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Pérez S, Layrón JE, Barrigón ML, Baca-García E, Marco JH. Perceived burdensomeness, thwarted belongingness, and hopelessness as predictors of future suicidal ideation in Spanish university students. Death Stud 2024; 48:454-464. [PMID: 37449532 DOI: 10.1080/07481187.2023.2235569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
The Interpersonal Theory of Suicide (IPTS) has received support for its role in understanding suicidal thoughts and behaviors. However, few longitudinal studies have focused on testing this theory in university students. The present study aimed to confirm the theoretical model of the IPTS in a sample of 225 Spanish university students, using path analysis in a longitudinal study. We assessed thwarted belongingness and perceived burdensomeness at T1 and hopelessness and suicidal ideation at T2, 12-14 weeks later. Moreover, we assessed suicidal ideation weekly for 14 weeks. Path analyses confirmed the Interpersonal Theory of Suicide model, with thwarted belongingness and perceived burdensomeness as direct and indirect predictors of suicidal ideation through hopelessness. Providers of guidance and clinical services in university settings should be trained to identify perceived burdensomeness, social belongingness, hopelessness, and suicidal ideation when screening for suicide prevention.
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Affiliation(s)
- Sandra Pérez
- Department of Personality, Assessment and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Jose Enrique Layrón
- School of Doctorate, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
- Faculty of Psychology, International University of Valencia, Valencia, Spain
| | - Maria Luisa Barrigón
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Gregorio Marañón, Madrid, Spain
| | - Enrique Baca-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
- Department of Psychiatry, Centre Hospitalier Universitaire De Nîmes, Nîmes, France
- Universidad Autónoma de Madrid, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain
- Universidad Católica del Maule, Talca, Chile
- CIBERSAM (Centro de Investigación Biomédica en Red Salud Mental), Carlos III Institute of Health, Madrid, Spain
| | - Jose H Marco
- Department of Personality, Assessment and Psychological Treatments, Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutricion (CIBEROBN), Madrid, Spain
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Marco JH, Castejón J, Isern C, Grau L, Pérez Rodríguez S. Longitudinal evolution of meaning in life and its relationship with coping strategies in Spanish patients with a breast cancer diagnosis. Support Care Cancer 2023; 31:424. [PMID: 37358665 DOI: 10.1007/s00520-023-07885-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Changes in Meaning in life (MIL) have been shown to be particularly important when people face very stressful events such as receiving a cancer diagnosis and treatment. Active coping strategies have been related to higher levels of MIL in people with a diagnosis of cancer. OBJECTIVE To explore the evolution of MIL in a sample of cancer patients at the time of their diagnosis and three, six, and nine months after surgery, and identify the association between coping strategies three months after diagnosis (T2) and levels of MIL at the different moments in the cancer process (T1-T4). METHODS We assessed MIL at diagnosis and three, six, and nine months after surgery, and coping strategies (fighting spirit, anxious preoccupation, hopelessness, fatalism, and cognitive avoidance) three months after surgery, in 115 women with a diagnosis of Stage I-III breast cancer. RESULTS We found higher levels of MIL nine months after surgery, compared to previous stages. MIL correlated significantly and positively with a fighting spirit and cognitive avoidance, and negatively with hopelessness and anxious preoccupation. CONCLUSIONS Results highlight the importance of coping in relation to meaning-making processes in cancer. Meaning-centred interventions could help patients who are in the process of coping with cancer to make sense of their lives and the experience.
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Affiliation(s)
- Jose H Marco
- Department of Personality, Assessment and Psychological Treatments, Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutricion (CIBEROBN), Madrid, Spain
| | - Jessica Castejón
- Hospital Clínica Benidorm, Alicante, Spain
- Escuela de doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | | | - Lola Grau
- Department of Personality, Assessment and Therapeutic Interventions, Universidad Catolica de Valencia, Valencia, Spain
| | - Sandra Pérez Rodríguez
- Department of Personality, Assessment and Psychological Treatments, Universidad de Valencia, Valencia, Spain.
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Quero S, Palau-Batet M, Tur C, Mor S, Campos D, Rachyla I, Grimaldos J, Marco JH. Effect of an internet-based intervention for adjustment disorder on meaning in life and enjoyment. Curr Psychol 2022. [DOI: 10.1007/s12144-022-03177-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Abstract
Introduction
Positive psychological variables, such as meaning in life and the capacity for enjoyment, are important resilience factors against negative behaviors and symptoms. These constructs are related to better emotional regulation strategies, a greater perception of control over one’s life, and better mental health in general. Adjustment disorder (AjD) is a prevalent condition defined as the failure to adapt to a stressful event.
