Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

This paper introduces the Special Section on Depression and Personality, first, by presenting an outline of relevant research on the interaction between depression and personality dysfunction and, then, by mapping the contributions of the authors on current challenges and future directions in the field. The intersection between affective disorders and personality dysfunction is relevant in at least 2 general ways. First, it signals a new direction in clinical research that calls for an emphasis on underlying functional domains and personality characteristics, rather than on phenotypic presentations of depression. Second, it challenges the effectiveness of usual treatment protocols for patients with complex depression. Both directions in research are naturally linked: new treatments should be based on interventions that map on deficits in functional domains as well as on personality characteristics that influence clinical presentation and responses to treatment. The Special Section will introduce the reader to scientific work carried out by the Millennium Institute for Research in Depression and Personality, which tackles some of these important issues.

Depression in adolescents constitutes a public health problem that can be effectively treated with psychotherapy. However, it is still necessary to improve the understanding of the process of change. A qualitative approach was used to characterize the content of therapeutic change in psychotherapies with adolescents with depressive symptoms from several perspectives (adolescents, therapists, and external observers). Post-therapy follow-up interviews with 6 purposively selected adolescents and their therapists were conducted. The Youth Outcome Questionnaire, the Beck Depression Inventory, and a sociodemographic and clinical survey were administered to the patients. Eight external observers followed an observation and coding manual to identify change moments in video recordings of the therapy sessions. A content analysis revealed convergences and divergences in the participants' evaluation of psychotherapy and change facilitators. The adolescents and external observers both ascribed importance to intrapsychic changes, whereas the therapists emphasized behavioral changes. The importance of integrating multiple perspectives in order to understand psychotherapeutic change is discussed.

Personality functioning may be a vulnerability factor for the development of depressive disorders and will influence how these are expressed in each patient. Diagnosing the structural capacities and vulnerabilities of a patient's personality will facilitate the planning of therapy. This article introduces the Operationalized Psychodynamic Diagnosis Structure Questionnaire (OPD-SQ), a personality structure assessment instrument, covering its theoretical background, its translation into Spanish, and its adaptation process. Preliminary results of its administration to convenience samples are presented (clinical sample: 192 patients diagnosed with depression; nonclinical sample: 112 students and administrative staff from a university in Santiago, Chile). High internal consistency (Cronbach's alpha) was found for the OPD-SQ and its subscales, except for the Attachment to External Objects scale. Differences were observed between the scores of the clinical and nonclinical samples (Welch's t-test), as well as direct and high Pearson's correlations coefficients between OPD-SQ and depressive symptomatology and psychological distress levels. The results presented lay the groundwork for future studies aimed at contributing to the validation of the OPD-SQ for use in clinical and research settings.

Within the context of individual and family mental health, the relationship between couple satisfaction and depressive symptomatology has been well documented. A second generation of studies have focused on finding variables that could modulate this relationship; however, the role of the reflective functioning (RF) in the relationship between these 2 variables has not been examined. This study explored the moderating effect of reflective functioning (Reflective Functioning Scale) on the relationship between couple satisfaction (Relationship Assessment Scale) and depressive symptomatology (Beck Depression Inventory I) in a sample of 50 couples with children under 3 years old, purposively selected in 21 municipalities of the Metropolitan Region of Chile. A multilevel regression analysis revealed that couple satisfaction has an inverse effect on depressive symptomatology. The analysis also showed a moderating effect of RF on the relationship between these 2 variables: compared to people with low RF, those with high RF display a more intense inverse correlation between couple satisfaction and depression. The clinical implications of these findings are discussed.

Considering the perspective of personality polarities (Blatt, 2004, 2007, 2008), the aim of this study was to describe the relationship between levels of self-criticism and dependence (DEQ) in patients with depression (BDI-I) and dropout of psychotherapy, exploring the mediating role of the therapeutic alliance (WAI-P) and the moderating role of patients' age. Using a longitudinal design and covenience sampling, 81 adult patients receiving brief psychotherapy were recruited at a private health center in Santiago, Chile. Twenty-two of these patients dropped out of treatment. Based on a regression model with interaction terms and controlling for patients' sex, schooling, and age and therapists' years of experience, results indicate that the higher the level of self-criticism the higher the probability of dropping out psychotherapy. This relationship is not explained by the therapeutic alliance. The association between self-criticism and drop out is not observed in younger patients (30 years), yet it is present in older patients (> 40 years). In addition, the higher the dependence, the lower the probability of dropping out of psychotherapy.

