Spanish Validation of the Interpersonal Needs Questionnaire and the Acquired Capability for Suicide Scale Among Mexican University Students.

Introduction: the rate of death by suicide has increased in Mexico, representing a significant public health problem. To prevent and treat this phenomenon, it is crucial to identify reliable suicide risk factors among Mexicans. The Interpersonal Theory of Suicide has demonstrated empirical support for the role of thwarted belongingness, perceived burdensomeness, and acquired capability in the development of suicidal desire and behaviors. The measure of the theory's constructs-the Interpersonal Needs Questionnaire (INQ) and the Acquired Capability for Suicide Scale (ACSS)-has also shown good psychometric qualities. Objective: translate, culturally adapt and validate these instruments. Method: 495 university students from Mexico City participated in two independent samples (n = 239; n = 256). For the INQ, the available version in Spanish was used. For the ACSS, the most current version in English was used. Based on the results from the first sample, items were modified, eliminated, or added for the second sample. Results: the INQ demonstrated good fit (RMSEA = .054, TLI = .97, IFI = .97, NFI = .95) with an internal consistency of .77 and .87 for thwarted belongingness and perceived burdensomeness, respectively. The ACSS obtained similar results (RMSEA = .011, CFI = .99, TLI = .99, IFI = .99, NFI = .91); the internal consistency was .77. Discussion and conclusions: the Spanish version of the instruments display good psychometric properties and can be used to measure the constructs of the interpersonal theory of suicide. However, further replication is needed to support generalizability in other Spanish-speaking populations.

Introducción: la tasa de suicidios ha aumentado en México, esto representa un problema de salud pública. Para prevenir y tratar este fenómeno es crucial identificar predictores confiables del suicidio en mexicanos. La teoría interpersonal del suicidio ha demostrado sustento empírico acerca del papel de la pertenencia fallida, el percibirse como una carga y la capacidad adquirida en el desarrollo del deseo y conducta suicida. Los instrumentos que miden estos constructos­Cuestionario de Necesidades Interpersonales (INQ, por sus siglas en inglés) y Escala de Capacidad Adquirida para el Suicidio (ACSS, por sus siglas en inglés)­han mostrado buenas cualidades psicométricas. Objetivo: traducir, adaptar culturalmente y validar estos instrumentos. Método: 495 estudiantes universitarios de la Ciudad de México participaron en dos muestras independientes (n = 239; n = 256). Para el INQ se usó la versión disponible en español. Para la ACSS, se usó la versión más actualizada en inglés. Según los resultados de la primera aplicación, se modificó la redacción de algunos ítems, se eliminaron otros y se agregaron nuevos para la segunda aplicación. Resultados: el INQ alcanzó índices de buen ajuste (RMSEA = .054, TLI = .97, IFI = .97, NFI = 95) con consistencia interna de .77 y .87 para pertenencia fallida y percibirse como carga, respectivamente. La ACSS obtuvo resultados similares (RMSEA = .011, CFI = 99, TLI = .99, IFI = .99, NFI = .91); la consistencia interna fue .77. Discusión y conclusiones: las versiones en español de los instrumentos mostraron buenas propiedades psicométricas y pueden usarse para medir los constructos de la Teoría Interpersonal del Suicidio. Sin embargo, se requiere replicar el estudio para apoyar la generalización a otras poblaciones de habla hispana.

Escala de Respuestas Emocionales por Estrés al Traslado en Transporte Público / Scale of Emotional Responses due to Commuting Stress in Public Transport

Resumen El traslado cotidiano entre la casa y el trabajo demanda un importante uso de recursos personales y puede llegar a ser estresante. El objetivo fue construir y evaluar una escala de respuestas emocionales por el estrés en el traslado en transporte público para la Zona Metropolitana del Valle de México de manera exploratoria. Método: Se realizó un estudio cualitativo a través de entrevistas semi estructuradas con el propósito de identificar emociones asociadas a la experiencia de estrés por el traslado para desarrollar los reactivos de acuerdo con el contexto. Posteriormente, dos estudios cuantitativos permitieron evaluar las propiedades psicométricas. Participaron 196 y 298 personas respectivamente. La aplicación de la escala se realizó en línea en septiembre de 2020 y abril de 2021. Resultados: la escala incluyó 26 respuestas emocionales asociadas al estrés. En el Análisis Factorial Exploratorio se redujo a nueve emociones negativas (X2=1183, gl=36, p=.001, KMO=.94, 60% de varianza explicada, Alfa ordinal=.93), corroboradas en el Análisis Factorial Confirmatorio (X2=41.87, gl=26, X2/gl=1.61, p=.025; RMR=.036, SRMR=.036, RMSEA=.045; GFI=.997, CFI=.999, TLI=.998). Conclusión: la propuesta exploratoria de la escala para evaluar las respuestas emocionales por el estrés en el traslado presenta valores adecuados para aplicarse en la Zona Metropolitana del Valle de México.