Objective
This study presents secondary analysis data on the effect of an Internet-delivered cognitive-behavioral therapy intervention (iCBT) for AjD on meaning in life and capacity for enjoyment, compared to a control group.
Method
The sample consisted of 68 participants with AjD. 34 in the iCBT condition and 34 in the control group). Meaning in life was assessed by the Purpose-in-Life Test-10, and the Environmental Rewards Observation Scale was used to assess the capacity for enjoyment. The iCBT intervention focused on acceptance and processing of the stressful event. Intent-to-treat mixed-model analyses without any ad hoc imputations and using Cohen’s d effect comparisons were conducted.
Results
The results revealed a significant main effect of time and a significant group x time interaction in all the measures. Significantly higher pre-post score differences were found in the treatment condition.
Discussion
Meaning in life and capacity for enjoyment can change after an iCBT intervention for AjD. Therapeutic implications of the results and future lines of research about the role of meaning in life in AjD are discussed.
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Marco JH, Cañabate M, Martinez C, Baños RM, Guillen V, Perez S. Corrigendum: Meaning in Life Mediates Between Emotional Deregulation and Eating Disorders Psychopathology: A Research From the Meaning-Making Model of Eating Disorders. Front Psychol 2022; 13:849974. [PMID: 35242091 PMCID: PMC8887549 DOI: 10.3389/fpsyg.2022.849974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jose H Marco
- Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Montserrat Cañabate
- University CEU Cardenal Herrera, Castellón de la Plana, Spain.,Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Cristina Martinez
- Personality, Assessment and Treatments, Catholic University of Valencia San Vicente Martyr, Valencia, Spain
| | - Rosa M Baños
- Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Verónica Guillen
- Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Sandra Perez
- Personality, Assessment and Treatments, Catholic University of Valencia San Vicente Martyr, Valencia, Spain
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Marco JH, Gallego-Hernández de Tejada B, Guillén V, Baños RM, Pérez S. Meaning in Life Buffers the Association between Perceived Burdensomeness, Thwarted Belongingness, and Frequency of Non-Suicidal Self-Injuries in Spanish Adolescents. J Clin Med 2021; 10:jcm10214867. [PMID: 34768387 PMCID: PMC8584760 DOI: 10.3390/jcm10214867] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescence is a developmental stage when there is a high risk of engaging in non-suicidal self-injury (NSSI). There is recent interest in the study of thwarted belongingness and perceived burdensome as variables associated with the frequency of NSSI in adolescents. Meaning in life (MIL) might be negatively associated with thwarted belongingness and perceived burdensomeness. To date, no studies have analyzed the buffering role of MIL in the association between thwarted belongingness and perceived burdensomeness and the frequency of lifetime NSSI in Spanish adolescents. AIMS (a) To test whether thwarted belongingness and perceived burdensomeness are associated with frequency of lifetime NSSI; (b) to test whether MIL moderates the association between thwarted belongingness and frequency of lifetime NSSI; and (c) to test whether MIL moderates the association between perceived burdensomeness and frequency of lifetime NSSI. METHOD The sample consisted of N = 1531 participants (n = 736, 48.1%, were men, and n = 795, 51.9%, were women) between 12 and 18 years old from Spain. The participants filled out the Inventory of Statements about Self-Injury, Purpose-In-Life Test-Adolescent Version, and Interpersonal Needs Questionnaire. Moderation analyses were performed. RESULTS No statistically significant differences were found in the frequency of lifetime NSSI in the adolescents based on gender. Thwarted belongingness and perceived burdensomeness were positively associated with the frequency of lifetime NSSI in Spanish adolescents. MIL was a moderating variable between thwarted belongingness and the frequency of lifetime NSSI, and between perceived burdensomeness and the frequency of lifetime NSSI. CONCLUSIONS Thwarted belongingness and perceived burdensomeness might be positively associated with the frequency of lifetime NSSI, and MIL might be negatively associated with the frequency of lifetime NSSI. Thus, adding these variables to current descriptive theories of NSSI in adolescents would allow us to improve assessment and treatment protocols for adolescents with NSSI.
