Psychological factors as coping skills to attenuate the gestational stress response / Factores psicológicos como medidas de afrontamiento para modular la respuesta al estrés gestacional

OBJECTIVE: Although in the 1940s there was an important decrease in global maternal/infant mortality rates, by the 1990s these rates had become stagnant. Many strategies to decrease maternal/infant mortality had been used, which included the prevention of pregnancy complications. Several studies showed an association between these complications and the stress perceived during pregnancy. However, there are some discrepancies which challenge this association. We believe that these discrepancies are due to the lack of understanding about the pregnant stress response and consequently the ways it is measured. The aim of this study was to understand how pregnant women perceive motherhood, pregnancy stressors and the psychological factors that attenuate the stress response. MATERIALS AND METHODS: A qualitative study was conducted that explores the perception of gestational stress in 32 pregnant women who were recruited in different Health Centers. Semi-structured interviews were carried out which were conducted by the PhD student in charge of the project and each interview lasted 15-20 min. Since the interviews were audio-recorded they were transcribed and the information was then categorized according to the three issues raised in the objective (motherhood, pregnancy stressors, and psychological factors that attenuate the stress response). RESULTS AND CONCLUSIONS: We found that the gestational stress response and also its magnitude are influenced not only by how women perceive the aspects, but also and most importantly by its articulation. Likewise, results show that gestational stress is only attenuated when women perceive and cope with both the positive and negative aspects of pregnancy and motherhood

OBJETIVO: Si bien en 1940 hubo una disminución importante en las tasas globales de mortalidad materno/infantil, hacia 1990 estas tasas se estancaron. Desde entonces se han utilizado muchas estrategias para disminuir la mortalidad materno/infantil, las cuales incluyen la prevención de las complicaciones del embarazo. Varios estudios mostraron una asociación entre estas complicaciones y el estrés percibido durante el embarazo. Sin embargo, hay algunas discrepancias que desafían esta asociación. Creemos que estas discrepancias se deben al poco entendimiento que tenemos sobre la respuesta al estrés durante el embarazo y, en consecuencia, en la forma en que esta se mide. Es por ello que el objetivo de este estudio es comprender cómo las mujeres embarazadas perciben la maternidad, los estresores propios del embarazo y los factores psicológicos que modulan la respuesta al estrés. MATERIALES Y MÉTODOS: Se realizó un estudio cualitativo que explora la percepción sobre el estrés gestacional en 32 mujeres embarazadas que eran derechohabientes de los centros de salud. Para ello se realizaron entrevistas semiestructuradas, las cuales fueron realizadas por la estudiante de doctorado encargada del proyecto, y cada una tuvo una duración de 15 a 20 min. Puesto que las entrevistas fueron audiograbadas, se transcribieron y se categorizó la información de acuerdo con los 3 temas planteados en el objetivo (percepción de la maternidad, estresores propios del embarazo y factores psicológicos moduladores de estrés). RESULTADOS Y CONCLUSIONES: Encontramos que la respuesta del estrés gestacional y su magnitud son influidas no solo por la percepción que tiene la mujer de estos aspectos, sino sobre todo por su articulación. Además, los resultados muestran que el estrés gestacional solo se atenúa cuando las mujeres perciben y enfrentan tanto los aspectos positivos como los negativos del embarazo y la maternidad

Design and Psychometric Analysis of the Stressors and Modulators of Gestational Stress Inventory (SMGSI).

Gestational stress is associated with many maternal and child complications, however, this association must be taken with care, since there are studies that find inconsistent results between stress measures and maternal complications. It is believed that the lack of convergence is due to the way in which gestational stress is evaluated.The aim of the present study was to design and validate an instrument based on a bio-psycho-social model of gestational stress. The design and validation process of the inventory was divided into four phases: (a) Construction of the items bank and content validity, (b) construct validity, (c) inventory reliability and (d) convergent and discriminant validity with psychometric instruments that have been used in other investigations to evaluate gestational stress.A valid and reliable Stressors and Modulators of Gestational Stress Inventory (SMGSI) conformed by two scales was developed: (a) Gestational stressors, which is formed by two factors, the psychological stressors and social stressors with a variance of 48.5% and 51.8% and a reliability of .79 and .67, respectively; and (b) gestational stress modulators integrated by 8 items that explain 55.2% of the variance and with a reliability of .92. In conclusion, a valid and reliable tool was obtained that measures gestational stress from a bio-psycho-social perspective. This inventory allows for the identification of allostatic and pantostatic stress, making it useful as a diagnostic tool to prevent maternal and childhood complications that are associated with chronic gestational stress.

Estrés percibido y felicidad en adultos mexicanos según estado de salud-enfermedad / Perceived stress and happiness among Mexican adults split by health-illness condition

Resumen El presente estudio tuvo como objetivo analizar la relación entre el estrés percibido y la felicidad en adultos mexicanos, así como comparar ambas variables según el estado de salud-enfermedad. La muestra estuvo conformada por 762 adultos mexicanos con una media de edad de 44.96 años, de los cuales el 70.3 % reportó no padecer ninguna enfermedad. Se utilizó la Escala de Estrés Percibido y el Inventario de Felicidad Auténtica. Adicionalmente, los participantes reportaron si padecían alguna enfermedad y seleccionaron, posteriormente, en una lista de opciones. Mediante el SPSS v.24 se realizaron análisis de frecuencias, descriptivos, análisis de correlación y análisis de varianza de un factor. En los resultados se observó una correlación negativa y estadísticamente significativa entre el estrés percibido y la felicidad. Por su parte, solo se observaron diferencias significativas en la subescala de estrés percibido "sobrepasado por la situación"; fue mayor en el grupo de personas con una enfermedad aguda en comparación con el grupo de personas sanas. Se discuten los principales hallazgos, así como las implicaciones para la práctica psicológica.

