Estigma en mujeres de peso alto a través de un análisis fenomenológico interpretativo

Tener peso alto es una característica que ha sido devaluada y denigrada socialmente, convirtiendo a las personas de cuerpos grandes en víctimas de estereotipos, prejuicios y discriminación, lo que se ha denominado estigmatización por el peso, fenómeno que ocurre especialmente en mujeres. El objetivo de este estudio fue describir las experiencias de estigma de peso de mujeres con obesidad que viven en el sur de Chile. Participaron seis mujeres entre 20 y 57 años a través de entrevistas semi-estructuradas realizadas de manera remota. Mediante Análisis Fenomenológico Interpretativo se identificaron cuatro supratemas y diversos subtemas, los supratemas son: 1. La obesidad como parte de la persona. 2. Las experiencias de sentirse discriminada. 3. Todo gira en función del peso. 4. Lo que la sociedad piensa de la obesidad, los que en su conjunto permiten caracterizar la experiencia de vivir con obesidad y sufrir el estigma asociado al peso en distintos ámbitos de sus vidas, incluso en contextos sanitarios. Las consecuencias de esta experiencia son diversas y negativas, destacando el impacto que tiene en su autoestima y las constantes emociones negativas que derivan de las situaciones de discriminación. Estos resultados ponen de manifiesto la importancia de avanzar hacia la diversidad y aceptación corporal, lo que supone un desafío a la sociedad en general y en particular a los proveedores de salud, ya que se requiere de intervenciones libres de prejuicios y orientadas a la salud y el bienestar de las personas.

Carrying a high weight is a characteristic that has been devalued and socially denigrated, turning people with large bodies into victims of stereotypes, prejudice, or discrimination, which has been called weight stigmatisation, a phenomenon that occurs especially in women. The aim of this study was to describe the weight stigma experiences of women with obesity who live in southern Chile. Six women between 20 and 57 years of age participated in semi-structured interviews conducted remotely. Through Interpretative Phenomenological Analysis four supra-themes and several sub-themes were identified, the supra-themes are: 1. Obesity as part of the person. 2. Experiences of feeling discriminated. 3. Everything is about weight. 4. what society thinks of obesity, which together allow characterising the experience of living with obesity and suffering the weight stigma in different areas of their lives, including in health contexts. The consequences of this experience are diverse and negative, highlighting the impact it has on their self-esteem and the constant negative emotions that derive from discrimination situations. These results highlight the importance of moving toward body diversity and acceptance, which is a challenge for society in general and health care providers in particular, as it requires interventions free from prejudice and orientated to the health and well-being of individuals.

Problemas de salud mental en universitarios durante la pandemia por COVID-19: ¿qué tipo de ayuda buscan? / Mental health problems in university students during the COVID-19 pandemic: What kind of help do they seek?

Introducción: La pandemia por COVID-19 ha tenido un impacto negativo en el bienestar psicológico de la población, siendo los jóvenes un grupo especialmente vulnerable. Objetivo: El presente estudio se propuso examinar los niveles de búsqueda de ayuda (formal e informal) para problemas en salud mental y sus variables asociadas en una muestra de estudiantes universitarios de la Región de La Araucanía, en el contexto de la pandemia por COVID-19. Método: A través de un muestreo no probabilístico por conveniencia, se reclutó a 500 estudiantes de entre 18 y 29 años. Se describió y comparó su nivel de búsqueda de ayuda, así como variables que podrían obstaculizarla o facilitarla, según género. Adicionalmente, se estimaron modelos de regresión lineal múltiple diferenciados por género, con la búsqueda de ayuda informal como variable criterio. Resultados: Se evidenció una renuencia general a buscar ayuda (formal e informal) tanto en hombres como mujeres, una mayor experimentación de malestar psicológico y mayor conocimiento sobre salud mental en mujeres. Finalmente, se observaron diferencias en los predictores de la búsqueda de ayuda informal entre hombres y mujeres, siendo el apoyo social y las emociones negativas en pandemia los únicos comunes entre géneros. Conclusión: Se discuten los bajos niveles de búsqueda de ayuda evidenciados, y las diferencias observadas en variables asociadas, en función de la brecha de género en salud mental.

