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"Madrigal, Claudia"
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Understanding illness awareness in Alzheimer’s disease: a qualitative study with patient–caregiver dyads in Colombia
by
Madrigal, Claudia
,
Aguillón, David
,
Ramos, Claudia
in
Alzheimer's disease
,
awareness
,
Caregivers
2026
Diminished awareness of illness is a frequent neuropsychiatric symptom in people with Alzheimer's disease. It has been linked to emotional and behavioral challenges such as depression, apathy, irritability, and poor adaptation to loss of function. Despite its clinical importance, little is known about how individuals and their caregivers understand and experience illness awareness, particularly in low- and middle-income countries.
To explore the meaning of illness awareness and the factors associated with its impairment, as experienced and described by people living with Alzheimer's disease and their caregivers in Medellín, Colombia.
Semi-structured interviews were conducted with 20 individuals diagnosed with major neurocognitive disorder due to Alzheimer's disease and 24 caregivers. A grounded theory approach guided data collection and analysis, allowing for an inductive exploration of shared meanings and contextual influences.
For these patient-caregiver dyads, being aware of illness meant recognizing cognitive, emotional, and behavioral changes linked to the neurodegenerative process. Awareness and its disruption were shaped by personal characteristics (such as personality and emotional resilience), prior life experiences, socioeconomic conditions, and the quality of social support. Caregivers who felt emotionally supported and well-informed about the disease were better equipped to support changes in awareness in the person with dementia without increasing distress.
Understanding the cultural and interpersonal dimensions of illness awareness offers critical insights for the design of interventions that address absence of awareness with sensitivity and compassion. Recognizing how awareness is formed, preserved, or lost can inform more person-centered approaches to care.
Journal Article
The Role of Gender and Age in the Emotional Well-Being Outcomes of Young Adults
by
López-Madrigal, Claudia
,
Peralta-Sánchez, Francisco Javier
,
Martínez-Vicente, José Manuel
in
Adaptation
,
Adaptation, Psychological
,
Adolescent
2021
Young adults face different stressors in their transition to college. Negative emotions such as stress can emerge from the demands they face. This study aimed at gaining an improved understanding of the role that gender and age play in the well-being of young adults. Coping strategies, resilience, self-regulation, and positivity were selected as indicators of well-being. Descriptive and inferential analysis have been conducted. Results show that well-being varies significantly with age and gender. Gender was predominantly involved in the acquisition of the well-being outcomes, highly predicting problem-focused coping strategies. No interaction effects were found between gender and age. An improved understanding of the developmental factors involved in well-being outcomes will enlighten future interventions aimed at improving young people’s resources to face adversity.
Journal Article
Difficulties in Establishing “Truth” Conditions in the Assessment of Addictive Smartphone Use in Young Adults
by
López-Madrigal, Claudia
,
Sádaba-Chalezquer, Charo
,
Serrano, Cecilia
in
Adolescent
,
Analysis
,
Anxiety
2022
The smartphone revolution has placed powerful, multipurpose devices in the hands of youth across the globe, prompting worries about the potential negative consequences of these technologies on mental health. Many assessment tools have been created, seeking to classify individuals into problematic and non-problematic smartphone users. These are identified using a cutoff value: a threshold, within the scale range, at which higher scores are expected to be associated with negative outcomes. Lacking a clinical assessment of individuals, the establishment of this threshold is challenging. We illustrate this difficulty by calculating cutoff values for the Short Version of the Smartphone Addiction Scale (SAS-SV) in 13 Spanish-speaking samples in 11 countries, using common procedures (i.e., reliability, validity, ROC methodology). After showing that results can be very heterogeneous (i.e., they lead to diverse cutoff points and rates of addiction) depending on the decisions made by the researchers, we call for caution in the use of these classifications, particularly when researchers lack a clinical definition of true addiction—as is the case with most available scales in the field of behavioral addictions—which can cause an unnecessary public health alert.
Journal Article
Self-Esteem, Happiness, and Flourishing in Times of COVID-19: A Study During the Lockdown Period in Ecuador
by
Hidalgo-Andrade, Paula
,
Serrano, Cecilia
,
Hermosa-Bosano, Carlos
in
Adult
,
Communicable Disease Control
,
Coronaviruses
2022
Objective: Several studies have investigated the negative toll the pandemic has had on people’s mental health. However, there is limited research on the pandemic’s effect on positive mental health variables. This article reports on the levels of self-esteem and well-being (flourishing and happiness) in a sample of adults living in Ecuador and their relationships with the characteristics of their personal situation and the effects of the COVID-19 pandemic had on their personal lives. Methods: A total of 766 adults completed an anonymous online survey between March and August 2020. Results: Participants reported average scores in the flourishing scale, the majority considered themselves to be happy or very happy people, and more than half presented high levels of self-esteem. Age, education, socioeconomic status, time spent using mobile phones and on hobbies, among others, explained self-esteem, happiness, and flourishing. Conclusion: The relationships between sociodemographic and situational variables of confinement during the pandemic are discussed, as well as the possible predictors of happiness, flourishing, and self-esteem.
