Recent studies have emphasized the importance of childhood memories of threatening experiences an... more Recent studies have emphasized the importance of childhood memories of threatening experiences and submissiveness in a diversity of psychological disorders. The purpose of this work was to study their specific relationship with hallucination proneness and ideas of reference in healthy subjects. The ELES scale for measuring memory of adverse childhood experiences, the DES‐II scale for measuring dissociation, the LSHS‐R scale for measuring hallucination proneness, and the REF for ideas of reference were applied to a sample of 472 subjects. A positive association was found between childhood memories of adverse experiences and hallucination proneness and ideas of reference, on one hand, and dissociation on the other. A mediation analysis showed that dissociation was a mediator between the memory of adverse childhood experiences and hallucination proneness on one hand, and ideas of reference on the other. When the role of mediator of the types of dissociative experiences was studied, it was found that absorption and depersonalization mediated between adverse experiences and hallucination proneness. However, this mediating effect was not found between adverse experiences and ideas of reference. The relationship between these last two variables was direct. The results suggest that childhood memories of adverse experiences are a relevant factor in understanding hallucination proneness and ideas of reference. Similarly, dissociation is a specific mediator between adverse childhood experiences and hallucination proneness.
Background: The Early Life Experiences Scale (ELES) evaluates the memory of threat and subordinat... more Background: The Early Life Experiences Scale (ELES) evaluates the memory of threat and subordination perceived in childhood family relationships based on social rank theory. This scale was adapted to Spanish, its factor structure was tested by cross-validation, and its psychometric properties were explored. Method: 960 subjects participated (863 subjects from the general population and 97 patients). Results: Data confirm the factor structure of the original version by Authors (2003), obtaining a similar model with three factors: submission, threat, and devaluation, which explained 66.31% of the variance. The Spanish version of the ELES was comprised of the same number of items as in the original study and showed adequate indices of validity, internal consistency, retest and combined reliability. Conclusions: The Early Life Experiences Scale (ELES) can be a useful measure for evaluating early life experiences. Its application may be very relevant in studying the relationship between these experiences and psychopathological manifestations in constructing explanatory models.
Eating and Weight Disorders: Studies on Anorexia, Bulimia and Obesity, 2019
Purpose
The main objective of this study was to analyse the factor structure and psychometric pro... more Purpose The main objective of this study was to analyse the factor structure and psychometric properties of a Spanish validation of the Body Image Avoidance Questionnaire (BIAQ) in a community sample of adolescents.
Methods A total of 4283 people (55.9% girls, aged 12–18) participated.
Results Confirmatory factor analysis corroborated four first-order factors related to a second-order factor including the total BIAQ score, with excellent fit and invariance across sex. The total internal consistency of the questionnaire was adequate, although two factors showed low reliability. Strong relationships were found with scales evaluating preoccupation with weight and dysmorphic concerns, and moderate correlations with dissatisfaction and investment in appearance. It was found that 24.06% of adolescents with body image disturbance could be at risk of developing a body image disorder.
Conclusions The results of this study support the use of the Spanish translation of the BIAQ for assessing behavioural characteristic of body image disturbance.
Introduction: This article reports on a mediational study performed from a proposal relating posi... more Introduction: This article reports on a mediational study performed from a proposal relating positive and negative indicators in clinical and nonclinical populations on a psychopathological severity continuum. We analyzed a mediation model of the development of vulnerability to psychosis, recalled threatening experiences, and submission to or devaluation by caregivers, in which aberrant salience and fatigue are the mediating variables on ideas of reference.
Method: The sample consisted of 437 participants (295 healthy controls and 142 patients), and the study design was ex-post-facto, transversal, and multivariate.
Results: Early threat, submission and devaluation experiences were found to be significantly related to ideas of reference and to the aberrant salience and fatigue variables. Aberrant salience and fatigue partially mediated the relationship between recalled adverse experiences with caregivers and the presence of ideas of reference.
Conclusions: This study shows the importance of aberrant salience and fatigue in the development of Psychotic-like Experiences such as ideas of reference. The continuum model suggests that these processes may be analyzed in clinical and nonclinical populations.
OBJECTIVE:
The purpose of this article was to study the relationship of self-focused attention an... more OBJECTIVE: The purpose of this article was to study the relationship of self-focused attention and dissociation with the dialogical relationship persons diagnosed with psychosis have with their voices.
METHOD: The DAIMON Scale was applied to 62 persons diagnosed with psychosis to measure the dialogical relationship with their voices, and the Cambridge depersonalization scale, the Tellegen absorption scale, and the self-focused attention scale.
RESULTS: The results showed that the dialogical relationship with the voices was associated with high levels of self-focused attention (private and public), depersonalization, and absorption. It was also found that absorption mediated significantly between public self-focused attention and the dialogical relationship with the voices.
CONCLUSIONS: The role of dissociation and self-focused attention in forming the dialogical relationship a person with psychosis has with the voices is discussed and approaches to treatment are suggested.
This study examined a moderated mediation model testing whether dysmorphic concern is related to ... more This study examined a moderated mediation model testing whether dysmorphic concern is related to behaviour altered to change appearance. This relationship is potentially mediated by depressive symptomatology (dysphoria and self-esteem) and ideas of reference about “laughing, commenting” and “attention, appearance,” and each mediated relationship moderated by sex. The sample was made up of 3377 adolescents from 12 to 18 years old (Mage = 14.52; SD = 1.65, 56.5% girls). The results showed that dysphoria and ideas of reference about “laughing, commenting” and “attention, appearance” partially mediated the relationship between dysmorphic concern and behavioural impairment related to body image. The relationship with dysphoria was moderated by sex, such that the mediation effect was stronger in girls than in boys. This result implies that girls who are worried about some characteristic of their appearance and show dysphoria are at greater risk of altered behaviour involving avoidance or controlling their appearance than boys. In addition, a possible risk of body dysmorphic disorder (3.45% of the sample) was found, with very prominent hiding behaviour using clothing or control behaviours, such as frequent weighing and looking at oneself in the mirror too much. Implications of these findings are discussed.