Introduction: The COVID-19 pandemic has impacted the psychological well-being of the population, with young people being a particularly vulnerable group. Aim: The present study examines help-seeking intention for mental health problems and associated variables among male and female university students in La Araucanía Region during the COVI-19 pandemic. Method: A sample of 500 students aged 18 to 29 was recruited through non-probabilistic convenience sampling. Help-seeking levels and facilitating or hindering variables were compared by gender. Multiple linear regression models were estimated separately by gender to predict the criterion variable of informal help-seeking. Results: The results indicate that both men and women are reluctant to seek help (formal and informal). Women reported higher levels of psychological distress and greater knowledge about mental health than men. Differences in predictors of informal help-seeking between men and women are evidenced, with social support and negative emotions in pandemic being the only common predictors between genders. Conclusion: The low levels of help-seeking evidenced, and the differences observed in associated variables based on the gender gap in mental health, are discussed.

Factores de riesgo cardiometabólico y funcionamiento cognitivo: el rol de la reserva cognitiva / Association between cardiometabolic risk and cognitive impairment

Background: Several risk factors are associated with cognitive impairment in older people, but little attention has been paid to cardiometabolic variables, as well as how cognitive reserve can mediate this association. Aim: To determine the association of cardiometabolic risk factors with cognitive functioning and whether the cognitive reserve mediates this association. Material and Methods: A cross-sectional study with 300 participants with a median age of 56 years (53% male) was conducted. Participants had a cognitive functioning assessment. Fasting glucose, HDL-cholesterol, and blood pressure were measured. Results: A Structural Equation Modeling, revealed a direct effect of cardiometabolic latent risk factors on both a cognitive functioning (β = -.204; p = .056), and cognitive reserve factors (β = -.236, p = .04). Cognitive reserve was directly associated with cognitive functioning (β = .327, p = .01), but did not mediate the association between the cardiometabolic risk factors and cognitive functioning (β = .077, p = .07). The overall goodness of fitness was excellent χ2 (50) = 58.357, p = .195, comparative fit index = .980, Tucker-Lewis Index = .974, root mean square error of approximation = .023 and Standardized Root Mean Square Residual = .041. Conclusions: A direct effect of cardiometabolic risk factors on cognitive functioning was observed.

Evaluación de funcionamiento cognitivo en adultos: Análisis y contrastación de tres de los instrumentos de mayor divulgación en Chile / Psychometric properties of three instruments to detect dementia

Background Several instruments are available to measure cognitive functioning in older adults. However, there is paucity of information about their factorial structure and psychometric properties. Aim To determine the factorial structure and the internal reliability of the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA) and the Adenbrookke´s Cognitive Examination (ACE-R), and their cognitive impairment detection capabilities. Material and Methods MMSE, MoCA and ACE-R were applied to 203 older adults aged 54 to 88 years (77% women), excluding participants with dementia. Results The factorial structure of the MMSE suggested that items referred to memory process should be eliminated due to their low reliability and factor loading (b = 0.12; p = 0.146). Although the MoCA had a good reliability, object denomination process items also had to be dropped (b = 0.22; p = 0.003). The ACE-R demonstrated a single factorial structure for all cognitive processes and had a good internal consistency. MMSE, MoCA and ACE-R classified as having dementia 5, 27 and 42% of participants, respectively. Conclusions MoCA and the ACE-R scales appear as better instruments to detect dementia in older people.