Abstract The stress in urban settings is related to a greater request for personal resources to face situations of daily life, such as the commuting, since in big cities, people spend a lot of time on it, and sometimes is uncomfortable and annoying, which can cause stress. Commuting stress has been assessed, through commuting daily hassles, commuting stressful features and physiological responses, but it is possible assess it through emotional responses. The aim of this study was to develop and assess an exploratory scale of emotional responses for the study of commuting stress by public transport in an urban area of México that is densely populated. Method, a cross sectional design was used, in which a qualitative exploratory study was carried out through 23 individual semi-structured interviews and two focus group, where it was identified the main emotions experienced during the commuting stress to develop the items in the language of the population. Subsequently, those emotions were compared with emotions proposed in previous studies to complement the scale. Thus, 26 emotions were included to assess the commuting stress through emotional responses. Finally, two quantitative studies were carried out to assess the psychometric properties of the scale, in which 196 and 298 people participated, respectively. The scale was applied online in September 2020 and in April 2021. Results, from the 26 emotional stress responses were reduced to nine negative emotions in an Exploratory Factor Analysis (X2=1183, df=36, p=.001, KMO= .94, 60% variance, Alfa ordinal=.93). This solution was corroborated with a Confirmatory Factor Analysis (X2=41.87, d.f.=26, X2/d.f.=1.61, p=.025; RMR= .036, SRMR=.036, RMSEA=.045; GFI=.997, CFI=.999, TLI=.998). Conserve only nine negative emotions is due to statistical analysis but also because some emotions referred to conditions of physical exhaustion or body energy level. On the other hand, positive emotions were related with pleasant commuting situations, not with the commuting stress experience. Conclusion, the exploratory scale to assess the commuting stress through emotional responses presents acceptable values to be applied in this urban area of Mexico.

Extended resection for seizure control of pure motor strip focal cortical dysplasia during awake craniotomy: illustrative case.

BACKGROUND: Focal cortical dysplasias (FCD) represent highly intrinsically epileptogenic lesions that require complete resection for seizure control. Resection of pure motor strip FCD can be challenging. Effective control of postoperative seizures is crucial and extending the boundaries of resection in an eloquent zone remains controversial. OBSERVATIONS: The authors report a 52-year-old right-handed male with refractory epilepsy. The seizure phenotype was a focal crisis with preserved awareness and a clonic motor onset of right-hemibody. Epilepsy surgery protocol demonstrated a left pure motor strip FCD and a full-awake resective procedure with motor brain mapping was performed. Further resection of surgical boundaries monitoring function along intraoperative motor tasks with no direct electrical stimulation corroborated by intraoperative-neuromonitorization was completed as the final part of the surgery. In the follow-up period of 3-years, the patient has an Engel-IB seizure-control with mild distal lower limb palsy and no gate compromise. LESSONS: This report represents one of the few cases with pure motor strip FCD resection. In a scenario similar to this case, the authors consider that this variation can be useful to improve seizure control and the quality of life of these patients by extending the resection of a more extensive epileptogenic zone minimizing functional damage.

Adaptación de la Escala de Activación Conductual para la Depresión (BADS) en pacientes con cáncer / Adaptation of the Behavioral Activation for Depression Scale (BADS) in cancer patients

OBJETIVO: adaptar la Behavioral Activation for Depression Scale (BADS) y someterla a análisis factorial confirmatorio en una muestra de pacientes oncológicos. MÉTODO: Estudio instrumental en dos fases, en la fase 1 se tradujo y adaptó la escala original (BADS) al castellano según los estándares de la American Psychological Association (n= 101), en la fase 2 se aplicó la escala obtenida en la fase anterior y se sometió a análisis factorial confirmatorio (n= 341). RESULTADOS: el análisis factorial confirmatorio arrojó una escala formada por cuatro factores y 12 reactivos, con un ajuste: X2= 1,24 gl= 48 p=,118; CFI= ,98, TLI= ,98, RMSEA= ,027, NFI= ,93, RFI= ,91, IFI= ,98, PNFI= ,68; tuvo una correlación negativa media con los constructos de ansiedad y depresión. CONCLUSIONES: la adaptación de la Escala de Activación Conductual para la Depresión dirigida a pacientes oncológicos, tiene propiedades psicométricas aceptables lo que permite tener un instrumento adecuado para medir el nivel de activación conductual en esta población

To adapt the Behavioral Activation for Depression Scale (BADS) and submit it to confirmatory factor analysis in an oncological patients sample. METHOD: Instrumental study in two phases, phase 1 followed the American Psychological Association standards to translate and adapt the original scale (BADS) to Spanish (n=101), in phase 2 we applied the scale obtained in the previous phase and submitted it to confirmatory factor analysis (n= 341). RESULTS: the confirmatory factorial analysis showed a scale consisting of four factors and 12 items, with a fit: X2 = 1.24 gl = 48 p = .118; CFI = .98, TLI = .98, RMSEA = .27, NFI = .93, RFI = .91, IFI = .98, PNFI = .68; had a medium negative correlation with anxiety and depression constructs. CONCLUSIONS: The adaptation of the Behavioral Activation Scale for Depression aimed at cancer patients has acceptable psychometric properties, which allows have an adequate instrument to measure the level of behavioral activation in this population

