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Background: Women's dissatisfaction with perinatal health care services is associated with poor postpartum outcomes for the mother and the baby. The Mackey Childbirth Satisfaction Rating Scale is a frequently used measure of women's childbirth satisfaction. However, its factor structure has been inconsistent across investigations. The goal of this study was to evaluate the psychometric properties of the scale (i.e., factor structure and sources of validity evidence). Methods: This study is a descriptive prospective investigation. Participants included 106 pregnant women (mean age = 31.86, SD = 4.12) recruited from a public university hospital situated in South Madrid. Sources of construct validity of the Mackey were explored with the Women's View of Birth Labor Satisfaction Questionnaire. Sources of criterion validity were investigated with measures of pain (labor, delivery, and just after birth) and post‐traumatic stress symptoms. Results: Minor adaptations in item distribution resulted in an adequate fit of the original six‐factor solution of the Mackey scale (i.e., oneself, the partner, the baby, the nurse, the physician, and overall satisfaction). Sources of validity evidence supported the construct and criterion validity of the scale. Conclusions: Obtaining a psychometrically and conceptually sound factor solution is fundamental when validating a scale. With the present study, researchers and clinicians (e.g., midwives) will be able to measure women's childbirth satisfaction in a more robust manner. Both antecedents and consequences of satisfaction were found to correlate with several satisfaction subscales, which might help guide prevention programs in mother care in a more efficient way. [ABSTRACT FROM AUTHOR]

Gambling is becoming increasingly frequent and problematic, especially due to the explosion of online alternatives. Evaluating the severity of gambling symptomatology is therefore more important than ever. However, innovations in the gambling field have generally focused on its treatment rather than its evaluation. The Gambling Symptom Assessment Scale (G-SAS) is a well-established measure of gambling-related symptomatology (e.g., gambling urges, gambling-related thoughts and behaviours, and interpersonal functioning). The aim of this study is to validate a Spanish adaptation of the G-SAS so that individual differences in gambling symptomatology can be assessed by clinicians and researchers. The internal structure of the G-SAS was investigated using an exploratory factor analysis with a sample of 364 individuals from the general population in Spain (mean age = 28.84 years, SD = 11.73; 54% males). A four-factor structure was preferred considering fit indices (Chi-square = 22.62, p =.162, RMSEA = 0.030, CFI = 0.998, TLI = 0.995) and internal consistency estimates (0.67 ≤ α ≤ 0.89). The factors were labelled gambling-related symptoms, control of gambling urges/thoughts, interference, and arousal. Regarding construct validity, the four factors of the G-SAS were positively and significantly (all p <.001) correlated with measures of problematic gambling severity (0.40 ≤ r ≤.73), problematic gambling diagnostic (0.40 ≤ r ≤.67), gambling cognitions (0.48 ≤ r ≤.57), impulsivity (0.26 ≤ r ≤.42), anxiety (0.22 ≤ r ≤.38), and depression (0.16 ≤ r ≤.42), and negatively with quality of life (-0.24 ≤ r≤-.42). In sum, this study provides Spanish clinicians and researchers with a tool that serves to assess the status of individuals in relation to gambling symptomatology, which can be used to screen for at-risk profiles and evaluate treatment response. [ABSTRACT FROM AUTHOR]

Aim: This study explores the profile of pregnant women interested in the online assessment of their emotional status according to their sociodemographic and obstetric characteristics, history of psychopathology, and healthcare setting used (private vs. public). Design: This is a comparative and descriptive cross‐sectional study. Method: Participants were 281 Spanish pregnant women assessed with the MamáFeliz (HappyMom) website. Results: Participants were probably to be unemployed, in a relationship, and generally had a high educational level and an intermediate economic status. Most of them were primiparous, had non‐complicated natural pregnancies and presented healthy habits and good physical and emotional health, despite 31.3% of them had a history of psychological treatment. Our results reveal the profile of women interested in the online assessment of their emotional status, which can contribute to improving future initiatives to facilitate rapid screenings of perinatal mental health by nurses in both public and private settings. [ABSTRACT FROM AUTHOR]

Our study examined the 'paradox of wellbeing' among women with fibromyalgia and the role of cognitive fusion on wellbeing in relation to age. A total of 228 women diagnosed with fibromyalgia according to the American College of Rheumatology criteria were included. In order to explore the conditional effects of age in the moderation analyzes, as recommended in the PROCESS Macro, the 16th, 50th, and 84th percentiles were calculated. These percentiles define three age groups that we will call younger (from 30 to 53 years), middle-aged (from 54 to 60 years) and older women (from 61 to 78 years). We found a 'paradox of wellbeing' among fibromyalgia patients which has not yet been reported: the older the patients, the higher scores on hedonic (positive affect) and eudaimonic (activities engagement) wellbeing. A moderation effect of age was found in the relationship between cognitive fusion and wellbeing (cognitive fusion showed negative associations with positive affect and activities engagement but not among older patients). Our study underscores the need of personalized interventions for fibromyalgia patients to improve their wellbeing. Especially in younger and middle-aged patients, it would be of interest interventions in cognitive defusion through Acceptance and Commitment Therapy (ACT). [ABSTRACT FROM AUTHOR]

