The assessment of transdiagnostic dimensions of emotional disorders: Validation of the Multidimensional Emotional Disorders Inventory (MEDI) in adolescents with subthreshold anxiety and depression.

BACKGROUND: The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. METHOD: The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. RESULTS: The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LIMITATIONS: Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. CONCLUSION: The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.

Youth screening depression: Validation of the Patient Health Questionnaire-9 (PHQ-9) in a representative sample of adolescents.

BACKGROUND: Depression symptoms and mood disorders constitute one of the major public health challenges among youths. Thus, early prevention and intervention for depression should be a priority. The main goal of the present study was to validate the Patient Health Questionnaire-9 (PHQ-9) scores in a school-based sample of non-clinical adolescents. METHOD: Stratified random sampling was conducted. Participants were 2235 students (M = 14.49, SD =1.76, range= 12-18 years), 52.9 % were female, from 34 secondary schools in Spain. Several previously validated self-reported questionnaires of mental health and psychopathology were administrated. RESULTS: The unidimensional factorial model of the PHQ-9 items showed adequate goodness of fit indices. Strong measurement invariance across gender was found. Omega for the PHQ-9 total score was 0.87. The PHQ-9 total score was positively associated with anxiety symptoms and emotional and behavioral problems, and negatively associated with prosocial behavior and quality of life. CONCLUSIONS: The PHQ-9 is a brief, easy, and reliable tool for assessing self-reported depressive symptoms in both clinical and school settings. PHQ-9 may be used as a screening tool for universal early detection and monitorization of depression symptoms during adolescence.

Problematic Internet Use in adolescents: New psychometric evidence for the Spanish short form of the Compulsive Internet Use Scale.

OBJECTIVES: Problematic Internet Use (PIU) has become a worldwide problem in recent years. Among screening instruments for PIU, the Compulsive Internet Use Scale (CIUS) is perhaps the most widely used. Psychometric properties of the full CIUS are not convincing, however, and the short form (CIUS-S) has shown promising results, albeit limited to the English version, with little evidence in Spanish. Therefore, the aim of the present work was to study the psychometric properties of the CIUS-S scores in a large sample of Spanish adolescents. METHOD: The sample consisted of 1790 participants, 816 male (45.6%), 961 female (53.7%), and 13 other (0.7%) . Mean age was 15.70 years (SD = 1.26). RESULTS: The five-items one-dimensional model displayed appropriate goodness-of-fit indices. Strong measurement invariance model across age and partial across gender was found. Furthermore, the CIUS-S was positively associated with several indicators of poor well-being and mental health, and negatively associated with prosocial behavior, self-esteem, and feeling of belonging. CONCLUSION: Overall, the CIUS-S scores appear reliable and valid in its Spanish version for adolescent populations, supporting its aim to detect and prevent a problem that has become a major worldwide issue in the last years.

Parental Support and Gender Moderate the Relationship Between Sexual Orientation and Suicidal Behavior in Adolescents.

BACKGROUND: The scientific literature indicates that people from sexual minorities may be at increased risk for mental health difficulties. Moreover, parental support could play a protective role against poor mental health. The objective of this study was to examine whether a person's sexual orientation was related to a greater risk of mental health problems in a representative sample of adolescents. In addition, the study analyzed the possible moderating effect of parental support in the relationship between sexual orientation and mental health, as also moderated by participant gender. METHOD: The sample consisted of 1790 secondary-school students. Indicators of emotional and behavioral difficulties, symptoms of depression, psychotic-like experiences, suicidal behavior, well-being, and self-esteem were assessed. RESULTS: The results indicated significant main effects of gender and sexual orientation. Having a diverse sexual orientation (i.e., lesbian/gay, bisexual and questioning) was related to increased risk of mental health difficulties. Moreover, the results showed a significant interaction effect of gender and sexual orientation on suicidal behavior. Finally, the results showed the moderating effect of parental support and gender in the relationship between sexual orientation and suicidal behavior. CONCLUSIONS: These findings highlight the importance of promoting sexual minority youths' mental health and well-being.

Impact of lockdown on the addictive behavior of university students in La Rioja. / Impacto del confinamiento en la conducta adictiva de los universitarios riojanos.