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Affiliation(s)
- Jose H. Marco
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-963-983-431
| | - Blanca Gallego-Hernández de Tejada
- Departamento de Personalidad, Evaluación e Intervención Terapéutica, Facultad de Psicología, Universidad Católica de Valencia, San Vicente Mártir, 46100 Burjassot, Spain;
| | - Verónica Guillén
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rosa M. Baños
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sandra Pérez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
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Pérez S, García-Alandete J, Gallego B, Marco JH. Characteristics and Unidimensionality of Non-suicidal Self-injury in a Community Sample of Spanish Adolescents. Psicothema 2021; 33:251-258. [PMID: 33879298 DOI: 10.7334/psicothema2020.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few studies have explored the prevalence and unidimensional structure of Non-Suicidal Self-Injury (NSSI) in Spanish adolescents. METHOD In this study, we estimated the prevalence, types, and functions of NSSI in 1,733 Spanish adolescents, and we tested the unidimensional factorial structure of non-suicidal self-injury. RESULTS 24.6% of the adolescents referred to having self-injured at least once during their lifetime, and 12.7% had self-injured using more severe methods of NSSI. The most frequent types of NSSI were interfering with wounds (14.6%), scratching (12.5%), and hitting (11.7%). We found no differences between genders in NSSI frequency. The majority of the participants who self-injured referred to intrapersonal functions. The confirmatory factor analyses of the ISAS-I structure showed a single factor with 10 items, thus supporting the unidimensionality of the construct of NSSI. CONCLUSIONS NSSIs reflect difficulties in regulating emotions or managing interpersonal relationships in young Spanish people, and these behaviours seem to constitute a unique and latent dimension. Thus, there is a need for intervention programmes focused on managing problems of emotional regulation and maladaptive self-injury behaviours.
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Affiliation(s)
- Sandra Pérez
- Universidad Católica de Valencia "San Vicente Mártir"
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Marco JH, Cañabate M, Martinez C, Baños RM, Guillen V, Perez S. Meaning in Life Mediates Between Emotional Deregulation and Eating Disorders Psychopathology: A Research From the Meaning-Making Model of Eating Disorders. Front Psychol 2021; 12:635742. [PMID: 33833719 PMCID: PMC8021913 DOI: 10.3389/fpsyg.2021.635742] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/10/2021] [Indexed: 01/31/2023] Open
Abstract
Emotional dysregulation, age, gender, and obesity are transdiagnostic risk factors for the development and maintenance of eating disorders (EDs). Previous studies found that patients with ED had less meaning in life than the non-clinical population, and that meaning in life acted as a buffer in the course of ED; however, to the data, there are no studies about the mediator role of meaning in life in association between the emotional dysregulation and the ED psychopathology. Objective: To analyze the mediating role of meaning in life in the relationship between emotional dysregulation and the ED psychopathology in three samples with diverse risk factors for ED. Method: Sample 1, n = 153 undergraduate young women; sample 2, n = 122 participants with obesity; and sample 3, n = 292 participants with ED. Multiple mediation analysis was performed. Results: Sample 1: meaning in life showed a mediation effect between emotional dysregulation and the ED psychopathology (direct effect β = 0.390, p < 0.05) (indirect effect β = 0.227, p < 0.05), body satisfaction (direct effect β = −0.017, p < 0.05) (indirect effect β = −0.013, p < 0.01), and depression symptoms (direct effect β = 1.112, p < 0.001) (indirect effect β = 0.414, p < 0.001); sample 2: meaning in life showed a mediation effect between emotional dysregulation and binge eating and purging behaviors (direct effect β = 0.194, p < 0.01) (indirect effect β = 0.054, p < 0.05) and depression symptoms (direct effect β = 0.357, p < 0.001) (indirect effect β = 0.063, p < 0.05); sample 3: meaning in life showed a mediation effect between emotional dysregulation and the ED psychopathology (direct effect β = 0.884, p < 0.001) (indirect effect β = 0.252, p < 0.007), body satisfaction (direct effect β = −0.033, p < 0.05) (indirect effect β = −0.021, p < 0.001), borderline symptoms (direct effect β = 0.040, p < 0.001) (indirect effect β = 0.025, p < 0.001), and hopelessness (direct effect β = 0.211, p < 0.001) (indirect effect β = 0.087, p < 0.001). Conclusions: These studies suggest the importance of considering meaning in life as a variable in the onset and maintenance of ED.
