Influencia del tiempo psicológico y el autocontrol en el malestar psicológico en adultos argentinos / Influence of psychological time and self-control on psychological distress in Argentinian adults

Resumen El objetivo de este estudio fue conocer si la temporalidad subjetiva -perspectiva y foco temporales- y la capacidad de autocontrol e impulsividad repercuten en el malestar psicológico, en particular durante la pandemia por COVID-19. La conjetura teórica es que el tiempo psicológico está estrechamente vinculado a la autorregulación, que influye en el desarrollo de la impulsividad y el autocontrol e impacta en el malestar psicológico. Se diseñó un modelo y se realizó un estudio empírico cuantitativo, no experimental y transversal (. = 279; 78 % mujeres; ME = 30.14 años; DE = 11.21). Los resultados del análisis de correlación mostraron relaciones significativas entre las variables de interés. Para determinar las variables predictoras del malestar psicológico se realizó un análisis de regresión lineal múltiple. El 48 % de la varianza del malestar psicológico fue explicado por el pasado negativo, autocontrol e impulsividad, y focos temporales futuro y presente. Finalmente, se probó el modelo teórico diseñado para analizar los efectos directos e indirectos del malestar psicológico a través de un análisis de senderos que presentó un buen ajuste a los datos, ya que explicó el 50 % de la varianza de aquel. La perspectiva y el foco temporal explicaron el 53 % de la variabilidad del autocontrol, y presentaron efectos indirectos sobre el malestar psicológico a través del autocontrol. El autocontrol influyó de manera inversa en el malestar. Los hallazgos indican que el tiempo subjetivo y el autocontrol sirven para explicar estados psicológicos, incluso en pandemia, lo cual confirma estudios previos que muestran la importancia de las variables de personalidad -además de las biológicas y contextuales- en la aparición de malestar psicológico.

Abstract Psychological time is an essential aspect of humans. Two of the most important notions of subjective temporality are time perspective and temporal focus. Time perspective is a process by which the flow of personal and social experiences are framed in five different temporal categories: past negative, past positive, present hedonistic, present fatalistic and future. Temporal focus refers to the attention people devote to thinking about the past, present, and future. Previous research shows there is a strong relation between psychological time and self-regulatory processes, specifically self-control and impulsivity. Self-control is the ability to inhibit impulsive behaviors or reactions that can keep the person from pursuing the proposed goals. On the other hand, impulsivity refers to a short attention span and a tendency to engage in risky behaviors, and to prefer immediate rewards. Both subjective temporality and self-regulatory processes influence behaviors and psychological states such as psychological distress. In particular, the objective of this study was to find out if subjective temporality -time perspective and temporal focus-- and self-control and impulsivity have repercussions on psychological distress, particularly during the COVID-19 pandemic, in an Argentinian sample. The theoretical conjecture is that subjective temporality is closely linked to self-regulation, which influences the development of impulsivity and self-control, and impacts psychological distress. A quantitative, non-experimental, and cross-sectional empirical study was carried out (. = 279; 78 % women; ME = 30.14 years old; SD = 11.21). Firstly, the results of the correlational analysis showed significant relations between the variables. Then, to facilitate further analyses, an index variable of self-control was created, which included the scores of self-control and three dimensions of impulsivity. An optimal parallel analysis was performed. It indicated the existence of a single dimension. Then a semi-confirmatory factor analysis was ran, which showed acceptable results (KMO = .68; X. (6) = 198.8, . < .001; GFI = .99; RMSR = 0.03). Thirdly, to determine the predictive variables of psychological distress, a multiple linear regression analysis was performed. It was found that 48 % of the variance of psychological distress was explained by negative past, self-control index, and future and present temporal focuses (. (4, 266) = 64.66, . < .001, R. = .49, R. adjusted = .48). The best predictor variable was past negative. Afterwards, a theoretical model was tested to explain the direct and indirect causes of psychological distress. It presented a good fit (X./gl = 1.63; GFI = .99; RMSEA = .04). Time perspective and temporal focus explained 53 % of the variability of self-control and presented indirect effects on psychological distress through self-control. Self-control inversely influenced psychological distress; more self-control generates less psychological distress. The model explained half of the variance of psychological distress (R. = .50). The findings indicate that subjective temporality and self-control explain psychological states, even during a pandemic, which confirms previous studies that show the importance of personality variables -in addition to biological and contextual variables- in the manifestation of psychological distress. The results support the theory that psychological time can be considered as a personality trait underlying self-control and psychological distress. A theoretical and practical discussion of the results is presented.

Uso pasivo de redes sociales y malestar psicológico. El rol de la comparación social / Passive use of social media sites and psychological distress. The role of social comparison

Resumen La presente investigación se focalizó en los diferentes tipos de uso (activo/pasivo) que hacen los usuarios de redes sociales y los efectos psicológicos que esto puede conllevar, sobre todo en aquellos sujetos tendientes a compararse con los demás. Por un lado, se examinó el poder predictor de variables relacionadas al uso de redes sociales (i. e., tiempo de conexión, tipo de uso -pasivo/activo-, motivaciones de uso) y la comparación social, sobre el malestar psicológico percibido (i. e., depresión, ansiedad, estrés). Por otro lado, se analizó el rol mediador de la comparación social en la relación entre el uso pasivo de redes sociales y la percepción de malestar psicológico percibido. La muestra fue de conveniencia y estuvo compuesta por 420 sujetos de población general (211 hombres, 209 mujeres), con una media de edad de 40.29 años (DE = 14.93). Se utilizaron los siguientes instrumentos de recolección de datos: Motives for SMSs use Scale; Iowa-Netherlands Comparison Orientation Measure (INCOM-E), Depression, Anxiety and Stress Scale (DASS-21) y una escala diseñada ad-hoc para evaluar el uso activo y pasivo que se hace de redes sociales. Los resultados obtenidos mostraron que la comparación social es el principal predictor de malestar psicológico junto con el motivo de uso relacionado con pasatiempo/exhibicionismo. Además, se pudo comprobar un efecto indirecto del uso pasivo sobre el malestar psicológico considerando a la comparación social como variable mediadora. Por lo tanto, usar pasivamente las redes generaría mayor malestar si el usuario tiende a compararse con quienes realizan las publicaciones.

Abstract The present investigation is framed in the field of cyberpsychology. It aimed to analyze the predictive power of variables related to the use of social media sites -SMSs- (i. e., connection time, type of use -passive / active-, motivations for use) and social comparison, on perceived psychological distress (i. e., depression, anxiety, stress). Furthermore, the mediating role of social comparison in the relationship between the passive use of SMSs and the perceived psychological distress, was also analyzed. It is important to study these topics since different international studies have shown inconsistent and contradictory results regarding the effects of SMSs use on individuals' well-being (e. g., Frison y Eggermont, 2015; Kraut et al., 2002; Nie et al., 2015). Consequently, some studies have focused on understanding whether the manner in which people use the networks, whether actively or passively, explains how technology impacts on users' well-being and/or psychological distress (Verduyn et al., 2015). The negative impact of passive use of SMSs can be explained by the Social Comparison Theory (Festinger, 1954), which suggests that people tend to evaluate themselves in comparison with others. These comparisons might generate negative effects on the individual (Giagkou et al., 2018) and, according to Lup et al. (2015), social comparison may be a mediating variable in this association. Regarding participants of the study, a convenience sample of 420 subjects of general population was studied (211 men, 209 women). The mean age was 40.29 years old (SD = 14.93). The majority of the participants (n = 278) lived in Buenos Aires City and surroundings. In terms of variables related to the use of SMSs, when asked about type of SMSs, most participants reported using more than one SMS, mainly Facebook (72 %) and Instagram (57 %). Regarding time spent on SMSs, 60 % of the respondents used their favorite SMS more than three times a day. The mean daily time engaged on all the SMSs exceeded five hours. Data were gathered using the Motives for SMSs use Scale (Lupano Perugini y Castro Solano, 2021a), the Iowa-Netherlands Comparison Orientation Measure (INCOM-E) (Buunk et al., 2005; Gibbons y Buunk, 1999), the Depression, Anxiety and Stress Scale (DASS-21) (Antúnez y Vinet, 2012; Lovibond y Lovibond, 1995). Furthermore, a survey to assess individuals' use of social networks was designed. The first part explored the most frequently used SMSs, the number and type of friends/followers, and the time spent on SMSs. The main SMSs were listed and participants were asked to indicate whether they used them or not, and if they did, they rated the amount of time spent on SMSs daily. The total amount of time per day was also surveyed. The second part of the survey was designed based on The Passive Active Use Measure (PAUM, Gerson et al., 2017) and some users' suggestions. This instrument assesses the frequency of certain activities performed on the networks to find out if participants make active use (e. g., posting information, commenting) or passive use (e. g., viewing profiles and posts, scrolling). The obtained results showed that social comparison is the main predictor of psychological distress. The motivation for use related to pass time / exhibitionism was also a significant predictor. In addition, an indirect effect of passive use on perceived psychological distress could be verified, considering social comparison as a mediating variable. Therefore, using the social networks passively would generate greater discomfort if the user tends to compare themselves with those who make the publications. The results of this study allow both users and healthcare and education providers to have greater knowledge of the consequences of using social media on individuals' overall well-being, and to promote their proper use.

