Cognitive factors as mediators of the relationship between childhood trauma and depression symptoms: the mediating roles of cognitive overgeneralisation, rumination, and social problem-solving.

Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors - cognitive overgeneralisation, rumination and social problem-solving - as mediating factors in the relationship between childhood trauma and symptoms of depression.Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants (N = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling.Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies.Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problem-solving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma.

Since the relationship between childhood trauma and depression is not straightforward, the study addresses a significant gap in the understanding of the relationship between childhood trauma and depression symptoms by focusing on cognitive factors as potential mediators among depressed patients.Childhood trauma not only has a direct positive effect on depression symptoms but also indirectly influences depression through self-overgeneralisation and rumination, which contribute to elevated depression, while effective social problem-solving strategies act as a protective factor, leading to decreased depression symptoms.The significance of above cognitive overgeneralisation factors in shaping the relationship between childhood trauma and depression symptoms suggests that therapeutic interventions targeting these cognitive factors might be hold promise in improving mental health outcomes for this vulnerable population.

Bullying and cyberbullying, what do they have in common and what not? A latent class analysis / Acoso y ciberacoso, ¿qué es igual y qué es distinto? Un análisis de clases latentes

El acoso escolar y el ciberacoso se presentan como comporta-mientos de riesgo durante la adolescencia. Aunque se ha reconocido una importante relación entre ambos fenómenos, aspectos referidos a su preva-lencia, la semejanza y diferencia entre uno y otro, la transferencia de roles, así como los aspectos emocionales, sociales y morales asociados aún están sin resolver. El objetivo fue explorar los perfiles de implicación en acoso y ciberacoso a través de un análisis de clases latentes y examinar su asocia-ción con desconexión moral, ajuste social y normativo y rumiación de la ira. Se presenta un estudio longitudinal en dos tiempos con 3,006 escolares de secundaria (Medad= 13.53; 51.9% chicas). Se utilizaron autoinformes ampliamente validados en la población de referencia. Los resultados mos-traron cuatro clases latentes: no implicados, víctimas-cibervíctimas, agreso-res victimizados y totalmente implicados. Análisis de regresión logística identificaron un bajo ajuste social en los totalmente implicados, bajo ajuste normativo y alta desconexión moral en perfiles mixtos, y alta rumiación de la ira en todos los perfiles de implicación, principalmente en agresores vic-timizados. Se discuten estos resultados en términos de su valor para com-prender los matices que distinguen el acoso y ciberacoso, de la existencia de roles puros y mixtos y de las variables emocionales, sociales y morales asociadas.(AU)

Bullying and cyberbullying are risky behaviours which normally occur during adolescence. Although an important relationship has been recognized between the two phenomena, issues related to their prevalence, the similarity and difference between them, the transfer of roles, as well as the emotional, social, and moral aspects associated with them, remain un-resolved. The aim of this study was to explore the roles ofinvolvement in bullying and cyberbullying through an analysis of latent classes, and exam-ine their association with moral disengagement, social and normative ad-justment, and anger rumination. The study had a two-stage longitudinal de-sign, with 3,006 secondary school students (Mage= 13.53; 51.9% girls), us-ing extensively validated self-reports in the reference population. The re-sults showed four latent classes: uninvolved, victim-cybervictim, bully-victim and wholly involved. Logistic regression analyses identified a low social adjustment in those wholly involved, low normative adjustment and high moral disengagement in mixed profiles, and high anger rumination in all involvement profiles, mainly in bully-victim. These results are discussed in terms of their value in understanding the distinctions between bullying and cyberbullying, the existence of pure and mixed roles, and the associat-ed emotional, social, and moral variables.(AU)

Relaciones entre atención, claridad y reparación emocional con respuestas rumiativas en universitarios de Lima

El factor de atención emocional ha sido reportado con frecuencia negativamente asociado con indicadores de salud mental; al contrario de los resultados obtenidos con los factores de claridad y de reparación emocional. Los objetivos del estudio fueron examinar las relaciones entre atención, claridad y reparación emocional con los factores de respuestas rumiativas y determinar si la relación entre la atención emocional y rumiación varía de acuerdo con los niveles de atención, claridad y reparación emocional en estudiantes universitarios de Lima, Perú. Para ello, primero se realizó un estudio de la estructura factorial y la confiabilidad de la TMMS-24 y de la Escala de Respuestas Rumiativas, en 320 estudiantes de una universidad pública de Lima, Perú. Segundo, se llevó a cabo un estudio correlacional mediante la aplicación de ambos instrumentos a 529 estudiantes de la misma universidad. En la muestra total se obtuvo que ambos factores de rumiación correlacionaron positivamente con atención emocional, pero solo reproche correlacionó con claridad y con reparación, siendo tal correlación negativa. Para determinar si la relación positiva entre atención y rumiación varía con los niveles de atención, claridad y reparación, se compararon las correlaciones entre atención y rumiación correspondientes a los grupos de baja, media y alta atención, claridad y reparación. Estas comparaciones mostraron que la relación entre atención y los factores de rumiación variaban solo en función del nivel de reparación. Los resultados indican diferencias importantes en la manera en que se relaciona cada factor de rumiación con la atención emocional, por un lado, y con la claridad y la reparación emocional, por el otro.

The emotional attention factor has been often reported as negatively associated with mental health indicators, contrary to the results attained with the emotional clarity and repair factors. The objectives of this study were to examine relationships between emotional attention, clarity and repair and factors of ruminative responses and to determine whether the relation between emotional attention and rumination could vary according to the levels of emotional attention, clarity and repair in university students from Lima, Peru. For this, in first place, a study was carried out to determine the factor structure and the internal consistency of the TMMS-24 and the Ruminative Responses Scale in 320 undergraduates of a public university in Lima, Peru. After this psychometric study, it was carried out a correlation study in 529 undergraduates from the same university. In the whole sample, both rumination factors positively correlated with emotional attention, but only brooding correlated with clarity and repair, negatively. In order to determine whether the positive relation between attention and rumination varies with the levels of attention, clarity and repair, the attention-rumination correlations were compared between groups of low, medium and high attention, clarity and repair. These comparisons shown that the relationship between attention and rumination factors varied only as a function of the level of repair. These results indicate important differences in the way that each rumination factor is related with emotional attention, on the one hand, and with emotional clarity and repair, on the other.

