The Flourishing Scale: Psychometric Properties in Breast Cancer Patients.

BACKGROUND/OBJECTIVE: Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being and it is commonly assessed with the Flourishing Scale (FS). To our knowledge, no studies have analyzed the psychometric properties of the FS in breast cancer patients. Our aim here was to provide validity evidence for use of the FS in this context. METHOD: Participants were 217 Spanish women with breast cancer who completed the FS and other scales assessing positive psychology constructs (life satisfaction, positive affect, resilience, self-esteem, optimism) and indicators of psychological maladjustment (negative affect, depression, anxiety, and stress). The internal structure of the FS was analyzed using confirmatory factor analysis (CFA). We calculated the average variance extracted (AVE) to evaluate convergent validity, and both McDonald's omega and Cronbach's alpha coefficients to estimate reliability. Item analysis was performed by computing corrected item-total correlations. Validity evidence based on relationships with other variables was obtained through Pearson correlation analysis, controlling for age and cancer stage. RESULTS: The CFA supported a single-factor structure, with adequate goodness-of-fit indices (CFI = 0.997, NNFI = 0.996, RMSEA = 0.069, and SRMR = 0.047) and standardized factor loadings ranging from 0.70 to 0.87. The value of the AVE was 0.63, and the reliability coefficient obtained with both procedures was 0.91. Corrected item-total correlations ranged from .62 to .78. Correlation analysis showed direct and strong associations between the FS score and scores on positive psychology constructs (range from 0.43 to 0.74), the strongest correlations being with positive affect and life satisfaction. The FS score was inversely correlated with scores on depression, anxiety, stress, negative affect, and pessimism (range from -0.14 to -0.52), the strongest association being with stress. DISCUSSION: The FS is a useful tool for exploring well-being in the breast cancer context, providing useful information for psychological assessment.

Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients.

Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.

Life Satisfaction and Character Strengths in Women With Breast Cancer: Zest and Hope as Predictors.

BACKGROUND: Empirical evidence shows that life satisfaction is positively related to character strengths, and although this association has been observed in different populations, it is scarce in breast cancer patients. This study analyzes the relationship between character strengths and life satisfaction in Spanish women diagnosed with breast cancer. METHODS: A sample of 117 women completed the Satisfaction with Life Scale (SWLS) and the Spanish version of the VIA Inventory of Strengths (VIA-IS). Correlation analysis and regression modeling were performed to determine which strengths predict life satisfaction. RESULTS: The results of the correlation analysis showed that 15 strengths were positively and significantly associated with life satisfaction, with the highest correlations corresponding to zest, hope, curiosity, social intelligence, love, gratitude, and judgment. Regression modeling indicated that of these, zest and hope were key strengths for predicting life satisfaction. CONCLUSIONS: These findings suggest that intervention programs based on the development of zest and hope could help to improve life satisfaction and, therefore, the psychological well-being of women with breast cancer.

Effectiveness of child sexual abuse prevention programs on knowledge acquisition: A meta-analytical study.

BACKGROUND: Child sexual abuse (CSA) is a type of maltreatment considered a global health problem. CSA is a traumatic experience with important consequences for the victim's health. It is essential to report the effectiveness of CSA prevention programs to offer society useful tools to combat this abuse. OBJECTIVE: We aimed to study the effectiveness of CSA prevention programs on the knowledge acquisition based on comparing pre- and post-treatment changes, and also if their effectiveness is related to program-related and methodological variables. PARTICIPANTS AND SETTINGS: Standardised mean change (with studies that report pre-post program measures) of the effectiveness of CSA prevention programs published between 2014 and 2021 was carried out. METHODS: The general effectiveness of these programs and whether the results were influenced by program-related variables (the duration, the target population, participants' age, or the type of intervention) or by methodology-related factors (the agent who taught them, the geographical area where they were carried out or the way the programs were evaluated) were analysed. A total of 43 samples analysing knowledge about CSA as a dependent variable were included. RESULTS: The results reported a combined effect size considered large (dMR = -0.96, 95 % CI [-1.10, -0.82], p < .001). High inter-study heterogeneity was observed in the meta-analysis, although only the geographic area where the studies were conducted appears as a significant moderator. CONCLUSIONS: In conclusion, the prevention programs included in this analysis significantly improved the participants' knowledge acquisition.

Development and psychometric properties of the Stressors in Breast Cancer Scale.

