This study examines the predictive capacity of the Spanish adaptation of the Influential Relationships Questionnaire (IRQ) in the clinical course of patients with first-episode psychosis. A total of 119 patients diagnosed with psychotic disorders (ICD-10 F20-F31), aged 18 to 35 years and living with one or both parents, were recruited from a Community Mental Health Unit and followed for three years. During initial evaluations, patients completed the short version of the IRQ, in addition to routine clinical assessments. Outcome variables included the number of relapses, hospital admissions, and time to relapse/admission, obtained from clinical records and follow-up databases.The criticism dimension of the IRQ showed the strongest predictive power, with significant and moderate-to-strong correlations with all outcome measures, particularly when referred to fathers. Care was negatively correlated with relapses and admissions, suggesting a protective effect, although with smaller effect sizes. Overinvolvement showed weak and inconsistent associations, while restriction was not significantly related to outcomes. Regression analyses confirmed the explanatory capacity of criticism, accounting for up to 23% of the variance in admissions in the paternal subgroup. Patients in the highest-criticism tertile showed markedly higher rates of relapse and admission compared to those in the lowest tertile.These findings confirm the predictive validity of the Spanish adaptation of the IRQ and highlight the importance of perceived criticism as a key dimension in the family emotional climate of first-episode psychosis. The results underscore the clinical relevance of incorporating the assessment of perceived criticism into routine practice and of including parents, particularly fathers, in therapeutic interventions.

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.

Eating disorders (EDs) are a group of disorders characterized by altered eating behaviors and/or the emergence of behaviors pertaining to weight control. Some studies report a relationship between coping strategies adopted in the face of stress and EDs. However, the latest review on this topic was carried out in 2008 by Quiles & Terol. A systematic review of studies that have investigated the relationship between coping strategies and EDs in clinical (anorexia nervosa, bulimia nervosa, or binge eating disorder) and non-clinical populations, aged 12-25 years has been conducted. Articles in English and Spanish were selected from Web of Science and Psycinfo databases in the last 15 years. Eighteen articles were finally included in the review. The results show a higher use of negative, avoidant, and emotion-focused coping strategies in populations with eating disorders or with high scores on questionnaires; additionally, results uncovered a higher use of positive coping strategies in populations without eating disorders or with low scores on questionnaires measuring ED symptomatology.

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.

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.

Physiological oscillations, such as those involved in brain activity, heartbeat, and respiration, display inherent rhythmicity across various timescales. However, adaptive behavior arises from the interaction between these intrinsic rhythms and external environmental cues. In this study, we used multimodal neurophysiological recordings, simultaneously capturing signals from the central and autonomic nervous systems (CNS and ANS), to explore the dynamics of brain and body rhythms in response to rhythmic auditory stimulation across three conditions: baseline (no auditory stimulation), passive auditory processing, and active auditory processing (discrimination task). Our findings demonstrate that active engagement with auditory stimulation synchronizes both CNS and ANS rhythms with the external rhythm, unlike passive and baseline conditions, as evidenced by power spectral density (PSD) and coherence analyses. Importantly, phase angle analysis revealed a consistent alignment across participants between their physiological oscillatory phases at stimulus or response onsets. This alignment was associated with reaction times, suggesting that certain phases of physiological oscillations are spontaneously prioritized across individuals due to their adaptive role in sensorimotor behavior. These results highlight the intricate interplay between CNS and ANS rhythms in optimizing sensorimotor responses to environmental demands, suggesting a potential mechanism of embodied predictive processing.

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.

La evaluación de la calidad de la atención en el ámbito de la salud es un requisito obligatorio para la mejora de los servicios ofrecidos. Sin embargo, existen pocas medidas válidas y estandarizadas, especialmente en el campo de la atención psicológica clínica. El objetivo del presente estudio es el desarrollo y validación de un índice de medida de la calidad asistencial desde la perspectiva de los especialistas de psicología clínica, que permita una evaluación ágil y de fácil interpretación. Participaron 83 especialistas de psicología clínica del Servicio Andaluz de Salud. Mediante análisis psicométricos, se obtuvo un índice compuesto por cuatro indicadores esenciales, con excelentes valores de consistencia interna e índices de ajuste adecuados para un modelo unidimensional. El índice obtenido es una herramienta útil, fiable, válida y sensible para la monitorización de la calidad de las prestaciones de psicología clínica y la evalu ación de programas de mejora basados en evidencias empíricas.

Predictive coding framework posits that our brain continuously monitors changes in the environment and updates its predictive models, minimizing prediction errors to efficiently adapt to environmental demands. However, the underlying neurophysiological mechanisms of these predictive phenomena remain unclear. The present study aimed to explore the systemic neurophysiological correlates of predictive coding processes during passive and active auditory processing. Electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS) and autonomic nervous system (ANS) measures were analyzed using an auditory pattern-based novelty oddball paradigm. A sample of thirty-two healthy subjects was recruited. The results showed shared slow evoked potentials between passive and active conditions that could be interpreted as automatic predictive processes of anticipation and updating, independent of conscious attentional effort. A dissociated topography of the cortical hemodynamic activity and distinctive evoked potentials upon auditory pattern violation were also found between both conditions, whereas only conscious perception leading to imperative responses was accompanied by phasic ANS responses. These results suggest a systemic-level hierarchical reallocation of predictive coding neural resources as a function of contextual demands in the face of sensory stimulation. Principal component analysis permitted to associate the variability of some of the recorded signals.

