[Overweight and obesity in children aged 5-11 years in Mexico - Why is necessary an interdisciplinary approach?] / Sobrepeso y obesidad en niños de 5 a 11 años en México en el periodo 1999-2021: ¿por qué es necesario un abordaje interdisciplinario?

INTRODUCTION: overweight and obesity in children are serious public health problems in Mexico. OBJECTIVE: to analyze the behavior of the prevalence of overweight and obesity in children from 5 to 11 years of age and to present projections on the prevalence for the period 2022-2026. METHODOLOGY: ecological and retrospective study whose units of analysis were groups of children of Mexico with overweight and obesity in the period 1999-2021, according to information collected from six National Health and Nutrition Surveys. For the projections the classical method of least squares was used, for a trend analysis of both conditions for the period 2022-2026. RESULTS: Overweight in girls and obesity in boys shows a high prevalence in the period 1999-2021, even though the trend analysis for the period 2022-2026 shows a slight decrease in overweight for the group of boys and a slight increase in overweight for girls, as well in obesity for both groups. CONCLUSIONS: due to the high prevalence of overweight and obesity in children from 5 to 11 years of age in Mexico, an interdisciplinary approach is required to identify which dimensions (biochemical, psychological, interpersonal and social) participate in the problem, considering three environments contributing for psychological and social development of children, the ecological-social, the family and the school.

Psychological, interpersonal, and clinical factors predicting time spent on physical activity among Mexican patients with hypertension.

BACKGROUND: It is widely known that physical activity is the key to the optimal management and clinical control of hypertension. PURPOSE: This research was conducted to identify factors that can predict the time spent on physical activity among Mexican adults with hypertension. METHODS: This cross-sectional study was conducted among 182 Mexican patients with hypertension, who completed a set of self-administered questionnaires related to personality, social support, and medical adherence and health care behaviors, body mass index, and time since the disease diagnosis. Several path analyses were performed in order to test the predictors of the study behavior. RESULTS: Lower tolerance to frustration, more tolerance to ambiguity, more effective social support, and less time since the disease diagnosis predicted more time spent on physical activity, accounting for 13.3% of the total variance. The final model shows a good fit to the sample data (pBS =0.235, χ2/gl =1.519, Jöreskog and Sörbom's Goodness of Fit Index =0.987, adjusted modality =0.962, Bollen's Incremental Fit Index =0.981, Bentler-Bonett Normed Fit Index =0.946, standardized root mean square residual =0.053). CONCLUSION: The performance of physical activity in patients with hypertension depends on a complex set of interactions between personal, interpersonal, and clinical variables. Understanding how these factors interact might enhance the design of interdisciplinary intervention programs so that quality of life of patients with hypertension improves and they might be able to manage and control their disease well.

["Consumption of restricted foods" in Mexican hypertensive patients]. / "Consumo de alimentos restringidos" en pacientes mejicanos hipertensos.

BACKGROUND: Strict adherence to personal health recommendations is necessary to improve the clinical control of arterial hypertension. OBJECTIVE: To identify predictors of the behavior to avoid the "consumption of restricted foods" in a sample of hypertensive patients from Tamaulipas, Mexico. METHOD: Participants were 183 patients with arterial hypertension diagnosis, who completed two self-administered questionnaires and different questions regarding adherence and self-care behaviors. A trajectory analysis was used for the interpretation of data. RESULTS: Less tolerance to frustration, a major affective social support and a lower body mass index were behavior predictors to avoid the consumption of restricted foods (pBS= 0.294, χ2/gl= 1.417, GFI = 0.993, AGFI = 0.965, NFI = 0.934, IFI = 0.980 y SRMR = 0.040), explaining approximately 20% of the variance in the study behavior. CONCLUSION: The study of adherence and self-care behaviors demands to identify what and how some personal and interpersonal variables are influencing in their daily practice, which can contribute to improve the interdisciplinary interventions programs in clinical and communitarian settings for attending patients living with arterial hypertension.

«Consumo de alimentos restringidos» en pacientes mejicanos hipertensos / «Consumption of restricted foods» in Mexican hypertensive patients

Introducción: la adhesión estricta a las recomendaciones del personal de salud es requisito indispensable para coadyuvar en el control clínico de la hipertensión arterial. Objetivo: identificar los predictores de la conducta «consumo de alimentos restringidos» en una muestra de pacientes hipertensos de Tamaulipas, México. Método: participaron 183 pacientes diagnosticados con hipertensión arterial, quienes respondieron a un par de instrumentos y a diferentes preguntas sobre conductas de adhesión y cuidado de la salud. Para la interpretación de los datos se utilizó un análisis de trayectoria. Resultados: una menor tolerancia a la frustración, un mayor apoyo social afectivo y un menor índice de masa corporal predijeron la conducta de evitar el «consumo de alimentos restringidos» (pBS = 0,294, χ2/gl = 1,417, GFI = 0,993, AGFI = 0,965, NFI = 0,934, IFI = 0,980 y SRMR = 0,040), explicando aproximadamente un 20% de la varianza en la conducta de estudio. Conclusión: el estudio de las conductas de adhesión y cuidado de la salud pasa necesariamente por identificar qué y cómo ciertas variables personales e interpersonales están influyendo en su práctica diaria, lo cual puede contribuir a mejorar los programas de intervención interdisciplinaria en los ámbitos clínico y comunitario para la atención de pacientes que viven con hipertensión arterial (AU)

