Adaptation of a scale to measure coping strategies in informal primary caregivers of psychiatric patients.

WHAT IS KNOWN ON THE SUBJECT?: Informal caregivers of psychiatric patients are vulnerable to many disturbances associated with the stress related to their activity. Caregivers who show a coping style focused on problem-solving report less psychological distress, and this approach positively influences the recovery process of the psychiatric patient. There are some questionnaires to measure coping styles in caregivers of psychiatric patients, but most of them do not have the minimum psychometric properties that a scale must fulfil. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The authors present an adapted and validated scale for measuring both active and passive coping strategies used by informal caregivers to face daily stressful situations with psychiatric patients. The study is an example of how scales can be adapted to small samples (n < 200). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The scale could be helpful for generating strategies to support the family caregiver, as well as for measuring the results of interventions. The scale could also be used to identify how coping styles of informal caregivers are related to recovery process of psychiatric patients. ABSTRACT: Background The recovery process of a psychiatric patient is related to his primary informal caregiver's style of coping with stress. There is insufficient literature on validations of instruments that measure coping styles in this population. Objective To adapt and validate a scale to measure coping strategies in primary informal caregivers. Method The adapted scale was based on the Extreme Coping Scale of López-Vázquez and Marván. Items from that scale were adapted for application to informal caregivers. The scale was administered to 122 primary informal caregivers of patients from two psychiatric institutions in Mexico. Psychometric analyses were performed to determine the scale's properties. Results The scale was composed of 20 items (six less than in the original scale) and two factors: (i) active coping (Cronbach's alpha = .837) and (ii) passive coping (Cronbach's alpha = .718). Discussion The findings are discussed in the light of the importance of studying the relationship between coping styles and the well-being of both informal caregivers and psychiatric patients. Implications for practice The scale could be used by health practitioners and researchers to generate strategies to support the family caregiver, as well as to measure the results of interventions.

Mexican adolescents' experience of menarche and attitudes toward menstruation: role of communication between mothers and daughters.

OBJECTIVES: First, to explore the kind of information that Mexican mothers give their daughters about menstruation before their menarche, and to study the impact of this communication on how prepared the daughters felt when they experienced their menarche. Second, to investigate the influence of the menarcheal experience on attitudes toward menstruation. DESIGN: Cross-sectional survey. SETTINGS: Sample of adolescents attending 3 different public schools. PARTICIPANTS: 405 Mexican postmenarcheal adolescents, aged 12-15 years. INTERVENTION: Participants answered a questionnaire that had 3 parts: (a) General data, (b) topics related to menses that participants had discussed with their mothers prior to menarche, and (c) menarcheal experience. They also answered a questionnaire about menstrual attitudes. RESULTS: Although most of the participants knew what they should do when they experienced their menarche, only 39% stated they had felt prepared to start menstruating. Regarding menstrual attitudes, adolescents scored highest on Negative Feelings and Secrecy rather than on Positive Feelings. Participants who had previously discussed the emotional aspects of menses with their mothers were more likely to claim they had felt prepared to start menstruating when they got their first period (OR = 3.45). The fact that adolescents felt prepared to start menstruating predicted positive attitudes toward menstruation (ß = .19) CONCLUSIONS: Discussing the emotional aspects of menses prior to menarche is crucial to being prepared for menarche, and to holding positive attitudes toward menstruation. Information on biological knowledge and practical aspects of menses needs to be supplemented with emotional issues.

Premenarcheal Mexican girls' expectations concerning perimenstrual changes and menstrual attitudes.

