Measuring the shadows: A systematic review of chronic emptiness in borderline personality disorder.

BACKGROUND: Chronic feelings of emptiness is an under-researched symptom of borderline personality disorder (BPD), despite indications it may be central to the conceptualisation, course, and outcome of BPD treatment. This systematic review aimed to provide a comprehensive overview of chronic feelings of emptiness in BPD, identify key findings, and clarify differences between chronic feelings of emptiness and related constructs like depression, hopelessness, and loneliness. METHOD: A PRISMA guided systematic search of the literature identified empirical studies with a focus on BPD or BPD symptoms that discussed chronic feelings of emptiness or a related construct. RESULTS: Ninety-nine studies met criteria for inclusion in the review. Key findings identified there were significant difficulties in defining and measuring chronic emptiness. However, based on the studies reviewed, chronic emptiness is a sense of disconnection from both self and others. When experienced at frequent and severe levels, it is associated with low remission for people with BPD. Emptiness as a construct can be separated from hopelessness, loneliness and intolerance of aloneness, however more research is needed to explicitly investigate these experiences. Chronic emptiness may be related to depressive experiences unique to people with BPD, and was associated with self-harm, suicidality, and lower social and vocational function. CONCLUSIONS AND IMPLICATIONS: We conclude that understanding chronic feelings of emptiness is central to the experience of people with BPD and treatment focusing on connecting with self and others may help alleviate a sense of emptiness. Further research is required to provide a better understanding of the nature of chronic emptiness in BPD in order to develop ways to quantify the experience and target treatment. Systematic review registration number: CRD42018075602.

Validez y consistencia interna del instrumento Vínculo entre padres e hijos neonatos / Internal consistency and validity of the instrument Attachment between parents and newborn children

OBJETIVO: Determinar la validez y la consistencia interna del instrumento Vínculo entre padres e hijos neonatos versión en español resultado de la adaptación transcultural del Maternal Attachment Inventory (MAI) de Mary Müller. MATERIALES Y MÉTODO: Estudio descriptivo metodológico - psicométrico, cuya validez facial y de contenido se logró con la participación de un panel de expertos y 385 potenciales padres con bajo nivel de escolaridad. Para la validez de constructo y consistencia interna la muestra fue de 352 padres de recién nacidos a término. RESULTADOS: La validez facial para la población general mostró una comprensión global y por ítems superior a 90 %, y un índice de aceptabilidad superior en las tres categorías valoradas; igualmente el índice de Kapa y Fleiss mostró concordancia interjueces para cada uno de los ítems por encima de 0.69. La validez de contenido global presenta fuerte pertinencia y relevancia con un índice de Kapa y Fleiss de 0.71 y 0.77 respectivamente. En la validez de constructo el análisis factorial exploratorio arrojó cuatro factores con una varianza total explicada por el índice de Kaiser-Meyer-Olkin (KMO) de 73 %, y la consistencia interna por el Alfa de Cronbach fue de 0.7 para el total de la escala. CONCLUSIONES: El instrumento Vínculo entre padres e hijos neonatos es válido y confiable para medir el vínculo afectivo en el contexto colombiano cuyo uso favorece la práctica de enfermería basada en evidencia en contextos diversos como Unidades de Cuidado Neonatal y en la práctica ambulatoria

OBJECTIVE: To determine the validity and internal consistency of the instrument Attachment between parents and newborn children, spanish version as a result from the transcultural adaptation of the Maternal Attachment Inventory (MAI) by Mary Muller. MATERIALS AND METHOD: Methodological - psychometric descriptive study, whose facial and content validity was achieved with the participation of a panel of experts and 385 potential parents with low level of schooling. For the validity of construct and internal consistency the sample was 352 parents of full-term newborns. RESULTS: Facial validity for the general population showed a global and item understanding of more than 90%, and a higher acceptability rate in the three categories valued; likewise, the Kapa and Fleiss index showed inter-concordance for each of the items above 0.69. The validity of global content has a strong pertinence and relevance with a Kapa and Fleiss index of 0.71 and 0.77 respectively. In the validity of the construct, the exploratory factor analysis yielded four factors with a total variance explained by the Kaiser-Meyer-Olkin Index (KMO) of 73%, and the internal consistency by Cronbach's Alpha was 0.7 for the total of the scale. CONCLUSIONS: The Attachment between parents and newborn children instrument is valid and reliable to measure the affective attachment in the Colombian context whose use favors the practice of evidence-based nursing in diverse contexts such as Neonatal Care Units and in ambulatory practice

