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- ItemThe experience of social status in a Chilean sample as a predictor of health outcomes(2024) Rodríguez González, Laura Cristina; Repetto Lisboa, Paula Beatriz; Pontificia Universidad Católica de Chile. Escuela de PsicologíaThis dissertation explores the complex relationship between social status and health outcomes within a Chilean sample, offering a comprehensive examination of the status syndrome proposed by Michael Marmot. The research adopts a multidisciplinary approach to investigate how the psychological experience of social status, particularly autonomy and social integration, influences physiological stress markers. The dissertation comprises two empirical studies and a theoretical discussion presented in three manuscripts.The first manuscript provides a theoretical exploration linking the status syndrome with Self-Determination Theory (SDT). By integrating concepts of autonomy and social integration from the Capability Approach with the basic psychological needs posited by SDT. In addition, this manuscript proposes a structured intervention model aimed at enhancing well-being through health promotion strategies tailored to individuals' social contexts. The second manuscript focuses on adapting and validating a measurement instrument assessing the perception of economic inequality within the Chilean context.The third manuscript empirically investigates the association between social status experiences and cardiovascular health markers, specifically blood pressure and C-reactive protein (CRP) levels. This study builds on the work of Seeman et al. (2014), which measured generalized control and social integration in relation to allostatic load, by incorporating negative affectivity as a critical component of the status syndrome. Collectively, this dissertation raises important questions about the status syndrome and underscores the need to further explore its mechanisms, particularly in diverse populations and healthcare contexts. Understanding these complexities is crucial for informing population health interventions and addressing less visible health indicators that exert a detrimental effect on health.
- ItemParental personality traits and emotion regulation difficulties: their relationship with early triadic interactions and infant’s socioemotional development(2024) Muzard Costa, Antonia María; Olhaberry Huber, Marcia; Pontificia Universidad Católica de Chile. Escuela de PsicologíaBackground: socioemotional development is a pivotal aspect of human life, particularly during infancy, and is intricately woven within the personal and interpersonal dynamics of caregiver- infant interactions. This longitudinal study represents a pioneering exploration into the associations between mothers’ and fathers’ personality traits, emotion regulation difficulties, triadic interactions, and infants’ socioemotional development during the perinatal period. Objective: The primary objective was to investigate the complex interplay between parental personality traits and emotion regulation difficulties in mother-father-baby triads with its impact on early triadic interactions and infants’ socioemotional development. Methods: In this non-experimental, longitudinal study, 55 Chilean mother-father-baby triads were assessed from pregnancy until infant’s sixth month after birth. Additionally, parental levels of personality functioning, relationship satisfaction, depressive symptomatology and childhood adverse experiences were considered as potential covariables. Results: Findings revealed that maternal and paternal attributes have particular predictive values and exert distinct influences on both triadic interactions as well as infant’s socioemotional development from pregnancy until infants’ 6-months postpartum. Notably, maternal emotionality and paternal agreeableness, as well as both significant caregiver’s emotion regulation difficulties emerged as significant factors when fostering collaborative triadic interactions and enhancing infant’s socioemotional development. Additionally, when cofounding variables were included, maternal depressive symptomatology emerged as a significant predictor of infant’s socioemotional difficulties at 6-months postpartum. Moreover, the study highlights the moderating role of triadic interactions, emphasizing their significance in influencing the relationship between maternal emotion regulation difficulties and infant’s socioemotional development. Discussion: This research stresses the need for a comprehensive longitudinal perspective in understanding the impact of significant caregivers’ characteristics upon early triadic interactions and infant’s socioemotional development. Therefore, it acknowledges the unique dynamics of the perinatal period, while considering the individualities within each family triad which is crucial for unraveling the complexities inherent in the intricate fabric of family relationships and infant’s socioemotional development.
- ItemGuided internet-based intervention for postpartum depression symptoms: Development and feasibility trial(2024) Franco Vivanco, Pamela Verónica; Olhaberry Huber, Marcia; Pontificia Universidad Católica de Chile. Escuela de PsicologíaPostpartum depression (PPD) represents a significant concern in Chile due to its high prevalence and considerable treatment gap. Amidst this challenge, the prevalent use of digital technologies and parenting applications offers new avenues for delivering Internet-based psychological interventions (IBIs), which have shown effectiveness in mitigating depression symptoms and hold potential for addressing PPD. This doctoral thesis project embarked on developing and assessing an IBI tailored for PPD, named “Mamá, te entiendo” (“Mom, I get you”). This 8-week guided intervention, aiming to diminish depressive symptoms among postpartum women, is rooted in cognitive-behavioral therapy, incorporating insights from mentalization and attachment theories, and delivered through a web app. Developed in line with the CeHRes Roadmap framework, this human-centered approach involved a systematic review, online surveys, focus groups, usability tests, interviews, and a technical pilot for its creation. To assess the intervention’s feasibility, acceptability, and preliminary efficacy, a pilot randomized controlled trial with 65 postpartum women diagnosed with minor to major depression was conducted. Participants were allocated to either the intervention or a waitlist control group, with assessments at the baseline, post-intervention (8 weeks), and one-month post-intervention (12 weeks). This mixed-methods approach combined quantitative and qualitative analyses to gain insights into participant experiences. Primary outcomes focused on feasibility and acceptability measures like recruitment rates, attrition, and participant satisfaction and engagement. Secondary outcomes examined depression symptoms, perceived social support, mother-infant bonding, and maternal self-efficacy. “Mamá, te entiendo” showed promising feasibility and acceptability, characterized by high satisfaction and engagement levels, although adherence posed a challenge. Participants highlighted several strengths: emotional support, beneficial content, practical exercises, empathetic e-coach feedback, and a user-friendly interface. However, some faced barriers like extensive texts, difficulty tracking progress, and time constraints. Initial efficacy findings indicated no significant differences across outcomes between the intervention and control groups. Nonetheless, both groups experienced improvements in PPD symptoms, mother-infant bonding, and maternal self-efficacy, which could be attributed to spontaneous recovery or concurrent mental health treatments. This study marks the first attempt in Chile to evaluate a psychological IBI for PPD symptoms, underscoring the potential and acceptability of technology-driven mental health solutions.
