High-risk pregnancy and its relationship with the neurodevelopment and behavior of 2-year-old children.

High-risk pregnancies elevate maternal stress, impacting offspring neurodevelopment and behavior. This study, involving 112 participants, aimed to compare perceived stress, neurodevelopment, and behavior in high-risk and low-risk pregnancies. Two groups, high-risk and low-risk, were assessed during pregnancy for stress using hair cortisol and psychological analysis. At 24 months post-birth, their children's neurodevelopment and behavior were evaluated. Results revealed higher perceived stress and pregnancy-related concerns in high-risk pregnancies, contrasting with low-risk pregnancies. Offspring from high-risk pregnancies displayed elevated internalizing behavior scores, while low-risk pregnancies showed higher externalizing behavior scores. Additionally, women in low-risk pregnancies exhibited increased cortisol concentrations 24 months post-delivery. These findings underscore the necessity for early stress detection and prevention programs during pregnancy, particularly in high-risk cases, to enhance maternal and infant health.

Does stress response axis activation differ between patients with autoimmune disease and healthy people?

Many studies have shown that patients with autoimmune disease present a hypoactive hypothalamic-pituitary-adrenal (HPA) axis, but the results are controversial. Our objective was to study differences in stress response axis activity between patients with autoimmune disease and healthy people. The study sample consisted of 97 women divided into four groups: 37 healthy women (HW), 21 with systemic lupus erythematosus (SLE), 21 with Sjögren's syndrome (SS), and 18 with systemic sclerosis (SSc). After being exposed to a stress task, participants' skin conductance and salivary cortisol levels were measured in order to assess their response to psychological stress. Diurnal cortisol concentrations were assessed by measuring salivary cortisol in samples collected five times over one day. In addition, self-administered questionnaires were used to assess psychological variables. A time × group interaction effect was found (p = 0.003) in salivary cortisol secretion in response to stressful challenge. The healthy group presented normal activation, the SS and SLE groups showed no activation, and the SSc group presented a similar activation pattern to the HW group, except at the time of recovery. Total cortisol production (AUCg) was higher in the SSc group than in the HW group (p = 0.001). Differences were also observed in the cortisol AUCg collected over one day between healthy women and patients with SLE (p = 0.004) as well as with SSc (p = 0.001): women with SLE and SSc presented higher total hormone production than healthy women. Patients with autoimmune disease present a different HPA axis response, which may contribute to the harmful effects of stress in these diseases.

Efecto del confinamiento por COVID-19 en el estado mental de pacientes con lupus eritematoso sistémico / Effect of COVID-19 confinement on the mental status of patients with systemic lupus erythematosus

Antecedentes y objetivo: Las pacientes con lupus eritematoso sistémico (LES) son más vulnerables a presentar mayores niveles de estrés y síntomas psicopatológicos que la población general sana, por lo que el brote de la COVID-19 podría alterar su estado psicológico. El objetivo fue analizar el impacto psicológico de la pandemia y del confinamiento sobre los niveles de estrés y sintomatología psicopatológica en pacientes con LES.Pacientes y métodoEn este estudio transversal se compararon niveles de estrés mediante la Escala de Estrés Percibido y el Inventario de Vulnerabilidad al Estrés, y síntomas psicopatológicos mediante el Inventario de síntomas SCL-90-R, en pacientes con LES durante el período de confinamiento (grupo 1; n=276) con respecto a pacientes con LES evaluadas en un período anterior a la pandemia (grupo 2; n=152).ResultadosLa comparación entre ambos grupos mostró que existían diferencias estadísticamente significativas en vulnerabilidad al estrés (p<0,0001), depresión (p≤0,05), ansiedad (p≤0,05), ansiedad fóbica (p<0,0001), sensibilidad interpersonal (p≤0,043), y psicoticismo (p≤0,023). En estas variables el grupo de pacientes con lupus en confinamiento obtuvo puntuaciones superiores.ConclusionesEl confinamiento y la amenaza del brote por COVID-19 ha tenido importantes repercusiones en el estado psicológico de las pacientes con LES, mostrando altos niveles de estrés, ansiedad y depresión. Estos hallazgos muestran su vulnerabilidad ante una alerta de salud pública, y señala la necesidad de realizar un abordaje psicológico de estas pacientes mientras dure el estado de emergencia sanitaria, así como ante posibles rebrotes del virus. (AU)

Background and objective: Patients with systemic lupus erythematosus (SLE) are more vulnerable to higher levels of stress and psychopathological symptoms than the general healthy population. Therefore, the COVID-19 outbreak could alter their psychological state. The objective was to analyze the psychological impact of the pandemic and confinement on stress levels and psychopathological symptoms in patients with SLE.Patients and methodIn this cross-sectional study, stress levels were compared with the Perceived Stress Scale, the Stress Vulnerability Inventory and psychopathological symptoms of the SCL-90-R Symptom Inventory in patients with SLE during the period of confinement (group 1; n=276) in comparison to patients with SLE evaluated in a period before the pandemic (group 2; n=152).ResultsThe comparison between both groups showed there were statistically significant differences in vulnerability to stress (P<.0001), depression (P≤.05), anxiety (P≤.05), phobic anxiety (P<.0001), interpersonal sensitivity (P≤.043), and psychoticism (P≤.023). In these variables, the group of patients with lupus in confinement obtained higher scores.ConclusionsThe confinement and threat of the COVID-19 outbreak had important repercussions on the psychological state of patients with SLE with high levels of stress, anxiety, and depression. These findings show their vulnerability to a public health alert and indicate the need to carry out a psychological approach to these patients while the state of health emergency lasts as well as to possible outbreaks of the virus. (AU)