Parenting styles and aggressive adolescents: relationships with self-esteem and personal maladjustment / Los estilos parentales y los adolescentes agresivos: su relación con la autoestima y el desajuste personal

Current emergent studies are seriously questioning if parental strictness contributes to adolescent adjustment. This study examined whether the relationship between authoritative (warmth and strictness), authoritarian (strictness without warmth), indulgent (warmth without strictness), and neglectful (neither warmth nor strictness) parenting styles shows equal or different pattern of adjustment and maladjustment for aggressive and non-aggressive adolescents. The sample consisted of 969 Spanish adolescents, 554 females (57.2%) and 415 males, ranging from 12 to 17 years old. Families were classified into one of four typologies by their scores on warmth and strictness, and the adolescents were grouped by their aggressiveness (low vs. high). Adolescent adjustment was captured with three self-esteem indicators (emotional, physical, and family) and personal maladjustment with five indicators (negative self-esteem, negative self-adequacy, emotional irresponsiveness, emotional instability, and negative worldview). It was tested main and interaction effects between parenting and aggressiveness considering also sex and age factors. Findings showed that aggressive adolescents always had the worst socialization outcomes (i.e., the lowest self-esteem and the highest personal maladjustment). Aggressive and non-aggressive adolescents have a common pattern: both, indulgent and authoritative parenting styles were always associated with better outcomes than either authoritarian or neglectful parenting, but indulgent parenting style was associated with the best outcomes across all the criteria. In contrast with previous evidence about the idea that parental strictness and imposition might be beneficial to raise aggressive adolescents, present findings highlight the positive impact of parental warmth even with aggressive adolescents. Implications for family interventions were considered

Investigaciones emergentes cuestionan que la severidad parental contribuya al ajuste del adolescente. Este estudio examina si la relación entre los estilos parentales autorizativo (afecto y severidad), autoritario (severidad sin afecto), indulgente (afecto sin severidad) y negligente (ni afecto ni severidad) presenta patrones de ajuste y desajuste iguales o diferentes en adolescentes agresivos y no agresivos. Participaron 969 adolescentes españoles, 554 mujeres (57.2%) y 415 varones, de 12 a 17 años. Las familias se clasificaron en un estilo parental según sus puntuaciones en afecto y severidad y los adolescentes se agruparon por agresividad (baja vs. alta). Se captó el ajuste mediante tres indicadores de autoestima (emocional, física y familiar) y el desajuste personal con cinco indicadores (autoestima negativa, autoeficacia negativa, falta de respuesta emocional, inestabilidad emocional y visión negativa del mundo). Se probaron efectos principales y de interacción para estilos parentales y agresividad, considerando también sexo y edad. Los análisis mostraron que los adolescentes agresivos siempre tenían los peores resultados (i.e., la menor autoestima y el mayor desajuste personal). Los adolescentes agresivos y no agresivos comparten un patrón común: los estilos indulgente y autorizativo siempre se asociaron con mejores resultados que el autoritario o el negligente, pero el estilo indulgente se asoció con los mejores resultados en todos los criterios. A diferencia de estudios previos que consideraban que el rigor y la severidad de los padres podrían ser beneficiosos en hijos agresivos, los presentes resultados resaltan el impacto positivo del afecto parental incluso en adolescentes agresivos. Se consideraron las implicaciones para las intervenciones familiares

Are humor styles predictors of hope? sex and age differences in Italian adolescents and young adults

