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.

PsicAP transdiagnostic protocol of group cognitive-behavioral training for emotional disorders in Dominican Republic: a randomized controlled trial protocol.

Emotional disorders (ED) such as anxiety, depression and somatization are extremely prevalent disorders that can affect an individual's quality of life and functionality. Primary Health Care (PHC) is the first place to identify most patients with these conditions. Mental health services in the Dominican Republic, as well as in Latin America and the Caribbean in general, are unable to provide appropriate care for most people with mental disorders. Using evidence-based treatment protocols is also crucial to make progress in helping people with ED. The PsicAP project is a group intervention that uses a transdiagnostic approach and is grounded in cognitive-behavioral techniques. The program is implemented in 7 group sessions, each lasting for one and a half hours. The program has been shown to be effective in reducing clinical symptoms, dysfunction, and in improving quality of life. It is also a non-time-intensive, low-cost treatment that is helpful for addressing EDs in a PHC context. The objective is to bring psychological treatments into PHC facilities of Dominican Republic, making them more accessible for a larger amount of the population.

Design and validation of virtual environments for the treatment of cleaning obsessive-compulsive disorder.

During the coronavirus outbreak, it was noted that pre-existing psychological illnesses worsened, and numerous research indicate that those with contamination-related obsessions and cleaning compulsions (C-OCD) may be more affected. Virtual Reality (VR) and other immersive technologies have shown to be effective for the treatment of disorders related to anxiety, thus showing their potential to transform OCD treatment by means of integrating virtual elements. VR exposure has shown benefits compared to live or imagined exposure, however, to be effective it must be able to elicit high emotional arousal in users. Based on this, the present work aimed to develop different virtual environments scenarios and evaluate their efficacy in generating an emotional response in people with C-OCD symptoms. Based on the literature review, two virtual scenarios were created (dirty public bathroom and unhygienic kitchen). Subsequently, two groups were then constituted: C-OCD group (n = 20, aged between 18 and 48 years) characterized by an obtained score of more than 13 points (cut-point) in the Yale-Brown Scale for Obsessive-Compulsive Disorder (Y-BOCS) and by showing C-OCD symptoms when doing the structured interview (SCID-I), and a control group (n = 20, aged between 18 and 56 years), all participants were residents of the Dominican Republic. Exposure to the virtual environments generated high levels of state and subjective anxiety in both groups, although significantly higher in the C-OCD group. The results obtained indicate that the VR scenarios developed are suitable for eliciting emotional responses and, consequently, that they can be used to complement the treatment of C-OCD.

Psychometric properties of the survey work-home interaction nijmegen in Argentinian population.

Frictions between work and family life have increased during the COVID-19 pandemic, causing negative consequences on the mental health and quality of life of workers. Without validated instruments, it is not possible to determine the impact of Work-Family and Family-Work conflict. To date, no studies have been conducted to provide evidence of the validity and reliability of The Survey Work-Home Interaction Nijmegen (SWING; 22 items) in the population of Argentine workers. The SWING was administered to 611 Argentine workers of both sexes (73.6% female) aged between 18 and 70 years (M = 35.33; SD = 9.16) selected from a non-probabilistic accidental sampling. The confirmatory factor analysis showed satisfactory fit indices of the original four-factor model (χ2 = 647.073, gl = 203, CFI = 0.93, GFI = 0.92, NFI = 0.90, TLI = 0.92, RMSEA = 0.05, SRMR = 0.05, AIC = 557.9, BIC = 821.5). The level of reliability was acceptable (α between 0.68 and 0.86, ω = 0.79-0.89). The relationships of the subscale scores with the engagement and burnout variables were as expected according to previous studies. Having an instrument adequately adapted to the population of Argentine workers facilitates the development of studies aimed at evaluating the role of W-F or F-W interactions and their implications for health and productivity.

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.

A nationwide cross-sectional study of workers' mental health during the COVID-19 pandemic: Impact of changes in working conditions, financial hardships, psychological detachment from work and work-family interface.

