Evaluación de factores asociados a la ansiedad social y a otras psicopatologías en adolescentes / Assessment of factors associated to social anxiety and other psychopatologies in adolescents

Introduction The study of factors associated with anxiety and social phobia is a subject of recent interest in mental health. Specifically, shyness in children seems to act as an early expression of social phobia that may later consolidate into a clinical entity. The presence of certain psychopathologies and particular styles of child rearing in parents, are perceived by their children, are associated with the emergence of social phobia in adolescence. On the other hand, social anxiety disorder during adolescence or early adulthood may predict subsequent depressive disorders. The presence of both disorders (anxiety and social phobia) during adolescence increases the probability of suffering from them recurrently in early adulthood. Family structure and cohesion as well as stressful life events have been found to be associated with mood disorders during the childhood-youth period. However, studies conducted with young subjects are scarce, even though understanding the factors associated to different psychopathologies in the youth has proven of great value in clinical practice and epidemiology. For this reason, we attempt to evaluate, in a sample of three groups of adolescents (social anxiety, other psychopathologies and without psychopathologies) the possible demographical factors, competences and clinical indexes that could be associated with the different conditions under consideration. Methodology A sample of 1012 adolescents (582 women and 430 men) with an average age of 15.80 years (SD = 1.48) fulfilled a series of tests to assess demographical variables, psychosocial competences and clinical indexes. Results The difference between the average scores in the Escala de Ansiedad en Interacción Social -SIAS- was significant for the variables sex and the school year. Sex and couple relationships significantly affect the probability of manifesting social anxiety and other psychopathologies, respectively. Some competences significantly affect the probability of social anxiety, whereas others affect the probability of developing other psychopathologies. The majority of the 46 clinical indexes assessed demonstrate a significant effect on the probability of developing both conditions. Discussion and conclusions The results indicate that, in line with previous studies, the average score of women in the SIAS is slightly higher than in men. The average score in the SIAS of the young people from formative cycles was slightly higher than in the subjects from the obligatory secondary education and high schools. Very few studies have informed on the differences in social anxiety associated with the educational level. Women presented significantly higher probability of suffering from social anxiety than men. Unexpectedly, adolescents who maintained couple relationships also showed significantly higher probabilities than the rest of suffering from other psychopathologies. Some psychosocial competences, especially those related to the situations of social interactions, have a significant effect on the probability of developing social anxiety, whereas others (social and behavioural) influence other psychopathologies. In general and to a large extent, the findings are coherent and explainable, although some of them are contradictory. This could be caused by the difficulty to evaluate the complex construct of psychosocial competences. The majority of the evaluated clinical indexes showed a significant effect on the probability of developing of social anxiety and other psychopathologies. This effect is more evident in the group of young people with other psychopathologies than in the group of adolescents with social anxiety. Previous studies have found similar results, especially in the indexes referring to the general measures of anxiety and depression, specific measures of anxiety and avoidance of social situations and personality.

Introducción El estudio de factores asociados a la ansiedad y fobia social constituye un tema de reciente interés. Concretamente, la timidez infantil parece actuar como una expresión temprana de la fobia social que más tarde se puede consolidar como cuadro clínico. La percepción de los hijos sobre la presencia de ciertas psicopatologías y de determinados estilos de crianza de los padres se asocia a la aparición de la fobia social en la adolescencia. El trastorno de ansiedad social durante la adolescencia o la adultez temprana puede predecir trastornos depresivos subsecuentes. La presencia de ambos trastornos (ansiedad y fobia social) durante la adolescencia incrementaría la probabilidad de padecerlos de manera recurrente a lo largo de la adultez temprana. La estructura y la cohesión familiar, así como los sucesos estresantes de la vida, se han asociado con trastornos afectivos en la etapa infanto-juvenil. En la actualidad, los estudios realizados en estas edades son escasos, aun cuando el entendimiento de los factores asociados a distintas psicopatologías en la edad temprana reviste importancia clínica y epidemiológica. Por ello, pretendemos evaluar en una muestra de adolescentes formada por tres grupos (ansiedad social, otras psicopatologías y sin psicopatologías) los posibles factores demográficos, de competencias e índices clínicos que pueden estar asociados a las diferentes condiciones estudiadas. Metodología Una muestra de 1012 adolescentes (582 mujeres y 430 hombres) con una edad media de 15.80 años (DT = 1.48) completó en su medio escolar una serie de pruebas que evalúan variables demográficas, competencias psicosociales e índices clínicos. Resultados La diferencia de medias en las puntuaciones de la Escala de Ansiedad en Interacción Social -SIAS- fue significativa para las variables sexo y curso escolar. El sexo y la relación de pareja ejercieron un efecto significativo en la probabilidad de manifestar ansiedad social y otras psicopatologías, respectivamente. Algunas competencias mostraron un efecto significativo en la probabilidad de presentar ansiedad social, mientras que otras lo hicieron en la probabilidad de desarrollar otras psicopatologías. La mayoría de los 46 índices clínicos evaluados mostró un efecto significativo en la probabilidad de sufrir ambas condiciones. Discusión y conclusiones Los resultados indican que la puntuación media de las mujeres en la SIAS superó ligeramente a la de los hombres, lo que coincide con estudios previos. La puntuación media en la SIAS de los jóvenes que formaron los ciclos formativos fue ligeramente superior a la de los procedentes de educación secundaria obligatoria y de bachillerato. Hay pocos estudios que informen de diferencias en la ansiedad social asociadas al nivel de estudios. Las mujeres presentaron una probabilidad significativamente mayor que los hombres de sufrir ansiedad social. Los adolescentes que mantenían relaciones de pareja también mostraron significativamente más posibilidades que el resto de presentar otras psicopatologías, el cual es un resultado inesperado. Algunas competencias psicosociales, especialmente las que se relacionan con las situaciones de interacción social, han mostrado un efecto significativo en la probabilidad de sufrir ansiedad social, mientras que otras (sociales y de actuación) lo han hecho en la probabilidad de desarrollar otras psicopatologías. En general, gran parte de estos hallazgos tienen coherencia y explicación, aunque algunos son contradictorios, lo que puede deberse a la dificultad de evaluar el constructo de competencias psicosociales por su complejidad. Por último, la mayoría de los índices clínicos evaluados presentó un efecto significativo en la probabilidad de desarrollar ansiedad social y otras psicopatologías. Este último efecto fue más notorio en el grupo de jóvenes con otras psicopatologías que en el grupo de adolescentes con ansiedad social. Diversos estudios encuentran resultados parecidos a los hallados en éste, especialmente en los índices referentes a medidas generales de ansiedad o depresión, específicas de ansiedad y evitación en situaciones sociales, y de personalidad.

