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.

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.

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.

Special Issue on Mental Health and Well-Being in Adolescence: Environment and Behavior.

Psychological problems in children and adolescent populations range from 10% to 20% [...].

[Evidence-Based Psychological Treatments for Adults: A Selective Review]

Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.

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.

Six Weeks of Confinement: Psychological Effects on a Sample of Children in Early Childhood and Primary Education.

Spain has been one of the countries most affected by the health crisis derived from COVID-19. Within this country, the city of Madrid has registered the highest number of infections and deaths. This circumstance led to the adoption of strict confinement measures for a period of 6 weeks. The objective of the present study was to investigate the psychological effects that this confinement has had on the psychological well-being of a sample of children from Madrid. A total of 167 families with children aged between 3 and 11 years participated in this study. The parents evaluated the children through the System of Evaluation of Children and Adolescents (SENA) scale in the month of February and refilled part of the same scale after the children had spent between 4 and 6 weeks confined. The comparison between the two measures showed no change among the 3-year-old children. However, change was observed among the 6-10-year-old. Children in Primary Education obtained lower scores in dimensions related to self-regulation (emotional, attentional, and behavioral) and in willingness to study. The results are discussed in light of the situation experienced between the months of March and May 2020.

Identifying extended psychosis phenotypes at school: Associations with socio-emotional adjustment, academic, and neurocognitive outcomes.

The main goal of the present study was to explore the latent structure of extended psychosis phenotypes in a representative sample of adolescents. Moreover, associations with socio-emotional adjustment, academic achievement, and neurocognition performance across the latent profiles were compared. Participants were 1506 students, 667 males (44.3%), derived from random cluster sampling. Various tools were used to measure psychosis risk, subjective well-being, academic performance, and neurocognition. Based on three psychometric indicators of psychosis risk (schizotypal traits, psychotic-like experiences, and bipolar-like experiences), four latent classes were found: non-risk, low-risk, high reality distortion experiences, and high psychosis liability. The high-risk latent groups scored significantly higher on mental health difficulties, and negative affect, and lower on positive affect and well-being, compared to the two non-risk groups. Moreover, these high-risk groups had a significantly higher number of failed academic subjects compared to the non-risk groups. In addition, no statistically significant differences in efficiency performance were found in the neurocognitive domains across the four latent profiles. This study allows us to improve the early identification of adolescents at risk of serious mental disorder in school settings in order to prevent the incidence and burden associated with these kinds of mental health problems.

The Relationship between Emotion Regulation and Emotion Knowledge in Preschoolers: A Longitudinal Study.

Numerous studies have shown the important role of both emotion regulation (ER) and emotion knowledge (EK) in child development. Despite the number of studies carried out on both variables, there is practically no research on the developmental relationship between these two constructs. We present a longitudinal study to explore the relationship between EK and ER in preschoolers in which we measured these variables over 3 academic years in a cohort of 108 preschool children using the Test of Emotion Comprehension (TEC) and the Emotion Regulation Checklist (ERC). The ERC is divided into 2 subscales: Emotional Regulation (ER) and Lability/Negativity (L/N). Two cross-lagged models were constructed in order to examine the predictive power of ER and L/N on EK across the three time points. The results suggest that ER is an ability that precedes and predicts EK during preschool years. We also discuss the theoretical and practical implications of these findings.

Suicidal behaviour in adolescents: A network analysis. / Conducta suicida en adolescentes: un análisis de redes.