BACKGROUND: The COVID-19 disease has changed people's work and income. While recent evidence has documented the adverse impact of these changes on mental health outcomes, most research is focused on frontline healthcare workers and the reported association between income loss and mental health comes from high-income countries. In this study we examine the impact of changes in working conditions and income loss related to the COVID-19 lockdown on workers' mental health in Argentina. We also explore the role of psychological detachment from work and work-family interaction in mental health. METHODS: A total of 1049 participants aged between 18 and 65 who were working before the national lockdown in March 2020 were recruited using a national random telephone survey. Work conditions included: working at the usual workplace during the pandemic, working from home with flexible or fixed schedules, and being unemployed or unable to work due to the pandemic. Measures of financial hardship included income loss and self-reported financial problems related to the outbreak. Work-family interface included measures of work-family conflict (WFC) and family-work conflict (FWC). Mental health outcomes included burnout, life satisfaction, anxiety and depressive symptoms. Data were collected in October 2020. RESULTS: Home-based telework under fixed schedules and unemployment impact negatively on mental health. Income loss and particularly self-reported financial problems were also associated with deterioration of mental health. More than half of the participants reported financial problems, and those who became unemployed during the pandemic experienced more often financial problems. Finally, psychological detachment from work positively influenced mental health; WFC and FWC were found to negatively impact on mental health. CONCLUSIONS: Countries' policies should focus on supporting workers facing economic hardships and unemployment to ameliorate the COVID-19' negative impact on mental health. Organisations can protect employees' mental health by actively encouraging psychological detachment from work and by help managing work-family interface. Longitudinal studies are needed to more thoroughly assess the long-term impact of the COVID-19-related changes in work and economic turndown on mental health issues.

COVID-19 pandemic and health worker stress: The mediating effect of emotional regulation.

BACKGROUND/INTRODUCTION: Psychological and physical well-being of health personnel has been significantly affected by COVID-19. Work overload and continuous exposure to positive COVID-19 cases have caused them fatigue, stress, anxiety, insomnia and other detriments. This research aims: 1) to analyze whether the use of cognitive reevaluation and emotional suppression strategies decreases and increases, respectively, stress levels of health personnel; 2) to quantify the impact of contact with patients with COVID-19 on stress levels of medical staff. METHOD: Emotion regulation strategies (cognitive reevaluation and emotional expression) and stress levels were evaluated in 155 Dominican physicians who were treating people infected with COVID-19 at the moment of the study (67.9% women and 32.1% men; mean age = 34.89; SD = 9.26). In addition, a questionnaire created by the researchers quantified the impact that contact with those infected had on their stress levels. RESULTS: Contact with patients with COVID-19 predicts increased use of emotion suppression strategies, although is not associated with the use of cognitive reevaluation. These findings lead to an even greater increase in stress on health care providers. CONCLUSIONS: Contextual contingencies demand immediate responses and may not allow health personnel to use cognitive re-evaluation strategies, leaning more towards emotion suppression. However, findings regarding high levels of stress require the implementation of intervention programs focused on the promotion of more functional emotion regulation strategies. Such programs may reduce current stress and prevent post-traumatic symptoms.

Using Constrained Factor Mixture Analysis to Validate Mixed-Worded Psychological Scales: The Case of the Rosenberg Self-Esteem Scale in the Dominican Republic.

