aggressive behavior is a problem that affects individuals and society. The General Aggression Model integrates a set of variables that influence the probability of exhibiting aggressive behavior, among which is emotional regulation and frustration. This research assesses the relationships between cognitive emotional regulation and frustration intolerance. A total of 419 adult subjects were administered the Frustration Intolerance Scale, the Cognitive Emotional Regulation Scale and the Aggression Questionnaire. Positive relationships were found in most of the maladaptive cognitive emotional regulation strategies and negative re lationships between most of the adaptive cognitive emotional regulation strategies with the aggressive behavior, and positive relationships between all the dimensions of the frustration intolerance and the aggressive behavior. The Multiple Regression Analysis shows that the vari ables that produce a significant change in aggressiveness are catastrophization and blaming others, as well as the frustration intolerance referring to rights. By means of path analysis, it was verified that these three variables can explain 41% of the variability in aggressiveness.

Propiedades psicométricas de una escala breve de autoeficacia para la conducción en conductores de Argentina / Psychometric properties of a driving self-efficacy scale-short form in Argentinean drivers

El objetivo de este estudio fue traducir y evaluar las propiedades psicométricas de la escala de autoeficacia para la conducción desarrollada por Dorn y Machin (2004). Se analizó la estructura factorial de la escala, la confiabilidad y se recogieron evidencias de validez externa en una muestra de 447 conductores de la ciudad de Córdoba, Argentina. Adicionalmente, se analizó la invarianza factorial en base al sexo. Los resultados obtenidos por medio de análisis factorial confirmatorio ratifican la estructura unidimensional de la escala, y la invarianza de sus parámetros (configural, métrica y escalar) en hombres y mujeres. Se verificó una consistencia interna adecuada mediante el coeficiente alfa y omega (.81 en ambos casos) y se obtuvieron evidencias satisfactorias de validez externa de las puntuaciones de la escala con medidas de percepción de riesgo, conducción riesgosa, e historial de choques y multas de tránsito. Por último, se comprobó que la escala resulta relativamente robusta frente al sesgo de deseabilidad social. En conjunto, los resultados avalan la validez y confiabilidad de la escala para su uso en Argentina, aunque se requieren nuevas investigaciones que analicen propiedades psicométricas adicionales.

The purpose of this study was to translate and examine the psychometric properties of a driving self-efficacy scale developed by Dorn and Machin (2004). The factor structure, reliability and external validity of the scale were examined in a sample of 447 drivers from Cordoba, Argentina. In addition, measurement invariance across sex was also tested. Results from a confirmatory factor analysis support the unidimensional structure of the scale and the invariance of its parameters (configural, metric and scalar) between men and women. Reliability analyses using alpha and omega coefficients revealed high internal consistency (coefficients equal to .81 in both cases) and satisfactory evidence of external validity of the scale scores, with measures of risk perception, risky driving, history of traffic crashes and fines. Finally, results also showed that the scale seems to be relatively robust against response biases due to social desirability. In summary, findings support the validity and reliability of the scale in Argentina. However, further studies analyzing additional psychometric properties are needed.