Variables del confinamiento por COVID-19 predictoras de sintomatología ansiosa y depresiva en mujeres embarazadas / Confinement variables by COVID-19 predictors of anxious and depressive symptoms in pregnant women

Antecedentes y objetivos: La aparición de una enfermedad altamente contagiosa obligó a confinar a la población en casi todo el mundo, ocasionando el aumento de problemática psicológica, siendo las mujeres embarazadas un grupo especialmente vulnerable a sufrir consecuencias negativas. El objetivo de esta investigación fue comprobar qué variables de confinamiento o estrés psicológico están relacionadas con el aumento de la sintomatología ansiosa y depresiva en mujeres embarazadas, como consecuencia de la pandemia ocasionada por la COVID-19.Materiales y métodosLa muestra estuvo compuesta por 131 mujeres embarazadas que vivieron el confinamiento impuesto por el Gobierno de España el 14 de marzo de 2020. Se recogieron variables sociodemográficas, obstétricas, relacionadas con el confinamiento y variables psicológicas.ResultadosEl estrés percibido, estrés específico del embarazo, así como el insomnio son variables predictoras en la mayoría de síntomas ansiosos (obsesiones y compulsiones, ansiedad y ansiedad fóbica) y depresivos relacionados con la COVID-19.ConclusionesEs importante destinar futuras intervenciones psicológicas en esta población al control del estrés y monitorización del sueño, ya que estas variables influyen en el incremento de ansiedad y depresión. (AU)

Background and objectives: The appearance of a highly contagious disease forced the confinement of the population in almost all parts of the world, causing an increase in psychological problems, with pregnant women being a particularly vulnerable group to suffer negative consequences. The aim of this research was to check which confinement or psychological stress variables are related to the increase of anxious and depressive symptoms in pregnant women, as a consequence of the pandemic caused by the COVID-19.Materials and methodsThe sample was composed of 131 pregnant women who experienced the confinement imposed by the Government of Spain on March 14, 2020. Sociodemographic, obstetric, confinement related and psychological variables were collected.ResultsPerceived stress, pregnancy-specific stress, as well as insomnia are predictive variables in most anxious (obsessions and compulsions, anxiety and phobic anxiety) and depressive symptoms related to COVID-19.ConclusionsIt is important to focus future psychological interventions in this population on stress control and sleep monitoring, since these variables influence the increase of anxiety and depression. (AU)

Psychological and sociodemographic variables related to cortisol in hair in Spanish healthy population

Some recent researches have shown the important role of hair cortisol as a retrospective biomarker of chronic stress. The aim of this research was to investigate the relationship between hair cortisol levels and sociodemographic and psychological variables, such as perceived stress levels and psychopathological symptoms on a Spanish population. The sample consisted of 347 healthy people, 230 women and 117 men, with an average age of 33.39 years (SD = 12.63). Hair cortisol levels were measured by obtaining a hair sample. In addition, a psychological assessment composed by: Analogic-Visual Stress Scale, Perceived Stress Scale (PSS), Symptom Checklist 90 Revised (SCL-90-R) and the assessment of vital stressful events suffered, was carried out. The mean cortisol level was 108.93 pg/mg (SD = 66.43) in men, and 120.38 pg/mg (SD = 87.26) in women. The linear hierarchical regression showed that Analogic-Visual Stress Scale and perceived stress levels were related with higher hair cortisol levels (R2 = .032; t = 2.21; p = .029). Due to the relationship between daily stress levels, Analogic-Visual Stress Scale, anxiety sub-scale of SCL 90-R and perceived stress levels with hair cortisol levels, we conclude that there is a relation between perceived yourself stressed and the physiological levels

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Escalas de apoyo social para los hábitos alimentarios y para el ejercicio: propiedades psicométricas / Scales for social support for eating habits and exercise: psychometric properties

OBJETIVO: El apoyo social puede introducir cambios favorables en el estilo de vida de cara a reducir el riesgo cardiovascular. El objetivo de este estudio fue verificar dichos cambios en la población clínica que participó en el mismo y presentar las propiedades psicométricas de dos escalas de apoyo social: los hábitos alimentarios y el ejercicio. Ambas fueron aplicadas en pacientes con síndrome metabólico (SM). MÉTODOS: Participaron 135 sujetos en un programa de modificación de estilo de vida. Las medidas sociodemográficas, psicológicas y de estilo de vida fueron tomadas en el Hospital Universitario Virgen de las Nieves (HUVN) de Granada (España) durante 2013 y 2014. Se realizaron los siguientes análisis: análisis factorial confirmatorio(AFC), de la consistencia interna, de la sensibilidad al cambio y de la estabilidad temporal. RESULTADOS: El AFC confirmó la estructura original de ambas escalas, excepto por la exclusión del factor 2 (familia) de la escala de apoyo social para el ejercicio. Para la escala de apoyo social, el ajuste local, todos los ítems presentaron altos valores de cargas factoriales y fiabilidades individuales (lamda≥0,64 y R2≥0,41, respectivamente). Para la escala de ejercicio, el ajuste local, los ítems presentaron altos valores de cargas factoriales y fiabilidades individuales (lamda≥0,62 y R2≥0,38, respectivamente). Los valores de consistencia interna resultaron entre adecuados y excelentes, con cifras de alfa de Cronbach entre 0,714 y 0,864. En cuanto a la sensibilidad al cambio, el grupo experimental aumentó la percepción del apoyo social para la alimentación y para el ejercicio. El grupo de control no presentó diferencias significativas. CONCLUSIONES: Los resultados muestran niveles adecuados de validez y fiabilidad, demostrando que las escalas son adecuadas para evaluar el apoyo social en pacientes con SM