Construcción y validación del Cuestionario de Pica y Rumiación (CuPRu) en adolescentes y adultos jóvenes mexicanos / Construction and validation of the Pica and Rumination Questionnaire in Mexican adolescents and young adults

La investigación de los trastornos de Pica y Rumiación se ha centrado en niños, personas con discapacidad y mujeres embarazadas, lo anterior tieneimportantes implicaciones debido a que se desconoce si estos se presentan en otras etapas del desarrollo y en otras poblaciones. Su padecimientoconduce a importantes problemas en la salud e incluso pueden llegar a derivar en la muerte, por lo que es indispensable contar con instrumentosde tamizaje válidos y confiables. Por tanto, el objetivo de este estudio fue desarrollar un instrumento para detectar los síntomas y conductas detrastornos de Pica y Rumiación, así como determinar sus propiedades psicométricas. Los reactivos fueron elaborados a partir de la revisión de laliteratura y posteriormente fueron sometidos a revisión por siete expertos en el área, obteniendo coeficientes V de Aiken que indican un alto acuerdoentre jueces respecto al contenido del instrumento. Asimismo, se verificó su confiabilidad a partir de los coeficientes alfa 0.85 y omega 0.93. Posteriomente se llevó a cabo un Análisis Factorial Exploratorio y Confirmatorio, donde logró una estructura de cuatro factores que explican el 48.35%de la varianza, además los siguientes índices que corroboran un ajuste adecuado CMIN = 2.41, GFI = 0.92; AGFI = 0.89; CFI = 0.93; RMR=.063y RMSEA = 0.064. Por último, se realizó la calibración de los reactivos donde se observó que todos discriminaban adecuadamente. En conclusión,las propiedades psicométricas obtenidas en este estudio demuestran que el Cuestionario de Pica y Rumiación, es válido y confiable. (AU)

Research on Pica and RuminationDisorders has focused on children, people with disabilities, and pregnant women. This has important implications because it is unknown whetherthese occur at other stages of development and in other populations. These conditions leads to important health problems and can even lead todeath, so it is essential to have valid and reliable screening instruments. Therefore, the objective of this study was to develop an instrument to detectthe symptoms and behaviors of Pica and Rumination disorders, as well as to determine their psychometric properties in Mexican adolescents andyoung adults. The items were prepared from the review of the literature and were subsequently submitted for review by seven experts in the area,obtaining Aiken’s V coefficients that indicate a high agreement between judges regarding the content of the instrument. Likewise, the reliability ofthe scale was verified from the calculation of the alpha and omega coefficients, where the following indices were obtained: 0.85 and 0.93. Subsequently, an Exploratory and Confirmatory Factor Analysis was carried out, where a structure of four factors was achieved that explains 48.35% of thevariance, in addition to the following indices that corroborate an adequate fit CMIN = 2.41, GFI = 0.92; AGFI = 0.89; CFI = 0.93; RMR =.063 andRMSEA = 0.064. Finally, the calibration of the reagents was carried out where it was observed that all discriminated adequately. In conclusion, thepsychometric properties obtained in this study show that the Pica and Rumination Questionnaire is valid and reliable. (AU)

Co-occurrence of approach and avoidance in prolonged grief: a latent class analysis.

Background: Prolonged grief disorder (PGD) has been included in the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders 5 Text Revision (DSM-5-TR). Loss-related avoidance behavior perpetuates grief and effective interventions for prolonged grief symptoms target such avoidance behavior. Yet, behaviors characterized by approach of loss-related cues (i.e. rumination, yearning, proximity seeking) are also implicated in prolonged grief reactions.Objective: To solve this paradox, we will test the Approach Avoidance Processing Hypothesis, which holds that loss-related approach and avoidance behaviors co-occur in PGD, using latent class analyses (LCA).Methods: Two-hundred eighty-eight bereaved adults (92% female) completed questionnaires assessing loss-related approach behaviors (rumination, yearning, proximity seeking), loss-related avoidance behaviors (anxious avoidance, experiential avoidance) and ICD-11 and DSM-5-TR prolonged grief symptoms.Results: LCA demonstrated the best fit for a three-class solution comprising a low approach/low avoidance class (n = 98, 34%), a high approach/low avoidance class (n = 79, 27%), and a high approach/high avoidance class (n = 111, 39%). The latter class showed significantly higher prolonged grief symptom levels and higher odds of probable PGD compared to the other classes.Conclusions: Co-occurrence of loss-related approach and avoidance appears characteristic to prolonged grief reactions. Distinguishing bereaved people with these behavioral patterns from those solely experiencing loss-related approach behaviors may improve the efficacy of PGD therapies.

A latent class analysis of bereaved adults showed high approach/high avoidance, high approach/low avoidance and low approach/low avoidance classes.The high approach/high avoidance class showed highest prolonged grief symptoms and higher odds of probable prolonged grief disorder.Co-occurrence of loss-related approach and avoidance appears to characterize prolonged grief.

Validez de constructo y propiedades psicométricas del cuestionario “Respuestas al afecto positivo” (RAP) / Construct validity and psychometric properties of the questionnaire "Responses to Positive Affect" (RAP)

Los estudios constatan el papel de la rumia depresiva como un amplificador del estado de ánimo negativo, sin embargo, se conoce menos sobre la rumia relacionada con el afecto positivo. Presentamos la validez de constructo y propiedades psicométricas del cuestionario “Respuestas al afecto positivo” (RAP) en una muestra de 302 personas de la población general (55,2% mujeres), con edades entre los 18 y 68 años (M= 28,6; DT= 12,0). Los análisis factorial exploratorio y confirmatorio indican una estructura de dos factores: rumia positiva centrada en la emoción y en la persona (α= 0,88) y amortiguación (α= 0,83), ambos con una adecuada invarianza configural, métrica y escalar por sexo. Los dos factores presentan una adecuada validez convergente, discriminante e incremental con constructos relacionados con el afecto negativo y positivo. Los resultados se discuten atendiendo a los estudios revisados y se propone el RAP como instrumento de evaluación en procedimientos terapéuticos que tratan de potenciar el afecto positivo y el bienestar psicológico. (AU)