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Affiliation(s)
- Jose H Marco
- Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Montserrat Cañabate
- University CEU Cardenal Herrera, Castellón de la Plana, Spain.,Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Cristina Martinez
- Personality, Assessment and Treatments, Catholic University of Valencia San Vicente Martyr, Valencia, Spain
| | - Rosa M Baños
- Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Verónica Guillen
- Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Sandra Perez
- Personality, Assessment and Treatments, Catholic University of Valencia San Vicente Martyr, Valencia, Spain
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Perez S, Lorca F, Marco JH. "Dissociation, posttraumatic stress symptoms, emotional dysregulation, and invalidating environments as correlates of NSSI in borderline personality disorder patients". J Trauma Dissociation 2020; 21:520-535. [PMID: 31994457 DOI: 10.1080/15299732.2020.1719262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Theoretical models have proposed that inadequate caregiving environments undermine the development of adaptive regulation strategies at early stages and can lead children to inadequate regulation skills for coping with distress, such as dissociation, posttraumatic stress, and NSSI. The main aim of this work was to examine NSSI types and functions and the relationship between the aforementioned variables and lifetime NSSI in 102 patients with BPD diagnoses or BPD subthreshold symptoms. In addition, we explored the moderator role of dissociation between invalidating environments and NSSI. Results showed that 83.7% of the sample self-injured more than 5 times during their lifetime; 62.7% swallowed dangerous substances; 58.8% hit themselves; and 46% cut themselves. Regression analyses revealed that the model including variables with significant correlations with NSSI explained 27% of the variance in NSSI, with dissociation and invalidating behaviors of the father best explaining the variance in NSSI. In addition, dissociation moderated the association between invalidating behaviors of the father and NSSI. These results highlight the important role of invalidating environments, dissociation, and posttraumatic stress symptoms in NSSI in patients with BPD, and the need to assess and treat dissociation and posttraumatic symptoms in this population.
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Affiliation(s)
- Sandra Perez
- Department of Personality, Assessment and Therapeutic Interventions, Universidad Católica De Valencia "San Vicente Mártir" , Valencia, Spain
| | - Fátima Lorca
- Escuela De Doctorado (School of Doctoral Studies), Universidad Católica De Valencia "San Vicente Mártir" , Valencia, Spain
| | - Jose H Marco
- Department of Personality, Assessment, and Psychological Treatments, Universidad De Valencia , Valencia, Spain
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Pérez S, Ros MC, Folgado JEL, Marco JH. Non-suicidal Self-injury Differentiates Suicide Ideators and Attempters and Predicts Future Suicide Attempts in Patients with Eating Disorders. Suicide Life Threat Behav 2019; 49:1220-1231. [PMID: 30357895 DOI: 10.1111/sltb.12521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/16/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We aimed first to identificate psychopathological variables differentiating between suicide ideators, suicide attempters and patients without suicide ideation or attempts, and second to identificate better predictors of suicide attempts longitudinally. METHOD We compared suicide ideation, hopelessness, borderline symptoms, frequency, types, number of different non-suicidal self-injury (NSSI) methods, intrapersonal and interpersonal functionality of NSSI in a sample of 238 patients with Eating Disorders (1) with no history of suicide ideation or suicide attempts (n = 150); (2) with recent suicide ideation (n = 65); and (3) with suicide attempts in the previous year (n = 23). In addition, we analyzed the predictive power of the mentioned variables over the number of suicide attempts 7 months after the first assessment. RESULTS The group of suicide attempters showed a major number of different methods of NSSI, higher frequency of NSSI, cutting, and more NSSI intra and interpersonal functions than the group of ideators. Unlike in previous studies, hopelessness did not differentiate between patients with ideation and suicide attempts. In addition, the best predictor of suicide attempts 7 months later was frequency of NSSI at T1 (N = 123). CONCLUSIONS Cutting, frequency and different methods of NSSI, intra and interpersonal functions were risk factors that differentiated ideators from attempters, being frequency of NSSI the best predictor of suicide attempts longitudinally. Thus, patients with ED with NSSI should be the focus of preventive interventions for suicidal behavior.