BACKGROUND:
Aberrant salience (AS), related to classical delusional mood and self-disturbances, m... more BACKGROUND: Aberrant salience (AS), related to classical delusional mood and self-disturbances, may be one of the keys to early detection of psychosis, before abnormal assignment of significance. As adolescence is a critical period in development of the self and there are few instruments for evaluating AS, validation of the Aberrant Salient Inventory (ASI) is proposed for use in the general adolescent population.
METHODS: A sample of 4,523 participants, 53.6% women, from 11 to 18 years of age (M = 14.31, SD = 1.66), from 29 schools in Western Andalusia (Spain) were evaluated collectively.
RESULTS: Good fit was found in the answers, and the original five-factor structure of the inventory was replicated. Reliability (ordinal alpha) was adequate both for the total (.95) and for the factors (.74. to .85). Invariance across sex, adequate indicators of concurrent (ideas of reference) and divergent (negative symptoms) validity, and sensitivity of .88 were found.
CONCLUSIONS: The results suggest the ASI for use in the general adolescent population, and show that 7% of the sample could be at risk of beginning psychosis.
Aims: This study addresses the psychometric properties of a Spanish validation of the REF scale o... more Aims: This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis. Methods: A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses-154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84. Results: Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the "causal explanations", "Songs, newspapers, books" and "laughing and commenting" REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders. Conclusions: The results provide satisfactory that the REF scale could be used to study psychosis.
Background: Negative symptoms (NS) may be observed in the general population in an attenuated for... more Background: Negative symptoms (NS) may be observed in the general population in an attenuated form and in high-risk mental states. However, they have been less studied in the general population than positive symptoms, in spite of their importance at the insidious onset of schizophrenia and their appearance before positive symptoms. This study aimed to analyze the empirical structure of the Spanish version of the Self-Evaluation of Negative Symptoms (SNS) Scale and find its psychometric properties and invariance of measurement across sex and age in a sample of adolescents. Methods: The sample consisted of 4521 adolescents (53.6% female) from 11 to 18 years of age.
Background: Ideas of reference (IRs) are observed in the general population on the continuum of t... more Background: Ideas of reference (IRs) are observed in the general population on the continuum of the psychotic phenotype (as a type of psychotic-like experiences, PLE). The instruments usually used to evaluate IRs show some problems: They depend on the cooperation of the participant, comprehension of items, social desirability, etc. Aims: The Testal emotional counting Stroop (TECS) was developed for the purpose of improving evaluation of individuals vulnerable to psychosis and its relationship with ideas of reference. The TECS (two versions) was applied as an implicit evaluation instrument for IRs and related processes for early identification of persons vulnerable to psychosis and to test the possible influence of emotional symptomatology. Method: A total of 160 participants (67.5% women) from the general population were selected (Mean (M) = 24.12 years, standard deviation (SD) = 5.28), 48 vulnerable and 112 non-vulnerable. Results: Vulnerability to psychosis was related to greater latency in response to referential stimuli. Version 4 of the TECS showed a slight advantage in identifying more latency in response to referential stimuli among participants with vulnerability to psychosis (Cohen's d = 1.08). Emotional symptomatology (especially stress), and IQ (premorbid) mediated the relationship between vulnerability and IR response latency. Conclusions: The application of the implicit Testal emotional counting Stroop test (TECS) is useful for evaluating processes related to vulnerability to psychosis, as demonstrated by the increased latency of response to referential stimuli.
Inner speech is a familiar experience for us but, in general, few systematic studies have been do... more Inner speech is a familiar experience for us but, in general, few systematic studies have been done on the subject. Recent studies have included this phenomenon in the development of auditory hallucinations. The purpose of this article is to propose and validate the Spanish version of the Varieties of Inner Speech Questionnaire (VISQ), to which we have added a new factor called Dialogues with Self-Positions in Inner Speech. It is further intended to test the relationship between this scale, dissociation, and proneness to hallucinations. For this purpose, 318 students completed the VISQ, plus a dissociation scale and another one for hallucination proneness. The results show the scale's good psychometric reliability and validity. Dissociation was found to mediate between the VISQ scale and hallucination proneness. The implications for hallucination models and future lines of research are discussed.
The two fold aim of this study was first, to analyze the effects of
anticipatory fatigue, emotion... more The two fold aim of this study was first, to analyze the effects of anticipatory fatigue, emotional symptomatology and belonging to a clinical group on the physical and cognitive perception of fatigue, and second, to explore the potential moderating effect of anticipatory fatigue on the relationship between symptomatology or clinical condition and perceived fatigue. The conditional and partial effects of independent variables were analyzed by hierarchical regression in an ex-post-facto correlational design. The sample was composed of 317 participants (29% from a clinical population). Anticipatory fatigue (by an ad hoc scale), and perception of fatigue (by the Chalder Fatigue Scale) were measured. Emotional symptoms were assessed by Goldberg’s GHQ-28 questionnaire. Anticipatory fatigue and emotional symptoms (mainly depressive) had significant effects on cognitive and physical fatigue. Belonging to the clinical group significantly and exclusively predicted cognitive fatigue. Furthermore, anticipatory fatigue moderated between-group effects (clinical versus general) and cognitive fatigue. In brief, emotional symptoms (mainly depressive) and anticipatory fatigue significantly predicted perceived cognitive and physical fatigue. Anticipation of fatigue moderated the effect of clinical group on cognitive fatigue after controlling for depressive symptomatology.
Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in phy... more Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in physical appearance with social avoidance and behavior directed at controlling the defect in appearance. This study attempted to adapt the factor structure of two instruments that cover the DC construct, the Dysmorphic Concern Questionnaire (DCQ) and the Body Dysmorphic Disorder Examination Self-Report (BDDE-SR), to Spanish and establish their psychometric properties. A total of 920 subjects (62.7% women, M age = 32.44 years) participated. Exploratory and Confirmatory Factor Analysis of both scales found adequate goodness of fit indices. A one-dimensional structure was found for the DCQ and two first-order factors (dissatisfaction/preoccupation with body image (BI) and BI avoidance behavior) were identified for the BDDE-SR. The psychometric test–retest reliability and validity properties (content, convergent, and discriminant) were satisfactory. It is suggested that the DC construct includes both cognitive and behavioral aspects and may represent a continuum of severity with Body Dysmorphic Disorder at the end.
Recent studies have established associations between
relating to voices and distress. However, th... more Recent studies have established associations between relating to voices and distress. However, the potential influence of mindfulness on this relationship has received little attention. This study was designed to explore the extent to which associations between relating to voices and distress are mediated by mindfulness. A cross-sectional study was conducted to explore the associations between these variables. A sample of 62 patients with psychotic disorder were given the Voices and You Scale (VAY) to measure the relational style with the voices, the Mindfulness and Awareness Scale (MAAS) to measure the capability of mindfulness, and the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) to measure anxiety and depression, respectively. The results showed a negative association between a dysfunctional style of relating to the voices and mindfulness. It was also found from simple mediation analysis that the mindfulness variable negatively mediated the dysfunctional relational style with voices and distress. Mindfulness is a variable that can mediate the effect of relating style upon voices and distress and should be a target of therapeutic intervention.
To adapt and validate the Leiden Index of Depression Sensitivity-Revised for evaluating cognitive... more To adapt and validate the Leiden Index of Depression Sensitivity-Revised for evaluating cognitive reactivity to depressive mood to Spanish and validate this Spanish version. To find the scale's factor structure and psychometric properties. The sample consisted of 600 participants (103 patients and 497 subjects from the general population). A four-factor structure was found, a general factor evaluating cognitive reactivity was proposed and ten items were eliminated. A brief version of the (LEIDS-R24) scale is proposed. The factors and the overall scale have adequate internal consistency, and the results of validation show that all the factors on the scale predict depressive symptomatology (BDI-II) adequately, and are highly correlated with the Dysfunctional Attitudes Scale and BDI-II scales. The complete scale adequately discriminated depressive symptomatology in general population subjects and patients with anxiety and depressive disorders. No significant differences were found in the LEIDS-R24 measurement between subjects with anxiety and depressive disorder. The LEIDS-R24 scale may be a useful brief measure for evaluating cognitive reactivity to depressive mood and analyzing the vulnerability which could be common to persons with anxiety and depressive disorders.
Background. Referential thinking (RT) is a common characteristic of human mentation. In psychopat... more Background. Referential thinking (RT) is a common characteristic of human mentation. In psychopathology, RT has been traditionally associated with psychosis. In this study we analyze RT (self-references, SR) differences between clinical and control samples, and we identify variables to predict RT. METHODS. 120 adults (70 patients and 50 control subjects from the general population), with a mean age of 34.49 (SD, 10.63); 60% female. RESULTS. The number of SR among patients, especially patients with diagnosed psychoses, was significantly greater than that among controls. No significant differences in RT were observed among patients characterized by axis II diagnoses or between patients characterized on different axes. The variables that were most predictive for SR were psychotic thinking (MCMI-II personality inventory, thought disorder), conceptual disorganization (BPRS psychiatric scale), age, and vulnerability indicators of mood disturbances (DAS scale). This set of state and trait variables accounted for 56.4% of the RT variance. CONCLUSIONS. There were more differences between patients and controls in terms of frequency of SR than of content (RT processes occur along a continuum). RT may be both a manifestation of state (with an additive effect on other psychopathologies), and a manifestation of trait (a characteristic of psychotic processes, one possibly associated with vulnerability indicators of mood disorders).
The present study describes the evaluation procedure and therapeutic approach in a case of schizo... more The present study describes the evaluation procedure and therapeutic approach in a case of schizotypal disorder. The intervention carried out was of the cognitive behavioural type. In parallel, a follow-up of a fundamental measure for this disorder is accomplished: the referential thinking, by means of brief time-series. In this analysis, a clear but progressive decrease of the criteria is obtained. The post-treatment results show a general improvement in every aspects, bringing out: the interpersonal relationships, the absence of hallucinations, the increase of the capacity for enjoyment, the decrease of unusual content of thought, erroneous interpretations of reality, aggressiveness and unusual language. Distractibility, suspicion and conceptual disorganization slightly persist.
