Psychological Inflexibility in People with Chronic Psychosis: The Mediating Role of Self-Stigma and Social Functioning.

Psychosis is associated with self-stigmatization and loss of social functioning that increase the severity of the disorder. Psychological inflexibility (PI)-an individual's tendency to suppress undesirable private events-plays a fundamental role in the emergence and worst prognosis of psychosis. The main objective of this study was to analyze whether self-stigma and social functioning mediate the association of PI with the severity of psychosis in adults with chronic schizophrenia. The study was carried out with a sample of 103 outpatients. The Acceptance and Action Questionnaire, the Internalized Stigma of Mental Illness Scale, and the Social Functioning Scale were used for clinical assessments. Data analyses were performed by using the PROCESS macro for SPSS. Results showed that the link between PI and the severity of psychosis is not direct, but is better explained by mediation of the self-stigma and social functioning of those assessed. PI also predicts worse social functioning without the need to take self-stigma into account. Moreover, self-stigma alone does not predict the severity of psychotic symptoms; this relationship has to be mediated by social functioning. These findings suggest that interventions designed to increase psychological flexibility, such as Acceptance and Commitment Therapy (ACT), may offer an alternative to attenuate the negative impact of self-stigma and to improve the social functioning.

Effects of Covid-19 confinement on the mental health of children and adolescents in Spain.

In Spain, in order to control COVID-19 transmission, one of the strictest confinement measures in the world for children and teenagers has been implemented. From 14 March to 26 April 2020 underage Spaniards were not allowed to leave their homes, except for reasons of force majeure. This could have consequences on their mental health in both the short and the long term. Thus, the aim of the present study was to explore the consequences of confinement on the mental health of Spanish children and teenagers, at the time when minors had been locked down in their homes between 8 and 10 days. The sample was composed of 590 confined Spanish children and teenagers between 8 and 18 years old. The scales of Depression, Self-esteem, Anxiety, Problems with Emotional Regulation, Rage Control Problems, Integration and Social Competence, Somatic Complaints, Rebellious Behaviour, as well as Awareness of the Problems of the Assessment System for Children and Adolescents (SENA) were used. The results revealed that, during confinement, children and adolescents showed emotional and behavioural alterations. This study, as far as we know, is the first one to explore the psychological consequences of lockdown in minors while it was taking place, with them being the ones directly assessed.

Mediation of the stigma in the influence of negative symptomatology over recovery in psychosis / Mediación del estigma en la influencia de la sintomatología negativa sobre la recuperación en psicosis

Background/Objective: The interest in recovery processes in psychotic disorders has boosted the necessity of knowledge about the factors that could influence in such recovery. Negative symptomatology and the stigma have been negatively linked to the recovery process in psychosis. The aim of this investigation is to improve the understanding of how the recovery process is affected by negative symptomatology based on the analysis of the mediating effects of the internalized stigma. Method: The sample was composed of 114 people that had experienced, at some point in their life, at least one clinically relevant psychotic episode. CAPE-42, STORI and ISMI were used for the evaluation. The macro PROCESS for SPSS was used. The indirect effect was calculated using 10.000 samples of bootstrap for the bootstrap confidence intervals (IC) corrected for bias. Results: The results show that the influence of negative symptomatology predicts the stigmatization of the person regarding his disorder. This predicts a negative influence in the recovery process of the psychosis. Conclusions: These results back the importance of adding the reduction of the stigma as a specific strategy to improve the recovery process in psychotic disorders. (AU)

