A multicomponent positive psychology group intervention for people with severe psychiatric conditions; a randomized clinical trial.

OBJECTIVE: The aim of this study was to examine the efficacy and effectiveness of a theory-driven multicomponent positive psychology intervention to improve well-being for individuals with severe psychiatric conditions (SPCs) in comparison with treatment as usual (TAU). This intervention moves away from the traditional psychiatric perspectives that focused on symptoms and deficits, promoting a broader view of outcomes such as noncritical self-acceptance, strengths, and positive relationships with others, among other things. METHOD: A two-arm randomized and outcome-blinded trial with pre-post and 6-month follow-up evaluations was conducted to assess the intervention. A total of 141 participants were allocated to either the experimental condition or the waiting list group receiving their TAU. A mixed-effect model was used to examine the efficacy of the intervention and a repeated-measures Student's t-test for the follow-up effectiveness analysis. RESULTS: The intervention protocol was highly acceptable for participants, showing very high participant satisfaction as well as good attendance and adherence rates. At the end of the group therapy, participants reported a significant improvement in self-acceptance and environmental mastery and, these changes were maintained in the follow-up assessment after 6 months. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The results of this randomized control trial provide further evidence supporting that positive psychology approaches can be a powerful complementary strategy to promote more comprehensive psychiatric rehabilitation services for people with SPCs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Relación entre empleo y bienestar emocional en personas con trastorno mental grave / Relationship between employment and emotional state in people with severe mental disorder

Las personas con un diagnóstico de trastorno mental grave (TMG) tienen tasas de desempleo notablemente superiores a las de la población general. Esto se asocia con mayor riesgo de exclusión social y de marginalidad, y favorece la cronicidad de las dificultades personales y sociales. Este estudio observacional pretende evaluar la relación entre el empleo y el estado emocional subjetivo en personas con TMG. El estudio incluyó 744 participantes (304 con TMG usuarias de recursos de rehabilitación psicosocial, 168 personas con TMG con empleo protegido y 272 personas sin TMG con empleo ordinario), con una edad media de 41.9 años y 50.1% mujeres. De los 744 participantes, 577 (77.6%) tuvieron empleo remunerado (409 (60.9%) empleo ordinario y 168 (29.1%) empleo protegido); 244 (32.8%) comunicaron que tenían un diagnóstico de psicosis y 400 (53.8%) que tenían reconocida la discapacidad. Las personas con empleo tuvieron mejores valores de bienestar psicológico subjetivo (p=0.013) que las personas sin empleo, independientemente del diagnóstico o de la discapacidad. Sin embargo, no hubo diferencias significativas en bienestar psicológico subjetivo entre las personas con empleo ordinario y con empleo protegido (p=0.687). Como conclusión, las personas con empleo remunerado tuvieron mayor bienestar psicológico subjetivo que las personas sin empleo, independientemente del diagnóstico, de la discapacidad o de que el empleo fuera ordinario o protegido. (AU)

People with a diagnosis of severe mental disorder (SMD) have significantly higher unemployment rates than the general population. This is associated with a greater risk of social exclusion and marginalization, and favors the chronicity of personal and social difficulties. This observational study aims to assess the relationship between employment and subjective emotional state in people with a SMD diagnosis. The study included 744 participants (304 with a SMD diagnosis who were users of psychosocial rehabilitation resources, 168 with a SMD diagnosis with supported employment, and 272 people without diagnosis of SMD with ordinary (non-supported) employment), with a mean age of 41.9 years and 50.1% women. Out of the 744 participants, 577 (77.6%) had an employment (409 (60.9%) ordinary employment and 168 (29.1%) supported employment), 244 (32.8%) reported that they have a diagnosis of psychosis and 400 (53.8%) that they have a recognized disability. People with an employment had better subjective psychological well-being values than people without an employment (p=0.013), regardless of diagnosis or disability. There were no significant differences in subjective psychological well-being between people with ordinary employment and people with supported employment (p=0.687). In conclusion, people with a paid employment had higher subjective psychological well-being than people without an employment, regardless of diagnosis, disability or whether the employment was ordinary or supported. (AU)

Trauma and posttraumatic stress disorder in Spanish public mental health system clients with severe psychiatric conditions: Clinical and demographic correlates.