The study analyzed relationships among humor styles and hope and deepen the role of humor styles as predictors of hope in 582 Italian adolescents and young adults (with age ranged between 14 and 27). Sex and age differences were observed. The Humor Styles Questionnaire was used to assess the inclination to adopt positive (affiliative/self-enhancing) and negative (aggressive/self-defeating) humor styles, and Hope Scale was used to evaluate the general level of hope ("overall" hope score) and its two components (agency/pathways). Significant differences for sex and age-groups were found. Correlation analyses pointed out that positive humor styles were positively related to hope, and self-defeating humor was negatively associated to hope. Linear regressions displayed that self-enhancing and affiliative styles positively influenced hope while self-defeating negatively affected hope. The emerged relationships suggested that promoting the use of humor to amuse the others facilitate interpersonal relationships especially in developmental age

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Appreciation and illegitimate tasks as predictors of affective well-being: disentangling within- and between-person effects / El reconocimiento profesional y las tareas improcedentes como predictores del bienestar afectivo: la desagregación de los efectos intrapersonales e interpersonales

This study examines the effects of appreciation and illegitimate tasks on affective well-being. As empirical results often refer to inter-individual effects but are interpreted in terms of intra-individual effects, we try to disentangle the two. In longitudinal multilevel structural equation models with data of 308 participants, appreciation predicted affective well-being in the expected direction both on the within-level and the between-level, whereas illegitimate tasks had a stronger effect on the between level. On the within-level, appreciation buffered the effect of illegitimate tasks for two of the four facets of affective well-being. Demonstrating a convergent and pervasive effect of appreciation on both levels but diverging effects of illegitimate tasks implies that finding on one level may, but need not, work on the other level as well

Este estudio analiza los efectos del reconocimiento profesional y de las tareas improcedentes en el bienestar afectivo. Dado que los resultados empíricos a menudo aluden a los efectos interindividuales pero se interpretan como efectos intraindividuales, intentamos desintrincar ambos. En los modelos de ecuaciones estructurales longitudinales de múltiples niveles con datos de 308 participantes el reconocimiento profesional predecía el bienestar afectivo en la dirección esperada, tanto en cada nivel como entre los distintos niveles, mientras que las tareas improcedentes producían un mayor efecto entre niveles. En cada nivel el reconocimiento amortiguaba el efecto de las tareas improcedentes en dos de los cuatro aspectos del bienestar afectivo. Demostrar un efecto convergente y generalizado del reconocimiento en ambos niveles pero efectos divergentes de las tareas improcedentes implica que el resultado en un nivel puede, aunque no tiene por qué, funcionar también en el otro nivel

Conhecimentos dos adolescentes sobre sexualidade e afetos / Adolescent knowledge on sexuality and affects

Background: In the school environment, sex education is included in health education, and it is essential to address it clearly in the various age groups. With a view to healthy sexuality, adolescents should acquire knowledge in this area. Objectives: To identify the interlocutor of adolescents, attending the 6th grade, to talk about sexuality and affections. To evaluate the effect of formative intervention on adolescents' level of knowledge on the subject. Methods: Longitudinal study in a short panel, conducted in an accidental nonprobabilistic sample, for convenience, consisting of 110 adolescents attending the 6th grade. A self-completed questionnaire with sociodemographic characterization of students / parents, a person with whom they talk about sexuality and affections and a scale of knowledge was used. Results: Participants are between 10 and 14 years old with an average of 11.53 (+/- 0.591SD). The adolescents are mostly male (60.1%), living in urban areas (82.5%) with their father and mother (82.2%). They revealed adequate knowledge on the theme of sexuality and affection (44.7%); they highlighted teachers as interlocutors to talk about sex (54.5%) and parents to talk about affect (60.0%). In the present study, it is the younger adolescents and those living in urban areas who have the best levels of knowledge about sexuality and affection. Conclusion: Adolescents improved their level of knowledge after the formative intervention on "Sexuality & Affections", a fact that reinforces the importance of this type of health education sessions in the school context

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Life satisfaction and self-rated health in adolescents: the relationships between them and the role of gender and age