Abstract The present study aimed to analyze the relationship between perceived stress and happiness in Mexican adults, and test for differences in both variables according to the health disease condition. The sample consisted of 762 Mexican adults with an average age of 44.96 years, of which 70.3% reported not suffering from any disease. The Perceived Stress Scale and the Authentic Happiness Inventory were used. In addition, participants reported if they suffer from any disease, later selecting from a list of options. Using the SPSS v.24, frequency, descriptive, correlation and analysis of variance of one factor were performed. Negative and statistically significant correlation between perceived stress and happiness was found. On the other hand, only significant differences were observed in the subscale of perceived stress "overwhelmed by the situation" being greater in the group of people with an acute illness, compared to the group of healthy people. The main findings as well as implications for psychological practice are discussed.

Design and psychometric analysis of the Stressors and Modulators of Gestational Stress Inventory (SMGSI)

Gestational stress is associated with many maternal and child complications, however, this association must be taken with care, since there are studies that find inconsistent results between stress measures and maternal complications. It is believed that the lack of convergence is due to the way in which gestational stress is evaluated. The aim of the present study was to design and validate an instrument based on a bio-psycho-social model of gestational stress. The design and validation process of the inventory was divided into four phases: (a) Construction of the items bank and content validity, (b) construct validity, (c) inventory reliability and (d) convergent and discriminant validity with psychometric instruments that have been used in other investigations to evaluate gestational stress. A valid and reliable Stressors and Modulators of Gestational Stress Inventory (SMGSI) conformed by two scales was developed: (a) Gestational stressors, which is formed by two factors, the psychological stressors and social stressors with a variance of 48.5% and 51.8% and a reliability of .79 and .67, respectively; and (b) gestational stress modulators integrated by 8 items that explain 55.2% of the variance and with a reliability of .92. In conclusion, a valid and reliable tool was obtained that measures gestational stress from a bio-psycho-social perspective. This inventory allows for the identification of allostatic and pantostatic stress, making it useful as a diagnostic tool to prevent maternal and childhood complications that are associated with chronic gestational stress

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Valores normativos del sistema internacional de imágenes afectivas en población mexicana: diferencias entre Estados Unidos, Colombia y México / Normative Values of the International Affective Picture System in Mexicans: Differences between USA, Colombia and Mexico

Resumen Uno de los instrumentos con mayor evidencia empírica y versatilidad para el estudio de las emociones y la motivación es el Sistema Internacional de Imágenes Afectivas (International Affective Picture System, IAPS). Sin embargo, no ha sido probado en población mexicana. Por esta razón el presente estudio tuvo por objetivo determinar los valores normativos en valencia, arousal y dominancia para los conjuntos 13, 14, 19 y 20 del IAPS en población mexicana, e identificar las diferencias con países de América (Colombia y Estados Unidos). Participaron 408 estudiantes quienes evaluaron 238 imágenes del IAPS a través del Self-Assessment Manikin (SAM). Los resultados mostraron que la distribución de las imágenes en el espacio afectivo bidimensional (valencia-arousal) adoptan la forma esperada de boomerang, coincidiendo con lo encontrado en otras poblaciones. Sin embargo, en población mexicana es más fuerte la relación entre valencia apetitiva y arousal que entre valencia aversiva y arousal. En conclusión, los valores normativos de los conjuntos 13, 14, 19 y 20 pueden ser utilizados en población mexicana para el estudio objetivo de las emociones.

Abstract The International Affective Picture System (IAPS) is an instrument to the study of emotions and motivation with a high empirical evidence and versatility. However, it has not been tested in Mexican population, for that reason the aim of this study was to determine the normative values of valence, arousal and dominance for the IAPS sets of pictures 13, 14, 19 and 20 in Mexican population. Participants were 408 students who assessed 238 images of the IAPS through the Self-Assessment Manikin (SAM). The results showed that the pictures distribution on the two-dimensional affective space (valence-arousal); take a boomerang form, which is consistent with the findings in other populations. Nevertheless, in the Mexican population there was a stronger relationship between appetitive valence and arousal than the one observe in aversive valence and arousal. In conclusion the normative values in the IAPS sets of pictures 13, 14, 19 and 20 can be used in the study of emotions in Mexican people.

Evaluating Stress during Pregnancy: Do We Have the Right Conceptions and the Correct Tools to Assess It?

Gestational stress is believed to increase the risk of pregnancy failure and perinatal and adult morbidity and mortality in both the mother and her child or children. However, some contradictions might arise from methodological issues or even from differences in the philosophical grounds that guide the studies on gestational stress. Biased perspectives could lead us to use and/or design inadequate/incomplete panels of biochemical determinations and/or psychological instruments to diagnose it accurately during pregnancy, a psychoneuroimmune-endocrine state in which allostatic loads may be significant. Here, we review these notions and propose a model to evaluate and diagnose stress during pregnancy.