Perception of danger, coping strategies, and mental health in university population / Percepción de peligro, estrategias de afrontamiento y salud mental en población universitaria

Objective: This study aimed to relate life satisfaction and psychological distress to coping with the perception of criminal danger in university students. Method: Three scales were used: The Life Satisfaction Scale, the K-10 Psychological Distress Scale, and the Coping with Perceived Danger Scale. A total of 370 university students participated, of whom 65.4% were female, and 13.8% had experienced crime in the previous two years. Result: A positive and statistically significant relationship was found between coping with perceived danger, such as cautious avoidance (r=0.274, p ≤ 0.00), preventive coping (r=0.344, p ≤ 0.00), and extreme avoidance (r=0.207, p ≤ 0.00), with psychological distress. These relationships were even stronger for victims of crime. Women show higher levels of psychological distress and more cautious, avoidant and extreme coping strategies in the face of danger compared to men. Finally, a negative and significant relationship was observed between psychological distress and life satisfaction. Conclusion: It appears that regardless of whether a person has been a victim of crime in the last two years, perceptions of danger and strategies of cautious and even extreme crime prevention are related.

Objetivo: El objetivo de este estudio fue relacionar la satisfacción con la vida y el malestar psicológico con el afrontamiento frente a la percepción de peligro delictual en universitarios. Método: Se utilizaron tres escalas, la escala de satisfacción con la vida, la escala de malestar psicológico k-10, y la escala de afrontamiento frente a la percepción de peligro. Participaron 370 estudiantes universitarios, de los cuales un 65,4% son mujeres y un 13,8% han sufrido un delito en los últimos 2 años. Resultados: Se encontró una relación positiva, con un tamaño del efecto pequeño entre el afrontamiento frente la percepción de peligro, como evitación prudente (r=0,274, (p ≤ 0,00), afrontamiento preventivo (r=0,344, p ≤ 0,00) y evitación extrema (r=0,207, p ≤ 0,00) con malestar psicológico. En víctimas de delitos, estas relaciones se hacen más fuertes. Las mujeres muestran un mayor malestar psicológico, así como también estrategias de afrontamiento frente al peligro más prudentes, preventivas y extremas que los hombres. Por último, se observa una relación negativa y significativa entre malestar psicológico y satisfacción con la vida. Conclusión: Se videncia que independiente de que, si la persona es víctima de un delito en los últimos dos años, la percepción de peligro y las estrategias llevadas a cabo para prevenir el delito de forma prudente e incluso extrema, se relacionan entre sí.

Factores asociados a malestar psicológico durante la pandemia de COVID-19 en personal de salud de un hospital público de Ecuador / Related factors to psychological distress during the COVID-19 pandemic in the health staff of a public hospital in Ecuador

Fundamento: La pandemia por el coronavirus SARS-CoV-2, genera afectaciones en las esferas social, económica y sanitaria de un país, y de manera particular, consecuencias psicológicas negativas en el personal sanitario de hospitales públicos, considerados como la primera línea de atención a pacientes con esta enfermedad. Objetivo: Describir factores asociados a la presencia de malestar psicológico en el personal sanitario de un hospital general público en Ecuador, durante la pandemia de COVID-19. Metodología: Estudio no experimental, de corte transversal, con alcance descriptivo-correlacional. Los datos correspondieron a 276 funcionarios de la salud que respondieron un instrumento online, con un módulo de datos sociodemográficos y una escala de tamizaje de malestar psicológico, estos se aplicaron después de una intervención en salud dirigida al personal de salud realizada al inicio de la pandemia, en mayo del año 2020. Se realizaron análisis descriptivos y de asociación, mediante el software SPSS 25.0. Resultados: La muestra estuvo compuesta por 76.1 % de mujeres, 23.9 % de hombres, con una media de edad de 36 años, en mayor cantidad con profesionales de Enfermería (33.7 %), seguido de Medicina (24.3 %). El 70.7 % del personal de salud presentó malestar psicológico, de estos, el 26.1 % con indicativo de trastorno mental. Se encontraron tres variables asociadas a la presencia de malestar psicológico: clima laboral, teletrabajo y convivir con grupos de riesgo. Conclusiones: El personal de Salud ha presentado afectación en su salud mental asociado a las condiciones sociolaborales durante la pandemia.

Background: The SARS-CoV-2 coronavirus pandemic affects the social, economic and health spheres of a country, especially negative psychological consequences to the health staff of public hospitals, considered as the first line of care for patients with this disease. Objective: To describe factors related to the presence of psychological distress in the health personnel of a public general hospital in Ecuador, during the COVID-19 pandemic. Methodology: Non-experimental, cross-sectional study with a descriptive-correlational scope. The data corresponded to 276 health officials who answered to an online instrument, with a sociodemographic data module and a psychological distress screening scale, these were applied after a health intervention aimed at health personnel conducted at the beginning of the pandemic, in May 2020. Descriptive and association analyzes were performed using SPSS 25.0 software. Results: The sample was made up of 76.1 % women, 23.9 % men, mean age of 36 years, with a greater number of Nursing professionals (33.7 %), followed by Medicine (24.3 %). 70.7 % of the health personnel presented psychological distress, out of these, 26.1 % showed mental disorder. Three variables related to the presence of psychological distress were found: work environment, teleworking and living with risk groups. Conclusions: Health staff has presented mental health distress related to socio-labor conditions during the pandemic.

Respuestas psicológicas a la cuarentena por pandemia de COVID-19 en población colombiana / Psychological responses to the COVID-19 pandemic quarantine in Colombian population

Resumen Introducción: el presente estudio analiza el estrés percibido, las estrategias de afrontamiento, su regulación emocional, impacto y malestar psicológico, durante la cuarentena por la pandemia de COVID-19 en la población colombiana. Método: muestra no probabilística de 356 adultos que respondieron un cuestionario en línea. Resultados: se encontraron puntuaciones medias y altas en estrategias de afrontamiento y regulación emocional activas y puntuaciones bajas en estrés, malestar psicológico e impacto de la cuarentena. El 38.76 % presentó puntuaciones que indican riesgo de trastorno por estrés postraumático. Las mujeres, los menores de 35 años, los bachilleres, los estudiantes y las personas que viven solas presentan mayores afectaciones. Se encontraron relaciones estadísticamente significativas de estrés con todas las variables, excepto con apoyo social y convivientes durante la cuarentena. Por último, se encontró asociación positiva del estrés con desahogo, supresión expresiva, impacto de la cuarentena y malestar psicológico; y asociación negativa con planificación, aceptación, revaluación cognitiva y edad mayor de 25 años. Conclusiones: los resultados contribuyen a comprender las respuestas ante la cuarentena e identificar factores de vulnerabilidad para diseñar programas de prevención e intervención.