The purpose of this study was to analyze the relationships between self-reported life satisfaction, self-rated health, gender, and age in adolescents. 1,141 secondary school students aged between 12 and 17 participated in our study. The data were analyzed using bivariate and nonlinear canonical correlation analyses. The results of the bivariate correlation analysis support the results of previous studies. Life satisfaction was positively correlated with same-day perceived health (r = .37; p < .01) and negatively correlated with anxiety/depression (r = -.37; p < .01). Same-day perceived health was positively correlated with health in the past 12 months (r = .38; p < .01) and negatively correlated with pain/discomfort (r = -.32; p < .01) and with anxiety/depression (r = -.32; p < .01). The nonlinear canonical correlation analysis provided further evidence of the relationship between the variables, suggesting the complementarity of the indicators of self-rated health analyzed. Multiple fit values showed that demographic variables age (.61) and gender (.56) were the variables with the best discriminatory power. Graphically, two groups of related variables were displayed. A non-linear analysis better explains the relationships between the variables analyzed, showing that age and gender have a high level of discriminatory power for life satisfaction and self-rated health, suggesting a role as a moderator in the relationship between health and well-being variables

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Is love triarchic or monarchical-hierarchical? a proposal of a general factor of love and a scale to measure it

One of the most widely used measures for evaluating love is the Triangular Love Scale (TLS) by Sternberg (1986) based on his Triarchic theory according to which, love is comprised of three reasonably independent components (intimacy, passion and commitment). However, different investigations contradict this idea. The purpose of the present investigation is to verify whether the structure of love is triarchic, with three independent factors, or monarchical-hierarchical, with a first level where the three components of love would be located, and a second higher level where they would be grouped together in a general factor of love. In order to do this, in addition to the use of the TLS scale, another equivalent called Quality Partner Relationship Scale (QPRS) was developed to test the stability of the results found, and to propose a measure of love based on the Sternberg components, but simpler and without problems of overlap between items. To test this question, we used a sample of 610 people matched by sex, age and social class, all of whom were partnered at the time of the evaluation. Confirmatory Factor Analyses were used to test the research objective, something that had not been done so far, and it was found that the structure that best fitted the data was monarchical-hierarchical in the case of the TLS as well as in the one of the QPRS. We can then state that love is structured around a general factor in which the three components are grouped: Intimacy, passion and commitment

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Urdu translation of Friendship Scale: evidence for the validity and measurement invariance across gender

Social isolation is a state of nearly-absolute lack of interaction between an individual and society. The Friendship Scale (Hawthorne, 2006) is a measure of social isolation that needed to be translated in the Urdu language for its validation for the Pakistani population owing to its brevity and sound psychometric properties. For the Urdu translation, the standard back-translation procedure was adopted, and the cross-language validation of the translated version was undertaken on a purposive sample of (N = 60) older adults with a minimum age of 60 years. The test-retest reliability of one week for the Urdu-English and English-Urdu version was .95 and .97, respectively. In an independent purposive sample of older adults (N = 500; men = 263 and women = 237) from Lahore and Sargodha districts, the CFA of the Friendship Scale revealed a single factor solution with six indicators, which demonstrated configural, metric, and scalar invariance across both genders and comparable latent mean scores of men and women. The Friendship Scale demonstrated a significant positive relationship with depression and non-significant association with the assimilation, which provided evidence for the convergent and discriminant validities, respectively. Furthermore, evidence of the concurrent validity was established as the older adults whose spouses had died scored significantly higher on the Friendship scale as compared to their counterparts who were living with their spouses. These pieces of evidence suggest that the Urdu version of the Friendship scale is a reliable and valid measure of flourishing for both genders

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Enhancing engagement through job resources: the moderating role of affective commitment

