Implementation of the Recovery Model and Its Outcomes in Patients with Severe Mental Disorder.

BACKGROUND: The recovery model assumes that the patient can experience personal growth even while maintaining symptoms of a mental disorder. In order to achieve this recovery, the practices of professionals must also change. However, in our setting, there are limited data on the implementation of practices based on the recovery model and their effect on personal recovery. OBJECTIVE: To describe the association between professionals' practices and patients' personal recovery. METHODS: An observational and cross-sectional study in which the Recovery Self-Assessment (RSA) was used to assess the degree of implementation of the different practices and the Recovery Assessment Scale (RAS) was used to assess the personal recovery of 307 patients with severe mental disorders. RESULTS: Patients attended by professionals who followed the recovery model obtained a greater personal recovery (p < 0.001, d = 1.10). The dimension associated with greater recovery was that of working toward life goals. The least implemented dimensions had to do with offering treatment options and patient participation in decision-making. This study was conducted in accordance with STROBE (STrengthening the Reporting of OBservational studies in Epidemiology). CONCLUSIONS: Although this is a cross-sectional study that does not allow us to establish causal relationships, it shows that the model with which mental health professionals work is associated with patients' chances of recovery. We therefore consider that it is important to foster the implementation of practices based on the recovery model within mental health care.

A longitudinal comparative study of a multicouple group and single-couple psychosocial intervention while experiencing infertility.

This is a quasi-experimental, nonequivalent design study investigating the efficacy of multicouple group and single-couple intervention formats aimed at diminishing the psychosocial impact of infertility. The review studies carried out to date that have assessed this subject do not show consistent findings and although increasing the efficacy and efficiency of intervention formats more than justifies their analysis, there are no studies making this particular comparison. Eighty-seven infertile couples who were in assessment for their infertility and/or were close to undergoing some kind of assisted reproductive technology process participated in a psychosocial intervention either under the multicouple group or single-couple subconditions, or acted as controls. The variables of depression, anxiety, and fertility quality of life were used for evaluating psychosocial impact. Comparisons were made: (a) between the intervention condition and controls and (b) between the two subconditions. The results support the efficacy of the intervention both in the dyadic latent growth curve models analysis carried out and in the treatment effect calculation. Although in the comparison between the multicouple and single-couple format, some differences generally favoring the single format one were found, they were not conclusive. Therefore, the results are in line with review studies that did not find the group format to be more effective. Although this study provides valuable information, its limitations mean that further research needs to be carried out. When selecting the intervention format, therapists should also weigh up others aspects, such as the intervention goal, patient's needs and characteristics, reproductive history, and current stage of infertility.

Study on the Interdependent Relationship between the Marital Satisfaction Variable and the Psychosocial Impact of Infertility and Anxiety Disposition, According to Gender.

This study assessed the relationship between the marital satisfaction variable and the psychosocial impact of infertility and anxiety disposition, testing for possible gender-based differences. Comparisons performed on 87 couples did reveal differences and analyses disclosed that depression, anxiety and quality of life can influence the assessment each partner makes of their relationship, through an interdependent process. One partner's marital satisfaction can be influenced by those variables in the other partner. These findings indicate that psychosocial care for infertile couples must involve both partners and that they should be made aware of the effect of interdependence on marital satisfaction.

A Multicenter Study into Burnout, Perceived Stress, Job Satisfaction, Coping Strategies, and General Health among Emergency Department Nursing Staff.

Burnout is a major problem among nurses working in emergency departments and is closely related to a high turnover of personnel, nursing errors, and patient dissatisfaction. The aims of this study were to estimate burnout, perceived stress, job satisfaction, coping and general health levels experienced by nurses working in emergency departments in Spain and to analyze the relationships between sociodemographic, occupational, and psychological variables and the occurrence of burnout syndrome among these professionals. A cross-sectional study was conducted in four emergency departments in Andalusia (Spain) from March to December 2016. The study sample was composed of n = 171 nurses. An ad hoc questionnaire was prepared to collect sociodemographic and work data, and the Maslach Burnout Inventory, the Perceived Stress Scale, the Font-Roja Questionnaire, the Brief Cope Orientation to Problem Experience and the General Health Questionnaire were used. The prevalence of high burnout was 8.19%. The levels of perceived stress and job satisfaction were moderate. The most frequent clinical manifestations were social dysfunction and somatic symptoms, and problem-focused coping was the strategy most used by nurses. Lack of physical exercise, gender, years worked at an emergency department, anxiety, social dysfunction, and avoidance coping were significant predictors of the dimensions of burnout.