OBJECTIVE: Social support can introduce favorable changes in lifestyle to reduce the cardiovascular risk. The aim of this study was to verify these changes in the clinical population participating in this study and present the psychometric properties of the scales of social support for 'Eating Habits' and 'Exercise' in patients diagnosed with metabolic syndrome. METHODS: 135 participants attending a programme for changing lifestyle habits. Sociodemographic, psychological, and lifestyle variables were assessed at the Hospital Universitario Virgen de las Nieves (HUVN) in Granada (Spain) between 2013 and 2014. The following procedures were used: Confirmatory factor analysis (CFA), internal consistency, sensibility to change and temporal stability. RESULTS: The AFC confirmed the original structure of both scales, except for the exclusion of factor 2 (family) from the social support scale for the year. For the social support scale, the local adjustment, all items presented high values of factor loads and individual reliability (lamda≥0.64 and R2≥0.41, respectively). For the exercise scale, the local adjustment, the items presented high values of factor loads and individual reliability (lamda≥0.62 and R2≥0.38, respectively). Internal consistency values were between adequate and excellent, with Cronbach's alpha figures between 0.714 and 0.864. Regarding sensitivity to change, the experimental group increased the perception of social support for food and exercise. The control group did not show significant differences. CONCLUSIONS: Our results show adequate indices for validity and reliability of the measures. Both measures appeared to be useful to assess social support in patients diagnosed with metabolic syndrome

Estrés, ira y dieta mediterránea como factores predictores del síndrome metabólico / Stress, anger and Mediterranean diet as predictors of metabolic syndrome

Antecedentes y objetivo: El síndrome metabólico (SM) es un conjunto de condiciones metabólicas que incluyen obesidad abdominal, reducción de las concentraciones de colesterol unido a las high density lipoproteins (c-HDL, «lipoproteínas de alta densidad»), triglicéridos elevados, aumento de la presión arterial e hiperglucemia. Dado que se trata de una enfermedad multicausal, el objetivo de este estudio es identificar las variables psicológicas, emocionales y de estilo de vida que pueden ejercer una influencia sobre los diferentes componentes del SM. Pacientes y métodos: Estudio transversal con 103 pacientes diagnosticados de SM (47 varones y 56 mujeres). Se recogieron medidas antropométricas, clínicas y analíticas para valorar las variables asociadas al SM. También se evaluaron las principales variables psicológicas y emocionales. Resultados: Se realizaron diferentes pruebas de regresión lineal múltiple para identificar qué variables eran predictoras del SM. Las variables dependientes fueron el índice de masa corporal (IMC), la circunferencia abdominal, el c-HDL y la calidad de vida, y las variables predictoras fueron el estrés psicológico, la ira y la adherencia a la dieta mediterránea. Los resultados mostraron que el estrés psicológico era un predictor de la calidad de vida (β=−0,55, p≤0). De igual modo, la ira fue un predictor del IMC (β=0,23, p=0,047) y de la circunferencia abdominal (β=0,27, p=0,021). Según lo previsto, la adherencia a la dieta mediterránea fue un predictor del c-HDL (β=0,2, p=0,045) y de la calidad de vida (β=−0,18, p=0,031). Conclusiones: Los resultados confirman un vínculo entre la adherencia a ciertos hábitos alimentarios y el estilo de vida; sin embargo, se sitúan un paso por delante y resaltan la importancia de los factores psicológicos y emocionales como el estrés y la ira en algunos componentes del SM

Background and objective: Metabolic syndrome (MetS) is a cluster of metabolic conditions that include abdominal obesity, reduction in cholesterol concentrations linked to high density lipoproteins (HLDc), elevated triglycerides, increased blood pressure and hyperglycaemia. Given that this is a multicausal disease, the aim of this study is to identify the psychological, emotional and lifestyle variables that can have an influence on the different MetS components. Patients and methods: A cross-sectional study with 103 patients with diagnostic criteria for MetS (47 male and 56 female). Anthropometric, clinical and analytical measurements were collected to assess the variables associated with MetS. The main psychological and emotional variables were also assessed. Results: Different multiple linear regression tests were performed to identify which variables were predictive of MetS. The dependent variables were body mass index (BMI), abdominal circumference, HDLc, and quality of life, and the predictive variables were psychological stress, anger and adherence to a Mediterranean diet. The results showed that psychological stress was a predictor of quality of life (β=−0.55, P≤0). Similarly, anger was a predictor of BMI (β=0.23, P=.047) and abdominal circumference (β=0.27, P=.021). As expected, adherence to a Mediterranean diet was a predictor of HDLc (β=0.2, P=.045) and of quality of life (β=−0.18, P=.031). Conclusions: The results confirm a link between adherence to certain dietary habits and lifestyle, however they go one step further and show the importance of psychological and emotional factors like psychological stress and anger in some MetS components

Depresión posparto, un problema de salud pública mundial

La depresión posparto es un trastorno mental afectivo severo, que afecta hasta al 56% de las mujeres latinas residentes en México y Estados Unidos durante los primeros 4 meses tras el nacimiento de su bebé. Su incidencia mundial es del 15%, y está incluida en el Manual Diagnóstico y Estadístico de los Trastornos Mentales, quinta edición (DSM-5) bajo la denominación de “trastorno depresivo durante el período perinatal”. Se asocia a suicidio y filicidio, y el primero es una de las causas más importantes de muerte materna durante el período perinatal.