The objective of this study was to determine both the perimenstrual changes that Mexican premenarcheal girls expect to experience and their attitudes toward menstruation. A total of 750 premenarcheal girls in fifth and sixth grade were studied. Participants completed a Perimenstrual Change Checklist, which listed 20 negative possible perimenstrual changes and ten positive ones, and a Spanish version of the Adolescent Menstrual Attitude Questionnaire. The results showed a set of mostly negative perimenstrual expectations, the most common being discomfort, cramps or abdominal pain and mood swings. Concerning menstrual attitudes, the girls scored highest on secrecy, followed by negative feelings and by positive feelings. The girls who perceived menstruation as a negative event and with secrecy, expected more negative perimenstrual changes, while those who perceived menstruation as a positive event expected more positive perimenstrual changes. We believe premenarcheal girls, with no personal experience, must be more influenced by cultural stereotypes which are of a negative nature.

A comparison of menstrual changes expected by pre-menarcheal adolescents and changes actually experienced by post-menarcheal adolescents in Mexico.

This survey explored para-menstrual changes that Mexican pre-menarcheal girls expect to experience and paramenstrual changes actually experienced by post-menarcheal girls. The survey included 95 pre-menarcheal girls who reported what they expected to experience in the para-menstruum, and their answers were compared with para-menstrual changes reported by 98 post-menarcheal girls. There were more post-menarcheal than pre-menarcheal girls who reported negative physical changes, while more pre-menarcheal girls expected to experience negative changes related to cognitive-emotional expressions. Regarding positive para-menstrual changes, despite the fact that hardly any of the girls named them, more post-menarcheal girls reported positive changes than pre-menarcheal girls who expected the changes. The dominant menstrual discourse concerning menstruation focused on para-menstrual negative changes, which can lead pre-menarcheal girls to anticipate their periods with fear and to overlook positive changes that may occur in the para-menstruum.

Women's beliefs about the prevalence of premenstrual syndrome and biases in recall of premenstrual changes.

The present study investigated the relationship between women's beliefs about the prevalence of premenstrual syndrome (PMS) and biases in recall of premenstrual changes. Forty-nine women completed the Moos Menstrual Distress Questionnaire (R. H. Moos, 1968) both retrospectively and prospectively. Afterward, they were asked about their beliefs concerning the prevalence of PMS. The women reported higher premenstrual changes when they completed the retrospective questionnaire. Seventy-five percent of the women believed that the majority of women have premenstrual changes. From this percentage, those who answered that the majority also experience PMS were more biased in their premenstrual changes in the retrospective assessment. Many women have a misperception about the meaning of PMS; consequently, they amplify their premenstrual changes in recall, reflecting women's cultural stereotypes rather than their actual experiences.

Premenstrual symptomatology: role of prior knowledge about premenstrual syndrome.

OBJECTIVE: Most women have some premenstrual symptoms that may be influenced by diverse environmental factors. The aim of this study was to determine the influence of knowledge about premenstrual syndrome (PMS) in the reports of women and their symptoms. METHOD: We studied 86 healthy Mexican women whose highest level of education was sixth grade. Participants were assigned to one of two groups. The experimental group watched a videotape describing PMS and its negative consequences in daily life. The control group watched a videotape describing the menstrual cycle. The Menstrual Distress Questionnaire was administered to all women during the first week after menstruation, after which they were shown their designated videotape, and the questionnaire was administered again after the next menstruation. RESULTS: In the control group, there were no significant differences in premenstrual symptoms reported both before and after the women watched the videotape. However, women in the experimental group reported more severe premenstrual symptoms after watching the videotape. CONCLUSIONS: These results suggest that after observing the videotape, women's expectancies of negative symptoms in the premenstrual phase increased. Thus, the symptoms reported by these women were enhanced.

Premenstrual symptoms in Mexican women with different educational levels.

Most women present some premenstrual symptoms, which may be influenced by diverse sociocultural factors. The authors studied the premenstrual symptoms of 89 healthy Mexican women living in rural areas and whose education ranged from no schooling to middle school attendance, and 182 women living in urban areas whose education ranged from elementary school to professional studies. The Menstrual Distress Questionnaire (R. H. Moos, 1968) was completed by all the women during the premenstrual and postmenstrual phases of one menstrual cycle. The percentage of women who reported mild symptoms was 87% on somatic scales and 86% on psychological scales. Premenstrual symptoms were more severe among women engaged in professional studies. Urban women reported more severe psychological symptoms than rural women. When women who were engaged in professional studies were excluded from the data analyses, no differences between the groups were found. Thus, it appears that the women's level of education affected premenstrual symptoms more than their rural or urban backgrounds did.