Study of the Differential Consequences of Neglect and Poverty on Adaptive and Maladaptive Behavior in Children.

The consequences of physical neglect on retardation in the development of adaptive behaviors and the increased risk of poor physical and mental health are well documented. As physical neglect is a phenomenon found almost exclusively among socially deprived people, it is important to distinguish the health effects caused by neglect from those caused by poverty. The objective of this study was to compare the effects of poverty and physical neglect on the development of problematic externalizing and internalizing behaviors, adaptive skills, and school problems among school children between the ages of 3 and 12. A group of 157 children were chosen from 28 Andalusian schools and classified in three homogeneous groups. Children in group 1 (n = 53) had two target conditions: living in slums (poverty) and suffering from neglect. Children in group 2 (n = 52) had one target condition: living in the same slums as the children in group 1, but not suffering from neglect. Group 3 (n = 52) consisted of children from other (non-slum) neighborhoods who did not suffer from neglect. Adaptive and maladaptive behaviors were evaluated with the Behavior Assessment System for Children (BASC). Significant differences were found between group 1 and group 2, but there were no important differences between group 2 and group 3. The conclusion was that externalizing and internalizing problems, school problems, and low adaptive skills found in neglected children were associated with neglect rather than with poverty or socially deprived environments.

A New Intervention Procedure for Improving Classroom Behavior of Neglected Children: Say Do Say Correspondence Training.

Although neglect is the most common form of child maltreatment, a review of the literature since 1980 reveals a lack of controlled child neglect intervention programs. The aim of this study is to assess a new intervention program to improve the classroom behavior of children exposed to neglect only, by reducing disruptive conduct and promoting adaptive conduct. Two matched groups were selected with children of the same ages, sex, and social class (cultural and economic level) and with mothers of similar ages. The experimental group comprised of five children suffering from neglect and no other type of maltreatment. The control group had five children not abused or neglected. All the children were in the same class at school. The percentage of time per session that each child spent engaged in disruptive behavior was measured (baseline) and was found significantly higher among neglected children. Say-Do-Say Correspondence Training was applied with the neglected children and a rapid, significant reduction in their disruptive behavior was observed (and statistically confirmed), bringing such behavior down to the level of the control (i.e., non-neglected) children. These results were maintained when the intervention was halted. We concluded that the adaptive and classroom behavior of neglected children can be improved with this non-intrusive intervention.

Perceptual Styles and Cannabis Consumption Prediction in Young People.

Given that risk perception has been found to be both a vulnerability and a protective factor with respect to consumption, the objectives of this study were to find out whether there exist specific patterns of risk perception associated with cannabis use and, if so, how they relate to cannabis consumption and to the sources of information on drugs accessed by young people. An ex post facto study was carried out with 1851 young Andalusians aged 18 to 29, using an adaptation of the Andalusian Government "Andalusian Population versus Drugs" survey. For the first objective, a cluster analysis was carried out in which three perceptual style groups were formed: "Strict", "Permissive-Awareness" and "Lax". Cannabis use in the "lax" group was found to be 14.31 times more frequent than in the "strict" group and 2.75 times more frequent than in the "permissive-awareness" group. A logistic regression analysis was also performed, which correctly predicted 80.4% of users and non-consumers. Correlation was found between perceptual styles and the sources of information used about drugs. This study identified three different risk perception styles that heavily correlated to cannabis consumption and to the type of sources young Andalusians use to obtain information about drugs, suggesting the need for a change in preventive policy.

Can parenting practices predict externalizing behavior problems among children with hearing impairment?

Objective: To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. Methods: The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. Results: Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. Conclusion: Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.

Can parenting practices predict externalizing behavior problems among children with hearing impairment?

OBJECTIVE: To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. METHODS: The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. RESULTS: Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. CONCLUSION: Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.

Family variables related to behavioral problems in childhood.

The aim of this study is to ascertain whether there are any differences in the parenting practices received by two groups of children who obtain low-risk and high-risk scores, respectively, in relation to conduct problems and determine which parenting variables are linked with the presence or absence of this kind of problematic behavior. We selected a sample of 30 children between 6 and 14 years old with risk scores in behavioral problems according to the Behavior Assessment System for Children (BASC), and another similar group with low scores in this variable. After applying the Parent-Child Relationship Inventory (PCRI) to both parents, we carried out a binomial logistic regression analysis which resulted in a prediction model for the 80% of the sample, composed of the Parenting variables: communication and role orientation from the mothers, and parental support, autonomy and limit setting (the most significant factor) from the fathers. Finally, the utility of results to raise intervention strategies within the family is discussed.

