Raquel Vázquez-Morejón

Given the growing global prevalence and significant impact of depression and anxiety, both in general and within the workplace, understanding the underlying mechanisms contributing to emotional disorders is essential. This study examined whether self-esteem mediates the relationship between experiential avoidance and emotional disorders, focusing on depression and anxiety. We conducted a cross-sectional analysis of 174 outpatients from a community mental health center, who completed self-report measures of experiential avoidance, self-esteem, depression, and anxiety. We used the PROCESS macro for mediation analysis, and the results indicated that self-esteem significantly mediated the relationship between experiential avoidance and both depression and anxiety. We analyzed the mediation model within the framework of self-determination theory, which suggested that interventions aimed at reducing experiential avoidance and enhancing self-esteem could be effective for emotional disorders. In this study, we highlight the importance of addressing both experiential avoidance and self-esteem in the therapeutic context. We also discuss implications for clinical practice and limitations of the current study.

Background: Suicide is a major public health problem affecting an increasing number of people. It is a complex and multicausal phenomenon whose first step is passive suicidal ideation (PSI). The identification of people with PSI could facilitate specific interventions with those who are at greater risk and/or suffering. Aims: To explore the frequency of passive suicidal ideation (PSI) and its association with sociodemographic, psychological, and psychopathological variables in a sample of persons seen in first consultation in a community mental health unit. Methods: Data from 2,354 persons seen in first consultation in a community mental health unit were analyzed. Descriptive statistics were used for quantitative variables, and frequency distribution was used for qualitative variables. Differences between groups were explored using the t -test for independent groups and Chi-square for qualitative variables. Results: The results showed a high frequency of these ideas in the analyzed sample, with a notable prevalence where more than half of the subjects (55.6%) reported experiencing these ideas in the last 2 weeks. There was a significant association of these ideas with sociodemographic variables such as age, type of cohabitation, and employment status. Likewise, significant positive associations were observed with symptom severity (depressive and anxious) and with the functional impact of these symptoms, with an increase in the PSI as symptom intensity and functional impact increase. Experiential avoidance and social support also showed a highly significant association with PSI. There was an increase in PSI as experiential avoidance increased and a decrease in PSI as social support increased. Conclusions: The high prevalence of PSI within the clinical mental health sample highlights the critical need for targeted interventions. The significant associations with sociodemographic variables, symptom severity, functional impact, experiential avoidance, and social support emphasize the multifaceted nature of PSI and the importance of addressing these factors in clinical practice to effectively reduce PSI and improve overall mental health outcomes.

Este trabajo reúne tres reseñas del libro De repente, la maldita lucidez. Experiencias y reflexiones de un cuidador en salud mental en el que su autor, mediante un género híbrido entre la narrativa y el ensayo, reelabora sus recuerdos como cuidador de personas con trastornos mentales graves y reflexiona de forma crítica sobre el significado de la experiencia de la locura. En la primera reseña, Juan Daniel Ramírez Garrido analiza cómo en la obra analizada se imbrican memoria y ficción, narrativa y ensayo, desde una perspectiva muy personal. Por su parte, Antonio Vázquez Morejón pone en relación el libro con la perspectiva psico-biográfica, medio de comprensión de la psicopatología del que han hecho gala autores como Oliver Sack. Completa esta revisión polifónica El recorrido profesional y científico por los capítulos ensayísticos del libro que hace Raquel Vázquez-Morejón, en los que destaca la perspectiva histórico-cultural y existencial de la experiencia de la locura adoptada por el autor. Cierra esta reseña coral un último apartado en el que el autor del libro dialoga con sus críticos.

Background: The relevance of family relationships in the outcome of various disorders has been highlighted from different domains. Specifically, empirical studies on the relationship between the outcome of schizophrenia and various affective dimensions of family relationships have allowed the identification of particularly relevant aspects: criticism, hostility, and over-protection.Aims: The present study aims to adapt and validate an abbreviated Spanish version of the Influential Relationship Questionnaire (IRQ), an instrument that measures the patient’s own perception of the affective dimensions of family relationships.Method: Participants were 188 patients (63.8% male) of the Public Health Service in Andalusia (Spain) with a diagnosis of schizophrenia or a related disorder. One hundred and thirty-six participants provided data related to both father and mother, and 52 only related to mother or father, so the analyses were carried out with a total of 324 questionnaires. Simultaneously, in 130 participants, the Perceived Criticism Scale was applied, and in 50 cases, relatives were asked to complete the Family Attitudes Scale.Results: Principal component analysis allowed for the identification of four factors that explained 61.53% of the total variance (criticism, over-protection, restriction, and care). The values of Cronbach’s alpha coefficient, as well as the omega coefficient, showed high consistency. The temporal reliability for an interval of 3 months was high. The correlations between the IRQ dimensions and the other variables included in the study were significant and in the expected direction.Conclusions: The results support the reliability and validity of the abbreviated version of the IRQ.