A common method to collect information in the behavioral and health sciences is the self-report. However, the validity of self-reports is frequently threatened by response biases, particularly those associated with inconsistent responses to positively and negatively worded items of the same dimension, known as wording effects. Modeling strategies based on confirmatory factor analysis have traditionally been used to account for this response bias, but they have recently become under scrutiny due to their incorrect assumption of population homogeneity, inability to recover uncontaminated person scores or preserve structural validities, and their inherent ambiguity. Recently, two constrained factor mixture analysis (FMA) models have been proposed by Arias et al. (2020) and Steinmann et al. (2021) that can be used to identify and screen inconsistent response profiles. While these methods have shown promise, tests of their performance have been limited and they have not been directly compared. Thus the objective of the current study was to assess and compare their performance with data from the Dominican Republic of the Rosenberg Self-Esteem Scale (N = 632). Additionally, as this scale had not yet been studied for this population, another objective was to show how using constrained FMAs could help in the validation of mixed-worded scales. The results indicated that removing the inconsistent respondents identified by both FMAs (≈8%) reduced the amount of wording effects in the database. However, whereas the Steinmann et al. method only cleaned the data partially, the Arias et al. (2020) method was able to remove the great majority of the wording effects variance. Based on the screened data with the Arias et al. method, we evaluated the psychometric properties of the RSES for the Dominican population, and the results indicated that the scores had good validity and reliability properties. Given these findings, we recommend that researchers incorporate constrained FMAs into their toolbox and consider using them to screen out inconsistent respondents to mixed-worded scales.

Design and Validation of Augmented Reality Stimuli for the Treatment of Cleaning Obsessive-Compulsive Disorder.

Fear to contamination is an easy-to-provoke, intense, hard-to-control, and extraordinarily persistent fear. A worsening of preexisting psychiatric disorders was observed during the COVID-19 (coronavirus disease 2019) outbreak, and several studies suggest that those with obsessive-compulsive disorder (OCD) may be more affected than any other group of people. In the face of worsening OCD symptoms, there is a need for mental health professionals to provide the support needed not only to treat patients who still report symptoms, but also to improve relapse prevention. In this line, it is recommended to improve alternative strategies such as online consultations and digital psychiatry. The aim of this study is to develop augmented reality (AR) stimuli that are clinically relevant for patients with cleaning OCD and assess their efficiency to obtain emotionally significant responses. Four AR stimuli were developed: a plastic bag full of garbage, a piece of bread with mold, a dirty sports shoe, and a piece of rotten meat. All stimuli were shown to a clinical group (17 patients with cleaning OCD) and a control group (11 patients without OCD). Relevant results were the design of the AR stimuli. These stimuli were validated with the statistical difference in perceived anxiety in the meat stimuli between the clinical and control groups. Nevertheless, when looking at effect sizes, all stimuli present effect sizes from small (plastic bag) to large (meat), with both shoe and bread between small and medium effect sizes. These results are a valuable support for the clinical use of these AR stimuli in the treatment of cleaning OCD.

A narrative review of emotion regulation process in stress and recovery phases.

The difficulty in studying the relationship between stress and emotional regulation is due to the need to contemplate a dynamic perspective that analyzes the moderating role of stress. In fact, stress involves different phases or stages, and the neurocognitive processes involved in emotion regulation differ significantly between these phases. The period of anticipation of stressful events can be fundamental to understand the process of stress regulation; however, surprisingly few works have analyzed the differential activation of brain networks involved in cognitive regulation during the phases of stress and recovery. Taking this into consideration, within this study we propose to analyze in an integrated way the psychological and neurobiological processes during the phase of stress and recovery, with the aim of improving our understanding of the mechanisms that underlie successful and unsuccessful stress regulation. We consider that from the present review we contribute to achieve a better understanding of the mechanisms underlying successful and unsuccessful stress regulation would contribute to the improvement of prevention and treatment interventions for mental disorders.

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.

Realidade virtual na prática de mindfulness em psicoterapia: uma revisão narrativa / Realidad virtual en la práctica del mindfulness: una revisión narrativa / Virtual reality in the practice of mindfulness in psychotherapy: a narrative review