Background: A diagnosis of breast cancer generates psychological stress, due not only to treatment and its side effects but also to the impact on different areas of the patient's daily life. Although there are instruments for measuring psychological stress in the cancer context, there is currently no tool for assessing stressors specific to breast cancer. Aims: The aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS). Method: A panel of experts evaluated the clarity and relevance of scale items, providing validity evidence based on test content. Psychometric properties of the scale were then analyzed. Results: Validity evidence based on the internal structure of the SBCS was obtained through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), following a cross-validation strategy. The CFA supported a second-order factor model with five dimensions: physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future. This structure was invariant across two groups distinguished by time from cancer diagnosis (less than 3 and 3 years or more from diagnosis). Reliability, based on McDonald's omega and Cronbach's alpha coefficients, ranged from 0.83 to 0.89 for factor scores, and reached 0.95 for total scores. Validity evidence was also provided by correlations with depression, anxiety, perceived stress, and perceived health and quality of life. Discussion: The results support the use of the SBCS for measuring stress as a stimulus in the breast cancer context. Implications for clinical practice and research are discussed.

Personality, emotions and coping styles: predictive value for the evolution of cancer patients.

This study had a twofold goal: to define differences in psychological aspects between cancer patients and a control group and to explore the predictive value of such aspects for the evolution of the disease two years later. Firstly, personality, anxiety, anger and depression were assessed in both groups. Results of t-analyses revealed significant group differences. In personality, cancer patients had higher levels of neuroticism and lower levels of extraversion, agreeableness and conscientiousness than the control group. In emotional variables, cancer patients had higher levels of anxiety and some aspects of anger, but there were no group differences in depression levels. Secondly, applying a quasi-prospective design, the predictive value of personality, emotions and coping styles for the evolution of cancer (favourable or unfavourable) was explored using generalized linear models and logistic regression. A four-predictor logistic model was fitted: Anger Expression-In, Resignation, Self-blame and Conscientiousness, indicating that the higher Anger Expression-in, Resignation, and Self-blame scores together with a lower Conscientiousness score, the more likely it is for patients' cancer to evolve unfavourably. These results indicate the crucial role of psychological aspects for the evolution of the disease and the need to include such aspects in the design of clinical interventions.

General Health and Resilience of Breast Cancer Patients: The Mediator Role of Affective Well-Being.

A considerable percentage of breast cancer patients present adequate psychological adjustment and do not become distressed after a breast cancer diagnosis, or, if they do, they manage to recover quickly, which is reflected in their general health. This study aims to determine the role of some psychological mechanisms that affect psycho-oncological adjustment, specifically, resilience and well-being, in a sample of 109 breast cancer patients. For this purpose, participants completed questionnaires on general health, resilience, and well-being (life satisfaction and affect). Correlation analyses and a multiple mediation model were carried out. The results revealed that Pearson correlations between all variables showed strong associations between general health scores and positive and negative affect scores, and moderate associations with life satisfaction and resilience scores. Furthermore; in the mediation model, the total percentage of variance explained by the overall model was 55% (R2 = 0.55), where resilience was associated with positive and negative affect, and that influenced general health. These results show that affective well-being is especially relevant in breast cancer patients in terms of its mediating role in resilience, making it clear that an appropriate intervention focused on managing patients' affective status can have a favorable impact on their overall health.

Knowledge and Myths About Child Sexual Abuse in Mexican Women.

Child sexual abuse (CSA) is a terrible type of maltreatment that occurs in all countries and social statuses, but due to the shame and taboo that it creates, it is still riddled with myths and false beliefs that make it difficult for the population and the authorities to adequately determine its prevalence. The objective of this work was to explore what Mexican women know about CSA. The participants were Mexican women (N = 499) who filled out a questionnaire comprising ten items referring to truths and myths about CSA, indicating their degree of agreement with them on a Likert scale. The results showed that although Mexican women have quite adequate knowledge about CSA, they still hold wrong beliefs about the child's feelings toward the abuser or the child victim becoming an adult abuser. Likewise, differences were found in the myths and truths about CSA held by women under 40 and over 40 years of age.

What Do We Know About Child Sexual Abuse? Myths and Truths in Spain.

