Diferencias en el estilo atribucional y de la autoestima en una muestra de pacientes Delirantes

SUMMARYIntroductionThe attributional style along with the self-esteem (that plays a centralrole in the development and maintenance of the pathological state)is a very important mediating element in the delusion, so we find thenecessity to realise basic studies of these processes.In the field of psychology, and mainly in the personality area,the atributional style has a great relevance, when understanding thecausal attributions like mechanisms of facing that guide the conductof the subject. In this way, we see the importance that supposes thestudy of the dysfunctional attribution to be able to replace it on theother adaptive, mainly in the pathologies where delusions beliefsexist.In the present investigation the influence has been analyzedthat carries out the variable attributional style and the self-esteem inthe delusional ideas (defined by the 4th edition of the Diagnostic andStatistical Manual of Mental Disorders [DSM-IV] as «false belief basedon the realization of incorrect inferences about external reality, beliefsthat are held firmly believe despite of almost everyone else, anddespite of constitutes an obvious proof or evidence otherwiseindisputable») in a sample of delusional patients in comparison witha group control.Most of the research, focus on the dimension of «Internal» inthis study (following previous research), is to examine attributionalbiases in the reasoning of delirious patients. Therefore, the departurehypotheses are the following: a) the delusional patients, more thanthe normal subjects, will realise in their social reasoning more externalattributions for the negative events that stop the positives; b) thedelusional patients, like the control group, tend to realise global andexcessively stable attributions, as much for positive events as fornegative events; and c) the delusional patients in comparison withthe control group will indicate a high self-esteem.Patients and methodsTo carry out this research both self-esteem and attributional stylehave been tested in a sample of 20 delusional in-patients (85% aremen and 15% women of average age of 36.20 years) entered theunit of Rehabilitation of a Psychiatric Hospital of Santiago deCompostela (Spain) and have been compared to 40 normal controlsubject in age and sex with the experimental group that do not ownpsychiatric history, no upheaval that requires treatment.The criteria of inclusion have been the following: a) all of thepatients were entered the unit of Rehabilitation, b) the patients haddelusional ideas at the moment of the tests, c) their diagnosis fulfilledthe criteria according to DSM-IV for paranoid schizophrenia (16patients) and delusions upheaval (paranoid) (4 patients), d) the agesof the patients had to be included between 20 and 50 years, e) noneof the patients had a history of drug use, f) patient did not showevidence of organic brain disorders, g) all of them had a score initems 1 (delusion), 5 (magnitude), and 6 (mistrust/damage) in thepositive scale of PANSS (PANSS-P) of more than 3, and h) all thepatients had more than 5 years of disease.One is comparative, observational, and cross-sectional andhomodemic a study according to the propose classification byFeinstein and with a design of cases and controls.The instruments applied in the study were: a) Rosenberg Self-esteem Scale (EA), is an instrument for assessing the patient’s globalself-esteem; b) Attributional Style Questionnaire (ASQ), which is aself-administered questionnaire consisting of twelve situations, sixpositive (success) and six negative (failure), against which the subjectmust indicate the causes they attribute its occurrence; and c) Positiveand Negative Syndrome Scale for Schizophrenia (PANSS), suitablefor evaluation of positive and negative symptoms in schizophrenia.Of the thirty items included in the PANSS, seven are positive scale(PANSS-P), seven the negative scale (PANSS-N), and the sixteenremaining general psychopathology scale (PANSS-PG).All the instruments used for the study, count on theircorresponding data of reliability and validity.In this investigation a descriptive analysis of the object of studyhas been carried out variable, which provided us the frequencyallocation, percentage, averages, medians and standard deviationsfor each of them.ResultsThe results of this investigation show that the delusional patientsrealised more external attributions for the negative events that thegroup normal control, and more internal for the positives.The delusional patients realised a causal attribution in stabilityand globality for the negative events similar to the one of the normalones. Nevertheless, before positive events have been significantdifferences between both groups in relation to the stability, not thusfor the globality. Also the delusional patients, like the group normalcontrol, indicated a high self-esteem.