Validation of the generalized anxiety disorder screener (gad-7) in Spanish pregnant women / Validación de la Escala de Cribado del Trastorno de Ansiedad Generalizado (GAD-7) en mujeres embarazadas españolas

BACKGROUND: Anxiety during pregnancy is one of the most common mental health problems and a significant risk factor for postpartum depression. The Generalized Anxiety Disorder-7 (GAD-7) is one of the most widely used self-report measures of anxiety symptoms available in multiple languages. This study evaluates the psychometric properties and underlying factor structures of the Spanish GAD-7 among pregnant women in Spain. METHOD: Spanish-speaking pregnant women (N = 385) were recruited from an urban obstetrics setting in Northern Spain. Women completed the GAD-7 and the anxiety subscale of the Symptom Checklist (SCL90-R) at three time points, once per trimester. The reliability, concurrent validity, and factor analyses were conducted to evaluate the psychometric properties and factor structure, respectively. RESULTS: In the first trimester, the GAD-7 demonstrated good internal consistency (a = 0.89). GAD-7 is positively correlated with SCL90-R (anxiety subscale; r = 0.75; p < 0.001). The proposed one-factor structure is found using exploratory factor analysis -FACTOR program - with Unweighted Least Squares procedure and optimal implementation of parallel analysis (GFI = 0.99). CONCLUSIONS: Health providers should screen for anxiety using the GAD-7 during pregnancy among urban Spanish-speaking samples to provide appropriate follow-up care

ANTECEDENTES: la ansiedad durante el embarazo es uno de los problemas de salud más comunes y un factor de riesgo para la depresión posparto. El Trastorno de Ansiedad Generalizada-7 es una de las medidas de autoinforme de síntomas de ansiedad más utilizadas en varios idiomas. Este estudio evalúa las propiedades psicométricas y la estructura factorial del GAD-7 español en mujeres embarazadas. MÉTODO: se reclutaron mujeres embarazadas (N = 385) de un entorno de obstetricia urbana en el norte de España. Las mujeres completaron el GAD-7 y la subescala de ansiedad del SCL90-R en tres puntos temporales. La fiabilidad, la validez concurrente y los análisis factoriales se realizaron para evaluar las propiedades psicométricas y las estructuras factoriales, respectivamente. RESULTADOS: en la primera toma de medidas el GAD-7 demostró una buena consistencia interna (a = 0.89). GAD-7 se correlaciona positivamente con SCL90-R (subescala de ansiedad; r = 0.75; p < 0.001). Mediante análisis factorial exploratorio - programa FACTOR, extracción de factores de mínimos cuadrados no ponderados, análisis paralelo con implementación óptima - se obtiene una estructura unifactorial (GFI = 0.99). CONCLUSIONES: los profesionales deberían evaluar la ansiedad usando el GAD-7 durante el embarazo entre muestras urbanas de habla hispana para brindar atención adecuada

Psicología y lesiones deportivas: un estudio en lanzadores de béisbol / Psychology and sports injuries: a study in baseball pitchers / Psicologia e lesões esportivas: um estudo em lançadores de beisebol

La etiología multifactorial de las lesiones, así como la alta incidencia y prevalencia en lanzadores de béisbol requiere que éstas sean abordadas también desde la Psicología. En la presente investigación se estudian 48 lanzadores de béisbol en Villa Clara, Cuba, para determinar la relación entre variables psicológicas asociadas al rendimiento del deportista y las lesiones sufridas. Se aplicó el Cuestionario de Aspectos Deportivos y Lesiones, el Inventario de Ansiedad Rasgo-Estado, el Inventario de Ansiedad Estado en Competición y el Inventario Psicológico de Ejecución Deportiva. Los resultados muestran una alta prevalencia de lesiones, las que ocurren con mayor frecuencia en la competición. La mayoría de las variables psicológicas establecen relación con la experiencia y el número de lesiones sufridas, estimándose además el efecto negativo que éstas producen sobre la ansiedad, la autoconfianza, el control del afrontamiento negativo, el control de la atención y el control visual e imaginativo

The multifactorial etiology of injuries, as well as the high incidence and prevalence in baseball pitchers, requires that they also should be deal with from Psychology. This research studies 48 baseball pitchers in Villa Clara, Cuba, to determine the relationship between psychological variables associated with the athlete's performance and the injuries they've suffered. The Sports Aspects and Injuries Questionnaire, the State-Trait Anxiety Inventory, the State Anxiety Inventory in Competition and the Psychological Inventory of Sports Execution were applied. The results show a high prevalence of injuries, which occur most frequently in competition. Most of the psychological variables are related to the experience and the number of injuries suffered, also estimating the negative effect that they produce on anxiety, self-confidence, control of negative coping, control of attention and visual and imaginative control

A etiologia multifatorial das lesões, bem como a alta incidência e prevalência em lançadores de beisebol, requere que estas sejam abordadas também a partir da Psicologia. Na presente investigação, 48 lançadores de beisebol são estudados em Villa Clara, Cuba, para determinar a relação entre variáveis psicológicas associadas ao desempenho do atleta e as lesões sofridas. Foram aplicados o Questionário de Aspectos Esportivos e Lesões, o Inventário de Ansiedade Traço-Estado, o Inventário de Ansiedade do Estado em Competição e o Inventário Psicológico de Execução Esportiva. Os resultados mostram uma alta prevalência de lesões, que ocorrem mais frequentemente na competição. A maioria das variáveis ​​psicológicas está relacionada à experiência e ao número de lesões sofridas, estimando também o efeito negativo que produzem na ansiedade, autoconfiança, controle do enfrentamento negativo, controle da atenção e controle visual e imaginativo

La hiperlaxitud articular como marcador de ansiedad en niños / Joint hypermobility is a marker for anxiety in children

