Individual differences and health in chronic pain: are sex-differences relevant?

Background: Because psychological variables are known to intercorrelate, the goal of this investigation was to compare the unique association between several well-established psychological constructs in pain research and pain-related outcomes. Sex differences are considered because pain is experienced differently across sex groups. Methods: Participants were 456 consecutive chronic pain patients attending a tertiary pain clinic (mean age = 58.4 years, SD = 14.8, 63.6% women). The study design was cross-sectional. Psychological constructs included personality (NEO-Five Factor Inventory), irrational thinking (General Attitudes and Beliefs Scale), and coping (Social Problem Solving Inventory). Outcomes were pain severity and interference (Brief Pain Inventory) and physical, general, and mental health status (Short Form-36). To decide whether the bivariate analyses and the two-block, multivariate linear regressions for each study outcome (block 1 = age, sex, and pain severity; block 2 = psychological variables) should be conducted with the whole sample or split by sex, we first explored whether sex moderated the relationship between psychological variables and outcomes. An alpha level of 0.001 was set to reduce the risk of type I errors due to multiple comparisons. Results: The moderation analyses indicated no sex differences in the association between psychological variables and study outcomes (all interaction terms p > .05). Thus, further analyses were calculated with the whole sample. Specifically, the bivariate analyses revealed that psychological constructs were intercorrelated in the expected direction and mostly correlated with mental health and overall perceived health status. In the regressions, when controlling for age, sex, and pain severity, psychological factors as a block significantly increased the explained variance of physical functioning (ΔR2 = .037, p < .001), general health (ΔR2 = .138, p < .001), and mental health (ΔR2 = .362, p < .001). However, unique associations were only obtained for mental health and neuroticism (β = − 0.30, p < .001) and a negative problem orientation (β = − 0.26, p < .001). Conclusions: There is redundancy in the relationship between psychological variables and pain-related outcomes and the strength of this association is highest for mental health status. The association between psychological characteristics and health outcomes was comparable for men and women, which suggests that the same therapeutic targets could be selected in psychological interventions of pain patients irrespective of sex

The Unified Protocol for Transdiagnostic Treatment of Perinatal Depression: A Case Study

This case study aims to present the application of the Unified Protocol (UP) for the Transdiagnostic Treatment of Emotional Disorders in the case of a 38-year-old pregnant woman with a peripartum onset of major depressive disorder and anxiety symptoms. The UP is a cognitive-behavioral intervention based on the shared etiological and maintenance mechanisms of emotional disorders (i.e., mood, anxiety, and related disorders). The UP helps to modify maladaptive emotion-regulation strategies and enhance tolerance of unpleasant and intense emotions (sadness, anxiety, anger, etc.). Whereas previous studies demonstrate the efficacy of the UP in different emotional disorders, to our knowledge, none of them have used the UP to treat perinatal emotional disorders. After the eight UP modules of individual treatment, a significant decrease in anxiety, depression, negative affect, and anxiety sensitivity, and also an increase in positive affect were observed. These results were maintained at the 12-month follow-up. In addition to its clinical utility and acceptance, these results indicate that the UP can be adapted and personalized for the treatment of perinatal emotional disorders. Future studies with larger samples and controlled experimental designs should be developed to demonstrate its efficacy. Furthermore, as the UP seems to be useful in a group format, future efforts should be focused on the UP with perinatal women in a group format

XI Congreso Nacional y l lnternacional de la Asociación Española de Psicología Clínica y Psicopatología

La Asociación Española de Psicología Clínica y Psicopatología (AEPCP) junto con la Universidad de Zaragoza presentan el XI Congreso Nacional y I Internacional de la AEPCP que se celebrará los días 24 a 26 de octubre de 2019 en la ciudad de Teruel. El objetivo de este congreso bianual es divulgar el avance del conocimiento a través del intercambio de resultados y experiencias de distintos sectores científicos y profesionales vinculados con la salud integral de las personas. Por tanto, el congreso se dirige a profesores, investigadores, profesionales de la salud y la salud mental, estudiantes y residentes interesados en la Psicología Clínica, la Psicología de la Salud y la Psicopatología. En esta ocasión, el congreso pone de relieve los importantes avances surgidos en los últimos años desde la investigación en psicopatología, con influencia en la conceptualización de los trastornos psicológicos, su diagnóstico y su tratamiento. Hacemos referencia al enfoque transdiagnóstico en salud mental. Desde este enfoque es posible identificar las variables etiológicas y mantenedoras de distintos trastornos psicológicos o grupos de trastornos y diseñar tratamientos centrados en el abordaje de estas variables, con independencia de las etiquetas diagnósticas. Las ponencias plenarias las llevarán a cabo cinco mujeres, científicas y clínicas, de reconocido prestigio internacional que compartirán su conocimiento respecto a las intervenciones transdiagnósticas para el tratamiento de los trastornos emocionales en niños, adolescentes y adultos, en los trastornos de la conducta alimentaria y en los trastornos de la personalidad. La ponencia de clausura nos ayudará a cuestionarnos si, desde el lugar que ocupamos, estamos haciendo lo suficiente para que los tratamientos basados en la evidencia lleguen a todas las personas que lo necesitan. Sin dejar al margen el interés por otros aspectos de la Psicología Clínica y de la Salud, y de los aspectos sociales y éticos de nuestra disciplina, el programa incluye simposios, mesas redondas, mesas de comunicaciones y posters con temáticas muy diversas, todas ellas, de sumo interés y presentadas por profesionales, clínicos e investigadores de nuestro país. El presidente, vicepresidenta y los comités de organización y científico de este congreso, esperan que el programa sea del agrado de los asistentes y pueda contribuir a la actualización de conocimientos, el intercambio de experiencias y buenas prácticas profesionales, el establecimiento de contactos y redes de trabajo, y al disfrute y celebración de lo que nos une, la ciencia