Background: Strict adherence to personal health recommendations is necessary to improve the clinical control of arterial hypertension. Objective: To identify predictors of the behavior to avoid the «consumption of restricted foods» in a sample of hypertensive patients from Tamaulipas, Mexico. Method: Participants were 183 patients with arterial hypertension diagnosis, who completed two self-administered questionnaires and different questions regarding adherence and self-care behaviors. A trajectory analysis was used for the interpretation of data. Results: Less tolerance to frustration, a major affective social support and a lower body mass index were behavior predictors to avoid the consumption of restricted foods (pBS = 0.294, χ2/gl = 1.417, GFI = 0.993, AGFI = 0.965, NFI = 0.934, IFI = 0.980 y SRMR = 0.040), explaining approximately 20% of the variance in the study behavior. Conclusion: The study of adherence and self-care behaviors demands to identify what and how some personal and interpersonal variables are influencing in their daily practice, which can contribute to improve the interdisciplinary interventions programs in clinical and communitarian settings for attending patients living with arterial hypertension (AU)

Errores conceptuales y metodológicos en psicología y salud: estudio de caso sobre el uso y abuso del modelamiento con ecuaciones estructurales / Conceptual and methodological mistakes in psychology and health: a case study on the use and abuse of structural equation modelling

Se analiza un trabajo de investigación que se justificó en la teoría del desarrollo psicopatológico, los factores protectores, la autorregulación, la resiliencia y la calidad de vida en una muestra de personas que vivían con diabetes tipo 2 e hipertensión; para el análisis de los datos se utilizó el modelamiento con ecuaciones estructurales (MEE). Aun cuando los autores concluyen sobre la pertinencia de los datos a la teoría probada, incurren en errores lógicos, conceptuales, metodológicos y de interpretación que, tomados en conjunto, evidencian una flagrante ruptura teoría-datos

It is analyze a research which was justified on the theory of psychopathology development, protector factors, self-regulation, resilience, and quality of life among persons who lived with type 2 diabetes and hypertension; for data analysis the structural equation modeling (SEM) was used. Although the authors conclude on the adequacy of data to the tested theory, they incur in logical, conceptual, methodological and interpretation mistakes that, taken together, show a flagrant breakdown theory-data

Un análisis crítico del concepto de resiliencia en psicología / A critical analysis of the concept of resilience in psychology

Se analiza el concepto de resiliencia en psicología, poniendo especial énfasis en autores iberoamericanos que lo utilizan en sus investigaciones. Se demuestra cómo, una vez que se parte de una confusión lógica, de ésta se desprende una conceptual, de la que a su vez se desprende una metodológica, para concluir con una de interpretación. Una cadena de confusiones que al final del camino nos permiten justificar por qué el de resiliencia es un concepto que no es ni útil ni pertinente para la psicología

The concept of resilience in the psychology is analyzed, with special emphasis in Ibero-American authors who used it in their research. I argue how, once the authors’ part of a logical confusion, this one become in a conceptual confusion, which in turn follows a methodological, concluding with one of interpretation confusions. A successive chain of confusions which allows justifying why resilience is a concept that is neither helpful nor relevant to psychology

Adherencia al tratamiento en pacientes hipertensos con sobrepeso u obesidad / Adherence to treatment in hipertensive with overweight or obesity

No disponible

This cross-sectional study evaluates the association between stress-related situations and social support with treatment adherence, in a sample of 173 hypertensive patients with overweight or obesity. Participants answered questions related to treatment adherence (consumption of prescription drugs, according to the doses and times specified). They were considered three stress-related situations (decision making, tolerance to ambiguity and tolerance to frustration) and two types of social support (emotional and confidence) as predictors of adherence. Multiple linear regression analysis showed the influence of two stress-related situations (decision making and tolerance for ambiguity) in overweight patients, and social support in patients with obesity. The association of stress-related situations and social support with the practice of three adherence behaviors was different depending on the patients was different depending on whether the patient is overweight or obese. We discuss the implications of findings for the purposes of designing, implementing and evaluating programs to improve treatment adherence in hypertensive patients (AU)

La psicología positiva: ¿ciencia y práctica de la psicología? / Positive psychology: the science and practice of psychology?

La psicología positiva no es una ciencia de la psicología, pues carece de un objeto de estudio propio y específico, así como de las categorías conceptuales con que se le represente teóricamente. Por consiguiente, carece de una teoría tecnológica que haga posible traducir el conocimiento científico en conocimiento aplicable a los problemas sociales en los que la dimensión psicológica es pertinente. Se concluye que la psicología positiva es algo más que una "buena moda" o una "magia simpática"; constituye, en esencia, un intento injustificado e infructuoso por dar vida propia a una nueva y distinta psicología; en suma, es un ejemplo conspicuo de la sinrazón de la razón

Positive psychology is not a science of psychology, because it lacks a specific subject matter as well as conceptual categories that theoretically represent it. Even more, it is not built on the foundations of a theory that would make it possible to translate scientific knowledge into technological knowledge, applicable to social problems in which the psychological dimension is relevant. We conclude that positive psychology is more than just a "good fashion" or "sympathetic magic"; it is, in essence, an unwarranted and fruitless attempt to give life to a new and very different psychology. In short, it is a conspicuous example of the illogic of logic

Psicología y salud en México: algunas reflexiones basadas en el sentido común y la experiencia / Psychology and Health In Mexico: Some Reflections Based on Common Sense and the Experience