Previous studies confirm the role of depressive rumination in the exacerbation of negative mood. However, less is known about rumination in relation to positive affect. We present the construct validity and psychometric properties of the Responses to Positive Affect (RAP) questionnaire in a sample of 302 people from the general population (55.2% female), aged 18-68 years (M= 28.6, SD= 12.0). Exploratory and confirmatory factor analyses indicate a two-factor structure: emotion- and person-centered positive rumination (α= .88) and buffering (α= .83), both with adequate configural, metric and scalar invariance by sex. The two factors present adequate convergent, discriminant and incremental validity with constructs related to negative and positive affect. The results are discussed according to the studies reviewed and the RAP is proposed as an assessment instrument in therapeutic procedures that seek to enhance positive affect and psychological wellbeing. (AU)

Psychometric properties of the Diurnal Insomnia Symptoms Response Scale (DISRS) in a Mexican population sample APPENDIX / Propiedades psicométricas de la Escala de Respuestas a los Síntomas Diurnos del Insomnio (DISRS) en una muestra de población mexicana

Abstract Introduction Increased rumination is associated with longer night-time sleep onset latency and poorer sleep quality and efficiency in people with insomnia symptoms. Objective To validate the Diurnal Insomnia Symptoms Response Scale (DISRS) in a general population sample. Method 102 participants (women = 67 and men = 35) comprising patients and relatives who attended an outpatient consultation at a health center in Mexico City were evaluated. The English-Spanish-English translation system was used by two Spanish-speaking experts on the subject, an independent bilingual expert translated the new version of the scale into English, which was then compared with the original. The following self-administered questionnaires were used to evaluate the convergent, discriminant validity of this tool: the Ruminative Response Scale (RRS), the Insomnia Severity Index (ISI), and Penn State Worry Questionnaire (PSWQ). Results The internal consistency of the scale items was α = .93. Principal components factor analysis yielded three factors with an eigenvalue of greater than one, which together explain 59.5% of the variance. Correlations between the total DISRS score and the cognitive-motivational dimensions (r = .938, p < .01), negative state (r = .898, p < .01) and tiredness (r = .853, p < .01) were statistically significant. Insomnia symptoms (SCC = .89) outweighed worries (SCC = .33) and ruminant responses (SCC = .33) when discriminating between cases with low and high levels of rumination associated with insomnia symptoms. Discussion and conclusion Our results suggest that the DISRS scale has adequate psychometric properties that make it valid and reliable for use with the Mexican population.

Resumen Introducción Los pensamientos rumiativos se asocian con mayor latencia del sueño, peor calidad y eficiencia de sueño en personas con insomnio. Objetivo Realizar la validación de la escala de respuestas a los síntomas diurnos del insomnio (DISRS) en una muestra de población general en México. Método Se evaluaron a 102 participantes (mujeres = 67 y hombres = 35) que acudieron a consulta externa de un centro de salud de la Ciudad de México. Se utilizó el sistema de traducción inglés-español-inglés, un experto bilingüe independiente tradujo al inglés la nueva versión de la escala y se verificó con el original. Para evaluar la validez convergente y discriminante del DISRS, se aplicó la Escala de Respuestas Rumiativas (RRS), el Índice de Severidad del Insomnio (ISI) y el Cuestionario de Preocupaciones de Pensilvania (PSWQ). Resultados La consistencia interna de los ítems fue α = .93. El análisis factorial de componentes principales determinó tres factores con valor propio superior a uno, que explican 59.5% de la varianza. Las correlaciones del puntaje del DISRS con las dimensiones cognitivo-motivacional (r = .938, p < .01), estado negativo (r = .898, p < .01) y cansancio (r = .853, p < .01) resultaron significativas. Los síntomas de insomnio (CCE =.89) tuvieron más peso que las preocupaciones (CCE = .33) y las respuestas rumiativas (CCE = .33) al discriminar a los casos con bajos y altos niveles de rumiación asociada al insomnio. Discusión y conclusión La escala DISRS en español tiene adecuadas propiedades psicométricas que la hacen válida y confiable para ser utilizada en población mexicana.

Análisis de las respuestas cognitivas relacionadas con el diagnóstico de cáncer en pacientes mexicanos / Cognitive response related to cancer diagnosis in Mexican patients

Resumen La evaluación subjetiva ha sido descripta como una variable mediadora para la respuesta emocional. Se presenta con diferentes contenidos y estilos. El estilo cognitivo se refiere a la manera en que se piensa sobre el estresor, por ejemplo: la rumiación (pensamientos intrusivos, repetitivos, que generan malestar emocional), la evitación (intentos por no pensar en el estresor) y el compromiso cognitivo (enfocados en búsqueda de sentido o solución). En base a esta respuesta emocional, se busca explorar y describir los pensamientos relacionados con el cáncer en un grupo de diez pacientes con la enfermedad. En un estudio cualitativo, se les pidió a diez pacientes con cáncer que indicaran los cinco pensamientos más frecuentes desde su diagnóstico. Se analizó el contenido mediante la técnica top down (teoría a contenido) y, a partir de los estilos de respuestas cognitivas, se clasificó el contenido de los pensamientos reportados por estilo de pensamiento (rumiación, compromiso cognitivo o evitación), por temporalidad (pasado, presente y futuro) y por valencia (positiva o negativa). Posteriormente, se hizo el análisis bottom up (contenido a teoría). Se hicieron tablas cruzadas para identificar los contenidos según el estilo de pensamiento, la temporalidad y la valencia. En los pensamientos con estilo rumiativo, el enfoque temporal se dirigía en su mayoría al futuro y al pasado, mientras que el compromiso cognitivo se enfocaba en el presente. Esta diferencia fue estadísticamente significativa mediante una prueba de chi cuadrado. Dentro de los temas relacionados con la incertidumbre, se refirieron a la muerte, al pronóstico de la enfermedad, a la respuesta de la familia y a las finanzas (en el futuro) y a las causas y culpa (en el pasado).