Non-suicidal self-injuries in a sample of Mexican university students / Autolesiones no suicidas en una muestra de estudiantes universitarios mexicanos

Abstract Introduction Non-suicidal self-injuries (NSSI) are a worldwide health problem that affects principally young people, and can impact negatively the mental and physical health of those that self-injure. Objective To examine the frequency of NSSI in 564 undergraduate students (132 male, 432 female) from Mexico City and the association of NSSI with depressive symptoms, anxiety, impulsivity, self-efficacy, and emotion regulation. Method A convenience sample of 564 undergraduate students (aged 17-26 years) from eight universities in the Mexico City metropolitan area completed a survey in their classrooms. Results Of the total sample, 30.9% had experimented at some point in their lifetime with NSSI on one to four occasions, while 26.9% had recurrent NSSI (i.e., five or more occasions). Nearly eleven percent self-injured in the prior 12 months. The NSSI most often reported among those who self-injured was cutting oneself (48.0%). Recurrent self-injurers reported higher levels of depression and impulsivity, and less self-efficacy than those who had experimented with such behaviors or without any lifetime NSSI. While 54.4% perceived the need for professional help, only 18.1% sought professional services. Discussion and conclusion NSSI is a hidden problem in the college population in Mexico City which needs to be addressed by university administrators and mental health professionals. Depressive symptomatology, impulsivity, and self-efficacy are factors that should be considered when developing preventive intervention strategies.

Resumen Introducción Las autolesiones no suicidas (ANS) son un problema mundial de salud que afecta principalmente a jóvenes, y puede impactar de manera negativa la salud mental y física de la persona que se autolesiona. Objetivo Examinar la frecuencia de ANS en 564 estudiantes de licenciatura (132 hombres, 432 mujeres) de la Ciudad de México y la asociación de las ANS con síntomas depresivos, ansiedad, impulsividad, autoeficacia y regulación emocional. Método Una muestra de conveniencia de 564 estudiantes universitarios (edades 17-26 años) de ocho universidades del área metropolitana de la Ciudad de México completó una encuesta en sus salones de clases. Resultados Del total de la muestra, 30.9% se habían infligido ANS de manera experimental de una a cuatro ocasiones, mientras que 26.9% presentaron ANS recurrentes (cinco o más ocasiones) en algún momento en su vida. Casi once por ciento reportaron ANS en los 12 meses previos. Las ANS reportadas con mayor frecuencia entre aquellos que se autolesionaron fueron cortarse a sí mismos (48.0%). Las personas con autolesiones recurrentes reportaron mayores niveles de depresión e impulsividad, y menos autoeficacia que aquellas que habían experimentado con estos comportamientos o sin ninguna historia de ANS en su vida. Aunque 54.4% percibían la necesidad de atención, solo 18.1% buscaron servicios profesionales. Discusión y conclusión Las ANS son una problemática oculta en la población universitaria de la Ciudad de México, la cual necesita ser atendida por las autoridades universitarias y los profesionales de la salud. La sintomatología depresiva, impulsividad y autoeficacia son factores que se deben considerar para desarrollar estrategias preventivas.

Direct Endonasal Approach with Partial Upper Posterior Septectomy. A "Rescue Flap" Technique Modification.

Objective Report a modification of the "rescue flap" technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution. Design Prospective study. Setting Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León. Main Outcome Measures Since April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below. Results Nineteen patients were included in this report. Six patients presented transoperatory cerebrospinal fluid (CSF) leak, so a nasoseptal rescue flap was harvested. No patients developed postoperative CSF leak in this group. Two patients were submitted to a second surgical procedure. Nasoseptal flap was harvested without complications. In both patients, the size of the flap was enough to cover the dural defect and avoid CSF leak. Conclusion Direct endonasal approach with a partial posterior septectomy allows enough exposition of the sphenoidal sinus while preserving the nasoseptal septum with the possibility of a successful rescue flap when needed.

Distress tolerance dimensions and smoking behavior among Mexican daily smokers: A preliminary investigation.

