The Negative Impact of Group Psychological Abuse on Life Satisfaction and Well-being.

In the context of the adverse effects of psychological abuse, this study examined satisfaction with life, psychological well-being, and social well-being in survivors of social groups that are high-demand, manipulative, totalitarian, or abusive toward their members. We specifically tested the mediating role between group psychological abuse and current well-being of psychological stress suffered after leaving the group. An online questionnaire was administered to 636 Spanish-speaking former members of different groups, 377 victims of group psychological abuse and 259 nonvictims. Participants reporting group psychological abuse showed significantly lower levels of life satisfaction, psychological well-being, and social well-being compared to nonvictims. Greater differences in well-being between victims and nonvictims were related to positive relationships with others (d = .85), self-acceptance (d = .51), social integration (d = .44), and social acceptance (d = .41). Victims' life satisfaction and well-being were positively correlated with the time that has passed since leaving the group, but nonsignificant effects were found regarding the type of the group (i.e., religious vs. nonreligious), the age at which they joined the group (i.e., born into or raised in the group vs. during adulthood), the length of group membership, and the method of leaving (i.e., personal reflection, counseled, or expelled). Moderate associations were found between group psychological abuse, psychological stress, and well-being measures, and results demonstrated that psychological stress mediated the impact of group psychological abuse on life satisfaction and well-being. Understanding the negative impact of group psychological abuse on well-being is important to promote survivors' optimal functioning during their integration process into the out-group society.

The impact of group psychological abuse on distress: the mediating role of social functioning and resilience.

Background: Previous studies indicate that social functioning and resilience can mitigate the adverse psychological effects of interpersonal violence. Unfortunately, the role of these variables has not been studied in survivors of groups, organizations, and communities in which psychological abusive strategies are inflicted to recruit and dominate their members. Objective: To examine the mediating role of social functioning and resilience in the relationship between psychological abuse experienced in the past while in a group and current psychosocial distress and psychopathological symptoms. Method: In this cross-sectional study, an online questionnaire was administered to 794 English-speaking former members of different kinds of groups, such as religious, pseudo therapeutic, pyramid scheme groups, and others. Among them, 499 were victims of group psychological abuse and 295 were non-victims. Results: Victims of group psychological abuse reported lower levels of social functioning and resilience than non-victims, and higher levels of psychosocial difficulties and psychopathological symptoms. Serial mediation analyses revealed that social functioning and resilience mediated part of the impact of group psychological abuse on psychosocial difficulties and psychopathological symptoms. Sex and age joining the group were included as covariates. Participants who had experienced higher levels of group psychological abuse tend to have poorer social functioning, which is related to lower resilience. In turn, lower levels of social functioning and resilience are related with higher distress. Conclusions: This research sheds light on the underlying mechanisms involved in the relationship between group psychological abuse and distress suffered following this kind of traumatic experiences. Findings highlight the protective role of social adjustment, which can help promote and enhance resilience and mitigate psychosocial difficulties and psychopathological symptoms in survivors of group psychological abuse.

Antecedentes: Estudios previos indican que la adaptación social y la resiliencia pueden mitigar los efectos psicológicos adversos de situaciones de violencia interpersonal. Desafortunadamente, no se ha estudiado aún el rol de estas variables en supervivientes de grupos, organizaciones y comunidades en las cuales se aplican estrategias de abuso psicológico para reclutar y dominar a sus miembros.Objetivo: Examinar el rol mediador de la adaptación social y la resiliencia en la relación entre el abuso psicológico experimentado en un grupo en el pasado y el malestar psicosocial y síntomas psicopatológicos sufridos en la actualidad.Método: Se diseñó un estudio transversal y se administró un cuestionario online a 794 personas de habla inglesa exmiembros de grupos de distinta naturaleza, como religiosos, pseudo terapéuticos, de estructura piramidal, u otros. De ellas, 499 fueron víctimas de abuso psicológico en grupo y 295 personas no fueron víctimas.Resultados: Las víctimas de abuso psicológico en grupos reportaron menores niveles de adaptación social y resiliencia que las personas que no fueron víctimas, y mayores niveles de dificultades psicosociales y síntomas psicopatológicos. Los análisis de mediación en serie revelaron que la adaptación social y la resiliencia mediaron parte del impacto del abuso psicológico en las dificultades psicosociales y los síntomas psicopatológicos. El sexo y la edad de entrada al grupo fueron introducidos como covariantes. Los participantes que han experimentado mayores niveles de abuso psicológico en grupos tienden a tener menor funcionamiento social, lo que está relacionado con menor resiliencia. En consecuencia, menores niveles de funcionamiento social y resiliencia se relacionan con mayor malestar.Conclusiones: Este estudio ayuda a comprender los mecanismos subyacentes implicados en la relación del abuso psicológico en grupos y el malestar sufrido después de este tipo de experiencias traumáticas. Los hallazgos resaltan la importancia del rol protector de la adaptación social, el cual puede ayudar a promover y mejorar la resiliencia y a mitigar las dificultades psicosociales y síntomas psicopatológicos en supervivientes de abuso psicológico en grupos.