One of the consequences of the COVID-19 health crisis was the general lockdown. Research shows that lockdown situations may cause changes in addictive behaviors. The objective of the present study was to analyze the impact of lockdown on the addiction pattern of university students in order to design interventions adjusted to the students' needs. The study was conducted through a non-probabilistic sample of 540 students, with a mean age of 22.3 years and a proportion of women of 69.3%. The results indicated a significant decrease in the consumption of tobacco, alcohol, and psychotropic drugs during the participants' lockdown, both in the number of users and in the amounts consumed. Regarding behaviors related to behavioral addictions, participants showed a significant increase in problematic Internet use and use of video games and eSports, although the level of gambling decreased. Despite the fact that consumption patterns were reduced due to changes in the leisure and free time patterns of this population subgroup, it was possible to identify some indicators that deserve attention due to their increase, such as relapses in smoking, an increase in the number of participants who drank alcohol on a daily basis and an increase in the level of discomfort related to the use of technology. The implications of the results are analyzed and possible actions demanded by the students are examined.

Una de las implicaciones de la crisis sanitaria de la COVID-19 ha sido el confinamiento de la población. La investigación previa muestra que las situaciones de confinamiento provocan cambios en las conductas adictivas. El objetivo del presente estudio fue conocer el impacto del confinamiento en el patrón de las adicciones de los y las estudiantes universitarios con la intención de diseñar intervenciones ajustadas a las necesidades de esta población. La muestra no probabilística estuvo compuesta por 540 estudiantes de la Universidad de La Rioja, con una media de edad de 22,3 años y una proporción de mujeres del 69,3%. Los resultados indicaron un descenso significativo en el consumo de tabaco, alcohol y psicofármacos durante el confinamiento de los y las participantes tanto en el número de consumidores como en las cantidades consumidas. Respecto a las conductas relacionadas con las adicciones comportamentales, los y las participantes indicaron un aumento significativo del uso problemático de Internet y de videojuegos y eSports, aunque descendió el nivel de juego de apuestas. A pesar de que los patrones de consumo se vieron reducidos por el impacto que el confinamiento tuvo en los patrones de ocio y tiempo libre de este subgrupo poblacional, se identificaron algunos indicadores merecedores de atención por su aumento, como recaídas en el consumo de tabaco, aumento del número de participantes que consumen alcohol a diario y aumento en el nivel de malestar relacionado con el uso de Internet. Se analizan las implicaciones de los resultados y se examinan posibles acciones demandadas por el estudiantado.

Assessing Cyberbullying in Adolescence: New Evidence for the Spanish Version of the European Cyberbullying Intervention Project Questionnaire (ECIP-Q).

The prevention of cyberbullying at school requires assessing its prevalence by means of brief measurement instruments with adequate psychometric properties. The present study aims to study the psychometric properties of the European Cyberbullying Intervention Project Questionnaire (ECIP-Q) in a sample of 1777 Spanish adolescents (54.1% women, M = 15.71 years; SD = 1.26), selected by stratified random cluster sampling. The two-factor model (victimization and aggression) displayed appropriate goodness of-fit indices. Configural measurement invariance model across gender was found. The omega reliability coefficient for the victimization subscale was 0.82, and for the aggression subscale was 0.68. The ECIP-Q scores were negatively associated with self-esteem and prosocial behavior, and positively associated with depression symptoms and emotional and behavioral difficulties. Significant differences were found between victim and non-victim groups, and between aggressor and non-aggressor groups on the same variables. Victims and aggressors scored lower on self-esteem, and higher on depression symptoms and emotional and behavioral difficulties than those not involved in cyberbullying situations. These findings contribute to demonstrate the satisfactory psychometric quality of the ECIP-Q scores as an assessment tool for cyberbullying in Spanish adolescents.

The Healthy Context Paradox: When Reducing Bullying comes at a Cost to Certain Victims.

Bullying remains one of the most serious problems affecting school systems around the world. The negative consequences of bullying in the short and long term have been widely documented, showing that victimized students are at greater risk of suffering psychosocial distress. In this paper, we first summarize the current situation of bullying prevention, adopting a contextual perspective, and briefly highlighting the characteristics of the most effective prevention programs. Secondly, we address a disturbing phenomenon detected in classrooms where bullying has been reduced through interventions and which has been termed "the healthy context paradox". In these healthier contexts, students who remain in a situation of victimization have been found to present poorer psychological adjustment after the intervention. Understanding the causes of this phenomenon may offer clues for the prevention of bullying. In this regard, we present three hypotheses recently proposed to explain the phenomenon. Finally, we offer some implications for the study and prevention of bullying derived from "the healthy context paradox".

Development and Validation of a Brief Version of the European Bullying and Cyberbullying Intervention Project Questionnaires (EBIP-Q and ECIP-Q).