Research has shown that affective commitment, one of three components of organizational commitment defined by Meyer and Allen (1991), can act as a moderator in relationships between job stressors and worker's psychological tension. However, due to the scarcity of studies that investigate the moderating effect of this commitment component on relationships between positive variables, the purpose of this study is to examine the moderating role of affective commitment in the relationship between autonomy, peer support, supervisory support and perceived organizational support (POS), as job resources, on engagement. In this sense, we analyzed the data provided by a sample of Portuguese employees (N = 554), from an organization belonging to the consultancy sector. Firstly, we aimed to examine the direct effects of those job resources on engagement, and, then, examine the impact of affective commitment as a moderator on these relationships. The results partially support the hypotheses formulated. Indeed, there was a positive relationship between the job resources studied - work autonomy, peer support, supervisory support and POS - and engagement. Furthermore, according to our hypothesis, the interaction established between affective commitment and autonomy, significantly exacerbates the positive effect of this job resource on workers well-being, that is, on their engagement (b = .08, p < .05). However, contrary to our hypothesis, the affective commitment does not moderate the relationship between the other job resources and engagement. This study contributes to a deepest knowledge about the potentialities of affective commitment, reinforcing the importance of consider it as a contextual resource

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Mood Monitoring Over One Year for People With Chronic Obstructive Pulmonary Disease Using a Mobile Health System: Retrospective Analysis of a Randomized Controlled Trial.

BACKGROUND: Comorbid anxiety and depression can add to the complexity of managing treatment for people living with chronic obstructive pulmonary disease (COPD). Monitoring mood has the potential to identify individuals who might benefit from additional support and treatment. OBJECTIVE: We used data from the sElf-management anD support proGrammE (EDGE) trial to examine: (1) the extent to which the mood-monitoring components of a mobile health system for patients with COPD were used by participants; (2) the levels of anxiety and depression symptoms among study participants; (3) the extent to which videos providing advice about coping with low mood were viewed; and (4) the characteristics of participants with differing levels of mood and utilization of mood monitoring. METHODS: A total of 107 men and women with a clinical diagnosis of COPD, aged ≥40 years old, were recruited to the intervention arm of the EDGE trial. Participants were invited to complete the Patient Health Questionnaire-8 and the Generalized Anxiety Disorder-7 test every four weeks using a tablet computer. Mood disturbance based on these measures was defined as a score ≥5 on either scale. Participants reporting a mood disturbance were automatically directed (signposted) to a stress or mood management video. Study outcomes included measures of health status, respiratory quality of life, and symptoms of anxiety and depression. RESULTS: Overall, 94 (87.9%) participants completed the 12-month study. A total of 80 participants entered at least one response each month for at least ten months. On average, 16 participants (range 8-38 participants) entered ≥2 responses each month. Of all the participants, 47 (50%) gave responses indicating a mood disturbance. Participants with a mood disturbance score for both scales (n=47) compared with those without (n=20) had lower health status (P=.008), lower quality of life (P=.009), and greater anxiety (P<.001) and increased depression symptoms (P<.001). Videos were viewed by 64 (68%) people over 12 months. Of the 220 viewing visualizations, 70 (34.7%) began after being signposted. Participants signposted to the stress management video (100%; IQR 23.3-100%) watched a greater proportion of it compared to those not signposted (38.4%; IQR 16.0-68.1%; P=.03), whereas duration of viewing was not significantly different for the mood management video. CONCLUSIONS: Monitoring of anxiety and depression symptoms for people with COPD is feasible. More than half of trial participants reported scores indicating a mood disturbance during the study. Signposting participants to an advisory video when reporting increased symptoms of a mood disturbance resulted in a longer view-time for the stress management video. The opportunity to elicit measures of mood regularly as part of a health monitoring system could contribute to better care for people with COPD.

A critique of validity analysis from instruments assessing the affective domain.

BACKGROUND: Schools and colleges of pharmacy need to show evidence that their students have internalized professional values, and many choose to do so through quantitative instruments. A review of the literature was completed to identify the evidence of validity of the scores from instruments designed to assess pharmacy students in the affective domain. METHODS: Electronic databases were searched to identify instruments. Basic information regarding the instruments, the facets of validity assessed, and the evidence for validity were reviewed. RESULTS: Of the studies identified, 25 focused on assessing the affective domain and reported evidence of at least one facet of validity. Most reported evidence of validity from two or more sources, and most reported evidence concerning test content and internal structure (i.e. internal consistency reliability or factor analysis). Other sources of validity were missing from most studies. IMPLICATIONS: More research is needed to investigate the validity of the scores of instruments developed to assess pharmacy students within the affective domain, especially regarding relations to other variables, response processes, and consequences of use.