¿Puede el índice de masa corporal pregestacional relacionarse con el estado psicológico y físico de la madre durante todo el embarazo? / May pregestational body mass index be related to mother's psychological and physical condition during pregnancy?

Introducción: el índice de masa corporal (IMC) pregestacional afecta a la salud de la madre durante y después del embarazo, y se relaciona con un aumento del riesgo a sufrir diabetes gestacional, preeclampsia o muerte fetal. Además, el IMC pregestacional elevado aumenta los niveles de ansiedad, estrés y depresión, lo que conlleva al aumento de riesgo de aborto, bajo peso al nacer y prematuridad. Objetivos: comprobar si existen diferencias en estrés, síntomas psicopatológicos y variables fisiológicas durante el embarazo, entre embarazadas con IMC pregestacional normal e IMC pregestacional elevado. Métodos: han participado 156 mujeres embarazadas evaluadas longitudinalmente durante los tres trimestres de embarazo divididas en dos grupos: grupo con IMC pregestacional normal (n = 115) y grupo con IMC pregestacional elevado (n = 41). Se midieron niveles de estrés, síntomas psicopatológicos, hipertensión y glucosa. Resultados: los resultados mostraron que existían diferencias estadísticamente significativas entre los dos grupos en estrés específico del embarazo y en las subescalas del SCL-90-R: depresión, ideación paranoide y la escala de síntomas generales en el primer trimestre; en el segundo trimestre, en estrés específico del embarazo y subescalas (somatizaciones, obsesión compulsión, sensibilidad interpersonal, depresión, ansiedad, ideación paranoide y en las escalas generales; y en estrés percibido) y las subescalas somatizaciones, ansiedad y en la escala SP en el tercer trimestre. También se encontraron diferencias entre ambos grupos en tensión arterial diastólica en el primer trimestre, y en tensión arterial sistólica y diastólica en el tercer trimestre. Conclusiones: el IMC pregestacional elevado se relaciona con mayor estrés psicológico y con síntomas psicopatológicos y fisiológicos durante el embarazo

Introduction: pregestational Body Mass Index (BMI) affects mother's health during and after pregnancy and is related to negative outcomes such as low birth weight and preterm birth. Higher pregestational BMI may increase anxiety, stress and depression. Objectives: to assess potential differences on stress, psychopathological symptoms and physiological variables during pregnancy, among pregnant women with normal pregestational BMI rates and high pregestational BMI rates. Methods: a sample of 156 pregnant women were longitudinally assessed during the three trimesters of pregnancy. They were divided into two groups: a group with normal pregestational BMI rates (n = 115) and a group with high pregestational BMI rates (n = 41). Stress levels, psychopathological symptoms, blood pressure and glucose blood levels were assessed. Results: in the first trimester, significant differences were found between groups regarding pregnancy-specific stress and some of the SCL-90-R subscales (depression, paranoid ideation and global wellness index). In the second trimester, there were differences regarding pregnancy-specific stress and some of the SCL-90-R subscales (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, paranoid ideation and the general scales, global wellness index and symptoms free). In the third trimester, there were differences between groups regarding perceived stress and some of the SCL-90-R subscales (somatization, anxiety and the general scale symptoms free). Significant differences were found between groups on diastolic blood-pressure in the first trimester, and systolic and diastolic blood-pressure in the third trimester. Conclusions: higher pregestational BMI is related to higher psychological stress, higher psychopathological symptoms and elevated blood-pressure during pregnancy

Adherencia al tratamiento en pacientes con lupus eritematoso sistémico / Adherence to treatment in patients with systemic lupus erythematosus

Antecedentes y objetivo: El incumplimiento terapéutico constituye un importante problema asistencial en pacientes con lupus eritematoso sistémico (LES). Conocer los factores asociados de este puede ser de gran utilidad en el ámbito clínico. El objetivo de esta investigación fue analizar la influencia de las variables sociodemográficas, clínicas y psicológicas sobre la adherencia al tratamiento en una muestra española de mujeres con LES. Pacientes y método: En este estudio transversal-observacional se evaluó el grado de adherencia al tratamiento, el estado clínico y psicopatológico, el estrés psicológico y la autoeficacia en mujeres con LES. La muestra se dividió en 2 grupos: adherentes y no adherentes. Mediante un análisis de regresión logística se identificaron los factores asociados a la falta de adherencia en esta población. Resultados: Se evaluaron 72 pacientes (edad media: 36,7±12,2 años). El 63,9% no tuvieron adherencia. Un bajo nivel educativo, estar desempleada, vivir en pareja y el consumo de alcohol se asociaron a una baja adhesión al tratamiento. Se encontraron diferencias entre el grupo adherente y el no adherente en las subescalas psicopatológicas de somatización, obsesión-compulsión e índices psicopatológicos generales, así como en el estrés percibido, obteniendo puntuaciones más altas las pacientes adherentes. El uso de antiinflamatorios no esteroideos (AINE), tener artrosis y mayor alteración psicopatológica fueron predictores significativos de la adherencia al tratamiento, explicando entre el 35 y el 47% de la variabilidad de esta. Conclusiones: La falta de adherencia al tratamiento de las pacientes con LES fue alta y parece estar influida por factores clínicos y psicopatológicos (AU)