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Affiliation(s)
- Sandra Pérez
- Department of Personality, Assessment and Therapeutic Interventions, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
| | | | - Jose E Layron Folgado
- School of Doctorate. Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
| | - Jose H Marco
- Department of Personality, Assessment and Psychotherapeutic Interventions, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
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Pérez S, García-Alandete J, Cañabate M, Marco JH. Confirmatory factor analysis of the Inventory of Statements About Self-injury in a Spanish clinical sample. J Clin Psychol 2019; 76:102-117. [PMID: 31454078 DOI: 10.1002/jclp.22844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The main aim of the present study was to confirm the two-factor structure of the Inventory of Statements About Self-injury- Part II (ISAS-II), analyze its psychometric properties and test-retest reliability of Parts I and II of the ISAS. METHOD The sample was composed of 355 Spanish participants diagnosed with eating disorders or borderline personality disorder (mean age 27.89, standard deviation = 13.31; 315 women, 40 men). Two models proposed for the ISAS-II were analyzed by means of confirmatory factorial analysis. RESULTS A two-factor model was confirmed, and a model with self-care included in the intrapersonal factor was preferable. The ISAS-II showed positive correlations with emotional dysregulation. Test-retest reliability showed statistically significant correlations at 7 months (n = 123). CONCLUSION The ISAS-II is a valid instrument to assess nonsuicidal self-injury in Spanish populations, making it possible to assess these behaviors, which require valid and reliable measures worldwide.
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Affiliation(s)
- Sandra Pérez
- Department of Personality, Assessment, and Psychotherapeutic Interventions, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - Joaquín García-Alandete
- Department of Neuropsychobiology, Methodology, and Basic and Social Psychology, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - Montserrat Cañabate
- School of Doctorate, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain.,Department of Nursing, Universidad CEU Cardenal Herrera, Castellón, Spain
| | - Jose H Marco
- Department of Personality, Assessment, and Psychological Treatments, Faculty of Psychology, Universidad de Valencia, Valencia, Spain
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Pérez S, Marco JH, Cañabate M. Non-suicidal self-injury in patients with eating disorders: prevalence, forms, functions, and body image correlates. Compr Psychiatry 2018; 84:32-38. [PMID: 29679850 DOI: 10.1016/j.comppsych.2018.04.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/04/2018] [Accepted: 04/07/2018] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION More than one third of patients with eating disorders report NSSI. Moreover, negative attitudes and feelings toward the body, body dissatisfaction, and body image disturbances have been linked to NSSI in community and clinical samples. However, there is a lack of studies exploring NSSI frequency and functions and the specific relationship between multidimensional body image dimensions and NSSI in eating disorder patients. OBJECTIVES First, we explored the frequency, types, and functions of NSSI in a sample of 226 Spanish female participants with eating disorders (ED). Second, we explored differences in NSSI and body image depending on the ED restrictive-purgative subtype; and third, we explored differences in body dissatisfaction, body image orientation, and body investment in eating disorder patients without NSSI (n = 144), with NSSI in their lifetime (n = 19), and (b) with NSSI in the previous year (n = 63). RESULTS Of the overall sample, 37.1% (n = 89) had a history of self-injury during their lifetime, and 27.1% (n = 65) had self-injured in the previous year. Among the types of ongoing NSSI, the most frequent were banging (64.6%) and cutting (56.9%). Restrictive vs purgative patients differed on NSSI lifetime, Appearance Evaluation, Body Areas Satisfaction, Body Protection and Feelings and Attitudes toward the Body. Moreover, significant differences were found on Appearance Evaluation, Body Areas Satisfaction, Positive Feelings and Attitudes towards the Body, Body Protection, and Comfort with physical contact, between participants without a history of self-injury and both NSSI groups. DISCUSSION Body dissatisfaction and body investment have been found to be variables related to NSSI. Thus, the present study highlights the importance of working on body image in ED patients to reduce the frequency of NSSI.
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Affiliation(s)
- Sandra Pérez
- Department of Personality, Assessment and Therapeutic Interventions, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain.