The therapeutic alliance is an important component of the therapeutic process; however, very few studies have explored how the therapeutic alliance is constructed with adolescent patients. A single case study with a mixed methodology was conducted to identify moments of rupture and attempts to resolve the therapeutic alliance, based on the microanalysis of the successful treatment of an adolescent with identity diffusion indicators and depressive symptomatology. The Youth Outcome Questionnaire-Self Report, the Assessment of Identity Development in Adolescence, the Beck Depression Inventory (BDI-I), and the Social Problem Solving Inventory-Revised were administered. Thirty-two sessions were analyzed using the Ruptures and Resolutions Coding System developed by Eubanks, Muran, and Safran (2015), in which 29 rupture moments were found (11 withdrawals and 18 confrontations). The frequency and characteristics of these relevant moments, as well as their relationship with therapeutic success at the end of the process, were analyzed through pre-post differences, using Z-ratio. The clinical implications of immediately resolving moments of rupture during the session are discussed.

Evidence has been found of an association between participation in risk behaviors and the perception of their risks and benefits. The use of personal music players (PMPs) is one of the most common non-occupational noise activities, especially among the young. The aim of the study was to develop a questionnaire to assess the positive consequences (benefits) perceived by adolescents and the negative consequences (risks) of listening to music on these devices. The construction and validation process occurred in 3 phases: item pool development; establishment of content validity; and estimation of construct validity, criterion-related validity, and internal consistency, with an accidental sample of 694 adolescents from 2 schools of Cordoba, Argentina. The results of the exploratory and confirmatory factor analyses revealed a 2-dimensional factorial structure. Together, both factors correctly classified 64.6% and 74% of adolescents with high and low exposure to music through PMPs. This questionnaire can be used to detect adolescents with risky listening and to develop strategies to promote protective behavior.

The theory of attributions has long been used to study people's explanations for the origin of poverty. Nevertheless, research on the perceived causes of wealth has thus far been sidelined and isolated from the study of poverty attributions. This article focuses on the relationship between poverty and wealth attributions from a latent variable measurement perspective. To examine this relationship, two basic attribution types were considered: internal (based on individual behavior) and external (based on socio-structural determinants). Answers to a 10- indicator scale from the Social Justice and Citizenship Participation survey were analyzed. The instrument was administered to a stratified cluster probability sample in Chile in 2013 (N = 1245). Based on prior evidence, a confirmatory factor model of internal and external poverty and wealth attributions was estimated (four factors). Based on it, a second-order two-factor model was estimated, one of internal and another of external attributions. For the first time results yield evidence of common attributions for poverty and wealth

The aim of the study was to validate the Reasons for Living (RFL) Inventory in Chile, using a purposive and consecutive sample of 705 mental health patients in the Metropolitan Region. The RFL scale assesses the importance ascribed to reasons for living when contemplating suicide. The factorial structure of the scale was analyzed through exploratory and confirmatory analysis of the original instrument. Internal consistency, construct validity, and concurrent validity were studied and score parameters were defined. The suggested cut-off point for Chile is 4.1, which means that lower scores indicate a higher probability of suicide risk. Sensitivity was estimated at 62.1% and specificity at 66%, which is considered to be acceptable, given the high incidence of false negatives and positives. The result of the evaluation warns health professionals to clinically investigate the suicide risk detected when administering the instrument. Additionally, results highlight the adaptive and therapeutic potential of the reasons to stay alive for the treatment of depressive patients who are contemplating suicide.

The aim of this study was to examine the internal structure of the Big Five Inventory (BFI) in a nonprobability sample of 332 students (82.83% women) aged between 16 and 48 years (M = 20,39) who attended a private university in Metropolitan Lima, Peru. An exploratory factor analysis was performed using unweighted least squares and oblique Procrustes rotation with fully specified target matrix. In addition, the linear Pearson correlations between the factors were calculated. The BFI was found to have a factor structure similar to that of the original test, although 7 items were removed. The 37-items version displayed good internal consistency according to ordinal alpha, omega, and H. In conclusion, the BFI exhibits favorable psychometric indicators that suggest that it can be used in group evaluations and basic research.