RESUMO A associação entre mindfulness (MF) e Realidade Virtual (RV) é recente. O MF vem sendo utilizado na psicoterapia em razão dos efeitos terapêuticos observados. Entretanto, não são todos os pacientes que conseguem obter o benefício desse recurso, sendo a RV uma via para o trabalho com o MF por facilitar o sentido de presença. Este artigo teve como objetivo realizar uma revisão narrativa da literatura sobre a utilização terapêutica da RV na prática de MF. Foram analisados 23 artigos completos, sendo os principais focos de pesquisa: o aprimoramento dos ecossistemas imersivos e dos recursos terapêuticos no contexto do MF em relação à experiência do usuário; o desenvolvimento de recursos tecnológicos econômicos; material de fácil manuseio para facilitar a experiência do usuário. Concluímos que a RV pode ser facilitadora como ferramenta no tratamento de pacientes cujo perfil se enquadra em terapia mediada por MF, embora sejam necessários estudos controlados que permitam compreender as especificidades da RV e as variáveis com valor terapêutico.

RESUMEN La asociación entre mindfulness (MF) y Realidad Virtual (VR) es reciente. MF se ha utilizado en psicoterapia debido a los efectos terapéuticos observados. Sin embargo, no todos los pacientes pueden obtener el beneficio de este recurso, siendo la RV una forma de trabajar con el MF porque facilita el sentido de presencia. Este artículo tuvo como objetivo realizar una revisión narrativa de la literatura sobre el uso terapéutico de la RV en la práctica de MF. Se analizaron 23 artículos completos, siendo los principales focos de investigación: la mejora de ecosistemas inmersivos y recursos terapéuticos en el contexto de MF en relación a la experiencia del usuario; el desarrollo de recursos tecnológicos económicos; material fácil de manejar para facilitar la experiencia del usuario. Concluimos que la RV puede ser un facilitador como herramienta en el tratamiento de pacientes cuyo perfil encaja en la terapia mediada por MF, aunque son necesarios estudios controlados para entender las especificidades de la RV y las variables con valor terapéutico.

ABSTRACT The association between mindfulness (MF) and Virtual Reality (VR) is recent. MF has been used in psychotherapy due to the therapeutic effects reported. However, not all patients are able to obtain the benefits of this resource, and VR becomes a way to work with MF as it facilitates the sense of presence. This paper presents a narrative review of the literature about therapeutic uses of VR in the practice of MF. A total of 23 complete papers were analyzed, being the main research focuses: the improvement of immersive ecosystems and therapeutic resources in the context of MF in relation to the user experience; the development of economic technological resources; easy to handle material to facilitate the user experience. We concluded that VR can be a facilitator as a tool in the treatment of patients who could benefit from MF-informed therapy, although controlled studies are needed to understand the specificities of VR and the variables with therapeutic value.

Validación del inventario de pensamientos negativos en respuesta al dolor en población argentina con cefaleas primarias / Validation of the inventory of negative thoughts in response to pain in the argentine population with primary headaches

Resumen: Procesos cognitivos tales como pensamientos negativos son importantes moduladores de la experiencia de dolor. El Inventario de Pensamientos Negativos en Respuesta al Dolor (INTRP) es una herramienta que permite evaluar los pensamientos automáticos negativos asociados a la experiencia dolorosa. El presente trabajo se enfoca en la validación del INTRP en población argentina. Se testearon varios modelos previos, llegando al mejor ajuste el modelo de cinco factores: 1) autoverbalizaciones negativas, 2) pensamientos negativos de apoyo social, 3) pensamientos de discapacidad, 5) pensamientos de falta de control y 5) pensamientos de autoinculpación. Este modelo posee la misma estructura factorial que la hallada en la versión española, el cual posee un nivel mayor de especificidad en la detección de cogniciones asociadas al dolor. Se puede concluir que el INTRP es una herramienta confiable para su uso en el ámbito clínico que permita enfocar la terapia psicológica de argentinos con cefaleas.

Abstract: Cognitive processes such as negative thoughts are important modulators of the pain experience. The Inventory of Negative Thoughts in Response to Pain (INTRP) is a tool that allows evaluating negative automatic thoughts associated with the painful experience. The present work focuses on the validation of the INTRP in the Argentine population. Several previous models were tested, reaching the best fit of the five-factor model: 1) negative self-verbalizations, 2) negative thoughts of social support, 3) thoughts of disability, 5) thoughts of lack of control and 5) thoughts of self-blame. This model has the same factor structure as that found in the Spanish version, which has a higher level of specificity in detecting cognitions associated with pain. It can be concluded that the INTRP is a reliable tool for use in the clinical setting that allows to focus the psychological therapy of Argentines with headaches.