| | - Jose H Marco
- Department of Personality, Assessment and Therapeutic Interventions, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
| | - Montse Cañabate
- School of Doctorate, Universidad Católica de Valencia "San Vicente Mártir", Valencia, Spain
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Marco JH, Tormo-Irun MP. Cyber Victimization Is Associated With Eating Disorder Psychopathology in Adolescents. Front Psychol 2018; 9:987. [PMID: 29962992 PMCID: PMC6010659 DOI: 10.3389/fpsyg.2018.00987] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/28/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Technology is constantly evolving in a vast number of fields. In this way, cyber victimization is associated with psychopathology, and body appearance is a primary target of cyberbullies. Thus, the literature demonstrates a clear association between bullying and unhealthy eating behaviors in adolescents. However, studies that have examined the association between cyber victimization and eating disorder psychopathology are scarce. Objective: (1) To analyze whether there are differences in the cyber victimization scores depending on the gender, controlling for age; (2) to analyze whether cyber victimization is negatively associated with eating disorder psychopathology; (3) to analyze whether this association is moderated by the level of Appearance Evaluation. Method: Participants in the present study included 676 adolescents, 367 girls and 309 boys from several cities of Spain. The mean age for the overall sample was 14.28 years (SD = 1.65), ranging from 12 to 19. The participants filled out the questionnaires ECIPQ, MBSRQ, and EAT. Results: Cyber victimization was associated with eating disorders psychopathology, Appearance Evaluation, and Overweight Preoccupation. Appearance Evaluation moderated the association between Cyber victimization and the eating disorder psychopathology. Conclusion: It is necessary to assess vulnerability to eating disorders in adolescents who have been victims of cyberbullying.
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Affiliation(s)
- Jose H Marco
- Facultad de Psicología, Magisterio y Ciencias de la Educación, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
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Marco JH, Cañabate M, García-Alandete J, Llorca G, Real-López M, Beltrán M, Pérez S. Body image and nonsuicidal self-injury: Validation of the Body Investment Scale in participants with eating disorders. Clin Psychol Psychother 2017; 25:173-180. [PMID: 28924984 DOI: 10.1002/cpp.2142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 08/10/2017] [Accepted: 08/18/2017] [Indexed: 11/08/2022]
Abstract
The Body Investment Scale (BIS) assesses body image feelings, body care, protection of the body, and comfort in touch, in order to identify and distinguish participants with self-harming and self-destructive tendencies. However, the psychometric properties of the BIS were not analysed in participants diagnosed with eating disorders. The main objective of the present study is to confirm the factor structure of the Spanish version of the BIS and analyse its psychometric properties in a sample composed of women diagnosed with eating disorders. Participants were 250 Spanish women between 12 and 60 years old (M = 26.05, SD = 11.97) diagnosed with eating disorders. A confirmatory factor analysis showed a poor fit of the original BIS. The final model showed an acceptable 4-factor structure (Body Feelings, α = .88; Body Touch, α = .82; Body Protection, α = .77; Body Care, α = .68), with a good fit to the data (SBχ2(246) = 393.21, CFI = .906, IFI = .908, RMSEA = .049). The relationships between the BIS and both the Purpose-In-Life Test-10 Items and Beck Hopelessness Scale were analysed, as well as differences in the BIS score according to nonsuicidal self-injuries and suicidal ideation in the past year. The BIS is an appropriate instrument to assess the body investment dimension of body image in women with eating disorders.
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Affiliation(s)
- J H Marco
- Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - M Cañabate
- Escuela de doctorado, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - J García-Alandete
- Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
| | - G Llorca
- Consorcio Hospitalario Provincial de Castellón, Castellón, Spain.,Universitat Jaume I, Castellón, Spain
| | - M Real-López
- Consorcio Hospitalario Provincial de Castellón, Castellón, Spain.,Universitat Jaume I, Castellón, Spain
| | - M Beltrán
- Hospital Universitario de la Ribera de Alzira, Valencia, Spain
| | - S Pérez
- Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
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Pérez S, Marco JH, García-Alandete J. Psychopathological Differences Between Suicide Ideators and Suicide Attempters in Patients with Mental Disorders. Clin Psychol Psychother 2016; 24:1002-1013. [PMID: 28004442 DOI: 10.1002/cpp.2063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/07/2016] [Accepted: 11/21/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although suicide is one of the leading causes of death worldwide, there is a need for studies to identify variables that can differentiate patients with suicide ideation at risk of transitioning to an attempt. METHOD In this study, we assessed suicide ideation and attempts, non-suicidal self-injury (NSSI), hopelessness, borderline symptoms and meaning in life in a sample of 348 patients with different diagnoses of mental disorders. We divided the sample into four subgroups: patients without suicide ideation or suicide attempts; patients with current suicide ideation; patients with lifetime suicide attempts and patients with a suicide attempt in the previous year. RESULTS The group with suicide attempts in the previous year showed higher levels of hopelessness, borderline symptoms and NSSI, and lower levels of meaning in life than the other groups. LIMITATIONS Groups were composed of unequal numbers of patients, and in some of them, the sample size was small. The sample was composed mainly of women with eating disorders. The study design was retrospective, and so the results must be considered in terms of correlates. CONCLUSIONS Our results suggest that hopelessness, borderline symptoms-including NSSI-and meaning in life play a key role in suicide attempts. Thus, psychotherapeutic interventions should focus on managing NSSI, searching for meaning and managing emptiness, loss of control and feelings such as self-contempt in patients with suicide ideation. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE Recent suicide attempters show higher levels of hopelessness, borderline symptoms and NSSI than lifetime attempters and suicide ideators. Clinicians should focus attention on assessing hopelessness, borderline symptoms and NSSI in those with suicide ideation. Lower levels of meaning in life are related to recent suicide attempts. Levels of hopelessness differentiate between recent and lifetime suicide attempters.
