Relationship between Thought Style, Emotional Response, Post-Traumatic Growth (PTG), and Biomarkers in Cancer Patients.

(1) Introduction: Cancer diagnosis has been related to depression, anxiety, and distress, as well as to post-traumatic growth (PTG). One of the mediating variables for emotional response is thought style (rumination, cognitive avoidance, and cognitive engagement). (2) Aim: To identify the relationship between thought style and emotional responses to cancer. A secondary aim was to identify the relationship between emotional responses and inflammatory immunological biomarkers. (3) Method: A total of 115 patients with cancer were included in the study. Before initiating cancer treatment, patients were assessed using the Hospital Anxiety and Depression Scale (HADS), distress thermometer, and Post-Traumatic Growth Inventory (PTGI). Patients provided their most recent blood biometry. (4) Results: Rumination correlated with anxiety, depression, and distress. Cognitive avoidance correlated with PTG (-0.240) and distress (-0.209). Cognitive engagement correlated with PTG (0.393). Regarding thought style and biomarkers, a negative correlation was observed for absolute neutrophils with cognitive avoidance (-0.271) and rumination (0.305). Regarding biomarkers and emotional responses, there was a negative correlation between PTG and absolute lymphocytes (-0.291). There was also a correlation between PTG and neutrophils (0.357) and neutrophil-to-lymphocyte ratio (NLR) (0.295). (5) Conclusions: Thought style is related to the emotional response to a cancer diagnosis; rumination is related to depression, distress, and anxiety; and cognitive engagement is related to PTG. PTG is related to inflammation and immunological biomarkers.

Validación de la Escala de Prácticas Espirituales con víctimas de violencia política en Chile / Validation of the Spiritual Practices Scale with victims of political violence in Chile

Resumen En este artículo se presenta la validación de una versión abreviada de la Escala de Prácticas Espirituales de Parsian y Dunning (2009). Para ello, se utilizó una muestra de personas adultas (n = 251, M = 60.85, DT = 13.40) víctimas de violencia política en Chile durante la dictadura cívico militar (1973-1990). Para valorar la estructura de la escala se realizó un Análisis Factorial Confirmatorio (AFC), se calculó el índice de fiabilidad (α = .85) y se valoró la validez convergente con una serie de correlaciones bivariadas entre variables. De acuerdo a lo esperado, el AFC informa un adecuado ajuste a la estructura unifactorial y los resultados dan cuenta de la relación significativa entre las prácticas espirituales y el crecimiento postraumático y entre las prácticas espirituales y la religiosidad. La relación entre estas dos últimas es media-baja (r = .29), lo cual permite concluir que, aunque relacionadas, son constructos diferentes. A partir del análisis de los datos, no se puede concluir que exista relación entre las prácticas espirituales con la edad y el nivel de ingresos. En conclusión, la versión abreviada de la Escala de Prácticas Espirituales presenta adecuados niveles de fiabilidad y validez, por lo que resulta recomendable para ser utilizada en la medición de prácticas espirituales, especialmente en aquellas poblaciones que no se adscriben a una fe teísta.