Psychometric properties of a brief Spanish version of Stigmatizing Situations Inventory / Propiedades psicométricas de una versión breve en español del Inventario de Situaciones Estigmatizantes

Abstract Overweight and obese people are a frequent target of weight stigma. However, there are no Spanish-Language validated inventories measuring weight stigma situations. Therefore, we sought to validate a brief Spanish version of the Stigmatizing Situations Inventory (SSI) in a sample of Chilean adults. A psychometric study with 377 adults was designed (Mage = 45.0, SD = 8.7; 62% female). Twenty-four items available from two previous versions of the SSI developed were back-translated from English to Spanish, and semantically adapted to the Chilean sample. We explored the factorial structure with 173 participants, and then confirmed it with 204 subjects. We obtained evidence of concurrent validity with other psychological measures, as well as evidence of reliability. Our results identified a single factor structure grouping 10-items, with factorial loadings greater than .60. The overall fit indices are excellent. There is evidence of concurrent validity with body mass index (r = .43), anger (r = .19), anxiety (r = .29), and daily life discrimination (r = .26); all with p < .05. The reliability of our version is high (α = .91). The brief Spanish version of the SSI is a 10-items reliable and valid scale with one-dimensional factorial structure. This scale can be used by researchers and healthcare professionals studying psychological consequences of obesity.

Resumen Las personas con sobrepeso u obesidad enfrentan frecuentemente situaciones de estigmatización por el peso; sin embargo, no existen instrumentos validados en español que midan este constructo. En consecuencia, el objetivo de este estudio fue examinar las propiedades psicométricas una versión breve del Inventario de Situaciones Estigmatizantes (ISE) en población chilena. Participaron 377 adultos (Medad = 45.0, DE = 8.7; 62% mujeres). Veinticuatro ítems disponibles en versiones previas del ISE fueron retrotraducidos del inglés al español y adaptados semánticamente. La estructura factorial fue explorada con los registros de 173 de los participantes, y posteriormente confirmada con los 204 restantes. Fue identificada una estructura uni-factorial, con cargas factoriales > .60 e indicadores de bondad de ajuste excelentes. La consistencia interna del inventario fue alta (α = .91). Además se obtuvo evidencia de la validez concurrente del ISE con otras medidas: índice de masa corporal (r = .43), ira (r = .19), ansiedad (r = .29) y discriminación en la vida diaria (r = .26); todos con p < .05. La versión breve en español del ISE mostró ser válida y confiable. Esta escala puede ser utilizada por investigadores y profesionales de la salud que estudian las consecuencias psicológicas de la obesidad.

Estigma de obesidad, cortisol e ingesta alimentaria: un estudio experimental con mujeres / Association between weight-based stigmatization psychological stress and calorie intake

Background: Weight-based stigmatization is frequent among overweight and obese people. Aim: To determine the association between weight-based stigmatization, psychological stress, cortisol, negative emotions, and eating behavior in a sample of middle-aged women. Material and Methods: Eighty-two women aged 45 ± 8 years, 55% with overweight or obesity, were randomly allocated to watch a video called "Stigma: the human cost of obesity" or a control video about planet earth. The effect of watching either video on calorie consumption, psychological stress and cortisol reactivity was assessed. Cortisol was measured on four salivary samples. Psychological stress and negative emotions were self-reported. Results: Among women who watched the stigmatizing video, there was a direct association between psychological stress and calorie intake, but negative emotions did not mediate this association. Moreover, psychological stress moderated the association between watching the stigmatizing video and the cortisol output (β = 0.32; p = 0.005). Conclusions: Women with high psychological stress have a greater intake of calories. After watching the stigmatizing video, a greater psychological stress is associated with greater cortisol output.

Estigma de obesidad, su impacto en las víctimas y en los Equipos de Salud: una revisión de la literatura / The effects of weight stigmatization on obese people and health care professionals

Weight stigmatization is defined as the devaluation of others based on weight, a visible and specific characteristic that cannot be hidden. The consequences of weight stigmatization have been studied in victims and healthcare providers. This narrative literature review describes the consequences of weight stigmatization in victims and healthcare practitioners. According to several studies, high levels of psychological dysfunction in victims coexist with negative stereotypes in healthcare professionals, since the latter are exposed to the same negative media messages about obesity. Thus, weight stigmatization contributes to increase the burden of obesity, since when obese patients perceive that they are discriminated by healthcare professionals, their unhealthy behaviors persist and they have a low adherence to obesity treatment and medical recommendations.