Abstract Introduction: The aim of this study was to analyze the perceived stress, coping strategies, emotional regulation, impact of the event, and psychological distress during quarantine due to COVID-19 pandemic in the Colombian population. Method: Non-probabilistic sample made up of 356 adults who answered an online questionnaire. Results: It was found medium and high scores in active coping strategies and emotional regulation, and low scores in stress, psychological distress and impact of quarantine. The 38.76 % presented scores that indicate risk of post-traumatic stress disorder. Women, people under 35 years of age, high school graduates, students, and living alone during the quarantine showed higher affectation. Statistically significant correlations of stress with all variables except with social support and cohabitants during quarantine were found. Finally, it was found a positive association of stress with venting, expressive suppression, the impact of quarantine, and psychological distress, and negative association with planning, acceptance, cognitive reappraisal, and age over 25 years. Conclusions: These results contribute to understanding responses to quarantine and to identify vulnerability factors to design prevention and intervention programs.

Estilos de cuidados y la implicación como protector psicológico del cuidador de personas con Parkinson en España / Care styles and involvement as a psychological protective of the caregiver of people with Parkinson's disease in Spain

Resumen Los familiares de personas con enfermedad de Parkinson (EP) se enfrentan a una variedad de situaciones estresantes como consecuencia del desempeño de su rol de cuidadores. Esto puede tener un impacto negativo en su calidad de vida. Un mayor conocimiento de la relación entre las variables evaluadas en los cuidadores puede ser importante de cara a implementar programas de intervención eficaces. El objetivo fue explorar la personalidad y las estrategias de afrontamiento en familiares cuidadores de personas con EP, estudiando su relación con el malestar psicológico y el grado de implicación en los cuidados. Se trabajó con una muestra de 106 cuidadores que completaron los cuestionarios de personalidad NEO-FFI, estrategias de afrontamiento COPE-28, malestar psicológico CORE-OM y un instrumento para evaluar la implicación del cuidador realizado a partir del índice Katz. El análisis de regresión logística mostró que las personas con puntuaciones por encima de la media en neuroticismo y por debajo en el resto de factores de personalidad y estrategias de afrontamiento tenían más riesgo de padecer malestar psicológico (OR = 9.250; p < .001) y una menor implicación en los cuidados (OR = 4.125; p < .001). Estos resultados sugieren que la personalidad y las estrategias de afrontamiento pueden contribuir a identificar estilos para los cuidados más eficientes, que impliquen una mayor participación en los cuidados con un menor impacto negativo.

Abstract Carers of people with Parkinson's disease (PD) experience stressful situations as a result of performing their role as caregivers. This can have a negative outcome on their quality of life. A greater understanding of the relationship between the variables assessed in caregivers can be important in implementing effective intervention programs. The aim of this study was to explore the personality and coping strategies used by family caregivers of people with PD, analyzing their relationship with psychological distress and the carer involvement. A cross-sectional study based on a sample of 106 caregivers of people with Parkinson's disease tested the hypothesis that personality and coping strategies can contribute to identifying differences in carer involvement and psychological distress. Caregiver psychological distress was assessed using the CORE-OM questionnaire. The CORE-OM is able to distinguish the population within the clinical and non-clinical range. NEO Five-Factor Inventory (NEO-FFI) was used to assess personality. Coping strategies were evaluated with the COPE-28 inventory. An operational measure of the carer involvement was also used. For this purpose, an adaptation of the Katz index assessing basic functional capacity was made. Results: First, all cases were clustered according to personality variables and coping strategies. A K-means cluster analysis was performed and two groups were requested. After this, binary logistic regression analysis was used to test the research hypothesis. The resulting clusters in the above analysis were selected as predictors. Two analyses were performed. In the first, the dependent variable in logistic regression analysis was the psychological distress of the caregivers (dichotomized variable: clinical and non-clinical). Results showed that people clustered within cluster 1 had a 9.250 times higher risk of psychological distress than those included in cluster 2 (OR = 9.250; p < .001). In a second logistic regression analysis, the dependent variable was participation in care (dichotomized variable: low - high carer involvement). The group of people belonging to cluster 1 showed a carer involvement 4.125 times lower than the people grouped in cluster 2 (OR = 4.125; p < .001). The results of this research suggest the existence of a relationship between psychological variables and carer involvement, showing two different styles of care, which are described based on the personality and coping strategies of the family caregivers. In addition, we found that these styles of care show clear differences in efficiency, reflected in greater carer involvement and a lower psychological distress. The results reported that the cluster of people with below-average scores on neuroticism and above-average scores on the other personality factors (extraversion, openness to experience, agreeableness, and conscientiousness) and coping strategies (planning; active coping; emotional support; social support; positive re-evaluation and acceptance) were associated with increased carer involvement and reduced risk of psychological distress. It has already been suggested that high scores in neuroticism may affect the need to take on a large number of care-related tasks or manage stressful situations in people with PD (Tew et al., 2013). However, our results indicate that the definition of different types of caregivers, where other care-related variables are also included, can help define more efficient styles of care. This is associated with increased carer involvement and minor psychological distress. We propose that in the future these variables be investigated in order to know the outcome of carer involvement and psychological distress, contributing to the description of more efficient care styles in family caregivers.

Cumplimiento y satisfacción con el aislamiento durante la pandemia de COVID-19 en Argentina y exploración de su impacto psicológico / Compliance and satisfaction with lockdown during the COVID-19 pandemic in Argentina and exploration of its psychological impact ISSN 2718-7845. Actualizaciones en sida e infectología. Buenos Aires. julio 2021. volumen 29. número 106: 72-84 Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0Internacionalhttps://creativecommons.org/licenses/by-nc/4.0/i

Como respuesta a la propagación de la pandemia de COVID-19, Argentina implementó el aislamiento social, preventivo y obligatorio (ASPO). Este estudio analizó factores asociados con el cumplimiento y la satisfacción con el ASPO a 30 días de su implementación en Argentina e indagó en las respuestas emocionales autoinformadas a esta medida. Una encuesta en línea, diseñada ad hoc, fue respondida por 2965 participantes de los 24 distritos del país entre el 18 y el 21 de abril de 2020. El 68,4% (n = 2021) eran de género femenino y el 31,6% (n = 935) masculino. La media de edad fue 43,49 años (DE = 14,97). Se realizaron pruebas de chi-cuadrado y análisis de regresión logística para explorar asociaciones entre diferentes variables y los niveles de cumplimiento y satisfacción. Las respuestas emocionales se analizaron cualitativamente. Pertenecer a un grupo en riesgo para COVID-19, haber experimentado una reducción en los ingresos del hogar y una mayor satisfacción con el ASPO se asociaron con mayores probabilidades de cumplimiento total. La menor satisfacción se asoció con ser de género masculino, pertenecer a un grupo en riesgo para COVID-19, priorizar la economía tanto como (o más que) la salud, y haber experimentado una reducción en los ingresos del hogar. Las respuestas emocionales reportadas con mayor frecuencia estuvieron relacionadas con la ansiedad y el afecto negativo o deprimido, aunque también se mencionaron estrategias de afrontamiento y emociones positivas. Estos resultados contribuyen a generar recomendaciones para mejorar la efectividad en la implementación de estas medidas para el control de la pandemia de COVID-19

In response to the spread of the COVID-19 pandemic, Argentina implemented social, preventive, and mandatory lockdown (SPML). This study analyzed factors associated with compliance and satisfaction with the SPML 30 days after its implementation in Argentina and self-reported emotional responses to this measure. An online survey, designed ad hoc, was answered by 2,965 participants from the 24 districts of the country between April 18 and 21, 2020. From them, 68.4% (n = 2021) were female and 31.6% (n = 935) were male. The mean age was 43.49 years (SD = 14.97). Chi-square tests and logistic regression analysis were performed to explore associations between different variables and levels of compliance and satisfaction. Emotional responses were qualitatively analyzed. Belonging to a group at risk for COVID-19, having experienced a reduction in household income, and greater satisfaction with the SPML were associated with higher odds of total compliance. Lower satisfaction was associated with being male, belonging to a group at risk for COVID-19, prioritizing economy as much as (or more than) health, and having experienced a reduction in household income. The most frequently reported emotional responses were related to anxiety and negative or depressed affect, although coping strategies and positive emotions were also mentioned. These results contribute to generating recommendations to improve the effectiveness of the implementation of these measures for the control of the COVID-19 pandemic.