Propiedades psicométricas del Inventario de Situaciones y Respuestas de Ansiedad Breve (ISRA-B) / Pyschometric properties of the Brief Inventory of Situations and Responses of Anxiety (ISRA-B)

INTRODUCCIÓN Y OBJETIVOS: La ansiedad es la reacción emocional más estudiada, que nos pone en alerta ante la posibilidad de obtener un resultado negativo, por lo que resulta adaptativa en la gran mayoría de las ocasiones, aunque también está en la base de los trastornos emocionales más prevalentes. Por ello, su evaluación ha generado mucha investigación y transferencia. El Inventario de Situaciones y Respuestas de Ansiedad (ISRA) fue desarrollado en España, incluye 22 situaciones (S) y 24 respuestas (R) de ansiedad, que al cruzarlas se forman 224 reactivos (del tipo «en tal S, experimento esta R»). Desde hace más de tres décadas ha sido ampliamente utilizado en la investigación, así como en la práctica, y se han publicado estudios sobre sus propiedades psicométricas en diferentes países. Una versión más breve (ISRA-B) de 46 ítems, sin contenidos cruzados S × R, sino una escala de 22 S y otra de 24 R, con las que evalúan las mismas ocho facetas de la ansiedad, ha mostrado buenas propiedades psicométricas también; sin embargo, existen menos publicaciones psicométricas en población española. El objetivo de este estudio fue analizar las propiedades psicométricas del ISRA-B en España. MÉTODO: Para ello se contó con 3,346 voluntarios (36.4% hombres), con edades de 15 a 94 años (media: 30.3; DE: 14.6). RESULTADOS: Los resultados confirmaron excelente consistencia interna para Total (.94) y subescala R (.91), buena para S (.89) y sistemas de respuesta Fisiológico (.86) y Cognitivo (.84), y aceptable para Motor (.70). También se encontró buena estabilidad test-retest al cabo de un mes (.78) y buena validez externa al correlacionar .87 con el ISRA original. La estructura factorial del ISRA-B obtenida se adecuó al modelo de Lang de tres sistemas de R y al modelo de Endler de interacción S × R, en los que se basa. Asimismo, se presentan los datos normativos, por sexo y grupo. CONCLUSIÓN: Se concluye que el ISRA-B es válido y confiable, mejora su aplicabilidad respecto al ISRA original, conservando sus propiedades psicométricas

INTRODUCTION AND OBJECTIVES: Anxiety is the most studied emotional reaction, which alerts us of the possibility of obtaining a negative result, making it adaptive in the vast majority of cases, although it is also one of the underlying factors of the most prevalent emotional disorders. Therefore, its assessment has generated a lot of research and transfer. The Inventory of Situations and Responses of Anxiety (ISRA) was developed in Spain and it includes 22 situations (S) and 24 responses (R) of anxiety, by which 224 items are formed by crossing them (i.e., «in such Situation, I experience this Reaction»). For more than three decades, it has been widely used in research and practice, and its psychometric properties have been published in different countries. A shorter, 46-item version (ISRA-B), with a 22 S scale plus another of 24 R was developed. The same eight facets of anxiety were assessed, showing good psychometric properties as well. However, there are few publications on the psychometric data using Spanish population. The objective of this study was to analyze the psychometric properties of ISRA-B in Spain. METHODS: Three thousand three hundred and forty six volunteers (36.4% men), aged 15 to 94 years (mean: 30.3; SD: 14.6) were included. RESULTS: The results confirmed excellent internal consistency for the Total (.94) and the Responses subscale (0.91), good for the Situations (0.89), as well as the Physiological (, 86) and Cognitive (0.84) response systems, and acceptable for the Motor (0.70). Good test-retest stability was also found after two months (0.78) and good external validity when correlated with the original ISRA (0.87). The results confirm the factor structure of the ISRA-B, adjusted to Lang's triple response system model and to Endler's S × R interaction model, on which it is based. Likewise, the normative data are presented, differentiated by sex and group. CONCLUSIONS: It is concluded that the ISRA-B is a valid and reliable instrument, which improves its applicability compared to the original ISRA by simplifying its format and number of items, while preserving its psychometric properties

