Effects of family therapy for substance abuse: A systematic review of recent research.

One of the most serious psychosocial problems worldwide is substance abuse because of its repercussions not only on the physical and psychological health of the abuser but also on their relational functioning. Among the well-established therapeutic approaches for the treatment of substance abuse is family therapy, which, in addition to influencing personal variables, promotes changes in family dynamics. The main objective of this study is to review the scientific literature published from 2010 to the present on the efficacy and effectiveness shown by family-based treatment approaches for substance use problems both in adolescent and adult samples. In addition, the effect on secondary variables such as family functioning and behavioral problems is evaluated. The empirical evidence accumulated in the last decade and reviewed in the present study indicates that the incorporation of family members in the treatment of substance abuse produces benefits by diminishing consumption and improving family functioning. Limitations of this study and of the research reviewed are discussed and directions for future research are provided.

Spanish Validation of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA): Introducing the ERQ-SpA.

Research on emotion regulation is now extensive and shows the benefits of the adaptive management of emotions for social functioning and psychological well-being. Our purpose was to test the psychometric properties of the Emotion Regulation Questionnaire for Children and Adolescents with a sample of nonclinical Spanish adolescents. A total of 462 secondary education students (223 girls, mean age = 13.89 years, SD = 1.38) participated. The instrument proved to be two-factor and gender-invariant. Results revealed the temporal stability of both emotion regulation strategies, while the predictive validity study revealed that depressive symptoms were negatively related to cognitive reappraisal, and positively related to expressive suppression. Our findings support the use of the ERQ-SpA in Spanish adolescents.

The relationship between perceived emotional intelligence and depressive symptomatology: the mediating role of perceived stress.

This study investigated the mediating role of perceived stress in the relationship between perceived emotional intelligence and depressive symptoms in adolescence. A total of 661 high school Spanish students participated in the study. The analyses indicated that the effects of each of the perceived emotional intelligence sub-scales (namely, Attention, Clarity and Repair) on depressive symptomatology were partially mediated by perceived stress. Specifically, the mediating effect was negative for Clarity and Repair, but positive for attention. The analysis also showed that the direct effects were positive for all sub-scales. These results suggest that the promotion of stress management skills may be core in the development of prevention and treatment programs for depression in adolescents, and possibly more beneficial than the promotion of emotion regulation skills. Our findings, along with previous evidence, suggest that emotional attention, as measured in the present study, may be targeting a pathological type of attention.

Profiles and Risk Factors for Teen Dating Violence in Spain.

Teen dating violence (TDV) refers to a wide range of partner-directed harmful behaviors among adolescents. Since it was first documented in the 1980s, there is a growing interest in TDV due to its potentially devastating mid- and long-term consequences. Aiming at the early detection of TDV onset with prevention purposes, research has focused on the detection of typologies of perpetrators and/or victims as well as on identifying risk and protective factors for its occurrence. Research with Spanish adolescents, however, is very limited. To fill this gap, we recruited a total of 2,319 adolescents from different regions in Spain, out of which, 1,079 reported having had a romantic partner during the last year. These filled out measures of TDV (perpetration and victimization), school aggression, hostile and benevolent sexism, empathy, assertiveness, psychological inflexibility (general measures), and psychological inflexibility with prejudice thoughts. A cluster analysis revealed that adolescents could be divided into two clusters as a function of their TDV profile: Cluster 1, including close to 76% of the sample (boys and girls), presented low TDV perpetration and victimization; Cluster 2, including 24% of the sample (boys and girls), presented higher TDV perpetration and victimization. Regression analyses revealed that, as compared to those in Cluster 1, adolescents in Cluster 2 were more likely to be older boys who scored high in benevolent sexism, overt and relational school aggression, and personal distress, and low in behavior regulation skills, perspective taking, and practical personal ability. We discuss the implications of these findings for the design of evidence-based TDV prevention campaigns.

School Violence towards Peers and Teen Dating Violence: The Mediating Role of Personal Distress.

