La resiliencia como mediador entre el síndrome del quemado (burnout) y el bienestar subjetivo en residentes de hospitales españoles / Resilience as a mediator between burnout syndrome and subjective well-being in Spanish hospital residents

Numerosos estudios han demostrado el impacto del síndrome del quemado(burnout) en el bienestar de los residentes, sin embargo, los mecanismos queexplican esta influencia siguen sin estar claros. Este estudio analizó el grado delsíndrome del quemado, así como su evolución en los años formativos y el papelmediador de la resiliencia entre el síndrome y el bienestar subjetivo en una muestrade 237 residentes de diferentes especialidades de hospitales españoles. A losparticipantes se les administró el “Inventario del síndrome del quemado deMaslach”, la “Escala de resiliencia de Connor-Davidson” y la “Escala reducida debienestar subjetivo”. Del total de residentes, el 48,9% puntuaron alto en elsíndrome del quemado, el 53,6% en agotamiento emocional y el 74,7% endespersonalización. Los niveles del síndrome aumentaron según avanza laresidencia y la resiliencia medió en la relación entre los niveles de síndrome delquemado y de bienestar subjetivo. Estos resultados sugieren que la resiliencia es unfactor protector a implementar en programas preventivos. (AU)

Ample research has supported the detrimental impact of burnout on the wellbeing of resident doctors. However, the mechanisms accounting for this influenceremain unclear. Consequently, this study analysed for the first time the degree ofburnout as well as its evolution throughout the residency period and tested themediational role of resiliency in the relationship between burnout and its subscalesand well-being in a sample of 237 Spanish residents of different specialties fromSpanish hospitals. Participants were administered the Maslach Burnout Inventory, the Connor Davidson Resilience Scale and the short-version scale of SubjectiveWell-being. From the total sample of residents, 48.9% reported high levels of totalburnout, 53.6% in the subscale of emotional burnout and 74.7% indepersonalization. Additionally, burnout levels increased as the residency periodprogressed, and resilience mediated the relationship between burnout andsubjective well-being level. Such findings suggest resilience as a protector factoragainst burnout that should be included in prevention programs. (AU)

The Proactive-Reactive Resilience as a Mediational Variable Between the Character Strength and the Flourishing in Undergraduate Students.

The aim of this research was to delimit the predictive and mediational model of resilience between character strengths to predict flourishing, in a sample of undergraduate students. After signing their informed consent, 642 university students completed three validated scales (i.e., character strengths, resilience, and flourishing). Using an ex post facto design, regression, structural modeling, and mediation analyses were carried out, in order to construct a multi-causal predictive model. Results indicated a consistent predictive direct effect of character strengths on resilience and flourishing and of resilience on flourishing. As hypothesized, resilience also showed a mediating effect on the relationship between character strengths and flourishing. Additionally, results also revealed that the reactive and proactive factors of resilience were explained by different character strengths (e.g., emotional strength/cognitive, interpersonal strengths), reinforcing the idea that the two directions are complementary and necessary. Finally, several implications were established for the practice of positive psychology.

Endophenotypes: A conceptual link between anorexia nervosa and autism spectrum disorder.

The paper, by translating the concept and the two models of endophenotype (EP), strengthens the hypothesis that there exists a linkage between anorexia nervosa (AN) and autism spectrum disorder (ASD). Specifically, the paper synthesizes empirical research that supported the idea that individuals with AN and individuals with ASD share similarities with respect to their neurocognitive EPs and temperament EPs. The paper then introduces an innovative structure to emphasize the subtle difference between neurocognitive EPs and temperament EPs in relation to AN and ASD. This structure constitutes the categorization of the shared neurocognitive EPs to the liability-index model of EP and the shared temperament EPs to the mediational model of EP. The paper argues that the shared neurocognitive EPs under the liability index model of EP are trait markers signaling the effects of genes on the phenotypes of AN and ASD; whereas, the shared temperament EPs under the mediational model of EP are state markers describing the symptomatic status of AN and ASD. The proposition of the paper suggests clinicians and researchers should target the atypical state markers (i.e., temperament EPs) shared between AN and ASD when tailoring environment-based treatments for individuals with AN who exhibit autistic behaviors and individuals with ASD who display disordered eating behaviors or anorexic symptoms.

Body-Image Acceptance and Action Questionnaire: Its deleterious influence on binge eating and psychometric validation.

Background/Objectives: This study aimed to explore the psychometric properties of BI-AAQ (Body-Image Acceptance and Action Questionnaire) and the body image psychological flexibility role as a mediator in a pervasive path towards binge eating in Brazilian samples. Method: This cross-sectional study was conducted in clinical (overweight or obese women currently in treatment for weight loss; n= 330) and non-clinical (general population; n= 682) groups of women. Results: BI-AAQ has one-factor structure, excellent internal consistency, ability to detect differences between groups and measurement invariance across samples. It was also negatively associated with self-compassion and positively associated with binge eating severity, drive for thinness and self-criticism. Conclusions: This study provides data confirming the robust psychometric properties of BI-AAQ in qualitatively different samples. Furthermore, an additional study conducted in a clinical sample of women with overweight or obesity revealed that body image psychological inflexibility has emerged as a partial and significant mediator of the effect of self-criticism and drive for thinness on binge eating severity.