Journal Article
A Path Analysis Model of Self- vs. Educational-Context- Regulation as Combined Predictors of Well-Being in Spanish College Students
by
López-Madrigal, Claudia
,
de la Fuente Arias, Jesús
,
García-Manglano, Javier
in
Adaptation, Psychological
,
Behavior
,
Behavioral health care
2022
Previous literature has established the importance of personal and contextual factors in college students’ trajectories. Following the Self- vs. External-Regulation Behavior Theory (2021) and the 3P Biggs Model, the present study aimed at analyzing a structural linear model that validates the joint effect of self-regulation, educational context, age, and gender (as personal and contextual presage variables) with other meta-abilities, such as coping strategies, resilience, and positivity (process variables), and specific well-being outcomes, such as flourishing and health (product variables). A sample of 1310 Spanish college students was analyzed, aged 17 to 25, and a cross-sectional study with an ex post facto design was performed. Association and structural equation modeling (SEM) was performed using SPSS software (v.26) and AMOS (v.23). Results show that individual and contextual factors have an important role in the acquisition of psychological competencies in young adults. Self-regulation was proven to be an important meta-ability that predicts personal well-being and behavioral health outcomes. Complementarily, educational context was shown to be an external predictor of other skills, such as problem-focused strategies, and positive outcomes such as flourishing and behavioral health. Practical implications and limitations are discussed.
Journal Article
Psychological Factors, Leisure Activities, and Satisfaction during the COVID-19 Pandemic: A Cross-Sectional Study in Eleven Spanish-Speaking Countries
by
Fernández-Zapico, Aurelio
,
Hidalgo-Andrade, Paula
,
Serrano, Cecilia
in
Age differences
,
Analysis
,
Coronaviruses
2021
The COVID-19 pandemic has affected the lives of millions of people worldwide. This study aimed to analyze the effects of several psychological factors (self-esteem, self-control, and emotional stability) over lifestyle-related variables (time spent on leisure activities) and the levels of satisfaction (family, friends, work, and leisure satisfaction) experienced during the COVID-19 outbreak. Data for this article were retrieved as part of a cross-sectional international study conducted in eleven Spanish-speaking countries between March and September 2020. The analyses were conducted using the responses of 9500 persons (65.95% women, 34.05% men). Structural equation modeling was used to test the direct and indirect effects of the psychological variables on satisfaction variables mediated by the time engaged in leisure activities. Our model indicated that psychological factors significantly predicted the amount of time spent in leisure activities and satisfaction. Overall, results indicate that self-esteem is a relevant psychological factor to consider in the development of psychological interventions directed at promoting healthy lifestyles. Nevertheless, further research is needed to validate the direction of the associations found in this study.
Journal Article
Impact of genetic counseling and testing in individuals at high risk of familial Alzheimer's disease from Latin America: a non‐randomized controlled trial
by
Varela, Luz Estela
,
Picasso, Juan Pablo
,
Lopera, Francisco
in
Alzheimer's disease
,
autosomal dominant Alzheimer's disease
,
Clinical trials
2025
INTRODUCTION This study involved evaluating a tailored genetic counseling and testing (GCT) protocol for families at risk of autosomal dominant Alzheimer's disease (ADAD) in Latin America (LatAm), focusing on essential cultural and regional adaptations. METHODS We conducted a non‐randomized controlled trial among ADAD families in Colombia and Argentina. Participants were categorized based on their decision to learn their genetic status (GS), with further comparisons between mutation‐positive versus mutation‐negative participants who learned their status. Psychological impacts were measured using validated scales for anxiety and depression. RESULTS Of the 122 eligible participants, 97 completed the GCT protocol, and 87 opted to learn their GS. There were no clinically significant differences in psychological distress between those who learned their status and those who did not, nor between mutation‐positive and mutation‐negative individuals. DISCUSSION The GCT protocol effectively managed psychological impacts in ADAD families and was positively received, demonstrating the importance of culturally adapted GCT protocols. Highlights We examined the adaptation and efficacy of a GCT protocol in LatAm for families at risk of ADAD. The GCT protocol mitigated psychological distress among at‐risk ADAD families. The study confirms the protocol's cultural appropriateness and psychological safety. Future studies should explore the long‐term psychological and public health impacts of GCT and use of GCT for treatment options.