School violence towards peers and teen dating violence are two of the most relevant behaviour problems in adolescents. Although the relationship between the two types of violence is well established in the literature, few studies have focused on mediators that could explain this empirical relationship. We departed from the evidence that relates anger, emotional distress and impaired empathy to teen dating violence and juvenile sexual offending, to explore the role of personal distress, i.e., a self-focused, aversive affective reaction to another's emotion associated with the desire to alleviate one's own, but not the other's distress; as a possible mechanism linking school violence towards peers and teen dating violence in a sample of Spanish adolescents. We also explored the prevalence of emotional and physical teen dating violence, both occasional and frequent, and the differences between boys and girls. A total of 1055 adolescents (49.2% boys and 50.8% girls) aged between 11 and 17 years (M = 14.06, SD = 1.34) who had had at least one romantic relationship within the last year, completed measures of school violence towards peers, teen dating violence, and personal distress. Statistical analyses revealed that occasional and frequent teen dating violence (both physical and emotional) was more frequent in girls than in boys, and that personal distress functioned as a partial mediator, with an overall model fit higher for boys than girls: in boys, partial mediation occurred for both physical and emotional teen dating violence; in girls, partial mediation occurred only for physical violence. The interpretation of the results is tentative given the novel nature of the study, and points to the evidence of the emotional costs of school violence and the importance of emotion and behavior regulation to undermine the social costs of personal distress.

Transactional Links between Teacher-Adolescent Support, Relatedness, and Aggression at School: A Three-Wave Longitudinal Study.

This study examines the reciprocal effects between two school-based relationships within the classroom-namely, perceived teacher support and relatedness with classmates-and school aggression (overt and relational) across two courses of secondary education. Participants were 654 adolescents (48% boys), who were assessed in three waves: first, at the beginning of the academic year (T0), second, at the end of the same academic year (T1), and third, at the beginning of the next academic year (T2) (Mage wave 1 = 13.98 years). Autoregressive cross-lagged modeling was applied. Results show a protective effect of relatedness against relational aggression in both genders. Moreover, we observed a protective effect of perceived teacher support at the beginning of the course for later school aggression as well as a risk effect if this perceived teacher support is maintained throughout the course. These effects were observed in relation with gender-atypical forms of aggression (overt in girls and relational in boys). Finally, aggression had negative consequences for relatedness in girls and for teacher support through the mediation of relatedness in boys. Gender differences and practical implications of these findings are discussed.

Academic Competence, Teacher-Student Relationship, and Violence and Victimisation in Adolescents: The Classroom Climate as a Mediator.

School violence is a serious social and public health problem prevalent worldwide. Although the relevance of teacher and classroom factors is well established in the literature, few studies have focused on the role of teacher perceptions in school violence and victimisation and the potential mediational role of classroom climate in this relationship. A total of 2399 adolescents (50% girls), aged between 11 and 18 years (M = 14.65, SD = 1.78) and enrolled in five Spanish Secondary Compulsory Education schools completed measures of classroom climate, school violence towards peers and perception of peer victimisation, and their teachers informed about their academic competence and the teacher-student relationship. Correlational analyses revealed that whereas academic competence perceived by the teacher was negatively related to overt violence and victimisation, its relationship with pure relational violence was positive. Structural equation modelling analyses showed that variables of classroom climate (involvement, affiliation, and teacher support) perceived by the students functioned as partial mediators between teacher perceptions of academic competence and of teacher-student relationship and violence and victimisation. In the mediational model, teacher perception of academic competence acted as a direct protective factor against violence and victimisation, and teacher perception of teacher-student relationship acted as a direct risk for violence, as well as an indirect protective factor through classroom climate for victimisation. The interpretation of these results points to the importance of the teacher's subjective perceptions in the prevention of violence and victimisation problems and their practical implications for the classroom climate perceived by students.

Predictive Psychosocial Factors of Child-to-Parent Violence in a Sample of Mexican Adolescents.

The aim of this study was to carry out a psychosocial analysis of child-to-parent violence (CPV) in a sample of school adolescents, considering a set of individual variables (psychological distress, problematic use of social networking sites, and perceived non-conformist social reputation) and family variables (open and problematic communication with parents) according to sex. The sample consisted of 3,731 adolescents (54% boys), aged between 14 and 16 years (M = 14.6 years, SD = 0.567), from the state of Nuevo León, Mexico. The scores of the boys and girls were analyzed to check for differences. Also, correlations between all the study variables were calculated. Finally, a multiple stepwise regression analysis was carried out for the total sample and also for boys and girls separately. Results confirmed the important role of individual variables as predictors of CPV in boys and girls. The main difference between boys and girls was observed in the predictive weight of problematic use of social networking sites, which was higher in girls than in boys. Open communication with the father was a significant factor for predicting the decrease of CPV levels in the case of boys, while open communication with the mother predicted the decrease of CPV in girls. Problematic communication with the mother showed similar values in boys and girls when predicting CPV, however, the predictive weight of problematic communication with the father was higher in girls than in boys. These results are interesting and have important implications for the prevention of CPV.