Antecedentes/Objetivo: El interés por los procesos de recuperación en los trastornos psicóticos ha impulsado la necesidad de conocer los factores que podrían influir en dicha recuperación. La sintomatología negativa y el estigma se han relacionado negativamente con el proceso de recuperación de la psicosis. El objetivo de esta investigación es mejorar la comprensión sobre cómo el proceso de recuperación se ve afectado por la sintomatología negativa a partir del análisis de los efectos mediadores del estigma internalizado. Método: La muestra estuvo compuesta por 114 personas que habían experimentado, en algún momento de su vida, al menos un episodio psicótico clínicamente relevante. Para la evaluación se usaron el CAPE-42, STORI and e ISMI. Se utilizó el macro PROCESS para SPSS. El efecto indirecto se calculó utilizando 10.000 muestras de bootstrap para los intervalos de confianza (IC) de bootstrap corregidos por sesgo. Resultados: Los resultados muestran que la influencia de la sintomatología negativa predice la estigmatización de la persona con respecto a su trastorno, y esto predice una influencia negativa en el proceso de recuperación de la psicosis. Conclusiones: Estos resultados respaldan la importancia de sumar la reducción del estigma como estrategia específica para mejorar el proceso de recuperación en los trastornos psicóticos. (AU)

Anger Rumination and Mindfulness: Mediating Effects on Forgiveness.

(1) Background: Different investigations relate mindfulness practice as a strategy to cope with and improve negative repetitive thinking states and forgiveness. (2) Methods: The aim is to analyze the mediating processes of mindfulness as a trait and the changes in the anger rumination on forgiveness. This sample comprised 264 undergraduate students (M = 24.13 years, SD = 11.39). The instruments used were the Anger Rumination Scale (ARS), the Five Facet Mindfulness Questionnaire (FFMQ) and the Heartland Forgiveness Scale (HFS). For data analysis, the spillover effect was calculated using 10,000 bootstrap samples for the bootstrap confidence intervals (CI). (3) Conclusions: The results confirm that the relationship between mindfulness practice and forgiveness is mediated by changes in mindfulness trait and anger rumination. Given the results obtained, it is considered appropriate to extend the study to samples from other countries, as well as to contexts of depressive rumination or anxiety.

Mediation of the stigma in the influence of negative symptomatology over recovery in psychosis.

Background/Objective: The interest in recovery processes in psychotic disorders has boosted the necessity of knowledge about the factors that could influence in such recovery. Negative symptomatology and the stigma have been negatively linked to the recovery process in psychosis. The aim of this investigation is to improve the understanding of how the recovery process is affected by negative symptomatology based on the analysis of the mediating effects of the internalized stigma. Method: The sample was composed of 114 people that had experienced, at some point in their life, at least one clinically relevant psychotic episode. CAPE-42, STORI and ISMI were used for the evaluation. The macro PROCESS for SPSS was used. The indirect effect was calculated using 10.000 samples of bootstrap for the bootstrap confidence intervals (IC) corrected for bias. Results: The results show that the influence of negative symptomatology predicts the stigmatization of the person regarding his disorder. This predicts a negative influence in the recovery process of the psychosis. Conclusions: These results back the importance of adding the reduction of the stigma as a specific strategy to improve the recovery process in psychotic disorders.

Antecedentes/Objetivo: El interés por los procesos de recuperación en los trastornos psicóticos ha impulsado la necesidad de conocer los factores que podrían influir en dicha recuperación. La sintomatología negativa y el estigma se han relacionado negativamente con el proceso de recuperación de la psicosis. El objetivo de esta investigación es mejorar la comprensión sobre cómo el proceso de recuperación se ve afectado por la sintomatología negativa a partir del análisis de los efectos mediadores del estigma internalizado. Método: La muestra estuvo compuesta por 114 personas que habían experimentado, en algún momento de su vida, al menos un episodio psicótico clínicamente relevante. Para la evaluación se usaron el CAPE-42, STORI and e ISMI. Se utilizó el macro PROCESS para SPSS. El efecto indirecto se calculó utilizando 10.000 muestras de bootstrap para los intervalos de confianza (IC) de bootstrap corregidos por sesgo. Resultados: Los resultados muestran que la influencia de la sintomatología negativa predice la estigmatización de la persona con respecto a su trastorno, y esto predice una influencia negativa en el proceso de recuperación de la psicosis. Conclusiones: Estos resultados respaldan la importancia de sumar la reducción del estigma como estrategia específica para mejorar el proceso de recuperación en los trastornos psicóticos.