Group Psychological Abuse and Psychopathological Symptoms: The Mediating Role of Psychological Stress.

In the context of the long-term effects of psychological abuse, this study examined psychological stress and psychopathological symptoms in survivors of groups with cultic dynamics where abusive behaviors take place on an ongoing basis. We specifically tested the mediating role of psychological stress suffered after the departure from the group between the group psychological abuse experienced and current psychopathology. An online questionnaire was administered to 608 Spanish-speaking former members of different groups. We distributed participants into a sample of victims (N = 365) and a sample of nonvictims (N = 243), according to whether or not they reported having experienced group psychological abuse. Moderate associations were found among group psychological abuse, psychological stress, and psychopathological symptoms. Greater differences in psychological stress intensity between samples were related to personal conflicts (ηp2 = .30) and social relations (ηp2 = .29). Greater differences in psychopathological symptoms were related to paranoid ideation (ηp2 = .17), psychoticism (ηp2 = .15), depression (ηp2 = .15), and interpersonal sensitivity (ηp2 = .13). Moreover, mediation testing demonstrated that psychological stress partially mediated the impact of group psychological abuse on psychopathological symptoms. These findings contribute to a better understanding of the long-term effects of group psychological abuse. Survivors of abusive groups not only need help in dealing with psychopathological symptoms, but also need resources to cope with stressful environmental demands. Interventions should address both psychological stress and clinical symptoms to promote survivors' health and well-being during their integration process into the outgroup society.

Development and Validation of a Measure of Emotional Distress in Survivors of Group Psychological Abuse.

In the context of the negative consequences of psychological abuse, a scale was developed to specifically assess the emotional disturbances in individuals who had experienced abusive behaviors over a period of time within a cultic group. The Emotional Distress Scale in Survivors of Abusive Groups (EDS-SAG) was administered, along with other relevant measures of group psychological abuse and psychopathological symptoms, to 706 Spanish-speaking former members of different groups, distributed into two samples according to whether they had experienced group psychological abuse (n = 413) or not (n = 293). Analyses supported a unidimensional structure of the 18 items on the EDS-SAG, explaining 50.7% of the total variance. This factorial solution was found to be stable when the sample of victims was split by sex and by the age of involvement in the group. Results also showed adequate reliability of the scores and significant associations between the scores on the EDS-SAG and the scores on measures of group psychological abuse (PAEGS: .86, p < .001) and psychopathological symptoms (BSI: .30, p < .001; PTCI: .46, p < .001). The results obtained reveal that this new scale is a suitable tool for measuring emotional distress in Spanish-speaking survivors of abusive groups. In the research field, it would be possible to evaluate the antecedents of emotional distress or their protective factors. In applied contexts, it would be possible to rigorously evaluate the emotional difficulties of abuse victims, allowing a better diagnosis and therapeutic approach. All of this will contribute to the assessment and understanding of the long-term consequences of group psychological abuse.

[Epidemiology of guillain-barré syndrome in Peru]. / Epidemiología del síndrome de guillain-barré en el Perú.