Childbirth expectations during pregnancy are important factors related to birth satisfaction. The aim of this study is to validate the Childbirth Expectation Questionnaire (CEQ) in a sample of Spanish pregnant women; 231 women responded to the CEQ during their first trimester of pregnancy and 106 of them completed a re-test at the third trimester. Exploratory analyses with 1-to-6 factor solutions were carried out to investigate the internal structure of the CEQ. The three-factor solution (spousal support and control, medical support and environment, and labor pain and distress) showed the best properties in terms of model fit, number of items per factor, and item loadings. The internal consistency of scales was also good (.79 ≥ α ≤.93). Test-retest analyses showed significant intercorrelations between expectations from the first to the third trimester of pregnancy. There is a need to assess childbirth expectations, and our results suggest that the CEQ is a valid and useful instrument to be used among Spanish pregnant women. [ABSTRACT FROM AUTHOR]

Background: Research on traditional gender beliefs has highlighted their psychological impact and social implications for women. The purpose of this study was twofold. First, we aimed to adapt and validate the Spanish version of the Multicultural O'Kelly Women's Beliefs Scale. Next, we explored its sources of validity evidence in relation to intimate partner violence, stress, and depression. Based on the Rational Emotive Behavior Therapy framework, traditional gender beliefs were expected to be associated with higher levels of intimate partner violence, stress and depression. We also expected to obtain a psychometrically-sound factor structure of the Multicultural O'Kelly Women's Beliefs Scale.Methods: A sample of Spanish women (N = 322) completed the Multicultural O'Kelly Women's Beliefs Scale, the Beck's Depression Inventory II, the Modified Conflict Tactics Scale, and the Stress Perceived Scale. To test the psychometric properties of the Multicultural O'Kelly Women's Beliefs Scale we implemented exploratory and confirmatory factor analyses and an analysis of the area under the curve.Results: Regarding the psychometric properties of the scale, statistical analysis revealed a one-factor dimensionality (Global traditionalism) and supported a reduction of items in the original instrument. The abbreviated version (eight items) obtained the best fit indices. Considering the association between traditional gender beliefs and psychological outcomes, we found that traditional gender beliefs were associated with increased severity of stress, depressive symptoms and reciprocal verbal aggression.Conclusion: The Spanish adaptation of the Multicultural O'Kelly Women's Beliefs Scale provided a very short, psychometrically robust and clinically relevant measure of traditional gender beliefs. In addition to the association between traditional gender beliefs and mental health outcomes, an important finding was the relationship between traditional gender beliefs and intimate partner violence. Our scale might be used in clinical settings by helping women to identify their traditional gender beliefs and replace them by healthy and goal-oriented beliefs, which would also contribute in achieving a more egalitarian society. [ABSTRACT FROM AUTHOR]

Introduction : The coronavirus disease 2019 (COVID-19) emergency has imposed important challenges in the lives of individuals, particularly since the restriction of free movement. In Spain, this mandatory home confinement started on March 14, 2020. In this scenario, some calls have been made to better understand the exact impact of the quarantine on the emotional status of individuals across time. Materials and Methods : On the first day that the Spanish government imposed the quarantine, our team launched an online longitudinal study to monitor emotional responses to the COVID-19 emergency over time. For 2 weeks, 187 people have responded to a daily diary on emotion functioning. An emotion network analysis was performed to study the network structure of 30 mood states and its changes during the first 2 weeks of the quarantine. Results : The emotional network showed critical changes in the interactions of emotions over time. An analysis of mean emotional levels did not show statistically significant changes in mood over time. Interestingly, two different network patterns were found when the sample was divided between those with favorable responses and those with unfavorable responses. Discussion : This new approach to the study of longitudinal changes of the mood state network of the population reveals different adaptation strategies reflected on the sample's emotional network. This network approach can help identify most fragile individuals (more vulnerable to external stressors) before they develop clear and identifiable psychopathology and also help identify anti-fragile individuals (those who improve their functioning in the face of external stressors). This is one of the first studies to apply an emotional network approach to study the psychological effects of pandemics and might offer some clues to psychologists and health administrators to help people cope with and adjust to this critical situation. [ABSTRACT FROM AUTHOR]