Longitudinal Relationships Between Positive Affect, Loneliness, and Suicide Ideation: Age-Specific Factors in a General Population.

The aims of this study were to analyze whether positive and negative affect, social support, and loneliness are factors longitudinally related to suicide ideation in the general population in different age groups. A total of 2,392 individuals from a nationally representative sample of the Spanish general population were evaluated in 2011-2012 and in 2014-2015. After including relevant control variables in the analyses, lower positive affect was prospectively related to ideation in 18- to 59-year-old individuals, whereas feelings of loneliness were related to ideation in 60-year-and-older individuals. Social support was not associated with suicide ideation in any age group. These results are in line with the need for age-tailored suicide prevention programs. The present findings might also suggest that health care professionals should consider feelings of loneliness rather than social support to assess the presence of suicide ideation in older people.

Salud mental, afectividad positiva y bienestar en prisión: un estudio comparativo entre jóvenes y mayores presos / Mental health, positive affectivity and wellbeing in prison: a comparative study between young and older prisoners

Objetivos: Explorar las características sociodemográficas, psicológicas y psicopatológicas, así como evaluar la conducta de una muestra de internos. Materiales y métodos: Se cuenta con una muestra total, entre jóvenes y mayores, de 182 internos del Centro Penitenciario Madrid III. La investigación se ha llevado a cabo con una batería de cuestionarios psicológicos de autoinforme y medidas objetivas obtenidas a través de los expedientes penitenciarios. Se realizaron comparaciones de las medias para ver si existen diferencias significativas entre los dos grupos (jóvenes y mayores) en las variables analizadas. Resultados: El análisis muestra que no existen diferencias significativas en los niveles de bienestar de jóvenes y mayores. Sin embargo, los jóvenes muestran grados más elevados de malestar psicológico, presentan más emociones negativas y una conducta más desadaptada en la prisión (consumen más cannabis y tienen más expedientes disciplinarios). Las personas mayores regulan mejor sus emociones, adoptan mejor las perspectivas de otros, mostrándose además más amables. Conclusiones: Las personas mayores que están en prisión, comparados con los más jóvenes, presentan un mejor ajuste psicológico, más recursos internos y un mejor nivel de adaptación al medio penitenciario, a pesar de no existir diferencias en variables asociadas como, por ejemplo, el tiempo en prisión

Objective: To explore socio-demographic, psychological and psychopathological characteristics, as well as to evaluate behaviour in a sample of inmates. Material and methods: A sample of 182 young and elderly inmates of the Madrid III Prison was used. The research was carried out with a battery of self-report psychological questionnaires and objective measurements obtained through the prison files. Comparisons of means were made to see if there are significant differences between the two groups (young and elderly inmates) in the variables analysed. Results: The analysis shows that there are no significant differences in wellbeing between young and elderly inmates. However, young people have higher levels of psychological distress, more presence of negative emotions and have a more maladjusted behaviour in prison (they consume more cannabis and have more disciplinary proceedings registered). Older people regulate their emotions better, adopt the perspectives of others more effectively and show themselves to be friendlier. Conclusions: The elderly inmates in prison, compared with the youngest ones, have better psychological adjustment, more internal resources and are better adapted to the prison environment despite there being no differences in related variables such as time in prison

Determinants of compassion satisfaction, compassion fatigue and burn out in nursing: A correlative meta-analysis.