- ItemExperiencias y significados asociados a las transiciones y las relaciones familiares en el período postdevelación del abuso sexual infantil intrafamiliar, desde las narrativas de figuras parentales y hermanos no ofensores(2023) Latorre Latorre, María Soledad; Cornejo Cancino, Marcela; Pontificia Universidad Católica de Chile. Escuela de PsicologíaLa presente investigación aborda el fenómeno del abuso sexual infantil, el cual es una problemática social y de salud pública (Collin-Vézina et al., 2013; Mathews & Collin-Vézina, 2019; OMS, 2020), que significa una violación de los derechos humanos de los niños, niñas y adolescentes víctimas (INDH, 2018). Su alcance trasciende a las víctimas directas e impacta a sus familiares y figuras significativas de sus entornos.
- ItemVivencias subjetivas de enfermedad en pacientes con epilepsia generalizada con crisis tónico clónicas y su relación con el proceso de construcción de la identidad personal(2023) Rossi Mery, José Luis; Behn Berliner, Alex Joseph; Pontificia Universidad Católica de Chile. Escuela de PsicologíaIntroducción. Vivir epilepsia se asocia en general con una percepción de estigma social, especialmente en presencia de afectos negativos y problemas de autoestima. Los factores psicosociales adversos están entre los que con más frecuencia suelen desencadenar las manifestaciones agudas de la epilepsia. Además, son escasos los estudios que abordan aspectos psicológicos de la epilepsia, como por ejemplo el posible impacto que la enfermedad puede tener en el desarrollo de la personalidad y la identidad personal. Objetivo. Describir las vivencias subjetivas en pacientes con epilepsia generalizada con crisis tónico clónicas, en relación a la experiencia de enfermedad y su potencial impacto en el proceso de construcción de la identidad personal. Método. Se realizó una investigación con enfoque cualitativo, de tipo exploratorio, descriptivo y transversal. Se estudió una muestra de 16 pacientes adultos, con epilepsia generalizada con crisis tónico clónicas, provenientes de 2 centros clínicos de la Región Metropolitana. Para garantizar los criterios de inclusión, se realizó un tamizaje en base a los cuestionarios MMSE, MINI y OPD-SQ y posteriormente, se utilizó una entrevista semi estructurada como principal instrumento de recolección de datos. Para cada entrevista se realizó un proceso de codificación abierta, selectiva y axial. Posteriormente, se realizó un análisis narrativo de tipo temático, en base a los objetivos específicos de la investigación. Resultados. En base a las narrativas de los participantes, fue posible establecer una relación entre las vivencias subjetivas de enfermedad y la identidad de los pacientes. Se evidencia una relación negativa entre las vivencias subjetivas de la enfermedad y el proceso de construcción de la identidad personal, identificando temas centrales en torno a la “limitación”, la vivencia de ser “diferentes” y percibir una identidad “frágil”. Estas vivencias se relacionaron con las diversas repercusiones psicosociales de la enfermedad. Se identifican además estrategias de afrontamiento, tales como el escape/evitación y la sobrecompensación, que pueden tener un impacto potencialmente disfuncional para la construcción de una identidad saludable y el desarrollo de trastornos emocionales comórbidos. Discusión. Los resultados revelan una percepción negativa de la enfermedad en el proceso de construcción de la identidad de los pacientes, que sugieren que las intervenciones farmacológicas deben ser complementadas con estrategias psicosociales de tratamiento. Se sugiere una aproximación teórica y clínica al estudio de la identidad en los pacientes con epilepsia, con el objetivo desarrollar dispositivos de intervención centrados en el abordaje de la experiencia subjetiva de los pacientes, mejorar su calidad de vida y prevenir el desarrollo de psicopatología comórbida. Finalmente se proponen futuras líneas de investigación, que permitan establecer diferencias por variables sociodemográficas, y variables clínicas. Se considera también la potencial relevancia clínica de los hallazgos para el diseño de intervenciones psicosociales y psicoterapéuticas centradas en el abordaje de la identidad de las personas con epilepsia.