INTRODUCTION: Distress intolerance has been implicated in various aspects of smoking maintenance and quit behavior, although past work has been conducted almost exclusively among European American samples. METHOD: The present study sought to extend past work by exploring distinct subdimensions of distress tolerance (Tolerance, Appraisal, Regulation, and Absorption) among a sample of 113 (53.1% female; Mage=22.81, SD=2.13) adult daily smokers from Mexico City, Mexico in regard to multiple indices of problematic smoking. RESULTS: Results indicated that the Appraisal dimension of distress intolerance was associated with smoking more cigarettes per day, a greater number of (lifetime) failed quit attempts, and an increased likelihood of early smoking relapse. These findings remained significant after controlling for negative affectivity, gender, alcohol usage as well as the variance accounted for by other distress tolerance dimensions. CONCLUSIONS: Such results provide novel preliminary empirical evidence that lesser perceived ability to tolerate distress because it is appraised as 'unacceptable' may be a particularly important element of the construct in terms of better understanding multiple public health relevant indicators of smoking for Mexican smokers. Overall, the present findings uniquely contribute to a growing body of research related to distress intolerance and its implications for explicating the nature of the maintenance of smoking behavior among a highly understudied segment of the smoking population (Mexican smokers).

Adaptación y propiedades psicométricas del Inventory of Statements About Self-injury en estudiantes mexicanos / Adaptation and psychometric properties of the Inventory of Statements About Self-injury in Mexican students

Resumen La presente investigación evalúa las propiedades psicométricas de la adaptación al español del Inventory of Statements About Self-injury de Klonsky y Glenn (2009). Esta escala evalúa las diferentes motivaciones o funciones que las personas refieren para realizar autolesiones no suicidas. Se aplicó la escala en una muestra (N = 435) de alumnos universitarios de ambos sexos con una historia de autolesiones no suicidas. El análisis factorial confirmatorio detectó 7 factores interpretables (autorregulación, venganza, búsqueda de sensaciones/fortaleza, evitando el suicidio, manifestando angustia, autodeterminación y embotamiento), 5 más que el instrumento original. La confiabilidad de la escala fue aceptable, con un alfa de Cronbach de 0.89 para la escala total y de 0.72 a 0.82 para cada factor. Se presenta la validez convergente a través de correlaciones positivas entre la escala y mediciones de depresión, ansiedad e impulsividad. El instrumento adaptado al español presenta propiedades psicométricas aceptables para la medición de autolesiones no suicidas en población universitaria mexicana.

Abstract This research evaluates the psychometric properties of the Spanish language adaptation of the Inventory of Statements About Self-injury (Klonsky and Glenn, 2009). This scale assesses the motivations or functions that people with non-suicidal self-injuries report for engaging in self-injurious behaviors. The inventory was administered to a sample of 435 male and female university students with a lifetime history of non-suicidal self-injuries. A confirmatory factor analysis detected 7 interpretable factors (self-regulation, revenge, sensation seeking/toughness, avoiding suicide, marking distress, self-determination and numbness), 5 more than the original instrument. The scale had adequate internal consistency with a Cronbach's alpha of 0.89 and Cronbach's alphas of 0.72 to 0.82 for each factor. Positive correlations between the scale and measures of depression, anxiety and impulsivity suggest the convergent validity of the scale. Overall, the scale presents acceptable psychometric properties for the measurement of non-suicidal self-injuries in a Mexican university population.

High and Low Trait Anger, Angry Thoughts, and the Recognition of Anger Problems.

This research had two goals: (1) it tested hypotheses of the State-Trait Model of anger, and (2) it explored characteristics that may distinguish individuals with high trait anger who recognize problems with their anger from those who do not recognize anger problems. Regarding the first goal, findings supported three hypotheses tested. In particular, compared to those low in trait anger, individuals with high trait anger reported: (a) more intense anger (intensity hypothesis), p < .001, effect size (η(2)) = .109; (b) more thoughts involving pejorative labeling/denigration, p < .001, η(2) = .280, thoughts of revenge, p < .001, η(2) = .170, more outward, negative anger expression (anger-out), p < .001, η(2) = .229, and more physically aggressive expression, p < .001, η(2) = .046-.123, (aggression hypothesis); and (c) more anger suppression (anger-in), p < .001, η(2) = .231, and fewer thoughts of self-control, p < .001, η(2) = .088, and behavioral efforts to control angry feelings (anger control-in), p < .001, η(2) = .116, and behavior (anger control-out), p < .001, η(2) = .260 (reduced positive coping hypothesis). For the second goal we employed two types of individuals, both with high trait anger: those who identified anger as a personal problem and wanted help, and those who did not identify anger as a personal issue. As a result, compared to those who did not report anger problems, those who reported anger problems demonstrated a higher overall propensity to experience anger (i.e., higher trait anger), p < .01, η(2) = .028, greater anger suppression and harboring grudges (anger-in), p < .001, η(2) = .035, fewer thoughts of self-control, p < .05, η(2) = .015, and attempts to control their angry feelings (anger-control-in), p < .05, η(2) = .016, and behavior (anger-control-out), p < .001, η(2) = .054. Gender was not associated with trait anger or anger problem recognition. Findings were discussed in terms of State-Trait Theory and implications for anger interventions.

