How to reduce the number of rating scale items without predictability loss?

Rating scales are used to elicit data about qualitative entities (e.g., research collaboration). This study presents an innovative method for reducing the number of rating scale items without the predictability loss. The "area under the receiver operator curve method" (AUC ROC) is used. The presented method has reduced the number of rating scale items (variables) to 28.57\% (from 21 to 6) making over 70\% of collected data unnecessary. Results have been verified by two methods of analysis: Graded Response Model (GRM) and Confirmatory Factor Analysis (CFA). GRM revealed that the new method differentiates observations of high and middle scores. CFA proved that the reliability of the rating scale has not deteriorated by the scale item reduction. Both statistical analysis evidenced usefulness of the AUC ROC reduction method.Comment: 14 pages, 5 figure

Contemplative positive psychology: Introducing mindfulness into positive psychology

A pesar de que mindfulness está integrado en muchos manuales de psicología positiva como una técnica “positiva”, apenas se han desarrollado las implicaciones que tiene su uso ni se ha investigado la relación entre mindfulness y bienestar humano. Analizar las principales potencialidades de los dos ámbitos, las posibilidades de integración, así como las posibles contradicciones entre sus mensajes, es fundamental de cara a establecer puentes. Mindfulness es más que una técnica de meditación, lleva implícitos una serie de valores y condicionantes éticos que se adecuan en buena medida con los presupuestos que se proponen desde la psicología positiva, como el desarrollo de la amabilidad, la compasión, y las emociones positivas. El objetivo de este artículo es presentar por un lado aspectos comunes y similitudes, y por otro lado diferencias entre mindfulness y la psicología positiva. También se presentarán los principales estudios que han investigado el papel que tiene mindfulness y las prácticas contemplativas sobre el bienestar humano. Finalmente se discutirá y plantearán futuras líneas de investigación e intervención para acercar ambas propuestas. Although mindfulness is included in many positive psychology manuals as a “positive” technique, the implications of its use have scarcely been developed and the relationship between mindfulness and human well-being has barely been researched. Analyzing the main strengths of the two fields, the possibilities for their integration and the potential contradictions between their messages is essential in order to establish connections. Mindfulness is more than a meditation technique. It has implicit within it a set of values and ethical conditions that coincide to a great extent with the proposed assumptions from positive psychology, such as the development of kindness, compassion, and positive emotions. The aim of this paper is to present, on the one hand, the commonalities and similarities, and on the other, the differences between mindfulness and positive psychology. We also present the main studies that have investigated the role of mindfulness and contemplative practices on human well-being. Finally future research will be discussed and intervention suggested in order to bring the two proposals together

Depression in internal medicine inpatients at the time of hospital discharge and referral to primary care

Background and objectives: This is the first multi-center study intended to document the prevalence, characteristics, and associations of depression in Medicine patients at the time of hospital discharge and their referral to Primary Care (PC). Methods: Adult patients randomly selected among consecutive admissions to Medicine wards in 8 hospitals in Spain, covering health districts, were examined in a two-phase ''case-finding'' procedure. Standardized, Spanish versions of instruments were used, including the Standardized Polyvalent Psychiatric Interview (SPPI) and Cumulative Illness Rating Scale (CIRS). Cases of depression were diagnosed according to ICD-10 general hospital research criteria. Results: Three hundred and twelve patients with treatable depression and 777 non-depressed controls were identified. In a conservative estimate, the global prevalence of major depression was 7.1%, dysthymia 4.2% and adjustment depression 7.1%, and 51.9% of cases were of moderate/ severe intensity. Depression was more frequent in women, the differences being significant in all categories of depression. The prevalence of depression was lower in individuals aged 85 or more years, the differences being significant in cases of both dysthymia and adjustment depression. A clear pattern of decreasing prevalence with age was observed in women. The depressed had as an average five medical systems affected, and higher CIRS scores compared with the controls, the differences being significant in cases of both major depression and dysthymia. Conclusions: This is the first report showing a considerable prevalence of treatable cases of depression in Medicine patients at the time of hospital discharge and referral to PC. Depression is associated with the severity of the medical condition, and differences observed by age and sex have clinical implications. Paper read at the 3rd Annual Meeting of the European Association of Psychosomatic Medicine, Nuremberg 2015. © 2022 Asociación Universitaria de Zaragoza para el Progreso de la Psiquiatría y la Salud Menta

