Análisis de redes de síntomas del trastorno de agorafobia en personas mayores de 65 años

El objetivo es realizar un análisis de redes de síntomas del trastorno de agorafobia (con o sin pánico) según la edad y el sexo, en una muestra representativa de 555 personas mayores de 65 años de la Comunidad de Madrid. La red se estimó utilizando el paquete InsingFit que implementa un procedimiento llamado eLasso. Los resultados revelan redes diferenciadas para hombres y mujeres, y para los grupos de edad de 65-74 y 75-84 años, encontrando un mayor porcentaje de ocurrencia en las mujeres tanto en las situaciones como en los síntomas de ansiedad y en las razones para sentir miedo. Las mujeres temen un mayor número de situaciones, mientras que los hombres parecen tener sus miedos más localizados y centralizados en situaciones relacionadas con el transporte y los viajes cuando los hacen solos. Estos resultados pueden ser interesantes para diseñar intervenciones que aborden los síntomas y sus relaciones mutuas más importantes, diferentes y características en función de la edad y el sexo.

Mental health in a heterogeneous clinical sample. A cross-sectional study of predictors and gender differences

Introduction

Women have been shown to be a vulnerable group in relation to mental health problems over time. Despite this, gender-focused studies are uncommon. The aim of this research is to study mental health in a sample of people with mental health problems and to analyze the differences and predictors focusing on gender.

Methods

A cross-sectional study is conducted in a heterogeneous clinical sample in terms of mental health problems (N = 160). Interviews with hetero-reported standardized questionnaires to collect the data are conducted. Descriptive analyses, mean difference and a regression analysis on mental health are carried out taking into account different sociodemographic, clinical and psychosocial variables.

Results

Women in the study present worse levels of mental health and subjective severity of the disorder. The main predictors of mental health are being female, followed by severity, shorter time with the diagnosis and internalized stigma.

Conclusion

Being female is the most robust predictor of worse mental health and symptomatology. Recommendations according to the results found proposing a gender perspective are suggested.

Evolution of intersectional perceived discrimination and internalized stigma during COVID-19 lockdown among the general population in Spain

BACKGROUND

Stigma and discrimination have been associated with different diseases and pandemics, with negative consequences for the people who suffered them and for their communities. Currently, COVID-19 has become a new source of stigmatization.

AIMS

The aim of the present study is to analyze longitudinally the evolution of intersectional perceived discrimination and internalized stigma among the general population of Spain, at three points in time throughout the confinement.

METHOD

Participants completed an online survey.

RESULTS

Results show an increase in both variables from the first to the second evaluation, and a slight decrease from the second to the third evaluation. Moreover, these changes are explained by depression, anxiety and family support.

CONCLUSIONS

These findings indicate the factors that need to be considered to reduce the perception of discrimination and the internalization of stigma, and their detrimental consequences, during an especially stressful event such as the current pandemic outbreak.

Proposed diagnostic criteria for mild cognitive impairment in Down syndrome population

BACKGROUND

Despite presenting higher risk of dementia, mild cognitive impairment (MCI) is not well defined in Down syndrome population.

OBJECTIVE

We aimed to describe cognitive and neuropsychological patterns associated with MCI in Down syndrome individuals.

METHOD

Two groups of adults with Down syndrome (control and prodromal) were studied throughout 3 years. Two linear mixed models and a model including the variables that best predicted group membership were built.

RESULTS

Behavioural Regulation Index (BRI) (Behaviour Rating Inventory of Executive Function test) and the model composed of BRI, abstraction and delayed verbal memory were the variable and model best predicting group membership, respectively.

CONCLUSION

Suggest a diagnosis of MCI when BRI is the earliest change perceived by caregivers and this is combined with low scores in abstract thinking, and when an amnesic pattern in delayed verbal memory is observed, but adaptive skills are preserved.