OBJECTIVE: To describe the epidemiological behavior of Guillain-Barré syndrome (GBS) in Peru. MATERIALS AND METHODS: Descriptive study of secondary data on the Ministry of Health (MINSA) hospital discharges during the period 2012-2017; EsSalud and SuSalud hospital discharges between 2015 and 2017; and national mortality data between 2014-2016. The identification of GBS in the databases was carried out using the International Classification of Diseases, 10th version, by means of code G610. Incidence, fatality rate, and mortality were estimated by age, sex, and department group. RESULTS: A total of 955 cases of GBS were identified in the database of MINSA hospital discharges between 2012 and 2017, with a higher frequency in men, within the 20 to 59-year old population. The national incidence of GBS per 100,000 inhabitants was 0.62 (2015), 0.92 (2016), and 0.91 (2017), being higher in older adults and in men. The overall case fatality rate was 3.5%, and was highest in those over 60. The average length of hospitalization was 16 ± 22 days. In addition, Lima is the department that accounted for more than 40% of all GBS cases; and Cusco, Lima, Callao, Lambayeque, and Arequipa had the highest incidence. CONCLUSIONS: This study provides relevant information to better understand the epidemiological behavior of GBS in Peru, and thus ensure adequate patient care nationally.

Objetivos. Describir el comportamiento epidemiológico del síndrome de Guillain-Barré (SGB) en el Perú. Materiales y métodos. Estudio descriptivo de datos secundarios sobre egresos hospitalarios del Ministerio de Salud (MINSA) durante el periodo 2012 - 2017, egresos hospitalarios de EsSalud y de SuSalud entre 2015 y 2017, y datos nacionales de mortalidad entre 2014-2016. La identificación del SGB en las bases de datos se realizó utilizando la Clasificación Internacional de Enfermedades, 10ª versión, mediante el código G610. Se estimó la incidencia, tasa de letalidad y mortalidad por grupos de edad, sexo y departamento. Resultados. En la base de datos de egresos hospitalarios del MINSA se identificaron un total de 955 casos de SBG entre 2012 y 2017, con una mayor frecuencia en hombres y en la población de 20 a 59 años. La incidencia nacional de SGB por cada 100 mil habitantes fue de 0,62 (2015), 0,92 (2016) y 0,91 (2017), siendo más alta en adultos mayores y en hombres. La tasa de letalidad global fue de 3,5%, y fue más alta en los mayores de 60 años. El promedio del tiempo de hospitalización fue de 16 ± 22 días.. Además, Lima es el departamento que concentró más del 40% de casos de SGB y Cusco, Lima, Callao, Lambayeque y Arequipa tuvieron la mayor incidencia. Conclusiones. Este estudio proporciona información relevante para entender mejor el comportamiento epidemiológico del SGB en el Perú, y así poder garantizar una atención adecuada de los pacientes a nivel nacional.

Epidemiología del síndrome de guillain-barré en el Perú / Epidemiology of guillain-barré syndrome in Peru

RESUMEN Objetivos. Describir el comportamiento epidemiológico del síndrome de Guillain-Barré (SGB) en el Perú. Materiales y métodos. Estudio descriptivo de datos secundarios sobre egresos hospitalarios del Ministerio de Salud (MINSA) durante el periodo 2012 - 2017, egresos hospitalarios de EsSalud y de SuSalud entre 2015 y 2017, y datos nacionales de mortalidad entre 2014-2016. La identificación del SGB en las bases de datos se realizó utilizando la Clasificación Internacional de Enfermedades, 10ª versión, mediante el código G610. Se estimó la incidencia, tasa de letalidad y mortalidad por grupos de edad, sexo y departamento. Resultados. En la base de datos de egresos hospitalarios del MINSA se identificaron un total de 955 casos de SBG entre 2012 y 2017, con una mayor frecuencia en hombres y en la población de 20 a 59 años. La incidencia nacional de SGB por cada 100 mil habitantes fue de 0,62 (2015), 0,92 (2016) y 0,91 (2017), siendo más alta en adultos mayores y en hombres. La tasa de letalidad global fue de 3,5%, y fue más alta en los mayores de 60 años. El promedio del tiempo de hospitalización fue de 16 ± 22 días.. Además, Lima es el departamento que concentró más del 40% de casos de SGB y Cusco, Lima, Callao, Lambayeque y Arequipa tuvieron la mayor incidencia. Conclusiones. Este estudio proporciona información relevante para entender mejor el comportamiento epidemiológico del SGB en el Perú, y así poder garantizar una atención adecuada de los pacientes a nivel nacional.