Child sexual abuse (CSA) is a terrible type of maltreatment that can have serious physical and psychological consequences for victims. These consequences include shame and are often taboo in conversation, which makes CSA very difficult to see. Therefore, multiple myths exist about CSA that can lead to misperceptions regarding issues such as its context, prevalence, and consequences. What is unknown cannot be addressed; therefore, the aim of this work was to investigate Spanish participants' knowledge about CSA as well as examine gender and educational level differences. A 10-item questionnaire comprising myths and truths about CSA was developed, taking into account existing literature. Participants (N = 1,540) had to rate their level of agreement with the statements. Some important aspects of CSA remain unclear, particularly in terms of the background of the victims (e.g., gender, educational level, CSA prevalence). Significant differences in the perception of CSA between men and women and among those with various educational levels were found: Men and people with lower levels of education held more myths about CSA. In conclusion, better knowledge about CSA is needed to get people involved in its prevention. We must consider the myths and truths about CSA when designing prevention programs and tailor educational programs to the target population.

The Satisfaction with Life Scale in breast cancer patients: Psychometric properties.

BACKGROUND/OBJECTIVE: This study aims to analyze the psychometric properties of the Satisfaction with Life Scale (SWLS), examining the reliability of scale scores and providing validity evidence for its use with breast cancer patients. We provide validity evidence based on internal structure and on relationships with positive psychological variables and other variables indicative of psychological adjustment. METHOD: Participants were 222 Spanish women with a diagnosis of breast cancer. They completed the SWLS and a battery of questionnaires measuring positive and negative affect, self-esteem, resilience, emotional intelligence, flourishing, optimism, depression, anxiety, and stress. RESULTS: Confirmatory factor analysis supported a single-factor structure for the SWLS, S-B χ2 (5) = 7.36, p = .19, CFI = .99, NNFI = .99, RMSEA = .046. The reliability of test scores estimated with McDonald's omega yielded a value of .80. Validity evidence was provided by a positive correlation between SWLS scores and positive affect, self-esteem, resilience, emotional intelligence (specifically, clarity and repair), flourishing, and optimism (range: .24, .69), and by a negative correlation with negative affect, pessimism, depression, anxiety, and stress (range: -.25, -.59). CONCLUSIONS: The Spanish version of the SWLS showed satisfactory psychometric properties and it is an appropriate measure for use in the breast cancer context.

ANTECEDENTES/OBJETIVO: El objetivo deestudio es examinar las propiedades psicométricas de la Escala de Satisfacción con la Vida (SWLS), analizando la fiabilidad de sus puntuaciones y aportando evidencias para su uso en pacientes con cáncer de mama. Se proporcionan evidencias de validez basadas en la estructura interna y en la relación con otras variables psicológicas positivas y con otras indicativas de ajuste psicológico. MÉTODO: Han participado 222 mujeres españolas diagnosticadas de cáncer de mama, que cumplimentaron la SWLS y medidas de afecto positivo y negativo, autoestima, resiliencia, inteligencia emocional, florecimiento, optimismo, depresión, ansiedad y estrés. RESULTADOS: El análisis factorial confirmatorio indicó una estructura unidimensional, S-B χ2(5) = 7,36, p = 0,19, CFI = 0,99, NNFI = 0,99, RMSEA = 0,046. La fiabilidad de las puntuaciones estimadas con omega de McDonald fue de 0,80. Las evidencias de validez mostraron correlaciones positivas entre las puntuaciones de SWLS y afecto positivo, autoestima, inteligencia emocional (específicamente, claridad y reparación), florecimiento y optimismo (rango 0,24 0,69), así como correlaciones negativas con afecto negativo, pesimismo, depresión, ansiedad, y estrés (rango -0,25 - 0,59). CONCLUSIONES: La versión española de la SWLS muestra adecuadas propiedades psicométricas, siendo una medida apropiada para utilizarla en pacientes de cáncer de mama.

Child Sexual Abuse in Mexican Women: Type of Experience, Age, Perpetrator, and Disclosure.

Child sexual abuse (CSA) is a type of maltreatment that occurs in practically all countries and social statuses. Due to the taboo and shame that surrounds it, CSA is a problem universally silenced despite the important consequences (both physical and psychological) that it has for the victim and their family. This work aimed to study the correlates of CSA in Mexican women. Our sample comprised 1058 women ranged from 18 to 73 years (M = 40.19; SD = 10.24). They completed an anonymous online survey including questions about all the different types of abuse, questions about who perpetrated it, at what age it happened, and whether the victim disclosed the abuse. Our results showed that, depending on the type of abuse, from 13.9% to 65.8% of the participants had suffered at least one episode of CSA throughout their childhood. The first episode typically occurred between 6 and 12 years old, with the perpetrator being a male. The youngest women reported higher rates of being shown pornography by a family member, whereas the oldest ones reported higher rates of exhibitionism by a stranger. Only 31.3% of the sample disclosed the abuse, usually to their mother or a peer. Differences among the correlates of the different types of abuse, the age of the victims, and the relationship with the perpetrator are discussed as well as the victims' feelings of being believed when they disclosed the abuse.