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: Patients with severe mental disorders have a high risk of premature death due to the interaction of various factors. Social functioning is a strategic functional factor in understanding the course of psychotic disorders. Aim: Analyze the relationship between social functioning and its various dimensions and survival during a 10-year follow-up. Method: The Social Functioning Scale (SFS) was administered to 163 close relatives of patients under treatment at a Community Mental Health Unit. Survival was described by Kaplan–Meier analysis and any differences in survival by level of social functioning were found by long-rank analysis. Finally, Cox regression was used to predict premature mortality. Results: Significant differences in mortality were identified in the interpersonal behavior dimension of social functioning, while there were no significant gender or diagnostic differences in the rest of the dimensions. The interpersonal behavior dimension and age were found to be factors predicting premature death. Conclusion: These findings show the protective effect of social functioning retained by patients with psychotic disorders on their survival, and the need to apply evidence-based psychotherapy focused on recovery of social functioning in the early stages of the disorder.

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.

Background: In recent years, several variables in the course of schizophrenia and related psychotic disorders have been studied. However, an instrumental analysis of the evolution of social functioning and behaviour problems has scarcely been explored. Aim: To analyse the evolution of social functioning and behaviour problems and find any diagnosis or gender differences. Method: The Social Functioning Scale (SFS) and the Behaviour Problems Inventory (BPI) were administered in Stages I (2003-2007) and II (2014-2017) to 100 close relatives of patients under treatment at a Community Mental Health Unit. A related samples t-test, analysis of variance and multivariate analysis of variance were performed to study the evolution and differences in social functioning and behaviour problems. Then a stepwise multiple linear regression analysis was done to predict the evolution of social functioning. Results: No deterioration in the evolution of social functioning or behaviour problems was observed, and schizophrenia patient scores were lower. Women scored higher in withdrawal/social engagement, interpersonal behaviour, independence-performance, independence-competence and total social functioning, with no significant differences in behaviour problems. Previous social functioning, underactivity/social withdrawal and education are predictive factors in the evolution of social functioning. Conclusion: The results show the need for implementing psychosocial intervention programs that promote functional recovery and keep problems from becoming chronic.

Background: Recovery is an essential construct in healthcare treatment for patients diagnosed with severe mental illnesses (SMI). Of all the psychometric instruments available for measuring recovery, the 41-item Recovery Assessment Scale (RAS) is the most widely used. Several brief versions have been proposed, including the 24-item version. In this study, the RAS-24 was adapted to European Spanish and validated in a clinical sample. Method: Participants (N = 309) diagnosed with SMI were recruited from a community mental health center and a work guidance center. The participants completed the RAS-24 and the Social Functioning Scale (SFS), both self-reported and family-reported versions. Results: The results showed good indices of fit for the original five-factor structure, acceptable internal consistency (alpha=.93; omega=.95), temporal reliability (ICC =.89, p<.01), and significant correlation with most of the SFS scales (total SFS self-report r=.50, p<.01; total SFS family reported r=.49, p<.01). Conclusions: These data support the use of this Spanish version as a measure of recovery in the Spanish clinical population.

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.

Background: Emotional Intelligence (EI) has been the subject of numerous investigations and has been connected to better adaptation to the environment in general and, in particular, to better mental health. Parents' EI seems to be passed on to their children through learning. There are few studies that evaluate the EI of parents in relation to the mental health of their children.

Objetivo: evaluación de la calidad asistencial de los servicios de psicología clínica en el Servicio Andaluz de Salud (SAS) desde la perspectiva de los/as facultativos/as. Método: investigación descriptiva; se elaboró un cuestionario de 39 ítems que evalúa diferentes dimensiones de la calidad asistencial (prevención, accesibilidad, idoneidad de intervenciones de evaluación y tratamiento, seguridad, y coordinación); han participado 83 facultativos/as especialistas de psicología clínica del SAS, lo que supone un 32’17% de la población de referencia en el momento de la recogida de datos. Resultados: la calidad asistencial actual de las prestaciones de psicología clínica en el SAS, partiendo de una ratio de 3,05 facultativos por cada100.000 habitantes, es deficiente, sobre todo en las variables de prevención, intensidad de las intervenciones de tratamiento y seguridad, y especialmente preocupante en los dispositivos del segundo nivel asistencial. Conclusiones: es urgente aumentar el número de profesionales especialistas en psicología clínica por cada 100.000 habitantes para reducir el riesgo que supone para los usuarios la deficiente intensidad con que se practican los tratamientos psicológicos; asimismo, es necesario establecer estándares de la carga de trabajo de los psicólogos clínicos para poder ofrecer una calidad asistencial adecuada, e integrar indicadores medibles de calidad en los sistemas de información de salud mental.