Variables que predicen la aparición de sobrecarga en cuidadores primarios informales de niños con cáncer / Variables that predict the appearance of burden in informal primary caregivers of children with cancer

El propósito del estudio fue identificar las variables psicológicas y las características del cuidado que predicen la aparición de carga en cuidadores primarios informales (CPI) de niños con cáncer, en un hospital de la ciudad de México. La muestra no probabilística constó de 100 participantes, quienes contestaron una batería integrada por la encuesta de salud para el CPI, la escala de carga del cuidador de Zarit, los inventarios de ansiedad y depresión de Beck, la escala de apoyo familiar para CPI y la escala de modos de afrontamiento al estrés de Lazarus y Folkman. Los resultados confirmaron que las mujeres (en la mayoría de los casos la madre del paciente) actúan como CPI de niños con cáncer. Las variables predictoras de la carga en el modelo de regresión múltiple por pasos fueron la depresión (R2 = 0,228), el número de áreas afectadas en la vida del cuidador (R2 = 0,319) y la ansiedad (R2 = 0,348). En total las tres variables explicaron el 34% de la varianza. Mientras que el estilo de afrontamiento, el apoyo familiar, el tiempo de cuidado del paciente, las horas diarias de cuidado de éste y el número de actividades que realiza no resultaron variables relevantes en la predicción de la carga. Los hallazgos podrían ser útiles para diseñar intervenciones que promuevan el bienestar físico, social y emocional de esta población, previniendo que los cuidadores se conviertan en pacientes

The purpose of the study was to identify the psychological characteristics and care variables that predict the onset of primary informal caregivers burden (CPI) of children with cancer, in a hospital in Mexico City. The nonrandom sample consisted of 100 participants, who answered an integrated battery conformed by a health interview for the CPI, the load scale for the Zarit caregiver, the anxiety and depression of Beck inventory, the family support for the CPI scale and the scale modes of coping with stress by Lazarus and Folkman. The results confirmed that women react as CPI to children with cancer, and in most cases the patient’s mother. The variables of burden model stepwise multiple regressions were depression (R2= 0.228), the number of affected areas in the caregiver’s life (R2 = 0.319) and anxiety (R2 = 0.348). In all the three variables explained 34% of variance. While coping style, family support, time to patient care, daily care hours and the number of activities carried out were not significant variables in predicting overload. The findings of this study could be useful for designing interventions that promote physical, social and emotional wellbeing of this population, preventing the patient from becoming caregivers

[Craniocerebral gunshot wounds in civilian population: Analysis of experience in a single center in Monterrey, México]. / Heridas craneales por proyectil de arma de fuego en población civil: análisis de la experiencia de un centro en Monterrey, México.

BACKGROUND: Gunshot wounds in civilian population of México were quite rare. Currently, conflicts amongst organized crime groups are carried out with weapons, which are considered as exclusive use by the nations army. OBJECTIVES: Describe the experience of our institution and share results of clinical and radiological factors influencing the prognosis of the patients. MATERIAL AND METHODS: Observational and retrospective study of patients with cranial gunshot wounds (GSW), which penetrated the duramater, treated from January 2009 - January 2013. We considered several demographic variables, Glasgow Coma Scale (GCS), upon admission, state of pupils, type of surgery and size of decompression, Glasgow Outcome Score (GOS) upon discharge, and after 6 months. RESULTS: Of 68 patients, we excluded those whose duramater was not penetrated, leaving 52 patients. The average age was 28.7 years, and 80.8% were males. All were surgically intervened, with 8% of general mortality. Mortality in the GCS 3 to 5 points group was 43%, from the 6 to 8 points it was 6%, and no deaths in the 9 to 15 points. In patients with both pupils fixed, anisocoric and isocoric, mortality was 67%, 7%, and 3%, respectively. Bihemispheric, multilobar and unihemispheric trajectory of the bullet plus ventricular compromise was related to a Glasgow Outcome Score ≤ 3 upon discharge in 90.9% of the cases. CONCLUSIONS: GCS upon admission and state of the pupils are the most influential factors in the prognosis. Patients with a GCS > 8 < 13 points upon admission, normal pupillary response, without ventricular compromise can benefit with early and aggressive surgical treatment.