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Affiliation(s)
- Sandra Pérez
- Universidad Católica de Valencia San Vicente Martir, Department of Personality, Assessment and Therapeutic Intervention, Valencia, Spain
| | - Jose H Marco
- Universidad Católica de Valencia San Vicente Martir, Department of Personality, Assessment and Therapeutic Intervention, Valencia, Spain
| | - Joaquin García-Alandete
- Universidad Católica de Valencia San Vicente Martir, Department of Personality, Assessment and Therapeutic Intervention, Valencia, Spain
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Marco JH, Pérez S, García-Alandete J, Moliner R. Meaning in Life in People with Borderline Personality Disorder. Clin Psychol Psychother 2015; 24:162-170. [PMID: 26639791 DOI: 10.1002/cpp.1991] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/19/2015] [Accepted: 10/23/2015] [Indexed: 11/06/2022]
Abstract
Low feelings of meaning in life are associated with depression, hopelessness and suicide, substance abuse and emotional dysregulation. The aim of this study is to offer results about the importance of the construct meaning in life in the psychopathology of BPD. In study 1, the sample was made up of 223 participants, 141 participants with BPD and 82 participants with another mental disorder but without BPD. In study 2, the sample was made up of 80 participants with BPD. Study 1 indicated that the participants with BPD had a lower feeling of meaning in life than the participants with mental disorders but without a BPD. Study 2 indicated that meaning in life was highly negatively correlated with the symptoms of BPD. The model composed of emotional dysregulation, and meaning in life was significantly associated with BPD psychopathology. The present study supports the association between meaning in life with the psychopathology of BPD. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE The results of this study suggest that meaning in life is a relevant variable in the psychopathology of BPD The results of this study suggest that meaning in life is associated with non-suicide self injuries This study suggests that current therapies for BPD should focus on increasing the meaning in life in these patients.
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Affiliation(s)
- Jose H Marco
- Universidad Católica de Valencia San Vicente Martir, Valencia, Spain
| | - Sandra Pérez
- Universidad Católica de Valencia San Vicente Martir, Valencia, Spain
| | | | - Reyes Moliner
- Universidad Católica de Valencia San Vicente Martir, Valencia, Spain
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Cebolla A, Oliver E, Baños R, Botella C, Zaragozá I, Alcañiz M, Moliner R, Marco JH, Jonquera M, Guillen V. PDA self-register system for eating disorders: a study on acceptability and satisfaction. Stud Health Technol Inform 2010; 154:50-52. [PMID: 20543268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Self-monitoring techniques, such as the use of dietary registers, are considered to be central to cognitive-behavioral treatment of Eating Disorders (ED). This information allows the clinician to identify the triggers of the behaviors associated to ED as purges and/or binges, and the associated thoughts and emotions, helping to carry out a more accurate assessment. Traditionally these registers are made with paper and pencil mode, where the patient has to register every eating and the emotions/thoughts associated; but this system has some problems, as low portability, low adherence or methodological difficulties. The use of PDA for self-registers can help to solve these problems. The aim of this study is to study the levels of acceptability and satisfaction with PDAs self-register system specifically designed for assessment and treatment of ED. Samples of 30 subjects diagnosed with ED are receiving a PDA with software specifically designed for recording type and amount of food, emotions before and after eating and other behaviors. The participants are completing self-register daily during a week, and afterwards answer an acceptance and satisfaction questionnaire. This work is in progress at the moment. It is expected that the PDA system will show high levels of acceptance and satisfaction.
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Affiliation(s)
- A Cebolla
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN)
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