A mediados de la pasada década se publicó un trabajo en el que se analizaba por qué, a pesar del desarrollo experimentado por la psicología y salud en México, en ese entonces se hadan evidentes dos problemas: la falta de reconocimiento profesional de la psicología y los psicólogos en los marcos normativos sobre la materia, por un lado, así como las dificultades que enfrentaban para su integración en los equipos interdisciplinarios de salud, por el otro. Casi una década después nos encontramos que en general la situación no ha cambiado de manera sustancial, lo que a final de cuentas se traduce en un ejercicio profesional que dista mucho de estar impactando positivamente al diseño, instrumentación y evaluación de programas de investigación e intervención en el seno mismo de las instituciones de salud. Con base en el sentido común y la experiencia de los autores, en este trabajo se discute sobre tres asuntos que consideramos pudieran ayudar a revertir dicha situación, en beneficio de la psicología y los psicólogos que se desempeñan en el ámbito de la salud.

In the middle of the last decade was published a work in which analyzed why, despite the development experienced by the psychology and health in Mexico, then became evident two problems: the lack of professional recognition of psychology and psychologists in the normative frameworks on the subject, on the one hand, as well as the difficulties faced by these for their integration into the interdisciplinary teams of health, on the other. Almost a decade later we find that overall the situation has not changed substantially, which ultimately translates into a professional practice that is far be positively impacting the design, implementation and evaluation of research and intervention programs in the context of health institutions. Based on common sense and the experience of the authors, in this work is discussed on three issues that we believe could help to reverse this situation, for the benefit of psychology and psychologists working in the health field.

Versión peruana de un cuestionario que mide variables psicológicas relacionadas con la adhesión (VPAD) en mujeres con cáncer de mama / Peruan version of a questionnaire measuring psychological variables related to adherence (PVRA) among breast cancer women

Objetivo: Adaptar y validar un instrumento que mide variables psicológicas relacionadas con conductas de adhesión (VPAD) en un grupo de mujeres con cáncer de mama. Método: Estudio transversal que contó con la participación de 110 mujeres con cáncer de mama que eran atendidas en el Instituto Nacional de Enfermedades Neoplásicas, en Lima, Perú. Para el tratamiento de los datos se utilizaron tres procedimientos estadísticos en forma consecutiva: un análisis factorial exploratorio, el coeficiente alfa (a) de Cronbach y el coeficiente de correlación de Pearson (r). Resultados: Se formaron tres factores con valores propios superiores a 1, que explican 45,6% de la varianza. Asimismo, se obtuvo una a de Cronbach = 0,70. Finalmente, se encontraron correlaciones diferenciadas y significativas a p < 0,01 y p < 0,05 entre las conductas de adhesión (“Asistir a Consulta con el Especialista”, “Asistir a Sesiones para Recibir Tratamiento en la Institución”, “Seguir una Dieta”, “Realizar Ejercicios para Rehabilitación” y “Cuidar las Zonas de Cuerpo a la Exposición de Calor”) con los tres factores del instrumento (“Competencias Pasadas”, “Motivos y Competencias para la Salud”, así como “Competencias Relacionadas con la Enfermedad, los Tratamientos y el Ajuste Social”). Conclusión: El instrumento posee óptimas propiedades psicométricas de confiabilidad, validez de constructo y concurrente, lo que garantiza su uso en mujeres con cáncer de mama del Perú (AU)

Objective: To adapt and to validate a self-administered questionnaire measuring psychological variables related to adherence behaviors (PVAB) among women with breast cancer. Method: A cross-sectional study was performed with 110 women who were being treated at the National Institute of Neoplastic Diseases, in Lima, Peru. For data treatment three consecutives statistics procedures were applied: an exploratory factorial analysis; the Cronbach’s alpha (a) coefficient, as well as the Pearson’s correlation coefficient (r). Results: A three-factor structure was found with values above 1 that, taken as a whole, explain 45,6% of the variance. Also, an overall Chronbach’s a coefficient = 0,70 was obtained. Significant and differential correlations at p < 0.01 y p < 0.05 values were found between behaviors (“Accomplishment Appointments with the Specialist”, “Accomplishment Appointments to Receive Treatment at HealthCare Institution”, “Following a Diet”, “Making Exercises for Rehabilitation”, and “Caring Body Parts from Heat Exposition”) with the three factors of the instrument (“Past Behavioral Competences”, “Motives and Health-Related Competences”, as well as “Disease and Treatment-Related Competences and Social Adjustment”). Conclusion: According to the results obtained, the instrument has optimal reliability, construct validity as well as concurrent validity, which allow us their future use among women with breast cancer from Peru (AU)

Relaciones sociales, variables psicológicas y conductas de adherencia en adultos con VIH / Social Relations, Psychological Variables and Adherence Behaviors in Adults with HIV

A cross-sectional study was conducted with the aim to test if the perceived difficulty to deal with social relationships would affect the role of a set of psychological variables on the practice of the adherence behaviors to antiretroviral therapy in a group of 111 people with HIV. Participants responded at to two self-administered questionnaires: Psychological variables and adherence behaviors, and Stress-related situations. A multiple regression analysis showed that the effect of psychological variables depends on how difficulties to establish social relationships are valuated: If there are difficulties, the weight is shifted to the reasons underlying adherence behavior (F [1, 44]= 49.582, p <.001), if there are none, it moves to an interaction between motives and competences in the past (F [2, 62]= 22.280, p <.001). The results have profound implications for the design of intervention programs, in which the objectives should be targeted to facilitate and/or improve in adults with HIV: Social competence to interact efficiently with significant people in their immediate environment, the individual psychological adjustment, as well as the efficient practice of adherence behaviors (AU)