Psychometric properties of the Spanish version of the anxiety control questionnaire-revised in pregnant women

Anxiety disorders are very frequent during pregnancy. Anxiety control is a generalized psychological vulnerability for its development. The aim of this study is to explore the psychometric properties of the Anxiety Control Questionnaire Revised (ACQ-R) in Spanish pregnant women. 275 women responded to measures of anxiety, depression, affect, and quality of life. The original three-factor solution of the ACQ-R (emotional, threat, and stress control) was replicated by confirmatory analysis. The model fit improved when item 15 was changed from the emotional to the stress scale. Significant associations between ACQ-R scores and depression, anxiety, affect, and quality of life were found. During pregnancy, the measurement of risk factors for the development of anxiety disorders is needed. The ACQ-R is a short and valid instrument that assesses anxiety control perception during pregnancy, which can be a mechanism underlying anxiety progression, and hence a potential target for treatment

Las propiedades psicométricas del Cuestionario de Expectativas sobre el Parto en una muestra de mujeres españolas gestantes

Childbirth expectations during pregnancy are important factors related to birth satisfaction. The aim of this study is to validate the Childbirth Expectation Questionnaire (CEQ) in a sample of Spanish pregnant women; 231 women responded to the CEQ during their first trimester of pregnancy and 106 of them completed a re-test at the third trimester. Exploratory analyses with 1-to-6 factor solutions were carried out to investigate the internal structure of the CEQ. The three-factor solution (spousal support and control, medical support and environment, and labor pain and distress) showed the best properties in terms of model fit, number of items per factor, and item loadings. The internal consistency of scales was also good (.79 ≥ α ≤ .93). Test-retest analyses showed significant intercorrelations between expectations from the first to the third trimester of pregnancy. There is a need to assess childbirth expectations, and our results suggest that the CEQ is a valid and useful instrument to be used among Spanish pregnant women.Las expectativas sobre el parto (evaluadas durante el embarazo) constituyen factores relevantes relacionados con la satisfacción del parto. El objetivo de este estudio es validar el Cuestionario de Expectativas sobre el Parto (CEQ según las siglas del nombre inglés) en una muestra de gestantes españolas. Un total de 231 mujeres cumplimentaron el CEQ durante el primer trimestre del embarazo y 106 de ellas cumplimentaron de nuevo el instrumento en el tercer trimestre. Se realizaron análisis exploratorios con soluciones factoriales de 1 a 6 factores para analizar la estructura interna del CEQ. La solución de tres factores (apoyo de la pareja y control, apoyo médico y ambiente y dolor durante el parto y malestar) mostró las mejores propiedades en cuanto a ajuste del modelo, número de ítems por factor y peso de los ítems. La consistencia interna de las escalas también fue buena (.79 ≥ α ≤ .93). Los análisis test-retest mostraron intercorrelaciones significativas entre las expectativas del primer y tercer trimestre del embarazo. Atendiendo a la necesidad de evaluar las expectativas sobre el parto, nuestros resultados sugieren que el CEQ es un instrumento válido y útil para ser utilizado en las gestantes españolas

Assessing irrational beliefs reliably and quickly: Refining and shortening the Spanish version of the Attitudes and Beliefs Scale

The Attitudes and Beliefs Scale (ABS) is a widely used measure of irrational beliefs (IBs) but has important psychometric problems. Our objective is to improve the psychometric quality of a Spanish version of the scale. Classical test theory, item response theory, and confirmatory factor analyses were combined to obtain a shorter version of the scale using 2 samples: one from the general population (n= 565) and another with chronic pain (n= 514). Pearson correlations were performed with IBs, personality and health measures to investigate sources of construct validity. After eliminating half of the items (12), the factorial fit of the scale became very good (RMSEA&lt; .08; CFI and TLI&gt; .95). IBs were associated with more neuroticism (.21≤ r≤ .61, p≤ .001) and poorer mental health (-.17≤ r≤ -.56, p≤ .001), as well as a less extraversion and conscientiousness (-.14≤ r≤ -.41, p≤ .01). These results were replicated in both samples, but IBs were only associated with poorer physical health in the general population sample. The shortened Spanish version of the ABS is a valid and reliable instrument that can be rapidly administered in clinical settings