Antecedentes: Se ha encontrado que el síndrome de hiperlaxitud articular (SHLA) está asociado a trastornos de ansiedad en poblaciones clínicas y no clínicas, aunque hasta la fecha ningún estudio ha evaluado esta asociación en niños. El objetivo principal de este estudio es evaluar el SHLA junto con la ansiedad, las medidas somáticas y conductuales en niños, para clarificar si el SHLA está asociado a cualquiera de estas variables en este rango de edad. Métodos: Se reclutó una muestra de 160 niños (74 chicas y 86 chicos) con edades comprendidas entre los 5 y los 17 años, procedentes de una clínica de salud mental de niños/adolescentes, para participar en el estudio. A todos los niños se les realizó una entrevista diagnóstica utilizando Mini International Neuropsychiatric Interview for Children and Adolescents. Los instrumentos utilizados incluyeron Child Behavior Checklist (CBCL), Screening Questionnaire to detect Hypermobility (SQ-CH) y Children Manifested Anxiety Scale (CMAS-R). Resultados: La prevalencia de SHLA en esta muestra fue del 22%, siendo significativamente alta en chicas (31%) en comparación con los chicos (14%) (χ2=6,83; p=0,001). El grupo SHLA obtuvo una puntuación considerablemente superior en la escala de ansiedad total CMAS-R (F=4,51; p=0,035), ansiedad fisiológica CMAS-R (F=7,19; p=0,008) y quejas somáticas CBCL (F=8,46; 0,004), y los análisis de regresión reflejaron que estas 3 variables eran factores predictivos de SHLA (χ2=36,77; p <0,001; r2=0,22). El grupo SHLA obtuvo también puntuaciones superiores en determinadas medidas conductuales. Conclusión: Los niños con SHLA tienen mayor frecuencia de trastornos de ansiedad y mayor intensidad de ansiedad fisiológica, quejas somáticas y, por tanto, podría utilizarse el SHLA como marcador para este fenotipo de ansiedad en los jóvenes

Background: Joint hypermobility syndrome (JHS) has been found to be associated with anxiety disorders in clinical and nonclinical populations, but to date no studies have evaluated this association in children. The main goal of this study is to evaluate JHS along with anxiety, somatic and behavioral measures in children to clarify if JHS is associated with any of these variables in this age range. Methods: A sample of 160 children (74 girls and 86 boys) ranging from 5 to 17 o were recruited from a Child-Adolescent Mental Health clinic to participate in the study. All children underwent a diagnostic interview using the Mini International Neuropsychiatric Interview for Children and Adolescents. Instruments used include the Child Behavior Checklist (CBCL), the Screening Questionnaire to detect Hypermobility (SQ-CH) and the Children Manifested Anxiety Scale (CMAS-R). Results: The prevalence of JHS in this sample was 22%, and this was significantly higher in girls (31%) than in boys (14%) (χ2=6.83; P=.001). The JHS group scored significantly higher in the CMAS-R total anxiety (F=4.51; P=.035), CMAS-R Physiological anxiety (F=7.19; P=.008) and the CBCL somatic complaints (F=8.46; 0.004) and regression analyses showed that these 3 variables were predictors of JHS (χ2=36.77; P<.001; r2=0.22). The JHS group also scored higher in some behavioral measures. Conclusion: Children with JHS have higher frequency of anxiety disorders and higher intensity of physiological anxiety, somatic complaints, and therefore, JHS might be used as marker for this anxiety phenotype in youngsters

Propiedades Psicométricas del Cuestionario de Preocupación Pensilvania (PSWQ) de las Versiones Original y Reducida en Muestras Mexicanas / Psychometric Characteristics of the Original and Brief Version of the Penn State Worry Questionnaire (PSWQ) in Mexican Samples

Introducción. En el siglo XXI los trastornos de ansiedad se han convertido en los más prevalentes en México, la preocupación excesiva es una de las primeras características que permiten su identificación. Contar con un instrumento válido y fiable que evalúe la preocupación patológica es fundamental para identificar el trastorno en su inicio. Metodología. El objetivo del presente trabajo fue analizar las propiedades psicométricas del cuestionario de Preocupación Pensilvania (PSWQ) en las cuatro diferentes versiones utilizadas en contextos clínicos en países de habla hispana: la escala original (PSWQ-16), la escala con ítems directos (PSWQ-16D) y dos versiones abreviadas (PSWQ-11 y PSWQ-8). Un total de 2.267 participantes respondieron a las diferentes versiones de los cuestionarios. Resultados. Nuestros resultados sugieren que la escala original (de 16 ítems) ajusta mejor al modelo de 2 factores relacionados. Sin embargo, el análisis con la versión del PSWQ con los reactivos directos y las versiones reducidas (de 11 y 8 reactivos), junto a otros argumentos indican que es más conveniente concebir el constructo de forma unidimensional. Además se observó una elevada consistencia interna y fiabilidad test-retest, así como una adecuada validez concurrente y discriminante. Conclusiones. Los resultados sugieren utilizar las versiones reducidas que muestran una estructura de un solo factor y mejores indicadores de ajuste. Se discuten los resultados y se sugieren futuras investigaciones

Background. In the XXI century anxiety disorders have become the most prevalent in Mexico, excessive worry is one of the first features that allows its identification. Have a valid and reliable instrument to assess the pathological worry is essential to identify the disorder from the beginning. Method. The aim of this study was to analyze the psychometric properties of the Penn state worry questionnaire (PSWQ) in the four different versions used in clinical contexts in Spanish-speaking countries: the original scale (PSWQ-16), the direct form of the scale (PSWQ-16D) and two abbreviated versions (PSWQ-11 y PSWQ-8). A total of 2,267 participants were given those versions of the questionnaire. Results. Our results suggest that the original scale (16 items) fits to two related factors model. However, the analysis of the PSWQ version with all the items in its direct form and short versions (11 and 8 direct items), together with other arguments indicate that it is more convenient to conceive a one dimensional construct. Besides high internal consistency and test-retest reliability, and adequate concurrent and discriminant validity. Conclusions. Results suggest use of the short versions (11 and 8 direct items) which shows a one-dimensional structure and the best goodness of fit indices. Results are discussed and future research are suggested

Ansiedad en técnicos de enfermería de atención primaria / Ansiedade em técnicos de enfermagem da atenção básica / Anxiety in primary care nursing technicians

Objetivo: Evaluar el nivel de ansiedad en el personal de enfermería de la Estrategia Salud de la Familia, con énfasis en los aspectos clave para la aparición de la ansiedad. Método: Estudio descriptivo, enfoque cuantitativo transversal, constituido por 28 técnicos de enfermería, mediante el Inventario de Ansiedad Traço-Estado (IDATE) como una herramienta para la recolección de datos. Resultados: 8 técnicos de enfermería mostraron niveles de alta ansiedad alta 20 baja ansiedad. Hubo un aumento en la puntuación en el IDATE-E en el momento durante la realización de actividades, con diferencia estadísticamente significativa en relación al momento antes. Los bajos salarios, la carga de trabajo y la devaluación profesional fueron identificados como factores responsables de causar la aparición de la ansiedad en el contexto del trabajo. Conclusión: El estudio muestra un predominio de baja ansiedad entre la población estudiada, sin embargo, fue posible detectar factores desencadenantes de ansiedad, lo que indica que estos aspectos pueden dañar la peculiaridad de la asistencia a los usuarios

Objetivo: A valiar o nível de ansiedade em técnicos de enfermagem da Estratégia de Saúde da Família, enfatizando os aspectos determinantes para o surgimento da ansiedade. Método: Estudo de característica descritiva, transversal, abordagem quantitativa, constituído por 28 Técnicos de Enfermagem, utilizando o Inventário de Ansiedade Traço-Estado (IDATE) como instrumento para a coleta de dados. Resultados: 8 técnicos de enfermagem apresentaram níveis de alta ansiedade e 20 de baixa ansiedade. Houve um aumento no escore no IDATE-E no momento durante a realização das atividades, com diferença estatística em relação ao momento antes. A baixa remuneração, sobrecarga de trabalho e desvalorização profissional foram apontados como fatores responsáveis por provocar o aparecimento da ansiedade no âmbito de trabalho. Conclusão: O estudo evidencia uma predominância da baixa ansiedade entre a população estudada, porém, foi possível detectar fatores desencadeadores da ansiedade, apontando de que tais aspect os podem vir a prejudicar a peculiaridade da assistência ao usuário

Objective : To evaluate the level of anxiety in nursing technicians of the Family Health Strategy, emphasizing the determinant aspects for the emergence of anxiety. Method: A descriptive, cross-sectional, quantitative approach, consisting of 28 Nursing Technicians, using the State-Trait Anxiety Inventory (STAI) as an instrument for data collection.Results: Eight nursing technicians presented levels of high anxiety and 20 of low anxiety. There was an increase in the S-Anxiety Scale score during the activities, with statistical difference in relation to the moment before. The low remuneration, work overload and professional devaluation were pointed out as factors responsible for provoking the appearance of anxiety within the scope of work. Conclusion: The study evidences a predominance of low anxiety among the study population; however, it was possible to detect factors triggering the anxiety, pointing out that such aspects may come to harm the peculiarity of the assistance to the user

The relationship of the preexisting anxiety problem with the demographic profile of cervical cancer patients

Objective: This study identified the association of the preexisting anxiety problem in women diagnosed with cervical cancer with their demographic characteristics. Method: This was a cross sectional study with 100 participants selected by purposive sampling method. Data were collected through Hamilton Anxiety Rating Scale (HARS) questionnaire and the medical records of participants. Results: Work status was the only demographic characteristic which was found to be statistically significantly related to the anxiety level of the participants before they were diagnosed with cervical cancer. Participants who worked at home as housewives were found to have higher anxiety level than those worked at the institutions or industry. Conclusions: Working women in this study were more likely to have the preexisting anxiety problem prior their cervical cancer diagnosis. This study implies the importance of promoting healthy lifestyle to manage daily stressors, considering various interrelated factors that may eventually contribute to cervical cancer development in women

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Propiedades psicométricas del Inventario de ansiedad estado-rasgo en población general y hospitalaria de República Dominicana / Psychometric properties of the State-Trait Anxiety Inventory in the general and hospital population of the Dominican Republic

ANTECEDENTES: El presente estudio tiene por objetivo: a) examinar la estructura interna del STAI en población dominicana; b) verificar la consistencia interna; c) obtener evidencias de validez de criterio correlacionando las puntuaciones del STAI con depresión, y d) comparar las puntuaciones del STAI en población general y hospitalaria, examinando su capacidad discriminativa. MÉTODO: Para la validación del STAI se utilizó una muestra de 1,034 participantes constituida por población general (n = 792) y hospitalaria (n = 242) de Santiago de los Caballeros, República Dominicana. RESULTADOS Y CONCLUSIONES: Los resultados avalan una solución factorial de 2 factores denominados ansiedad presente y bienestar. Esta solución da cuenta de adecuados índices de ajuste y consistencia interna aceptable y óptima. Por otra parte, los análisis de validez mediante comparación de grupos permiten corroborar que la escala distingue adecuadamente entre población general y psiquiátrica. Finalmente, se encuentran correlaciones fuertes entre la ansiedad y los niveles de depresión