Anuario De Psicologia Clinica Y De La Salud Annuary of Clinical and Health Psychology, 2011
... Health Psychology Año 2011 Volumen 07 Páginas 61 a 68 Artículo Regular Multidimensionalidad... more ... Health Psychology Año 2011 Volumen 07 Páginas 61 a 68 Artículo Regular Multidimensionalidad en la Escala de Pensamiento Referencial (REF): Análisis Factorial Exploratorio Eduardo Fernández Jiménez, Juan Francisco Rodríguez Testal y María Cristina ...
Recent studies have emphasized the importance of childhood memories of threatening experiences an... more Recent studies have emphasized the importance of childhood memories of threatening experiences and submissiveness in a diversity of psychological disorders. The purpose of this work was to study their specific relationship with hallucination proneness and ideas of reference in healthy subjects. The ELES scale for measuring memory of adverse childhood experiences, the DES‐II scale for measuring dissociation, the LSHS‐R scale for measuring hallucination proneness, and the REF for ideas of reference were applied to a sample of 472 subjects. A positive association was found between childhood memories of adverse experiences and hallucination proneness and ideas of reference, on one hand, and dissociation on the other. A mediation analysis showed that dissociation was a mediator between the memory of adverse childhood experiences and hallucination proneness on one hand, and ideas of reference on the other. When the role of mediator of the types of dissociative experiences was studied, it was found that absorption and depersonalization mediated between adverse experiences and hallucination proneness. However, this mediating effect was not found between adverse experiences and ideas of reference. The relationship between these last two variables was direct. The results suggest that childhood memories of adverse experiences are a relevant factor in understanding hallucination proneness and ideas of reference. Similarly, dissociation is a specific mediator between adverse childhood experiences and hallucination proneness.
Background: The Early Life Experiences Scale (ELES) evaluates the memory of threat and subordinat... more Background: The Early Life Experiences Scale (ELES) evaluates the memory of threat and subordination perceived in childhood family relationships based on social rank theory. This scale was adapted to Spanish, its factor structure was tested by cross-validation, and its psychometric properties were explored. Method: 960 subjects participated (863 subjects from the general population and 97 patients). Results: Data confirm the factor structure of the original version by Authors (2003), obtaining a similar model with three factors: submission, threat, and devaluation, which explained 66.31% of the variance. The Spanish version of the ELES was comprised of the same number of items as in the original study and showed adequate indices of validity, internal consistency, retest and combined reliability. Conclusions: The Early Life Experiences Scale (ELES) can be a useful measure for evaluating early life experiences. Its application may be very relevant in studying the relationship between these experiences and psychopathological manifestations in constructing explanatory models.
Eating and Weight Disorders: Studies on Anorexia, Bulimia and Obesity, 2019
Purpose
The main objective of this study was to analyse the factor structure and psychometric pro... more Purpose The main objective of this study was to analyse the factor structure and psychometric properties of a Spanish validation of the Body Image Avoidance Questionnaire (BIAQ) in a community sample of adolescents.
Methods A total of 4283 people (55.9% girls, aged 12–18) participated.
Results Confirmatory factor analysis corroborated four first-order factors related to a second-order factor including the total BIAQ score, with excellent fit and invariance across sex. The total internal consistency of the questionnaire was adequate, although two factors showed low reliability. Strong relationships were found with scales evaluating preoccupation with weight and dysmorphic concerns, and moderate correlations with dissatisfaction and investment in appearance. It was found that 24.06% of adolescents with body image disturbance could be at risk of developing a body image disorder.
Conclusions The results of this study support the use of the Spanish translation of the BIAQ for assessing behavioural characteristic of body image disturbance.
Introduction: This article reports on a mediational study performed from a proposal relating posi... more Introduction: This article reports on a mediational study performed from a proposal relating positive and negative indicators in clinical and nonclinical populations on a psychopathological severity continuum. We analyzed a mediation model of the development of vulnerability to psychosis, recalled threatening experiences, and submission to or devaluation by caregivers, in which aberrant salience and fatigue are the mediating variables on ideas of reference.
Method: The sample consisted of 437 participants (295 healthy controls and 142 patients), and the study design was ex-post-facto, transversal, and multivariate.
Results: Early threat, submission and devaluation experiences were found to be significantly related to ideas of reference and to the aberrant salience and fatigue variables. Aberrant salience and fatigue partially mediated the relationship between recalled adverse experiences with caregivers and the presence of ideas of reference.
Conclusions: This study shows the importance of aberrant salience and fatigue in the development of Psychotic-like Experiences such as ideas of reference. The continuum model suggests that these processes may be analyzed in clinical and nonclinical populations.
OBJECTIVE:
The purpose of this article was to study the relationship of self-focused attention an... more OBJECTIVE: The purpose of this article was to study the relationship of self-focused attention and dissociation with the dialogical relationship persons diagnosed with psychosis have with their voices.
METHOD: The DAIMON Scale was applied to 62 persons diagnosed with psychosis to measure the dialogical relationship with their voices, and the Cambridge depersonalization scale, the Tellegen absorption scale, and the self-focused attention scale.
RESULTS: The results showed that the dialogical relationship with the voices was associated with high levels of self-focused attention (private and public), depersonalization, and absorption. It was also found that absorption mediated significantly between public self-focused attention and the dialogical relationship with the voices.
CONCLUSIONS: The role of dissociation and self-focused attention in forming the dialogical relationship a person with psychosis has with the voices is discussed and approaches to treatment are suggested.