Relationship between meditative practice and self-reported mindfulness: The MINDSENS composite index

Mindfulness has been described as an inherent human capability that can be learned and trained, and its improvement has been associated with better health outcomes in both medicine and psychology. Although the role of practice is central to most mindfulness programs, practice-related improvements in mindfulness skills is not consistently reported and little is known about how the characteristics of meditative practice affect different components of mindfulness. The present study explores the role of practice parameters on self-reported mindfulness skills. A total of 670 voluntary participants with and without previous meditation experience (n = 384 and n = 286, respectively) responded to an internet-based survey on various aspects of their meditative practice (type of meditation, length of session, frequency, and lifetime practice). Participants also completed the Five Facets Mindfulness Questionnaire (FFMQ), and the Experiences Questionnaire (EQ). The group with meditation experience obtained significantly higher scores on all facets of FFMQ and EQ questionnaires compared to the group without experience. However different effect sizes were observed, with stronger effects for the Observing and Non-Reactivity facets of the FFMQ, moderate effects for Decentering in EQ, and a weak effect for Non-judging, Describing, and Acting with awareness on the FFMQ. Our results indicate that not all practice variables are equally relevant in terms of developing mindfulness skills. Frequency and lifetime practice - but not session length or meditation type - were associated with higher mindfulness skills. Given that these 6 mindfulness aspects show variable sensitivity to practice, we created a composite index (MINDSENS) consisting of those items from FFMQ and EQ that showed the strongest response to practice. The MINDSENS index was able to correctly discriminate daily meditators from non-meditators in 82.3% of cases. These findings may contribute to the understanding of the development of mindfulness skills and support trainers and researchers in improving mindfulness-oriented practices and programs

Interventions of computerized psychotherapies for depression in Primary Care in Spain

Currently, depression is a global health problem recognized by the WHO. The prevalence of this pathology in Primary Care is estimated at 19.5% worldwide, and 20.2% in Spain. In addition, the current intervention policies and protocols involve significant costs, both personal and economic, for people suffering from this disorder, as well as for society in general. On the other hand, the relapse rates after pharmacological interventions that are currently applied and the lack of effective specialized attention in mental health services reflect the need to develop new therapeutic strategies that are more accessible and profitable. Therefore, one of the proposals that are being investigated in different parts of the world is the design and evaluation of therapeutic protocols applied through Information and Communication Technologies, especially through the Internet and computer programs. The objective of this work was to present the current situation in Spain regarding the use of these interventions for the treatment of depression in Primary Care. The main conclusion is that although there is scientific evidence on the effectiveness of these programs, there are still important barriers that hinder their application in the public system, and also the need to develop implementation studies that facilitate the transition from research to clinical practice

A factor confirmation and convergent validity of the " areas of worklife scale" (AWS) to Spanish translation

Background: Perceived incongruity between the individual and the job on work-life areas such as workload, control, reward, fairness, community and values have implications for the dimensions of burnout syndrome. The “Areas of Work-life Scale” (AWS) is a practical instrument to measure employees´ perceptions of their work environments. AIMS: Validate a Spanish translation of the AWS, and it relationship with Masclach Burnout Inventory dimensions. Methods: The study was conducted in three medium-sized hospitals and seven rural and urban Primary Care centres (N = 871) in Spain. The “Maslach Burnout Inventory General Survey” (MBI-GS) and AWS were applied. We developed a complete psychometric analysis of its reliability, and validity. Results: Data on the reliability supported a good internal consistency (Cronbach a between .71, and .85). Construct validity was confirmed by a six factor model of the AWS as a good measure of work environments (¿2 (352) = 806.21, p < 0.001; ¿2/df = 2.29; CFI = 0.935, RMSEA = 0.039); concurrent validity was analysed for its relationship with other measures (opposing dimensions to burnout, and MBI), and each correlation between dimensions and subdimensions were statistically significant; as well, predictive validity, by a series of Multiple Regression Analysis examined the resulting patterns of the Confirmatory Factor Analysis (CFA) confirms the relationship between the work-life areas and burnout dimensions. Conclusions: Leiter and Maslach’s AWS has been an important instrument in exploring several work-life factors that contribute to burnout. This scale can now be used to assess the quality of work-life in order to design and assess the need for intervention programs in Spanish-speaking countries

