Motivational Influences on Health, Well-Being, and Lifestyle: Validation of the Spanish Version of the Treatment Self-Regulation Questionnaire in Four Health Domains.

BACKGROUND: Motivation is a central concept in self-determination theory (SDT). The Treatment Self-Regulation Questionnaire (TSRQ), which assesses motivation (autonomous, controlled, etc.), has been widely used. However, less is known about its applicability to samples such as college students, who may be at risk of having unhealthy behavior in many areas (including smoking, poor dietary habits, alcohol, or tobacco consumption). As this population is transitioning to adulthood, research is needed to understand motivation and changing health patterns. In addition, the lack of instruments for this population in Spain has made the measurement validation process a priority. The purpose of this psychometric study was to adapt the TSRQ to Spanish college students and to examine its structural and validity across four health domains. METHODS: Two samples of Spanish college students (n = 347 and n = 244) agreed to participate in the study. Participants completed a booklet containing measures of motivation, well-being, general health, anxiety, depression, and lifestyle. RESULTS: CFA supported a five-dimensional structure in each domain. Reliability values were also adequate for each questionnaire. Regarding other sources of validity, statistically significant relationships between self-determination, health, and well-being were clearly confirmed, and autonomy was a significant predictor of lifestyle. CONCLUSIONS: The Spanish version of the TSRQ showed adequate psychometric properties (dimensionality and internal structure, reliability, and validity evidence regarding its relationships with other constructs) in college students. The Spanish TSRQ will provide future research aimed to understand the motivational role in college students' health behavior and well-being.

Moderating Effect of Changes in Perceived Social Support during Pregnancy on the Emotional Health of Mothers and Fathers and on Baby's Anthropometric Parameters at Birth.

(1) Background: this study is based on a model of how changes in protective factors may affect the emotional health of mothers and fathers and thus influence the development of the baby. Our research goal is to determine whether variations in perceived social support moderate levels of stress and depression during pregnancy and/or the effect of parents' emotional health on the baby's anthropometric parameters. (2) Methods: to achieve these aims, a longitudinal study was made of 132 couples and babies, who were evaluated at weeks 12 and 32 of gestation and at birth. Separate analyses were performed for the mothers and fathers, focused on the role of social support in moderating their levels of depression and stress during pregnancy, and the consequent impact on the baby. (3) Results: the results obtained show the moderating effects of changes in social support on maternal and paternal stress and depression. Reduced social support during pregnancy is associated with higher levels of stress and depression in both parents and with a high cephalisation index in their babies. (4) Conclusions: special attention should be paid to social support, which can have a strong impact on the evolution of emotional health during pregnancy and concomitantly on the development of the baby.

Influence of Depression and Anxiety on Hemodialysis Patients: The Value of Multidisciplinary Care.

Affective disorders promote poorer outcomes in hemodialysis patients. According to the presence or not of depression/anxiety in these patients, aims were to analyze differences in sociodemographic, clinical and/or psychological factors and to identify predictors. One hundred eighty-six hemodialysis patients were classified based on their depression/anxiety status. Basal characteristics showed differences between groups where mainly male sex (Depression: OR 0.2; Anxiety: OR 0.3) albumin (Depression: OR 0.1; Anxiety: OR 0.2) and calcium levels (Depression: OR 0.5; Anxiety: OR 0.4), impaired quality of life (Depression: OR 1.4; Anxiety: OR 1.2) and psychological inflexibility (Depression: OR 1.3; Anxiety: OR 1.2) were associated (all p < 0.01) to these mental conditions. Multivariate models showed that worse quality of life (OR 1.3; p < 0.001) predicted depression while marital status (with a partner; OR 0.3; p = 0.025) and albumin levels (OR 0.1; p = 0.027) were protective factors. Depression represented a risk factor for anxiety (OR 1.2; p = 0.001), although calcium levels (OR 0.5; p = 0.039) would protect this state. Interestingly, psychological inflexibility predicted both disorders (Depression: OR 1.2, p < 0.001 and Anxiety: OR 1.1; p = 0.002). Results highlight the relevance of well-trained multidisciplinary hemodialysis units to control the influence of these factors on the presence of depression/anxiety, and thus, their impact on the patients' outcomes.

A New Instrument to Assess Children's Understanding of Death: Psychometrical Properties of the EsCoMu Scale in a Sample of Spanish Children.