Inescapable shocks accentuate fluctuations of forced swimming immobility in different phases of the rat estrous cycle.

The forced swimming test is an animal model that is sensitive to the different antidepressant treatments. On the other hand, it is also sensitive to the characteristic changes suffered by animals that have been previously exposed to different depression models. In the present study we explored the effects of inescapable shocks on the forced swimming test, during different phases of the rat estrous cycle. There was an increase of the immobility during diestrus as compared to estrus. Furthermore, inescapable shocks increased the immobility, but only during diestrus. Thus, the differences found between both phases of the estrous cycle were accentuated. Due to the fact that during diestrus there is an absence of progesterone, and that depressed women exacerbate their symptoms during the premenstrual phase, the authors suggest that the immobility registered during the forced swimming test may be useful in the study of premenstrual depression.

Clomipramine modifies fluctuations of forced swimming immobility in different phases of the rat estrous cycle.

Many symptoms that define the premenstrual syndrome (PMS) are present in depressive states. The fact that there are not adequate animal models to study the PMS may explain the lack of knowledge about its etiology. An alternative might be the use of animal models which are useful to study depression, such as the forced swimming test. Eighteen female rats were subjected to the forced swimming test once a week for six consecutive weeks. An increase of immobility was observed during diestrus as compared to estrus. On the other hand, some premenstrual symptoms have been suggested to be caused by the influence of gonadal hormones on the activity of central serotonergic systems. Thus, the effects of clomipramine were further studied. The drug reduced rat immobility during diestrus, so that the differences between the two estrous cycle phases disappeared. We conclude that the use of the forced swimming test might be a helpful model in the study of PMS.

[Premenstrual symptomatology in rural and urban zones]. / Sintomatología premenstrual en mujeres de área rural y urbana.

The objective of this study was to stablish the prevalence and severity of premenstrual symptoms in mexican women who live in a rural zone (n = 50) and in other group who live in a urban zone (n = 50). The Menstrual Distress Questionnaire (MDQ) was applied during the premenstrual and postmenstrual phases of one menstrual cycle. The 97% of the sample presented at least one premenstrual physical symptom, and the 95% of the women presented one psychological-behavioral symptom. There were not differences according with the severity of the physical symptoms between both groups of women. However, women in the urban zone reported more severe psychological-behavioral symptoms then the ones who live in the rural zone.

[Marital communication and premenstrual symptoms]. / Comunicación marital y síntomas premenstruales.

Most women have at least one premenstrual symptom. Despite the fact that these symptoms are sometimes light, they can affect the social environment. The relationship between premenstrual symptoms and marital communication was analysed in this study. 35 mexican couples were studies. Women's ages ranged from 35 to 40 and men's ages from 32 to 51. The conyugal time together fluctuated from 5 to 19 years. All women's cycles were regular. Women were given a menstrual symptoms questionnaire during two consecutive cycles. Furthermore, both spouses were given a marital communications questionnaire, twice in each woman's menstrual cycles: during premenstrual and postmenstrual phases. It was observed that marital communication decreased during the premenstrual period, compared to the postmenstrual phase. Moreover, it was found that the more severe the symptoms were the less marital communication was reported by women. Such co-relations were also given among men, at less degree, though. In brief, even women without being diagnosed for premenstrual syndrome have premenstrual symptoms apparently imperceptible which affect some aspects of their every day life such as marital communication.