Correlational analysis and predictive validity of psychological constructs related with pain in fibromyalgia

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia (FM) is a prevalent and disabling disorder characterized by a history of widespread pain for at least three months. Pain is considered a complex experience in which affective and cognitive aspects are crucial for prognosis. The aim of this study is to assess the importance of pain-related psychological constructs on function and pain in patients with FM.</p> <p>Methods</p> <p>Design</p> <p>Multicentric, naturalistic, one-year follow-up study.</p> <p><it>Setting and study sample</it>. Patients will be recruited from primary care health centres in the region of Aragon, Spain. Patients considered for inclusion are those aged 18-65 years, able to understand Spanish, who fulfil criteria for primary FM according to the American College of Rheumatology, with no previous psychological treatment.</p> <p>Measurements</p> <p>The variables measured will be the following: main variables (pain assessed with a visual analogue scale and with sphygmomanometer and general function assessed with Fibromyalgia Impact Questionnaire, and), psychological constructs (pain catastrophizing, pain acceptance, mental defeat, psychological inflexibility, perceived injustice, mindfulness, and positive and negative affect), and secondary variables (sociodemographic variables, anxiety and depression assessed with Hospital Anxiety and Depression Scale, and psychiatric interview assessed with MINI). Assessments will be carried at baseline and at one-year follow-up.</p> <p>Main outcome</p> <p>Pain Visual Analogue Scale.</p> <p>Analysis</p> <p>The existence of differences in socio-demographic, main outcome and other variables regarding pain-related psychological constructs will be analysed using Chi Square test for qualitative variables, or Student <it>t </it>test or variance analysis, respectively, for variables fulfilling the normality hypothesis. To assess the predictive value of pain-related psychological construct on main outcome variables at one-year follow-up, use will be made of a logistic regression analysis adjusted for socio-demographic and clinical variables. A Spearman Rho non-parametric correlation matrix will be developed to determine possible overlapping between pain-related psychological constructs.</p> <p>Discussion</p> <p>In recent years, the relevance of cognitive and affective aspects for the treatment of chronic pain, not only in FM but also in other chronic pain diseases, has been widely acknowledged. However, the relative importance of these psychological constructs, the relationship and possible overlapping between them, or the exact meaning of them in pain are not enough known.</p