Influence on Forgiveness, Character Strengths and Satisfaction with Life of a Short Mindfulness Intervention via a Spanish Smartphone Application.

Mindfulness-based interventions (MBI) are a recognized effective psychological practice characterized by attention control, awareness, acceptance, non-reactivity, and non-judgmental thinking obtained through the practice of meditation. They have been shown to be useful in reducing stress and enhancing well-being in different contexts. In this research, the effectiveness of an MBI was evaluated on variables that can promote successful job performance such as mindfulness trait, positive and negative affect, forgiveness, personality strengths and satisfaction with life. The intervention was carried out through a smartphone application called "Aire Fresco" (Fresh Air) during 14 days in the middle of the quarantine produced by the Covid-19 pandemic. The study sample was composed of 164 Spanish people who were distributed in two groups: control group and experimental group, which were evaluated before and after the intervention. The MANCOVA performed showed an overall positive effect of the intervention on the variables evaluated. The different ANCOVAs carried out showed that the intervention was beneficial in increasing mindfulness trait, reducing negative affect or increasing life satisfaction, among others. Our study is, as far as we know, the first to demonstrate the effectiveness of a brief intervention in mindfulness conducted using a smartphone application in Spanish.

Development and Validation of an Instrument for the Detection of Early Traumatic Experiences (ExpTra-S) in Patients With Psychosis.

The risk of the appearance of psychosis may reflect the existence of an underlying vulnerability, which may be influenced by environmental factors such as early traumatic experiences. This means that in clinical practice, the assessment of and approach to previous traumatic events is important in persons with psychotic disorders. The psychometric assessment of trauma has advanced considerably in recent years; however, there is no instrument that has been constructed and validated specifically for the evaluation of early traumatic experiences in the clinical population with psychosis. The main goal of this study was to present the construction and validation process of the Screening of Early Traumatic Experiences in Patients with Severe Mental Illness (ExpTra-S). The sample consisted of 114 patients who had experienced at least one psychotic episode (M = 35.5 years of age; SD = 9.26) and a comparison group of 153 young adults (M = 20.8 years of age; SD = 1.8). The factor analysis revealed an essentially one-dimensional structure. The ExpTra-S was associated with the positive dimension of the psychosis phenotype but not with the negative or affective dimensions, or subjective experiences. No items displayed differential functioning for sex and age. The ordinal alpha for the total score was 0.96. The patients with psychosis had a higher score for early traumatic experiences in comparison with the non-clinical group. The results obtained showed that the measuring instrument developed, the ExpTra-S, is a brief, simple, and useful measuring instrument for assessing the presence of early traumatic experiences in patients with severe mental illness.

Evaluación de experiencias traumáticas tempranas en adultos / Assessment of early traumatic experiences in adults

La presencia de experiencias traumáticas tempranas se ha asociado con una gran variedad de alteraciones psicopatológicas en la edad adulta. Esto hace que en la práctica clínica sea importante la evaluación y el abordaje de eventos traumáticos previos en los pacientes con diferentes trastornos mentales. El objetivo fundamental de este trabajo fue realizar una breve descripción y aproximación a los principales instrumentos de medida para la evaluación de las experiencias traumáticas tempranas, preferentemente en adultos; y presentar un nuevo instrumento de medida para la evaluación de las experiencias traumáticas tempranas en pacientes con trastorno mental grave. Los resultados mostraron que la mayoría de los instrumentos existentes proporcionan escaso o ningún apoyo psicométrico y se centran en evaluar un solo tipo de experiencia traumática, lo que reduce su aplicabilidad en la práctica clínica. Del mismo modo, son escasos los instrumentos que han sido adaptados y validados en población española. Futuros estudios deberían seguir examinando las propiedades psicométricas de este conjunto de autoinformes, con la finalidad de mejorar la evaluación de las experiencias traumáticas en la edad adulta

The presence of early traumatic experiences has been associated with a variety of psychiatric disorders in adulthood. This means that in clinical practice the assessment of and approach to previous traumatic events is important in patients with different mental disorders. The main purpose of this paper is, firstly, to provide a brief description and approximation of the main measurement instruments for the assessment of early traumatic experiences; and secondly to present the new self-report for the assessment of early traumatic experiences in patients with severe mental illness. The results show that most of the existing tools for assessing early traumatic experiences have little or no psychometric support and a number of instruments are designed to measure only one type of trauma, which reduces their clinical applicability. Similarly, there are few instruments that have been adapted to and validated in the Spanish population. Future studies should continue to examine the psychometric properties of this group of self-reports with the aim of improving the evaluation of early traumatic experiences in adulthood

Measuring stages of recovery from psychosis.