Background and objective: Non-adherence to treatment is usually a clinical problem in patients with systemic lupus erythematosus (SLE). Increasing the knowledge of predictors of treatment adherence can be meaningful in the clinical setting. The main objective of the present study was to analyse the influence of sociodemographic, clinical and psychological variables on the degree of treatment adherence in a sample of Spanish women with SLE. Patients and method: This is an observational-transversal study. All participants were evaluated for the degree of treatment adherence, their clinical status, psychopathological manifestations, the level of perceived stress and self-efficacy. The sample was divided into two groups (adherent vs non-adherent). The factors associated with a lack of adherence in this sample were analysed by means of logistic regression. Results: This study comprises 72 women with SLE (average age=36.72±12.2 years). Almost 64% of patients with SLE were non-adherent to treatment. The results showed that a low educational level, being unemployed, living with a partner and alcohol abuse were associated with low treatment adherence. There were significant mean differences between groups in psychopathological subscales of somatisation, obsession-compulsion and general psychopathological indices. There were also mean differences between groups for the level of perceived stress. The use of non-steroidal anti-inflammatory drugs, suffering arthrosis and scoring higher in dimensions of psychopathology were significant predictors of treatment adherence, explaining between 35% and 47% of its variability. Conclusions: Including the clinical and psychopathological manifestations as important aspects in the clinical reasoning of health professionals could improve the adherence to treatment of patients with SLE (AU)

Validez y fiabilidad de la escala de autoeficacia para el ejercicio físico en pacientes con síndrome metabólico / Validity and reliability of the self-efficacy to regulate exercise scale in patients with metabolic syndrome

Fundamentos: La autoeficacia percibida se refiere a la creencia en la propia capacidad para hacer algo. El objetivo de este trabajo fue obtener la validez y la fiabilidad de la escala de autoeficacia para el ejercicio físico (AEEF) en pacientes con síndrome metabólico (SM) y para ello fueron verificadas las propiedades psicométricas de la misma. Métodos: Participaron en el estudio 135 sujetos con una edad media de 55,5 años (DT=7,6) que cumplían los criterios diagnósticos para el SM. Se tomaron medidas sociodemográficas, psicológicas y de estilo de vida de los mismos. Los sujetos fueron reclutados en el Hospital Universitario Virgen de las Nieves (HUVN) de Granada (España) durante los años de 2013 a 2014. La caracterización de la muestra fue realizada a través de análisis descriptivos. Se realizó el análisis factorial, de la consistencia interna y de validez convergente del AEEF; las diferencias intra e intergrupales fueron evaluadas a través de la prueba t de Student. Resultados: Extrajimos una solución de 2 factores que explicaron el 72,7% de la varianza común. Los valores de consistencia interna para la puntuación total de la AEEF fueron de (0,925 y 0,864) según los valores del alfa de Cronbach y del método de las dos mitades de Guttman, respectivamente. Las correlaciones de la AEEF con la frecuencia de la práctica de ejercicios, la renuncia al sedentarismo, la asertividad, el estrés y la ira fueron estadísticamente significativas Conclusiones: Este es el primer estudio sobre las propiedades psicométricas de la versión española de la AEEF. Los resultados mostraron niveles aceptables de validez y fiabilidad en pacientes con SM. La escala demostró ser útil para evaluar la asociación de la autoeficacia relativa al ejercicio físico con distintas variables psicosociales y de estilo de vida

Background: Self-efficacy refers to beliefs in individuals' own capacities to do something. With the intent of evaluate the validity and reliability, we investigated the psychometric properties of the Self-Efficacy to Regulate Exercise Scale (SERES) in patients with metabolic syndrome (MetS). Methods: 135 participants with medical diagnosis of MetS took part in the study (Mage=55.5, SD=7.6). We investigated sociodemographic, psychological, and life-style variables. Participants were recruited at the Hospital Universitario Virgen de las Nieves (HUVN) in Granada (Spain) between 2013 and 2014. In order to characterise the sample, descriptive statistics were used. Factorial analysis, internal consistency and convergent reliability of the SERES were also calculated. Group differences were investigated using Student's t test. Results: A solution with two factors was extracted, which explained 72.7% of the variance of the SERES. The internal consistency values for the total score of the SERES were (0.925 and 0.864) according to the values of Cronbach's alpha and Guttman's two halves, respectively. Significant correlations of the SERES were detected for with physical exercise, assertiveness, stress, anger, and active life-style (e.g., renouncing to sedentary behaviours) Conclusions: This was the first study to report on psychometric properties of the SERES. Results supported the adequacy of the measure for use with patients with MetS. SERES seemed to be useful in evaluating self-efficacy in relation to physical exercise, psychosocial, and lifestyle variables

Protocolo del estudio de cohortes Gestastres sobre los efectos del estrés durante el embarazo mediante la medida del cortisol en cabello de la mujer y del recién nacido / GESTASTRES cohort study protocol on the effects of stress during pregnancy by measuring the cortisol in women’s and newborn's hair