Se realizó un estudio transversal con el objetivo de probar si la valoración de dificultades para relacionarse competentemente en el ámbito social afecta, y cómo, el rol de un conjunto de variables psicológicas en la práctica de conductas de adherencia al tratamiento antirretroviral. Participaron en el estudio un grupo de 111 personas con VIH que respondieron a dos instrumentos que evaluaron variables psicológicas y conductas de adherencia y situaciones vinculadas con estrés. Un análisis de regresión múltiple reveló que el peso de las variables psicológicas varía en función de si se valoran o no dificultades para relacionarse socialmente: si hay dificultades, el peso se traslada hacia los motivos que subyacen a las conductas de adherencia (F [1, 44]= 49,582, p <.001); si no las hay, el mismo se traslada hacia una interacción entre los motivos y el desempeño competencial en el pasado (F [2, 62]= 22,280, p <.001). Los resultados del estudio tienen profundas implicaciones para el diseño de programas de intervención, cuyos objetivos se deben orientar a facilitar y/o mejorar en los adultos con VIH: la competencia social para relacionarse de manera eficiente con personas significativas de su entorno inmediato, el ajuste psicológico en lo individual, así como la práctica consistente y eficiente de las conductas de adherencia (AU)

Desarrollo y personalidad: ¿Teorías formales o categorías tipo interfase? / Development and personality: formal theories or interface categories?

Se analiza la relación entre los fenómenos básicos y los fenómenos del desarrollo y la personalidad, en términos de si los primeros deberían concebirse como condición de existencia necesaria y suficiente de los segundos, y, a su vez, si los unos y los otros lo son de los últimos. Se concluye que dependiendo de cómo se plantee dicha relación, es que eventualmente tendrá sentido la construcción de teorías formales sobre el desarrollo y la personalidad, o bien caracterizar ambos fenómenos como categorías tipo interfase con fines de predicción.

The relationship between basic phenomena and development as well as personality is analyzed, in terms of whether the first should be seen as a necessary and sufficient condition for the existence of the second, and in turn the first two as conditions for the last one. We conclude that depending on how this relationship arises is what eventually will make sense to build formal theories of development and personality, or to characterize both phenomena as interface category types with predictive purposes.

Psicología y Salud (II): tendiendo puentes entre la Psicología Básica y la Aplicada. El rol del fenómeno de personalidad / Psychology and Health (II): building bridges between Basic and Applied Psychology. The role of the personality phenomenon

Una parte importante del contenido de lo psicológico en la salud y la enfermedad tiene que ver con la conducta de una persona en lo individual, es decir, con el fenómeno de personalidad. Sin una caracterización apropiada de este fenómeno se dificulta el cumplimiento de dos tareas sustantivas en la Psicología y Salud, a saber: 1) identificar y evaluar lo que una persona ha hecho en el pasado, de manera estable y consistente a lo largo del tiempo y entre situaciones, y 2) traducir los hallazgos en programas de prevención primaria, susceptibles de ser replicados bajo distintas condiciones y en diferentes escenarios. Con la finalidad de dar seguimiento a lo expuesto en un artículo previo (Piña, Ybarra, Alcalá y Samaniego, 2010), el presente trabajo se planteó con el objetivo de discutir por qué en el ámbito de la salud es fundamental que los modelos teóricos incluyan un conjunto debidamente articulado de categorías y conceptos que permitan vincular los niveles básico y aplicado, así como lo psicológico con los fenómenos de la salud y la enfermedad, dentro de los que se destaca el de personalidad.

An important part of the psychological aspect in health and sickness has to do with the conduct of a person as an indidual, that is to say, with the phenomenon of personality. Without an appropriate characterization of this phenomenon, compliance with two fundamental tasks in psychology and health is made difficult. These are 1) to identify and evaluate what a person has done in the past in a stable and consistent way over a period of time and between situations, and 2) to translate the findings into programs of primary prevention, able to be reproduced under different conditions and in different scenarios. With the purpose of following up what was stated in a previous article (Piña, Ybarra, Alcalá y Samaniego, 2010), this study was proposed with the objective of discussing why, in the context of health, it is fundamental that theoretical models include a properly coordinated set of categories and concepts which allow basíc and applied levels to be linked, as well as the psychological aspect with the phenomena of health and sickness, among those which highlight personality.

Uma parte importante do conteúdo do psicológico na saúde e a doença têm a ver com a conduta de uma pessoa no individua, é dizer, com o fenômeno da personalidade. Sem uma caracterização apropriada de este fenômeno e difícil o cumprimento de duas tarefas substantivas na psicología e saúde, que são as seguintes: 1) identificar e avaliar o que uma pessoa tem feito no passado de maneira estável e consiste ao longo do tempo e entre situações, e 2) traduzir os descobrimentos em programas de prevenção primaria susceptíveis de serem replicados baixos diferentes condições e distintos cenários. Com a finalidade de dar seguimento ao exposto num artigo prévio (Piña, Ybarra, Alcalá y Samaniego, 2010), o presente trabalho foi planejado com o escopo de discutir por que no âmbito da saúde é fundamental que os modelos teóricos incluam um conjunto devidamente articulado de categorías e conceitos que permitam vincular os níveis básico e aplicado; assim como o psicológico com os fenômenos da saúde e a doença, dentro dos que é destacado o de personalidade.