BACKGROUND: Mental health consumers invite us to abandon the pathology model, which is tied to pessimism, and instead to embrace a model of personal recovery that goes beyond being free from symptoms, and involves self-management of the illness. The Stages of Recovery Instrument (STORI) is a measure developed from the perspective of consumers according to a conceptual five-stage model of recovery. AIMS: The main aim of this work was to study the psychometric properties of the STORI, but we also set out to compare the stages of recovery in our sample with the five-stage model in the sample with which the scale was developed. METHODS: Our sample consisted of 95 people diagnosed with schizophrenia-spectrum psychoses, with a mean age of 34.74 (SD=9.25). RESULTS: The STORI scores showed adequate psychometric properties in this sample. Cluster analysis indicated that the three-cluster model fitted the data better than the five-cluster model. Internal consistency of the STORI scores ranged between .83 and .87. STORI stages were associated with Recovery Styles Questionnaire scores. DISCUSSION: The results provide empirical validation of the STORI in other countries. Empirical evidence revealed that the stages of recovery found in our own and other clinical samples differ from those found in the samples with which the scale was developed.

Reconocimiento de caras en la esquizotipia / Face recognition in schizotypy

Estudios previos sugieren la existencia de fallos en la percepción de uno mismo en la esquizofrenia y la esquizotipia y, en particular, una percepción inusual de la propia cara y de la de otros en la esquizotipia. El propósito de este estudio fue explorar las posibles diferencias en el reconocimiento de la propia cara y la de otros, entre las personas que puntúan alto y bajo en esquizotipia, además de confirmar si las dimensiones Cognitivo-perceptiva y de Desorganización de la esquizotipia, pero no la dimensión Interpersonal, guardan relación significativa con esas anomalías, según lo observado en estudios previos. La muestra estuvo formada por 219 adolescentes y jóvenes no clínicos, (53% mujeres). Los instrumentos empleados fueron el Self-Face Recognition Questionnaire (SFRQ), el Cuestionario de Personalidad Esquizotípica versión breve (SPQ-B) y el ESQUIZO-Q. La media de edad de los participantes fue de 16.3 años (DT = 1.18). Las comparaciones entre quienes puntúan alto y bajo en esquizotipia ofrece apoyo a la hipótesis de que los rasgos positivos (Cognitivo-perceptivos y de Desorganización) correlacionan significativamente con las dificultades en el reconocimiento de caras. Las mujeres mostraron mayores dificultades que los varones en el reconocimiento de caras, probablemente debido la tendencia a puntuar más alto en la dimensión Cognitivo-perceptiva (AU)

Studies suggest disturbances of self in schizophrenia and in schizotypy, and unusual perception of own and other faces in schizotypy. The purpose of this study was to explore possible differences between high and low scores on schizotypal questionnaires and self and others-face recognition, and confirm whether the cognitive-perceptual and disorganization dimensions of schizotypy, but not the interpersonal dimension, significantly correlated with such disturbances, as observed in previous studies. A sample of 219 nonclinical adolescent and young subjects (53% females) completed the Self-Face Recognition Questionnaire (SFRQ), the Schizotypal Personality Questionnaire-Brief (SPQ-B), and the Oviedo Schizotypy Assessment Questionnaire (ESQUIZO-Q). Mean age of the participants was 16.3 years (SD = 1.18). Comparisons between those participants scoring high and low in schizotypal traits offer further support that positive (Cognitive-perceptual and Disorganization) traits significantly correlate with face recognition difficulties; demonstrating girls more disturbances than boys in face recognition, probably due to higher scores in the Cognitive-perceptive dimension (AU)