ABSTRACT Objective. To describe the epidemiological behavior of Guillain-Barré syndrome (GBS) in Peru. Materials and Methods. Descriptive study of secondary data on the Ministry of Health (MINSA) hospital discharges during the period 2012-2017; EsSalud and SuSalud hospital discharges between 2015 and 2017; and national mortality data between 2014-2016. The identification of GBS in the databases was carried out using the International Classification of Diseases, 10th version, by means of code G610. Incidence, fatality rate, and mortality were estimated by age, sex, and department group. Results. A total of 955 cases of GBS were identified in the database of MINSA hospital discharges between 2012 and 2017, with a higher frequency in men, within the 20 to 59-year old population. The national incidence of GBS per 100,000 inhabitants was 0.62 (2015), 0.92 (2016), and 0.91 (2017), being higher in older adults and in men. The overall case fatality rate was 3.5%, and was highest in those over 60. The average length of hospitalization was 16 ± 22 days. In addition, Lima is the department that accounted for more than 40% of all GBS cases; and Cusco, Lima, Callao, Lambayeque, and Arequipa had the highest incidence. Conclusions. This study provides relevant information to better understand the epidemiological behavior of GBS in Peru, and thus ensure adequate patient care nationally.

Development and validation of a measure of emotional distress in survivors of group psychological abuse

In the context of the negative consequences of psychological abuse, a scale was developed to specifically assess the emotional disturbances in individuals who had experienced abusive behaviors over a period of time within a cultic group. The Emotional Distress Scale in Survivors of Abusive Groups (EDS-SAG) was administered, along with other relevant measures of group psychological abuse and psychopathological symptoms, to 706 Spanish-speaking former members of different groups, distributed into two samples according to whether they had experienced group psychological abuse (n = 413) or not (n = 293). Analyses supported a unidimensional structure of the 18 items on the EDS-SAG, explaining 50.7% of the total variance. This factorial solution was found to be stable when the sample of victims was split by sex and by the age of involvement in the group. Results also showed adequate reliability of the scores and significant associations between the scores on the EDS-SAG and the scores on measures of group psychological abuse (PAEGS: .86, p < .001) and psychopathological symptoms (BSI: .30, p < .001; PTCI: .46, p < .001). The results obtained reveal that this new scale is a suitable tool for measuring emotional distress in Spanish-speaking survivors of abusive groups. In the research field, it would be possible to evaluate the antecedents of emotional distress or their protective factors. In applied contexts, it would be possible to rigorously evaluate the emotional difficulties of abuse victims, allowing a better diagnosis and therapeutic approach. All of this will contribute to the assessment and understanding of the long-term consequences of group psychological abuse

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La "Escala de abuso psicológico experimentado en grupos": propiedades psicométricas de la versión española / The Psychological Abuse Experienced in Groups Scale: Psychometric properties of the Spanish version

The Psychological Abuse Experienced in Groups Scale (PAEGS) is a self-reported questionnaire measuring psychologically abusive behaviors experienced within a group. The purpose of this study was to analyze the psychometric properties of the PAEGS for its use in the Spanish-speaking population. An online questionnaire was administered to 269 former members of abusive groups and to 268 former members of non-abusive groups. The main results showed a one dimensional factor structure explaining 55.47% of the total variance with an internal consistency of .97, and a high discriminatory power to distinguish between abusive and non-abusive group experiences. In addition, significant correlations were found between the PAEGS and group abusiveness and psychological distress measures, providing further evidence of validity. The Spanish version of the PAEGS is proposed to overcome limitations of previous instruments, and it can be useful in research and applied contexts to assess the extent of psychological abuse experienced within a certain group