OBJECTIVE: Suicidal behaviour has not yet been analysed from a network approach in adolescent samples. It is imperative to incorporate new psychological models to understand suicidal behaviour from a different perspective. The main objective of this work was twofold: a) to examine suicidal behaviour through network analysis and b) to estimate the psychological network between suicidal behaviour and protective and risk factors in school-age adolescents. METHOD: Participants were 443 students (M = 14.3 years; SD = 0.53; 51.2% female) selected incidentally from different schools. Different instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, prosocial behaviour, subjective well-being, emotional intelligence, self-esteem, depressive symptomatology, empathy, positive and negative affect, and emotional regulation. RESULTS: The resulting network of suicidal behaviour was strongly interconnected. The most central node in terms of strength and expected influence was «Consider taking your own life¼. In the estimated psychological network of suicidal behaviour and risk and protective factors, the nodes with the highest strength were depressive symptomatology, positive affect, and empathic concern. The most influential nodes were those related to emotional intelligence abilities. Suicidal behaviour was positively connected to depression symptoms and negative affect, and negatively connected to self-esteem and positive affect. The results of the stability analysis indicated that the networks were accurately estimated. CONCLUSIONS: Suicidal behaviour can be conceptualized as a dynamic, complex system of cognitive, emotional, and affective characteristics. The new psychopathological and psychometric models allow us to analyse and understand human behaviour and mental health problems from a new perspective, suggesting new forms of conceptualization, evaluation, intervention, and prevention.

Psychotic-like experiences and cannabis use in adolescents from the general population. / Experiencias psicóticas atenuadas y consumo de cannabis en adolescentes de la población general.

The purpose of this study was to analyze the relationship between psychotic-like experiences and cannabis use in a representative sample of adolescents from the general population. A total of 1,588 students (M=16.13 years, SD = 1.36), 739 men (46.5%), selected by stratified random sampling by conglomerates from 98 classes in 34 schools participated in the survey. The instruments used were the Prodromal Questionnaire-Brief, the Strengths and Difficulties Questionnaire, the Modified Substance Use Questionnaire, the Penn Matrix Reasoning Test, the Family Affluence Scale-II, and the Oviedo Infrequency Scale. Results showed that a percentage of adolescents reported psychotic-like experiences and/or cannabis use. Prior to controlling for multiple confounders (gender, age, socio-economic level, alcohol use, smoking, emotional and behavioral problems, and IQ), cannabis use was associated with psychotic-like experiences. After adjustment for confounders, psychotic-like experiences were not seen to be associated with cannabis use. Mediational analyses showed that emotional and behavioral problems mediate the relationship between cannabis use and risk of psychosis. It seems that once the effect of multiple confounding variables is controlled for, the use of cannabis increases the risk of comorbid psychopathology and this in turn increases the risk of psychosis. These results suggest that the relationships established between psychotic experiences and cannabis are complex and mediated by relevant variables. Further studies should examine this relationship in follow-up studies and gene-environmental designs.

El propósito de este estudio fue analizar la relación entre las experiencias psicóticas atenuadas y el consumo de cannabis en una muestra representativa de adolescentes de la población general. Un total de 1,588 estudiantes (M=16,13 años; DT = 1,36), 739 eran hombres (46,5%), pertenecientes a 34 escuelas y 98 aulas, seleccionados mediante muestreo aleatorio estratificado por conglomerados, fueron encuestados. Los instrumentos administrados fueron el Cuestionario de Pródromos de Psicosis-Breve, el Cuestionario de Capacidades y Dificultades, el Cuestionario de Consumo de Sustancias Modificado, el Penn Matrix Reasoning Test (PMRT), la Family Affluence Scale-II y la Escala Oviedo de Infrecuencia de Respuesta. Los resultados mostraron que un porcentaje de adolescentes informaron de experiencias psicóticas atenuadas y/o consumo de cannabis. Antes de controlar el efecto de múltiples covariables (género, edad, nivel socio-económico, consumo de tabaco, problemas emocionales y CI), los jóvenes consumidores de cannabis informaron de un mayor riesgo teórico de psicosis. Cuando se controló el efecto de las covariables, las experiencias psicóticas no se asociaron con el consumo de cannabis. El análisis mediacional indicó que los problemas en el ajuste emocional y comportamental mediaban en la relación entre consumo de cannabis y experiencias psicotiformes. Parece ser que, una vez controlado el efecto de las múltiples variables de confundido, el uso de cannabis aumenta el riesgo de psicopatología comórbida y esta a su vez el riesgo de psicosis (mayor frecuencia de experiencias psicóticas). Estos resultados sugieren que la relación que se establece entre las experiencias psicóticas y el cannabis es compleja y se encuentra mediada por variables relevantes. Futuros estudios deberán examinar las interacciones Gen x Ambiente en estudios longitudinales.