Diseño e implementación de un programa de intervención clínica para adultos con distrés desde un modelo biopsicosocia

En las últimas décadas el término estrés ha adquirido un protagonismo cada vez mayor en los ámbitos científicos y académicos y también, formando parte del vocabulario cotidiano. Actualmente el ser humano nace, crece y se desarrolla en sociedades que le han brindado cierto grado de confort en relación con épocas pasadas. No obstante, sigue rodeado de numerosas situaciones (reales o imaginarias) que provocan la activación de mecanismos que intentan ajustarlo a las diversas demandas que diariamente se le presentan. En algunas ocasiones, y mediante un gran esfuerzo tanto a nivel biológico como psicológico y social, los seres humanos logran adaptarse a estos requerimientos e incluso salir fortalecidos de ellos. Sin embargo, en otros momentos, este esfuerzo es tan intenso y/o tan prolongado que sobreviene un fracaso adaptativo. Entre estos dos polos se ubican los conceptos de estrés y distrés, constituyéndose en innegables objetos de estudio de la Psicología debido a la impronta que ambos tienen sobre los procesos de salud y enfermedad, y, principalmente, porque esta disciplina cuenta con las herramientas para modificar o modular gran parte de las variables que, de modo directo o indirecto, generan las respuestas de estrés

A Randomized Controlled Trial of Fasting and Lifestyle Modification in Patients with Metabolic Syndrome: Effects on Patient-Reported Outcomes

Lifestyle interventions can have a positive impact on quality of life and psychological parameters in patients with metabolic syndrome (MetS). In this randomized controlled trial, 145 participants with MetS (62.8% women; 59.7 +/- 9.3 years) were randomized to (1) 5-day fasting followed by 10 weeks of lifestyle modification (F + LM; modified DASH diet, exercise, mindfulness; n = 73) or (2) 10 weeks of lifestyle modification only (LM; n = 72). Outcomes were assessed at weeks 0, 1, 12, and 24, and included quality of life (Short-Form 36 Health Survey Questionnaire, SF-36), anxiety/depression (Hospital Anxiety and Depression Scale, HADS), stress (Cohen Perceived Stress Scale, CPSS), mood (Profile of Mood States, POMS), self-efficacy (General Self-Efficacy Scale, GSE), mindfulness (Mindfulness Attention Awareness Scale, MAAS), and self-compassion (Self-Compassion Scale, SCS). At week 1, POMS depression and fatigue scores were significantly lower in F + LM compared to LM. At week 12, most self-report outcomes improved in both groups-only POMS vigor was significantly higher in F + LM than in LM. Most of the beneficial effects within the groups persisted at week 24. Fasting can induce mood-modulating effects in the short term. LM induced several positive effects on quality of life and psychological parameters in patients with MetS

Effects of Fasting and Lifestyle Modification in Patients with Metabolic Syndrome: A Randomized Controlled Trial

Background: Lifestyle interventions, such as fasting, diet, and exercise, are increasingly used as a treatment option for patients with metabolic syndrome (MS). This study assesses the efficacy and safety of fasting followed by lifestyle modification in patients with MS compared to lifestyle modification only. Methods: Single-blind, multicenter, parallel, randomized controlled trial in two German tertiary referral hospitals in metropolitan areas. Interventions: (a) 5-day fasting followed by 10 weeks of lifestyle modification (modified DASH diet, exercise, mindfulness; n = 73); (b) 10 weeks of lifestyle modification only (n = 72). Main outcomes and measures: Co-primary outcomes were ambulatory systolic blood pressure and the homeostasis model assessment (HOMA) index at week 12. Further outcomes included anthropometric, laboratory parameters, and the PROCAM score at weeks 1, 12, and 24. Results: A total of 145 patients with metabolic syndrome (62.8% women; 59.7 +/- 9.3 years) were included. No significant group differences occurred for the co-primary outcomes at week 12. However, compared to lifestyle modification only, fasting significantly reduced HOMA index (Delta = -0.8; 95% confidence interval [CI] = -1.7, -0.1), diastolic blood pressure (Delta = -4.8; 95% CI = -5.5, -4.1), BMI (Delta = -1.7; 95% CI = -2.0, -1.4), weight (Delta = -1.7; 95% CI = -2.0, -1.4), waist circumference (Delta = -2.6; 95% CI = -5.0, -0.2), glucose (Delta = -10.3; 95% CI = -19.0, -1.6), insulin (Delta = -2.9; 95% CI = -5.3, -0.4), HbA1c (Delta = -0.2; 95% CI = -0.4, -0.05;), triglycerides (Delta = -48.9; 95% CI = -81.0, -16.9), IL-6 (Delta = -1.2; 95% CI = -2.5, -0.005), and the 10-year risk of acute coronary events (Delta = -4.9; 95% CI = -9.5, -0.4) after week 1. Fasting increased uric acid levels (Delta = 1.0; 95% CI = 0.1, 1.9) and slightly reduced eGRF (Delta = -11.9; 95% CI = -21.8, -2.0). Group differences at week 24 were found for weight (Delta = -2, 7; 95% CI = -4.8, -0.5), BMI (Delta = -1.0; 95% CI = -1.8, -0.3), glucose (Delta = -7.7; 95% CI = -13.5, -1.8), HDL (Delta = 5.1; 95% CI = 1.5, 8.8), and CRP (Delta = 0.2; 95% CI = 0.03, 0.4). No serious adverse events occurred. Conclusions: A beneficial effect at week 24 was found on weight; fasting also induced various positive short-term effects in patients with MS. Fasting can thus be considered a treatment for initializing lifestyle modification for this patient group; however, it remains to be investigated whether and how the multilayered effects of fasting can be maintained in the medium and longer term