BACKGROUND: The present study aims to: a) examine the internal structure of STAI in the Dominican population; b) verify internal consistency; c) obtain evidence of criterion validity by correlating STAI scores with depression, and d) compare STAI scores in general and hospital population, to examine their discriminative capacity. METHOD: For the validation of the STAI scale, a sample of 1034 participants from the general (n = 792) and hospital (n = 242) population of Santiago de los Caballeros, Dominican Republic. RESULTS AND CONCLUSIONS: The results support a factorial solution of two factors, namely present anxiety and well-being. This solution provides adequate index of fit and optimum internal consistency. On the other hand, validity analyses through group comparison allowed us to confirm that the scale adequately distinguishes between general and psychiatric populations. Finally, there are strong correlations between anxiety and depression levels

Math anxiety, a hierarchical construct: Development and validation of the Scale for Assessing Math Anxiety in Secondary education / Ansiedad matemática, un constructo jerárquico: desarrollo y validación de la Scale for Assessing Math Anxiety in Secondary education

Secondary students' low achievement and engagement in mathematics is known to relate closely to their math anxiety. Despite the international body of research, the theoretical conceptualization of the construct math anxiety is still debated, showing strong discrepancies regarding its factor structure. Therefore, the aim of this paper is to develop and validate a new instrument, called Scale for Assessing Math Anxiety in Secondary education (SAMAS), by testing several models through confirmatory factor analysis. Data were collected from 563 secondary students, with an average age of 13.96 (SD = 1.09) years. Several models for the construct were tested through confirmatory factor analysis. The results largely confirmed that the hierarquical structure showed the best fit to the data (χ2 (166, N = 563) = 61.22; RMSEA = .046; SRMR = .045; NNFI = .94; CFI = .95), resulting in the psychometrically sound 20-item SAMAS, wherein math anxiety comprises three underlying factors

El bajo rendimiento y dedicación de los estudiantes de secundaria a las matemáticas está estrechamente relacionado con la ansiedad matemática. A pesar de la investigación internacional, la conceptualización teórica del constructo ansiedad matemática es todavía debatida, mostrando fuertes discrepancias relativas a su estructura factorial. Por tanto, el objetivo de este estudio es desarrollar y validar un nuevo instrumento, denominado Scale for Assessing Math Anxiety in Secondary Education (SAMAS), para el que se analizan diferentes modelos mediante Análisis Factorial Confirmatorio. La muestra estuvo compuesta por 563 estudiantes, con una edad media de 13.96 (DE=1.09) años. Los resultados ampliamente confirmaron que la estructura jerárquica fue la que arrojó el mejor ajuste del modelo (χ2[166, N = 563] =361.22; RMSEA = .046; SRMR = .045; NNFI = .94; CFI = .95), resultando en un instrumento psicométricamente robusto de 20 items, compuesto por 3 factores subyacentes (AU)

Positive and negative mental health across the lifespan: A cross-cultural comparison / Salud mental positiva y negativa a lo largo de la vida: una comparación transcultural

Mental health and well-being are closely related to age. Complete mental health includes psychopathological symptoms (negative mental health) and subjective well-being (positive mental health). The aim was to compare indicators of complete mental health across the lifespan cross-culturally. Method: We tested age trends in measures of resilience, social support and positive and negative mental health, including the subscales depression, anxiety and stress using data from national representative samples from Germany, Russia and the United States (U.S.) ranging in age from 18 to 100 (N=6,303). Results: The effects of age differed in each country. Today’s older Germans experienced more positive and less negative mental health whereas today's older Russians experienced less positive and more negative mental health than the younger people. In the U.S., positive mental health was higher among the older adults, but there was no effect of age for negative mental health. Age also had significant linear and curvilinear effects on resilience and social support. Conclusions: The pattern of mental health across the lifespan is clearly dependent on the nation (AU)

La salud mental y el bienestar están relacionados con la edad. La salud mental completa incluye síntomas psicopatológicos (salud mental negativa) y bienestar subjetivo (salud mental positiva). El objetivo es una comparación transcultural de los indicadores de salud mental completa a lo largo de la vida. Método: Hemos probado las tendencias de edad en medidas de resiliencia, apoyo social y salud mental positiva y negativa, incluyendo depresión, ansiedad y estrés, utilizando datos de muestras nacionales representativas de Alemania, Rusia y Estados Unidos con edades entre 18 y 100 años (N=6.303). Resultados: Los efectos de la edad diferían en cada país. Los alemanes mayores experimentaron una salud mental más positiva y menos negativa, mientras que los rusos mayores experimentaron una salud mental menos positiva y más negativa que los jóvenes. En Estados Unidos, la salud mental positiva fue mayor entre los adultos mayores, pero no hubo efectos de la edad para la salud mental negativa. La edad también tuvo efectos lineales y curvilíneos significativos sobre la resiliencia y el apoyo social. Conclusiones: El patrón de salud mental a lo largo de la vida depende claramente de la nación (AU)

Affective and Physicological correlates of the perception of unimodal and bimodal emotional stimuli / Correlatos afectivos y fisiológicos de la percepción de estímulos emocionales unimodales y bimodales

Background: Despite the multisensory nature of perception, previous research on emotions has been focused on unimodal emotional cues with visual stimuli. To the best of our knowledge, there is no evidence on the extent to which incongruent emotional cues from visual and auditory sensory channels affect pupil size. Aims: To investigate the effects of audiovisual emotional information perception on the physiological and affective response, but also to determine the impact of mismatched cues in emotional perception on these physiological indexes. Method: Pupil size, electrodermal activity and affective subjective responses were recorded while 30 participants were exposed to visual and auditory stimuli with varied emotional content in three different experimental conditions: pictures and sounds presented alone (unimodal), emotionally matched audio-visual stimuli (bimodal congruent) and emotionally mismatched audio-visual stimuli (bimodal incongruent). Results: The data revealed no effect of emotional incongruence on physiological and affective responses. On the other hand, pupil size covaried with skin conductance response (SCR), but the subjective experience was partially dissociated from autonomic responses. Conclusion: Emotional stimuli are able to trigger physiological responses regardless of valence, sensory modality or level of emotional congruence (AU)

