Assessment of emotional reactivity produced by exposure to virtual environments in patients with eating disorders

The aim of this study was to assess the usefulness of virtual environments representing situations that are emotionally significant to subjects with eating disorders (ED). These environments may be applied with both evaluative and therapeutic aims and in simulation procedures to carry out a range of experimental studies. This paper is part of a wider research project analyzing the influence of the situation to which subjects are exposed on their performance on body image estimation tasks. Thirty female patients with eating disorders were exposed to six virtual environments: a living-room (neutral situation), a kitchen with highcalorie food, a kitchen with low-calorie food, a restaurant with high-calorie food, a restaurant with low-calorie food, and a swimming-pool. After exposure to each environment the STAI-S (a measurement of state anxiety) and the CDB (a measurement of depression) were administered to all subjects. The results show that virtual reality instruments are particularly useful for simulating everyday situations that may provoke emotional reactions such as anxiety and depression, in patients with ED. Virtual environments in which subjects are obliged to ingest high-calorie food provoke the highest levels of state anxiety and depression

The Latin-America version of the Internalized Stigma of Mental Illness scale (LA- ISMI): A multicentric validation study from three Latin-America countries

International audienceBackgroundTo date, no data have been available concerning the psychometric characteristics of the Internalized Stigma of Mental Illness scale (ISMI-29) in Latin American countries. The aim of this study was to validate a Latin American version of the ISMI in people with schizophrenia.MethodsThe study included 253 stabilized outpatients with schizophrenia from 3 Mental Health Services in three Latin American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). We analyzed the psychometric properties using item response and classical test theories. An item reduction was then performed to improve the psychometric properties of the ISMI-29. The final version of the ISMI was tested for construct validity, reliability, external validity and differential item functioning (DIF).ResultsThe five-factor structure of the ISMI-29 was not confirmed using confirmatory factor analysis (RMSEA = 0.12, CFI = 0.77, and WRMR = 2.20). Seventeen items were discarded to obtain a satisfactory psychometric version. The ISMI-12 evaluates 3 dimensions: social stigma (4 items), stigma experience (4), and self-stigma (3). The factor structure accounted for 68% of the total variance. Internal consistency was satisfactory. The scalability was satisfactory, with INFIT statistics within an acceptable range. In addition, the results confirmed the absence of DIF and supported the invariance of the item calibrations between countries.ConclusionThe ISMI-29 is not valid in our sample and should not be used in Latin American countries. The ISMI-12 is the first internalized stigma questionnaire with satisfactory psychometric properties available in Latin American countries. Its brevity could facilitate its dissemination and use in clinical settings

Afrontamiento y etnia: Estrategias en niños y niñas aymara

Menores aymara han experimentado un proceso migratorio importante durante las últimas décadas, sin embargo, se han desarrollado escasos estudios en población infantil perteneciente a esta etnia. El objetivo de esta investigación es evaluar y comparar las estrategias de afrontamiento utilizado por niños y niñas Aymara y no Aymara. La muestra estuvo compuesta por 685 niños/as entre 9 y 15 años de escuelas municipales y colegios particular subvencionados de la ciudad de Arica. Los resultados muestran la inexistencia de diferencias poblacionales entre niños/as aymara y no aymara en relación a los problemas experimentados (pχ2> .05), el uso de estrategias de afrontamiento utilizadas (pt> .05) y la eficacia de estas últimas (pt> .05). Se concluye que los niños/as pertenecientes a la etnia estarían logrando adecuados mecanismos de afrontamiento en contextos urbanos

Mental health and life satisfaction in a sample of students from Northern Chile

It is relevant to specifically understand which are the mental health variables that most affect the satisfaction with life in the child and youth population for the optimal design of programs to promote their well-being. The relationship between mental health and life satisfaction is analyzed in a sample of students from 9 to 18 years old in the North of Chile. A correlational cross-sectional study is carried out, using the System of Evaluation of Children and Adolescents (SENA) and the Diener Life Satisfaction Scale (SWLS-C). A total sample of 3455 students is used, divided into primary and secondary schools. Two models of structural equations with good fit are obtained. Depression, self-esteem, and age are maintained in both. In primary school, school problems are added. Meanwhile, in secondary school, family problems and sex are added. The relationship is closer to the latter. The implications are discussed.It is important to specifically understand which are the mental health variables that affect the life satisfaction of children and adolescents most, in order to optimally design programs aimed at promoting their wellbeing. The relationship between mental health and life satisfaction in students aged 9 to 18 years from Northern Chile was analyzed. A correlational cross-sectional study was carried out, using the Assessment System for Children and Adolescents (SENA) and the Satisfaction with Life Scale (SWLS-C). A total sample of 3455 students was used, divided into primary and secondary school students. Two structural equation models with good fit were obtained. In both, depression, self-esteem and age were maintained. Among primary school students there also emerged problems with school. However, among secondary school students, problems related to family and gender appeared. The relationship was stronger concerning secondary school. Implications for public policies and interventions are discussed

Relationships between social stigma, stigma experience and self-stigma and impaired quality of life in schizophrenia accross three Latin-America countries