Background: Studies examining the effects of incorporating patients’ preferences into treatment outcomes highlight their impact on crucial aspects such as reduced dropout rates and enhanced effectiveness. Recognizing individuals’ rights to participate in decisions about their treatments underscores the importance of studying treatment preferences and the factors influencing these choices. Aim: This study aims to identify treatment preferences (psychological, pharmacological, or combined) among a sample of patients and to discern the psychosocial and clinical factors influencing these preferences. Methods: A total of 2,133 individuals receiving care at a community mental health unit completed assessments on anxious-depressive symptoms, social and occupational adjustment, and their treatment preference. Data analysis was conducted using SPSS, with descriptive statistics, Chi-square tests, and one-way ANOVA applied. Results: Preferences for treatments were distributed as follows: Combined (49.8%), psychological (33%), and pharmacological (10.6%). Factors such as diagnosis, severity of depressive and anxious symptoms, and functional impact were related to treatment preference with a moderate effect size. Meanwhile, various sociodemographic factors correlated with the selected treatment, though with a weak effect size. Conclusions: There is a pronounced preference for combined treatments. The significance of psychological treatments is evident, as four out of five participants favored them in their choices. Addressing these preferences calls for an exploration within the broader context of prescription freedom in mental health.

Purpose: The impact of social support on comprehensive measures of results (clinical and functional) of the course of schizophrenia was studied, understood and evaluated as a multidimensional construct differentiating sources of support (family vs. nonfamily). Methods: One hundred fifty-two patients diagnosed with schizophrenia were assessed with the Mannheim Interview on Social Support (MISS) and the Social Functioning Scale (SFS). The hypotheses were explored in a prospective longitudinal design, using a causal correlational analysis for their evaluation by applying structural equation models. Results: The only explanatory factor of social functioning was Nonfamily social support, while the only explanatory factor of clinical result measurements was Family social support, observing a clearly differentiated impact of the different sources of support on the schizophrenia result measurements. It was also found that while Family social support explained 6.8% of the variance in the clinical result measurements, Nonfamily social support explained 13.7% of the variance in social functioning. Conclusion: The results confirmed the differential importance of social support variables (family vs. nonfamily) in the clinical and functional result measurements of people with schizophrenia.

Background:The way people with psychosis psychologically adapt and manage the diagnosis of such a mental disorder has been considered a key factor that contributes to the emergence and aggravation of emotional problems. These beliefs about illness can be very important due to their possible association with stigma and its implications in terms of loss of roles and social status. Given the importance of these personal beliefs about the specific diagnosis of psychosis, the Personal Beliefs about Illness Questionnaire (PBIQ) and PBIQ-R have been developed.Aims:The present study aims to explore the psychometric characteristics of the Spanish version of the PBIQ-R in a sample of patients with a diagnosis of psychosis-related disorders.Method:Participants were 155 patients (54.8% male) of the Public Health Service in Andalusia (Spain). Those who consented to participate filled in the PBIQ-R, the Social Comparison Scale, and the PHQ-9 and GAD-7 to measure emotional symptoms.Results:All dimensions showed adequate internal consistency values: Cronbach’s alpha extends between .81 and .88; and McDonald’s omega ranges between .87 and .92. The temporal reliability for an interval of 3–4 weeks was high. The correlations between the PBIQ-R dimensions and the other variables included in the study were significant and in the expected direction. The factor analysis of the principal components of the PBIQ-R dimensions revealed a single factor in each of the dimensions that explained 64–74%.Conclusions:The results support the reliability and validity of the Spanish version of the PBIQ-R.

Assertiveness is a fundamental type of behavior for the creation and maintenance of positive relationships at work and the facilitation of team functioning. Therefore, the promotion of assertiveness contributes to improving work performance, preventing harassment at work, facilitating the adoption of safe behaviors and making critical decisions in terms of occupational health and safety. However, few studies have evaluated the effectiveness of assertive training to train occupational health, safety and environment (OHSE) technicians to facilitate their work as agents of change in the attitudes and behaviors of other workers. Therefore, an assertive training was carried out to increase assertiveness and decrease social anxiety in this type of professional. The training effectiveness was evaluated following a pretest–posttest group design. The results from both a pilot study in a sample of 328 undergraduate students and a study in a sample of 155 OHSE technicians indicated that the training was effective in achieving both objectives. Moreover, Cohen’s d statistics suggest that the effect size was intermediate. These results are discussed with respect to their role in contributing to occupational health safety and environment practices as well as to the organizations’ sustainability.

Background: The Work and Social Adjustment Scale (WSAS) is an instrument that can be easily applied for routine evaluation of the impact of mental disorders on patient functioning. In spite of the interest in its use, there is very little information available on its psychometric characteristics and even less in Spanish. Aims: The objective of this study was to analyse its psychometric characteristics. Method: The sample consisted of 441 patients treated in a community mental health unit. They filled out the WSAS and two psychopathology measures, one for anxiety and the other for depression. Fifty-five of them, chosen at random, were asked to fill out the scale again a second time to explore its temporal reliability. Results: The scale showed high internal consistency, a single factor that explained 60.4% of the variance, and temporal reliability of .78 for the total score. Significant correlations were found between the WSAS scores and the psychopathological measures, as well as significant differences between those working and those on leave. Conclusions: The results confirm the validity and reliability of the scale and support its possible use for routine evaluation of the functional impact of mental disorders.