BACKGROUND: Compassionate care is essential for better clinical and patient outcomes, but during healthcare provision it can be compromised by several factors. This study evaluates factors affecting compassion satisfaction, compassion fatigue and burnout in nursing. METHODS: Literature search in electronic databases was followed by data extraction, conversion, and meta-analyses under random effect model. Correlation coefficients (r) reported by individual studies were first converted to z-scores for meta-analyses and the overall effect sizes were then back-transformed into r. RESULTS: Eleven studies (4054 respondents; 64.34 [95% confidence interval: 38.82, 89.86] % response rate; age 39.81 [31.36, 48.27] years; 87.11 [79.48, 94.73] % females) were used for meta-analysis. There was a strong positive correlation between compassion fatigue and burnout (r = 0.59), whereas compassion satisfaction had weak negative correlation with compassion fatigue (r = -0.226) but moderate with burnout (r = -0.446). Stress and negative affect were moderately positively associated with compassion fatigue (r = 0.405) but weakly correlated with burnout (r = 0.119). Positive affect and personal/social factors had weak inverse relationship with burnout (r = -0.197). Positive affect also had a moderately positive relationship with compassion satisfaction (r = 0.396). Demographic or professional factors were not significantly related to compassion satisfaction, compassion fatigue, or burnout. CONCLUSION: In nursing, a variety of stressful factors and negative affect promote compassion fatigue and burnout whereas positive affect is helpful in achieving compassion satisfaction.

Distributed affective space represents multiple emotion categories across the human brain.

The functional organization of human emotion systems as well as their neuroanatomical basis and segregation in the brain remains unresolved. Here, we used pattern classification and hierarchical clustering to characterize the organization of a wide array of emotion categories in the human brain. We induced 14 emotions (6 'basic', e.g. fear and anger; and 8 'non-basic', e.g. shame and gratitude) and a neutral state using guided mental imagery while participants' brain activity was measured with functional magnetic resonance imaging (fMRI). Twelve out of 14 emotions could be reliably classified from the haemodynamic signals. All emotions engaged a multitude of brain areas, primarily in midline cortices including anterior and posterior cingulate gyri and precuneus, in subcortical regions, and in motor regions including cerebellum and premotor cortex. Similarity of subjective emotional experiences was associated with similarity of the corresponding neural activation patterns. We conclude that different basic and non-basic emotions have distinguishable neural bases characterized by specific, distributed activation patterns in widespread cortical and subcortical circuits. Regionally differentiated engagement of these circuits defines the unique neural activity pattern and the corresponding subjective feeling associated with each emotion.

Burden of COPD in patients treated in different care settings in the Netherlands.

INTRODUCTION: Care for patients with chronic obstructive pulmonary disease (COPD) can be provided in primary, secondary or tertiary care. Whether and to what extent patients with COPD treated in various healthcare settings differ in disease burden and healthcare utilization remains unknown. Therefore, daily symptoms, functional mobility, mood status, health status and healthcare utilization were compared between COPD patients in various care settings, to explore possibilities for healthcare-optimization. METHODS: Current data are part of the Chance study. Demographics, functional mobility (Care Dependency Scale (CDS); Timed-Up-and-Go (TUG) test), mood status (Hospital Anxiety and Depression scale (HADS)), health status (COPD Assessment test (CAT); Clinical COPD questionnaire (CCQ); COPD specific St. George Respiratory questionnaire (SGRQ-C)), received treatments and severity of physical and psychological symptoms were assessed in subjects with and without COPD. RESULTS: 836 subjects (100 primary care patients, 100 secondary care patients, 518 tertiary care patients and 118 non-COPD subjects) were included. The burden of disease significantly increased from primary care to tertiary care. However, in all three healthcare settings a high percentage of patients with an impaired health status was observed (i.e. CAT ≥10 points, 68.0% vs. 91.0% vs. 94.5%, respectively). Furthermore, many patients treated in secondary care remain highly symptomatic despite treatment, while others with low burden of disease would allow for de-intensification of care. CONCLUSION: This study revealed important shortcomings and challenges for the care of COPD patients in the Netherlands. It emphasizes the need for detailed patient characterization and more individualized treatment, independent of the healthcare setting.