International audienceThe relationships between stigma and quality of life in schizophrenia (QoL) have been extensively explored but have mostly focused on self-stigma and self-esteem and have never been explored in Latin-America. The objective of this study was to determine which stigma dimensions were associated with QoL in a sample of community-dwelling SZ subjects of three Latin-American countries. Stabilized outpatients with SZ were recruited in three Mental Health Services in three Latin-American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). Stigma and Qol-SZ were evaluated by self-administered questionnaires, the Internalized Stigma of Mental Illness scale (ISMI-12) and the SQoL-18. 253 participants were included. In multivariate analyses, QoL has been associated with each stigma dimension (social stigma, stigma experience and self-stigma), independently of age, gender, education level, ethnicity, age at illness onset, illness symptomatology and mental health treatment. More specifically, social stigma was significantly associated with impaired psychological and physical well-being, self-esteem and friendship. Self-stigma was significantly associated with impaired psychological well-being, self-esteem and autonomy. The present results confirm the importance of stigma in QoL of SZ subjects and identify new targets to develop stigma-orientated programs. Most of the previous programs have focused on self-stigma while social stigma has shown to be associated with a wide range of impaired QoL areas. Stigma and QoL may have a bidirectional relationship and targeting some specific QoL areas (like autonomy through self-empowerment approaches) may also improve the effectiveness of these programs to reduce stigma impact on the quality of life of subjects with schizophrenia. Future studies should also explore differences across countries as subjects from Bolivia were more frequently Aymara and reported higher stigma and lower QoL than SZ subjects from other countries

Impact of the relationship primary caregivers help in the quality of life of patients with advanced cancer.

Introducción: Este estudio evaluó el impacto de la figura del cuidador primario en la calidad de vida (CV) de pacientes con cáncer avanzado. Método: El diseño de investigación es exploratorio descriptivo-correlacional y el muestreo no probabilístico por conveniencia con un error de estimación no superior al 5%. La muestra estuvo compuesta por 34 pacientes diagnosticados con cáncer avanzado y sus respectivos cuidadores primarios, todos ellos pertenecientes a una unidad hospitalaria especializada en tratamientos paliativos. Se administraron los instrumentos FACT-G, SF-36 y la escala de sobrecarga del cuidador de Zarit. Resultados: Los resultados indican que la CV global de los pacientes oncológicos es percibida negativamente, lo que sugiere que los problemas de salud física y emocional deterioran el funcionamiento físico cotidiano y las actividades sociales del mismo. Por su parte, los cuidadores valoran positivamente su CV; no obstante aquellos que proveen de cuidados a pacientes en estadios de funcionalidad más avanzados de la enfermedad presentan un leve grado de sobrecarga en las áreas física, social, psíquica y económica de su vida. Asimismo, se concluyó que la CV del paciente, en la dimensión estado funcional, se ve afectada positivamente por las dimensiones función social, bienestar y vitalidad del cuidador. Conclusiones: Se constata que, efectivamente, el nivel de deterioro en las dimensiones física y funcional del paciente influye en la percepción que éstos tienen de su CV, así como también que los cuidadores de pacientes en estadios más críticos de la enfermedad se ven sobrecargados, probablemente, debido al rol más activo que deben asumir.Introduction: This study evaluated the impact of the primary caregiver on the quality of life (QL) of patients with advanced cancer. Method: The research design is exploratory descriptive-correlational with non-probabilistic sampling for convenience with error not exceeding 5%. The sample was composed of 34 patients diagnosed with advanced cancer and their respective primary caregivers, all of whom from a hospital unit specialized in palliative treatment. The instruments FACT-G, SF-36 and Zarit’s caregiver overload scale were used. Results: The results show that the overall QL of cancer patients is perceived negatively, which suggests that physical and emotional health problems deteriorate the patient’s daily physical and social activities. With regard to caregivers, these rate their own QL positively; however those who provide care to patients with a more advanced state of cancer present a slight amount of overload in the physical, social, psychological and economic aspects of their lives. As such, the study concluded that the patient’s functional state dimension is positively affected by the caregivers’s social functions, welfare and vitality. Conclusions: it can be observed that indeed, the level of deterioration in the functional and physical dimensions of the patient has an influence on the perception that they have of their QL, in addition to caregivers of patients in the more critical stages of the illness regarding themselves as overloaded, probably due to the more active role that they have to take on

Impacto de la relación de ayuda de cuidadores primarios en la calidad de vida de pacientes con cáncer avanzado