Expresión fenotípica de la esquizotipia en función del género y la edad en población general adolescente / Phenotypic expression of schizotypy as a function of gender and age in the general adolescent population

El principal objetivo de este trabajo fue examinar la influencia del género y la edad en la expresión fenotípica de la esquizotipia en dos muestras representativas de adolescentes españoles. La primera muestra la formaron un total de 1618 participantes (M = 15.9 años; DT = 1.2) y la segunda la formaron 1455 adolescentes (M =15.9 años, DT = 1.2). Para la evaluación de los rasgos esquizotípicos se utilizó el ESQUIZO-Q-A: Cuestionario Oviedo para la Evaluación de la Esquizotipia-Abreviado (Fonseca-Pedrero et al., 2010). El género y la edad son dos variables sociodemográficas que influyeron en la expresión de los rasgos esquizotípicos en población adolescente. En relación con el género, en la primera muestra, los varones obtuvieron mayores puntuaciones medias que las mujeres en la dimensión Negativa; en cambio, las mujeres obtuvieron mayores puntuaciones en Desorganización Interpersonal. En la segunda muestra, los varones obtuvieron mayores puntuaciones medias que las mujeres en las dimensiones Negativa y Distorsión de la Realidad. En relación con la edad, en la primera muestra, los adolescentes de más edad puntuaron más alto en Desorganización Interpersonal, en comparación con los de menor edad. En la segunda muestra, los adolescentes más jóvenes puntuarón más alto en comparación con los de mayor edad en la dimensión Negativa. En todos los casos los tamaños del efecto entroncados fueron insignificantes (excepto para la dimensión Negativa). En convergencia con la literatura previa, este patrón diferencial es similar al hallado en pacientes con esquizofrenia y en adultos no clínicos, y su hallazgo mejora nuestra comprensión acerca de la expresión fenotípica de la esquizotipia durante este periodo evolutivo (AU)

The main objective of the present study was to examine the influence of gender and age in the phenotypic expression of schizotypy in two representative samples of Spanish adolescents. The first sample was composed of a total of 1,618 participants (M = 15.9 years; SD = 1.2) and the second sample was composed of 1,455 adolescents (M =15.9 years, SD = 1.2). The ESQUIZO-Q: Cuestionario Oviedo para la Evaluación de la Esquizotipia-Abreviado (The Oviedo Schizotypy Assessment Questionnaire-Brief) (Fonseca-Pedrero et al., 2010) was used for the assessment of schizotypal traits. Gender and age were found to be two sociodemographical variables that influenced the expression of schizotypal traits in adolescents. In regard to gender, the males in the first sample obtained higher mean scores than the females in the Negative dimension; however, the females obtained higher mean scores in Social Disorganization. In the second sample, the males obtained higher mean scores than the females in the Negative and the Reality Distortion dimensions. In regard to age, in the first sample, the younger adolescents scored higher in Social Disorganization compared to the older adolescents. In the second sample, the younger adolescents obtained higher scores than the older adolescents in the Negative dimension. In all cases the effect sizes were small (except Negative). In convergence with the previous literature, this differential pattern is similar to that found in patients with schizophrenia and in nonclinical adults, and contributes to our comprehension of the phenotypic expression of schizotypy during this developmental period (AU)

Instrumentos de medida para la evaluacióndel fenotipo psicótico / No disponible

El propósito fundamental de este trabajo fue llevar a cabo una revisión de los principales instrumentos de medida disponibles para la evaluación del fenotipo psicótico en población general. Esta revisión viene a cubrir una limitación en el campo de la evaluación de los síntomas psicóticos atenuados en nuestro país y ofrece al profesional de la psicología un conjunto de herramientas interesantes para su utilización en el quehacer diario. Los resultados mostraron que los autoinformes analizados presentan un correcto comportamiento psicométrico, siendo de utilidad para examinar los síntomas psicóticos atenuados en muestras de la población española, así como para la detección precoz de personas con vulnerabilidad latente a la psicosis. Futuros estudios deberían seguir examinando las propiedades métricas de este conjunto de autoinformes en estudios longitudinales, así como llevar a cabo estudios multicéntricos de carácter nacional, con la finalidad última de mejorar la detección y la prevención de individuos de riesgo de síndrome psicótico (AU)