Abstract Spirituality, or what motivates the search for the sacred from particular and free positions, allows us to provide a framework from which to interpret the experience of loss and suffering, contributing in different ways to the resignification and re-authorship of people after the trauma. It is related to resilience, with that ability to overcome adverse events. It favors the mitigation of the negative effects of the traumatic event and fosters healthy and successful psychological development -despite the suffering caused by an external situation- by promoting the construction and redefinition of people's life purpose -one of the central components of human well-being-, being especially relevant in those who have been victims of trauma. Thus, spirituality can contribute to the reconfiguration of the narrative about the survived experience from practices that promote spiritual emotion such as the actions of meditating or praying, the latter considered as one of the mechanisms of self-revelation that is fundamental within the post traumatic growth process. Spirituality and religion maintain a complex interrelation that at times makes difficult the distinction between them. However, this distinction is especially sensitive and necessary when it comes to accounting for spirituality in people who do not profess a theistic faith. This is the case of a significant part of people with left-wing ideologies -who suffered some type of violence during the military dictatorships implanted from the second half of the 20th century in Latin America. Particularly in Chile, the civic-military dictatorship (1973-1990) was especially cruel with people of left-wing ideologies, many of them not ascribed to a belief of a theistic order. In this context, it is relevant to account for spiritual practices -differentiating them from religious beliefs- in relation to post-traumatic growth in people victims of political violence. For this objective we have proposed in this article the validation of the short version of the Parsian and Dunning (2009) Spiritual Practice Scale. For this purpose, we utilized a sample of adult people victims of political violence in Chile during the military dictatorship between 1973 and 1990 (n = 251, M = 60.85, DT = 13.40). To assess the structure of the scale, we estimated a confirmatory factor analysis (CFA). The reliability index was calculated (α = .85) and the convergent validity was assessed with a series of bivariate correlations between variables. As expected, the CFA reports an adequate adjustment to the unifactorial structure and the results show the significant relationship between spiritual practices and post-traumatic growth (r = .45), and between spiritual practices with religiosity (r = .29). Being the relationship between spiritual practices and religiosity medium-low, it allows us to conclude that although they are related, they are different constructs. From the analysis of the data, it cannot be concluded that there is a relationship between spiritual practices with age and income level. In conclusion, the short version of the Spiritual Practices Scale presents adequate levels of reliability and validity, so it is recommended to be used in the measurement of spiritual practices, especially in those populations that do not adhere to a theistic faith.

Constructing Collective Memories regarding Conflicto Armado Interno in Perú (1980-2000): Psychologýs Role and Contributions Based upon Experiences of Collective Reprocessing of Memories in Educational Contexts.

The construction of collective memory with regard to Conflicto Armado Interno (Internal Armed Conflict CAI) -violence that occurred in Perú between 1980 and 2000- is still a challenge that produces disputes and tension. It has been studied mostly by social scientists, from the point of view of 'memory' studies. Despite the great explanatory power of Psychology in understanding these type of processes, its contribution has mainly focused on mental health. Education has been the least researched area, despite the role the Truth and Reconciliation Committee attributed to education in schools and universities, in constructing memories about war. In this context, we reflect on the role of Psychology on constructing collective memory in educational settings. Starting from Hallbach´s classic theory of collective memory, to contributions from cognitive psychology and post-traumatic growth studies, we analyze two experiences in educational contexts with the purpose of proposing some guidelines for research and intervention.

Otimismo e ganho percebido em cuidadores de crianças com câncer / Optimism and benefit finding in caregivers of children with cancer / Optimismo y crecimiento psicológico postraumático en los cuidadores de niños con câncer

Com o objetivo de analisar as relações entre otimismo e ganho percebido em cuidadores de crianças com câncer, constituiu-se uma amostra de conveniência de 60 cuidadores, com média de idade de 36,5 anos (DP=9,17), 81,7% de mulheres, em um hospital de referência. Utilizaram-se os instrumentos: Teste de Orientação da Vida, Inventário de Desenvolvimento Pós-Traumático, e questionário sociodemográfico e clínico. Após análise estatística descritiva e inferencial, verificou-se correlação positiva entre otimismo e ganho percebido (percepção de recursos e competências pessoais). Otimismo e ganho percebido também se associaram às variáveis clínicas e sociodemográficas: cuidadores casados e com crianças fora de quimioterapia referiram maior ganho percebido; e cuidadores cujos filhos tinham mais tempo de tratamento, se mostraram mais otimistas e com maior ganho percebido. Conclui-se que características individuais e clínicas devem ser consideradas em intervenções com foco na ressignificação da experiência de ter um filho com câncer e o crescimento frente à adversidade.