Propiedades psicométricas de la escala de negatividad social de Newsom en universitarios chilenos / Psychometric properties of Newson´s social negativity exchange scale in a Chilean college age students

El objetivo de este estudio fue estimar las propiedades psicométricas de la Escala de Negatividad Social de Newsom, la cual mide el efecto negativo de las interacciones sociales en el bienestar individual. Para ello, se seleccionó a 526 universitarios, realizando análisis factorial exploratorio con 50% de la muestra y análisis factorial confirmatorio con el restante 50%. A diferencia de la estructura de cuatro factores sugerida por los autores, los resultados de este estudio indican que la escala tiene una estructura factorial de dos factores, agrupando el primer factor 4 ítems y el segundo 8. Las cargas factoriales fueron superiores a 0,3 y se obtuvieron buenos indicadores de bondad de ajuste. La consistencia interna de la escala, medida con Alfa de Cronbach fue 0,86. La evidencia sugiere que la Escala de Negatividad Social de Newsom es un instrumento válido y confiable que puede ser utilizado en población Chilena.

The purpose of this study was to determine the psychometric properties of the Social Negativity Exchange Scale developed by Newsom et al, which is defined as the negative effect that social interactions have on individual wellbeing. Thus, a sample of five hundred and twenty two (n= 526) college-age students was non-randomly selected. An exploratory factor analysis was conducted with 50% of them, and then a confirmatory factor analysis with the others. A two-factor solution was identified, with the first factor grouping four items and the second factor eight items. Fit indexes were good, with factorial loadings greater than .3. the total scale reliability was .86. The evidence obtained in this study suggests that the Newsom´s Social Negativity Exchange Scale is a valid and reliable scale to be used with Chilean population.

Validación de la versión en Español de la Escala de Optimismo Disposicional (LOT-R) en una muestra Chilena de estudiantes universitarios / Validation of the Spanish Version of the Life Orientation Test-Revised (LOT-R) in a Chilean sample of college age students

El Optimismo Disposicional se asocia con mejores resultados de salud física y mental. Disponer de instrumentos válidos y confiables para su medición es fundamental. El presente estudio tuvo por objetivo confirmar la estructura factorial y la confiabilidad de la versión en Español del Life Orientation Test-Revised (LOT-R) en una muestra de 526 estudiantes universitarios Chilenos (65% hombres), cuyo promedio de edad fue 21 años. Se realizó Análisis Factorial Confirmatorio, con estimación de máxima verosimilitud, corrección Satorra-Bentler y análisis de consistencia interna. Los resultados confirman una estructura factorial unidimensional de seis ítemes, cargas factoriales superiores a .35 e indicadores de bondad de ajuste excelentes. La confiabilidad del instrumento fue adecuada, estimándose un Alfa de Cronbach equivalente a .72. Los resultados obtenidos, sumado a que esta escala tiene tan sólo seis ítemes, sugieren que el LOT-R es un instrumento válido y confiable, fácilmente utilizable en población Chilena para medir Optimismo Disposicional.

Optimism is a variable associated with better physical and mental health outcomes. Thus, a valid and reliable measure that account for this construct is needed. Therefore, this study had as purpose to confirm the factorial structure, and reliability of the Life Orientation Test-Revised Spanish version with a large sample of 526 Chilean College age students (Mage = 21 years old; 65% Male). A Confirmatory Factor Analysis, with Maximum Likelihood, and Satorra-Bentler correction was performed. The internal consistency was estimated with Cronbach Alpha. The results confirmed a single factor solution with six indicators, and factorial loadings greater than .35. The overall goodness of fit is excellent, and the internal consistency was adequate (.72). These results, in addition to the short lenght of the scale, suggest that the LOT-R is a valid and reliable measure of optimism that can be easyly used with Chilean population.