This study examined a moderated mediation model testing whether dysmorphic concern is related to ... more This study examined a moderated mediation model testing whether dysmorphic concern is related to behaviour altered to change appearance. This relationship is potentially mediated by depressive symptomatology (dysphoria and self-esteem) and ideas of reference about “laughing, commenting” and “attention, appearance,” and each mediated relationship moderated by sex. The sample was made up of 3377 adolescents from 12 to 18 years old (Mage = 14.52; SD = 1.65, 56.5% girls). The results showed that dysphoria and ideas of reference about “laughing, commenting” and “attention, appearance” partially mediated the relationship between dysmorphic concern and behavioural impairment related to body image. The relationship with dysphoria was moderated by sex, such that the mediation effect was stronger in girls than in boys. This result implies that girls who are worried about some characteristic of their appearance and show dysphoria are at greater risk of altered behaviour involving avoidance or controlling their appearance than boys. In addition, a possible risk of body dysmorphic disorder (3.45% of the sample) was found, with very prominent hiding behaviour using clothing or control behaviours, such as frequent weighing and looking at oneself in the mirror too much. Implications of these findings are discussed.
BACKGROUND:
Aberrant salience (AS), related to classical delusional mood and self-disturbances, m... more BACKGROUND: Aberrant salience (AS), related to classical delusional mood and self-disturbances, may be one of the keys to early detection of psychosis, before abnormal assignment of significance. As adolescence is a critical period in development of the self and there are few instruments for evaluating AS, validation of the Aberrant Salient Inventory (ASI) is proposed for use in the general adolescent population.
METHODS: A sample of 4,523 participants, 53.6% women, from 11 to 18 years of age (M = 14.31, SD = 1.66), from 29 schools in Western Andalusia (Spain) were evaluated collectively.
RESULTS: Good fit was found in the answers, and the original five-factor structure of the inventory was replicated. Reliability (ordinal alpha) was adequate both for the total (.95) and for the factors (.74. to .85). Invariance across sex, adequate indicators of concurrent (ideas of reference) and divergent (negative symptoms) validity, and sensitivity of .88 were found.
CONCLUSIONS: The results suggest the ASI for use in the general adolescent population, and show that 7% of the sample could be at risk of beginning psychosis.
Aims: This study addresses the psychometric properties of a Spanish validation of the REF scale o... more Aims: This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis. Methods: A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses-154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84. Results: Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the "causal explanations", "Songs, newspapers, books" and "laughing and commenting" REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders. Conclusions: The results provide satisfactory that the REF scale could be used to study psychosis.
Background: Negative symptoms (NS) may be observed in the general population in an attenuated for... more Background: Negative symptoms (NS) may be observed in the general population in an attenuated form and in high-risk mental states. However, they have been less studied in the general population than positive symptoms, in spite of their importance at the insidious onset of schizophrenia and their appearance before positive symptoms. This study aimed to analyze the empirical structure of the Spanish version of the Self-Evaluation of Negative Symptoms (SNS) Scale and find its psychometric properties and invariance of measurement across sex and age in a sample of adolescents. Methods: The sample consisted of 4521 adolescents (53.6% female) from 11 to 18 years of age.
Background: Ideas of reference (IRs) are observed in the general population on the continuum of t... more Background: Ideas of reference (IRs) are observed in the general population on the continuum of the psychotic phenotype (as a type of psychotic-like experiences, PLE). The instruments usually used to evaluate IRs show some problems: They depend on the cooperation of the participant, comprehension of items, social desirability, etc. Aims: The Testal emotional counting Stroop (TECS) was developed for the purpose of improving evaluation of individuals vulnerable to psychosis and its relationship with ideas of reference. The TECS (two versions) was applied as an implicit evaluation instrument for IRs and related processes for early identification of persons vulnerable to psychosis and to test the possible influence of emotional symptomatology. Method: A total of 160 participants (67.5% women) from the general population were selected (Mean (M) = 24.12 years, standard deviation (SD) = 5.28), 48 vulnerable and 112 non-vulnerable. Results: Vulnerability to psychosis was related to greater latency in response to referential stimuli. Version 4 of the TECS showed a slight advantage in identifying more latency in response to referential stimuli among participants with vulnerability to psychosis (Cohen's d = 1.08). Emotional symptomatology (especially stress), and IQ (premorbid) mediated the relationship between vulnerability and IR response latency. Conclusions: The application of the implicit Testal emotional counting Stroop test (TECS) is useful for evaluating processes related to vulnerability to psychosis, as demonstrated by the increased latency of response to referential stimuli.
Inner speech is a familiar experience for us but, in general, few systematic studies have been do... more Inner speech is a familiar experience for us but, in general, few systematic studies have been done on the subject. Recent studies have included this phenomenon in the development of auditory hallucinations. The purpose of this article is to propose and validate the Spanish version of the Varieties of Inner Speech Questionnaire (VISQ), to which we have added a new factor called Dialogues with Self-Positions in Inner Speech. It is further intended to test the relationship between this scale, dissociation, and proneness to hallucinations. For this purpose, 318 students completed the VISQ, plus a dissociation scale and another one for hallucination proneness. The results show the scale's good psychometric reliability and validity. Dissociation was found to mediate between the VISQ scale and hallucination proneness. The implications for hallucination models and future lines of research are discussed.