BACKGROUND: In order to prevent school bullying and cyberbullying, brief measurement instruments with adequate psychometric properties are required. The objective of this study was to develop a combined reduced version of the European Bullying Intervention Project Questionnaire (EBIP-Q) and the European Cyberbullying Intervention Project Questionnaire (ECIP-Q) for its use in the screening of bullying-related behaviors at school. METHOD: The sample consisted of 1777 students, between 14 and 18 years of age (M = 15.71; SD = 1.26), of which 54.1% were female. RESULTS: The resulting reduced version presents adequate psychometric properties with reliability coefficients between ω = .72 and ω = .82. Factor analyses indicate that both bullying and cyberbullying are structured around two factors: victimization and aggression. The correlations between the scores of the original version and the reduced version were adequate. Bullying and cyberbullying was associated with different indicators of socioemotional adjustment. CONCLUSIONS: The European Bullying and Cyberbullying Intervention Project Questionnaire Brief version (EBCIP-QB) seems to be brief, useful, and have adequate psychometric properties for the assessment of bullying and cyberbullying in Spanish adolescents.

Spanish normative data of the Strengths and Difficulties Questionnaire in a community-based sample of adolescents: Datos normativos españoles del Cuestionario de capacidades y dificultades (SDQ) en una muestra comunitaria de adolescentes.

Background/Objective: The Strengths and Difficulties Questionnaire self-report (SDQ-S) has been extensively used to assess mental health problems among children and adolescents. However, previous research has identified substantial age and country variation on its psychometric properties. The aim of this study was three-fold: i) to evaluate internal structure and measurement invariance of the Spanish version of the SDQ; ii) to analyze age and gender-specific effects on the SDQ subscales; and iii) to provide Spanish normative data for the entire age range of adolescence. Method: Data were derived from two representative samples of adolescents aged 14 to 19 years old, selected by stratified random cluster sampling years (N = 3378). Results: The reliability of the Total difficulties score was satisfactory, but some subscales showed lower levels of internal consistency. Confirmatory factor analysis supported the original five-factor model. Finally, results revealed that SDQ scores were influenced by the gender and the age of participants; thus, the normative banding scores and cut-off values were provided accordingly. Conclusions: This study validates the Spanish SDQ-S for the entire age range of adolescence. However, more cross-country and cross-age research is needed to better understand the inconsistent findings on SDQ reliability.

Neurocognitive Functioning in Adolescents at Risk for Mental Health Problems.

BACKGROUND: The main goal of the study was to assess the neurocognitive performance in adolescents at high psychometric risk for mental health problems. METHOD: A sample of 48 participants at high risk for mental disorders and an age-gender matched healthy comparison group of 48 adolescents were identified from a community-derived sample of 1,509 adolescents. The Strengths and Difficulties Questionnaire problems and the University of Pennsylvania Computerized Neuropsychological Test Battery for children (included 14 tasks assessing five neurobehavioral domains: executive functions, episodic memory, complex cognition, social cognition, and sensorimotor speed) were used. RESULTS: Relative to healthy comparison participants, individuals at high risk showed significant impairments across almost all neurocognitive domains (executive functions, episodic memory, complex cognition, social cognition, and sensorimotor speed). CONCLUSIONS: These findings demonstrate that neurocognitive impairments can be shown in adolescents at high psychometric risk for mental health problems before the onset of more severe psychological problems.

Study of Positive and Negative Affect and Neurocognitive Functioning in Adolescents.

The main purpose of the present work was to study neurocognitive performance of adolescents at risk for emotional difficulties. The sample included a total of 1,509 adolescents from stratified random cluster sampling. Derived from this sample, a group of high-risk (n = 92) and a comparison group (n = 92) were selected based on the short version of the Positive and Negative Affect Schedule (PANAS) for comparison on the University of Pennsylvania computerized neuropsychological test battery for children (PENN). A Multivariate analysis of covariance (MANCOVA) was performed taking the scores on the PENN as dependent variables and the two groups derived from the scores of the PANAS (at risk vs. comparison) as a fixed factor. Adolescents at high risk of presenting affectivity problems showed statistically significant differences in several different neurocognitive domains, in accuracy, λ = .820, F(9, 160,000) = 3.913, p < .01, partial η² = .180; speed, λ = .502, F(5, 88,000)= 17.493, p < .01, partial η² = .498; and efficiency, λ = .485, F(4, 89,000) = 23.599, p <.01, partial η² = .515. The high risk group showed lower neurocognitive performance than the comparison group. In addition, a positive statistically significant correlation was found between all the neurocognitive competences (p < .05). Results found in this study reveal that neurocognitive impairments can be shown in adolescents at psychometric high risk for emotional problems before transition to more severe psychological problems.