La "Escala de abuso psicológico experimentado en grupos" (PAEGS, por sus siglas en inglés) es un cuestionario autoadministrado que mide comportamientos de abuso psicológico experimentados en el seno de un grupo. El objetivo de este estudio fue analizar las propiedades psicométricas del PAEGS para su uso en población hispanoparlante. Se administró la PAEGS en línea a 269 ex-miembros de grupos abusivos y a 268 e-miembros de grupos no abusivos. Los principales resultados mostraron una estructura factorial unidimensional que explicó el 55,47% de la varianza total con una consistencia interna de 0,97, así como un alto poder discriminatorio para distinguir entre experiencias grupales abusivas y no abusivas. Además, se encontraron correlaciones significativas entre la PAEGS y medidas del grado de abuso que caracteriza al grupo y de malestar psicológico aportándose mayores indicios de validez. Se propone la versión española de la PAEGS para superar las limitaciones de instrumentos previos, pudiendo resultar de utilidad tanto en el ámbito de la investigación como en contextos aplicados para evaluar el grado de abuso psicológico experimentado dentro de un determinado grupo

Measuring psychological abuse in same-sex couples: evidence of validity of the EAPA-P in a Spanish-speaking sample / Evaluación del abuso psicológico en parejas del mismo sexo: evidencias de validez de la EAPA-P en una muestra de habla hispana

Antecedentes: La investigación del abuso psicológico en parejas del mismo sexo se ha incrementado en las últimas décadas. Sin embargo, los pocos estudios de validación de medidas estandarizadas se han realizado en países anglosajones. La Escala de Abuso Psicológico Aplicado en la Pareja (EAPA-P) es un cuestionario auto-administrado que mide comportamientos abusivos experimentados en relaciones de pareja. El objetivo del presente estudio fue analizar las propiedades psicométricas de la EAPA-P en parejas del mismo sexo compuestas por personas hispano-hablantes. Método: 372 lesbianas, gais y bisexuales participaron en el estudio a través de un cuestionario en línea. Se examinó la estructura interna, las correlaciones con una medida de malestar psicológico y la capacidad de discriminación de la escala. La fiabilidad se examinó mediante el coeficiente alfa ordinal. Resultados: Se extrajo un único factor que explicó el 52.27% de la varianza total, obteniendo una fiabilidad de .95. El análisis discriminante reveló una puntuación mayor de 12 como punto de corte óptimo para identificar la victimización. Se hallaron correlaciones significativas entre las puntuaciones de la EAPA-P y sintomatología depresiva. Conclusiones: La EAPA-P parece ser un instrumento válido y fiable para evaluar el abuso psicológico en personas hispano-hablantes en parejas del mismo sexo

Background: Research on psychological abuse in same-sex couples has increased in the last decades. However, the few studies validating standardized measures to assess the phenomenon have been conducted in English-speaking countries. The Psychological Abuse in Intimate Partner Violence Scale (EAPA-P) is a self-reported questionnaire measuring psychologically abusive behaviors experienced in intimate partner relationships. The aim of this study was to analyze the psychometric properties of the EAPA-P in Spanish-speakers in same-sex couples. Method: 372 lesbian, gay and bisexual individuals participated in the study through an online questionnaire. Validity evidence was tested using factor analysis and correlations with a measure on psychological distress, as well as examining the discriminatory power of the scale. Internal consistency reliability was calculated with the ordinal Alpha coefficient. Results: The main results showed a one-dimensional factor structure explaining 52.27% of the total variance with a reliability of .95. The discriminant analysis revealed a score higher than 12 in a range from 0 to 76 as the optimal cut-off point to identify victimization. Significant correlations were found between the EAPA-P scores and depressive symptomatology. Conclusions: The EAPA-P appears to be a valid and reliable instrument to assess victimization of psychological abuse in Spanish-speakers in same-sex couples

Development and validation of the Psychological Abuse Experienced in Groups Scale / Desarrollo y validación de la Escala de Abuso Psicológico Experimentado en Grupos

The aim of this study is the development and analysis of the psychometric properties of a new instrument to assess the possible psychological abuse experienced in a group setting. The Psychological Abuse Experienced in Groups Scale was administered to 138 people who self-identified as former members of abusive groups. An exploratory factor analysis revealed a common factor, which showed appropriate reliability. The scale scores were correlated with a prior measure aimed to assess group abusiveness, providing evidence of external validity. Participants reported a higher degree of psychological distress than normative samples, and those who requested psychological counseling after leaving the group had suffered group psychological abuse to a greater extent. The scale covers a wide range of subtle and explicit abusive behaviors and overcomes the limitations of previous instruments, being useful in both research and applied settings (AU)