Executive Functions Influence on Memory Process in Patients with Paranoid Schizophrenia and Bipolar Disorders with and without Psychotic Symptoms. A Pilot Study

The objective of the present study was to evaluate whether declarative memory deficits are related to executive function deficits (EF), since they could be a consequence of a poor organization of the material to memorize. This interaction between both cognitive processes can be studied simultaneously in a single task such as the Test of Memory Strategies (TSM). 23 patients with paranoid schizophrenic disorder, 11 with bipolar disorder with psychotic symptoms, 13 with bipolar disorder without psychotic symptoms and 15 healthy subjects were evaluated with the TSM; with the memory test Texts A and B (subtest of the Barcelona neuropsychological assessment battery), which assesses short-term and immediate recall without the influence of EF; and with the Trail Making Test (TMT): Part A (sustained attention) and Part B (executive control). The patients groups and the control group showed an improvement in memory performance across each of the TSM conditions. However, this facilitating effect of the strategies differed among the groups (the patients with higher EF deficits showed less improvement). Regarding these results, we conclude that this cognitive process cannot be independent of EF. However, due to the pilot nature of this study, it would be recommended to replicate these findings in new studies.

Effects of COVID-19 lockdown on perceived discrimination and internalized stigma in people with previous mental disorder diagnoses in Spain

COVID-19 disease control efforts and consequences are likely to be complicated by the impact of fear and stigmatization of the novel coronavirus. These complications may also worsen due to the potential compounding of COVID-19 related stigma with stigmatization associated with previously diagnosed conditions. This exploratory study analyzes the experiences of the stigma associated with COVID-19 lockdown in people with different previous diagnoses 2 and 5 weeks after the beginning of the state of emergency in Spain. Gender and age were controlled as covariables and 1,052 people participated in the study. The diagnosis groups were: Psychiatry and mental health (n = 71), Cardiovascular disease (n = 42), Neurological disease (n = 23), Lung disease (n = 53), and No diagnosis (n = 863). The instruments used to measure the stigma were the Intersectional Day-to-Day Discrimination Index and two items of the Internalized Stigma of Mental Illness scale. Analysis of covariance of repeated measures and analysis of variance, including Scheffe's post hoc test, were performed. We found significant differences in stigma among the first and second evaluation. Regarding the previous diagnosis, no differences were found at Time 1, but significant differences were found at Time 2, with those having a previous psychiatric or mental health diagnosis reporting higher levels of perceived discrimination and internalized stigmatization. Our results suggest that people with previous stigmatizing conditions might be more vulnerable to experiencing stigma in a confinement situation. In order to reduce the burden of the COVID-19 stigma, health interventions should also consider the resulting intersection of effects on internalized stigma and perceived discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Network Analysis of Major Depressive Disorder Symptoms and Age- and Gender-Related Differences in People over 65 in a Madrid Community Sample (Spain)

Major depressive disorder (MDD) is one of the most prevalent conditions among mental disorders in individuals over 65 years. People over 65 who suffer from MDD are often functionally impaired, chronically physically ill, and express cognitive problems. The concordance between a clinician-assessed MDD diagnosis in a primary care setting and MDD assessed with a structured clinical interview in older adults is only approximately 18%. Network analysis may provide an alternative statistical technique to better understand MDD in this population by a dimensional approach to symptomatology. The aim of this study was to carry out a network analysis of major depressive disorder (MDD) in people over 65 years old. A symptom network analysis was conducted according to age and gender in 555 people over 65, using a sample from the MentDis_ICF65+ Study. The results revealed different networks for men and women, and for the age groups 65–74 and 75–84. While depressive mood stood out in women, in men the network was more dispersed with fatigue or loss of energy and sleep disturbances as the main symptoms. In the 65–74 age group, the network was complex; however, in the 75–84 age group, the network was simpler with sleep disturbances as the central symptom. The gaps between the networks indicate the different characteristics of MDD in the elderly, with variations by gender and age, supporting the idea that MDD is a complex dynamic system that has unique characteristics in each person, rather than a prototypical classification with an underlying mental disorder. These unique characteristics can be taken into account in the clinical practice for detection and intervention of MDD.