In order to analyze the relationship between optimism and benefit finding in caregivers of children with cancer, a convenience sample with 60 caregivers was made up, with an average age of 36.5 (DP=9.17), 81.7 women, in a referral hospital. The tools used were: Life Orientation Test, Post-traumatic Growth Inventory and socio-demographic and clinical questionnaire. After the descriptive and inferential statistical analysis, the positive correlation between optimism and benefit finding (perception of resources and personal skills) was observed. Optimism and benefit finding were also associated with clinical and socio-demographic variables: married caregivers and with children without chemotherapy reported greater benefit finding; and caregivers whose children had a longer treatment period turned out to be more optimistic and with greater benefit finding. It is concluded that individual and clinical characteristics should be considered in interventions focused on reframing the experience of having a child with cancer and the growth face to adversities.

Para analizar la relación entre optimismo y crecimiento psicológico postraumático en los cuidadores de niños con cáncer, se constituyó una muestra de conveniencia de 60 cuidadores, con una edad media de 36,5 años (DE = 9,17), 81,7 % de mujeres, en un hospital de referencia. Los instrumentos utilizados fueron: Life Orientation Test, Posttraumatic Growth Inventory y cuestionario sociodemográfico y clínico. Tras el análisis estadístico descriptivo e inferencial, se constató una correlación positiva entre el optimismo y la ganancia percibida (Percepción de recursos y habilidades personales). El optimismo y la ganancia percibida también se asociaron con variables clínicas y sociodemográficas: los cuidadores casados y los niños sin quimioterapia reportaron una mayor ganancia percibida; y los cuidadores cuyos hijos tuvieron más tiempo de tratamiento, fueron más optimistas y percibieron una mayor ganancia. Se concluye que las características individuales y clínicas deben ser consideradas en intervenciones enfocadas a replantear la experiencia de tener un hijo con cáncer y crecimiento ante la adversidad.

Mulheres diagnosticadas com câncer de mama: impacto do crescimento pós-traumático / Women diagnosed with breast cancer: impact of post-traumatic growth

Câncer é possivelmente a doença mais temida na atualidade. Por seu caráter crônico, exige ajustamentos em múltiplos domínios na vida do paciente, com evidências indicando que fatores físicos, emocionais, cognitivos, interpessoais e comportamentais estão inter-relacionados e contribuem para o ajustamento de cada indivíduo. A perspectiva de superação de uma experiência desafiadora como o câncer pode resultar no desenvolvimento do que alguns autores denominam de crescimento pós-traumático. O objetivo consistiu em identificar os fatores relacionados ao crescimento pós-traumático a partir do diagnóstico e tratamento de câncer de mama. Participaram deste estudo trinta mulheres diagnosticadas com câncer de mama em tratamento no Hospital de Base. Para o processo de coleta de dados foram utilizados, questionário sociodemográfico, Escala de Ansiedade e Depressão Hospitalar, Escala de esperança de Herth, Escala de Apoio Social, Escala de Ajustamento Mental para o câncer e Inventário de Crescimento Pós-Traumático. Como resultado verificou-se que variáveis como idade, possuir um companheiro, maior tempo de diagnóstico, esperança, menores indicadores de depressão, maior nível de escolaridade e religião são fatores que colaboram para o desenvolvimento do crescimento pós-traumático. Estes resultados apontam para a importância da identificação destas variáveis no perfil psicossocial de pacientes com câncer, e principalmente para a necessidade de elaborar intervenções que possam promover a manutenção e o desenvolvimento de fatores de proteção em face aos estressores do tratamento.

Cancer is possibly the most feared disease today. Due to its chronic nature, it requires adjustments in multiple domains in the patient's life, with evidence indicating that physical, emotional, cognitive, interpersonal and behavioral factors are interrelated and contribute to the adjustment of each individual. The prospect of overcoming a challenging experience like cancer can result in the development of what some authors call post-traumatic growth. The objective was to identify factors related to post-traumatic growth from the diagnosis and treatment of breast cancer. Thirty women diagnosed with breast cancer undergoing treatment at the Base Hospital participated in this study. For the data collection process, a sociodemographic questionnaire, Hospital Anxiety and Depression Scale, Herth's Hope Scale, Social Support Scale, Mental Adjustment Scale for cancer and Post-Traumatic Growth Inventory were used. As a result, it was found that variables such as age, having a partner, longer diagnosis time, hope, lower indicators of depression, higher level of education and religion are factors that contribute to the development of post-traumatic growth. These results point to the importance of identifying these variables in the psychosocial profile of cancer patients, and mainly to the need to develop interventions that can promote the maintenance and development of protective factors in the face of treatment stressors.