Antecedentes: a pesar de la naturaleza multisensorial de la percepción, la investigación que se ha hecho hasta el momento sobre las emociones se ha centrado en las señales emocionales típicamente unimodales. Según nuestro conocimiento, no existen estudios previos sobre cómo las señales emocionales incongruentes pueden afectar el tamaño de la pupila. Objetivos: investigar los efectos de la percepción de la información emocional audiovisual incongruente sobre las respuestas de tipo fisiológico y afectivo. Método: el tamaño pupilar, la actividad electrodérmica y las respuestas subjetivas afectivas de 30 participantes fueron registradas mientras ellos veían y escuchaban estímulos con contenido emocional que fueron expuestos en tres condiciones experimentales diferentes: imágenes y sonidos presentados aisladamente (unimodal); estímulos audiovisuales emocionalmente coincidentes (congruente bimodal); y estímulos audiovisuales emocionalmente no coincidentes (incongruente bimodal). Resultados: el estudio no reveló un efecto de la incongruencia emocional sobre las respuestas fisiológicas y afectivas. De otra parte, se encontró que el tamaño pupilar presenta una covariación con la actividad dérmica. Sin embargo, la experiencia subjetiva se mostró parcialmente disociada de las respuestas autónomas. Conclusión: los estímulos emocionales tienen la capacidad de desencadenar reacciones fisiológicas, independientemente de la valencia, modalidad sensorial o nivel de congruencia (AU)

Análisis de los factores que influyen en la afectación psicológica, la capacidad funcional y la calidad de vida en pacientes con parálisis facial periférica / Analysis of factors contributing to psychological distress, functional capacity and quality of life in patients with peripheral facial palsy

Introducción y objetivos. El objetivo de este trabajo es analizar diferentes factores que pueden influir en la afectación psicológica, la capacidad funcional y la calidad de vida en personas que han sufrido una parálisis facial periférica (PFP) no resuelta completamente. Material y métodos. Se realizó un estudio transversal retrospectivo con 31 pacientes que habían sufrido una PFP cuya resolución fue incompleta. Los factores analizados fueron: severidad, edad, sexo, lateralidad, etiología, grado de lesión inicial del nervio, tiempo de evolución, estado civil y ocupación laboral. Se utilizaron cuestionarios de afectación psicológica (Escala de Ansiedad y Depresión Hospitalaria [HADS]), discapacidad (Índice de Discapacidad Facial [FDI]) y calidad de vida (Facial Clinimetric Evaluation Scale [FaCE]). Resultados. El factor más relevante fue la severidad, con correlaciones estadísticamente significativas con el FaCE total (r=0,596; p<0,01), el FaCE social (r=0,444; p<0,05), el FDI física (r=0,539; p<0,01), y el FDI total (r=0,395; p<0,05). La edad se correlacionaba con el FDI social (r=0,36; p<0,05). Los que tenían pareja presentaban mayor discapacidad, con diferencias de medias estadísticamente significativas en el FDI física (p<0,01) y el FDI total (p<0,01). Trabajar de cara al público asociaba una peor calidad de vida, con diferencias estadísticamente significativas en el FaCE total (p<0,05). Conclusión. La severidad de la PFP tiene una correlación directa con la discapacidad y la calidad de vida. La edad influye en la discapacidad social. El estado civil se asocia con la discapacidad y el trabajo con la calidad de vida. La influencia del resto de factores es poco relevante (AU)

Introduction and objectives. The aim of this study was to analyse various factors that can contribute to psychological distress, functional capacity and quality of life in people with incompletely resolved peripheral facial palsy (PFP). Material and methods. We performed a retrospective cross-sectional study in 31 patients with incompletely resolved PFP. The factors analysed were: severity, age, gender, laterality, aetiology, degree of initial nerve injury, duration, marital status and occupation. Psychological distress was assessed through the Hospital Anxiety and Depression Scale (HADS), disability through the Facial Disability Index (FDI) and quality of life through the Facial Clinimetric Evaluation Scale (FaCE) questionnaires. Results. The most important factor was severity, with statistically significant correlations with FaCE Total (r=0.596; p<0.01), FaCE Social (r=0.444; p<0.05), FDI Physical (r=0.539; p<0.01), and FDI Total (r=0.395; p<0.05). Age was correlated with FDI Social (r=0.36; p<0.05). Patients with a partner showed more disability, with statistically significant differences in mean scores of FDI Physical (p<0.01) and FDI Total (p<0.01). Working with the public was associated with lower quality of life, with statistically significant differences in FaCE Total (p<0.05). Conclusion. The severity of PFP is directly correlated with disability and quality of life. Age influences social disability. Marital status is associated with disability and occupation with quality of life. The other factors studied had little influence (AU)

Psychometric properties of the Dutch Anxiety Change Expectancy Scale (ACES-NL)

Research demonstrates that patients’ expectations about treatment outcome are an important predictor of actual psychotherapeutic treatment outcome. So far, only few psychometrically sound expectancy questionnaires are available to assess treatment expectancy. The Anxiety Change Expectancy Scale (ACES) is a promising 20-item questionnaire which measures patients’ expectations about being able to change anxiety regarding and regardless from treatment. Psychometric properties of the Dutch language version of the ACES (ACES-NL) are investigated in 212 patients referred to a mental health institute because of suspected anxiety disorders. Reliability (i.e., internal consistency, inter-item, test-retest reliability) is investigated. Validity is examined in terms of internal structure and relations with the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), Beck Hopelessness Scale (BHS) and Self-Efficacy Scale (SES). Reliability statistics are good to excellent. Factor analysis reveals a one factor solution. Meaningful relations with relevant MMPI-2-RF scales are established. BHS and SES scores demonstrate satisfactory concurrent and discriminant validity. Treatment outcome expectancy is discussed against the background of relevant models. Further research on predictive validity of the ACES-NL is warranted (AU)