Risk and Protective Factors in Adolescent Suicidal Behaviour: A Network Analysis.

Given that death by suicide continues to rank among the top three causes of death during adolescence, new psychological models may contribute critical insight towards understanding the complex interactions between risk and protective factors in suicidal behaviour. The main objective of this study was to analyse the psychological network structure of suicidal behaviour and putative risk and protective factors in school-aged adolescents. METHODS: Stratified random cluster sampling was performed. The final sample comprised 1790 students (53.7% female, M = 15.7 years, SD = 1.26). Instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, prosocial behaviour, subjective well-being, self-esteem, depressive symptomatology, academic performance, socio-economic status, school engagement, bullying, and cyberbullying. RESULTS: In the estimated psychological network, the node with the highest strength was depressive symptomatology, and that with the highest expected influence value was bullying. Suicidal behaviour was positively connected to symptoms of depression and behavioural problems. In addition, suicidal behaviour was negatively connected to self-esteem and personal well-being. The results of the stability analysis indicated that the network was accurately estimated. CONCLUSIONS: Suicidal behaviour can be conceptualised as a dynamic, complex system of cognitive, emotional, and affective characteristics. New psychological models allow us to analyse and understand human behaviour from a new perspective, suggesting new forms of conceptualisation, evaluation, intervention, and prevention.

Bullying, Cyberbullying and Mental Health: The Role of Student Connectedness as a School Protective Factor.

Traditional bullying and cyberbullying are linked to adverse mental health outcomes. Student connectedness has been recently identified as a potential protective factor in these relationships. Nonetheless, the multilevel nature of these interactions has been frequently overlooked. The present study pretends to fill this gap by exploring the associations between individual levels of bullying and cyberbullying and three adjustment outcomes (i.e., suicidal behavior, symptoms of depression, and self-esteem), as well as the moderating role of the school level of student connectedness on these relationships. The participants in this work were 1,774 students aged 14-18 years (M = 15.70, SD = 1.26), of which 53.7% were female, from 31 secondary schools in Spain. We used previously validated self-reported questionnaires in this study. Traditional victimization and cybervictimization, as well as cyberbullying, were positively related to suicidal behavior and depression, and were negatively related to self-esteem. Conversely, individual levels of student connectedness were associated with lower levels of suicidal behavior and depression, and with higher levels of self-esteem. Moreover, school levels of student connectedness buffered the adjustment problems experienced by victims of cyberbullying. These findings highlight the importance of student connectedness as a possible target for school-based cyberbullying prevention.

El acoso escolar y el ciberbullying están asociados a efectos adversos para la salud mental. La cohesión entre estudiantes se ha identificado recientemente como un potencial factor protector respecto a este tipo de relaciones. No obstante, con frecuencia se ha pasado por alto la naturaleza multinivel de estas interacciones. El presente estudio pretende llenar este vacío explorando la asociación entre el nivel individual de acoso y ciberbullying y tres indicadores de ajuste (i.e., conducta suicida, síntomas de depresión y autoestima), así como el papel moderador del nivel escolar de cohesión estudiantil en estas relaciones. Los participantes fueron 1,744 estudiantes de 14-18 años (M = 15.70, DT = 1.26), de los cuales el 53.7% eran mujeres, de 31 centros de educación secundaria de España. En el estudio se utilizaron autoinformes previamente validados. La victimización tradicional y la cibervictimización, así como el ciberbullying, se relacionaron positivamente con la conducta suicida y la depresión y negativamente con la autoestima. Por el contrario, los niveles individuales de cohesión entre estudiantes se asociaron con niveles más bajos de conducta suicida y depresión y con niveles más elevados de autoestima. Además, los niveles escolares de cohesión entre estudiantes amortiguaron los problemas de adaptación experimentados por las víctimas de ciberbullying. Estos hallazgos destacan la importancia de la cohesión entre estudiantes como un posible objetivo de cara a la prevención del ciberbullying.

Mental Health Difficulties Related to Suicidal Behavior in Adolescents: The Moderating Role of Self-Esteem.