El objetivo de este estudio es el desarrollo y análisis de las propiedades psicométricas de un nuevo instrumento para evaluar el posible abuso psicológico experimentado por una persona en el seno de un grupo. La Escala de Abuso Psicológico Experimentado en Grupos se administró a 138 personas auto-identificadas como exmiembros de grupos abusivos. Mediante un análisis factorial exploratorio se extrajo un factor común que mostró una adecuada fiabilidad. Las puntuaciones de la escala correlacionaron con una medida previa que evalúa el grado de abuso que caracteriza a un grupo, aportando evidencias de validez externa. Los participantes reportaron un mayor grado de malestar psicológico que en muestras normativas y aquellos que buscaron atención psicológica tras abandonar el grupo reportaron haber sufrido abuso psicológico en mayor grado. La escala cubre un amplio rango de conductas abusivas tanto explícitas como sutiles y permite superar las limitaciones de instrumentos previos, resultando útil tanto en el campo académico como en el aplicado (AU)

Group psychological abuse: taxonomy and severity of its components / Abuso psicológico en grupos: taxonomía y severidad de sus componentes

The purpose of this study was to delimit group psychological abuse through a psychosocial approach. An operational definition of the phenomenon and a taxonomy of group psychological abuse strategies were proposed based on a review of the scientific literature. A panel of 31 experts in the area evaluated the content of the taxonomy and judged the severity of the strategies through a Delphi study. Group psychological abuse was defined by the application of abusive strategies, their continued duration, and their ultimate aim, i.e., subjugation of the individual. The taxonomy showed adequate content validity. Experts’ judgments allowed for hierarchically organizing the strategies based on their severity, being the most severe those directed to the emotional area. Operationalizing, classifying, and organizing the strategies hierarchically contributes to a better delimitation of the phenomenon, which is useful for both the academic and applied fields (AU)

Se diseñó un estudio con el propósito de delimitar el abuso psicológico en grupos desde una aproximación psicosocial. A partir de una revisión de la literatura científica, se propuso una definición del fenómeno y una taxonomía de las estrategias de abuso psicológico en grupos. Un panel de 31 expertos evaluó el contenido de la taxonomía y juzgó la severidad de las estrategias a través de un estudio Delphi. El abuso psicológico en grupos es definido por la aplicación de estrategias abusivas, su duración continuada y su objetivo último, el sometimiento del individuo. La taxonomía mostró una adecuada validez de contenido. El juicio de expertos permitió jerarquizar las estrategias en función de su severidad, siendo las más severas aquellas que inciden en el ámbito emocional. Operativizar, clasificar y jerarquizar las estrategias contribuye a una mejor delimitación del fenómeno, útil tanto en el campo académico como en el aplicado (AU)

[Forestier disease. Case report and literature review]. / Enfermedad de Forestier. Reporte de un caso y revisión bibliográfica.

BACKGROUND: Forestier disease is a systemic disorder characterized by ossification of the anterior spinal longitudinal ligament (ALL) in at least three adjacent vertebrae, and diffuse spinal enthesopathy. Indication for surgical treatment is rare and limited to cases of related myelopathy, fracture or significant dysphagia. Few cases of surgical treatment are reported in the medical literature. Surgical treatment depends on the particular symptoms or complications, and usually involves osteophytectomy through the standard anterior approach. Surgery may bring about complications, such as pharyngeal paralysis, thrombosis, infections and respiratory obstruction. CLINICAL CASE: 79-year old male with dysphagia of 10 years of evolution, and hoarseness and respiratory distress since 8 years ago. Screening studies showed a diffuse calcification of anterior longitudinal ligament along with large cervical osteophytes. Forestier disease and secondary dysphagia were diagnosed. Surgical treatment consisted of resection of bone exostoses in C4 and C5 vertebral bodies. Six months after surgery, the patient reported improvement of esophageal and respiratory symptoms without evidence of recurrence on imaging studies. CONCLUSIONS: Data on Forestier disease's epidemiological nature and impact on life quality in Mexico is unknown. An increase in its occurrence is projected as the Mexican population ages. An observational study is required to identify the characteristics of this disease in Mexico.