Abstract Cancer has been defined by the World Health Organization as "a disease caused by abnormal cells growing uncontrollably in the body, going beyond their usual boundaries, invading adjoining parts of the body and spreading to other organs". Being diagnosed with cancer has been described as an experience with diverse emotional reactions and difficulties in adaptation, having psychological consequences, being most common depression, anxiety and psychological distress; but also, some patients present positive consequences after having a cancer diagnosis, such as post traumatic growth, which includes positive changes presented after the disease experience. Subjective appraisal about cancer has been defined as a mediating variable for the emotional response presented after a stressor, such as cancer diagnosis, treatment, or important changes during disease process (initiating and finalizing treatment, presenting relapse or remission, as well as when having control studies). The subjective appraisal can be presented with different thought content and styles. Thought style is referred as the way thoughts about the stressor are presented, it has been classified as rumination (thoughts that are intrusive and repetitive that also increase psychological distress), cognitive engagement (thoughts associated with problem solving and meaning finding) or avoidance (aiming to stop thinking about stressor or feeling associated with it). Depending on the thought style presented at a stressor, could be the emotional response (anxiety, depression, distress, post-traumatic growth). The aim of the present study was to describe the thoughts (style, content, valence and temporality) related to cancer diagnosis in a group of ten oncologic patients. To identify if differences between thought style, valence and temporality were presented. The study design is qualitative from a phenomenological point of view. Ten oncologic (different cancer type, clinical stage and treatment) patients were asked to write the five more frequent thoughts since their cancer diagnosis. Each thought was classified by: thought style, valence, and temporality (top-down, classifying the thoughts according to theory). The same thoughts were also classified in semantic units (bottom-up, classifying the thoughts according to their own contents), generating concerns from the content. Cross tabs were made to identify contents and temporality for thought style and valence, which were analyzed by chi square to identify differences between thought style, temporality and valence. The most common thought style was cognitive engagement, followed by rumination (almost same frequency). On what respects to thought style and temporality, rumination was more focused on past (causes and attributions of cancer) and future (uncertainty about death and treatment effectiveness); meanwhile, cognitive engagement was focused on present (to enjoy present moment and focus on daily actions). Chi square was made to identify if this difference was significant, showing temporality was significantly different in cognitive engagement and rumination. The concerns identified in study participants were uncertainty about future and disease, family (communication and wellness of the family), finances (due to expensive treatments), causes and guilt about having cancer. Thoughts that were more centered in present, were more likely to be associated with cognitive engagement. Cognitive engagement has been described previously as an important variable associated with post traumatic growth. Thoughts centered in the past and present were more associated with rumination. Rumination has been associated with depression and post-traumatic stress disorder. Because of mediating role of thought style in disease adaptation, emotional response to the disease, and the relation of this adaptation with the perception of quality of life in cancer patients, the design of psychological interventions aiming on promoting cognitive engagement by problem solving skills, meaning finding, and focusing on present could be a research line derived from present studies results.

Síndrome de rumiación, revisión crítica / Rumination syndrome: Critical review

El síndrome de rumiación es un trastorno funcional caracterizado por la regurgitación involuntaria de los alimentos recientemente ingeridos desde el estómago hacia la boca, donde puede ser remasticados o expulsados. Desde el punto de vista clínico, se caracteriza por episodios repetidos de regurgitación de alimentos sin esfuerzo, con vómitos frecuentes como queja habitual. El mecanismo físico que genera los eventos de regurgitación depende de un proceso involuntario que altera las presiones abdominal y torácica, acompañado de una unión esofagogástrica permisiva. El diagnóstico del síndrome de rumiación es clínico: destaca la importancia de realizar una anamnesis exhaustiva sobre las características de los síntomas. Las pruebas complementarias se utilizan para corroborar el diagnóstico o descartar otra enfermedad orgánica. El tratamiento está enfocado a terapias conductuales como primera línea, reservando las terapias farmacológicas y quirúrgicas para casos refractarios.

Rumination syndrome is a functional disorder characterized by the involuntary regurgitation of recently swallowed food from the stomach into the mouth, from where it can be re-chewed or expelled. Clinically, it is characterized by repeated episodes of effortless food regurgitation. The most usual complaint is frequent vomiting. The physical mechanism that generates regurgitation events is dependent on an involuntary process that alters abdominal and thoracic pressures accompanied by a permissive oesophageal-gastric junction. The diagnosis of rumination syndrome is clinical, highlighting the importance of performing an exhaustive anamnesis on the characteristics of the symptoms. Complementary tests are used to corroborate the diagnosis or rule out organic pathology. Treatment is focused on behavioural therapies as the first line, reserving pharmacological and surgical therapies for refractory cases.

Brooding Rumination and Anxiety Sensitivity: Associations WithDepressive and Anxiety Symptoms in Treatment-seeking Smokers / Rumiación y Sensibilidad a la Ansiedad: Asociaciones con SíntomasDepresivos y de Ansiedad en Fumadores que Buscan Tratamiento ParaDejar de Fumar

Background: This study explores the shared and specific associations of brooding rumination and anxiety sensitivity to depression and anxiety symptomatology in a sample of treatment-seeking smokers. Methods: The sample was composed of 275 treatment-seeking adult smokers. Hierarchical linear regression analyses were conducted to examine the relations of both variables with depressive and anxiety symptoms. Results: Greater brooding rumination and anxiety sensitivity predicted higher levels of depression and anxiety symptoms. A specific relationship emerged after controlling for comorbid symptoms (depressive or anxiety symptoms) where brooding rumination was associated with depressive symptoms and anxiety sensitivity with anxiety symptoms. Conclusions: The findings showed that the variables examined are transdiagnostically related to emotional symptoms, but this relationship was symptomatology-specific when controlling for comorbid symptoms (depressive or anxiety symptoms). Due to the impact of affective symptoms on abstinence outcomes, these findings have relevant clinical implications. In the context of smoking cessation treatment, identifying shared and specific vulnerabilities might contribute to tailoring and designing more precise and effective interventions for quitting smoking.