Motivos y uso de preservativo en estudiantes universitarios de Ciudad Juárez (México) / Motives and preventive behaviors related to condom use among university students in Ciudad Juárez (Mexico)

Se condujo un estudio transversal que contó con la participación de 798 estudiantes universitarios, pertenecientes a una institución de educación superior que se localiza en Ciudad Juárez, México. Los participantes respondieron a un instrumento que mide variables psicológicas y comportamientos sexuales de prevención y de riesgo relacionados con la infección por el VIH. Un análisis de regresión lineal múltiple mostró los siguientes resultados: los predictores del comportamiento uso del preservativo a lo largo de la vida sexual activa fueron los motivos "para evitar un embarazo" y "para evitar una ITS" (F [2, 271] = 14.863; p < 0.005), mientras que para el comportamiento uso del preservativo con parejas ocasionales lo fue el motivo "para evitar un embarazo" (F [2, 145] = 0.957; p < 0.005). Puesto que los motivos que subyacen al uso de preservativo difieren en función del tipo de comportamiento, es necesario que los programas de intervención tengan en cuenta el papel de esa variable y su influencia sobre el posterior entrenamiento competencial, tendiente a promover la práctica eficiente de los comportamientos de prevención (AU)

A cross-sectional study of psychological variables underlying different sexual behaviors was carried out in Ciudad Juarez, Mexico. The sample consisted of 798 university students from a higher education institution. Participants answered a questionnaire measuring psychological variables underlying preventive and high-risk sexual behaviors related to HIV infection. A multiple regression analysis showed the following results: condom use behavior across an active sexual life was predicted by two types of motives "I used it to avoid a pregnancy" and "I used it to avoid a sexual infection" (F [2, 271] = 14.863; p < 0.005), while condom use with casual partners was predicted by one motive "I used it to avoid a pregnancy" (F [2, 145] = 0.957; p < 0.005). Because motives underlying condom use behaviors are different, prevention programs need to recongnize these motives and their influential role in the processes of competencies training, aimed at promoting the efficient practice of preventive behaviors (AU)

Un modelo psicológico en los comportamientos de adhesión terapéutica en personas con VIH / A psychological model for therapeutic adherence behaviors in persons with HIV

Introduction HIV infection is a disease that demands a consistent and efficient practice of adherence behaviors related to antiretroviral treatment. However, research findings in the last few years have shown that psychological and social variables (e.g., depression, stress, low motivation, as well as little or no social support) interfere with the practice of those behaviors. This facilitates the clinical progression of the disease, and reduces the quality of life and survival time in people living with HIV. The intersection area between psychology and health involves widely diverse theoretical models, including self-regulation, health beliefs, and the one linking information-motivation-behavior. Such models have sought to account for the way in which the addressed variables affect adherence behavior. While analyzing psychological factors, these models usually emphasize either cognitive concepts or adopt a more traditional stance such as relating adherence behavior to personality, motivation, behavioral skills and stress management. Although this diversity seems inclusive, it fails to integrate explanations on therapeutic adherence under a more comprehensive theoretical umbrella. Thus, the present study was conducted within the scope of an interactive-functional model which attempts to articulate the interaction of sets of biological and psychological variables along four phases. The first involves psychological processes and results variables; the second comprises the diagnostic of HIV infection and later development of other opportunistic diseases; the third contains two types of behavior: therapeutic adherence and disease-related behaviors; the fourth involves conventional biological indicators and health outcomes. This model contrasts with others not only in the sense of proposing an inter-behavioral approach derived from Kantor's work, including articulated behavioral and personality theories, but it also proposes an interactive and functional emphasis on analyzing those variables assumed to determine therapeutic adherence behaviors. Such variables subsume personality phenomena, behavioral competencies and motives to behave. Thus, the approach includes those consistent ways in which HIV-positive persons interact with stress-related situations which contain unpredictable, ambiguous or uncertain stimulus signals and behavior consequences. The behavioral competencies category synthesizes what the patient knows on HIV, including those self-care actions that need to be taken efficiently. For instance, what is HIV-AIDS, what are the clinical stages of the infection, what medications help, how should they be used and, above all, why is so important to take medications in a consistent and efficient manner on the basis of the indications of the healthcare personnel. On the other hand, motives or motivation refer, in the traditional conception, to variables related to willing to act. It is said that a person is motivated to engage in therapeutic adherence behaviors when he/she is willing to behave accordingly, after having understood the relation between such behavior and some specific consequences. Such consequences may vary widely, ranging from interpersonal in nature, such as verbal praise or support from others, and intrinsic, such as self-perceived physical and psychological well-being. Materials and method A cross-sectional study was carried out in order to identify predictors of adherence behaviors related to antiretroviral treatment in a group of 68 persons living with HIV. Participants answered two self-administered questionnaires: i) psychological factors and adherence behaviors, and ii) stress-related situations in three modalities: decision-making, tolerance to ambiguity, and tolerance to frustration. Data analysis included univariate statistics, the Pearson's x² test, the T-test for independent samples, as well as a linear multiple regression analysis. Results Of the total of participants, 58 (85.3%) reported that they self-administered their antiretroviral medication everyday of the last week, and 10 (14.7%) did it with some inconsistence. Differences were significant (x² [1] =33.882; p<0.001); the T-test showed a significant difference among adherents and non-adherents in the motivation variable (t [66] = -27.954; p<0.001). Finally, the linear multiple regression analysis contributed as predictor of the adherence behaviors at variables like motivation (β =O.8O2; p<0.001), as well as low stress-related situations in the modalities of decision-making ( β = -0.268; p<0.01) and tolerance to frustration ( β = -0.280; p<0.01), with the adjusted determination coefficient [adjusted R²] = 0.629, thus explaining 62.9% of the total variance. Discussion The results of this study show that persons with HIV who are 100% adherent to antiretroviral medication are those who are clearly more motivated and are experiencing less stress-related to decision-making, as well as higher levels of tolerance to frustration. These findings suggest that interventions aimed at improving the treatment of HIV-positive patients should expressly include components related to these factors. It seems especially relevant to consider two additional aspects: first, once psychological factors are identified and explained through research, they need to be translated into viable intervention strategies subject to systematic methodological evaluation. Second, interventions must be consistent with the theoretical assumptions underlying the model used so that those techniques designed or selected to establish adequate medication use and other adherence and well-being-inducing behaviors will actually result effective. Given the context of the institutional treatment of this condition, it seems especially relevant to insure that such programs actually have an interdisciplinary character in order to facilitate and maintain therapeutic adherence. Such inter-professional collaboration is especially important in a public healthcare context in which resources, ranging all the way from facilities, equipment and caregiver salaries to the schooling of the patients, pose special challenges in places like Latin American countries, where real optimization can occur mainly through the quality of integrated professional performance. After all, the key healthcare ingredient in public health problems affecting ever-growing portions of the population, such as the HIV infection, remains the human being, i.e., actual persons with biological, psychological, and social functional components.

