Aplicacià N De La Terapia De Afrontamiento Del Estrà S

Salud Mental 2009;32:251-258
Aplicación de la terapia de afrontamiento del estrés en dos poblaciones con alto estrés

Aplicación de la terapia de afrontamiento del estrés
en dos poblaciones con alto estrés: pacientes crónicos
y personas sanas
María Isabel Peralta-Ramírez,1 Humbelina Robles-Ortega, 1
Nuria Navarrete-Navarrete,2 Juan Jiménez-Alonso2
Artículo original

SUMMARY
Introduction
Stress iscurrently considered a health risk factor. Numerous studies
have shown that people with high levels of perceived stress present a
greater number of complaints at both the physical and psychological
levels. In this context, programs have been developed directed toward
adequately coping with stress, and the effectiveness of these programs
on the symptomatology of a psychological nature in healthypersons
with a high level of perceived stress has been shown. However, there
have been fewer studies that have shown whether this type of therapy
affects the somatic symptomatology of healthy people in any way.
On the other hand, programs for chronically ill patients directed
toward achieving a better adaptation to their life conditions are equally
effective. A population that presents considerablyhigh levels of stress
is the one consisting of people suffering from a chronic illness. Thus,
through the immunological modulation it produces, the stress may
be exacerbating the course of the disease. One prototype of this is
systemic lupus erythematosus (SLE). SLE is a syndrome whose clinical
expression depends on the degree to which there is a convergence of
an immune regulation disorder and astrong genetic base, hormonal
influence, and various exogenous agents. SLE can be manifested by
general malaise, fever, fatigue, weight loss, skin rashes, joint
inflammation, anemia, inflammation of the lymphatic glands,
lowering of the defenses against infection, and cardiac, kidney,
neurological, and pulmonary alterations. This autoimmune disease
is usually associated with high levels of painand impairment in
different systems, producing high levels of stress in the patients who
suffer from it. Nevertheless, although stress has already been shown
to be one environmental factor that can produce a worsening in lupus
symptoms, there have been no studies carried out with the objective
of testing the effectiveness of stress management therapy and its
physical and emotional consequences inthese patients.
For this reason, this study has a double objective: on the one
hand, to corroborate, once again, the efficacy of cognitive-behavioural
stress management therapy in the control of certain psychological
processes and, on the other hand, to take one more step by testing
whether there is a reduction in the perception of self-reported somatic
symptoms both in healthy people and in thosewith a chronic disease.

1
2

Material and method
Fifty-two people participated in this study. Twenty-two were patients
with lupus from the University Hospital in Granada. The other 30
were people without chronic diseases who attended the Psychological
Attention Service at the University of Granada to receive therapy for
coping with stress, as they claimed to have high levels of it.
To evaluatethe level of stress, we used the Stress Vulnerability
Inventory by Beech, Burns and Scheefield, and the Scale of Recent
Life Experiences (SRLE) by Kohn and Macdonald. To evaluate
depression, we used the Beck Depression Inventory (BDI), and for
anxiety, the Trait Anxiety Inventory (STAI-R) by Spielberger, Gorsuch
and Lushene. For the self-reported somatic symptoms, we used the
Revised SomaticSymptoms Scale (SSS-R) by Sandín, Valiente and
Chorot. In addition, in the patients with SLE, the SLEDAI index, or
Index of Activity of the Disease, was obtained.
The therapy received was cognitive-behavioural in nature, and
it was carried out during 13 sessions which were grouped in the
following blocks: Conceptualization of the stress, cognitive
restructuring; Deactivation techniques; Approaching the...