Introducción: Este estudio evaluó el impacto de la figura del cuidador primario en la calidad de vida (CV) de pacientes con cáncer avanzado. Método: El diseño de investigación es exploratorio descriptivo-correlacional y el muestreo no probabilístico por conveniencia con un error de estimación no superior al 5%. La muestra estuvo compuesta por 34 pacientes diagnosticados con cáncer avanzado y sus respectivos cuidadores primarios, todos ellos pertenecientes a una unidad hospitalaria especializada en tratamientos paliativos. Se administraron los instrumentos FACT-G, SF-36 y la escala de sobrecarga del cuidador de Zarit. Resultados: Los resultados indican que la CV global de los pacientes oncológicos es percibida negativamente, lo que sugiere que los problemas de salud física y emocional deterioran el funcionamiento físico cotidiano y las actividades sociales del mismo. Por su parte, los cuidadores valoran positivamente su CV; no obstante aquellos que proveen de cuidados a pacientes en estadios de funcionalidad más avanzados de la enfermedad presentan un leve grado de sobrecarga en las áreas física, social, psíquica y económica de su vida. Asimismo, se concluyó que la CV del paciente, en la dimensión estado funcional, se ve afectada positivamente por las dimensiones función social, bienestar y vitalidad del cuidador. Conclusiones: Se constata que, efectivamente, el nivel de deterioro en las dimensiones física y funcional del paciente influye en la percepción que éstos tienen de su CV, así como también que los cuidadores de pacientes en estadios más críticos de la enfermedad se ven sobrecargados, probablemente, debido al rol más activo que deben asumir

Attitudes and burden in relatives of patients with schizophrenia in a middle income country

BACKGROUND: Most studies of family attitudes and burden have been conducted in developed countries. Thus it is important to test the generalizability of this research in other contexts where social conditions and extended family involvement may be different. The aim of this study was to assess the relationship between the attitudes of caregivers and the burden they experience in such a context, namely Arica, a town located in the northernmost region of Chile, close to the border with Peru and Bolivia. METHODS: We assessed attitudes towards schizophrenia (including affective, cognitive and behavioural components) and burden (including subjective distress, rejection and competence) in 41 main caregivers of patients with schizophrenia, all of whom were users of Public Mental Health Services in Arica. RESULTS: Attitude measures differed significantly according to socio-demographic variables, with parents (mainly mothers) exhibiting a more negative attitude towards the environment than the rest of the family (t = 4.04; p = 0.000).This was also the case for caregivers with a low educational level (t = 3.27; p < 0.003), for the oldest caregivers (r = 0.546; p = 0.000) and for those who had spent more time with the patient (r = 0.377; p = 0.015). Although attitudes had significant association with burden, their explanatory power was modest (R2 = .104, F = 4,55; p = .039). CONCLUSIONS: Similar to finding developed countries, the current study revealed a positive and significant relationship between the attitudes of caregivers and their burden. These findings emphasize the need to support the families of patients with schizophrenia in this social context

Quality of life in caregivers of patients with schizophrenia: A literature review

<p>Abstract</p> <p>Background</p> <p>A couple of decades ago, hospitals or psychiatric institutions were in charge of caring for patients with schizophrenia; however, nowadays this role is performed by one or more patient's relatives. Evidence shows that informal caregivers experience negative changes in their quality of life (QOL). The aim of this study is to review the main factors associated with the QOL of caregivers of people with schizophrenia.</p> <p>Methods</p> <p>A search through databases from journals published last decade between 1998 and 2008 was performed. In accordance with the inclusion criteria, titles and abstracts of citations obtained from the search were examined independently by two authors and irrelevant articles discarded. The full text of those studies considered relevant by either reviewer were obtained and assessed independently. Where differences of opinion rose they were resolved by discussion. Out of the 258 references, 37 were included in the review.</p> <p>Studies which assessed factors associated with caregivers of people with schizophrenia's quality of life were included and the information summarized.</p> <p>Results</p> <p>Evidence suggest that physical, emotional and economic distress affect negatively caregiver's QOL as a result of a number of unfulfilled needs such as, restoration of patient functioning in family and social roles, economic burden, lack of spare time, among other factors.</p> <p>Conclusion</p> <p>Decreased QOL may be associated with caregivers' burden, lack of social support, course of the disease and family relationships problems. In addition, in developing countries, QOL is affected by caregivers' economic burden. High quality research is needed in order to identify factors associated with QOL over time and testing the efficacy of interventions aiming to improve QOL in caregivers of patients with schizophrenia.</p

The Mediating Role of Contextual Problems and Sensation Seeking in the Association between Substance Use and Mental Health in Adolescents from Northern Chile

Substance use is a risk behavior that has been associated with adverse mental health outcomes in adolescence. The aim of this study was to determine the relation between behavioral problems, emotional problems, and substance use as well as the mediating role of contextual problems and sensation seeking in this relation. A cross-sectional study of 2277 adolescents from Northern Chile was conducted. The System for the Evaluation of Children and Adolescents (SENA) was used to assess substance use, contextual problems, sensation seeking, and emotional and behavioral problems. Through a mediational model, it was observed that substance use has a positive indirect effect on emotional and behavioral problems when both contextual problems and sensation seeking act as mediating variables. An indirect effect of substance use on contextual problems with sensation seeking as a mediator was also observed. The results suggests that context and sensation seeking are a relevant source of information in understanding adolescents and their propensity to use drugs. Interventions based on addressing contextual problems (problems with school, peers, and family) and enhancing personal resources should be implemented in order to reduce substance use in adolescents as well as the consequences it can generate in the short, medium, and long term