Personality Profiles and Psychological Adjustment in Breast Cancer Patients.

Dispositional personality characteristics may play a role in psychosocial adjustment to any disease, including cancer. PURPOSE: The purpose of this study is to identify personality profiles in breast cancer patients and to determine whether these profiles are associated with psychological adjustment or psychopathology. METHODS: Participants were 109 women (mean age, 52.01) diagnosed with breast cancer. They completed the Millon Clinical Multiaxial Inventory-III (MCMI-III), the Life Orientation Test-Revised (LOT-R), the Satisfaction with Life Scale, and the Positive and Negative Affect Scales. RESULTS: The analysis revealed two different personality profiles: (a) one group, comprising 38.23% of the sample, was characterized by paranoid, negativistic, and dependent personality traits and was considered as a "vulnerable group"; and (b) another group (61.77%) was characterized by compulsive, histrionic, and narcissistic personality traits and was considered as a "psychologically adjusted group". The vulnerable group scored higher than the psychologically adjusted group on all clinical syndromes, with scores above 60 on the anxiety, somatoform, dysthymic, and bipolar scales (score on anxiety being above 75); in contrast, the psychologically adjusted group did not reach a base rate score of 60 on any of the clinical syndromes, showing no manifestations of psychopathology. Additionally, the vulnerable group scored lower than the psychologically adjusted group on optimism, life satisfaction, and positive affect, but higher on negative affect. CONCLUSIONS: The results suggest that personality traits could affect the psychological adjustment of breast cancer survivors. We discuss the implications of belonging to each group and highlight the importance of early identification of vulnerable women in order to facilitate clinical and psychological support.

Psychometric properties of the Connor-Davidson Resilience Scale in women with breast cancer.

The aim was to analyse the psychometric properties of the 10-item version of the Connor-Davidson Resilience Scale (CD-RISC 10©) in breast cancer patients. METHOD: A sample of 169 Spanish women who had undergone surgery for breast cancer completed the CD-RISC 10©, along with questionnaires assessing life satisfaction, emotional intelligence, self-esteem, and positive and negative affect. RESULTS: Confirmatory Factor Analysis supported a single-factor structure with adequate fit indices. Reliability was analysed by calculating McDonald's omega coefficient, which yielded a value of .83. Validity evidence based on relationships with other variables was provided by positive and significant correlations between scores on the CD-RISC 10© and scores on emotional intelligence (clarity and repair), life satisfaction, self-esteem and positive affect, and by a negative and significant correlation with negative affect. The majority of these correlations were above |.50|. CONCLUSIONS: The CD-RISC 10© has satisfactory psychometric properties and is a suitable tool for measuring resilience in patients with cancer. The instrument is quick and easy to apply and may be used in both clinical and research contexts.

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las propiedades psicométricas de la versión de 10 ítems de la Escala de Resiliencia Connor-Davidson (CD-RISC 10©) en pacientes con cáncer de mama. Método: Una muestra de 169 mujeres españolas que se habían sometido a cirugía por cáncer de mama completaron el CD-RISC 10©, junto con cuestionarios que evaluaban la satisfacción vital, inteligencia emocional, autoestima, y afecto positivo y negativo. Resultados: El análisis factorial confirmatorio apoyó una estructura unifactorial con índices de ajuste adecuados. La fiabilidad se analizó calculando el coeficiente omega de McDonald que arrojó un valor de 0,83. Fue proporcionada evidencia de validez de relación con otras variables mediante correlaciones positivas y significativas entre las puntuaciones en el CD-RISC 10© y las puntuaciones en inteligencia emocional (claridad y reparación), satisfacción vital, autoestima y afecto positivo, y por una correlación negativa y significativa con afecto negativo. La mayoría de estas correlaciones estaban por encima de 50|0,50|. Conclusiones: El CD-RISC 10© tiene propiedades psicométricas satisfactorias, siendo una herramienta adecuada para medir la resiliencia en pacientes con cáncer. El instrumento es rápido y fácil de aplicar y puede usarse tanto en contextos clínicos como de investigación.