Ansiedad y fobia social: revisión de los autoinformes más utilizados en población adulta e infanto-juvenil / Anxiety and social phobia: review of the selt-reports more used in adult and children-youth population

La evaluación de la ansiedad y fobia social es una tarea compleja debido a la implicación de varios componentes y dimensiones en la misma. Esto implica la necesidad de instrumentos de evaluación específicos con adecuadas propiedades psicométricas. El objetivo de la presente revisión teórica es ofrecer una descripción de los autoinformes más utilizados en la evaluación de la ansiedad y fobia social en población adulta e infanto-juvenil, así como de sus propiedades pisométricas en muestras anglosajonas y de habla española. En general, existen más medidas de evaluación de este trastorno en población adulta que en infanto-juvenil, disponiéndose de una multitud de datos psicométricos. Los autoinformes empleados en poblaciones de niños y adolescentes son escasos, encontrándose pocos estudios psicométricos, especialmente en población española; incluso, algunas de estas medidas de autoinformes requieren su adaptación a esta población. Se discute la implicación de estos hallazgos, ofreciendo algunas conclusiones al respecto.

Evaluación de la relación entre rasgos psicopatológicos de la personalidad y la calidad del sueño

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Abstract: Introduction. Diverse studies llave demonstrated the relationship between psychopathology and sleep alterations. Data proceeding from the ambulatory psychiatric field show that 70-75% of the patients experience sleep problems. The most frequent complaints refer to nighttime sleep alterations, excessive daytime sleep, difficulty with morning waking, and disturbances in the circadian rhythm of the sleep-wake cycle. Many studies, most of which use patient samples, have associated psychopathological personality traits and sleep disorders. All of these studies reveal that subjects with sleep disorder tend to be characterized by psychopathological traits (anxiety, psychasthenia, depression, etc.). There is some evidence that the structure of some dream dysfunctions (such as insomnia) is similar among general population and psychiatric samples; differences are more quantitative than qualitative. In samples of university students, the percentage of individuals who report bad sleep quality has been similar to the percentage of insomniacs in general population. With the aim to delve more deeply into the analogy between the sleep quality of normal subjects and clinical samples, and given the shortage of studies relating psychopathological traits of personality and sleep quality in normal population, this study intends to explore the relationship between the psychopathological personality variables included in the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the sleep quality evaluated with the Pittsburg Sleep Quality Index in a sample ofsubjects who have no diagnosed sleep disorder. The psychopathological variables included in the MMPI-2 which predict sleep quality in a non-clinical sample are also determined. Methodology. A sample of 222 individuals (186 women and 36 men) with a mean age of 21.65 years (SD=2.81) completes the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Pittsburg Sleep Quality Index (PSQI), which provide an overall sleep quality measure and seven partial scores for different dimensions: Subjective sleep quality, Sleep latency, Sleep duration, Sleep habit efficiency, Sleep alterations, the use of hypnotic medication, and daytime dysfunction. Results. Some psychopathological traits (hypochondria, anxiety, and depression) correlate positively with almost all of the sleep quality dimensions comprising the PSQI. From a logistic regression model developed to predict the probability of being a good or bad sleeper, hypochondria and anxiety are the only statistically significant predictors. Discussion and conclusions. Human sleep, from a behavioral perspective, would be explained from four different dimensions: Circadian time (sleep-wake cycle situation on the nictemero), Organism (intrinsic factors such as age, sleep patterns, emotional states, etc.), Behavior (facilitating or inhibiting behaviors), and Environment (temperature, light, noise, etc.). Psychopathological personality traits, the main objective of this study, can also be included within the second component (organism). Previous studies using the MMPI have associated insomnia to high anxiety levels, depression, hypochondria, hysteria, and psychasthenia. The MMPI has also been considered to be a useful instrument in identifying different personality profiles ininsomnia subjects. There are, however, only a few studies focusing on the relationship between these personality traits and sleep quality in normal subjects. The results indicate that this study sample the subjects do not present serious sleep disorders. All of the components pertaining to the Pittsburg Sleep Quality Index present mean scores below the middle response range, situated in 1.5. However, if we consider the total score and bear in mind that a score of five is the cut-off point used to differentiate good sleepers from bad sleepers, we can classify 45.94% of the