[Analysis of behavior related to use of the Internet, mobile telephones, compulsive shopping and gambling among university students]. / Análisis de comportamientos relacionados con el uso/abuso de Internet, teléfono móvil, compras y juego en estudiantes universitarios.

The aim of this study is to obtain knowledge about habits related to addictive behaviour (pathological gambling, Internet, compulsive shopping, use of mobile telephones, etc.) that may be displayed by young students at the University of Cordoba (Spain), and to relate this behaviour with variables such as age, sex, course year, macro-field of study (arts/sciences) and the consumption of substances such as alcohol, tobacco, cannabis and cocaine. Using an ex-post facto single-group design (Montero & Leon, 2007), we applied a questionnaire especially designed to gather socio-demographic information on substance use and behavioural patterns related to "non-substance" addictions, which included the Shopping Addiction Test, Echeburua's Internet Addiction Test (2003) and Fernandez-Montalvo and Echeburua's Short Pathological Gambling Questionnaire (1997). A total of 1,011 students participated in the study (42.7% males and 57.3% females), with an age range of 18 to 29. Significant differences were found between mean score on the questionnaires and variables such as age, sex, field of studies and course year. It would seem that being female is a protective factor for Internet and gambling addiction, being a sciences student is a risk factor for gambling addiction, and being older and being an arts student are risk factors for shopping addiction. In conclusion, it can be stated that the students surveyed showed moderate incidence of behaviours such as Internet browsing, gambling, shopping and mobile phone use, whilst a very small group are close to having an addiction problem with such behaviours.

A comparative study of speech development between deaf children with cochlear implants who have been educated with spoken or spoken+sign language.

OBJECTIVE: To compare speech development following unilateral cochlear implant (CI) between a group of prelingually deaf children who have been educated exclusively using spoken language and another group who have used two languages (spoken and sign language). DESIGN: A simple group quasi-experimental design was used with a control group. METHODS: The sample comprised 7 girls and 11 boys, aged between 4 and 8 years old, who received a CI between the ages of 15 months and 5 years old. The sample was divided into two groups, G1-bilingual and G2-spoken language. In both groups, aspects such as speech intelligibility, receptive vocabulary, psycho-linguistic skills, adaptive behaviour and behavioural problems were measured. RESULTS: The children in Group 1 (bilingual) had better verbal and manual expression whereas those in Group 2 (spoken) achieved better results in terms of speech intelligibility, auditory reception and grammatical closure. These differences were confirmed statistically using Analysis of Variance. No significant differences were observed in relation to: receptive vocabulary, social and communicative skills, visual reception, auditory and visual association, visual closure and visual or auditory sequential memory. CONCLUSION: The development of speech in these children is irrefutable; however, this study contributes a paradoxical element to the discussion: the bilingual group obtained better results in verbal fluency, hence these children should be able to evoke a greater number of words than those educated using just spoken language.

In-home psychosocial skills training for patients with schizophrenia.

OBJECTIVE: The purpose of this study was to test an intervention that adapted the University of California, Los Angeles (UCLA) social and independent living skills program for application in the patient's home and in an outpatient setting in Spain. METHODS: An intervention group of 32 patients with schizophrenia was selected for comparison with a matched control group of patients who were undergoing conventional outpatient treatment for schizophrenia during six-month treatment periods. The Positive and Negative Syndrome Scale (PANSS) scoring system was used to compare the two groups, with a pretest-posttest design. RESULTS: Analysis of variance indicated a significant phase-by-treatment interaction effect of the intervention on PANSS scores. CONCLUSIONS: The results of this study suggest that a combination of outpatient follow-up care and in-home care centered on psychosocial skills training is more effective than conventional treatment in improving general symptoms among individuals with schizophrenia.

Type a behavior pattern as a predictor of psychiatric sick-leaves of Spanish teachers.

The present study examined the relationship between the Type A Behavior Pattern and certain psychopathological disorders, namely, anxiety and depression, within an occupational setting. A sample group of 100 high school teachers (37 men and 63 women) who had taken one or more psychiatric leaves of absence were studied. An additional 100 teachers (47 men and 53 women), with no history of psychiatric sick-leaves, were randomly assigned to a control group. The groups shared the same organizational setting. The Jenkins Activity Survey, Form H, was administered to assess the Type A Behavior Pattern of both groups. Binomial logistic regression analysis indicated this pattern was related to psychiatric sick-leaves.