Journal Article
Impact of genetic counseling and testing in individuals at high risk for Alzheimer ´s Disease from Latin America
by
Picasso, Juan Pablo
,
Lopera, Francisco
,
Aguilar, Laura Ramirez
in
Alzheimer's disease
,
Anxiety
,
Clinical assessment
2025
Background This study evaluates a tailored genetic counseling and testing (GTC) protocol for families at risk of Autosomal Dominant Alzheimer ´s Disease (ADAD) in Latin America, focusing on the essential cultural and regional adaptations. Several factors may influence the decision of whether family members decide to learn genetic status. Although the main drivers influencing the decisions to seek genetic testing have been widely studied in High‐Income Counties (HIC), these questions remain relatively unknown in Low and Middle‐Income countries (LMICs) such as those in Latin America (LatAm). Method The primary aim of this study was to investigate the psychosocial impact of genetic testing in asymptomatic individuals from families with ADAD. We conducted a non randomized, controlled trial among ADAD families in Colombia and Argentina. The primary outcome included change from baseline in depression and general anxiety in the test group relative to the control group. Participants were categorized based on their decision to learn their genetic status, with further comparisons between mutation‐positive versus mutation‐negative individuals within those informed. Psychological impacts were measuring using validated scales for depression and anxiety in the group relative to the control group. Result Of the 122 eligible participants, 97 completed the GTC protocol; 87 opted to learn their genetic status. There were no clinically significant differences in psychological distress between those who learned their status and those who did not, nor between mutation‐positive and mutation‐negative individuals. Mutation‐positive carriers who learned their genetic status experienced a statistically significant increase in depression scores but remained below the cut‐off point considered indicative of clinically significant depression. Conclusion Our primary finding is showed no clinically meaningful differences in distress‐related outcomes between individuals learning their genetic status relative to those who didn’t. Our findings confirm that genetic testing is well‐tolerated when using a protocol that provides screening, education, counseling, and follow‐up sessions. In addition, we provide preliminary insights into the psychological impact associated with learning one's genetic status in familial AD, contributing significantly to the field of medical genetics in the region.
Journal Article
Clinical Manifestations
by
Mora-Henao, Beatriz E
,
Restrepo-Fernández, Carlos M
,
Lopera, Francisco
in
Adult
,
Aged
,
Alzheimer Disease - diagnosis
2025
This study evaluates a tailored genetic counseling and testing (GTC) protocol for families at risk of Autosomal Dominant Alzheimer ´s Disease (ADAD) in Latin America, focusing on the essential cultural and regional adaptations. Several factors may influence the decision of whether family members decide to learn genetic status. Although the main drivers influencing the decisions to seek genetic testing have been widely studied in High-Income Counties (HIC), these questions remain relatively unknown in Low and Middle-Income countries (LMICs) such as those in Latin America (LatAm).
The primary aim of this study was to investigate the psychosocial impact of genetic testing in asymptomatic individuals from families with ADAD. We conducted a non randomized, controlled trial among ADAD families in Colombia and Argentina. The primary outcome included change from baseline in depression and general anxiety in the test group relative to the control group. Participants were categorized based on their decision to learn their genetic status, with further comparisons between mutation-positive versus mutation-negative individuals within those informed. Psychological impacts were measuring using validated scales for depression and anxiety in the group relative to the control group.
Of the 122 eligible participants, 97 completed the GTC protocol; 87 opted to learn their genetic status. There were no clinically significant differences in psychological distress between those who learned their status and those who did not, nor between mutation-positive and mutation-negative individuals. Mutation-positive carriers who learned their genetic status experienced a statistically significant increase in depression scores but remained below the cut-off point considered indicative of clinically significant depression.
Our primary finding is showed no clinically meaningful differences in distress-related outcomes between individuals learning their genetic status relative to those who didn't. Our findings confirm that genetic testing is well-tolerated when using a protocol that provides screening, education, counseling, and follow-up sessions. In addition, we provide preliminary insights into the psychological impact associated with learning one's genetic status in familial AD, contributing significantly to the field of medical genetics in the region.
Journal Article
Sarcoma treatment in the era of molecular medicine
by
Grünewald, Thomas GP
,
Krumbholz, Manuela
,
Seeling, Carolin
in
Adolescent
,
Bone cancer
,
Bone Neoplasms
2020
Sarcomas are heterogeneous and clinically challenging soft tissue and bone cancers. Although constituting only 1% of all human malignancies, sarcomas represent the second most common type of solid tumors in children and adolescents and comprise an important group of secondary malignancies. More than 100 histological subtypes have been characterized to date, and many more are being discovered due to molecular profiling. Owing to their mostly aggressive biological behavior, relative rarity, and occurrence at virtually every anatomical site, many sarcoma subtypes are in particular difficult‐to‐treat categories. Current multimodal treatment concepts combine surgery, polychemotherapy (with/without local hyperthermia), irradiation, immunotherapy, and/or targeted therapeutics. Recent scientific advancements have enabled a more precise molecular characterization of sarcoma subtypes and revealed novel therapeutic targets and prognostic/predictive biomarkers. This review aims at providing a comprehensive overview of the latest advances in the molecular biology of sarcomas and their effects on clinical oncology; it is meant for a broad readership ranging from novices to experts in the field of sarcoma.
Graphical Abstract
Sarcomas are heterogeneous and clinically challenging soft tissue and bone cancers. The current article comprehensively reviews recent advances in the molecular characterization of sarcoma subtypes, and describes novel therapeutic targets and biomarkers in this field.
Journal Article