The two fold aim of this study was first, to analyze the effects of
anticipatory fatigue, emotion... more The two fold aim of this study was first, to analyze the effects of anticipatory fatigue, emotional symptomatology and belonging to a clinical group on the physical and cognitive perception of fatigue, and second, to explore the potential moderating effect of anticipatory fatigue on the relationship between symptomatology or clinical condition and perceived fatigue. The conditional and partial effects of independent variables were analyzed by hierarchical regression in an ex-post-facto correlational design. The sample was composed of 317 participants (29% from a clinical population). Anticipatory fatigue (by an ad hoc scale), and perception of fatigue (by the Chalder Fatigue Scale) were measured. Emotional symptoms were assessed by Goldberg’s GHQ-28 questionnaire. Anticipatory fatigue and emotional symptoms (mainly depressive) had significant effects on cognitive and physical fatigue. Belonging to the clinical group significantly and exclusively predicted cognitive fatigue. Furthermore, anticipatory fatigue moderated between-group effects (clinical versus general) and cognitive fatigue. In brief, emotional symptoms (mainly depressive) and anticipatory fatigue significantly predicted perceived cognitive and physical fatigue. Anticipation of fatigue moderated the effect of clinical group on cognitive fatigue after controlling for depressive symptomatology.
Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in phy... more Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in physical appearance with social avoidance and behavior directed at controlling the defect in appearance. This study attempted to adapt the factor structure of two instruments that cover the DC construct, the Dysmorphic Concern Questionnaire (DCQ) and the Body Dysmorphic Disorder Examination Self-Report (BDDE-SR), to Spanish and establish their psychometric properties. A total of 920 subjects (62.7% women, M age = 32.44 years) participated. Exploratory and Confirmatory Factor Analysis of both scales found adequate goodness of fit indices. A one-dimensional structure was found for the DCQ and two first-order factors (dissatisfaction/preoccupation with body image (BI) and BI avoidance behavior) were identified for the BDDE-SR. The psychometric test–retest reliability and validity properties (content, convergent, and discriminant) were satisfactory. It is suggested that the DC construct includes both cognitive and behavioral aspects and may represent a continuum of severity with Body Dysmorphic Disorder at the end.
Recent studies have established associations between
relating to voices and distress. However, th... more Recent studies have established associations between relating to voices and distress. However, the potential influence of mindfulness on this relationship has received little attention. This study was designed to explore the extent to which associations between relating to voices and distress are mediated by mindfulness. A cross-sectional study was conducted to explore the associations between these variables. A sample of 62 patients with psychotic disorder were given the Voices and You Scale (VAY) to measure the relational style with the voices, the Mindfulness and Awareness Scale (MAAS) to measure the capability of mindfulness, and the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) to measure anxiety and depression, respectively. The results showed a negative association between a dysfunctional style of relating to the voices and mindfulness. It was also found from simple mediation analysis that the mindfulness variable negatively mediated the dysfunctional relational style with voices and distress. Mindfulness is a variable that can mediate the effect of relating style upon voices and distress and should be a target of therapeutic intervention.
To adapt and validate the Leiden Index of Depression Sensitivity-Revised for evaluating cognitive... more To adapt and validate the Leiden Index of Depression Sensitivity-Revised for evaluating cognitive reactivity to depressive mood to Spanish and validate this Spanish version. To find the scale's factor structure and psychometric properties. The sample consisted of 600 participants (103 patients and 497 subjects from the general population). A four-factor structure was found, a general factor evaluating cognitive reactivity was proposed and ten items were eliminated. A brief version of the (LEIDS-R24) scale is proposed. The factors and the overall scale have adequate internal consistency, and the results of validation show that all the factors on the scale predict depressive symptomatology (BDI-II) adequately, and are highly correlated with the Dysfunctional Attitudes Scale and BDI-II scales. The complete scale adequately discriminated depressive symptomatology in general population subjects and patients with anxiety and depressive disorders. No significant differences were found in the LEIDS-R24 measurement between subjects with anxiety and depressive disorder. The LEIDS-R24 scale may be a useful brief measure for evaluating cognitive reactivity to depressive mood and analyzing the vulnerability which could be common to persons with anxiety and depressive disorders.
Background. Referential thinking (RT) is a common characteristic of human mentation. In psychopat... more Background. Referential thinking (RT) is a common characteristic of human mentation. In psychopathology, RT has been traditionally associated with psychosis. In this study we analyze RT (self-references, SR) differences between clinical and control samples, and we identify variables to predict RT. METHODS. 120 adults (70 patients and 50 control subjects from the general population), with a mean age of 34.49 (SD, 10.63); 60% female. RESULTS. The number of SR among patients, especially patients with diagnosed psychoses, was significantly greater than that among controls. No significant differences in RT were observed among patients characterized by axis II diagnoses or between patients characterized on different axes. The variables that were most predictive for SR were psychotic thinking (MCMI-II personality inventory, thought disorder), conceptual disorganization (BPRS psychiatric scale), age, and vulnerability indicators of mood disturbances (DAS scale). This set of state and trait variables accounted for 56.4% of the RT variance. CONCLUSIONS. There were more differences between patients and controls in terms of frequency of SR than of content (RT processes occur along a continuum). RT may be both a manifestation of state (with an additive effect on other psychopathologies), and a manifestation of trait (a characteristic of psychotic processes, one possibly associated with vulnerability indicators of mood disorders).
The present study describes the evaluation procedure and therapeutic approach in a case of schizo... more The present study describes the evaluation procedure and therapeutic approach in a case of schizotypal disorder. The intervention carried out was of the cognitive behavioural type. In parallel, a follow-up of a fundamental measure for this disorder is accomplished: the referential thinking, by means of brief time-series. In this analysis, a clear but progressive decrease of the criteria is obtained. The post-treatment results show a general improvement in every aspects, bringing out: the interpersonal relationships, the absence of hallucinations, the increase of the capacity for enjoyment, the decrease of unusual content of thought, erroneous interpretations of reality, aggressiveness and unusual language. Distractibility, suspicion and conceptual disorganization slightly persist.