Preditores de sofrimento psicológico e prevalência de transtornos mentais autodeclarados em profissionais de saúde e na população em geral durante a pandemia de Covid-19 no Brasil / Predictors of psychological distress and prevalence of self-reported mental disorders in health care professionals and in the general population during the Covid-19 pandemic in Brazil

O fardo dos transtornos mentais pode aumentar durante a pandemia de Covid-19. Por isso, é estratégico caracterizar a saúde mental da população. Analisamos dados coletados pela Internet de 164.881 profissionais de saúde e 5.635 participantes da população geral. O Índice de Gravidade Global (GSI) do Inventário Breve de Sintomas, diagnóstico autodeclarado de transtornos mentais, características sociodemográficas, estado de saúde física, história de contato com a Covid-19, percepções e preocupações e medidas preventivas adotadas foram comparados entre as amostras. Análises de regressão múltipla foram usadas para investigação de fatores associados ao GSI. O distresse psicológico foi classificado como alto ou muito alto em 13,4% dos profissionais de saúde e em 31,4% dos participantes da população geral. A prevalência de transtornos mentais ao longo da vida foi 36% para profissionais de saúde e 44,7% para a população geral, sendo os mais frequentes transtornos depressivos e ansiedade generalizada. Entre os profissionais de saúde, ser do sexo feminino e mais jovem foi associado à maior distresse psicológico. Para a população geral foram preditores de distresse a classe econômica e um domicílio com mais pessoas. Foram significativamente associados ao GSI sintomas de Covid-19, sentir-se menos produtivo no trabalho, medo de transmitir o vírus para a família, medo de dificuldades financeiras e sentir que os relacionamentos em casa pioraram. A prevalência de transtornos mentais atinge parte relevante da população brasileira. Fatores sociodemográficos, aspectos familiares e instabilidade financeira devem ser considerados no entendimento do distresse psicológico durante a pandemia.(AU)

BACKGROUND: The burden of mental disorders is likely to increase during the Covid-19 pandemic. Knowing the rate of psychological distress and mental disorders, its severity, and factors associated with psychological distress is strategical. METHOD: We analyzed online cross-sectional data from 164,881 health professionals and from 5,635 participants from the general population in Brazil. The Global Severity Index (GSI) from the Brief Symptom Inventory, self-reported diagnosis of mental disorders, sociodemographic characteristics, and factors related to Covid-19, such as physical health status, diagnosis and contact history, perceptions and concerns, and precautionary measures were compared between samples. Multiple regression analysis was used to investigate factors related to GSI scores. RESULTS: Psychological distress was high or very high in 13.4% of health professionals and in 31.4% of the general population. Health professionals reported a lower rate of current or previous history of mental disorders (36%) than participants from the general population (44.7%). Age (younger) and gender (female) predicted higher psychological distress for health professionals and economic class (lower) and household size (more members) for the general population. People with higher GSI scores reported to have experienced more physical symptoms associated with Covid-19, feeling less productive at work, being afraid of transmitting the coronavirus to the family, fear of financial difficulties, and feeling that home relations were worse during the pandemic outbreak. CONCLUSIONS: Psychological distress at the first wave of Covid-19 was associated with sociodemographic features and an anxious perception of physical symptoms, virus transmission to loved ones, disruption of family relations, and financial situation.(AU)

INTRODUCCIÓN: Es probable que la carga de los trastornos mentales aumente durante la pandemia de Covid-19. Conocer la tasa de malestar psicológico y de los trastornos mentales, su gravedad y los factores asociados al malestar psicológico es estratégico. MÉTODO: Se analizaron datos transversales en línea de 164.881 profesionales de la salud y 5.635 participantes de la población general de Brasil. Se compararon entre las muestras el Índice de Gravedad Global (GSI) del Inventario Breve de Síntomas, el diagnóstico auto declarado de trastornos mentales, las características sociodemográficas y los factores relacionados con la Covid-19. Se utilizó un análisis de regresión múltiple para investigar los factores relacionados con las puntuaciones del GSI. RESULTADOS: El malestar psicológico era alto o muy alto en 13,4% de los profesionales de la salud y en 31,4% de la población general. Los profesionales de la salud declararon tasa de 36% de trastornos mentales y la población general de 44,7%. La edad (más joven) y el sexo (femenino) predijeron un mayor malestar psicológico para los profesionales de la salud y la clase económica (más baja) y el tamaño de la familia (más miembros) para la población general. Las personas con puntuaciones más altas en el GSI declararon haber experimentado más síntomas físicos asociados a la Covid-19, sentirse menos productivos en el trabajo, tener miedo de transmitir el coronavirus a la familia, temer dificultades económicas y sentir que las relaciones domésticas empeoraron. CONCLUSIONES: La angustia psicológica se asoció a las características sociodemográficas y a la percepción ansiosa de los síntomas físicos, la transmisión del virus a los seres queridos, la perturbación de las relaciones familiares y la situación económica.(AU)

Predictores de conductas alimentarias de riesgo en estudiantes de bachillerato / Predictors of risk eating behaviors in high school students

Resumen El objetivo principal de este estudio fue identificar variables sociodemográficas y psicosociales capaces de predecir las conductas alimentarias de riesgo (CAR) en estudiantes de bachillerato. Participaron 988 adolescentes (541 mujeres y 447 hombres) de entre 14 y 18 años de edad (M = 16.79, DE = 1.50). Además de las CAR (Atracón-purga, Medidas compensatorias y Restricción), examinadas a través del Cuestionario Breve de Conductas Alimentarias de Riesgo, fueron evaluadas las variables psicosociales siguientes: apoyo familiar y de amigos, ajuste escolar, victimización, ideación suicida, estrés académico, insatisfacción corporal y depresión; finalmente, las variables sociodemográficas incluidas fueron: sexo, edad, horas de sueño al día y horas dedicadas al Internet o las redes sociales. Mediante tres análisis de regresión lineal múltiple, uno para cada CAR (R2 = .36, .16 y .55, respectivamente; todas con p < .001), se pudieron identificar distintas variables predictivas, entre las que destacaron la insatisfacción corporal, la depresión y el sexo (mujeres). La identificación de estas variables puede contribuir a la mejora de las estrategias de prevención en materia de CAR y, por ende, de los trastornos alimentarios entre adolescentes.

Abstract The main objective of this study was to identify sociodemographic and psychosocial variables capable of predicting risk eating behaviors (REB) in high school students. Participants were 988 adolescents (541 women and 447 men) between 14 and 18 years of age (M = 16.79, SD = 1.50). In addition to the REB (Binge-purge, Compensatory behavior and Restriction), examined through the Brief Questionnaire on Risk Food Behaviors, the following psychosocial variables were also evaluated: family and friend support, school adjustment, victimization, suicidal ideation, academic stress, body dissatisfaction and depression; finally, the sociodemographic variables included were: sex, age, hours of sleep per day and hours dedicated to the Internet or social networks. Through three multiple linear regression analyzes, one for each REB (R2 = .36, .16 and .55, respectively; all with p < .001), different predictive variables could be identified, among which stood out the body dissatisfaction, the depression and sex (women). The identification of these variables can contribute to the improvement of prevention strategies in terms of REB and eating disorders among adolescents.