OBJECTIVE: The objective was to analyze the moderating effect of self-esteem on the relationship between mental health difficulties and suicidal behavior in adolescence. METHOD: The sample was composed of 1,790 Spanish adolescents (M = 15.70 years; SD = 1.26; 53.7% girls) through a stratified random sampling by cluster at classroom level. The participants completed questionnaires about emotional symptoms, behavioral problems, peer relationship difficulties, hyperactivity, suicidal behavior, and self-esteem. RESULTS: The results evidenced gender differences, showing that girls tend to have more emotional symptoms (t = -15.27; p ≤ .001; d = -0.71), more difficulties in peer relationship (t=-2.49; p = .013; d = -0.12) and less self-esteem (t = 12.15; p ≤ .001; d = 0.57), as well as more suicidal behaviors (t = -5.36; p ≤ .001; d = -0.25) than boys. It is also noted that emotional and behavioral difficulties influence suicidal behavior (R2 = 0.35; ΔF = 197.42; p ≤ .001). In addition, self-esteem appeared to act as a protective factor, buffering the relationship between emotional and behavioral problems and suicidal behavior (R2 = 0.39; F = 376.92; p ≤ .001). CONCLUSIONS: Adolescents who present mental health difficulties might commit suicidal behavior if they have an unfavorable attitude toward themselves. However, the risk of committing suicidal behavior decreases if their attitude toward themselves is favorable. Thus, the development of self-esteem may be included in intervention programs for the prevention of suicidal behavior.HIGHLIGHTSGirls present more suicidal behaviors and less self-esteem than boys.Mental health difficulties influence the appearance of suicidal behavior.Self-esteem moderates the relationship between emotional problems and suicidal behavior.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

Adolescents' Bipolar Experiences and Suicide Risk: Well-being and Mental Health Difficulties as Mediators.

Bipolar disorder is usually accompanied by a high suicide risk. The main aim was to identify the risk and protective factors involved in suicide risk in adolescents with bipolar experiences. Of a total of 1506 adolescents, 467 (31%) were included in the group reporting bipolar experiences or symptoms, 214 males (45.8%) and 253 (54.2%) females. The mean age was 16.22 (SD = 1.36), with the age range between 14 and 19. Suicide risk, behavioral and emotional difficulties, prosocial capacities, well-being, and bipolar experiences were assessed through self-report. Mediation analyses, taking gender as a moderator and controlling age as a covariate, were applied to estimate suicide risk. The results indicated that the effect of bipolar experiences on suicide risk is mediated by behavioral and emotional difficulties rather than by prosocial behavior and subjective well-being. Specifically, emotional problems, problems with peers, behavior problems, and difficulties associated with hyperactivity were the most important variables. This relationship was not modulated by gender. However, the indirect effects of some mediators varied according to gender. These results support the development of suicide risk prevention strategies focused on reducing emotional difficulties, behavioral problems, and difficulties in relationships with others.

Suicidal behavior assessment in adolescents: Validation of the SENTIA-Brief scale.

Suicide is a social-health problem in the youth population worldwide; however, there are no measuring instruments specifically designed for use in Spanish adolescents. The main goal of this work was to analyze the psychometric properties of a new measuring instrument, called SENTIA-Brief, for suicidal behavior assessment in Spanish adolescents.

Gambling in Spanish Adolescents: Prevalence and Association with Mental Health Indicators.

Concern about the development of behavioral addictions in adolescence, including gambling, has increased in recent years. Evidence shows that problem gambling can lead to personal, social, or health problems. However, even though gambling is an illegal activity, studies on this problem are quite limited in Spain. The main objective of this study was to analyze the prevalence of gambling in adolescents in Spain. Moreover, gambling behaviors were examined according to gender and age, and their possible relationship with several mental health indicators was analyzed. The results showed that 20.6% of the adolescents who participated in the study had gambled money in the past year. The highest gambling prevalence was found in boys and in adolescents from the age of 16 years old. Moreover, the results showed that gambling behavior was related to different mental health indicators.

Universal Patterns in Color-Emotion Associations Are Further Shaped by Linguistic and Geographic Proximity.

Many of us "see red," "feel blue," or "turn green with envy." Are such color-emotion associations fundamental to our shared cognitive architecture, or are they cultural creations learned through our languages and traditions? To answer these questions, we tested emotional associations of colors in 4,598 participants from 30 nations speaking 22 native languages. Participants associated 20 emotion concepts with 12 color terms. Pattern-similarity analyses revealed universal color-emotion associations (average similarity coefficient r = .88). However, local differences were also apparent. A machine-learning algorithm revealed that nation predicted color-emotion associations above and beyond those observed universally. Similarity was greater when nations were linguistically or geographically close. This study highlights robust universal color-emotion associations, further modulated by linguistic and geographic factors. These results pose further theoretical and empirical questions about the affective properties of color and may inform practice in applied domains, such as well-being and design.