COVID Feel Good-An Easy Self-Help Virtual Reality Protocol to Overcome the Psychological Burden of Coronavirus.

BACKGROUND: Living in the time of the COVID-19 means experiencing not only a global health emergency but also extreme psychological stress with potential emotional side effects such as sadness, grief, irritability, and mood swings. Crucially, lockdown and confinement measures isolate people who become the first and the only ones in charge of their own mental health: people are left alone facing a novel and potentially lethal situation, and, at the same time, they need to develop adaptive strategies to face it, at home. In this view, easy-to-use, inexpensive, and scientifically validated self-help solutions aiming to reduce the psychological burden of coronavirus are extremely necessary. AIMS: This pragmatic trial aims to provide the evidence that a weekly self-help virtual reality (VR) protocol can help overcome the psychological burden of the Coronavirus by relieving anxiety, improving well-being, and reinforcing social connectedness. The protocol will be based on the "Secret Garden" 360 VR video online (www.covidfeelgood.com) which simulates a natural environment aiming to promote relaxation and self-reflection. Three hundred sixty-degree or spherical videos allow the user to control the viewing direction. In this way, the user can explore the content from any angle like a panorama and experience presence and immersion. The "Secret Garden" video is combined with daily exercises that are designed to be experienced with another person (not necessarily physically together), to facilitate a process of critical examination and eventual revision of core assumptions and beliefs related to personal identity, relationships, and goals. METHODS: This is a multicentric, pragmatic pilot randomized controlled trial involving individuals who experienced the COVID-19 pandemic and underwent a lockdown and quarantine procedures. The trial is approved by the Ethics Committee of the Istituto Auxologico Italiano. Each research group in all the countries joining the pragmatic trial, aims at enrolling at least 30 individuals in the experimental group experiencing the self-help protocol, and 30 in the control group, over a period of 3 months to verify the feasibility of the intervention. CONCLUSION: The goal of this protocol is for VR to become the "surgical mask" of mental health treatment. Although surgical masks do not provide the wearer with a reliable level of protection against the coronavirus compared with FFP2 or FFP3 masks, surgical masks are very effective in protecting others from the wearer's respiratory emissions. The goal of the VR protocol is the same: not necessarily to solve complex mental health problems but rather to improve well-being and preserve social connectedness through the beneficial social effects generated by positive emotions.

Latent structure and factor invariance of somatic symptoms in the patient health questionnaire (PHQ-15).

BACKGROUND: Somatic symptoms are highly prevalent in primary care although insufficiently understood. The Patient Health Questionnaire (PHQ-15) is a valuable screening test but it has not yet been possible to unequivocally demonstrate its latent structure and measurement invariance. METHODS: A total of 1,255 patients from 28 primary care centres suffering symptoms of anxiety, depression or somatisation participated in a clinical trial. They completed the PHQ-15 at baseline and 374 retook it at three months. Exploratory structural equation modelling (ESEM) was used to compare three models: 1) a single global factor for somatisation, 2) four specific correlated factors, and 3) a bifactor model integrating the first two models. RESULTS: A multi-group invariance analysis of the best-fit model was performed: the bifactor model (χ2=25.17, df=23, p = 0.34, RMSEA=0.009, CFI=1.00, TLI=0.999). Strict invariance was good for both gender (RMSEA = 0.046, CFI = 0.973, TLI = 0.963) and age (RMSEA = 0.048, CFI = 0.964, TLI = 0.962). Configural and metric invariance were confirmed for moment of assessment, but scalar invariance was not. LIMITATIONS: The two main limitations were the sample (primary care patients with emotional disorders), which was not representative of the general population, and the utilisation of ESEM (vs. confirmatory factor analysis), which did not allow a second-order factor model to be tested. CONCLUSIONS: PHQ-15 showed a bifactor structure, providing both a single global measure of somatisation and specific measures of pain, gastrointestinal, cardiopulmonary and fatigue factors. Its factor invariance with regard to both gender and age was confirmed.