Mental Health Consequences of the Coronavirus 2020 Pandemic (COVID-19) in Spain. A Longitudinal Study

Background: Covid-19 remains a pandemic that most countries in the world are still dealing with. This is study aims to report the psychological impact of Covid-19 over time on the Spanish population. Methods: A longitudinal study (N = 1041) was carried out with two measurements: after 2 and 5 weeks starting from the declaration of the state of emergency in Spain. The presence of depressive symptoms, anxiety, and posttraumatic stress disease (PTSD) was evaluated by means of screening tests. Sociodemographic data, variables about Covid-19, loneliness, spiritual well-being, social support, discrimination, and a sense of belonging were collected. Results: The data showed how depressive symptomatology increased significantly over time, while anxiety and PTSD did not show statistically significant changes. Spiritual well-being and loneliness were the main predictors of psychological impact. A younger age was a significant predictor of depression and anxiety, while female gender was associated with anxiety and PTSD. Conclusions: The impact of the pandemic is sustained over time, even increasing in depression, and vulnerable groups that need greater psychological health support could be identified.

Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain

The pandemic caused by Covid-19 has been an unprecedented social and health emergency worldwide. This is the first study in the scientific literature reporting the psychological impact of the Covid-19 outbreak in a sample of the Spanish population. A cross-sectional study was conducted through an online survey of 3480 people. The presence of depression, anxiety and post-traumatic stress disorder (PTSD) was evaluated with screening tests from 14 March. Sociodemographic and Covid-19-related data was collected. Additionally, spiritual well-being, loneliness, social support, discrimination and sense of belonging were assessed. Descriptive analyses were carried out and linear regression models compiled. The 18.7% of the sample revealed depressive, 21.6% anxiety and 15.8% PTSD symptoms. Being in the older age group, having economic stability and the belief that adequate information had been provided about the pandemic were negatively related to depression, anxiety and PTSD. However, female gender, previous diagnoses of mental health problems or neurological disorders, having symptoms associated with the virus, or those with a close relative infected were associated with greater symptomatology in all three variables. Predictive models revealed that the greatest protector for symptomatology was spiritual well-being, while loneliness was the strongest predictor of depression, anxiety and PTSD. The impact on our mental health caused by the pandemic and the measures adopted during the first weeks to deal with it are evident. In addition, it is possible to identify the need of greater psychological support in general and in certain particularly vulnerable groups.

!e Psychological Impact of Six Weeks of Lockdown as a Consequence of COVID-19 and the Importance of Social Support: A Cross-Cultural Study Comparing Spanish and Russian Populations

Background. !e COVID-19 pandemic has been an unprecedented social and health emergency worldwide. Cross-cultural research on mental health during this situation is needed to better understand its consequences. Objective. To evaluate the di"erent psychological impacts of the crisis and lockdown situation during the #rst six weeks of COVID emergency measures in samples of the Spanish and Russian populations. Design. A cross-sectional study was conducted through an online survey (NSpain = 1041; NRussia = 743). !e prevalence of loneliness, depression, anxiety, perceived discrimination (PD), internalized stigma (IS), and perceived social support (PSS) was evaluated. Chi-square tests and t-tests were administered. The Enter Method were used to identify the predictors of the mental health impact. Results. Di"erences were found between the Russian and the Spanish populations. While the degrees of anxiety and depression did not di"er signi#cantly, loneliness, the alienation dimension of IS, and PD were more pronounced in the Russian respondents. In Spain, the predictor of less negative impact was PSS from various sources, while in Russia we only found PSS from the family. Conclusion. Although in both countries the impact at the clinical level seemed to be similar, di"erences were found at the psychosocial level. Variables with a strong cultural component may be key to determining the means of alleviating the e"ects of the crisis, with PSS being a fundamental protective factor. More crosssectional studies are needed to understand the impact of the pandemic in depth.