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Examining facets of depression and social anxiety: the relation among lack of positive affect, negative cognitions, and emotion dysregulation

Depression and Social Anxiety Disorder are commonly conceptualized by the presence of negative affect. However, these disorders are also characterized by lack of positive affect, presence of negative cognitions, and emotion dysregulation which may play an important role in the onset and maintenance of these disorders. The present study explored differences among these variables in 189 clinical patients diagnosed with Major Depression, Social Anxiety Disorder, or both. Results showed differences in lack of positivity F(2, 185) = 18.92, p = .0001, η2 = .17, presence of negative cognitions F(2, 185) = 13.97, p = .0001, η2 = .13, and the use of rumination F(2, 185) = 14.63, p = .0001, η2 = .14 and punishment F(2, 181) = 7.64, p = .001, η2 = .08 among groups. Overall, lack of positivity, negative cognitions, and emotion dysregulation were elevated in the comorbid group, whereas lack of positivity and negative cognitions were specifically found for patients diagnosed with depression compared to socially anxious patients. In addition, the study examined the relation of both, lack of positivity and negative cognitions, to emotion regulation processes among groups. Overall, lack of positivity was associated with fear and avoidance in the social anxiety group (all r > .417, p < .01), whereas lack of positivity and negative cognitions were associated with rumination across the three groups (all r > .370, p < .01). Limitations of the present study and future directions are discussed (AU)

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Asignatura pendiente: minimizar la ansiedad precolonoscopia / Issue pending: minimizing anxiety before colonoscopy

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Valoración de ansiedad y burnout en los profesionales de enfermería de un servicio de Nefrología / Assessment of anxiety and burnout in nurses of a unit of Nephrology

Introducción: La enfermería es por naturaleza una profesión con alto riesgo de generar estrés entre sus profesionales. Diversos estudios así lo demuestran1,2. Objetivos: - Valorar la presencia del burn out en nuestro servicio. - Valorar si existen diferencias entre TCAE y enfermeras. - Valorar si hay diferencias según la edad y el tiempo en el servicio. Metodología: Se realizó un estudio de tipo cualitativo, descriptivo, transversal y monocéntrico, en el servicio de nefrología del Hospital U. Rio Hortega de Valladolid. Para ello se utilizó dos cuestionarios, el BMI y el STAI. Resultados: Completaron los cuestionarios el 77,27 %. La muestra fue 11 enfermeras y 5 TCAE y solo uno era un hombre. Las edades oscilan de 28 y 62 años y el tiempo medio en el servicio fue 11,1 años. TEST MBI: - Subescala cansancio emocional: El 12.5% niveles muy altos, el 6.25% niveles medios y el resto niveles bajos. - Subescala de despersonalización: El 12.5% tenía niveles muy altos, el 25% niveles medios y el 62.5% niveles bajos. - Subescala de realización personal: El 25% tenía niveles bajos, el 31.25% tenía niveles medios y el 44.75% tenía niveles altos. Tomando como variables el tiempo trabajado y la edad no hay diferencia estadísticamente significativa. La media para la escala STAI-S fue de 19.53 ± 3.02 y para STAI-T fue de 14,24 ± 7,12. Conclusiones: Los profesionales sanitarios evaluados por el BMI tienen bajos niveles de agotamiento, y de ellos sólo una persona tiene síndrome de burn out. Las enfermeras tienen más agotamiento emocional pero están más satisfechas que las TCAE y la ansiedad es de carácter predominantemente transitorio en ambas (AU)

Introduction: Nursing is by nature a profession with high risk of generating stress among professionals. Several studies show it. Objectives: - Assess the presence of burn out in our unit. - Assess whether there are differences between nursing assistants and nurses. - Assess whether there are differences according to age and time of service. Methodology: A qualitative study, descriptive, cross-sectional and single-center, in the nephrology unit of the University Hospital Rio Hortega of Valladolid was carried out. For this purpose two questionnaires, BMI and STAI were used. Results: Questionnaires were completed on 77.27%. The sample was 11 nurses and five nursing assistants and only one was a man. The ages range from 28 to 62 years and the average time the unit was 11.1 years. TEST MBI: - Emotional exhaustion subscale: 12.5% very high levels, the 6.25% average levels and the rest low levels. - Depersonalization subscale: 12.5% had very high levels, 25% average and 62.5% low levels. - Personal fulfillment subscale: 25% had low levels, 31.25% had average levels and 44.75% had high levels. Taking as variables, time worked and age there are no statistically significant differences. The average for the STAI-S scale was 19.53 ± 3.02 and STAI-T was 14.24 ± 7.12. Conclusions: Healthcare professionals evaluated by BMI have low levels of exhaustion, of which only one person has a burn out syndrome. Nurses have more emotional exhaustion but are more satisfied than nursing assistants, and anxiety in both professions is predominantly transient (AU)

Sensibilidad química múltiple: evaluación clínica de la gravedad y perfil psicopatológico / Multiple chemical sensitivity: Clinical evaluation of the severity and psychopathological profile