Antecedentes/Objetivo: Este estudio tuvo como objetivo explorar las propiedades psicométricas del BI-AAQ (Body-Image Acceptance and Action Questionnaire) y el papel mediador de la inflexibilidad psicológica relacionada con la imagen corporal en una trayectoria nociva hacia la ingesta compulsiva en muestras brasileñas. Método: Este estudio transversal se llevó a cabo en grupos clínicos (mujeres con sobrepeso u obesidad actualmente en tratamiento para la pérdida de peso; n= 330) y no clínicos (grupo de población general; n= 682) de mujeres. Resultados: BI-AAQ presenta la estructura de un factor, excelente consistencia interna, capacidad para detectar diferencias entre grupos e invariancia de medida entre diferentes muestras. Sus puntuaciones se asociaron negativamente con la autocompasión y positivamente con la severidad de la compulsión alimentaria, búsqueda de la delgadez y autocrítica. Conclusiones: Este estudio proporcionó datos que confirman que el BI-AAQ tiene propiedades psicométricas sólidas en muestras cualitativamente diferentes. Además, un estudio adicional efectuado en una muestra clínica de mujeres con sobrepeso u obesidad reveló que la inflexibilidad psicológica relacionada con la imagen corporal emergió como mediadora parcial y significativa del efecto de la autocrítica y de la búsqueda de la delgadez sobre la severidad de la compulsión alimentaria.

The Association among Childhood Trauma, Pathological Dissociation and Gambling Severity in Casino Gamblers.

The aim of the present study was to explore the role of pathological dissociation in mediating the association between childhood trauma (CT) and gambling severity. One hundred seventy-one (134 men and 37 women) gamblers recruited in gambling environments (i.e., two Italian casinos) have been enrolled in the study. Psychopathological assessments included the Childhood Trauma Questionnaire (CTQ), the Dissociative Experiences Scale-Taxon (DES-T), the South Oaks Gambling Screen (SOGS), the CAGE and the Hospital Anxiety and Depression Scale. A mediational model, analyzing the direct and indirect effects of CTQ on SOGS through the mediating role of DES-T, showed that the relation between CTQ and SOGS was fully mediated by DES-T scores (b = 0.07; se = 0.15; p < 0.001). This finding raises the possibility that CT explains gambling severity through the presence of pathological dissociative symptoms and dissociative pathogenetic processes. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Gambling severity is associated with both childhood trauma and pathological dissociation in casino gamblers. A mediational model shows that the effect of childhood trauma on gambling severity is entirely mediated by pathological dissociation. From a clinical point of view, our results highlight the importance of assessing, and possibly treating, dissociative symptoms in individuals with gambling disorder.

The Association among Difficulties in Emotion Regulation, Hostility, and Empathy in a Sample of Young Italian Adults.

The aim of the present study was to assess the role of empathy in mediating the association between difficulties in emotion regulation and hostility. Three hundred and sixty young Italian adults (220 women and 140 men) were enrolled in the study. Psychopathological assessments included the Difficulties in Emotion Regulation Scale (DERS), the Interpersonal Reactivity Index and the Buss-Durkee Hostility Inventory (BDHI). Perspective taking (PT) and Personal distress (PD) are significantly associated with both DERS total score and BDHI total score. A mediational model analyzing the direct and indirect effects of DERS on BDHI through the mediating role of PT and PD showed that the relation between DERS and BDHI was partially mediated by PT total score (b = 0.16; se = 0.01; p = 0.02). Taken together our findings support the possibility that PT skills could play a crucial role in inhibiting hostility behaviors.

Mindfulness may both moderate and mediate the effect of physical fitness on cardiovascular responses to stress: a speculative hypothesis.

The psychological construct of mindfulness refers to an awareness that emerges by intentionally paying attention to the present experience in a non-judgmental or evaluative way. This particular quality of awareness has been associated to several indicators of physical and psychological health, and can be developed using mindfulness-based interventions (MBIs), and therefore MBIs have been successfully applied as preventive and complementary interventions and therapies in medicine and psychology. Together with quiet sitting and lying meditation practices, mindful physical exercises such as "mindful walking" and "mindful movement" are key elements in MBIs and couple muscular activity with an internally directed focus, improving interoceptive attention to bodily sensations. In addition, MBIs seem to share similar mechanisms with physical fitness (PF) by which they may influence cardiovascular responses to stress. Based on these facts, it is feasible to raise the question of whether physical training itself may induce the development of that particular quality of awareness associated with mindfulness, or if one's dispositional mindfulness (DM) (the tendency to be more mindful in daily life) could moderate the effects of exercise on cardiovascular response to stress. The role of mindfulness as a mediator or moderator of the effect of exercise training on cardiovascular responses to stress has barely been studied. In this study, we have hypothesized pathways (moderation and mediation) by which mindfulness could significantly influence the effects of PF on cardiovascular responses to stress and discussed potential practical ways to test these hypotheses.