Anuario De Psicologia Clinica Y De La Salud Annuary of Clinical and Health Psychology, 2011
... Health Psychology Año 2011 Volumen 07 Páginas 61 a 68 Artículo Regular Multidimensionalidad... more ... Health Psychology Año 2011 Volumen 07 Páginas 61 a 68 Artículo Regular Multidimensionalidad en la Escala de Pensamiento Referencial (REF): Análisis Factorial Exploratorio Eduardo Fernández Jiménez, Juan Francisco Rodríguez Testal y María Cristina ...
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Papers by Cristina Senín
The main objective of this study was to analyse the factor structure and psychometric properties of a Spanish validation of the Body Image Avoidance Questionnaire (BIAQ) in a community sample of adolescents.
Methods
A total of 4283 people (55.9% girls, aged 12–18) participated.
Results
Confirmatory factor analysis corroborated four first-order factors related to a second-order factor including the total BIAQ score, with excellent fit and invariance across sex. The total internal consistency of the questionnaire was adequate, although two factors showed low reliability. Strong relationships were found with scales evaluating preoccupation with weight and dysmorphic concerns, and moderate correlations with dissatisfaction and investment in appearance. It was found that 24.06% of adolescents with body image disturbance could be at risk of developing a body image disorder.
Conclusions
The results of this study support the use of the Spanish translation of the BIAQ for assessing behavioural characteristic of body image disturbance.
Method: The sample consisted of 437 participants (295 healthy controls and 142 patients), and the study design was ex-post-facto, transversal, and multivariate.
Results: Early threat, submission and devaluation experiences were found to be significantly related to ideas of reference and to the aberrant salience and fatigue variables. Aberrant salience and fatigue partially mediated the relationship between recalled adverse experiences with caregivers and the presence of ideas of reference.
Conclusions: This study shows the importance of aberrant salience and fatigue in the development of Psychotic-like Experiences such as ideas of reference. The continuum model suggests that these processes may be analyzed in clinical and nonclinical populations.
The purpose of this article was to study the relationship of self-focused attention and dissociation with the dialogical relationship persons diagnosed with psychosis have with their voices.
METHOD:
The DAIMON Scale was applied to 62 persons diagnosed with psychosis to measure the dialogical relationship with their voices, and the Cambridge depersonalization scale, the Tellegen absorption scale, and the self-focused attention scale.
RESULTS:
The results showed that the dialogical relationship with the voices was associated with high levels of self-focused attention (private and public), depersonalization, and absorption. It was also found that absorption mediated significantly between public self-focused attention and the dialogical relationship with the voices.
CONCLUSIONS:
The role of dissociation and self-focused attention in forming the dialogical relationship a person with psychosis has with the voices is discussed and approaches to treatment are suggested.
Aberrant salience (AS), related to classical delusional mood and self-disturbances, may be one of the keys to early detection of psychosis, before abnormal assignment of significance. As adolescence is a critical period in development of the self and there are few instruments for evaluating AS, validation of the Aberrant Salient Inventory (ASI) is proposed for use in the general adolescent population.
METHODS:
A sample of 4,523 participants, 53.6% women, from 11 to 18 years of age (M = 14.31, SD = 1.66), from 29 schools in Western Andalusia (Spain) were evaluated collectively.
RESULTS:
Good fit was found in the answers, and the original five-factor structure of the inventory was replicated. Reliability (ordinal alpha) was adequate both for the total (.95) and for the factors (.74. to .85). Invariance across sex, adequate indicators of concurrent (ideas of reference) and divergent (negative symptoms) validity, and sensitivity of .88 were found.
CONCLUSIONS:
The results suggest the ASI for use in the general adolescent population, and show that 7% of the sample could be at risk of beginning psychosis.
anticipatory fatigue, emotional symptomatology and belonging to a clinical group on the physical and cognitive perception of fatigue, and second, to explore the potential moderating effect of anticipatory fatigue on the relationship between symptomatology or clinical condition and perceived fatigue. The conditional and partial effects of independent variables were analyzed by hierarchical regression in an ex-post-facto correlational design. The sample was composed of 317 participants (29% from a clinical population). Anticipatory fatigue (by an ad hoc scale), and perception of fatigue (by the Chalder Fatigue Scale) were measured. Emotional symptoms were assessed by Goldberg’s GHQ-28 questionnaire. Anticipatory fatigue and emotional symptoms (mainly depressive) had significant effects on cognitive and physical fatigue. Belonging to the clinical group significantly and exclusively predicted cognitive fatigue. Furthermore, anticipatory fatigue moderated between-group effects (clinical versus general) and cognitive fatigue. In brief, emotional symptoms (mainly depressive) and anticipatory fatigue significantly predicted perceived cognitive and physical fatigue. Anticipation of fatigue moderated the effect of clinical group on cognitive fatigue after controlling for depressive symptomatology.
relating to voices and distress. However, the potential
influence of mindfulness on this relationship has received little
attention. This study was designed to explore the extent to
which associations between relating to voices and distress
are mediated by mindfulness. A cross-sectional study was
conducted to explore the associations between these variables.
A sample of 62 patients with psychotic disorder were given
the Voices and You Scale (VAY) to measure the relational
style with the voices, the Mindfulness and Awareness Scale
(MAAS) to measure the capability of mindfulness, and the
Beck Anxiety Inventory (BAI) and Beck Depression
Inventory-II (BDI-II) to measure anxiety and depression, respectively.