Memoria traumática: estrategias de afrontamiento adaptativas e inadaptativas / Traumatic Memories: Adaptive and Maladaptive Coping Strategies

Resumen En este artículo se analiza la relación existente entre los recuerdos traumáticos y las posibles estrategias para hacerles frente. Los recuerdos traumáticos son difíciles de integrar en la biografía de las personas afectadas y pueden interferir de forma significativa en su funcionamiento social, académico y profesional. Se distingue psicopatológicamente entre los recuerdos normales y los recuerdos traumáticos. Asimismo se analizan las estrategias de afrontamiento adaptativas, tales como la evitación cognitiva, la exposición terapéutica a los recuerdos traumáticos o la capacidad de perdón. Pero también hay un afrontamiento inadaptativo (nostalgia, sentimientos de odio y de venganza o conductas autodestructivas) que puede dar cuenta de las dificultades de recuperación en algunos pacientes. Por último, se examinan las estrategias de regulación emocional cognitiva y el papel de la resiliencia y del crecimiento postraumático para afrontar los recuerdos traumáticos. Se comentan las implicaciones de este estudio para investigaciones futuras en esta área.

Abstract In this paper the relationship between traumatic memories and coping skills to deal with them is analyzed. Traumatic memories are difficult to be integrated into the survivor's life story and can significantly interfere with social, educational and occupational functioning. From a psychopathological point of view, a distinction between normal and traumatic memories is made. Adaptive coping skills to deal with traumatic memories, such as cognitive avoidance, therapeutic exposure to traumatic memories or forgiveness, are analyzed. But there is also maladaptive coping, such as nostalgia, hate and revenge feelings or self-destructive behaviors, which should be taken into account to explain the difficulties of recovery in some patients. Finally, the cognitive emotion regulation strategies and the role of resiliency and post-traumatic growth in some patients to cope with traumatic memories are examined. Implications of this study for future research in this field are commented upon.

Posttraumatic Growth Inventory (PTGI): Adaptação e Validade Fatorial no Nordeste Brasileiro / Posttraumatic Growth Inventory (PTGI): Adaptation and Factorial Validity in the Brazilian Northeast / Posttraumatic Growth Inventory (PTGI): Adaptación y Validez Factorial en el Noreste de Brasil

O presente estudo objetivou verificar os parâmetros psicométricos do Posttraumatic Growth Inventory ­ PTGI, apresentando evidências de validade fatorial, consistência interna e etapas da sua adaptação transcultural. A amostra foi composta por 205 participantes, sua maioria do sexo feminino (59,03%), com idades variando entre 18 e 86 anos (M = 29,54; DP = 11,43). Estes responderam ao PTGI, Life Stressor Checklist ­ Revised e perguntas demográficas. Nas análises fatoriais confirmatórias, observa-se o modelo pentaforial como mais adequado para o PTGI, sendo estatisticamente superior ao tri e ao unifatorial. A consistência interna de seus fatores (alfa de Cronbach) variou de 0,70 a 0,86, com alfa geral de 0,92, valores considerados aceitáveis. Conclui-se que essa medida, apresentando evidências de validade de construto, pode ser usada adequadamente em pesquisas no contexto em que foi adaptada, entretanto, recomenda-se o uso do instrumento em amostras mais heterogêneas e a realização de outras análises, observando sua invariância fatorial.(AU)