Adaptación de las "Escalas de afecto positivo y negativo" (PANAS) en una muestra general española / An adaptation of the Positive and Negative Affect Schedules (PANAS) in a Spanish general sample

Las "Escalas de afecto positivo y negativo" (Positive and Negative Affect Schedule, PANAS) han sido ampliamente utilizadas para evaluar el afecto. Este trabajo tiene como objetivo analizar las propiedades psicométricas, estructura e invarianza factorial de una adaptación al español en una muestra general española (N= 1071). El coeficiente alfa de Cronbach fue de 0,92 para la Escala de afecto positivo y de 0,88 para la Escala de afecto negativo. Los análisis factoriales exploratorio y confirmatorio revelaron una estructura bifactorial de las PANAS y los análisis de invarianza factorial confirmaron la invarianza de esta adaptación en función del sexo y la edad. Asimismo, se encontraron correlaciones significativas en diferentes muestras entre las escalas del instrumento y otras medidas de afecto, depresión, ansiedad y bienestar. En conjunto, esta nueva versión de las PANAS supone algunas mejoras relevantes, especialmente en el ajuste de la traducción, y presenta buenas propiedades psicométricas en estas muestras

The Positive and Negative Affect Schedule (PANAS) have been widely used to measure affect. This study aimed to analyze the psychometric properties, structure and factorial invariance of an adaptation to Spanish in a general sample from Spain (N= 1071). Cronbach's alpha was .92 for Positive Affect Scale and .88 for Negative Affect Scale. Exploratory and confirmatory factor analyses revealed a two-factor structure of the PANAS. Factorial invariance analyses confirmed the invariance of this adaptation by sex and age. Furthermore, significant correlations were found in different samples between the scales of the instrument and other measures of affect, depression, anxiety and well-being. Overall, this new version of the PANAS has good psychometric properties in the samples analyzed

Covariation of depressive mood and spontaneous physical activity in major depressive disorder: toward continuous monitoring of depressive mood.

The objective evaluation of depressive mood is considered to be useful for the diagnosis and treatment of depressive disorders. Thus, we investigated psychobehavioral correlates, particularly the statistical associations between momentary depressive mood and behavioral dynamics measured objectively, in patients with major depressive disorder (MDD) and healthy subjects. Patients with MDD ( n = 14) and healthy subjects ( n = 43) wore a watch-type computer device and rated their momentary symptoms using ecological momentary assessment. Spontaneous physical activity in daily life, referred to as locomotor activity, was also continuously measured by an activity monitor built into the device. A multilevel modeling approach was used to model the associations between changes in depressive mood scores and the local statistics of locomotor activity simultaneously measured. We further examined the cross validity of such associations across groups. The statistical model established indicated that worsening of the depressive mood was associated with the increased intermittency of locomotor activity, as characterized by a lower mean and higher skewness. The model was cross validated across groups, suggesting that the same psychobehavioral correlates are shared by both healthy subjects and patients, although the latter had significantly higher mean levels of depressive mood scores. Our findings suggest the presence of robust as well as common associations between momentary depressive mood and behavioral dynamics in healthy individuals and patients with depression, which may lead to the continuous monitoring of the pathogenic processes (from healthy states) and pathological states of MDD.

Affect labeling enhances exposure effectiveness for public speaking anxiety.

Exposure is an effective treatment for anxiety but many patients do not respond fully. Affect labeling (labeling emotional experience) attenuates emotional responding. The current project examined whether affect labeling enhances exposure effectiveness in participants with public speaking anxiety. Participants were randomized to exposure with or without affect labeling. Physiological arousal and self-reported fear were assessed before and after exposure and compared between groups. Consistent with hypotheses, participants assigned to Affect Labeling, especially those who used more labels during exposure, showed greater reduction in physiological activation than Control participants. No effect was found for self-report measures. Also, greater emotion regulation deficits at baseline predicted more benefit in physiological arousal from exposure combined with affect labeling than exposure alone. The current research provides evidence that behavioral strategies that target prefrontal-amygdala circuitry can improve treatment effectiveness for anxiety and these effects are particularly pronounced for patients with the greatest deficits in emotion regulation.