Factores predictores de la violencia relacional en la adolescencia / Predictive factors of relational violence in adolescence

El objetivo del presente trabajo fue examinar la violencia relacional entre iguales desde una perspectiva psicosocial, analizando variables familiares (funcionamiento y comunicación familiar), sociales (reputación social - percibida e ideal - y actitud hacia la autoridad institucional) e individuales (malestar psicológico e ideación suicida) en adolescentes escolarizados. La muestra fue de 8115 adolescentes, con edades comprendidas entre los 11 y los 16 años, del estado de Nuevo León, México. Se realizó un análisis de regresión lineal múltiple, paso a paso, cuyos resultados mostraron que la dimensión más importante en la predicción de la conducta violenta relacional es la autopercepción no conformista, seguido del malestar psicológico. Finalmente, se discuten estos resultados y sus implicaciones.

The aim of this research was to study relational violence between peers from a psychosocial perspective, by analyzing family variables (family functioning and communication), social variables (social reputation ­both perceived and ideal­ and attitude towards institutional authority), and individual variables (psychological distress and suicide ideation) in adolescent students. The sample consisted of 8,115 adolescents aged 11 to 16 years from the State of Nuevo León, Mexico. We performed a forward stepwise multiple regression analysis, the results of which showed that the most important factor in the prediction of violent relational behavior at school is the nonconformist self-perception, followed by psychological distress. Finally, these results and their implications are discussed.

O sofrimento psíquico das mães adolescentes acolhidas institucionalmente / The psychic suffering of institutionally sheltered adolescent mothers / La détresse psychologique des mères adolescentes internées dans des institutions / El sufrimiento psíquico de las madres adolescentes acogidas institucionalmente

O objetivo deste estudo foi compreender as experiências emocionais de violência intrafamiliar vivida por mães adolescentes acolhidas institucionalmente. Trata-se de estudos de caso sobre três mães adolescentes institucionalizadas. Observou-se o sofrimento psíquico das adolescentes por meio de diversas situações: gravidez, brigas, fugas de casa, abandono do filho. Considera-se que a violência intrafamiliar afetou o processo de amadurecimento emocional das adolescentes.

The aim of this study was to understand the emotional experiences of intra-family violence experienced by sheltered adolescent mothers. This paper presents three case studies on sheltered adolescent mothers. The psychological suffering of the adolescent girls was observed through their accounts of several situations: pregnancy, fights, runaway episodes, and abandonment of their child. This study suggests that intra-family violence affected the adolescents' emotional maturation process.

Le but de cette recherche était de comprendre les expériences sentimentales de violence familiale vécue par des mères adolescentes internées dans des institutions. Il s'agit de trois études cas de mères adolescentes internées dans des institutions. Leur détresse psychologique résultait de différentes situations : grossesse, bagarres, fuite de la maison parentale, abandon d'enfant. Nous concluons que la violence familiale a affecté le processus de maturation émotionnelle de ces adolescentes.

El objetivo de este estudio fue comprender las experiencias emocionales de la violencia familiar, vivenciadas por las madres adolescentes aceptadas institucionalmente. Se trata del estudio de caso de tres madres adolescentes institucionalizadas. Se observó el malestar psicológico de las adolescentes en diferentes situaciones: embarazo, peleas, fuga del hogar y abandono del hijo. Se considera que la violencia doméstica afecta el proceso de maduración emocional de las adolescentes.

Ziel dieser Studie war es, die emotionale Erfahrung häuslicher Gewalt von institutionell betreuten jugendlichen Müttern nachzuvollziehen. Zu diesem Zweck wurden drei Fallstudien analysiert. Die psychische Belastung der jungen Mütter zeigte sich in verschiedenen Situationen, wie z.B. Schwangerschaft, Streitsituationen, Ausreißen, Aufgabe des Kindes. Wir kommen zum Schluss, dass häusliche Gewalt den emotionalen Reifeprozess der Jugendlichen beeinträchtigt.

Psychometric properties of the Life Orientation Test (LOT-R) and its relationship with psychological well-being and academic progress in college students / Propiedades psicométricas del Life Orientation Test (LOT-R) y su relación con el bienestar psicológico y el progreso académico en estudiantes universitarios

Abstract The aim of this study is to analyze the dimensionality of the Spanish version of the Revised Life Orientation Test (LOT-R), to examine the relationship between psychological well-being and dispositional optimism/pessimism in a sample of college students (n = 291), as well as to consider the effect of dispositional optimism/pessimism on academic progress. The results indicated that the properties of the Spanish version of the LOT-R (a= .72) were very similar to the original. The questionnaire clearly presented two partially independent factors, and the items assessing optimism demonstrated greater discriminant validity than the items assessing pessimism. Optimism was positively linked to psychological well-being and negatively related to psychological-distress. In the male students, a certain degree of preoccupation about academic results was linked to progress in studies, while excessive worry about academic progress could obstruct the successful completion of studies in the female students. These results suggest that the LOT-R can be used as a reliable and valid tool for the analysis of optimism and its positive effects on health and academic progress.

Resumen Este estudio pretende analizar la dimensionalidad de la versión española del Revised Life Orientation Test, para examinar la relación entre el bienestar psicológico y el optimismo/pesimismo disposicional en una muestra de estudiantes universitarios (n = 291) y analizar la repercusión del optimismo/pesimismo disposicional en el progreso académico. Los resultados indican que las propiedades de la versión española del Revised Life Orientation Test (a = 0.72) son muy similares a los de la versión original. El test presenta una estructura clara con dos factores parcialmente independientes, los ítems del factor optimismo tienen un poder discriminatorio mayor que los del factor de pesimismo. El optimismo está relacionado positivamente con el bienestar psicológico y negativamente con el malestar psicológico. En hombres, cierto grado de preocupación por los resultados académicos estaría relacionado con el progreso académico en los estudios, mientras que en mujeres, una excesiva preocupación académica podría ser perjudicial para finalizar con éxito los estudios. Estos resultados sugieren que el Revised Life Orientation Test puede ser un instrumento fiable y válido para analizar el optimismo y su relación con la salud y progreso académico.

Eficacia de la meditación para el control del malestar psicológico en gestantes con riesgo de complicaciones inminentes / Effectiveness of meditation to control the psychological discomfort in pregnant women at risk of inminent complications

Se realizó un estudio cuasi-experimental de corte transversal en 20 gestantes con alto riesgo de complicaciones inminentes, hospitalizadas en el Hospital Ginecoobstétrico Docente "Tamara Bunke Bider" de Santiago de Cuba, de enero a mayo del 2015, y que mostraban diferentes manifestaciones de malestar psicológico, con el fin de evaluar la eficacia de la meditación para reducir los síntomas de estas alteraciones. Para ello se efectuó una evaluación inicial previa a la intervención y una final, con la aplicación de la entrevista y los tests de IDARE, Zung y Conde; también se utilizó el test de McNemar para medir el nivel de asociación entre los resultados finales del tratamiento y la meditación. Como principal resultado se obtuvo que la práctica de la meditación fuera eficaz en la mejoría de los malestares ansioso y mixto, aunque su eficacia era reducida en las pacientes que presentaban disforia. De igual modo, la técnica contribuyó a elevar el autocontrol emocional en las embarazadas.

A quasi-experimental cross-sectional study in 20 pregnant women at high risk of inminent complications, hospitalized in "Tamara Bunke Bider" Teaching Ginecoobstetric Hospital in Santiago de Cuba, was carried out from January to May, 2015, that showed different manifestations of psychological discomfort, with the purpose of evaluating the effectiveness of meditation to reduce the symptoms of these disorders. An initial and final evaluations were carried out, with the interview and the IDARE, Zung and Conde tests; the McNemar test was also used to measure the association level between the final results of the treatment and the meditation. As main result it was obtained that the practice of meditation was effective in the improvement of the anxious and mixed discomfort, although its effectiveness was reduced in the patients that presented dysphoria. In the same way, the technique contributed to elevate the emotional selfcontrol in pregnant women.