Materialist and Post-Materialist Concerns and the Wish for a Strong Leader in 27 Countries

There is evidence that democracies are under threat around the world while the quest for strong leaders is increasing. Although the causes of these developments are complex and multifaceted, here we focus on one factor: the extent to which citizens express materialist and post-materialist concerns. We explore whether objective higher levels of democracy are differentially associated with materialist and post-materialist concerns and, in turn, whether this is related to the wish for a strong leader. Testing this hypothesis across 27 countries (N = 5,741) demonstrated a direct negative effect of democracies' development on the wish for a strong leader. Further, multi-level mediation analysis showed that the relation between the Democracy Index and the wish for a strong leader was mediated by materialist concerns. This pattern of results suggests that lower levels of democracy are associated with enhanced concerns about basic needs and this is linked to greater support for strong leaders.Peer reviewe

Materialist and Post-Materialist Concerns and the Wish for a Strong Leader in 27 Countries

There is evidence that democracies are under threat around the world while the quest for strong leaders is increasing. Although the causes of these developments are complex and multifaceted, here we focus on one factor: the extent to which citizens express materialist and post-materialist concerns. We explore whether objective higher levels of democracy are differentially associated with materialist and post-materialist concerns and, in turn, whether this is related to the wish for a strong leader. Testing this hypothesis across 27 countries (N = 5,741) demonstrated a direct negative effect of democracies' development on the wish for a strong leader. Further, multi-level mediation analysis showed that the relation between the Democracy Index and the wish for a strong leader was mediated by materialist concerns. This pattern of results suggests that lower levels of democracy are associated with enhanced concerns about basic needs and this is linked to greater support for strong leaders.Peer reviewe

What makes people decide who to turn to when faced with a mental health problem? Results from a French survey

<p>Abstract</p> <p>Background</p> <p>The unequal use of mental health care is a great issue, even in countries with universal health coverage. Better knowledge of the factors that have an impact on the pathway to mental health care may be a great help for designing education campaigns and for best organizing health care delivery. The objective of this study is to explore the determinants of help-seeking intentions for mental health problems and which factors influence treatment opinions and the reliance on and compliance with health professionals' advice.</p> <p>Methods</p> <p>441 adults aged 18 to 70 were randomly selected from the general population of two suburban districts near Paris and agreed to participate in the study (response rate = 60.4%). The 412 respondents with no mental health problems based on the CIDI-SF and the CAGE, who had not consulted for a mental health problem in the previous year, were asked in detail about their intentions to seek help in case of a psychological disorder and about their opinion of mental health treatments. The links between the respondents' characteristics and intentions and opinions were explored.</p> <p>Results</p> <p>More than half of the sample (57.8%) would see their general practitioner (GP) first and 46.6% would continue with their GP for follow-up. Mental health professionals were mentioned far less than GPs. People who would choose their GP first were older and less educated, whereas those who would favor mental health specialists had lower social support. For psychotherapy, respondents were split equally between seeing a GP, a psychiatrist or a psychologist. People were reluctant to take psychotropic drugs, but looked favorably on psychotherapy.</p> <p>Conclusion</p> <p>GPs are often the point of entry into the mental health care system and need to be supported. Public information campaigns about mental health care options and treatments are needed to educate the public, eliminate the stigma of mental illness and eliminate prejudices.</p

Revisiting the Measurement of Anomie

Peer reviewe

Cultural Values Moderate the Impact of Relative Deprivation

Relative deprivation (RD) is the judgment that one or one’s ingroup is worse off compared with some relevant standard coupled with feelings of dissatisfaction, anger, and resentment. RD predicts a wide range of outcomes, but it is unclear whether this relationship is moderated by national cultural differences. Therefore, in the first study, we used national assessments of individual-collectivism and power distance to code 303 effect sizes from 31 different countries with 200,578 participants. RD predicted outcomes ranging from life satisfaction to collective action more strongly within individualistic nations. A second survey of 6,112 undergraduate university students from 28 different countries confirmed the predictive value of RD. Again, the relationship between individual RD and different outcomes was stronger for students who lived in more individualistic countries. Group-based RD also predicted political trust more strongly for students who lived in countries marked by lower power distance. RD effects, although consistent predictors, are culturally bounded. In particular, RD is more likely to motivate reactions within individualistic countries that emphasize individual agency and achievement as a source of self-worth

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe