Análisis de las respuestas cognitivas relacionadas con el diagnóstico de cáncer en pacientes mexicanos / Cognitive response related to cancer diagnosis in Mexican patients

Resumen La evaluación subjetiva ha sido descripta como una variable mediadora para la respuesta emocional. Se presenta con diferentes contenidos y estilos. El estilo cognitivo se refiere a la manera en que se piensa sobre el estresor, por ejemplo: la rumiación (pensamientos intrusivos, repetitivos, que generan malestar emocional), la evitación (intentos por no pensar en el estresor) y el compromiso cognitivo (enfocados en búsqueda de sentido o solución). En base a esta respuesta emocional, se busca explorar y describir los pensamientos relacionados con el cáncer en un grupo de diez pacientes con la enfermedad. En un estudio cualitativo, se les pidió a diez pacientes con cáncer que indicaran los cinco pensamientos más frecuentes desde su diagnóstico. Se analizó el contenido mediante la técnica top down (teoría a contenido) y, a partir de los estilos de respuestas cognitivas, se clasificó el contenido de los pensamientos reportados por estilo de pensamiento (rumiación, compromiso cognitivo o evitación), por temporalidad (pasado, presente y futuro) y por valencia (positiva o negativa). Posteriormente, se hizo el análisis bottom up (contenido a teoría). Se hicieron tablas cruzadas para identificar los contenidos según el estilo de pensamiento, la temporalidad y la valencia. En los pensamientos con estilo rumiativo, el enfoque temporal se dirigía en su mayoría al futuro y al pasado, mientras que el compromiso cognitivo se enfocaba en el presente. Esta diferencia fue estadísticamente significativa mediante una prueba de chi cuadrado. Dentro de los temas relacionados con la incertidumbre, se refirieron a la muerte, al pronóstico de la enfermedad, a la respuesta de la familia y a las finanzas (en el futuro) y a las causas y culpa (en el pasado).

Abstract Cancer has been defined by the World Health Organization as "a disease caused by abnormal cells growing uncontrollably in the body, going beyond their usual boundaries, invading adjoining parts of the body and spreading to other organs". Being diagnosed with cancer has been described as an experience with diverse emotional reactions and difficulties in adaptation, having psychological consequences, being most common depression, anxiety and psychological distress; but also, some patients present positive consequences after having a cancer diagnosis, such as post traumatic growth, which includes positive changes presented after the disease experience. Subjective appraisal about cancer has been defined as a mediating variable for the emotional response presented after a stressor, such as cancer diagnosis, treatment, or important changes during disease process (initiating and finalizing treatment, presenting relapse or remission, as well as when having control studies). The subjective appraisal can be presented with different thought content and styles. Thought style is referred as the way thoughts about the stressor are presented, it has been classified as rumination (thoughts that are intrusive and repetitive that also increase psychological distress), cognitive engagement (thoughts associated with problem solving and meaning finding) or avoidance (aiming to stop thinking about stressor or feeling associated with it). Depending on the thought style presented at a stressor, could be the emotional response (anxiety, depression, distress, post-traumatic growth). The aim of the present study was to describe the thoughts (style, content, valence and temporality) related to cancer diagnosis in a group of ten oncologic patients. To identify if differences between thought style, valence and temporality were presented. The study design is qualitative from a phenomenological point of view. Ten oncologic (different cancer type, clinical stage and treatment) patients were asked to write the five more frequent thoughts since their cancer diagnosis. Each thought was classified by: thought style, valence, and temporality (top-down, classifying the thoughts according to theory). The same thoughts were also classified in semantic units (bottom-up, classifying the thoughts according to their own contents), generating concerns from the content. Cross tabs were made to identify contents and temporality for thought style and valence, which were analyzed by chi square to identify differences between thought style, temporality and valence. The most common thought style was cognitive engagement, followed by rumination (almost same frequency). On what respects to thought style and temporality, rumination was more focused on past (causes and attributions of cancer) and future (uncertainty about death and treatment effectiveness); meanwhile, cognitive engagement was focused on present (to enjoy present moment and focus on daily actions). Chi square was made to identify if this difference was significant, showing temporality was significantly different in cognitive engagement and rumination. The concerns identified in study participants were uncertainty about future and disease, family (communication and wellness of the family), finances (due to expensive treatments), causes and guilt about having cancer. Thoughts that were more centered in present, were more likely to be associated with cognitive engagement. Cognitive engagement has been described previously as an important variable associated with post traumatic growth. Thoughts centered in the past and present were more associated with rumination. Rumination has been associated with depression and post-traumatic stress disorder. Because of mediating role of thought style in disease adaptation, emotional response to the disease, and the relation of this adaptation with the perception of quality of life in cancer patients, the design of psychological interventions aiming on promoting cognitive engagement by problem solving skills, meaning finding, and focusing on present could be a research line derived from present studies results.

Apoyo y barreras sociales en el comportamiento alimentario de mujeres con obesidad / Support and social barriers received and given in the food behavior of obesity women

Resumen Una de las principales causas de la obesidad es la alimentación. La alimentación forma parte del medio social, y algunas de las variables sociales vinculadas con el bienestar y la salud son el apoyo y las barreras sociales. Por lo tanto, el objetivo del presente estudio fue analizar las diferencias en comportamiento alimentario, así como apoyo y barreras sociales recibidas y proporcionadas en mujeres con obesidad vs. normopeso en un contexto natural de alimentación. Participaron cinco mujeres con obesidad y cinco normopeso, quienes fueron videograbadas por cuatro días consecutivos durante el momento de la "comida" en su hogar. El alimento fue registrado y pesado; las conductas de alimentación, de apoyo y las barreras sociales fueron registradas a partir de catálogos de observación sistemática elaborados exprofeso. Los resultados mostraron que las mujeres con obesidad ingirieron más frecuentemente, y en mayor cantidad, bebidas endulzadas, antojitos mexicanos fritos y comida rápida. Además, fueron objeto de más barreras instrumentales que les impedían alimentarse saludablemente. En conclusión, es necesario abordar el medio social en el que la alimentación tiene lugar, ya que el tipo de interacciones sociales pueden jugar un papel importante en la alimentación.

Abstract One of the main causes of obesity is food. Food is part of the social environment and some of the social variables that have been linked to well-being and health are support and social barriers. Therefore, the aim was to analyze the differences on eating behavior, support and social barriers received and given between obesity women vs. normal weight women in the natural feeding context. Five women with obesity and five with normal weight participated, who were videotaped with their consent four consecutive days during the feeding time of the "food" in their home; food was recorded and weighed. We recorded eating behaviors, and behaviors of support and social barriers from a systematic observation catalog prepared exprofeso. The results showed that women with obesity ingested a greater frequency and quantity of sweetened beverages, fried Mexican snacks and fast food. In addition, they received a greater frequency of instrumental barriers to eat healthy. In conclusion, it is necessary to address the social environment in which food takes place, since the type of social interactions may be playing an important role in food.

Validación Psicométrica de la Adaptación Mexicana del Child Feeding Questionnaire / Psychometric Validation of the Mexican Adaptation of the Child Feeding Questionnaire

Resumen: El cuestionario de alimentación infantil (CFQ) desarrollado por Birch, Fisher, Grimm-Thomas, Markey, y Sawyer, (2001) es un instrumento ampliamente utilizado para evaluar las creencias, actitudes y prácticas alrededor de la alimentación infantil, sin embargo no se conocen sus propiedades psicométrias en población mexicana. El objetivo del presente estudio fue probar la confiabilidad y validez de constructo de la versión modificada del CFQ en población mexicana. Previo a la evaluación de las características psicométricas, la escala fue traducida al español, usando el método de traducción retraducción, a partir del cual se hicieron modificaciones a algunos ítems, para hacerlos culturalmente adecuados y se agregaron tres nuevos ítems. Participaron un total de 1157 mujeres con hijos de 5 a 12 años de edad. Se obtuvo una confiabilidad a través del coeficiente alpha de Cronbach de .858. Se confirmó la validez de constructo, a través del análisis factorial de componentes principales con rotación varimax, del cual se obtuvieron ocho factores que explican 59.99% de varianza. Se obtuvo un KMO de .785 y una Chi-cuadrada de 6400.172, p<.001. La presente versión muestra ser lingüística, culturalmente y psicométricamente apropiada para evaluar las prácticas, creencias y actitudes parentales hacia la alimentación infantil en madres mexicanas de niños de 5 a 11 años de edad.

Abstract: The Child Feeding Questionnaire developed by Birch, Fisher, Grimm-Thomas, Markey, & Sawyer, (2001) is a widely used mesurement to assess beliefs, actitudes and practices around child feeding. However, the psychometric characteristics of the CFQ for use with Mexican populations are unknown. The pupose of this stuydy was to test the reliability and validity of a modified version of the CFQ in mexican population. Prior to testing psychometric characteristics, the questionnaire was traslated into spanish usign a traslation-back-traslation method. Some adaptation were made, in order to make them culturally appropriate. Also three new items were added. The questionnaire was administered to 1157 mexican mothers of children aged 5-12 years. Constuct validity was assessed by principal componet factor analysis with varimax rotation, revealed the presence of eight major factors, which explain 59.99% of variance. Reliability was tested by Cronbach's alpha coefficient, and was aceptable for the eigth factors (a: .858). This modified eight factor CFQ appears to be a linguistically, and culturally appropriate instrument for assessing practices, attitudes and parental feeding beliefs in Mexican mother of 5 to12 years children.

La deseabilidad social revalorada: más que una distorsión, una necesidad de aprobación social / Social Desirability Reconsidered: More than Distortion, the Need for Social Approval

La deseabilidad social se ha conceptuado a través de los años principalmente como una tendencia a contestar un cuestionario de personalidad dando una imagen demasiado favorable de uno mismo. El estudio tuvo como objetivo evidenciar que la Deseabilidad Social es una medida sustantiva de personalidad que refleja una necesidad de aprobación social (NAS), más que un sesgo en las respuestas individuales. Para la realización del estudio colaboraron 1,235 participantes provenientes del D.F. Michoacán y Coahuila, de los cuales el 56% eran mujeres, con una media de edad de 28 años, de la población general. Se aplicaron 12 escalas psicológicas que con base en la literatura sugerían convergencia y divergencia tanto teórica como empírica respecto a las dos dimensiones identificadas como NAS-Positiva y NAS-Negativa, incluidas la exageración, honestidad, auto-estima y auto-monitoreo. Se identificó la red nomológica entre las variables de interés y las variables criterio. Tanto la NAS-Positiva y NAS-Negativa resultaron estar diferenciadas principalmente de la exageración y del automonitoreo. Finalmente se identificaron algunas variables asociadas a la NAS haciendo coincidente algunos hallazgos previos tales como que la agradabilidad, la regulación emocional, la orientación religiosa y el autocontrol son buenos predictores de ambos tipos de NAS.

Social desirability has been conceptualized through many years as a tendency to present oneself in a very fashionable picture. The aim of the present study is to demonstrate that social desirability is a substantive measure of a personality trait that reflects a need for social approval (NSA), rather than an individual response bias. A total sample of 1,235 participants of general population from the Federal District, Michoacan and Coahuila States was recruited, 56% were women, with a mean age of 28 years. Twelve scales were chosen from the extensive scientific literature of social desirability to prove convergence and divergence association to the current topic of need for social approval. Over-claiming, honesty, self-esteem, an self- monitoring scales were associated with the two dimension of Positive and Negative- NSA. The nomological network was identified between the variables of interest and the criterion variables. Both, positive and negative dimension of NSA clearly differentiate from Over-claiming and self-monitoring. Finally, agreeableness, emotional regulation, religious orientation and self-control are good predictors of both types of NSA.

Afecto positivo y negativo: ¿Una dimensión bipolar o dos dimensiones unipolares independientes? / Positive and negative affect: One bipolar dimension or two independent unipolar dimensions?