Se presenta el protocolo del estudio longitudinal del estrés perinatal desde la concepción hasta un año de vida. El estrés se relaciona con trastornos psicopatológicos, enfermedades cardiovasculares e inmunológicas. Durante el embarazo, la activación del eje hipotalámico-hipofisario-adrenal ante un estímulo estresante aumenta los niveles de cortisol. El estrés durante el embarazo tiene efectos sobre la madre, el feto y el bebé que pueden llegar a la adultez. Sin embargo, existen resultados contradictorios. En este estudio longitudinal se pretendía estudiar los niveles de estrés materno de 807 mujeres embarazadas durante los 3 trimestres de embarazo, mediante evaluación psicológica y mediante la innovadora técnica de niveles de cortisol en pelo. Se estudia la relación con los niveles de cortisol en pelo de recién nacidos, temperamento y neurodesarrollo de los bebés a los 6 y 12 meses de edad. Además, se miden variables sociodemográficas, historia obstétrica, parto y nacimiento, desarrollo fetal e infantil. Los resultados obtenidos permitirán promover la adopción de medidas preventivas y de intervención en Salud Pública

The aim was to present the longitudinal study protocol on the effects of perinatal stress from conception to one year of age. Stress is associated to psychopathological, cardiovascular and inmunological diseases. During pregnancy, the activation of the Hipotalamic-Pituitary-Adrenal results in an increased release of cortisol. Stress during pregnancy is related to maternal, fetal and infant negative outcomes that can last a lifetime. Nevertheless, contradictory findings have been reported. In this longitudinal study maternal stress is assessed from a sample of 807 pregnant women through hair cortisol levels and psychological questionnaires during the three trimesters of pregnancy. Besides, associations with the new-borns' hair cortisol levels, temperament and neurodevelopment at age 6 and 12 months are assessed. Sociodemographic, obstetrics, delivery, fetal and newborn development variables are included in analysis. Findings will be able to provide a better understanding of perinatal stress and will improve maternal, fetal and infant outcomes

Cuestionario de asertividad centrado en el estilo de vida (CACEV) en pacientes con síndrome metabólico: desarrollo y validación / The Lifestyle Related Assertiveness Questionnaire (LRAQ) in patients with metabolic syndrome: Development and validation

El objetivo de este trabajo es presentar las propiedades psicométricas del "Cuestionario de asertividad centrado en el estilo de vida" (CACEV) con una muestra de pacientes con síndrome metabólico. La muestra total fue de 136 sujetos de los que 79 terminaron el estudio (48 del grupo de tratamiento y 31 del grupo control), con seguimientos de 6 y 18 meses. Se han incluido los datos sociodemográficos, antropométricos, fisiológicos y bioquímicos de los participantes, aparte de las puntuaciones en el CACEV y en el "Inventario de asertividad" (IA). Los resultados del análisis factorial exploratorio del CACEV han revelado una estructura de tres factores: Expresar la preferencia por el ejercicio y la alimentación saludable, Decir que no al consumo de alimentos poco saludables y Decir que no a actividades obstaculizadoras del ejercicio físico. La consistencia interna (alfa= 0,925), la fiabilidad test-retest y la sensibilidad al cambio fueron adecuadas. Las propiedades psicométricas del CACEV indican que es un cuestionario válido y fiable para evaluar la asertividad centrada en el estilo de vida en personas con síndrome metabólica

The aim of this paper is to present the psychometric properties of the Lifestyle-Related Assertiveness Questionnaire (CACEV) in a sample of patients with metabolic syndrome. The total sample was 136 subjects, of whom 79 completed the study (48 from the treatment group and 31 from the control group), with follow-up at 6 and 18 months. Socio-demographic, anthropometric, physiological and biochemical data of the participants have been included, as well as the CACEV and the Assertiveness Inventory (AI) scores. The results of the exploratory factor analysis of CACEV have revealed a 3-factor structure: Expressing preference for exercise and healthy eating, Saying no to unhealthy food consumption and Saying no to activities that interfere with physical exercise. The internal consistency (alfa = .925), test-retest reliability and sensitivity to change were adequate. From the psychometric properties found in the CACEV, we can conclude that it is a valid and reliable questionnaire to evaluate lifestyle-related assertiveness in people with metabolic syndrome

Effects of the cognitive-behavioral therapy for stress management on executive function components

This study aims to determine whether it is possible to modify executive function in stressed individuals by means of cognitive-behavioral therapy for stress management. Thirty-one people with high levels of perceived stress were recruited into the study (treatment group = 18; wait-list group = 13). The treatment group received 14 weeks of stress management program. Psychological and executive function variables were evaluated in both groups pre and post-intervention. The treatment group showed improved psychological variables of perceived stress (t = 5.492; p = .001), vulnerability to stress (t = 4.061; p = .001) and superstitious thinking (t = 2.961; p = .009). Likewise, the results showed statistically significant differences in personality variables related to executive function, positive urgency (t = 3.585; p = .002) and sensitivity to reward (t = -2.201; p = .042), which improved after the therapy. These variables showed a moderate to high effect size (oscillates between 1.30 for perceived stress and .566 for sensitivity to reward). The cognitive-behavioral therapy for stress management may be an appropriate strategy for improving personality construct components related to executive function, however effects of the therapy are not showed on performance on the tests of executive function applied, as presented studies previous (AU)

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Adaptación y validación de la versión española de una medida específica de la calidad de vida en los pacientes con lupus eritematoso sistémico: el Lupus Quality of Life / Adaptation and validation of the Spanish version of a disease-specific quality of life measure in patients with systemic lupus erythematosus: The Lupus Quality of Life