sample as bad sleepers. In considering the scores for the different MMPI-2 clinical scales, we should mention that none of them reached the typical score of 60; therefore no trait was found to be clinically significant. Some psychopathological traits are linked to almost all of the sleep quality dimensions. Hypochondria, anxiety, and depression are present in the associations with subjective sleep quality, disturbances, or daytime sleepiness. Though no stronger relations between use of hypnotic medication and psychopathological traits have been found (none of them above 0.30), a similar trend on patients dependent on benzodiazepines (predominating traits as depression, psychasthenia and schizophrenia) has been showed. It is also important to point out the relationship between daily dysfunction and the WRK scale (work interferences), which reveals the negative effects of daytime sleepiness, even in subjects who do not present important sleep disorders, as in this sample. On the other hand, the relationship between daily dysfunction and hypochondria, depression, and schizophrenia found in this study has previously been verified in patients with excessive daytime sleepiness. When considering the global score, we can clearly inform that health concerns (reflected in the Hs, HEA, and Hy scales) and the negative emotional states (D, ANX, and DEP scales) are related to sleep quality. These two factors (health concerns and anxiety) are part of the regression model, revealing that an increase in hypochondria and anxiety scores significantly increases the probability of being a bad sleeper, that is to say, of having a poor sleep quality. This explicative model presents a good predictive capacity which allows us to correctly classify 68.50% of the sample. We can correctly predict 78.30% of the good sleepers and 53.90% ofthe bad sleepers (scores higher than 5 on the Pittsburg global index), which grants the model an adequate specificity and sensibility. It is, however, necessary to consider that data used for the estimation respond to a range of restricted scores, causing any effect to be much less important than if we had worked with a more heterogeneous group of subjects. For example, global sleep quality scores can oscillate between 0 and 21, but in our sample they are comprised between 0 and 15. It is possible that, in including subjects who present high scores on the scales used in this study, a greater number of significant sleep quality predictors with greater magnitudes would be emphasized. Nevertheless, our interest resides in exploring the relationship between health concerns, anxiety and depression levels, and sleep quality in a non-clinical sample. So far, this relationship has not been explored in depth. One common limitation of these non-randomized studies is the difficulty to generalize findings to the normal population. Nevertheless, we assume higher possibilities to generalize findings if our study results are similar to those obtained from other non-clinical samples. In conclusion, health concerns and anxiety levels are the psychopathological traits most related to sleep quality and which hold a certain capacity to determine this quality in a sample of normal subjects. Both variables are clearly related to insomnia, as has been revealed in many insomnia patient studies. Therefore, we can verify that the pattern followed in the relationship between psychopathological traits and sleep quality in a non-clinical sample is similar to that found in sleep disorder patient samples, supporting that relationship between psychopathological traits and sleep quality in normal subjects opposite to patients with dream disorders can be drawn more easily from a quantitative than a qualitative approach.

Análisis bibliométrico de la revista Journal of Sex Research: (1980-2003) / Bibliometric analysis of the journal of sex research (1980-2003)

En este artículo se realiza un análisis bibliométrico de la revista Journal of Sex Research durante el periodo 1980-2003 que proporciona datos sobre el número de artículos,los autores y los contenidos a partir de la base de datos PsycINFO. Dicho análisis muestra que el número de artículos publicados fue de 774, siendo en Estados Unidos el país más productivo

Influencias de diferentes factores psicológicos sobre el deseo sexual / Psychological factors that have influence on sexual desire

El objetivo de este trabajo es hacer una revisión de los factores psicológicos que influyen en el deseo sexual, aportando una serie de evidencias empíricas sobre dicha relación. Para conseguir este objetivo se parte del Modelo de Fuertes y López. quienes proponen que el deseo sexual se explica a partir de la interacción de tres dimensiones diferentes: activación neurohormonal, disposición cognitiva emocional y la presencia de determinados estímulos sexuales internos y externos. Este artículo se centra en la segunda y tercera dimensión. Así, se han seleccionado las variables psicológicas más importantes incluídas en la dimensión de la disposición cognitiva-emocional(actitudes sexuales y estados emocionales), centrándonos en algunas dimensiones de las mismas; finalmente se analiza la influencia de las fantasias sexuales sobre el deseo sexual (tercera dimensión del modelo)