EhcoBUTLER is an Information and Communication Technology (ICT) solution funded by the European Union (H2020; ID: 643566) and intended especially for elderly people with mild cognitive impairment (MCI) to improve their health, independence and quality of life, particularly at the social level. The purpose of this study is to assess the acceptability of ehcoBUTLER based on a survey delivered to potential users and actors involved in their care, exploring their expectations and preferences, while anticipating the system's functional requirements. The survey was delivered online to 313 participants (11% end users, 25% informal caregivers, 48% formal caregivers and 16% administration/management staff) from eight countries. Participants rated the different functionalities of ehcoBUTLER positively, 86.1% perceiving it as an interesting and useful system. Likewise, they assessed it as a commercially attractive product (75.1%). End users expressed a stronger preference for the social module. Nevertheless, they would be ready to pay a low monthly price for ehcoBUTLER. Professionals would be willing to pay choosing its functionalities modularly, but they would also expect it to be funded by the National Health System, centres or businesses. The conclusion is that all participants found ehcoBUTLER interesting, useful and ergonomic. However, to effectively implement it, it is necessary to bridge the digital gap and address the issue of insufficient investment in products aimed at older adults with cognitive impairment. To supplement cognitive training systems with social, emotional or entertainment functionalities could improve adherence to their use. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia (FM) is a prevalent and highly disabling chronic pain syndrome. However, differences among patients regarding how pain impacts on daily life are remarkable. The main aim of this study was to identify clinical and pain‐related cognitive variables characterizing patients reporting high adaptability despite experiencing severe chronic pain. Methods: Two hundred and eighty‐three Spanish patients with FM with high levels of pain were classified into 2 groups: (1) those reporting low impact of the syndrome, and (2) those with moderate‐to‐high impact. Perceived stress, anxiety, and depressive symptoms along with pain catastrophizing, psychological inflexibility, and perceived control over pain were evaluated. Differences in sociodemographics, years with FM, past/current major depressive disorder comorbidity, and health‐related economic costs (ie, medications, use of medical services, lost productivity due to sick leave) were also assessed. Stepwise logistic regression analyses predicting group membership from clinical variables and pain‐related cognitive processes as predictors were performed. Results: Lower stress, anxiety, and depressive symptoms, along with reduced pain catastrophism, psychological inflexibility, and perceived control over pain, were found in the low‐impact group. Significant predictors of group membership (low‐impact vs. moderate‐to‐high impact) in regression analyses were "cognitive fusion" (psychological inflexibility), "helplessness" (pain catastrophizing), and depressive symptomatology, together with pain intensity and other FM symptoms. Conclusions: The present study provides further evidence on resilience resources in chronic pain by identifying some variables (ie, reduced depressive symptomatology, pain catastrophizing, and psychological inflexibility) differentially characterizing a profile of patients with FM who are especially able to adapt to high levels of pain. [ABSTRACT FROM AUTHOR]

Objective: We analyzed the preference of three psychological intervention formats—individual, group, and online—in a sample of 267 patients with a primary diagnosis of emotional disorder in Spanish public mental health settings. Method: We studied patients’ preferences considering sociodemographic characteristics, diagnoses, history of psychological treatments, number of sessions, and satisfaction with past interventions. Results: Most participants (85.4%) preferred psychological treatment in an individual format, 14.2% in group, and 0.4% online. When comparing the people who chose individual and group treatment, no demographic or clinical differences were found. The arguments against group format were the lack of privacy and expression difficulties. Regarding online format, these included being considered impersonal and ineffective. Conclusion: The rejection of group and online psychotherapy formats allows us to define the actions we should carry out in public mental health settings to improve the acceptance of more cost-effective therapy formats. [ABSTRACT FROM AUTHOR]

Despite several models of coping have been proposed in chronic pain, research is not integrative and has not yet identified a reliable set of beneficial coping strategies. We intend to offer a comprehensive view of coping using the social problem-solving model. Participants were 369 chronic pain patients (63.78% women; mean age 58.89 years; standard deviation = 15.12 years). Correlation analyses and the structural equation model for mental health revealed potentially beneficial and harmful problem-solving components. This integrative perspective on general coping could be used to promote changes in the way patients deal with stressful conditions other than pain. [ABSTRACT FROM AUTHOR]