High and low trait anger, angry thoughts, and the recognition of anger problems

This research had two goals: (1) it tested hypotheses of the State-Trait Model of anger, and (2) it explored characteristics that may distinguish individuals with high trait anger who recognize problems with their anger from those who do not recognize anger problems. Regarding the first goal, findings supported three hypotheses tested. In particular, compared to those low in trait anger, individuals with high trait anger reported: (a) more intense anger (intensity hypothesis), p < .001, effect size (η2) = .109; (b) more thoughts involving pejorative labeling/denigration, p < .001, η2 = .280, thoughts of revenge, p < .001, η2 = .170, more outward, negative anger expression (anger-out), p < .001, η2 = .229, and more physically aggressive expression, p < .001, η2 = .046-.123, (aggression hypothesis); and (c) more anger suppression (anger-in), p < .001, η2 = .231, and fewer thoughts of self-control, p < .001, η2 = .088, and behavioral efforts to control angry feelings (anger control-in), p < .001, η2 = .116, and behavior (anger control-out), p < .001, η2 = .260 (reduced positive coping hypothesis). For the second goal we employed two types of individuals, both with high trait anger: those who identified anger as a personal problem and wanted help, and those who did not identify anger as a personal issue. As a result, compared to those who did not report anger problems, those who reported anger problems demonstrated a higher overall propensity to experience anger (i.e., higher trait anger), p < .01, η2 = .028, greater anger suppression and harboring grudges (anger-in), p < .001, η2 = .035, fewer thoughts of self-control, p < .05, η2 = .015, and attempts to control their angry feelings (anger-control-in), p < .05, η2 = .016, and behavior (anger-control-out), p < .001, η2 = .054. Gender was not associated with trait anger or anger problem recognition. Findings were discussed in terms of State-Trait Theory and implications for anger interventions (AU)

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Escala de carga del cuidador de Zarit: evidencia de validez en México / Zarit caregiver burden scale: evidence of validity in mexico

El propósito fue obtener evidencia de validez de la escala de carga del cuidador de Zarit en cuidadores primarios informales de niños con alguna enfermedad crónico degenerativa, en un hospital de la ciudad de México. La muestra constó de 252 participantes. Se utilizó la escala de carga del cuidador de Zarit (CBI), el cuestionario general de salud (GHQ-28) y el cuestionario de estrés percibido (PSS). El análisis factorial exploratorio y confirmatorio de la escala mostró que está conformada por tres factores que explican el 50% de la varianza. Tuvo un alfa de Cronbach de 0,84. y el modelo tuvo un buen ajuste con valores iguales o superiores a 0,90. La validez de criterio entre el GHQ-28 y el CBI arrojó un valor r=0,46. La validez de constructo se confirmó correlacionando el PSS y la CBI obteniendo un valor r=0,36

The purpose was to obtain evidence of the validity of the Zarit Burden Scale in informal primary caregivers of children with chronic illness, in a hospital in Mexico City. The sample consisted of 252 participants. The instruments used were Zarit Burden Interview (CBI), General Health Questionnaire (GHQ-28) and the Perceived Stress Scale (PSS). The exploratory and confirmatory factor analysis of the scale resulted in three factors which explain 50% of the variance. Cronbach's alpha was .84 and the model fit well with values equal to or above 0.90. The criterion validity obtained between the GHQ-28 and the CBI, showed a value r=0.46. The construct validity was estimated correlating the PSS and the CBI, obtaining a value r=0.36

Perforación tardía del ventrículo derecho con electrodo de fijación activa en el septum y estimulación diafragmática como primera manifestación clínica / Late right ventricular perforation with active fixation electrode in the septum with diaphragmatic stimulation as first clinical manifestation

La perforación miocárdica es una complicación infrecuente, relacionada con el implante de marcapasos y cardiodesfibriladores, que puede ocurrir al insertar los electrodos; sin embargo, en relación con la utilización de electrodos de fijación activa, ésta puede suceder después de varios días o semanas del implante. Se describe un caso clínico de un paciente a quien se le implantó un marcapasos bicameral con electrodos de fijación activa evidenciándose una semana más tarde perforación miocárdica por el electrodo ventricular, con estimulación diafragmática como manifestación clínica. Inicialmente no había evidencia radiológica de la perforación y requirió abordaje endovascular para extracción.

Myocardial perforation is a rare complication of pacemakers and defibrillators implantation that can occur when inserting the electrodes. However, regarding the use of active fixation electrodes, perforation can occur several days or weeks after the implant . We describe the case of a patient who was implanted a dual chamber pacemaker with active fixation electrodes. A week later we evidenced myocardial perforation by the ventricular electrode with diaphragmatic stimulation as clinical manifestation. Initially there was no radiological evidence of perforation and it required endovascular approach for extraction.

Taxonomic delimitation and drivers of speciation in the Ibero-North African Carex sect. Phacocystis river-shore group (Cyperaceae).

PREMISE OF THE STUDY: The Ibero-North African Carex sect. Phacocystis river-shore group is a set of perennial helophytic species with poorly defined taxonomic boundaries. In the present study, we delimited the different taxonomic units, addressed the phylogeographic history, and evaluated the drivers of differentiation that have promoted diversification of these plants. METHODS: We analyzed molecular data using statistical parsimony for plastid sequences (26 samples from 26 populations) and principal coordinate analysis, neighbor joining, and Bayesian analysis of population structure for AFLPs (186 samples from 26 populations). Chromosome numbers from 14 samples (9 populations) are newly reported. KEY RESULTS: Three species can be distinguished (C. acuta, C. elata, and C. reuteriana). Unexpectedly for rhizome-growing helophytes, the vegetative reproduction detected was incidental. The widespread C. elata was found to be a genetically poorly differentiated taxon, whereas the local C. reuteriana displayed geographical structuring. Geographical factors seem to be the main driver of differentiation for both taxa. CONCLUSIONS: Despite apparent morphological and ecological similarities, C. elata and C. reuteriana have disparate genetic structures and evolutionary histories, which may have originated from small ecological differences. Carex elata is broadly distributed throughout Europe, and its northern populations were recently founded, probably after the last glacial maximum. In contrast, C. reuteriana is an Ibero-North African endemic, with long-standing populations affected by isolation and limited gene flow. It is likely that high-density blocking effects and different gene-flow barriers act together to delimit its distribution and promote its relatively high population differentiation.

Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3.

Accumulating evidence suggests that anxiety sensitivity (fear of arousal-related sensations) plays an important role in many clinical conditions, particularly anxiety disorders. Research has increasingly focused on how the basic dimensions of anxiety sensitivity are related to various forms of psychopathology. Such work has been hampered because the original measure--the Anxiety Sensitivity Index (ASI)--was not designed to be multidimensional. Subsequently developed multidimensional measures have unstable factor structures or measure only a subset of the most widely replicated factors. Therefore, the authors developed, via factor analysis of responses from U.S. and Canadian nonclinical participants (n=2,361), an 18-item measure, the ASI-3, which assesses the 3 factors best replicated in previous research: Physical, Cognitive, and Social Concerns. Factorial validity of the ASI-3 was supported by confirmatory factor analyses of 6 replication samples, including nonclinical samples from the United States and Canada, France, Mexico, the Netherlands, and Spain (n=4,494) and a clinical sample from the United States and Canada (n=390). The ASI-3 displayed generally good performance on other indices of reliability and validity, along with evidence of improved psychometric properties over the original ASI.

Anxiety sensitivity and early relapse to smoking: a test among Mexican daily, low-level smokers.

The aim of the present investigation was to extend previous work on anxiety sensitivity (AS) and early smoking relapse among a sample of 130 (74 females) young adult (M (age) = 22.5 years, SD = 2.1) daily low-level smokers (9.3 cigarettes/day, SD = 11.5) from Mexico City, Mexico. Results indicated that of the global-level and lower-order factors (i.e., physical, mental incapacitation, and social concerns) on the Anxiety Sensitivity Index, only the physical concerns factor was significantly related to early lifetime smoking relapse. This effect was observed above and beyond the effects of negative affectivity, cigarettes smoked per day, and alcohol consumption, as well as beyond the other AS mental and social concerns factors. Findings provide novel evidence that AS is an important explanatory construct in early smoking relapse.

Taxonicity of anxiety sensitivity: a multi-national analysis.

Taxometric coherent cut kinetic analyses were used to test the latent structure of anxiety sensitivity in samples from North America (Canada and United States of America), France, Mexico, Spain, and The Netherlands (total n = 2741). Anxiety sensitivity was indexed by the 36-item Anxiety Sensitivity Index--Revised (ASI-R; [J. Anxiety Disord. 12(5) (1998) 463]). Four manifest indicators of anxiety sensitivity were constructed using the ASI-R: fear of cardiovascular symptoms, fear of respiratory symptoms, fear of publicly observable anxiety reactions, and fear of mental incapacitation. Results from MAXCOV-HITMAX, internal consistency tests, analyses of simulated Monte Carlo data, and a MAMBAC external consistency test indicated that the latent structure of anxiety sensitivity was taxonic in each of the samples. The estimated base rate of the anxiety sensitivity taxon differed slightly between nations, ranging from 11.5 to 21.5%. In general, the four ASI-R based manifest indicators showed high levels of validity. Results are discussed in relation to the conceptual understanding of anxiety sensitivity, with specific emphasis on theoretical refinement of the construct.