Comunicación marital y síntomas premenstruales. / [Marital communication and premenstrual symptoms]

Most women have at least one premenstrual symptom. Despite the fact that these symptoms are sometimes light, they can affect the social environment. The relationship between premenstrual symptoms and marital communication was analysed in this study. 35 mexican couples were studies. Womens ages ranged from 35 to 40 and mens ages from 32 to 51. The conyugal time together fluctuated from 5 to 19 years. All womens cycles were regular. Women were given a menstrual symptoms questionnaire during two consecutive cycles. Furthermore, both spouses were given a marital communications questionnaire, twice in each womans menstrual cycles: during premenstrual and postmenstrual phases. It was observed that marital communication decreased during the premenstrual period, compared to the postmenstrual phase. Moreover, it was found that the more severe the symptoms were the less marital communication was reported by women. Such co-relations were also given among men, at less degree, though. In brief, even women without being diagnosed for premenstrual syndrome have premenstrual symptoms apparently imperceptible which affect some aspects of their every day life such as marital communication.

Sintomatología premenstrual en mujeres de área rural y urbana. / [Premenstrual symptomatology in rural and urban zones]

The objective of this study was to stablish the prevalence and severity of premenstrual symptoms in mexican women who live in a rural zone (n = 50) and in other group who live in a urban zone (n = 50). The Menstrual Distress Questionnaire (MDQ) was applied during the premenstrual and postmenstrual phases of one menstrual cycle. The 97

of the sample presented at least one premenstrual physical symptom, and the 95

of the women presented one psychological-behavioral symptom. There were not differences according with the severity of the physical symptoms between both groups of women. However, women in the urban zone reported more severe psychological-behavioral symptoms then the ones who live in the rural zone.

Electroconvulsive shock decreases excitatory responses to serotonin in the caudate nucleus of the rat.

1. The present study explored the changes on the firing rate of caudate neurons, and the response to serotonin locally applied in rats submitted to electroconvulsive shock. 2. Electroconvulsive shock diminished the firing rate of caudate neurons and blocked the excitatory response produced by serotonin in a small amount of serotonin-sensitive neurons. 3. Results are likely to be related with transient changes in the receptor's affinity and dissociation constants, which may impinge on immediate memory retrieval.

Clomipramine increases firing rate in lateral septal neurons related with hippocampus.

Long-term clomipramine administration (CMI: 2.5 mg/kg IP, 25 days) effects on 274 identified hippocampus-septal neurons was assessed in rats. Stimulation of CA 1/dentate areas produced a biphasic response in 61% of lateral septal neurons. A brief activation was followed by a period of suppression of firing. In CMI-treated rats, the neurons showing this biphasic response increased their firing rate about fourfold, while the suppression of firing shortened around threefold. Other septal neurons (36%), in which only the burst of activation appeared but not suppression of firing, did not change their firing rate even after long-term CMI. In conclusion, CMI produces an increase of firing rate in lateral septal neurons receiving inhibitory hippocampal influence which is likely to be mediated by a disinhibitory process.

Clomipramine increases the responsiveness of raphe-cortical neurons in the rat.

The cerebral cortex of the rat possesses 5-HT1A receptor subtype; however, whether the activation of this receptor by dorsal raphe nucleus stimulation produces a similar action on neuronal cortical firing as antidepressants acting on serotonin (5-HT) function is unknown. Single-unit extracellular recordings were obtained from parietal cortex in rats in which dorsal raphe nucleus or cerebellar peduncle was stimulated. Results compared groups long-term treated with clomipramine (1.25 mg/kg i.p., twice a day, during 30 days) or saline (0.15 ml i.p., twice a day, during 30 days). Amplitude of traces, firing rate, and response to treatment with clomipramine proved to be different between cortical neurons responding to dorsal raphe nucleus or cerebellar peduncle stimulation. Clomipramine increased a long-lasting cortical suppression of firing elicited by dorsal raphe nucleus stimulation. Obtained data suggests that the responses of nearby cortical neurons containing different kinds of 5-HT receptors may relate to the involved pathways and that clomipramine seems to act on 5-HT1A receptor subtype.