The acquisition of the death concept in children may influence how these children cope with the losses that they will confront throughout their lives. At the present time, there is a lack of psychometric instruments in Spanish-speaking countries in order to evaluate the components of the death concept in children. The aim of this study was to create and validate a scale (EsCoMu-Escala sobre el Concepto de Muerte) in order to provide insight about the concept of death in children. The sample was formed by 358 children from ages 6 to 13 years. The final EsCoMu version has 27 items which serve to evaluate universality, irreversibility, non-functionality and causality. The results of the confirmatory factor analysis show an adequate fit index for the four dimensions model, reliability (α = 83) and validity evidence, specifically based on the children's age. In conclusion, EsCoMu is an instrument that shows adequate reliability and validity indices in order to assess the concept of death and its four components among children. Due to its simplicity, this instrument can be very useful if applied to the field of neurodevelopmental disorders.

Psychological distress and resilience of mothers and fathers with respect to the neurobehavioral performance of small-for-gestational-age newborns.

BACKGROUND: The existence of psychological distress (PD) during pregnancy is well established. Nevertheless, few studies have analyzed the PD and resilience of mothers and fathers during high-risk pregnancy. This study analyzes the differences between parents' PD and resilience and the relation between them and the neurobehavioral performance of their SGA newborns. METHODS: This prospective study compares two groups of parents and newborns: case group (52 parents and 26 SGA fetuses) and comparison group (68 parents and 34 appropriate-for-gestational-age, AGA, fetuses). In each group, the parents were evaluated during the last trimester of pregnancy, to obtain standardized measures of depression, stress, anxiety, and resilience. At 40 ± 1 weeks corrected gestational age, psychologists evaluated the state of neonatal neuromaturity achieved. RESULTS: Multivariate analysis of variance showed, in gender comparisons, that mothers obtained higher scores than fathers for psychological distress but lower ones for resilience. Similar differences were obtained in the comparison of parents' distress to intrauterine growth by SGA vs. AGA newborns. Mothers of SGA newborns were more distressed than the other groups. However, there were no differences between the fathers of SGA vs. AGA newborns. Regarding neurobehavioral performance, the profiles of SGA newborns reflected a lower degree of maturity than those of AGA newborns. Hierarchical regression analyses showed that high stress and low resilience among mothers partially predict low neurobehavioral performance in SGA newborns. CONCLUSIONS: These findings indicate that mothers of SGA newborns may need psychological support to relieve stress and improve their resilience. Furthermore, attention should be paid to the neurobehavioral performance of their babies in case early attention is needed.

Long-term effects of an intensive-practical diabetes education program on HbA1c and self-care.

OBJECTIVE: The purpose of this study was to implement an intensive and practical diabetes education program (DEP) and evaluate its long-term effects and its impact on psychosocial variables. It was hypothesized that the DEP would improve patients' metabolic control (A1c hemoglobin - HbA1c), technical knowledge, self-efficacy and frequency of self-care and decrease barriers and other parameters such as the body mass index (BMI) and LDL cholesterol. These results should be maintained at one-year follow-up. DESIGN AND SETTING: The sample was composed of 40 patients with diabetes type I who attended a diabetes outpatient clinic. A repeated measures design, considering medical and psychosocial variables at six months and one year, was used. RESULTS: Results have statistical and clinical implications. They revealed significant changes that were maintained at one-year follow-up in HbA1c, barriers to self-care, frequency of self-care, knowledge about the disease and perceived self-efficacy. The areas of self-care where the fewest changes took place were diet and exercise, which are highly related to cardiovascular risk factors and are very present in patients with diabetes. Specifically, no changes were observed in BMI or LDL cholesterol. CONCLUSION: The intensive DEP proved to be effective, although specific efforts should be made in certain areas to ensure longer-lasting benefits. Besides, including not only educational but also psychological strategies in patients' education to motivate them to make real lifestyle changes should be a priority in the design of any DEP.