Introducción y objetivo: La sensibilidad química múltiple (.SQM) es un trastorno multisistémico de etiología controvertida que afecta a algunos sujetos al exponerse a productos químicos a concentraciones no perjudiciales. El objetivo de este trabajo es describir las características epidemiológicas, clínicas y psicológicas de una muestra de pacientes con SQM, para un posterior tratamiento grupal específico. Pacientes y método: Estudio descriptivo de los pacientes diagnosticados de SQM en una unidad de toxicología, mediante la administración del cuestionario Quick Environmental Exposure and Sensitivity Inventory, junto con la entrevista estructurada SCID-II, la escala de ansiedad HAS y el test de personalidad tipo A, PCTA. Resultados: Se incluyeron 73 pacientes, con una edad media de 52,6 años (rango 33-77; DE 9,29), siendo 66 mujeres (90,4%). El 53% estaban clasificados como grado i-ii y ii. Sesenta y un pacientes (83%) presentaron algún tipo de comorbilidad, fundamentalmente dolor crónico, fibromialgia y fatiga crónica, con niveles de ansiedad mayores (puntuación media 19,2), predominio de rasgos de personalidad fóbico-evitativo y patrón de conducta tipo A (31,1%). Conclusiones: La SQM afecta principalmente a mujeres de mediana edad, con comorbilidades (dolor crónico, fibromialgia y fatiga crónica), elevada ansiedad y conductas de evitación. Este análisis previo debería ayudar a ofrecer un abordaje psicoterapéutico específico a estos pacientes (AU)

Introduction and objective: Multiple chemical sensitivity (MCS) is a multisystem disorder of controversial etiology, affecting some subjects when exposed to chemicals at no harmful concentrations. The objective of this paper is to describe the epidemiological, clinical and psychological features of a sample of patients with MCS for further specific group treatment. Patiens and method: Descriptive study of patients diagnosed with MCS in a toxicology unit. We administered the Quick Environmental Exposure and Sensitivity Inventory, the structured interview SCID-II, the anxiety scale HAS and the type A personality test, PCTA. Results: Seventy-three patients were included. The mean age was 52,6 years (range 33-77; SD 9.29). Sixty-six were females (90.4%). Fifty-three percent were classified as i-ii and ii grade. Sixty-one patients (83%) presented some type of comorbidity, mainly chronic pain, fibromyalgia and chronic fatigue. They exhibited higher levels of anxiety (average score of 19.2), prevalence of phobic-avoidant traits of personality and type A behavior in 31.1%. Conclusions: MCS affects middle-aged women with comorbidities (chronic pain, fibromyalgia and chronic fatigue) and high anxiety and avoidance behaviors. This preliminary analysis should help provide a specific therapeutic approach to these patients (AU)

Internal structure and clinical utility of the Anxiety Control Questionnaire-Revised (ACQ-R) Spanish version

Perceived control has shown predictive value for anxiety severity symptoms as well as cognitive-behavior therapy outcomes. The most commonly used measure of perceived control is the Anxiety Control Questionnaire (ACQ), and more recently the ACQ Revised (ACQ-R). However, both questionnaires have shown structural inconsistencies among several studies. Also, although the ACQ and ACQ-R seem to be multidimensional instruments, a single total score have been commonly used. This study examined the internal structure of the ACQ-R Spanish version using exploratory factor and exploratory bi-factor analysis in a sample of 382 college students and 52 people diagnosed of panic disorder (with or without agoraphobia). Also, in this study we assessed the preliminary diagnostic value of the ACQ-R scores. The results indicated that the ACQ-R Spanish version structure consisted of two factors: one related with perceived control of internal emotional reactions (Emotion Control) and another related with perceived control of external events (Threat and Stress Control). Both specific factors can be adequately summarized by a general factor (General Anxiety Perception of Control; CFI = .973, TLI = .954, RMSEA = .039; p = .002), which accounted for 70% of the common explained variance. The correlations between the ACQ-R scores and with variables like anxiety (r = -.66) or anxiety sensitivity (r = -.50) presented the expected pattern of results. Either the two dimensions structure or the total score have proved to be a good tool to distinguish between participants with panic disorder and non-clinical samples (area under the curve = 0.79) (AU)

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Preocupación por la apariencia física en usuarios de empresas multideportivas de México / Concern about physical appearance in users of multi-sports complexes in México / Preocupação com a aparência fisica em utentes de empresas multidesportivas do México

Las escalas de Ansiedad Físico-Social (SPAS-7 y de Dismorfia Muscular (Complejo de Adonis) son herramientas sensibles para evaluar la preocupación por la apariencia física. El objetivo es analizar la asociación entre la dismorfia muscular y la ansiedad físico-social e identificar las diferencias por sexo en usuarios de empresas de servicios deportivos integrados del noroeste de México. Mediante un muestreo aleatorio simple se eligieron 429 (231 hombres y 198 mujeres). A todos ellos se les aplicaron los cuestionarios SPAS-7 y Complejo Adonis en el centro deportivo correspondiente. Se encontraron diferencias estadísticamente significativas que muestran que las mujeres registran mayores niveles de ansiedad que los hombres (Media = 12.5 ± 5 DS y Media = 14.5 ± 6 DS; p < .000); no obstante, las mujeres obesas presentan mayores puntuaciones con respecto al resto (Media = 18.8 ± DS; p < .000). También se comprobó a través de un modelo de regresión que los años de práctica física, la frecuencia a la semana y la duración de la sesión de entrenamiento predicen la ansiedad físico-social y el Complejo Adonis. Además se evidenció que existe una asociación significativa entre los niveles de dismorfia muscular y de ansiedad