The main purpose of this paper is to offer a review of the principle measurement instruments for the assessment of the psychotic phenotypein the Spanish general population. This review covers a limitation present in the field of the assessment of psychotic-like symptoms in our territory and offers the psychology professional a group of interesting tools for their use in daily practice. The results showed that the analyzed self-reports presented adequate psychometric behavior being useful for the examination of psychotic-like symptoms in Spanish samples as well as the early detection of participants who present latent vulnerability for psychosis. Future studies should continue examining the psychometric properties of this group of self-reports, mainly in longitudinal studies, as well as conducting national multicentric studies with the aim of improving the detection and prevention of individuals at risk of psychotic disorder (AU)

Early psychopathological features in Spanish adolescents / Rasgos psicopatológicos tempranos en adolescentes españoles

Schizotypal experiences and depressive symptoms are quite common among adolescents, and have been considered as risk markers for schizophrenia-spectrum and mood disorders. The main goal of the present study was to analyze the relationship between schizotypal experiences and depressive symptoms in a community sample of non-clinical adolescents. The sample comprised a total of 1653 participants, 794 male (48%), with an average age of 15.94 years (SD = 1.23). Results showed that schizotypal traits and depressive symptoms were closely related at a subclinical level. Canonical correlation analysis indicated that the two sets of variables shared approximately 48% of the variance. The study of the dimensionality underlying the subscales of the self-reports revealed the presence of three components, namely: Depressive, Anhedonia and Reality Distortion. These results are convergent with previous studies conducted in both clinical and non-clinical samples, indicating overlap between schizotypal experiences and depressive symptoms (AU)

Las experiencias esquizotípicas y la sintomatología depresiva son fenómenos psicológicos comunes entre la población adolescente, y han sido considerados como marcadores de riesgo para los trastornos del espectro esquizofrénico y los trastornos del estado de ánimo. El principal objetivo de este estudio fue analizar la relación entre las experiencias esquizotípicas y la severidad de la sintomatología depresiva autoinformada en una muestra comunitaria de adolescentes. La muestra la conformaron un total de 1.653 participantes, 794 varones (48%), con una edad media de 15,94 años (DT= 1,23). Los resultados mostraron que los rasgos esquizotípicos y los síntomas depresivos se encontraron estrechamente relacionados a nivel subclínico. El análisis de correlación canónica indicó que ambos conjuntos de variables compartían aproximadamente el 48% de la varianza. El estudio de la dimensionalidad subyacente a las subescalas de los autoinformes reveló la presencia de tres componentes, a saber: Depresivo, Anhedonia y Distorsión de la Realidad. Estos resultados son convergentes con los estudios previos llevados a cabo tanto en muestras clínicas como no clínicas, indicando el solapamiento entre ambas entidades (AU)

Early psychopathological features in Spanish adolescents.

Schizotypal experiences and depressive symptoms are quite common among adolescents, and have been considered as risk markers for schizophrenia-spectrum and mood disorders. The main goal of the present study was to analyze the relationship between schizotypal experiences and depressive symptoms in a community sample of non-clinical adolescents. The sample comprised a total of 1653 participants, 794 male (48%), with an average age of 15.94 years (SD = 1.23). Results showed that schizotypal traits and depressive symptoms were closely related at a subclinical level. Canonical correlation analysis indicated that the two sets of variables shared approximately 48% of the variance. The study of the dimensionality underlying the subscales of the self-reports revealed the presence of three components, namely: Depressive, Anhedonia and Reality Distortion. These results are convergent with previous studies conducted in both clinical and non-clinical samples, indicating overlap between schizotypal experiences and depressive symptoms.