Adaptación al castellano de la Centrality of Event Scale (CES) / Adaptation of Centrality of Event Scale (CES) to Spanish

La "Centrality of Event Scale" (CES) es un instrumento utilizado para evaluar la centralidad que tiene una determinada experiencia en la persona. Estudios previos muestran que la centralidad es un constructo altamente relacionado con el estrés post-traumático, la depresión o el duelo complicado. El objetivo de este estudio fue realizar su adaptación al castellano y caracterizar su fiabilidad y validez. Participaron dos muestras compuestas por 208 y 320 estudiantes universitarios que completaron la CES y medidas de depresión (BDI), ansiedad (STAI) y sintomatologia de estrés post-traumático (PSS). Los resultados coinciden con los obtenidos con la versión original de la CES, tanto en consistencia interna (alfa de Cronbach de 0.92 y 0.94, para cada muestra), como en test-retest a los dos meses (r=0.803, p<0.01). El análisis de componentes principales muestra un único factor explicativo que daba cuenta del 45% de la varianza. Finalmente las puntuaciones de la CES muestran relaciones con diversos indices de psicopatologia, siendo además un predictor, junto con las medidas de ansiedad y depresión, del 32% de la sintomatologia de estrés post-traumático. La adaptación al castellano de la escala CES parece ser una medida válida y fiable sobre centralidad del evento.

The "Centrality of Event Scale" (CES) is an instrument used to assess the centrality that a particular event has in the person. Previous studies show that centrality is a construct highly relevant for post-traumatic stress symptomatho-logy, depression and complicated grief. The aim of this study was to adapt into Spanish the CES and obtain evidences of reliability and validity. Two samples consisting of208 and 320 college students participated in the study. They completed the CES and measures of depression (BDI), anxiety (STAI) and symptoms of post-traumatic stress (PSS). The results agree with those obtained by the original version of the CES, showing high internal consistency (Cronbach's alpha of 0.92 and 0.94, for each sample) and acceptable test-retest reliability at two months (r = 0.803, p < 0.01). The principal component analysis shows a single explanatory factor that accounted for 45% of the variance. Finally, CES scores show significative relationships with various indicators of psychopatholo-gy, and is also a predictor, along with measures of anxiety and depression, of the 32% of the symptoms of post-traumatic stress disorder. The Spanish version of the CES seems to be a valid and reliable measure of the centrality of the event.

Situación del VIH/SIDA en Latinoamérica al final del siglo XX: análisis de las diferencias entre países / Current situation of AIDS in Latin America in XX century: analysis of differences between countries

The aim of this article is to analyze the current situation of AIDS in Latin American countries. Specifically, to compare their situation with other geographic areas of the planet, the prevalence index per countries, distribution per sex and age and, finally, the main ways of transmission in each country. The most recent data published by OMS and demographic data obtained from the Latin American and Caribean Demographic Center (CELADE) was used. This analysis reflects that in Latin America it is impossible to talk about AIDS in a homogeneous way since the differences between countries are remarkable

Análisis de la teoria triárquia del amor de Sternberg segun la tecnica del desplegamiento / Analysis of the Sternberg?s love theor based on the unfolding method

En este estudio se ha realizado un análisis de la teoría del amor propuesta por Sternberg (1987-94). Para llevar a cabo la investigación se ha utilizado la técnica de desplegamiento, empleando una muestra de 365 sujetos, dividida ésta a su vez en dos submuestras, una de 200 universitarios y otra, obtenida en centros de trabajo y locales comerciales, de 165 personas de mayor edad. Así, se ha encontrado como los valores propuestos por Sternberg se ajustan sólo en algunos momentos específicos de la relación, a un continuo de medida para las relaciones de pareja definidos por los polos del amor Romántico –Amor de compromiso/ vacío. De igual forma, apuntar que, en contra de lo predicho por Sternberg, no se han encontrado diferencias sexuales en las preferencias referentes al componente de la pasión, Sin embargo, a favor de la teoría de Sternberg se observa una menor preferencia por la pasión en muestras de personas con una edad mayor en comparación con una muestra mas joven.

In this study, analysis of the Sternberg’s Love Theory (1987-94) has been made. This analysis has been based on the Unfolding Method with a swab composted by 365 subjects: 200 from University and 165 from Stores and Working places, older than first. Thus, the adjustment to the components proposed by Sternberg in a measure continuous: Romantic Love versus Commitment Love, only appears in specific moments of love relationships. Also, there is no sexual differences on the preferences made by swab respects on the component Passion, opponed fact to the Sternberg Theory. However, the results indicate Passion is more important for youngest that elder, supporting, in that way, Sternberg’s Theory.