Assessing irrational beliefs reliably and quickly: Refining and shortening the Spanish version of the Attitudes and Beliefs Scale

The Attitudes and Beliefs Scale (ABS) is a widely used measure of irrational beliefs (IBs) but has important psychometric problems. Our objective is to improve the psychometric quality of a Spanish version of the scale. Classical test theory, item response theory, and confirmatory factor analyses were combined to obtain a shorter version of the scale using 2 samples: one from the general population (n= 565) and another with chronic pain (n= 514). Pearson correlations were performed with IBs, personality and health measures to investigate sources of construct validity. After eliminating half of the items (12), the factorial fit of the scale became very good (RMSEA .95). IBs were associated with more neuroticism (.21≤ r≤ .61, p≤ .001) and poorer mental health (-.17≤ r≤ -.56, p≤ .001), as well as a less extraversion and conscientiousness (-.14≤ r≤ -.41, p≤ .01). These results were replicated in both samples, but IBs were only associated with poorer physical health in the general population sample. The shortened Spanish version of the ABS is a valid and reliable instrument that can be rapidly administered in clinical settings.La “Escala de actitudes y creencias” (EAC) es una medida de creencias irracionales (CI) muy utilizada, pero con problemas psicométricos. Nuestro objetivo fue mejorar la calidad psicométrica de la versión española de la EAC. Se combinó la teoría clásica de los tests, teoría de respuesta al ítem y análisis factorial confirmatorio para obtener una versión corta de la escala utilizando dos muestras, una de la población general (n= 565) y otra con dolor crónico (n= 514). Se realizaron correlaciones de Pearson con CIs, personalidad y medidas de salud para investigar las fuentes de validez de constructo. Tras eliminar la mitad de los ítems (12), el ajuste factorial de la escala fue bueno (RMSEA 0,95). Las CIs se asociaron con más neuroticismo (0,21≤ r≤0,61; p≤ 0,001), peor salud mental (-0,17≤ r≤ -0,56; p≤ 0,001), menor extraversión y responsabilidad (- 0,14≤ r≤ -0,41; p≤ 0,01). Estos resultados se replicaron en ambas muestras, pero las CIs sólo se asociaron con una peor salud física en la población general. La versión española abreviada de la EAC es válida, fiable y puede administrarse rápidamente en entornos clínicos

Influencia de la autoestima e imagen corporal en la satisfacción sexual de jóvenes universitarios

III Jornadas de Investigación para el Alumnado de SaludIntroducción: Recientemente, las investigaciones sobre sexualidad han tratado dedilucidar la importancia de factores psicológicos, como la autoestima o la imagen corporal,en la satisfacción sexual. Algunos estudios señalan la importancia del género eneste campo, con resultados incongruentes. El objetivo del presente trabajo es explorarla influencia de la autoestima e imagen corporal en la satisfacción sexual y si esta influenciadifiere en función del género en jóvenes universitarios. Método: La muestraestá formada por 367 sujetos (58% mujeres) con edades entre los 18 y 28 años(Media=21,23; DT=2,65). Todos respondieron la Nueva Escala de Satisfacción Sexual(NSSS), la Escala de Autoestima de Rosenberg (RSES) y el Cuestionario de la FormaCorporal (BSQ). Resultados: No se han encontrado diferencias de género estadísticamentesignificativas en satisfacción sexual (t= -0,80, p= ,422) pero sí en autoestima(t= 4,56, p≤ ,001) con una media superior en hombres, e insatisfacción con la imagencorporal (t= -10,31, p≤ ,001) con una media mayor en las mujeres. Tras controlar elefecto de la edad, la varianza en satisfacción sexual explicada por la autoestima eradel 9,7% en hombres y del 4,1% en mujeres. La imagen corporal no explicó la satisfacciónsexual en ninguno de los sexos. Conclusiones: Entre los jóvenes, no hay diferenciasde género en satisfacción sexual, pero las mujeres presentan menor autoestimay mayor insatisfacción con su imagen corporal. La autoestima juega un papelrelevante en la satisfacción sexual, sobre todo de los hombres. En la práctica clínica,es importante atender a las diferencias de género en los factores asociados a la satisfacciónsexual dado que éstas nos pueden guiar en la prevención y tratamiento deproblemas sexuales.Introduction: Recently, research on sexuality has focused on the importance of psychologicalfactors, such as self-esteem or body image, in sexual satisfaction. Somestudies highlight the importance of gender in this field. However, this topic remains unclear.The aim of this study is to explore whether the contribution of self-esteem andbody imagen on sexual satisfaction outcomes is also sensitive to sex. Method: Thesample was composed of 367 university students (58% female) aged 18 to 28 years(M= 21.23, SD= ± 2.65). They responded the New Sexual Satisfaction Scale (NSSS),the Rosenberg Self-esteem Scale (RSES) and the Body Shape Questionnaire (BSQ).Results: No gender differences in sexual satisfaction were found (t= -0.80, p=, 422) butin self-esteem (t= 4.56, p≤, 001) with a higher mean in men, and dissatisfaction withbody image (t= -10.31, p≤.001) with a higher mean in women. After controlling for age,the variance of sexual satisfaction explained by self-esteem was 9.7% for men and4.1% for women. Body image did not contributed to sexual satisfaction regardless ofgender. Conclusions: Among young people, there are no gender differences in sexualsatisfaction, but women have lower self-esteem and greater dissatisfaction with theirbody image. Self-esteem plays an important role in sexual satisfaction, especially inmen. In clinical practice, gender differences in the factors associated with sexual satisfactioncould guide sexual problem’s prevention and treatment