Malestar psicológico en mujeres con embarazo de alto riesgo / Psychological distress in high-risk pregnant women

La experiencia emocional de la mujer con embarazo de alto riesgo ante la maternidad es un tema poco estudiado, a pesar de la importancia que tiene preservar su salud emocional durante este proceso. Esta investigación analizó la experiencia de malestar psicológico en mujeres con embarazo de alto riesgo, según el riesgo médico diagnosticado, su vivencia de la maternidad y el papel que juegan la pareja, familia y redes de apoyo durante la gestación. Se realizó un estudio instrumental de casos múltiples. Se hicieron entrevistas semiestructuradas a 12 mujeres adultas con diagnóstico médico de embarazo de alto riesgo y se formaron tres grupos. Se realizó un análisis de significados de Kvale de los datos obtenidos. Los resultados mostraron que la vivencia de la maternidad y la manifestación de malestar psicológico en estas mujeres era diferente, dependiendo del riesgo médico diagnosticado. Además, podía ser de menor o mayor intensidad debido a la falta de planeación del embarazo, las experiencias obstétricas previas, no tener hijos vivos y contar con el apoyo de la pareja y la familia. Las mujeres con embarazo de alto riesgo vivían la maternidad como una experiencia dolorosa, con mucha angustia y miedo de perder el nuevo embarazo por complicaciones.

The emotional experience of maternity in high-risk pregnant women is a subject that has been seldom studied, despitethe importance of preserving the emotional health of women during this stage. This research analyzed the experience of psychological distress in women with high-risk pregnancy according to the medical risk diagnosed, their experience of maternity and the role of the partner, family and support networks during pregnancy. An instrumental multiple cases study was performed. By semi-structured interviews, we interviewed 12 adults’ women with medical diagnosis of high-risk pregnancy and three groups were formed. A Kvale analysis of meanings was performed on data. The results showed that the experience of motherhood and the manifestation of psychological distress in these women were different depending on the diagnosed medical risk; it may be of lower or higher intensity due to the lack of family planning, previous obstetric experiences, the lack of living children and also the support of the partner and the family. High-risk pregnant women lived mate I ty as a painful experience, with great anxiety and fear of losing the new pregnancy for medical complications.

Moderación de la Relación Entre Tensión Laboral y Malestar de Profesores Universitarios: Papel del Conflicto y la Facilitación Entre el Trabajo y la Familia / Moderation of the Relation Between Job Strain and the Dissatisfaction of University Professors: The Role of Conflict and of Facilitation Between Work and Family / Moderação da Relação Entre Tensão Laboral e Mal-estar de Professores Universitários: Papel do Conflito e a Facilitação Entre o Trabalho e a Família

Se evaluó si el conflicto y la facilitación entre trabajo y familia moderan la relación entre tensión laboral y salud psicológica, y si los niveles de conflicto y facilitación varían según el sexo. Se realizó un estudio transversal con 302 profesores de universidades públicas y privadas de Bogotá, quienes respondieron cuestionarios que evaluaban tensión laboral, conflicto y facilitación trabajo-familia y familia-trabajo, ansiedad, depresión, síntomas psicosomáticos, adaptación social y burnout. Los resultados indicaron que el conflicto trabajo-familia modera la relación entre tensión laboral y burnout, mientras que el conflicto familia-trabajo modera la relación entre tensión laboral y depresión. En ambos casos, reportes más altos de tensión laboral y conflicto estuvieron vinculados con mayores experiencias de malestar.

The study evaluated whether conflict and facilitation between work and family moderate the relationship between job strain and psychological health, and whether the levels of conflict and facilitation vary depending on sex. A cross-sectional study was carried out with 302 professors from public and private universities in Bogotá, who answered questionnaires evaluating job strain, work-family and family-work facilitation as well as conflict, anxiety, depression, psychosomatic symptoms, social adaptation and burnout. Results indicated that the work-family conflict moderates the relation between job strain and burnout, while the family-work conflict moderates the relationship between job strain and depression. In both cases, higher reports of job strain and conflict were linked to greater experiences of dissatisfaction.

Avaliou-se se o conflito e a facilitação entre trabalho e família moderam a relação entre tensão laboral e saúde psicológica, e se os níveis de conflito e facilitação variam segundo o sexo. Realizou-se um estudo transversal com 302 professores de universidades públicas e particulares de Bogotá, os quais responderam a questionários que avaliavam tensão laboral, conflito e facilitação trabalho-família e família-trabalho, ansiedade, depressão, sintomas psicossomáticos, adaptação social e burnout. Os resultados indicaram que o conflito trabalho-família modera a relação entre tensão laboral e burnout, enquanto o conflito família-trabalho modera a relação entre tensão laboral e depressão. Em ambos os casos, relatos mais altos de tensão laboral e conflito estiveram vinculados com maiores experiências de mal-estar.

Malestar psicológico en familiares de pacientes con daño neurológico durante la fase subaguda de NeuroRehabilitación / Psychological distress in relatives of patients with neurological damage during the subacute phase of NeuroRehabilitation

Durante la última década la Neurorehabilitación ha comenzado a prestar mayor atención a las familias de personas que adquieren un daño neurológico. Este giro parece responder a un creciente número de estudios describiendo importantes niveles de malestar psicólogico en dichas familias y advirtiendo de su impacto en el proceso de rehabilitación. En Chile, lamentablemente, no contamos con estudios que exploren el estado emocional de familiares en ninguna de las etapas de rehabilitación, esto, a pesar de existir guías clínicas que sugieren el abordaje familiar como meta central. Dicha falta de información limita tanto la capacidad diagnóstica como interventiva de los equipos de rehabilitación. El objetivo de este artículo es describir, y comparar, el perfil de malestar psicológico en familiares de personas con lesión cerebral y medular en etapa subaguda de rehabilitación. Método. 89 familiares de personas con daño neurológico (Lesión Cerebral Adquirida = 50; Trauma Raquimedular = 39) respondieron el General Health Questionnaire-28 como medida de malestar psicológico. Este instrumento que se compone de cuatro subescalas: síntomas somáticos, ansiedad e insomnio, disfunción social y depresión grave. Resultados. En ambas poblaciones el puntaje total del GHQ-28 se observó por encima de los estándares poblacionales, sugiriendo niveles clínicos de malestar psicológico en 90 por ciento de la muestra. No se observaron diferencias entre ambas poblaciones en términos de puntaje total o puntaje de subescalas, sugiriendo similares perfiles de malestar psicólogico. Dicho perfil se caracterizó por altos niveles de ansiedad e insomnio, seguido en menor grado de síntomas somáticos...

During the last decade NeuroRehabilitation has begun to pay more attention to the families of people with neurological damage. This shift seems to respond to a growing number of studies describing significant levels of psychological distress in families, and warning professionals of its potential impact in the process of rehabilitation. In Chile, unfortunately, we have no studies that explore the emotional state of families in any stage of the rehabilitation process, this, despite the existence of clinical guidelines suggesting to address family needs as a central goal. This lack of information limits rehabilitation teams’ ability as well as their capacity to develop interventions. The aim of this article is to describe, and compare, the profile of psychological distress in relatives of people with brain damage and spinal cord injuries, during the sub-acute phase of rehabilitation. Method. 89 relatives of people with neurological damage (Acquired Brain Injury = 50; Spinal Cord Injury = 39) completed the General Health Questionnaire-28, a self-report measure of psychological distress. This instrument has four subscales, each of them screening for different types of symptoms: somatic, anxiety/insomnia, social dysfunction and severe depression. Results. Both neurological groups presented GHQ-28 total scored above population standards, thus suggesting clinical levels of psychological distress in 90 percent of the sample. No differences were observed between the two groups in terms of GHQ-28 total score or subscale score, thus, suggesting similar profiles of psychological distress. High levels of anxiety and insomnia, followed to a lesser degree by somatic symptoms, characterized this profile...