Social Physique Anxiety (SPAS -7) and muscle dysmorphia (Adonis Complex) scales are sensitive tools to assess concern about physical appearance. The aim of this work is to analyse the association between muscle dysmorphia and social physique anxiety and identify the differences by gender in users of integrated sports complexes in north-west Mexico. Using simple random sampling, 429 (231 men and 198 women) were selected. SPAS-7 and Adonis Complex questionnaires were given in the relevant sports centre. Significant differences were4 found which showed that women reported higher levels of anxiety than men (M = 12.5 ± 5 SD and M = 14.5 ± 6 SD, p = .000); however, obese women reported much higher levels in relation to the others (M = 18.8 ± SD p < .000). It was also proved, using a regression model, that the number of years doing sports, the number of times a week and the duration of the training session predict social physique anxiety and the Adonis Complex. In addition, a significant association between muscle dysmorphia and anxiety levels was confirmed

As escalas de Ansiedade Físico-social(SPAS-7 e Dismorfia Muscular (Complexo de Adonis) são ferramentas sensíveis para avaliar apreocupação com a aparência física. O objectivo é analisar a associação entre a dismorfia muscular e a ansiedade físico-social e identificar as diferençaspor sexo em utentes de empresas de serviços desportivos integrados do noroeste do México. A amostra aleatória simples foi composta por 429 participantes (231 homens e 198 mulheres). A todos eles se aplicaram os questionários SPAS-7 eComplexo Adonisno centro desportivo correspondente. Verificaram-se diferenças estatisticamente significativas que mostram que as mulheres registaram maiores níveis de ansiedade que os homens (Média= 12.5 ± 5 dpe Média= 14.5 ± 6 dp; p < .000); não obstante, as mulheres obesas apresentam maiores pontuações nos restantes indicadores (Media= 18.8 ± 8 dp; p < .000). Também se comprovou através de um modelo de regressão que os anos de prática física, a frequência semanal e a duração da sessão de treinopredizem a ansiedade físico-social e o Complexo de Adonis. Adicionalmente, evidenciou-se que existe uma associação significativa entre os níveis dedismorfia muscular e de ansiedade

Children and adolescents who stutter: Further investigation of anxiety.

PURPOSE: Despite the greatly increased risk of social anxiety disorder in adults who stutter, there is no clear indication of the time of onset of this disorder in childhood and adolescence. The purpose of this study was to explore this issue further using the Revised Children's Manifest Anxiety Scale (RCMAS), so that appropriate interventions can be developed prior to adulthood. This is the first time the RCMAS has been completed by children younger than 11 years. Using the same test for both school-age children and adolescents can potentially identify when anxiety starts to develop from age 6 years through to adulthood. METHODS: The RCMAS was administered to 18 school-age boys, five school-age girls, 41 adolescent boys and nine adolescent girls who were seeking treatment for their stuttering. Participants also rated the severity of their own stuttering. RESULTS: All mean scaled scores on the four RCMAS subscales and Total Anxiety scores were within normal limits. However, for both groups of boys, scores on the Lie Scale were significantly higher than scores on the other three subscales. CONCLUSIONS: Experts suggest high scores on the RCMAS Lie Scale are indicative of participants attempting to present themselves in a positive light and so cast doubt on the veracity of their other responses on the test. One interpretation, then, is that the boys were concealing true levels of anxiety about their stuttering. The results suggest why findings of anxiety studies in children and adolescents to date are equivocal. Clinical implications are discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (a) discuss why understanding when anxiety starts in people who stutter is important, (b) describe the function of the RCMAS Lie sub scale and (c) summarize the possible implications of the RCMAS findings in this study.

The Spanish version of the believalbility of anxious feelings and thoughts questionnaire / Versión española del Cuestionario de Credibilidad de Sentimientos y Pensamientos Ansiógenos

BACKGROUND: Cognitive fusion is suggested to play an important role in the etiology and maintenance of anxiety disorders according to Acceptance and Commitment Therapy. This study presents the psychometric data of the Spanish version of a cognitive fusion measure in the context of anxiety: the Believability of Anxious Feelings and Thoughts Questionnaire (BAFT). METHOD: First, we back-translated the BAFT into Spanish and then, administered it to three samples, with a total of 598 participants, in addition to other relevant anxiety measures.RESULTS: Data were very similar to those obtained with the original BAFT version. The BAFT showed a very good internal consistency (overall α= .92) and a hierarchical factor structure with two lower-order factors and one hierarchical factor. Participants showing mild levels of anxiety symptoms scored higher on the BAFT than participants who scored below the cutoffs. BAFT scores were significantly related to anxiety symptoms and to measures of psychological inflexibility, anxiety sensitivity, and mindfulness facets. Moreover, the BAFT showed incremental validity relative to anxiety sensitivity. CONCLUSIONS: This Spanish version of the BAFT emerges as a reliable and valid measure of cognitive fusion with anxious thoughts and feelings

ANTECEDENTES: la fusión cognitiva juega un papel importante en la etiología y mantenimiento de los trastornos de ansiedad según la Terapia de Aceptación y Compromiso. Este estudio presenta datos psicométricos de la versión española del Cuestionario de Credibilidad de Sentimientos y Pensamientos Ansiógenos (BAFT). MÉTODO: se realizó una traducción inversa del BAFT al español y se administró a tres muestras, con un total de 598 participantes, conjuntamente con otras medidas de ansiedad. RESULTADOS: los datos fueron muy similares a los obtenidos en la versión original del BAFT. El BAFT mostró una muy buena consistencia interna (alfa promedio de .92) y una estructura jerárquica con dos factores de primer orden y un factor de segundo orden. Los participantes con niveles moderados de ansiedad puntuaron más en el BAFT que los participantes que mostraron puntuaciones inferiores. Las puntuaciones en el BAFT correlacionaron significativamente con variedad de síntomas de ansiedad y con medidas de inflexibilidad psicológica, sensibilidad a la ansiedad y facetas de mindfulness. El BAFT mostró validez incremental en relación a la sensibilidad a la ansiedad. CONCLUSIONES: la versión española del BAFT emerge como una medida fiable y válida de fusión cognitiva con pensamientos y sentimientos ansiógenos