Antecedentes: este estudio explora las asociaciones compartidas y específicas entre el factor reproches de la rumiación y la sensibilidad a la ansiedad con la sintomatología depresiva y ansiosa en una muestra de fumadores. Método: la muestra estaba formada por 275 fumadores adultos que demandaron tratamiento para dejar de fumar. Se realizó un análisis de regresión lineal jerárquica para examinar las relaciones de ambas variables con los síntomas depresivos y ansiosos. Resultados: mayores puntuaciones en rumiación-reproches y en sensibilidad a la ansiedad predijeron niveles más elevados de síntomas depresivos y ansiosos. Sin embargo, cuando se controlaron los síntomas comórbidos (depresivos o ansiosos), emergieron relaciones específicas entre la rumiación-reproches y los síntomas depresivos y entre la sensibilidad a la ansiedad y los síntomas ansiosos. Conclusiones: las variables examinadas se relacionan transdiagnósticamente con la sintomatología emocional, pero esta relación pasa a ser específica cuando se controlan los síntomas comórbidos (depresivos o ansiosos). Debido al impacto negativo que tienen los síntomas emocionales en la abstinencia, estos resultados pueden aportar implicaciones clínicas relevantes. La identificación de vulnerabilidades compartidas y específicas podría contribuir a adaptar y diseñar intervenciones más precisas y eficaces para dejar de fumar.

Rumination syndrome: Critical review. / Síndrome de rumiación, revisión crítica.

Rumination syndrome is a functional disorder characterized by the involuntary regurgitation of recently swallowed food from the stomach into the mouth, from where it can be re-chewed or expelled. Clinically, it is characterized by repeated episodes of effortless food regurgitation. The most usual complaint is frequent vomiting. The physical mechanism that generates regurgitation events is dependent on an involuntary process that alters abdominal and thoracic pressures accompanied by a permissive oesophageal-gastric junction. The diagnosis of rumination syndrome is clinical, highlighting the importance of performing an exhaustive anamnesis on the characteristics of the symptoms. Complementary tests are used to corroborate the diagnosis or rule out organic pathology. Treatment is focused on behavioural therapies as the first line, reserving pharmacological and surgical therapies for refractory cases.

Intolerance of uncertainty, rumination, post-traumatic stress symptoms and aggression during COVID-19: a serial mediation model.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic can be identified as a source of traumatic stress. Previous studies have shown that post-traumatic stress and intolerance of uncertainty are associated with aggressive behaviour. OBJECTIVE: In the present study, we aimed to test a serial mediation model, considering rumination and post-traumatic stress symptoms (PTSS) as mediators that link intolerance of uncertainty and aggression, while controlling the confounding effect of crisis-induced health and socioeconomic stressors during the COVID-19 pandemic. METHOD: A total of 714 participants [533 (74.6%) females, 176 (24.7%) males, aged 18-64 years (M age = 25.16, SD age = 9.34)] completed the following self-reported scales: Aggression Scale, COVID-19 stressors checklist, Short Version of the Intolerance of Uncertainty Scale, Impact of Event Scale with Modifications for COVID-19, and Ruminative Thought Style Questionnaire. RESULTS: The results revealed that there was an association between intolerance of uncertainty and aggressive behaviours. Moreover, the results of serial mediation analysis showed that intolerance of uncertainty predicts aggressive behaviours via rumination and PTSS. Besides, socioeconomic stressors are significantly associated with the level of PTSS and aggression, while health stressors are not significantly association with the level of PTSS and aggression. CONCLUSIONS: The findings provide several contributions to understand the link between intolerance of uncertainty and aggressive behaviours during the COVID-19 pandemic, and confirm the importance of early psychological intervention, especially for those who are more likely to ruminate and suffer from PTSS, to prevent aggression and violence in the long run. In addition to health-related regulations, it is important to take the social and economic aspects of the crisis into account and develop intervention strategies accordingly. Nevertheless, the limitations of cross-sectional mediation analysis in explaining causal relationships should be kept in mind, and future studies should extend these findings using longitudinal data.

Antecedentes: La pandemia por COVID-19 se puede identificar como una fuente de estrés traumático, y estudios previos mostraron que el estrés postraumático y la intolerancia a la incertidumbre están asociados con el comportamiento agresivo.Objetivo: En el presente estudio, nuestro objetivo fue probar un modelo de mediación en serie, considerando la rumiación y los síntomas de estrés postraumático (SEPT) como mediadores que vinculan la intolerancia a la incertidumbre y la agresión, controlando el efecto de confusión de los factores estresantes socioeconómicos y de salud inducidos por crisis durante la pandemia de COVID-19.Método: Un total de 714 participantes (533 [74,6%] mujeres, 176 [24,7%] hombres de entre 18 y 64 años (Medad = 25.16, DEedad = 9.34) completaron las siguientes escalas de auto-reporte: Escala de agresión, Lista de Chequeo de Factores Estresantes por COVID-19, Versión Corta de la Escala de Intolerancia a la incertidumbre, Escala de Impacto de Eventos con modificaciones para COVID-19 y Cuestionario de Estilo de Pensamiento Rumiante.Resultados: Los resultados revelaron una asociación entre la intolerancia a la incertidumbre y las conductas agresivas. Además, el resultado del análisis de mediación en serie mostró que la intolerancia a la incertidumbre predice comportamientos agresivos a través de la rumiación y los SEPT. Además, los factores de estrés socioeconómico están significativamente asociados con el nivel de SEPT y la agresión, mientras que los estresores de salud no están significativamente asociados con el nivel de SEPT y la agresión.Conclusiones: Los hallazgos brindan varias contribuciones para comprender el vínculo entre la intolerancia a la incertidumbre y los comportamientos agresivos durante la pandemia de COVID-19 y la importancia de la intervención psicológica temprana, especialmente para aquellos que tienen más probabilidades de presentar rumiación y sufrir SEPT para prevenir la agresión y la violencia a largo plazo. Además de las regulaciones relacionadas con la salud, es importante tener en cuenta los aspectos sociales y económicos de las crisis, y desarrollar en concordancia estrategias de intervención. No obstante, deben tenerse en cuenta las limitaciones del análisis de mediación transversal para explicar las relaciones causales y los estudios futuros deben ampliar los hallazgos mediante el uso de datos longitudinales.