Tratamiento psicofisiológico y conductual del trastorno de ansiedad

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Abstract: Panic disorder is a complex phenomenon according to its biochemical and psychosocial etiology. Therapeutic interventions of panic disorder are aimed to promote effectiveness through the combined use of medication and behavioral cognitive therapy. Anxiety is a normal human response. Moderate levels of anxiety are well accepted because they act as an aid to improve performance, and high levels of anxiety are experienced as normal if they are consistent with the demands of the situation. Persons with anxiety disorders complain of experiencing anxiety too often but they seek help also to overcome fears they recognize as irrational and intrusive. From a psychological point of view, behavioral cognitive techniques -such as hyperventilation control, exposure, and cognitive therapy- and structured problem solving have been successful in the treatment of the symptoms associated to anxiety. It is worth to emphasize that graded exposure is perhaps the most powerful technique assisting patients to overcome fearful situations. Cognitions are also important because it has been found that panic attacks occur when people process information in the external environment, as well as internal somatic stimuli, as though they were threatening experiences. In other words, they feel they have no control over their sensations. Panic attacks prevalence in Mexico City is 1.1% in men and 2.5% in women. It is more frequent among 25-to 34- year old single men and married women, with an average scholarity between 7 and 9 years. From a biological point of view, it is suggested that the etiology of panic attacks involves the participation of the serotonergic and adrenergic neurotransmitter systems, as well as the GABA/ benzodiacepine. Studies based on the noradrenergic theory had lead to conclude that panicking patients have more sensitive brainstem carbon dioxide receptors than normal control subjects. At the same time, other lines of work indicate that serotonergic transmission may also play an important role in the genesis of panic attacks. It has been found that patients with panic disorder may have a lower tolerance threshold to methoclorophenylpiperazine response than control subjects because of hypertensive serotonergic receptors. The accumulated laboratory evidence seems to support the idea that panic attacks begin with the stimulation of irritable foci in one of three brainstem areas: the medullary chemoreceptors, the noradrenergic pontine locus coeruleus, or the serotonergic midbrain dorsal raphe. On the other hand, biofeedback is a psychophysiological intervention that allows in the first place for the external control of some of the physical symptoms involved in this disorder, which is later transferred to internal control of psychophysiological cognitions and behaviors that enable the patient to prevent symptom's occurrence. Based on the principles of the General Systems Theory, biofeedback utilizes the concepts of self regulation and disregulation to describe the conditions under wich normally integrated self-regulatory systems may become imbalanced with regard to their positive and negative feedback loops. Technically, all that a person needs to do is to attend to the signals feedback and not to "try" to control them; the effects of a positive feedback loop should occur automatically, without conscious awareness, as long as the person processes the stimuli. Biofeedback has been effectively used in the treatment of essential hypertension, migraine headaches, Raynaud's disease, tension headaches, temporomandibular joint syndrome, asthma, primary dysmenorrhea, peptic ulcers, fecal incontinence, and conditioning of electroencephalographic rhythms, among other problems. The present study reports data from 32 panic disorder outpatients from the National Psychiatry Institute, Mexico City. They were randomly assigned to: Control Group (N = 14): daily doses of 75 milligrams of imipramine. The participants of this group were required to assist to the psychology department in order to obtain a baseline (pre-test and post-test) with the biofeedback equipment. In addition, every two weeks they visited a psychiatrist who verified that there were no collateral effects from the medicament. Experimental Group (N = 18): besides daily doses of imipramine, and visits to the psychiatrist, these patients went through eight multimodal biofeedback and behavioral cognitive techniques which were assisted with relaxation training sessions. All biofeedback sessions lasted 30 minutes divided in six five-minute trails. The first and final trials served to stabilize the biological responses, and the four middle trials were used to give biofeedback and reinforcement to the response being trained in addition to the verbal explanation of the changes occurring on the screen of the computer. All patients were assessed with the Anxiety Sensitivity Index, and with Beck's Anxiety and Depression Inventories. Results showed that patients in the experimental group reported significant lower scores in the anxiety sensitivity index than the control group. Post-test differences showed that the electromiographic and electrodermic activity from the experimental group was lower than the one from the control group. Diaphragmatic respiration training and progressive muscular relaxation and imagery proved to be effective in reducing the symptoms associated to panic attacks. The overall final result is that all patients improved clinically. They verbally reported that the intensity, frequency and evitative behaviors derived from panic attacks had almost disappeared. However, the cognitive factor of anxiety sensitivity changed significanty only in the experimental group. These findings support the hypothesis that clinical improvement results from a symptom "reattribution" which gives them cognitive skills to cope with stressing stimuli. Further studies should reassess the effectiveness of the combined treatment (imipramine and behavioral cognitive techniques). It is also recommended to expand the study to generalized anxiety disorder and to adjust the experimental design in order to incorporate a second phase with neurofeedback as independent variable. Equally important is to investigate the mechanisms of the hypnotic ability and its impact on the clinical improvement of anxiety disorders.

Anxiety sensitivity in six countries.

In the present study, the Anxiety Sensitivity Index-Revised (ASI-R; ) was administered to a large sample of persons (n=2786) from different cultures represented in six different countries: Canada, France, Mexico, The Netherlands, Spain, and the United States. We sought to (a) determine the factor structure and internal consistency of the ASI-R and (b) examine the correlations of the measure with psychiatric symptoms and personality dimensions in a single European non-English speaking country (The Netherlands). Partially consistent with the original hypothesis, the underlying structure of the anxiety sensitivity construct was generally similar across countries, tapping fear about the negative consequences of anxiety-related physical and social-cognitive sensations. Lower-order factors were moderately to strongly correlated with one another and showed good internal consistency. The observed lower-order ASI-R factors correlated with established psychiatric symptoms and with the personality trait of neuroticism. Partial correlations indicated that both factors are useful in accounting for variance in symptom measures. We discuss the results of this investigation in relation to the cross-cultural assessment of the anxiety sensitivity construct.