Gender differences in mental health during the economic crisis

Background: Economic crises have a negative effect on mental health. Little evidence has been published on the impact of economic downturns on male and female. The aim of the study was to analyze gender differences in specific mental disorders in primary care during the current economic recession in Spain. Method: A total of 7, 914 patients in 2006 and 5, 876 patients in 2010 were recruited to collect sociodemographic data and the Primary Care Evaluation of Mental Disorders. Results: Between 2006 and 2010 the prevalence of Major Depressive Disorder increased 155.7% in men and 104.9% in women; Generalized Anxiety Disorder increased 98.3% in men and 71.3% in women; and Multisomatoform Disorder increased 100.05% in men and 37% in women. The effect of the Employment confounder was significant across all comparisons: Major Depressive Disorder Generalized Odds Ratio=2.557 for Men (p<.001), 2.046 for Women (p=.002); Generalized Anxiety Disorder Generalized Odds Ratio= 2.153 (p<.001) for Men, 1.546 for Women (p<.001); and for Non-specific Multisomatoform Disorder Generalized Odds Ratio=1.680 for Men (p<.001) and 1.301 for women (p=.014). Conclusion: Overall prevalence of mental disorders increased significantly between 2006 and 2010, especially in males, who are more sensitive to the effect of the current economic recession than women. Antecedentes: el impacto de las crisis económicas sobre la salud mental está bien documentado, pero hay poca evidencia sobre el efecto diferencial que pueda tener entre hombres y mujeres. El objetivo fue analizar las diferencias de género en la prevalencia de trastornos mentales en atención primaria durante la recesión económica en España. Método: 7.914 pacientes en 2006-2007 y 5.876 en 2010-2011 fueron encuestados para recoger datos sociodemográficos y completar la entrevista Primary Care Evaluation of Mental Disorders. Resultados: entre 2006 y 2010 la prevalencia del Trastorno Depresivo Mayor incrementó 155, 7% en hombres y un 104, 9% en mujeres; el Trastorno de Ansiedad Generalizada aumentó 98, 3% en hombres y 71, 3% en mujeres; el Trastorno Multisomatomorfo incrementó 100, 05% en hombres y 37% en mujeres. El desempleo fue significativo en todos los análisis: Trastorno Depresivo Odds Ratio Generalizados= 2.557 en hombres (p<.001), 2.046 en mujeres (p= .002); Trastorno de Ansiedad Generalizada Odds Ratio Generalizados= 2.153 (p<.001) en hombres, 1.546 en mujeres (p<.001); Trastorno Multisomatoformo indiferenciado Odds Ratio Generalizados= 1.680 en hombres (p<.001) y 1.301 en mujeres (p= .014). Conclusiones: la prevalencia de los trastornos mentales se incrementó entre 2006 y 2010 en ambos sexos, pero especialmente en hombres, quienes son más sensibles a los efectos de la crisis económica

Cognitive-behaviour therapy for patients with Abridged Somatization Disorder (SSI 4,6) in primary care: a randomized, controlled study

Abstract Background Somatoform disorders are characterized by the presence of multiple somatic symptoms without an organic cause that completely explains their symptoms. These patients generate a high cost in health services. We aim to evaluate the effectiveness and feasibility of a cognitive-behaviour therapy (CBT) programme, administered in group and individual formats in primary care for patients who are diagnosed with abridged somatization disorder. Method/design Design: Multicentre, randomized, controlled trial involving 3 groups, one of which is the control group consisting of standardized recommended treatment for somatization disorder in primary care (Smith's norms) and the 2 others, the intervention groups, consisting of cognitive-behavioural therapy (10 sessions) administered in individual format (intervention group 1) or in group format (intervention group 2). Setting: 29 primary care health centres in the province of Zaragoza and 3 primary care health centres in the province of Mallorca, Spain. Sample: N = 204 patients, (68 in each of the three groups), aged 18–65 years, able to understand and read Spanish, who fulfil Escobar's criteria of Abridgged Somatization Disorder (SSI 4,6), stable with pharmacotherapy over the previous month, and who will remain stable for the next 3 months in the doctor's opinion, having signed informed consent. Intervention: Control group: Standardized recommended treatment for somatization disorder in primary care (Smith's norms). Intervention group: 10 weekly sessions of CBT, following a protocol designed by Prof. Escobar's group at UMDNJ, USA. There are 2 different treatment conditions: individual and group format. Measurements: Survey on the use of health services, number and severity of somatic symptoms, anxiety, depression, quality of life and clinical global impression. The interviewers will not know which group the patient belongs to (blind). The assessments will be carried out at baseline, post-treatment, 6 months and 12 post-treatment. Main variables: Utilization of health services, number and severity of somatic symptoms. Analysis: The analysis will be per intent to treat. We will use the general linear models of the SPSS v.15 statistical package, to analyse the effect of treatment on the result variable (utilization of health services, number and severity of somatic symptoms). Discussion It is necessary to develop more effective psychological treatments for somatoform disorders. This randomised clinical trial will determine whether cognitive behaviour therapy, both in group or in individual format, is effective for the treatment of these patients. Trial registration Current controlled trials ISRCTN69944771</p