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Coronavirus has blighted our world, hitting some countries harder than others. Morbidity and mortality rates make Madrid one of the worst affected places so far in the wake of the coronavirus. The aim of this study was to analyze the presence of post-traumatic growth during the coronavirus crisis and to understand the contribution of meaning, religiosity, and spirituality to such growth; 1,492 people completed the questionnaire; N = 1,091 residents in Madrid were selected for the study. We assessed the personal experience of COVID-19, the Spirituality, Religiosity, Meaning trough Purpose in Life-10 test, and Posttraumatic Growth (Community Post-Traumatic Growth Scale). Results showed significant differences for all measures of growth, with higher values in women. Sex and direct impact of COVID-19 accounted for 4.4% of the variance of growth. The different dimensions of meaning contribute differently to growth. Only religiosity was associated with total growth when meaning was included in the model. This same pattern of results is obtained in models predicting interpersonal and social growth. However, in predicting personal growth, it is spirituality that predicts this type of growth once meaning has been previously controlled for, while religiosity fails to reach a statistically significant level. Our results reflect the interest in maintaining the distinction between spirituality and religiosity, their different roles in traumatic growth and the different dimensions on which each has an effect. Finally, it confirms the importance of meaning in post-traumatic growth, especially the dimension of life goals and purposes.

Forgiveness seeking after a relational transgression is an important aspect of relational repair from an interpersonal perspective, although it has received much less attention than the process of granting forgiveness. This research focuses on the victim's perspective of the transgressor's behaviors and how they are related to forgiveness and offense characteristics. This paper proposes a multidimensional concept of seeking forgiveness that includes four dimensions: apologies, restorative action, relational caring behaviors, and diverting behaviors. A questionnaire for assessing these dimensions was developed and tested with a general population sample of 450 subjects. Participants recalled a specific offense and then answered a questionnaire about the perceived usefulness of different forgiveness-seeking behaviors, a forgiveness inventory, and several questions regarding the characteristics of the offense (severity, intentionality, and frequency). Our results support the four-factor structure of the questionnaire. As the perceived intentionality of the offense increases, behaviors that are directly related to the transgression, such as apologies and restorative actions, are experienced as less useful for forgiveness. The more hurtful the offense, the less useful the diverting behaviors are. Behavior such as apologies and restorative action are related to a lower (less) motivation for revenge, while all forgiveness-seeking behaviors are related to an increase in feelings of benevolence toward the offender.

IntroductionThe Spasticity-Plus Syndrome (SPS) in multiple sclerosis (MS) refers to a combination of spasticity and other signs/symptoms such as spasms, cramps, bladder dysfunction, tremor, sleep disorder, pain, and fatigue. The main purpose is to develop a user-friendly tool that could help neurologists to detect SPS in MS patients as soon as possible.MethodsA survey research based on a conjoint analysis approach was used. An orthogonal factorial design was employed to form 12 patient profiles combining, at random, the eight principal SPS signs/symptoms. Expert neurologists evaluated in a survey and a logistic regression model determined the weight of each SPS sign/symptom, classifying profiles as SPS or not.Results72 neurologists participated in the survey answering the conjoint exercise. Logistic regression results of the survey showed the relative contribution of each sign/symptom to the classification as SPS. Spasticity was the most influential sign, followed by spasms, tremor, cramps, and bladder dysfunction. The goodness of fit of the model was appropriate (AUC = 0.816). Concordance between the experts’ evaluation vs. model estimation showed strong Pearson’s (r = 0.936) and Spearman’s (r = 0.893) correlation coefficients. The application of the algorithm provides with a probability of showing SPS and the following ranges are proposed to interpret the results: high (> 60%), moderate (30–60%), or low (< 30%) probability of SPS.DiscussionThis study offers an algorithmic tool to help healthcare professionals to identify SPS in MS patients. The use of this tool could simplify the management of SPS, reducing side effects related with polypharmacotherapy.

Introduction: Bipolar disorder (BD) is a recurrent and disabling psychiatric disorder related to low-grade peripheral inflammation and altered levels of the members of the insulin-like growth factor (IGF) family. The aim of this study was to evaluate the plasma levels of IGF-2, insulin-like growth factor-binding protein 1 (IGFBP-1), IGFBP-3, IGFBP-5, IGFBP-7, and inflammatory markers such as tumor necrosis factor α (TNF-α), monocyte chemoattractant protein 1 (MCP-1), and macrophage inflammatory protein 1β (MIP-1β).Methods: We used the Young Mania Rating Scale (YMRS) to determine the severity of the symptomatology, while proteins were measured by enzyme-linked immunosorbent assay (ELISA). We included 20 patients with BD who suffered a manic episode and 20 controls. Some BD patients (n = 10) were evaluated after a period (17 ± 8 days) of pharmacological treatment.Results: No statistical difference was found in IGF-2, IGFBP-1, IGFBP-7, TNF-α, and MIP-1β levels. However, IGFBP-3 and IGFBP-5 levels were found to be statistically decreased in BD patients. Conversely, the MCP-1 level was significantly increased in BD patients, but their levels were normalized after treatment. Intriguingly, only IGFBP-1 levels were significantly decreased after treatment. No significant correlation was found between the YMRS and any of the proteins studied either before or after treatment or between IGF proteins and inflammatory markers.Discussion: To some extent, IGFBP-3 and IGFBP-5 might be further explored as potential indicators of treatment responsiveness or diagnosis biomarkers in BD.

Background: Multiple sclerosis (MS) treatment has radically improved over the last years; however, MS symptom management is still challenging. The novel Spasticity-Plus syndrome was conceptualized to frame several spasticity-related symptoms that can be addressed together with broad-spectrum medication, such as certain cannabinoid-based drugs. The aim of this project was to gain insight into Spanish neurologists' clinical experience on MS spasticity and associated symptoms, and to assess the acknowledgment and applicability of the Spasticity-Plus syndrome concept in patients with MS.Methods: Ten online meetings were conducted using the Workmat® methodology to allow structured discussions. Fifty-five Spanish neurologists, experts in MS management, completed and discussed a set of predefined exercises comprising MS symptom assessment and its management in clinical practice, MS symptoms clustering in clinical practice, and their perception of the Spasticity-Plus syndrome concept. This document presents the quantitative and qualitative results of these discussions.Results: The specialists considered that polytherapy is a common concern in MS and that simplifying the management of MS spasticity and associated manifestations could be useful. They generally agreed that MS spasticity should be diagnosed before moderate or severe forms appear. According to the neurologists' clinical experience, symptoms commonly associated with MS spasticity included spasms/cramps (100% of the specialists), pain (85%), bladder dysfunction (62%), bowel dysfunction (42%), sleep disorders (42%), and sexual dysfunction (40%). The multiple correspondence analysis revealed two main symptom clusters: spasticity-spasms/cramps-pain, and ataxia-instability-vertigo. Twelve out of 16 symptoms (75%) were scored >7 in a 0–10 QoL impact scale by the specialists, representing a moderate–high impact. The MS specialists considered that pain, spasticity, spasms/cramps, bladder dysfunction, and depression should be a treatment priority given their frequency and chance of therapeutic success. The neurologists agreed on the usefulness of the new Spasticity-Plus syndrome concept to manage spasticity and associated symptoms together, and their experience with treatments targeting the cannabinoid system was satisfactory.Conclusions: The applicability of the new concept of Spasticity-Plus in MS clinical practice seems possible and may lead to an integrated management of several MS symptoms, thus reducing the treatment burden of disease symptoms.