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Tesis Doctoral UNIVERSIDAD COMPLUTENSE DE MADRID FACULTAD DE PSICOLOGÍA TESIS DOCTORAL Tarea stroop como medida del impacto emocional en pacientes con cáncer de mama y familiares MEMORIA PARA OPTAR AL GRADO DE DOCTOR PRESENTADA POR Jesús Balandín Sánchez Directora María Isabel Casado Morales Madrid, 2014 © Jesús Balandín Sánchez, 2014 Universidad Complutense de Madrid Facultad de Psicología Tesis Doctoral “Tarea Stroop como medida del Impacto emocional en pacientes con cáncer de mama y familiares” Autor: D. Jesús Balandín Sánchez Director: Dra. Mª Isabel Casado Morales Madrid 2013 Tarea Stroop como medida del impac to emocional en pacientes con cáncer de mama y familiares Jesús Balandín Sánchez Universidad Complutense de Madrid Facultad de Psicología PROGRAMA COGNICIÓN EMOCIÓN Y ESTRÉS PSICOLOGÍA BÁSICA II Tesis Doctoral “Tarea Stroop como medida del Impacto emocional en pacientes con cáncer de mama y familiares” Autor: D. Jesús Balandín Sánchez Director: Dra. Mª Isabel Casado Morales Madrid 2013 2 Tarea Stroop como medida del impac to emocional en pacientes con cáncer de mama y familiares Jesús Balandín Sánchez Agradecimientos Deseo comenzar con mi más sincero agradecimiento a todos y cada uno de los sujetos experimentales, los pacientes y sus familiares, pues su padecimiento es a la vez, causa y consecuencia de esta investigación. Así mismo agradezco al bloque de profesores que se han cruzado en mi camino, por sus excelentes consejos para el propósito de la investigación. Particularmente, agradezco a la Dña. Laura Martín Javato y al Dr. Rubén Sanz Blasco su contribución estadística, a Doña Isabel Ponce su labor de corrección y edición esta tesis, y al Dr. Víctor V. Fernández ser amigo y germen de la realización de un doctorado. Mención especial por la contribución informática, a D. Miguel Ángel Sánchez Fariña por su profesionalidad, tesón y minuciosidad para el bien de este proyecto, y a Don Julio Manuel Diago García, principal artífice de la programación de la prueba. Ambos han hecho posible que la prueba sea computarizada, objetiva y ejemplo de efectividad y eficiencia. Gracias, como no, a la Dra. Mª Isabel Casado Morales, por ejercer de directora, entrenadora y motivadora; cuya disponibilidad total junto a su exquisito trato han puesto de manifiesto su distinguida profesionalidad y elevada calidad humana. Gracias a mis padres que tanto padecieron mi adolescencia de mal estudiante y que por la desgracia del cáncer no podrán ver éste y otros logros que tanta ilusión les hacían. Gracias por dármelo todo por nada. 3 Tarea Stroop como medida del impac to emocional en pacientes con cáncer de mama y familiares Jesús Balandín Sánchez Por último, mi agradecimiento y amor eterno a mi esposa Carmen y a mi hija Paula, principales damnificadas del proceso de investigación, por su afecto inagotable, por su apoyo incondicional, por ser dos seres únicos e irrepetibles, luz de mi vida y anhelo de mi ser, compañeras de mi vida: jamás podré corresponder a todo lo que me habéis dado. 4 Tarea Stroop como medida del impac to emocional en pacientes con cáncer de mama y familiares Jesús Balandín Sánchez “Existe la raza de aquellos que no llegan a las palabras mas que movidos por sus emociones, y la raza de los que no llegan a las emociones mas que movidos por las palabras.” Victoria Ocampo 5 Tarea Stroop como medida del impacto emocional en pacientes con cáncer de mama y familiares Jesús Balandín Sánchez Índice Pg. Resumen ..................................................................................................................10 Abstract ....................................................................................................................15 Parte Teórica Capítulo 1. Aspectos generales en cáncer ............................................................20 1.1 Definición. Crecimiento y progresión tumoral ...................................................21 1.2 Etiología ...........................................................................................................24 1.3 Epidemiología ..................................................................................................27 1.2.1 Incidencia en cáncer ..................................................................................27 1.2.2 Mortalidad en Cáncer. ...............................................................................29 1.2.3 Incidencia en cáncer de mama. .................................................................32 1.2.4 Mortalidad en cáncer de mama. ................................................................34 Capítulo 2. El cáncer de mama ..............................................................................36 2.1 Clasificaciones .................................................................................................37 2.2 Factores de riesgo ...........................................................................................40 2.3 Los primeros síntomas .....................................................................................44 2.4 Técnicas diagnósticas ......................................................................................46 2.5 Tratamientos ....................................................................................................48 2.5.1 Cirugía .......................................................................................................49 2.5.2. Radioterapia .............................................................................................51 2.5.3 Quimioterapia ...........................................................................................52 2.5.4. Terapia hormonal .....................................................................................55 2.5.5 Terapia biológica. .....................................................................................56 2.6 Avances ...........................................................................................................57 6 Tarea Stroop como medida del impacto emocional en pacientes con cáncer de mama y familiares Jesús Balandín Sánchez Capítulo 3. La psicooncología ...............................................................................62 3.1 Psicopatología en el paciente oncológico ........................................................67 3.1.1 Ansiedad y cáncer .....................................................................................69 3.1.2 Depresión y cáncer ....................................................................................80 3.1.3 Delirium y cáncer .......................................................................................85 3.1.4 Trastorno adaptativo mixto y cáncer ..........................................................87 3.2 Tratamiento psicológico en oncología ..............................................................90 3.2.1 Tratamiento psicológico y ansiedad .........................................................92 3.6.2 Tratamiento psicológico y depresión ........................................................93 3.6.3 Tratamiento psicológico y delirium ...........................................................95 3.6.4 Tratamiento psicológico y trastorno adaptativo mixto ................................96 3.3 Psicooncología y cáncer de mama ..................................................................97 3.4 Calidad de vida en cáncer de mama ..............................................................102 Capítulo 4. Impacto psicológico del cáncer en la unidad familiar ....................108 4.1 La estructura familiar ......................................................................................109 4.2 La dinámica familiar .......................................................................................111 4.3 El papel de los familiares ...............................................................................112 4.4 Aspectos comunicativos .................................................................................113 Capítulo 5. La Tarea Stroop y su vertiente emocional .......................................116 5.1 La tarea Stroop ..............................................................................................117 5.2 Aplicaciones ...................................................................................................118 5.3 La variante Stroop emocional ........................................................................119 5.4 La tarea Stroop en Psicología ........................................................................120 5.5 La tarea Stroop en cáncer .............................................................................121 7 Tarea Stroop como medida del impacto emocional en pacientes con cáncer de mama y familiares Jesús Balandín Sánchez Parte Empírica Capítulo 6. Elaboración de una Tarea Stroop .....................................................124 6.1 Análisis preliminar de palabras .....................................................................125 6.1.1 Lista preliminar de palabras. ...................................................................125 6.1.2 Evaluación de palabras a través de la prueba pictográfica S.A.M ...........127 6.1.3 Agrupación de las palabras según los criterios de valoración .................135 6.1.4 Selección de palabras para la tarea Stroop .............................................140 6.2 Programa “Stroop of Breast Cancer” (S-Breac) .............................................142 Capítulo 7. Impacto emocional en pacientes con cáncer de mama y familiares ..145 7.1 Objetivos ........................................................................................................146
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