Fundamento y objetivo: El lupus eritematoso sistémico (LES) es una enfermedad autoinmunitaria que afecta la calidad de vida. Hay varios instrumentos específicos que miden la calidad de vida relacionada con la salud (CVRS), pero ninguno se ha adaptado al español. El objetivo de este trabajo fue adaptar y validar en la población española una medida específica de la CVRS en los pacientes con LES. Pacientes y métodos: La adaptación se basó en el método de traducción y retrotraducción de la versión inglesa del LupusQoL (Lupus Quality of Life) y su aplicación en 115 adultos con LES. Resultados: El análisis factorial identificó 5 dominios del LupusQoL; la fiabilidad evidenció un alto coeficiente en el alfa de Cronbach de 0,977 y en el método de las 2 mitades de Guttman de 0,936; las correlaciones significativas del LupusQoL con el Medical Outcome Survey muestran alta validez convergente del cuestionario, mientras que las correlaciones con el Systemic Lupus Erythematosus Disease Activity Index y el System Lupus International Collaborating Clinics fueron bajas, lo que evidencia su validez discriminante. Conclusión. La versión española del LupusQoL cuenta con estables propiedades psicométricas para medir la CVRS en las personas con LES en ámbitos clínicos y de investigación en la población hispanoparlante (AU)

Background and objective: Systemic Lupus Erythematosus (SLE) is an auto-immune disease that seriously affects quality of life. There are various specific instruments that measure health-related quality of life (HRQOL), but none of them has been adapted to Spanish. We intended to adapt and validate in a Spanish population a specific HRQOL measure in patients with SLE. Patients and methods: The adaptation was carried out using the translation and back-translation method of the English version of the LupusQoL, with its subsequent application to 115 adults with SLE. Results: The factorial analysis identified 5 domains of the LupusQoL; the reliability tests showed a high Cronbach α coefficient of 0.977 and a high Guttman two-halves coefficient of 0.936; the significant correlations of the LupusQoL with the SF-36 showed a high convergent validity of the questionnaire; in addition, the correlations with the SLEDAI and SLICC were low, which showed its discriminated validity. Conclusion: The Spanish version of the LupusQoL has stable psychometric properties to measure HRQOL in people with SLE in clinical and research settings in a Spanish-speaking population (AU)

Aplicación de la terapia de afrontamiento del estrés en dos poblaciones con alto estrés: pacientes crónicos y personas sanas / Effectiveness of stress management therapy in two populations with high stress: chronic patients and healty people

Introduction Stress is currently considered a health risk factor. Numerous studies have shown that people with high levels of perceived stress present a greater number of complaints at both the physical and psychological levels. In this context, programs have been developed directed toward adequately coping with stress, and the effectiveness of these programs on the symptomatology of a psychological nature in healthy persons with a high level of perceived stress has been shown. However, there have been fewer studies that have shown whether this type of therapy affects the somatic symptomatology of healthy people in any way. On the other hand, programs for chronically ill patients directed toward achieving a better adaptation to their life conditions are equally effective. A population that presents considerably high levels of stress is the one consisting of people suffering from a chronic illness. Thus, through the immunological modulation it produces, the stress may be exacerbating the course of the disease. One prototype of this is systemic lupus erythematosus (SLE). SLE is a syndrome whose clinical expression depends on the degree to which there is a convergence of an immune regulation disorder and a strong genetic base, hormonal influence, and various exogenous agents. SLE can be manifested by general malaise, fever, fatigue, weight loss, skin rashes, joint inflammation, anemia, inflammation of the lymphatic glands, lowering of the defenses against infection, and cardiac, kidney, neurological, and pulmonary alterations. This autoimmune disease is usually associated with high levels of pain and impairment in different systems, producing high levels of stress in the patients who suffer from it. Nevertheless, although stress has already been shown to be one environmental factor that can produce a worsening in lupus symptoms, there have been no studies carried out with the objective of testing the effectiveness of stress management therapy and its physical and emotional consequences in these patients. For this reason, this study has a double objective: on the one hand, to corroborate, once again, the efficacy of cognitive-behavioural stress management therapy in the control of certain psychological processes and, on the other hand, to take one more step by testing whether there is a reduction in the perception of self-reported somatic symptoms both in healthy people and in those with a chronic disease. Material and method Fifty-two people participated in this study. Twenty-two were patients with lupus from the University Hospital in Granada. The other 30 were people without chronic diseases who attended the Psychological Attention Service at the University of Granada to receive therapy for coping with stress, as they claimed to have high levels of it. To evaluate the level of stress, we used the Stress Vulnerability Inventory by Beech, Burns and Scheefield, and the Scale of Recent Life Experiences (SRLE) by Kohn and Macdonald. To evaluate depression, we used the Beck Depression Inventory (BDI), and for anxiety, the Trait Anxiety Inventory (STAI-R) by Spielberger, Gorsuch and Lushene. For the self-reported somatic symptoms, we used the Revised Somatic Symptoms Scale (SSS-R) by Sandín, Valiente and Chorot. In addition, in the patients with SLE, the SLEDAI index, or Index of Activity of the Disease, was obtained. The therapy received was cognitive-behavioural in nature, and it was carried out during 13 sessions which were grouped in the following blocks: Conceptualization of the stress, cognitive restructuring; Deactivation techniques; Approaching the self-management of the pain; Social skills; Time control and organization; Personality pattern and its relationship with health; Anger management; Humour and optimism as coping strategies. Results Results showed that both groups presented a statistically significant reduction in stressful life experiences [F(1 .50) = 28.6; p<.000], vulnerability to stress [F(1 .50) = 1 05.25; p<0.000], depression [F(1 .50) = 68.33; p<0.000], and anxiety [F(1 .49) = 54.53; p<0.000] after the treatment. Moreover, the effect size of these variables was high in the group of patients with lupus and in the group of healthy patients, although it was higher in the latter group. Likewise, both groups presented a statistically significant improvement in the physical function, producing a reduction in the perceived somatic symptoms [F(1 .48) = 37.7; p<0.000] after the treatment. Furthermore, the effect of the treatment was high in both groups. Discussion This paper addresses a critically important issue: the effectiveness of cognitive-behavioral intervention in ameliorating psychosocial stress and enhancing the well-being of individuals with lupus and the group of people with high stress. In this improvement, there was not only a significant reduction in the score on vulnerability to stress and stressful life experiences, but a reduction in the levels of anxiety and depression and somatic symptoms. The findings of improvements in somatic symptoms suggest that this intervention might facilitate coping and change the cognitive appraisals of symptoms. Likewise, the impact of the intervention on psychosocial outcomes (depression, anxiety and perceived vulnerability to stress) may have implications for longer-term health behaviors and health outcomes. Although this reduction is significant in both groups, the effect size is greater in the group of people with high stress than in the group of lupus patients. Specifically, the somatic symptoms where a lower effect of the therapy was observed were the immunological, respiratory, musculoskeletal, and dermatological symptoms, which coincide with the most characteristic symptoms of lupus. This study supports, therefore, the importance of stress management programs not only to reduce the amount of stress, but also to improve the emotional variables and physical condition, both in people with chronic diseases and in healthy people with a high level of stress. The cognitive-behavior therapy is a new effective line of action in dealing with lupus, being necessary an overall integrated view of the patients with lupus, treating the clinical and psychological aspects.