Empatic accuracy in chronic pain: exploring patient and informal caregiver differences and their personality correlates

Background and objectives: Social factors have demonstrated to affect pain intensity and quality of life of pain patients, such as social support or the attitudes and responses of the main informal caregiver. Similarly, pain has negative consequences on the patient’s social environment. However, it is still rare to include social factors in pain research and treatment. This study compares patient and caregivers’ accuracy, as well as explores personality and health correlates of empathic accuracy in patients and caregivers. Materials and Methods: The study comprised 292 chronic pain patients from the Pain Clinic of the Vall d’Hebron Hospital in Spain (main age = 59.4 years; 66.8% females) and their main informal caregivers (main age = 53.5 years; 51.0% females; 68.5% couples). Results: Patients were relatively inaccurate at estimating the interference of pain on their counterparts (t = 2.16; p = 0.032), while informal caregivers estimated well the patient’s status (all differences p > 0.05). Empathic accuracy on patient and caregiver status did not differ across types of relationship (i.e., couple or other; all differences p > 0.05). Sex differences in estimation only occurred for disagreement in pain severity, with female caregivers showing higher overestimation (t = 2.18; p = 0.030). Patients’ health status and caregivers’ personality were significant correlates of empathic accuracy. Overall, estimation was poorer when patients presented higher physical functioning. Similarly, caregiver had more difficulties in estimating the patient’s pain interference as patient general and mental health increased (r = 0.16, p = 0.008, and r = 0.15, p = 0.009, respectively). Caregiver openness was linked to a more accurate estimation of a patient’s status (r = 0.20, p < 0.001), while caregiver agreeableness was related to a patient’s greater accuracy of their caregivers’ pain interference (r = 0.15, p = 0.009). Conclusions: Patients poorly estimate the impact of their illness compared to caregivers, regardless of their relationship. Some personality characteristics in the caregiver and health outcomes in the patient are associated with empathic inaccuracy, which should guide clinicians when selecting who requires more active training on empathy in pain settings.Gobierno de España FPU-AP2010-558Universitat Jaume I POSDOC/2016/1

How are information and communication technologies supporting routine outcome monitoring and measurement-based care in psychotherapy? A systematic review

Psychotherapy has proven to be effective for a wide range of mental health problems. However, not all patients respond to the treatment as expected (not-on-track patients). Routine outcome monitoring (ROM) and measurement-based care (MBC), which consist of monitoring patients between appointments and using this data to guide the intervention, have been shown to be particularly useful for these not-on-track patients. Traditionally, though, ROM and MBC have been challenging, due to the difficulties associated with repeated monitoring of patients and providing real-time feedback to therapists. The use of information and communication technologies (ICTs) might help reduce these challenges. Therefore, we systematically reviewed evidence regarding the use of ICTs for ROM and MBC in face-to-face psychological interventions for mental health problems. The search included published and unpublished studies indexed in the electronic databases PubMed, PsycINFO, and SCOPUS. Main search terms were variations of the terms "psychological treatment", "progress monitoring or measurement-based care", and "technology". Eighteen studies met eligibility criteria. In these, ICTs were frequently handheld technologies, such as smartphone apps, tablets, or laptops, which were involved in the whole process (assessment and feedback). Overall, the use of technology for ROM and MBC during psychological interventions was feasible and acceptable. In addition, the use of ICTs was found to be effective, particularly for not-on-track patients, which is consistent with similar non-ICT research. Given the heterogeneity of reviewed studies, more research and replication is needed to obtain robust findings with different technological solutions and to facilitate the generalization of findings to different mental health populations