This study aimed to verify the psychometric parameters of the Posttraumatic Growth Inventory - PTGI, presenting evidence of factorial validity, internal consistency and steps of cross-cultural adaptation. The sample consisted of 205 participants from northeastern Brazilian cities, mostly female (59.03%), aged between 18 and 86 years (M = 29.5, SD = 11.4). Participants answered the PTGI, the Life Stressor Checklist ­ Revised, and demographic questions. The confirmatory factor analysis observed the penta-factorial model as more suitable for PTGI, being statistically superior to three and one-factor. The internal consistency of its factors (Cronbach's alpha) ranged from .70 to .86, with general alpha of .92, values considered acceptable. It follows that this measurement, providing evidence of construct validity, can be properly used in research in the context in which it was adapted to, however, we recommend the use of the instrument in more heterogeneous samples and conducting other analyzes, observing its factorial invariance.(AU)

Este estudio tuvo como objetivo verificar los parámetros psicométricos del Posttrumatic Growth Inventory ­ PTGI, presentando evidencias de validez factorial, consistencia interna y etapas de su adaptación transcultural. La muestra fue compuesta por 205 participantes, en su mayoría de sexo femenino (59,03%), con edades entre 18 y 86 años (M = 29.5; SD = 11.4). Ellos respondieron el PTGI, Life Stressor Checklist ­ Revised y preguntas demográficas. En los análisis factoriales confirmatorios se observa el modelo pentafactorial como el más adecuado para el PTGI, siendo estadísticamente superior al tri y al unifactorial.La consistencia interna de sus factores (alfa de Cronbach) varió de 0,70 a 0,86,con alfa general 0,92, valores considerados aceptables. Esta medida, por presentar evidencias de validez de constructo, puede ser utilizada adecuadamente en investigaciones en el contexto en que fue adaptada, sin embargo, se recomienda el uso del instrumento en muestras más heterogéneas y la realización de otros análisis, observando su invariancia factorial.(AU)

Correlatos valorativos do crescimento pós-traumático em uma amostra brasileira / Value correlates of posttraumatic growth in an brazilian sample

Este estudo objetivou verificar a relação existente entre o Crescimento Pós-Traumático e os valores humanos, tendo como base a Teoria Funcionalista. Para tanto, participaram 212 pessoas com idades variando de 18 a 86 anos (m = 28 anos e dp = 11, 45), a maioria mulheres (55,4%), solteiros (67,2%) e com ensino superior incompleto (37,6%). Os participantes responderam ao Posttrumatic Growth Inventory (PTGI) e o Questionário de Valores Humanos Básicos. Foi realizada análise de correlação (r de Pearson) e regressões lineares múltiplas. Os resultados indicaram relações entre a subfunção existência com todos os fatores do PTGI, além das subfunções interativa, normativa, existência e realização apresentarem relação preditiva com o fator geral. Conclui-se que os resultados foram congruentes com a literatura especializada. Contribuindo para o avanço cientifico da temática, propõe­se uma investigação inovadora no trabalho da adaptação frente ao trauma e reafirma a centralidade dos valores na Psicologia Social. (AU)

This study aimed to verify the existing relationship between the Post-traumatic Growth and the human values, based on the Fundamentalist Theory. To this end, 212 people attended with ages ranging 18-86 years old (mean = 28 years, SD = 11, 45) in most women (55.4%), single (67.2%) and incomplete higher education (37.6%), which responded to Posttrumatic Growth Inventory (PTGI) and the Questionnaire of Basic Human Values. Correlation analysis was performed (Pearson's r) and multiple linear regressions. Resulting relationship between the subfunction existence with all PTGI factors, and to subfunction interactive, normative, existence and promotion presents relationship with the general factor. We conclude that the results were consistent with the literature. In order to contribute to the scientific advance of this topic, it is proposed an innovative investigation in the adaptation toward the trauma, as well as restate the centrality of the values in the Social Psychology. (AU)

Argentina (1976-1983): impacto y afrontamiento psicosocial / Argentina (1976-1983): Psychosocial Consequences and Coping

El presente estudio explora el impacto que tuvo la violencia represiva de la última dictadura militar argentina en una muestra de familiares de personas detenidas desaparecidas (n=30) y de personas que sobrevivieron a las cárceles de la dictadura (n=22). De los resultados se extrae que un tipo de afrontamiento activo de la experiencia y un apoyo social positivo, se relaciona con la posibilidad de dar sentido a lo ocurrido y la generación de una identidad en el sobreviviente. A la inversa, las formas de afrontamiento marcadas por la evitación se relacionan con más sintomatología de estrés postraumático, mayor alteración en el proceso de duelo y mayor impacto negativo en las creencias básicas.

This study explores the impact of repressive violence during the last Argentinean military dictatorship's on a sample of relatives of people detained-disappeared for political reasons (n = 30) and people who survived imprisionment and torture (n=22). Facing of the experience from a political point of view, remaining socially active and positive social support are string elements in providing sense to the experience and generating a positive identity as a survivor. Viceversa, hidding and avoidance are related to post-traumatic symptoms, difficulties in the mourning process and a greater negative impact on basic beliefs.

Crecimiento tras el trauma: Revisión general y estado actual / Growth Following Trauma: Overview and Current Status

Growth is commonly reported following all variety of stressful encounters. This phenomenon is receiving proliferating research attention, and much has been learned. In this article, we provide an overview of the current theoretical and empirical knowledge regarding growth. Most of this research concerns self-reported growth, but a small amount of research reviewed here concerns actual growth. In particular, we review theoretical models and empirical evidence of growth and relationships between growth and adjustment. We then address several methodological, cultural, and other important issues in this research area and conclude with directions for future research.

El crecimiento es algo que a menudo informan quienes han padecido sucesos estresantes. Este fenómeno está recibiendo un interés creciente y se ha aprendido ya mucho sobre ello. En este trabajo proporcionamos una revisión del conocimiento teórico y empírico relacionado con el crecimiento. La mayor parte de esta investigación hace referencia a crecimiento auto-informado, aunque una porción de la investigación revisada tiene que ver con crecimiento objetivo. En particular, revisamos modelos teóricos y evidencia empírica de crecimiento y las relaciones entre crecimiento y ajuste. Para finalizar, señalamos varios aspectos importantes metodológicos y culturales, entre otros, en esta área de investigación y concluimos con algunas orientaciones para la investigación futura.

Crecimiento post-traumático en supervivientes de cáncer y sus otros significativos: ¿crecimiento vicario o secundario? / Posttraumatic growth in cancer survivors and their significant others: vicarious or secondary growth?

Las enfermedades graves como el cáncer, aunque generan elevado malestar emocional y estrés en los supervivientes y en sus otros significativos, también pueden suponer un estímulo en la generación de crecimiento postraumático en ambos. Los mecanismos de cómo se produce este crecimiento postraumático (vicario vs. secundario) en los otros significativos no se han estudiado. En esta revisión se analizan la evidencia y relación del crecimiento post-traumático en supervivientes de cáncer y en sus otros significativos, principalmente sus parejas, madres y padres, en relación a estos mecanismos de transmisión vicario o secundario. Se concluye que, en general, el crecimiento post-traumático en los otros significativos es una experiencia vicaria íntimamente ligada al crecimiento del superviviente en cáncer, aunque ser mujer, madre o sufrir un cáncer avanzado facilitan procesos de crecimiento post-traumático secundario en los otros significativos, que se diferencian del superviviente.

Severe diseases such as cancer although generate high stress and emotional distress in survivors and their significant others, can also be a stimulus to promote posttraumatic growth. The mechanisms of this post-traumatic growth (vicarious vs secondary) in significant others have not been studied. This review examines the evidence and relationship between posttraumatic growth in cancer survivors and their significant others, mainly in their partners and parents, regarding these vicarious or secondary growth transmission mechanisms. We conclude that, in general, posttraumatic growth in significant others is a vicarious experience closely linked to the cancer survivor's growth. However, being a woman, mother or suffer an advanced cancer facilitate secondary posttraumatic growth processes insignificant others.