Introducción La infección por VIH es un padecimiento que demanda la práctica consistente y eficiente de los comportamientos de adhesión al tratamiento antirretroviral en sí y a otras actividades de apoyo al mismo. Sin embargo, en años recientes se ha identificado una diversidad de variables psicológicas y sociales (i.e., depresión, estrés, bajos niveles de motivación y carencia de apoyo social, principalmente) que dificultan la práctica de esos comportamientos, favoreciendo así el progreso clínico de la enfermedad y una reducción en la calidad y tiempo de sobrevida en las personas con VIH. En el subcampo de conocimiento conocido como psicología y salud existen diversos modelos teóricos con los que se ha buscado dar cuenta de cómo es que esas variables influyen sobre los comportamientos de adhesión; destacan, principalmente, el autorregulatorio, el de creencias en salud y el de información-motivación-habilidades conductuales. En general, se trata de modelos que, o bien privilegian el análisis de lo psicológico a partir de conceptos de naturaleza cognoscitiva, o bien carecen de análisis de fenómenos como los de estrés y personalidad, así como de los comportamientos asociados a la enfermedad. El presente estudio se realizó con base en un modelo psicológico para la investigación de los comportamientos de adhesión terapéutica; se trata de un modelo interactivo y funcional en el sentido de consignar la interacción de un conjunto de variables psicológicas y biológicas a lo largo de cuatro fases comportamentales en el proceso del desarrollo de padecimientos crónicos. En la primera se incluyen variables psicológicas de procesos y resultados; en la segunda el diagnóstico de la infección por VIH y el posterior desarrollo de otras enfermedades oportunistas; la tercera, psicológica, contempla la práctica de dos tipos de comportamientos, los de adhesión terapéutica y los asociados a la enfermedad; finalmente, en la cuarta se contemplan los indicadores biológicos convencionales y los resultados de salud. Materiales y método Se condujo un estudio transversal que tuvo como objetivo identificar predictores de los comportamientos de adhesión al tratamiento antirretroviral en 68 personas con VIH. Los participantes respondieron a dos instrumentos: i) factores psicológicos y comportamientos de adhesión, y ii) situaciones vinculadas con estrés. Para el análisis de los datos se utilizaron estadísticas univariadas, la x² de Pearson, la prueba T para muestras independientes y un análisis de regresión lineal múltiple. Resultados Del total de participantes, 58 (85.3%) respondieron que se habían administrado sus medicamentos todos los días de la última semana y los restantes 10 (14.7%) lo habían hecho con inconsistencia, diferencia que resultó significativa (x² [1] =33.882; p<0.001). La prueba T para muestras independientes arrojó una sola diferencia significativa entre las personas con VIH adherentes y no-adherentes en la variable motivos ( t [66] = -27.954; p<0.001); finalmente, el análisis de regresión lineal múltiple aportó como predictores de los comportamientos de adhesión a las variables motivos (β = 0.802; p<0.001) y bajos niveles de estrés vinculados con toma de decisiones ( β = -0.268; p<0.01) y con tolerancia a la frustración (β = -0.280; p<0.01), con un coeficiente de determinación [R² ajustado] = 0.629, es decir, que las tres variables explican 62.9% de la varianza total. Discusión Los resultados muestran que las personas con VIH 100% adherentes son aquellas que se encuentran claramente motivadas y que en general experimentan bajos niveles de estrés relacionados con la toma de decisiones y tolerancia a la frustración. Estos hallazgos sugieren que en el diseño e instrumentación de programas de intervención orientados a mejorar la adhesión de estos pacientes es indispensable incorporar módulos o componentes basados directamente en dichos factores, poniendo especial énfasis en programas interdisciplinarios.