Psychological distress in health sciences college students and its relationship with academic engagement / Mal-estar psicológico em estudantes universitários de ciências da saúde e sua relação com o Engagement / Malestar psicológico en estudiantes universitarios de ciencias de la salud y su relación con engagement académico

Objective: To determine the prevalence of psychological distress and its relationship with academic engagement (absorption, dedication and vigor), sex and degree among students from four public universities. Method: A non-experimental,comparative correlational, quantitative investigation without intervention. Study population: 1840 nursing and physical therapy students. The data collection tool used was a questionnaire. Results: A 32.2% prevalence of psychological distress was found in the subjects; a correlation between vigor and psychological distress was found for all of the subjects and also for women. High absorption and dedication scores and low psychological distress scores predicted higher vigor scores. Conclusion: The risk of psychological distress is high, especially for women. Women seem to have a higher level of psychological distress than men. Vigor, energy and mental resilience positively influence psychological distress and can be a vehicle for better results during the learning and studying process.





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Objetivo: Determinar a prevalência do mal-estar psicológico e a sua relação com o engagement acadêmico (absorção, dedicação e vigor) e as variáveis ​​sexo e formação profissional em estudantes de quatro universidades públicas. Método: Investigação quantitativa sem intervenção, estudo não experimental e correlacional comparativo. A amostra foi constituída por 1.840 alunos de Enfermagem e Fisioterapia e o instrumento de coleta de dados foi o questionário. Resultados: A prevalência do mal-estar psicológico foi encontrada em 32,2% dos indivíduos; foram encontradas correlações entre vigor e mal-estar psicológico para o conjunto dos sujeitos, principalmente para o grupo das mulheres. A existência de escores elevados para dedicação e absorção, e baixos para mal-estar psicológico é preditora de pontuações mais elevadas em vigor. Conclusão: O risco de mal-estar psicológico é elevado, especialmente nas mulheres. Estas se percebem com maior mal-estar psicológico que os homens. O vigor, a energia e a resistência, aplicados na relação com os estudos influenciam positivamente o mal-estar psicológico e podem ser um veículo para melhores resultados de aprendizagem
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Objetivo: Determinar la prevalencia del malestar psicológico y su relación con el engagement académico (absorción, dedicación y vigor) y con variables sexo y titulación, de los estudiantes de cuatro universidades públicas. Método: Estudio comparativo correlacional, investigación cuantitativa sin intervención, no experimental. Población 1840 estudiantes de Enfermería y Fisioterapia. La herramienta de recogida de datos fue el cuestionario. Resultados: Prevalencia de malestar psicológico en el 32.2% de los sujetos; se hallaron correlaciones entre vigor y malestar psicológico para el conjunto de sujetos y para el grupo de las mujeres. Las puntuaciones altas en absorción y dedicación y bajas en malestar psicológico, predicen valoraciones más altas en vigor. Conclusión: El riesgo de malestar psicológico es alto, especialmente para las mujeres. Éstas se perciben con mayor malestar psicológico que los hombres. El vigor, energía y resistencia con los estudios, influye positivamente sobre el malestar psicológico y puede ser un vehículo para unos mejores resultados del aprendizaje.
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Malestar psicológico determinado socialmente y abuso expresivo en varones / Psychological distress socially determined and expressive abuse in men

El objetivo de este artículo es conocer y describir la experiencia subjetiva de hombres que asisten a un programa reeducativo para detener su violencia familiar, en torno al malestar psicológico determinado socialmente y su expresión por medio de actos violentos. El acercamiento metodológico de esta investigación es de tipo cualitativo y se trata de un estudio crítico con enfoque interpretativo. Participaron cinco hombres que se reúnen en un centro gubernamental especializado para la atención de la violencia familiar ubicado en una Delegación política del sur en el Distrito Federal. El malestar psicológico de la vida cotidiana se abordó a partir de instrumentos clínicos y del análisis de entrevistas grupales que exploran variables sociales. Además, se presentan los significados de los abusos realizados por los hombres con el fin de expresar el malestar. Se describió una lógica de acumulación de malestar con origen social expresado en un acto de abuso, y mediado por una razón o conflicto que justifica el ataque físico y/o verbal. La expresión de malestar, en ocasiones, se acompaña por sentimientos de culpa posteriores a los eventos violentos. Los elementos que permiten los abusos expresivos contra la pareja y otros familiares son las creencias sobre la superioridad del hombre, la inferioridad física de las mujeres e hijos, la propiedad de la persona por ser esposa, la obligación de la duración de una relación "para toda la vida" y las creencias sobre el uso de la violencia en las relaciones. En términos de intervención con esta población, se destaca la importancia de considerar el papel que juegan las determinantes sociales del malestar psicológico provenientes del nivel macro para los programas sociales e intervenciones comunitarias.

The meanings of the abuses made by men to express discomfort were explored. A logic of accumulation of discomfort with social origin expressed in an act of abuse and mediated for a reason or conflict that justified the physical and/or verbal attack was described. Sometimes, the expression of discomfort was accompanied by guilt feelings after violent events. The expressive elements that allow abuses to partners and other family members are the beliefs about the superiority of men, the physical inferiority of women and children or the belief about their inferiority, the notion that wives are a property, the perception that relationships should last a lifetime, and beliefs about the use of violence in relationships. In terms of the intervention with this population, the study highlights the importance of considering the role of social determinants of distress from the macro level to the social programs and community interventions.

Inseguridad laboral percibida y malestar psicológico: evaluación de dos modelos predictivos en trabajadores suministrados de la ciudad de Concepción, Chile / Perceived job insecurity and psychological discomfort: evaluation of two predictive models in supplied workers of Concepción city, Chile

El objetivo del estudio fue evaluar dos modelos teóricos sobre la relación entre inseguridad laboral percibida y malestar psicológico, y sus variables predictoras (sexo, edad, situación de pareja, escolaridad y tipo de contrato), en 112 trabajadores suministrados de Concepción. El estudio es transversal de tipo explicativo. La recolección de los datos fue realizada mediante un muestreo intencionado. Los instrumentos utilizados fueron el Cuestionario de Salud General de Goldberg y Williams¹, una escala de inseguridad laboral percibida cuantitativa y otra cualitativa² y una encuesta con datos sociodemográficos-laborales. El análisis de las relaciones causales se realizó con el método de Análisis de Ecuación Estructural (SEM). Los resultados indican que los modelos no son aplicables a trabajadores suministrados chilenos. Ello podría deberse a diferencias en las situaciones de trabajo y formas de flexibilidad laboral de los participantes, en las condiciones estructurantes del empleo suministrado en Chile, y a la influencia de variables individuales asociadas con la subjetividad de los trabajadores.

The objective of the study was evaluating two theorical models on relation between perceived job insecurity and psychological discomfort, and their predictive variables (sex, age, marital status, educational level and type of contract), in 112 supplied workers of Concepción. It is a cross sectional and explanatory study. The analysis of causal relationships was made using the method of Structural Equation Modeling (SEM). The results indicate that the models are not applicable on Chilean supplied workers. This could be due to differences in work situations and forms of labor flexibility of the participants, in the structural conditions of employment provided in Chile, and the influence of individual variables associated with the subjectivity of workers.