Introducción Actualmente, el estrés se considera un factor de riesgo para la salud. Diversos estudios ponen de manifiesto que altos niveles de estrés presentan mayor número de quejas, tanto en el nivel físico como psicológico. En este contexto, se han desarrollado programas dirigidos a un adecuado afrontamiento del estrés, que han resultado eficaces en la modificación de variables emocionales. Sin embargo, no se ha estudiado la eficacia de la terapia en la mejoría de síntomas somáticos. Por otra parte, existen enfermedades en que, por la modulación inmunológica que produce, el estrés puede actuar exacerbando el curso de ésta. Un prototipo de lo anterior es el lupus eritematoso sistémico (LES), enfermedad de carácter autoinmune que suele conllevar importantes niveles de dolor y deterioro de diferentes sistemas, con lo que a su vez produce altos niveles de estrés en los pacientes que lo padecen. También está ampliamente demostrado que el estrés puede actuar como exacerbador de la enfermedad. Pese a ello, no se ha llevado a cabo ningún estudio que tenga como objetivo comprobar la eficacia de la terapia de afrontamiento al estrés por sus consecuencias físicas y emocionales. Por ello, el objetivo de este estudio ha sido valorar la eficacia de la terapia cognitivo-conductual en el manejo del estrés para comprobar si disminuye la percepción de los síntomas somáticos autoinformados, tanto en personas sanas como en personas con lupus. Material y método En este estudio han participado 52 personas, de las cuales 22 eran pacientes con lupus y 30 eran personas con alto estrés. Para evaluar el nivel de estrés hemos utilizado el Inventario de Vulnerabilidad al Estrés y la Escala de Experiencias Vitales Recientes (SRLE); para evaluar la depresión, el Inventario de Depresión de Beck (BDI); para la ansiedad, el Inventario de Ansiedad Rasgo (STAI-R); y para los síntomas somáticos autoinformados, la Escala de Síntomas Somáticos-Revisada (ESS-R). Además, en los pacientes con LES, se obtuvo el índice SLEDAI o índice de actividad de la enfermedad. Ambos grupos se evaluaron en las diferentes variables psicológicas descritas previamente antes y después del tratamiento. La terapia recibida fue de tipo cognitivo-conductual y se desarrolló a lo largo de 13 sesiones de hora y media. Resultados Los resultados mostraron que ambos grupos presentaban una reducción estadísticamente significativa en experiencias vitales estresantes [F(1 .50) = 28.6; p<0.000], vulnerabilidad al estrés [F(1.50) = 105.25; p<0.000], depresión [F(1.50) = 68.33; p<0.000] y ansiedad [F(1 .49)=54.53; p<0.000] después del tratamiento. El tamaño del efecto en estas variables fue alto tanto en el grupo de pacientes con lupus como en el grupo de personas sanas, siendo mayor en este último. Asimismo, ambos grupos presentaron una mejora estadísticamente significativa de la función física y se produjo una disminución de los síntomas somáticos percibidos [F(1 .48) = 37.7; p<0.000] después del tratamiento. Además, aunque es alto en ambos grupos, el efecto del tratamiento es mayor en el grupo de personas con alto estrés percibido. Discusión Nuestros datos indican que la terapia de afrontamiento del estrés influye positivamente tanto en el grupo de personas con alto estrés como en el grupo de pacientes de lupus. En dicha mejoría disminuyen de forma significativa las puntuaciones de vulnerabilidad al estrés, experiencias vitales estresantes, ansiedad y depresión. Por otro lado, con respecto a los síntomas somáticos experimentados por ambos grupos, los resultados muestran un descenso de la percepción de los mismos. Aunque esta disminución es significativa, el tamaño del efecto es mayor en el grupo de personas con alto estrés. Este estudio apoya, por tanto, la importancia de un programa de afrontamiento del estrés no sólo para disminuir la cantidad de estrés, sino para mejorar las variables emocionales y el estatus físico tanto en personas con enfermedades crónicas como en personas sanas, pero con alto estrés.