Motivación en Psicología y salud: motivación no es sinónimo de intención, actitud o percepción de riesgo / Motivation in health Psychology: motivation is not synonymous of intention, attitude or risk perception

Se revisa el uso del concepto de motivación en Psicología y salud. Se concluye que algunas teorías hacen un uso incorrecto del concepto, pues incurren en lo que Ryle llamó errores categoriales, lo cual compromete la interpretación que se hace de los resultados obtenidos en la práctica de la investigación.

It's review the motivation concept uses in health psychology. It's conclude that some theories make an incorrect concept uses, to commiting which Ryle's name as categorial mistakes, compromising the interpretation of the results gained in the research practice.

Efectos del tiempo de infección sobre predictores de adherencia en personas con VIH / Effects of length of infection on predictors of adherence in persons with HIV

A crosssectional study was made with the main objective to prove the effects of length of infection (in months) on predictors of adherence behaviors to antiretroviral therapy in a sample of 44 persons with HIV. A multiple linear regression analysis showed that motives and stress-related to high tolerance to ambiguity predicted adherence behaviors (F[3,43]= 8,310; p= 0.000). Using length of infection (average 55 months) as a criteria variable, in the group of ≤55 months predictors were motives and low depressive symptomatology (F[2,21]= 10,435; p= 0.001), meanwhile in the group of >55 months predictors were motives and stress-related to high tolerance to frustration (F[2,21]= 11,057; p= 0.001). The results of this study support the hypothesis of a causal relationship between the lenght of infection and predictors of adherence behaviors in people with HIV, aspect that must be considere in the proccesses of desing and implementing interdisciplinary intervention programs directed to promote the consistent and efficient practice of such behaviors (AU)

Se realizó un estudio transversal con el objeto de probar los efectos del tiempo de infección (en meses) sobre predictores de comportamientos de adherencia a la terapéuticaantirretroviral en una muestra de 44 personas con VIH. Un análisis de regresión lineal múltiple aportó como predictores de los comportamientos de adherencia a las variables motivos y estrés vinculado con alta tolerancia a la ambigüedad (F[3,43]= 8,310; p= 0.000). Al considerar el tiempo de infección en meses (media 55 meses) como variable criterio en el grupo de ≤55 meses emergieron como predictores las variables motivos y baja sintomatología depresiva (F[2,21]= 10,435; p= 0.001), mientras que en el grupo de >55 meses lo fueron las variables motivos y estrés vinculado con alta tolerancia a la frustración (F[2,21]= 11,057; p= 0.001). Los resultados de este estudio sugieren que el tiempo de infección es una variable crítica que afecta de manera diferencial el papel de los predictores de comportamientos de adherencia en personas con VIH, aspecto que debe ser tenido en cuenta al diseñar y desarrollar programas de intervención dirigidos a promoverla práctica consistente y eficiente de tales comportamientos (AU)

Predictores del comportamiento sexual con múltiples parejas en estudiantes de educación superior: un análisis por género / Predictors of sexual behavior with multiple partners in higher- education students: a gender-based analysis / Preditores do comportamento sexual com diversos casais em estudantes de educação superior: uma análise por género

Se realizó un estudio transversal cuyo objetivo fue el de identificar predictores del comportamiento sexual con múltiples parejas en una muestra de 423 estudiantes de una institución de educación superior que se localiza en Hermosillo, en el noroeste de México. Para el tratamiento de los datos se utilizaron de manera sucesiva la prueba T, la prueba U de Mann-Whitney, el coeficiente de correlación de Pearson (r) y un análisis de regresión lineal múltiple. El análisis de regresión para el grupo de hombres identificó como predictores del comportamiento a las variables edad biológica, edad de inicio de relaciones y una situación social -encontrarme en un lugar para adultos-,según lo cual las tres variables explican el 42.4% de la varianza total. Por otra parte, en el grupo de mujeres, los predictores fueron las variables edad biológica, edad de inicio de relaciones y un estado biológico -me encontraba excitada físicamente-,según lo cual éstas explican el 70.3% de la varianza total. Los resultados del presente estudio aportan información valiosa con respecto a las variables que facilitan que las personas de ambos géneros se relacionen sexualmente con múltiples parejas, aspecto que debe ser tenido en cuenta en el momento de diseñar e instrumentar programas para prevenir la infección por el VIH en ese sector de la población.

A cross-sectional study aimed at identifying predictors of sexual behavior with multiple partners in a sample of 423 higher-education students took place at Hermosillo city, Northwest of Mexico. For data processing, the T-test, the Mann-Whitney U-test, the Pearson’s (r) correlation coefficient, as well as a multiple regression analysis were used in consecutive order. Regression analysis by gender showed that biological age, age of sexual initiation, and a social situation -Finding myself in a place for adults- were predictors of the behavior in men, thus explaining 42.4% of the total variance. On the other hand, predictors of this behavior in women were biological age, age of sexual initiation, and one type of biological state -I was physically excited-, with these variables explaining 70.3% of the total variance. The results of this study contribute with valuable information to identifying the variables that facilitate both in men and women the practice of having multiple partners when performing sexual behavior, an aspect that must be considered at the time of designing and implementing HIV prevention programs in this population sector.