Introduction: The IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre-post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes., Methods and Analysis: Participants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed., Ethics and Dissemination: This study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities., Trial Registration Number: NCT04140838., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Recommendations on lifestyles during quarantine have been proposed by researchers and institutions since the COVID-19 crisis emerged. However, most of these have never been tested under real quarantine situations or derive from older investigations conducted mostly in China and Canada in the face of infections other than COVID-19. The present study aimed at exploring the relationship between a comprehensive set of recommended lifestyles, socio-demographic, and personality variables and mood during the first stages of quarantine. Methods : A virtual snow-ball recollection technique was used to disseminate the survey across the general population in Spain starting the first day of mandatory quarantine (15 March 2020) until three days later (17 March). In total, 2683 Spanish adults (mean age = 34.86 years, SD = 13.74 years; 77.7% women) from the general population completed measures on socio-demographic, COVID-related, behavioral, personality/cognitive, and mood characteristics. Results : In the present study, depression and anger were higher than levels reported in a previous investigation before the COVID-19 crisis, while vigor, friendliness, and fatigue were lower. Anxiety levels were comparable. The expected direction of associations was confirmed for the majority of predictors. However, effect sizes were generally small and only a subset of them correlated to most outcomes. Intolerance of unpleasant emotions, neuroticism, and, to a lesser extent, agreeableness, sleep quality, young age, and time spent Internet surfing were the most robust and strongest correlates of mood states. Conclusions : Some recommended lifestyles (i.e., maintaining good quality of sleep and reducing Internet surfing) might be more important than others during the first days of quarantine. Promoting tolerance to unpleasant emotions (e.g., through online, self-managed programs) might also be of upmost importance. So far, recommendations have been made in general, but certain subgroups (e.g., certain personality profiles and young adults) might be especially vulnerable and should receive more attention.

Background : Research exploring the relationship between personality and important pregnancy outcomes (i.e., depressive symptoms, adjustment, and perceived social support) tends to be cross-sectional, arguably due to the difficulties of conducting longitudinal and mental health research in this population. The objective of this study is to use a web-based solution to longitudinally explore how personality traits are associated, not only with the co-occurrence of these outcomes but also with their evolution during pregnancy. Stability and change of these outcomes will also be investigated. Methods : The sample included 85 pregnant women attending several medical centers in Spain. The web-based assessment included sociodemographic and obstetric variables (ad hoc) and personality (at the second trimester only), and outcomes at both the second and the third trimester (i.e., depressive symptoms, adjustment, and perceived social support). Results : The results showed that adjustment worsened from the second to the third trimester of pregnancy. Neuroticism (N), low extraversion (E), and psychoticism (P) were cross-sectionally and longitudinally associated with outcomes. In addition, N and, to a lesser extent P, uniquely contributed to the evolution of these outcomes in the multivariate analyses, including autoregressions. Conclusion : Personality and especially N and P should be evaluated early during pregnancy mental health screening. The use of a web page appears to be a useful tool for that purpose. Technologies might also help disseminate mental health prevention programs for these women, which would be especially recommended for those with a personality profile characterized by high N and P and, to a lesser extent, low E.

Background: Chronic pain has become a major health problem across the world, especially in older adults. Unfortunately, the effectiveness of medical interventions is modest. Some have argued that assessment strategies should be improved if the impact of medical interventions is to be improved. Ecological momentary assessment using smartphones is now considered the gold standard in monitoring in health settings, including chronic pain. However, to the best of our knowledge, there is no randomized controlled trial to show that telemonitoring using a smartphone app can indeed improve the effectiveness of medical treatments in adults with chronic pain. The goal of this study will be to explore the effects of using a smartphone app for telemonitoring adults with chronic pain., Methods: The study will be a randomized controlled trial with three groups: treatment as usual (TAU), TAU+app, and TAU+app+alarms. All groups will receive the adequate treatment for their pain, which will be prescribed the first day of study according to clinical guidelines. Assessment in the TAU group will be the usual at the Pain Clinic, that is, a paper-and-pencil evaluation at the onset of treatment (beginning of study) and at follow up (end of study, 30 days later). The other two groups (TAU+app and TAU+app+alarms) will be assessed daily using Pain Monitor, a smartphone app developed by our multidisciplinary team. Telemonitoring will only be made in the TAU+app+alarms group. For this group, physicians at the Pain Clinic may decide to adjust pain treatment in response to alarms. Telemonitoring is not the usual practice at the Pain Clinic and will not occur in the other two groups (TAU and TAU+app), so no changes in treatment are expected in these groups after the first appointment. The total sample size will be 150, with 50 patients in each group. The assessment protocol will be the same in all groups and will include pain intensity and side effects of the medication (primary outcomes), together with several pain-related variables like pain interference, activity level, use of rescue medication, pain catastrophizing, and pain acceptance, among others., Discussion: We believe that the present trial has important clinical implications. We think that telemonitoring using ecological momentary assessment is crucial to improve current interventions for pain. The armamentarium of available treatments for pain is large, so physicians can turn to different treatments or dosages in the presence of an undesired event. The use of the app for telemonitoring can allow for this rapid detection of unwanted events, thus improving patient safety (i.e., withdrawal of treatment causing side effects) and augmenting treatment effectiveness (i.e., changing an ineffective treatment or dosage). In a time when smartphones are a mainstream technology, we should take advantage of them in the promotion of health care., Trial Registration: ClinicalTrials.gov, NCT03247725 . Registered on 25 July 2017.