Towards an Explanatory Model of Suicidal Ideation: The Effects of Cognitive Emotional Regulation Strategies, Affectivity and Hopelessness.

Suicide constitutes a public health problem that has a significant economic, social and psychological impact on a global scale. Recently, the American Psychological Association has indicated that suicide prevention should be a public health priority. Suicidal ideation appears as a key variable in suicide prevention. The objective of this research was to verify the adjustment of an explanatory model for suicidal ideation, which considers the effects of cognitive emotion regulation strategies, affectivity and hopelessness. An open mode on-line sample of 2,166 Argentine participants was used and a path analysis was carried out. The results make it possible to conclude that the model presents an optimal fit (χ2 = .10, p = .75, CFI = .99, RMSEA = .01) and predicts 42% of suicidal thoughts. The model proves to be invariant based on age and gender. In conclusion, there is an importance of reducing the use of automatic strategies, such as repetitive negative thoughts of ruminative type, and increasing the use of more controlled strategies, such as reinterpretation or planning.

Factorial invariance of a computerized version of the GAD-7 across various demographic groups and over time in primary care patients.

BACKGROUND: The Generalized Anxiety Disorder 7-item scale (GAD-7) is commonly used by clinicians and researchers to screen for anxiety disorders and to monitor anxiety symptoms in primary care. However, findings regarding its factor structure are mixed, with most studies reporting a best-fitting for a one-factor structure, whereas others indicate a two-factor model. To be valid for comparisons, the GAD-7 should measure the same latent construct with the same structure across groups and over time. We aimed to examine the best-fit factor structure model of the GAD-7 among primary care patients and to evaluate its measurement invariance. METHODS: A total of 1255 patients completed the computerized version of GAD-7 and a subsample of 238 cases was assessed at the 3-month follow-up. A confirmatory factor analysis (CFA) was performed and analyses of multiple-group invariance were also conducted to determine the extent to which the factor structure was comparable across various sociodemographic groups and over time. RESULTS: The results showed that both a one- and two-factor structure (representing somatic and cognitive-affective components) were invariant across sociodemographic groups and over time. The two-factor structure provided the best model fit. LIMITATIONS: Results cannot be generalized to all primary care patients, as only patients whose general practitioners consider them to suffer emotional disorders were included. CONCLUSIONS: Our study supports the reliability and validity of the one- and two-factor model of the GAD-7, both for screening purposes and for monitoring response to treatment.

Towards an explanatory model of suicidal ideation: the effects of cognitive emotional regulation strategies, affectivity and hopelessness

Suicide constitutes a public health problem that has a significant economic, social and psychological impact on a global scale. Recently, the American Psychological Association has indicated that suicide prevention should be a public health priority. Suicidal ideation appears as a key variable in suicide prevention. The objective of this research was to verify the adjustment of an explanatory model for suicidal ideation, which considers the effects of cognitive emotion regulation strategies, affectivity and hopelessness. An open mode on-line sample of 2,166 Argentine participants was used and a path analysis was carried out. The results make it possible to conclude that the model presents an optimal fit (χ2 = .10, p = .75, CFI = .99, RMSEA = .01) and predicts 42% of suicidal thoughts. The model proves to be invariant based on age and gender. In conclusion, there is an importance of reducing the use of automatic strategies, such as repetitive negative thoughts of ruminative type, and increasing the use of more controlled strategies, such as reinterpretation or planning

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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.