Levou-se a cabo um estudo transversal cujo objetivo foi identificar preditores do comportamento sexual com diversos casais em uma amostra de 423 estudantes de uma instituição de educação superior localizada em Hermosillo, noroeste de México. Para o tratamento dos dados foram utilizados sucessivamente a prova T, a prova U de Mann-Whitney, o coeficiente de correlação de Pearson (r), e uma análise de regressão lineal múltiple. A análise de regressão para o grupo de homes mostrou como preditores do comportamento as variáveis idade biológica, idade de início das relações e uma situação social (achar-se em um lugar para adultos), que explicam 42.4% da variância total. No grupo das mulheres, os preditores foram as variáveis idade biológica, idade de início de relações e um estado biológico (achar-se excitada fisicamente), que explicam 70.3% da variância total. Os resultados deste estudo provem informação valiosa das variáveis que facilitam as relações sexuais de pessoas de ambos os gêneros com diversos casais. Este aspecto deve ser tido em conta ao desenhar e implantar programas de prevenção de infecção pelo VIH em esse sector da população.

[Association between stress and depression levels and treatment adherence among HIV-positive individuals in Hermosillo, México]. / Asociación entre los niveles de estrés y depresión y la adhesión al tratamiento en personas seropositivas al VIH en Hermosillo, México.

OBJECTIVES: To evaluate the association between variables related to stress, reasons, and depression, and adherence to treatment in HIV-positive individuals, and to analyze the robustness according to a theoretical psychology model. METHODS: This was a cross-sectional study of 25 female and 39 male HIV-positive participants receiving services at the Outpatient Center for Prevention and Treatment of HIV/AIDS and Sexually-transmitted Diseases (Centro Ambulatorio para la Prevención y Atención del VIH/Sida e Infecciones de Transmisión Sexual) in Hermosillo, Sonora, Mexico. The psychological variables, the degree of treatment adherence, stress-related circumstances, and the severity of depression were examined. Rates were calculated for the key variables associated with stress, reasons, and depression. The associations among variables were determined by multiple regression. RESULTS: During the month preceding the study, 65.6% of the 64 participants reported having faithfully followed the prescribed treatment, while 34.4% had failed, in some way, to follow the treatment (chi(2) = 6.250; P = 0.012). Regression analysis found that there was only one combination, an intermediate level of stress linked to tolerance of uncertainty and low levels of depression, that was significantly associated (F [3.58] = 3.298; P = 0.027) with adherence to treatment; the combination of these two variables explained 38.2% of the total variance found. CONCLUSIONS: The combination of stress levels with tolerance of uncertainty and depression could be used as a predictor for true compliance with prescribed treatment plans. These results should be taken into account when designing intervention and treatment-adherence campaigns in HIV-positive individuals.

Construcción y validación de un instrumento para la evaluación de la calidad de vida en personas con VIH / Construction and validation of an instrument to assess quality of life in persons with HIV

Entre los meses de abril de 2006 y mayo de 2007 se realizó un estudio transversal cuyo objetivo fue el de probar las propiedades psicométricas de un instrumento para la evaluación de la calidad de vida en personas con VIH. Participaron 149 personas con VIH pertenecientes a dos instituciones del sector salud que se localizan en dos ciudades del noroeste de México, a quienes se administró un instrumento que consta de 29 preguntas agrupadas en tres dominios: salud física, salud psicológica y habilidades personales y sociales. Para el tratamiento de los datos se utilizaron los siguientes procedimientos: la prueba de la t de Student para valorar el nivel de comprensión de las preguntas; un análisis factorial exploratorio con rotación varimax (normalización con Kaiser) para la validez de constructo; el coeficiente alfa de Cronbach para estimar la confiabilidad de la medida y el coefi ciente de correlación de Pearson (r) para evaluar la validez concurrente. Laprueba de la t de Student arrojó valores de significación estadística en las 29 preguntas; el análisis factorial exploratorio aportó cuatro factores con valores propios superiores a 1, que explican 50,93% de la varianza total; el coeficiente alfa de Cronbach para el instrumento en su conjunto fue de 0,86; finalmente, el coeficiente r de Pearson arrojó correlaciones entre las cuatro dimensiones entre sí, al igual que entre las dimensiones salud física y problemas agudos con carga viral, salud física y problemas crónicos con carga viral, así como habilidades sociales y personales con tiempo de infección en meses. El instrumento posee propiedades psicométricas de validez de constructo y validez concurrente, así como un buen nivel de confiabilidad.

Between May 2006 and April 2007 a cross-sectional study was made, with the main objective to prove the psychometric properties of an instrument to assess quality of life in persons with HIV. 149 persons withHIV participated who were being treated in two health facilities from two cities at the northwest of Mexico, whom responded to a self-administered instrument to assess quality of life in three domains: physical health, psychological health, and personal and social abilites. Four procedures of data analysis were used: the ttest for comparison of means, for assessing the comprehensibility of the questions; an exploratory factorial analysis with varimax rotation for determining construct validity; Cronbach’s alpha coeffi cient for determining reliability, and the Pearson’s correlation coeffi cient (r) for assessing concurrent validity. In all questions the t-test for comparison of means gave statistical signifi cance. A four-factor structure was found with the factorial analysis with varimax rotation, with eigen values above 1, that taken as a whole explain 50.93% of the total variance; an overall Cronbach’s alpha coefficient of 0.86 was obtained with the test of reliability. Thetest for concurrent validity showed correlations between the four-factors, as well as between the physical and acute problems with viral load, physical and chronic problems with viral load, and personal and social abilites with length of infection in months. According to the results obtained, the instrument has optimal reliability as well as construct validity and concurrent validity.