A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Routes to Symbolization: Intentionality and Correspondence in Early Understanding of Pictures

This research investigated the extent and nature of the informational support that enables young children to understand pictures as symbols. Two experiments were conducted using an object-retrieval task. The first experiment varied the amount (complete and no instructions) and kind of information (intended function of the symbol and picture-referent correspondence) provided to 30-month-old children. The results show that information which emphasizes intentionality was critical for symbolic comprehension. Although information about correspondence was not enough in itself, children came to achieve an insight halfway through the task, probably as a consequence of a comparison process. This study suggests that highlighting the heart of the symbolic relation, its intended function, is a privileged route in children's appreciation of a picture-referent relation. The second experiment shows that by 36 months of age, children figured out, with no instructions at all, the intentional nature of the symbol.     

Factorial and Diagnostic Validity of the Beck Depression Inventory-II (BDI-II) in Croatian Primary Health Care

The aim of this study was to examine the factorial and diagnostic validity of the Beck Depression Inventory-Second Edition (BDI-II) in Croatian primary health care. Data were collected using a medical outpatient sample (N = 314). Reliability measured by internal consistency proved to be high. While the Velicer MAP Test showed that extraction of only one factor is satisfactory, confirmatory factor analysis indicated the best fit for a 3-factor structure model consisting of cognitive, affective and somatic dimensions. Receiver operating characteristics (ROC) analysis demonstrated the BDI-II to have a satisfactory diagnostic validity in differentiating between healthy and depressed individuals in this setting. The area under the curve (AUC), sensitivity and specificity were high with an optimal cut-off score of 15/16. The implications of these findings are discussed regarding the use of the BDI-II as a screening instrument in primary health care settings.     

Religious upbringing and current religiosity in Spanish nursing and medicine students

The influence of religious education in the family upon current spiritual and religious tendencies was assessed in a sample of 599 Spanish nurse and medicine students using a religiosity scale and answers to a series of belief/disbelief statements. Results showed that nursing and medicine students were equally low-religious, with no differences in religiosity total scores between participants coming from religious families; however, medical students coming from nonreligious families showed higher religiousness than the corresponding nursing trainees. This distinction appeared both across religiosity items and in a variety of responses to belief/disbelief of Christian/secular assertions. Regression analysis showed that religious family background was a consistent predictor of religious beliefs at young adulthood, and its influence was higher for medical students. In addition to establish religious upbringing as an important factor modulating enduring religiosity, these findings provide distinctions between nurse and medical trainees, and reproduce, in a Spanish mainly catholic sample, the structure of religiosity factors previously found on North American mainline protestants.     

Coping with HIV Related Stigma and Well-Being

The goal of this study was to analyze the relationships to be found among stigma perception, active and avoidant coping strategies, and subjective and psychological well-being in a sample of 133 people with HIV. The results showed that stigma perception and avoidant coping strategies (venting, self-blame, denial, behavioural disengagement and substance use) were positively associated, whereas, both stigma perception and avoidant coping were negatively associated with different measures of well-being (affect balance, self-acceptance and environmental mastery). These negative relationships between stigma perception and the three well-being measures were mediated by the use of avoidant coping strategies. Results suggest that psychosocial intervention programs for people who report psychological distress arising from prejudice must be aimed at developing appropriate ways to deal with this prejudice. Intervention programs should also include strategies to directly increase well-being since from a positive psychology viewpoint certain interventions have been shown to do so, and HIV research has also shown that well-being is associated with lower mortality rates.     