Desde los trabajos pioneros de Bradburn (1969) el afecto positivo y el afecto negativo han sido concebidos como dos dimensiones unipolares independientes, aunque todavía se mantiene hoy en día la controversia teórica entre defensores de un modelo unidimensional bipolar y los de un modelo bidimensional unipolar. El objetivo de este artículo es revisar la problemática que rodea esta controversia tomando en consideración por un lado, los dos estados afectivos (el humor o tono afectivo y las emociones) y por otro lado, revisando los estudios y modelos teóricos provenientes de distintas áreas tales como Psicometría, Psicología Básica, neurociencia, Psicología Clínica y Psicología de la Salud. Finalmente, se ofrece una posible explicación a los datos contradictorios obtenidos en los distintos estudios. Se sugiere la conveniencia de hacer estudios claramente diferenciados sobre el humor y las emociones. Sobre el humor existen pocos trabajos, pero éstos ofrecen mayor apoyo a un modelo unidimensional bipolar. Sin embargo, sobre las emociones hay mayor cantidad de estudios que ofrecen mayor apoyo a un modelo bidimensional unipolar.

Since the seminal contribution of Bradburn (1969), positive and negative affect have been conceived as two independent unipolar dimensions. However, the controversy between these ideas and the supporters of a single bipolar dimension is nowadays still alive. In this review we identify two problems. The first one is of a conceptual nature, because, as Russell and Carroll (1999) pointed out, the term affection is not unambiguously defined and rarely researchers in this field make an explicit definition. According to Rosenberg (1988), there are at least two types of affective states, which are widely acknowledged: emotions and mood, or affective tone. Emotions are characterized for, and differ from mood in, appearing in response to an event, being intense, short-lived and specific. They are also characterized by provoking important physiological reactions in the individuals, as well as recognizable patterns of facial expression, and by determining individuals to behave congruently in relation to the emotion they are experiencing. Combining these two very different components of affect hinders the comparison of the work of different authors, and also the development of theoretical models combining the different aspects included within this concept. The second problem is related to the measurements used in the research assessing affect, where the possible existence of events or circumstances causing the affective state is not normally considered. Likewise, measurement regarding the duration of the affect are rarely performed, and objective measurements such as physiological correlates or facial expressions are not frequently collected. Consequently, instruments do not normally distinguish between mood and emotion. The aim of this paper is to review the most relevant questions regarding this debate taking into account, on the one hand, the two affective states included in the concept of affectivity (i.e., mood and emotion) and, on the other hand, the empirical and theoretical contributions provided by a wide range of disciplines such as Psychometry, Basic Psychology, neuroscience, and Clinical and Health Psychology. From Basic Psychology and Psychometry we reviewed the three fundamental argumentations advocating for an independence of positive and negative affect, as identified by Diener and Emmons (1984) and Russell and Carroll (1999): (1) that the correlation between items that evaluate the positive affect and negative affect is low, (2) that the correlation of items within the categories of positive affect and negative affect is high, and (3) that the two dimensions of affect correlate differently with other variables. A fourth argument is discussed referring to the variations of both affect types observed throughout a lifetime (Bushman & Crowley, 2010; Windsor & Anstey, 2010). From the neuro-scientific perspective we reviewed studies providing data on brain structures and neurotransmitters involved in both affect types, noting that all these studies have been carried out by inducing intense moods, which indeed might be classified as emotions rather than humor. From Psychopathology and Clinical Psychology we reviewed those disorders in which states of positive and negative mood can be experienced in a very intensive manner (positive and negative emotions), in very short periods of time and even at the same time. We also reviewed research studying the independent presence of positive and negative affect in several disorders, as well as some theoretical models on depression that indicate the possibility and desirability of adopting a 'dual' perspective in the assessment and the intervention strategies of both types of emotions in the depressive disorder and other disorders. A proposal about the reason of such contradictory findings is presented, and we suggest that research about this topic should be better conducted setting apart mood from emotions using tools that allow measuring those elements capable of distinguishing between affect types. Although the few existing studies about affective traits and mood seem to support the bipolar one-dimensional model, the conclusions drawn from the numerous investigations about emotions favor the two independent unipolar dimensions model.