Validación de la escala Kessler 10 (K-10) en la detección de depresión y ansiedad en el primer nivel de atención. Propiedades psicométricas / Validity of the kessler 10 (k-10) scale in detecting depression and anxiety disorders in the primary care services. Psychometric properties

According to studies conducted in different countries, it is estimated that approximately 30% to 50% of people with mental health problems are not recognized by the general practitioner. Given this situation, it has been proposed that the practitioner at the primary care services must play a decisive role in the early detection of cases by establishing a definitive diagnostic and a timely treatment. Several organizations have pointed out that one of the first actions that need to be implemented to fulfill the aims in the care of people with mental disorders is to prepare the first-contact doctors and to have a brief, low cost, self-applied, valid and reliable scale. The studies mention that using screening tests at the primary care level is crucial for the success of the programs. The detection and recognition of psychiatric symptomatology rates vary depending on the type of scale applied. The tools that have been widely used are the Goldberg's General Health Questionnaire (GHQ), Zung Self-Rating Depression Scale, Beck Depression Inventory, the Depression Symptom Checklist (DS 20), the Hopkins Symptom Checklist (SCL), the Hamilton Depression Scale, the Center for Epidemiologic Studies Depression Scale (CES-D), the Montgomery-Asberg Depression Rating Scale, the Geriatric Depression Scale (GDS), the self-administered computerized assessment (PROQSY), the criteria of the 3rd revised edition of the Diagnostical and Statistical Manual of Mental Disorders (DSM-III-R), the Structured Clinical Interview for DSM-IV (SCID), and the criteria of the Symptom Driven Diagnostic System for Primary Care (SDDS-PC), among others. The preliminary results confirm the existence of a high percentage of possible psychiatric cases (46.9%), but only 4% of cases are referral. The low capability of the general practitioner at the primary care level in detecting these pathologies has been confirmed as well. These scales have been applied in different scenarios and to different types of population. Although the dominating criteria for choosing the tool are sensitivity and specificity, some authors mention that strategies for adequately handling cases, such as the confirmation of the diagnosis and follow-up of the patients, are required once the treatment has started. In this paper, we present the psychometric characteristics of the Kessler (K-10) scale in detecting depression and anxiety disorders in the primary care. Material and methods The study is a methodological process that aims to validate the Kessler Psychological Distress scale (K-10). It was conducted in two health care centers of primary care level in Mexico City. The subjects were 280 individuals who requested attention at the mentioned centers and to whom the K-10 test was applied after giving their informed consent. Later on, the computerized version of the International Neuropsychiatric Interview (MINI), which uses the diagnostic criteria of the DSM-IV, was applied to the subjects in order to confirm the diagnostics for depression and anxiety. The MINI is a version adapted to Latin American Spanish by the National Institute of Psychiatry Ramon de la Fuente Muñiz. The diagnostic accuracy was processed following the MINI diagnoses for depression and anxiety closely, and the scores on the scale K-10 as a predictor. The sensitivity and specificity were calculated for all possible cut points in order to establish the optimal cut off point. The efficiency and maximum likelihood ratios were also calculated. The area under the ROC curve as well as the probability quotients, positive and negative (LR+ and LR-), were also calculated. The K-10 is a brief screening tool that can be easily applied by the primary care personnel which measures the psychological distress of a person during the four weeks prior to the application. It consists of ten questions with Likert-like answers that range from 1 to 5 and are categorized in a five level ordinal scale: Always, Very Often, Sometimes, Rarely, Never; where «Never¼ has an assigned value of 1, and «Always¼ has assigned value of 5. It has a minimum score of 10 and a maximum of 50. The ranges of the instrument are four levels: low (10-15), moderate (16-21), high (22-29) and very high (30-50). The instrument showed an internal consistency of 0.90 and it has been used in various population studies promoted by the World Health Organization as well as government organizations in Australia, Spain, Colombia and Peru. Results Out of 280 individuals to whom the tool was applied, 78.9% (221) were female and 21.1% (59) male. These values represent the proportion of patients attending the primary care services (95% confidence interval=±5.4%). The mean age of women was 39 years, and the mean age of men was 41. The 70.6% of the women manifested more psychological distress than men (52.5%)[χ2(1)=6.05,p=0.014. No other socio-demographic variable showed significant differences. The instrument is highly precise, it can detect up to 87% of depression cases, and 82.4% of anxiety cases. The scale was compared with the MINI and it presented a prevalence of 26.8% and 10.6%, respectively. Of the total of depression cases, 26.4% also presented anxiety; these represent a co-morbidity of 5.4%. The construct validity presented one factor alone that explains the 53.4% of the total variance, this is why the scale is considered as one-dimensional. In other words, the scale only measures the construct of the psychological distress. The internal consistency was α=0.901. Once the sensitivity and specificity for all cut off points had been determined using the MINI as a golden rule, it was observed that the cut off point for maximum sensitivity and specificity corresponded to 21 for the diagnosis of depression, and 22 for anxiety. Conclusions The K-10 is a good instrument for the detection of depression and anxiety cases at the primary care level which meets the criteria of validity and reliability. However, given that only one diagnosis was considered for all the range of anxiety disorders, the scale must be chosen carefully for all the other disorders that are not included in this paper. The use of the instrument is recommended for the general practitioners at the primary care level, mainly for diagnosing depression. Various studies in which other screening instruments have been used for the detection of depressive disorder at primary care point out that any screening method are useful in making the diagnosis. By using these instruments, the depression diagnosis at primary care level increases from 10% to 47%. The latter supports the fact that the selection of a good instrument turns out to be effective in detection, treatment and clinical outcomes of the entity. Since this recommendation is only one of the activities required in primary care level for good handling of detected cases, it is noteworthy to mention that a comprehensive care model that encompasses both the detection as well as the pharmacological and psychosocial treatments is required.

De acuerdo con estudios realizados en diferentes países se estima que aproximadamente hay entre 30% a 50% de personas que presentan algún problema de salud mental que no es reconocido por el médico general. En virtud de esta situación se ha propuesto como estrategia a la atención primaria como base del sistema de salud, lo que permitiría la detección temprana de pacientes con algún trastorno psiquiátrico. Diferentes organismos señalan que una de las primeras acciones para cumplir con los objetivos en la atención de personas con algún trastorno mental, consiste en contar con una escala breve, autoaplicable, válida y confiable y de bajo costo. En este trabajo se presentan las características psicométricas de la escala Kessler (K-10) para detectar trastornos depresivos y ansiosos. La K-10 es un instrumento de tamizaje breve y de fácil aplicación por el personal del primer nivel de atención y ha sido utilizada en diferentes estudios a nivel poblacional. En Australia, en 1997, se aplicó la K-10 en una encuesta de salud, por medio del Consejo Nacional de Encuestas de Salud Mental. Material y métodos Se trata de un estudio de proceso metodológico, cuyo objetivo fue la validación de la escala de malestar psicológico K-10 de Kessler. El estudio se llevó a cabo en dos Centros de Salud del primer nivel de atención en la Ciudad de México. Los participantes fueron 280 personas que acudieron a la consulta externa de dichos centros. Se utilizaron los criterios del DSM-IV para la confirmación del diagnóstico de depresión y de ansiedad, por medio de la Mini International Neuropsychiatric Interview (MINI), en su versión computarizada, adaptada al español latinoamericano en el Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. La validez diagnóstica se procesó utilizando los diagnósticos de la MINI para depresión y ansiedad como regla de oro y las puntuaciones obtenidas en la escala K-10 como predictor. Se calculó la sensibilidad y especificidad para todos los posibles puntos de corte con el fin de establecer el óptimo. Se calculó adicionalmente la eficiencia y las razones de máxima verosimilitud, así como el área bajo la curva ROC y los cocientes de probabilidad, positivo y negativo (LR+ y LR-). Resultados Del total de personas a quiénes se les aplicó la escala, el 78.9% (221) fueron mujeres y 21.1% (59) hombres. Estos valores representan la proporción en que los pacientes acuden a los servicios de primer nivel (IC 95%=±5.4%). El 70.6% de las mujeres presentaron mayor malestar psicológico en comparación con los hombres que representaron el 52.5% [χ²(1)=6.05,p=0.014]. En ninguna otra variable socio-demográfica se presentaron diferencias significativas. El instrumento tiene una alta precisión, ya que puede detectar hasta el 87% de los casos de depresión y un 82.4% de los casos de ansiedad. La escala se comparó con el MINI en español y presentó una prevalencia de 26.8% y 26.4%, respectivamente. Conclusiones El instrumento cumple con los criterios de validez y confiabilidad, por lo que se recomienda su uso por los médicos generales en el primer nivel de atención. Dado que esta recomendación sólo es una de las actividades que se requieren en la atención primaria para un buen manejo de los casos que se detecten, es necesario señalar que se requiere de un modelo de atención integral que incorpore tanto la detección como el tratamiento farmacológico y psicosocial.