A few electroconvulsive shocks produce more reliable effects of firing rate in lateral septal neurons than repetitive treatment in the rat.

Electroconvulsive shock is a common treatment used in depression, especially in cases in which suicide constitutes a risk. The recommendation for its use varies from one place to another, but there is an empirical agreement to avoid daily treatment or several treatments on the same day. The present study explored the actions of electroconvulsive shock in lateral septal firing rate in rats. The first or second once-a-day electroconvulsive shock produced a maximal increase in firing rate; however, effects vanished as treatment was repeated. Three consecutive electroconvulsive shocks on the same day also produced fewer changes in firing rate than once-a-day treatment. These results are likely to be related to clinical recommendations to avoid serial-repetitive treatment, and suggest that some resting time is required in treatment to achieve long-lasting changes in neuronal activity.

Sleep deprivation is a less potent agent than clomipramine in increasing firing rate in lateral septal neurons in the rat.

Acute injection of clomipramine or a 24-hour period of sleep deprivation produces an increased firing rate in lateral septal neurons of the rat. However, it is unknown whether changes in firing rate in lateral septal neurons also appear after repetitive treatments. This study explored and compared the effects of long-term clomipramine with those of sleep deprivation from 1 to 4 days in the firing rate of lateral septal neurons. The firing rate increased after both treatments; however, maximal effects occurred on different days. Clomipramine (1.25 mg/kg, i.p., twice a day) produced a stable, increased firing rate after 20 days of treatment. Twenty-four hours of total sleep deprivation produced changes in firing rate comparable to 10 days of clomipramine treatment. Changes in firing rate did not appear when animals were exposed to 12 h of sleep deprivation alternated with 12 h in housing cages. Therefore, it is concluded that 24 h of total sleep deprivation is a less effective treatment than clomipramine for producing changes in firing rate in lateral septal neurons.

Clomipramine enhances the excitatory actions of dorsal raphe nucleus stimulation in lateral septal neurons in the rat.

Clomipramine is a serotonin reuptake blocker which produces an increased rate of firing in lateral septal neurons of the rat. However, it is unknown whether the response of dorsal raphe nucleus stimulation on the firing rate of the lateral septal neurons is modified by clomipramine treatment. Two programs of stimulation were employed. In the first, iterative stimulation (0.3 Hz, 1 ms, 0.1 mA) produced a complex pattern of response in which activation responses predominated, and clomipramine increased the duration and the firing rate of afterdischarge. In the second program a short train of pulses (300 Hz, 500 ms, 0.1 ms) was applied to the dorsal raphe nucleus. Clomipramine increased both the duration and the frequency of firing with respect to the saline-treated group. The present data show that dorsal raphe nucleus stimulation produces a long-lasting increase in the firing rate of lateral septal neurons which is enhanced by clomipramine. Since clomipramine applied to the septal area produces a decrease in firing, it is concluded that actions taken by clomipramine on raphe nuclei produce a disinhibitory process in the lateral septal neurons.

Septal neurons related with hippocampus increase their firing rate after long-term clomipramine.

In the rat, long-term clomipramine increases the firing rate in lateral septal neurons. Although the hippocampus is the main afference for septal nuclei, it is unknown whether clomipramine increases the firing rate in most of hippocampal-septal neurons. Therefore, the present study explored the actions of long-term clomipramine in lateral septal neurons identified by their relation to the hippocampus. In most recordings, hippocampal stimulation produced a brief excitatory short-latency response, followed by a period of inhibition of firing. These neurons increased their firing rate after clomipramine treatment. Other septal neurons not respondent to hippocampal stimulation did not respond to clomipramine treatment, either. We concluded that only hippocampal-septal neurons are clomipramine responders too, and the drug-induced enhancement of firing rate is likely to be mediated by an interneuron-mediated disinhibition process.