Analysing the Simultaneous Relationship Between Life Satisfaction and Health-Related Quality of Life

This paper aims to examine whether life satisfaction and health-related quality of life (HRQoL) are simultaneously related, as well as to quantify the bias that occurs if simultaneity is not accounted for. The study sample consisted of 870 respondents, representative of the Spanish adult general population. Using a simultaneous equations system —with the satisfaction with life scale (SWLS) and the SF-6D index as outcome variables—, we found a simultaneous association between life satisfaction and HRQoL, although this relationship is heterogeneous in individual characteristics such as age and sex. More important, the fact of estimating the relationship between life satisfaction and HRQoL under a unidirectional approach severely underestimates the effect of life satisfaction on HRQoL and, to a lesser degree, the reverse direction effect. In consequence, policy decisions intended to improve satisfaction with life or HRQoL can be wrong if they rely on unidirectional estimates. Another relevant implication of this research is that, as a result of the simultaneous relationship between life satisfaction and HRQoL, not only health interventions may increase satisfaction with life, but also policies that improve life satisfaction can lead to positive side effects on HRQoL.     

Psychometric properties of a revised Spanish 20-item Toronto Alexithymia Scale adaptation in multiple sclerosis patients

There have been a small number of investigations of alexithymia in multiple sclerosis (MS) using the 20-item Toronto Alexithymia Scale (TAS-20). However, the TAS-20 factor structure has not yet been evaluated in a MS patient sample, and earlier Spanish translations of this instrument require some improvement. We aimed to evaluate the factorial validity and reliability of an improved Spanish translation of the TAS-20 (the TAS-20-S). The TAS-20-S was completed by 221 MS patients. Confirmatory factor analysis was used to compare the fit of six different factor models. Internal consistency and retest reliability coefficients were also computed. The correlated three-factor model and the higher-order factor model made up of Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally Oriented Thinking achieved the best fit. Alpha coefficients ranged between .87 and .67; mean inter-item correlations ranged between .48 and .20; and retest correlations after 6 months ranged between .61 and .52. A high degree of alexithymia was present in 18.1% of the sample. Reliability and the traditional three-factor structure were demonstrated for the TAS-20-S, which can now be recommended for assessing an aspect of emotional processing in MS patients.     

Peripheral spatial cues modulate spatial congruency effects: Analysing the “locus” of the cueing modulation

The spatial Stroop effect (slower left/right responses to left/right pointing arrows when they appear at spatially incongruent than at congruent locations) has often been used to examine the processing of irrelevant spatial information. We present data from two experiments in which the magnitude of such location-based interference is drastically reduced when the location of the arrow is precued by a spatial noninformative cue. The main aim of the present study was to clarify whether such modulation takes place at perceptual or at response-related stages of processing. First, we manipulated the spatial compatibility between the direction of the arrow and the location of the response so that each subject would respond with spatially compatible vs. incompatible key presses for each half of the experiment. We found that such manipulation did not have any effect on the standard reduction of the congruency effect by peripheral cues. In a second experiment, subjects made left/right key presses to directional arrows pointing bottom/up, which could appear equally often at left/right/bottom/up locations. In cued trials, we found a reduction of the congruency effect on the vertical axis (stimulus location-direction congruency), whereas congruency was unaffected by cueing in targets presented on the horizontal axis (stimulus-response location congruency). According to these results, we conclude that spatial noninformative cues modulate spatial Stroop interference by reducing the conflict between stimulus dimensions at perceptual- rather than motor-related stages of processing.     

Congruence or coherence? Emotional and physiological responses to colours in synaesthesia

Lexical–chromatic synaesthesia is a condition in which letters and/or words elicit percepts of synaesthetic colours, termed photisms. Anecdotal data suggest that synaesthetes are particularly sensitive to inconsistencies between their synaesthetic percepts and the real world, e.g., it can be annoying and unpleasant for them to see a letter printed in a colour different than the respective photism colour. For R, a synaesthete subject who participated in the present study, the photisms possess specific emotional values (a red photism is pleasing and attractive, green is repulsive and unpleasant, etc.). In contrast to the anecdotal data, R does not always find the colour–photism incongruence to be disturbing. More importantly, he states that it is the emotional coherence between the stimulus and the corresponding photism that matters. In a series of experiments, we studied this new concept of emotional coherence on three levels—subjective (self-report), behavioural, and physiological, corroborating R's introspective statements. Besides the implications of the concept of coherence itself, the results presented here suggest that even highly subjective cognitive constructs can be approached and measured experimentally, uncovering the workings of the underlying psychophysiological mechanisms.