Confirmatory factor analysis of the Revised UCLA Loneliness Scale (UCLA LS-R) in individuals over 65

GOALS

The UCLA LS-R is the most extensively used scale to assess loneliness. However, few studies examine the scale's use on older individuals. The goal of the study is to analyse the suitability of the scale´s structure for assessing older individuals.

METHOD

The UCLA LS-R scale was administered to a random sample of 409 community-dwelling residents of Madrid (53% women) aged 65-84 years (obtained from the MentDis_ICF65+ study). Confirmatory factor analysis was used to assess the factor structure of the UCLA LS-R.

RESULTS

The internal consistency of the scale obtained a Cronbach's alpha of .85. All the analysed models of factor structure of the UCLA LS-R achieved a fairly good fit and RMSEA values over .80. The models that best fit the empirical data are those of Hojat (1982) and Borges et al. (2008).

CONCLUSION

The data suggest an equivalent effectiveness of UCLA LS-R in adults under 65 and over 65, which may indicate a similar structure of the loneliness construct in both populations. This outcome is consistent with the idea that loneliness has two dimensions: emotional loneliness and social loneliness. The use of short measures that are easy to apply and interpret should help primary care professionals identify loneliness problems in older individuals sooner and more accurately.

Characterizing visual asymmetries in contrast perception using shaded stimuli

Previous research has shown a visual asymmetry in shaded stimuli where the perceived contrast depended on the polarity of their dark and light areas (Chacón, 2004). In particular, circles filled out with a top-dark luminance ramp were perceived with higher contrast than top-light ones although both types of stimuli had the same physical contrast. Here, using shaded stimuli, we conducted four experiments in order to find out if the perceived contrast depends on: (a) the contrast level, (b) the type of shading (continuous vs. discrete) and its degree of perceived three-dimensionality, (c) the orientation of the shading, and (d) the sign of the perceived contrast alterations. In all experiments the observers' tasks were to equate the perceived contrast of two sets of elements (usually shaded with opposite luminance polarity), in order to determine the subjective equality point. Results showed that (a) there is a strong difference in perceived contrast between circles filled out with luminance ramp top-dark and top-light that is similar for different contrast levels; (b) we also found asymmetries in contrast perception with different shaded stimuli, and this asymmetry was not related with the perceived three-dimensionality but with the type of shading, being greater for continuous-shading stimuli;

The Relationship Between Educational Years and Phonemic Verbal Fluency (PVF) and Semantic Verbal Fluency (SVF) Tasks in Spanish Patients Diagnosed With Schizophrenia, Bipolar Disorder, and Psychotic Bipolar Disorder

Semantic and verbal fluency tasks are widely used as a measure of frontal capacities. It has been well described in literature that patients affected by schizophrenic and bipolar disorders present a worse execution in these tasks. Some authors have also noted the importance of educational years. Our objective is to analyze whether the effect of cognitive malfunction caused by apathology is superior to the expected effect of years of education in phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) task execution. A total of 62 individuals took part in this study, out of which 23 were patients with schizophrenic paranoid disorder, 11 suffered from bipolar disorder with psychotic symptomatology, 13 suffered from bipolar disorder without psychotic symptomatology, and 15 participants were nonpathological individuals. All participants were evaluated with the PVF and SVF tests (animals and tools). The performance/execution results were analyzed with a mixed-model ANCOVA, with educational years as a covariable. The effect of education seems to be more determined by PVF FAS tests than by SVF. With PVF FAS tasks, the expected effect of pathology disappears when the covariable EDUCATION is introduced. With SVF tasks, the effect continues to be significant, even though the EDUACTION covariable dims such effect. These results suggest that SVF tests (animals category) are better evaluation tools as they are less dependent on the patients' education than PVF FAS tests.