Trait mindfulness, rumination, and well-being in family caregivers of people with acquired brain injury / Mindfulness como rasgo, la rumiación y el bienestar en los cuidadores de las personas con daño cerebral adquirido

This study examined the relationship between trait mindfulness, rumination, quality of life, anxiety, and depression in family caregivers of people with Acquired Brain Injury (ABI). Participants were 78 caregivers (75.6% women) aged between 22 and 80 years. The participants completed measures of behavioral and emotional problems in the person with ABI, trait mindfulness, symptoms of anxiety and depression, quality of life, and rumination. The results showed that mindfulness is associated with fewer symptoms of anxiety and depression and better quality of life, and that this is explained through less use of rumination. Likewise, behavioral and emotional problems of the person with ABI were associated with more depression and lower quality of life in the caregiver. Rumination explained part of this association. Finally, behavioral and emotional problems of the person with ABI were more strongly associated with depression in caregivers with low trait mindfulness. (AU)

Este estudio examinó la relación entre el rasgo de mindfulness, rumiación, calidad de vida, ansiedad y depresión en cuidadores de personas con daño cerebral adquirido (DCA). Participaron 78 cuidadores (75.6% mujeres) de edades comprendidas entre 22 y 80 años. Los participantes facilitaron medidas de problemas conductuales y emocionales de la persona con DCA, rasgo de mindfulness, síntomas de ansiedad y depresión, calidad de vida y rumiación. Los resultados mostraron que mindfulness se asocia a menos síntomas de ansiedad y depresión y más calidad de vida y que esto se explica a través de un menor uso de la rumiación. Asimismo, los problemas conductuales y emocionales de la persona con DCA se asocian a una mayor depresión y menor calidad de vida en el cuidador. La rumiación media parte de esta asociación. Finalmente, los problemas conductuales y emocionales de la persona con DCA se asocian más estrechamente a la depresión en los cuidadores con bajo nivel de mindfulness. (AU)

Diseño y análisis de propiedades psicométricas del Inventario de Estilos de Pensamiento en Respuesta al Cáncer (IEPRaC) / Design and psychometric properties analysis of the Thought Style in Response to Cancer Inventory (IEPRaC)

Una de las variables que ha sido definida como mediadora para la respuesta emocional ante el cáncer es el estilo de pensamiento. En contextos patológicos (por ejemplo, rumiación en depresión), y también en contextos normativos, se ha sugerido que el estilo de pensamiento puede predecir el ajuste ante un estresor. Existen instrumentos para evaluar de manera independiente los estilos de pensamiento (rumiación, evitación experiencial), pero ninguno está adaptado para población oncológica y ninguno incluye los tres estilos de pensamiento (rumiación, evitación y compromiso cognitivo). Objetivo: diseñar y estudiar las propiedades psicométricas de un instrumento que mida estilos de pensamiento en respuesta al diagnóstico oncológico. Método: Estudio instrumental, dividido en dos fases: la primera, elaboración de reactivos y jueceo de expertos y la segunda, análisis de propiedades psicométricas. Resultados: La versión final cuenta 15 ítems. La estructura interna resultó de tres factores, obtenidos a partir de un Análisis Factorial Exploratorio y corroborada mediante un Análisis Factorial Confirmatorio. Los valores de alfa de cronbach de las escalas resultaron adecuadas: la de Rumiación resultó de 0,87, la de Compromiso cognitivo de , 0,82 y de 0,72 la de evitación. Todos los ítems cuentan con evidencias de validez de contenido y propiedades psicométricas satisfactorias. La escala de Compromiso cognitivo fue la que obtuvo la puntuación media mayor y la de Rumiación mostró la menor. Conclusión: El Inventario de Estilos de Pensamiento en Respuesta al Cáncer (IEPRaC) cuenta con adecuadas propiedades psicométricas para ser utilizado en población oncológica mexicana (AU)

Thought style has been defined as one of the mediating variables to emotional response at a cancer diagnosis. It has been reported in pathological contexts (rumination in depression), but also in normative ones, it has been suggested that thought styles can predict adjustment to a stressor. There are measurement scales used to assess thought style independently (rumination, experiential avoidance), but none of them is adapted for oncologic population and none of them include all three thought styles. Aim: To design and assess psychometric properties of a scale of thought styles in response to a cancer diagnosis. Method: Instrumental Study, divided in two phases: the first, item elaboration and expert judge; the second, psychometric properties analysis. Results: Final version counts with 15 items. Intern Structure resulted in three factors, obtained by an Exploratory Factorial Analysis and corroborated by a Confirmatory Factorial Analisis. Cronbach’s alphas for the subscales resulted appropriate: for rumination 0.87, for cognitive engagement 0.82 and 0.72 for avoidance. All items have evidence for content validity and adequate psychometric properties. Results of Cognitive Engagement subscale had the higher mean and Rumination subscale was the lowest. Conclusion: Thought style in response to a cancer diagnosis scale (IERPaC) has adequate psychometric properties to be used in Mexican oncologic patients (AU)

Rumination syndrome. A review article. / Síndrome de rumiación. Artículo de revisión.

Rumination syndrome is a functional gastrointestinal disorder characterized by effortless postprandial regurgitation of ingested food into the mouth. An unperceived postprandial contraction of the abdominal wall could be a key mechanism. In those patients, retrograde flow of the ingested gastric content into the mouth is produced due to a simultaneous combination of elevated intra-abdominal pressure and negative intrathoracic pressure. The estimated prevalence is around 2% in the general adult population. The main clinical characteristics include: a) early postprandial regurgitation, b) the effortlessly regurgitated material is similar to the ingested food, c) the regurgitated material is spit out or swallowed again. The clinical diagnosis of rumination syndrome relies on the clinical criteria. High resolution esophageal manometry, ideally including impedance monitoring, can be an important adjunct for making the clinical diagnosis. Its management is based on instruction as to the nature of the pathology, education in postprandial diaphragmatic breathing, and the assessment of possible psychiatric comorbidity. Baclofen use is reserved for second-line treatment in patients with refractory symptoms.