The results showed a negative association between
a dysfunctional style of relating to the voices and mindfulness.
It was also found from simple mediation analysis that the
mindfulness variable negatively mediated the dysfunctional
relational style with voices and distress. Mindfulness is a variable
that can mediate the effect of relating style upon voices
and distress and should be a target of therapeutic intervention.
The main objective of this study was to analyse the factor structure and psychometric properties of a Spanish validation of the Body Image Avoidance Questionnaire (BIAQ) in a community sample of adolescents.
Methods
A total of 4283 people (55.9% girls, aged 12–18) participated.
Results
Confirmatory factor analysis corroborated four first-order factors related to a second-order factor including the total BIAQ score, with excellent fit and invariance across sex. The total internal consistency of the questionnaire was adequate, although two factors showed low reliability. Strong relationships were found with scales evaluating preoccupation with weight and dysmorphic concerns, and moderate correlations with dissatisfaction and investment in appearance. It was found that 24.06% of adolescents with body image disturbance could be at risk of developing a body image disorder.
Conclusions
The results of this study support the use of the Spanish translation of the BIAQ for assessing behavioural characteristic of body image disturbance.
Method: The sample consisted of 437 participants (295 healthy controls and 142 patients), and the study design was ex-post-facto, transversal, and multivariate.
Results: Early threat, submission and devaluation experiences were found to be significantly related to ideas of reference and to the aberrant salience and fatigue variables. Aberrant salience and fatigue partially mediated the relationship between recalled adverse experiences with caregivers and the presence of ideas of reference.
Conclusions: This study shows the importance of aberrant salience and fatigue in the development of Psychotic-like Experiences such as ideas of reference. The continuum model suggests that these processes may be analyzed in clinical and nonclinical populations.
The purpose of this article was to study the relationship of self-focused attention and dissociation with the dialogical relationship persons diagnosed with psychosis have with their voices.
METHOD:
The DAIMON Scale was applied to 62 persons diagnosed with psychosis to measure the dialogical relationship with their voices, and the Cambridge depersonalization scale, the Tellegen absorption scale, and the self-focused attention scale.
RESULTS:
The results showed that the dialogical relationship with the voices was associated with high levels of self-focused attention (private and public), depersonalization, and absorption. It was also found that absorption mediated significantly between public self-focused attention and the dialogical relationship with the voices.
CONCLUSIONS:
The role of dissociation and self-focused attention in forming the dialogical relationship a person with psychosis has with the voices is discussed and approaches to treatment are suggested.
Aberrant salience (AS), related to classical delusional mood and self-disturbances, may be one of the keys to early detection of psychosis, before abnormal assignment of significance. As adolescence is a critical period in development of the self and there are few instruments for evaluating AS, validation of the Aberrant Salient Inventory (ASI) is proposed for use in the general adolescent population.
METHODS:
A sample of 4,523 participants, 53.6% women, from 11 to 18 years of age (M = 14.31, SD = 1.66), from 29 schools in Western Andalusia (Spain) were evaluated collectively.
RESULTS:
Good fit was found in the answers, and the original five-factor structure of the inventory was replicated. Reliability (ordinal alpha) was adequate both for the total (.95) and for the factors (.74. to .85). Invariance across sex, adequate indicators of concurrent (ideas of reference) and divergent (negative symptoms) validity, and sensitivity of .88 were found.
CONCLUSIONS:
The results suggest the ASI for use in the general adolescent population, and show that 7% of the sample could be at risk of beginning psychosis.
anticipatory fatigue, emotional symptomatology and belonging to a clinical group on the physical and cognitive perception of fatigue, and second, to explore the potential moderating effect of anticipatory fatigue on the relationship between symptomatology or clinical condition and perceived fatigue. The conditional and partial effects of independent variables were analyzed by hierarchical regression in an ex-post-facto correlational design. The sample was composed of 317 participants (29% from a clinical population). Anticipatory fatigue (by an ad hoc scale), and perception of fatigue (by the Chalder Fatigue Scale) were measured. Emotional symptoms were assessed by Goldberg’s GHQ-28 questionnaire. Anticipatory fatigue and emotional symptoms (mainly depressive) had significant effects on cognitive and physical fatigue. Belonging to the clinical group significantly and exclusively predicted cognitive fatigue. Furthermore, anticipatory fatigue moderated between-group effects (clinical versus general) and cognitive fatigue. In brief, emotional symptoms (mainly depressive) and anticipatory fatigue significantly predicted perceived cognitive and physical fatigue. Anticipation of fatigue moderated the effect of clinical group on cognitive fatigue after controlling for depressive symptomatology.
relating to voices and distress. However, the potential
influence of mindfulness on this relationship has received little
attention. This study was designed to explore the extent to
which associations between relating to voices and distress
are mediated by mindfulness. A cross-sectional study was
conducted to explore the associations between these variables.
A sample of 62 patients with psychotic disorder were given
the Voices and You Scale (VAY) to measure the relational
style with the voices, the Mindfulness and Awareness Scale
(MAAS) to measure the capability of mindfulness, and the
Beck Anxiety Inventory (BAI) and Beck Depression
Inventory-II (BDI-II) to measure anxiety and depression, respectively.
The results showed a negative association between
a dysfunctional style of relating to the voices and mindfulness.
It was also found from simple mediation analysis that the
mindfulness variable negatively mediated the dysfunctional
relational style with voices and distress. Mindfulness is a variable
that can mediate the effect of relating style upon voices
and distress and should be a target of therapeutic intervention.