OBJECTIVE: Compared with the general population, those with severe psychiatric conditions have a substantially higher likelihood of trauma exposure, increased probability of developing posttraumatic stress disorder (PTSD), and more severe consequences if trauma is left untreated. Nevertheless, identification of trauma/PTSD continues to be a neglected mental health system priority. In Spain, few investigations have examined the prevalence of trauma, particularly in persons with severe psychiatric conditions. METHOD: This study reports findings from a trauma/PTSD screening within a large Madrid public mental health agency serving clients with severe psychiatric conditions. RESULTS: Of the 323 participants, 272 (84.2%) reported at least 1 traumatic event; and 124 (38.4%) met criteria for "probable" PTSD, although none had a medical record diagnosis of PTSD. Those with probable PTSD were predominantly male, were in their mid-40s, had received mental health services for 16 years on average, and endorsed 5.64 types of lifetime traumatic events. The most frequent and distressing traumatic event was the sudden, unexpected death of a loved one. The number of traumatic event types reported was positively correlated with PTSD symptom severity. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Despite lower Spanish general population prevalence of trauma/probable PTSD (compared with the United States and other Western countries), rates within those with co-occurring severe psychiatric conditions are high. These findings reinforce the importance of conducting system-wide screening in public mental health clinics serving persons with severe psychiatric conditions in Spain (and beyond), in order to address this ongoing but neglected issue, and begin to offer much-needed recovery services. (PsycINFO Database Record

Adaptación española del inventario para la depresión de Beck-II (BDI-II): propiedades psicométricas en población general / The spanish adaptation of Beck’s Depression Inventory-II (BDI-II): 2. Psychometric properties in the general population

Se presentan por primera vez datos normativos y de fiabilidad y validez factorial de la adaptación española del Inventario para la Depresión de Beck—II (BDI-II; Beck, Steer y Brown, 1996) obtenidos con una muestra de 470 adultos seleccionados de la población general española. La fiabilidad de consistencia interna del BDI-II fue elevada (coeficiente alfa de 0,87). Los análisis factoriales indicaron que el BDI-II mide una dimensión general de depresión compuesta por dos factores altamente relacionados, uno cognitivo-afectivo y otro somático-motivacional. En términos de consistencia interna y validez factorial, el BDI-II parece mejor instrumento para evaluar sintomatología depresiva en población general que su predecesor, el BDI-IA. La distribución de la puntuación total del BDI-II fue similar a la encontrada en estudios previos, con una media superior en 2 puntos a la que se suele obtener con el BDI-IA, lo que justifica incrementar las puntuaciones para definir las categorías de gravedad de la depresión. Además, se hallaron diferencias significativas en tales puntuaciones en función del sexo, la edad, el nivel de educación y el estado civil: las mujeres puntuaban más alto que los varones, las personas mayores de 60 años más que las personas de menor edad, las personas con estudios básicos o sin estudios más que las personas con estudios secundarios o universitarios, y las personas divorciadas, separadas o viudas más que las personas casadas o conviviendo con una pareja. Se ofrecen puntuaciones normativas para la muestra total, y se discute su utilidad para evaluar la significación clínica de los resultados de los tratamientos contra la depresión (AU)

This is the first study that provides normative data, reliability and factor validity for the Spanish adaptation of Beck’s Depression Inventory—II (BDI-II; Beck, Steer y Brown, 1996) with a sample of 470 Spanish community adults. Internal consistency estimate for the BDI-II was high (coefficient alpha of 0.89). Factor analyses suggested that the BDI-II measures a general dimension of depression consisting of two highly related factors, a cognitive-affective factor and a somatic-motivational one. In terms of both internal consistency and factorial validity, the BDI-II appears to be a stronger instrument to assess depressive symptomatology in community adults than its predecessor, the BDI-IA. Distribution of BDI-II scores was similar to that found in prior studies, yielding a mean that was 2 points higher than the one found with the BDI-IA. This difference supports the decision to increase cut-off scores to define categories of depression severity. In addition, age, sex, education level and civil status differences in the BDI scores were found: women scored higher than men, participants over 60 years old exceeded those who were younger, the group with the lowest education level scored higher than high-school or university education participants, and divorced, separated or widowed persons scored higher than married persons or persons cohabiting with a stable couple. BDI-II norm scores are provided for the complete community sample, and the usefulness of these scores for assessing clinical significance of therapy outcomes is discussed (AU)