Crecimiento postraumático y variables psicosociales en víctimas de violencia política / Posttraumatic growth and psychosocial variables among victims of political violence

Resumen Antecedentes: la dictadura militar chilena (1973-1990) dejó miles de víctimas entre afectados directos y familiares, quienes pudieron desarrollar diversas secuelas en su salud mental. Objetivos: el presente estudio buscó evaluar un modelo predictivo de crecimiento postraumático (CPT) que incluía la ideología política, el afrontamiento religioso y la rumiación, en víctimas de la violencia política durante la dictadura. Método: participaron 200 personas adultas reconocidas en el Programa de Reparación y Atención Integral de Salud (PRAIS), encargada de brindar apoyo a las víctimas directas de violaciones a los derechos humanos durante la dictadura, y a sus familiares. De ellos 104 son mujeres (52%) y 96 hombres (48%), en un rango de edad entre los 30 y 91 años. Se utilizaron como instrumentos el Inventario de Crecimiento Postraumático, la Escala Breve de Afrontamiento Religioso, la Escala de Rumiación relacionada con el Evento y la Escala de Ideología Política. Resultados: los principales resultados indicaron que el afrontamiento religioso positivo y la rumiación deliberada predijeron el CPT. La rumiación deliberada media parcialmente entre el afrontamiento religioso positivo y el CPT. Conclusión: se concluye que el afrontamiento religioso positivo y el procesamiento cognitivo deliberado favorecen los cambios positivos en víctimas directas de la violencia política y sus familiares. Ante esto, se refuerza la idea que las víctimas de estas violaciones logran crecer después de estas experiencias dolorosas.

Abstract Background: The Chilean military dictatorship (1973-1990) left thousands of victims among those directly affected and their families, who were able to develop various mental health sequelae. Objective: The present study sought to evaluate a predictive model of posttraumatic growth (PTG) that included political ideology, religious coping and rumination in victims of political violence during the dictatorship. Method: The study involved 200 adults recognised in the Programme for Reparation and Integral Health Care (PRAIS), which is responsible for providing support to direct victims of human rights violations and their family members during the dictatorship. Out of these, 104 were women (52%) and 96 were men (48%) ranging in age from 30 to 91 years. The Posttraumatic Growth Inventory, the Brief Religious Coping Scale, the Event-Related Rumination Scale and the Political Ideology Scale were used as instruments. Results: The main results indicated that positive religious coping and deliberate rumination predicted PTG. Deliberate rumination partially mediates between positive religious coping and PTG. Conclusion: It is concluded that positive religious coping and deliberate cognitive processing favour positive change in those directly affected by political violence and their family members. This reinforces the idea that victims of these violations manage to grow after these painful experiences.

Rumiación cognitiva y afecto negativo como predictores diferenciales de los síntomas psicopatológicos internalizantes / Cognitive rumination and negative affect as differential predictors of internalizing psychopathological symptoms

Resumen Los modelos transdiagnósticos para los problemas de ansiedad, depresión y somatización han tenido evidencia para variables como la rumiación cognitiva y el afecto negativo; sin embargo, las asociaciones diferenciales entre estas dos variables en la explicación psicopatológica requiere aún ser investigada. El objetivo fue analizar la relación entre la rumiación cognitiva según las dimensiones de la rumiación: reproche y reflexión, con el afecto negativo y los síntomas psicopatológicos internalizantes depresivos, ansiosos y psicosomáticos en adultos colombianos. Se llevó a cabo una investigación cuantitativa con un diseño transversal explicativo, en el que se definió una red estructural de relaciones entre constructos mediante un diagrama de senderos y ecuaciones estructurales. Se contó con una muestra final de 640 personas, con una edad media de 31.07 años (DE = 11.27). Los resultados indicaron correlaciones significativas parciales y de orden cero entre las variables transdiagnósticas y las sintomáticas internalizantes, mediante un modelo ajustado que permitió explicar en un 74 % estas problemáticas a partir de la rumiación cognitiva y la función mediadora parcial del afecto negativo. En los síntomas depresivos y ansiosos se obtuvo que están mediados parcialmente por el afecto negativo, mientras que la medida de somatización obtuvo un coeficiente de regresión significativo con el afecto negativo como predictor independiente. Estos resultados aportan a la comprensión de la interacción de la rumiación y el afecto en la aparición de los síntomas internalizantes de manera diferencial. Se recomendó contar con una muestra clínica que ayudaría a identificar con mayor precisión la varianza explicada del modelo obtenido, lo que favorecerá los actuales tratamientos transdiagnósticos disponibles.

Abstract The transdiagnostic models of anxiety, depression and somatization problems have had evidence for variables such as cognitive rumination and negative affect, however, the differential associations between these two variables in the psychopathological explanation, still need to be investigated. The aim was to analyze the relationship between cognitive rumination according to the two dimensions: brooding and reflection, with negative affect and depressive, anxious, and psychosomatic internalizing psychopathological symptoms. A quantitative research was carried out with an explanatory cross-sectional design in which a structural network of relationships between constructs was defined by a path diagram and structural equations. There was a final sample of 640 people with a mean age of 31.07 years (SD = 11.27). The results indicated significant partial and zero-order correlations between transdiagnostic and internalizing symptomatic variables, using an adjusted model that allowed explaining these problems in 74% from cognitive rumination, and the partial mediating function of negative affect. In depressive and anxious symptoms, they were partially mediated by the negative affect, while the somatization measure obtained a significant regression coefficient with the negative affect as an independent predictor. These results contribute to the understanding of the interaction of rumination and affect in the appearance of differential internalizing symptoms. It was recommended to have a clinical sample that would help to more accurately identify the explained variance of the obtained model, as well as favor the current and available transdiagnostic treatments.

Ruptura de pareja en adultos jóvenes y salud mental: estrategias de afrontamiento ante el estrés del término de una relación / Couple breakup in young adults and mental health: coping strategies in the face of stress at the end of a relationship

Resumen El presente estudio tiene el propósito de establecer la relación entre las estrategias de afrontamiento, síntomas depresivos y satisfacción con la vida en adultos jóvenes tras una ruptura amorosa. Para esto, se encuestó a 220 personas, 66,8 % mujeres, en edades de entre 18 y 40 años. Se aplicaron las escalas Brief COPE de estrategias de afrontamiento, Escala SWLS de Satisfacción Vital, Escala de Depresión CES-D del Centro de Estudios Epidemiológicos, Cuestionario ERQ de Regulación Emocional, Escala RRS de Respuesta Rumiativa, sumado a un cuestionario sociodemográfico. Se observó que las mujeres poseen más síntomas depresivos que los hombres. Además, el tiempo transcurrido desde la ruptura, la aceptación, la supresión, el brooding y el uso de sustancias predicen una sintomatología depresiva, y, por otro lado, el brooding, la aceptación y la búsqueda de apoyo social predicen satisfacción con la vida. De este modo, es posible enfocarse en las líneas de acción para promover respuestas más adaptativas y modificar las respuestas menos adaptativas en personas afectadas por una ruptura.

Abstract The aim of this study has been to analyze the coping strategies used by young adults after a breakup and their relationship with depressive symptoms and satisfaction with life. For this, 220 people were surveyed, 66.8% women, aged between 18 and 40 years. The Brief-COPE coping strategies scale, SWLS Satisfaction with Life Scale, CES-D Depression Scale of Center for Epidemiological Studies, ERQ Emotional Regulation Questionnaire, RRS Rumination Response Scale, and a sociodemographic questionnaire were applied. It was observed that women have more depressive symptoms than men. In addition, the time elapsed since the rupture, acceptance, suppression, brooding and substance use, predict depressive symptoms and, on the other hand, brooding, acceptance and the search for social support, predict satisfaction with life. In this way, it is possible to focus on the lines of action to promote more adaptive responses and modify less adaptive responses in people affected by a rupture.

Efectos del Antecedente de Abuso, Rumiación, Ansiedad y Depresión Sobre la Contracción Paradójica del Puborrectal / Effects of Abuse History, Rumination, Anxiety, and Depression on the Paradoxical Contraction of the Puborectalis Muscle / Efeitos do Antecedente de Abuso, Ruminação, Ansiedade e Depressão sobre a Contração Paradoxal do Puborretal

Resumen El objetivo de este trabajo fue determinar los efectos del antecedente de abuso sexual y emocional, rumiación, ansiedad y depresión sobre la contracción paradójica del puborrectal. Se realizó un estudio de campo con diseño transversal en 118 pacientes. Los resultados de los análisis de regresión demuestran que el antecedente de abuso sexual predice contracción paradójica del puborrectal, depresión y rumiación, además de ejercer efecto indirecto sobre depresión y ansiedad a través de rumiación. El antecedente de abuso emocional predice mayor ansiedad y menor depresión. La rumiación predice ansiedad y depresión. Se sugiere aplicar estos resultados en la práctica y explorar en estudios ulteriores las interrogantes derivadas de este trabajo.

Abstract The objective of this research was to determine the effects of sexual and emotional abuse history, rumination, anxiety, and depression on the paradoxical contraction of the puborectalis muscle. A cross-sectional study was carried out in 118 patients. The results of regression analyses show that a history of sexual abuse predicts paradoxical contraction of the puborectalis muscle, depression, and rumination, besides having an indirect effect on depression and anxiety through rumination. A history of emotional abuse predicts greater anxiety and less depression. The article suggests that these results must be applied in practice and that subsequent studies should explore the questions deriving from this research.

Resumo O objetivo deste trabalho foi determinar os efeitos do antecedente de abuso sexual e emocional, ruminação, ansiedade e depressão sobre a contração paradoxal do puborretal. Realizou-se um estudo de campo com desenho transversal em 118 pacientes. Os resultados das análises de regressão demonstram que o antecedente de abuso sexual prevê a contração paradoxal do puborretal, depressão e ruminação, além de exercer efeito indireto sobre depressão e ansiedade através da ruminação. O antecedente de abuso emocional prevê maior ansiedade e menor depressão. A ruminação prevê ansiedade e depressão. Sugere-se aplicar esses resultados na prática e explorar as interrogantes derivadas deste trabalho em estudos posteriores.

[Rumination syndrome: Diagnostic and therapeutic difficulties of a not so uncommon disorder]. / Síndrome de rumiación: dificultades diagnósticas y terapéuticas de un proceso no tan infrecuente.

INTRODUCTION: Rumination syndrome is an uncommon gastrointestinal functional disorder that may be difficult to diagnose, as not many physicians are aware of this condition. In many cases, patients undergo numerous tests and are prescribed several treatments based on erroneous diagnoses. When the correct diagnosis is eventually made, therapy for the syndrome can be difficult and complex because of its multifactorial nature. The aim of this study was to present our experience with this condition, by presenting an analysis of the clinical, diagnostic, and therapeutic data of our patients. PATIENTS AND METHOD: A prospective and retrospective study was conducted on all cases of rumination syndrome diagnosed between January 2010 and May 2016 in patients attending the Paediatric Gastroenterology Departments of two hospitals: Consorci Sanitari de Terrassa and Hospital Materno-Infantil Vall d'Hebron (Barcelona, Spain). RESULTS: The analysis included 12 patients, with a mean age at the onset of symptoms of 9 years and 1 month, and the mean time period to make the diagnosis was 2 years and 3 months. A mean of 8.1 complementary tests were carried out before establishing the diagnosis. In 10 of the 12 patients, some type of treatment had been given before the diagnosis of rumination syndrome, but was unsuccessful in all cases. Ten of our patients underwent the novel, experimental biofeedback therapy. CONCLUSIONS: Due to the limited knowledge of this condition among attending professionals in terms of the clinical presentation, diagnosis, and treatment, patients with rumination syndrome are often misdiagnosed and undergo numerous avoidable complementary tests, and invasive, costly treatments.