Psychological Flexibility With Prejudices Increases Empathy and Decreases Distress Among Adolescents: A Spanish Validation of the Acceptance and Action Questionnaire-Stigma.

Empathy is an emotional response that may facilitate prosocial behavior and inhibit aggression by increasing empathic concern for others. But the vicarious experience of other's feelings may also turn into personal distress when the person has poor regulation skills and holds stigmatizing beliefs. In thinking about the processes that may trigger the experience of personal distress or empathic concern, research on the influence of psychological flexibility and inflexibility on stigma is showing promising results. Both processes are assessed with the Acceptance and Action Questionnaire-Stigma (AAQ-S). The current study sought to carry out a validity study of a Spanish version of the AAQ-S with a sample of adolescents aged 11-17 years. The study included an expanded test of its predictive validity with measures at three times to evaluate the role of psychological flexibility and inflexibility as risk or protective variables for the development of personal distress and/or empathic concern in the stigmatizer. Statistical analyses confirmed a two-correlated-factor solution, the adequate reliability of both factors, and their construct and predictive validity in the expected direction. The stigmatizer's inflexible reaction to their stigmatizing thoughts predicted the occurrence of personal distress, whereas the stigmatizer's flexible reaction to their stigmatizing thoughts predicted the occurrence of empathic concern for others. These findings confirm the importance of considering the role of regulatory skills in the experience of empathic concern or personal distress in the presence of stigmatizing thoughts, with possible implications for the promotion of prosocial behavior and the reduction of aggressive behavior among adolescents.

Aggressive behavior in adolescence as a predictor of personal, family, and school adjustment problems.

BACKGROUND: The goal of the present study was to determine the extent to which aggressive behavior towards peers predicts greater personal, school, and family maladjustment in adolescent aggressors of both sexes. METHOD: The sample consisted of 1510 Spanish adolescents from 12 to 17 years old, who anonymously and voluntarily completed self-report questionnaires. RESULTS: Binary Logistic regression analysis showed that, regarding personal adjustment, aggressive behavior was significantly associated with high scores in depressive symptomatology, perceived stress and loneliness, and low scores in self-esteem, life satisfaction and empathy, for both sexes. In the school setting, aggressive behavior was related to low scores in academic engagement, friends in the classroom, perception of teacher support, and a positive attitude towards school. At the family level, significant relationships were observed between aggressive behavior and high scores in offensive communication and family conflict, and low scores in open communication with parents, general expressiveness, and family cohesion. CONCLUSIONS: In cases of peer violence it is necessary to give urgent attention to all those involved, since maladjustment in aggressors can be predicted in many levels of intervention.

Parenting Style and Reactive and Proactive Adolescent Violence: Evidence from Spain.

The aim of the present study was to analyze the relationship between the parenting styles-authoritative, indulgent, authoritarian, and neglectful-and reactive and proactive school violence among peers. These analyses were also performed by sex and age groups. The sample consisted of 2399 Spanish adolescents (50.2% male), aged between 12 and 18 years, mean (M) = 14.69, standard deviation (SD) = 1.82. A multivariate analisys of variance (MANOVA, 4 × 2 × 2) was applied, considering parenting style, sex, and age group (12⁻14 and 15⁻18 years) as independent variables to analyze the possible effects of interaction. Reactive, proactive, and pure violence were the dependent variables. The results showed the main effects of parenting styles, sex, and age, as well as an interaction between sex, age, and parenting styles. The interpretation of the findings suggested that the authoritarian parenting style was related to greater engagement in proactive and reactive violent behaviors. In relation to the effect of the interaction between sex, age, and parenting styles, it was observed that adolescents from indulgent families, of both sexes and in any of the studied age groups, obtained lower scores in proactive violence. The discussion highlights the importance of affection and warmth for well-adjusted children's behavior.

School aggression in adolescence: Examining the role of individual, family and school variables.

Background/Objective: The purpose of the present study was to analyse the role of family and classroom environments on the development of particular individual characteristics including level of empathy, attitude to institutional authority and perceived social reputation, and the mediational role these characteristics may play in school aggression. Relationships among variables were analysed by gender. Method: Participants in the study were 1,494 Mexican adolescents aged 12 to 18, 45% male, and drawn from six secondary schools. Structural equation models were calculated to test mediational effects among variables. Results: Findings obtained indicated that the level of empathy, the social reputation, and the attitude to authority mediated the relationship between the environment perceived by boys at home and school, and their aggressive behaviour at school. This mediation was partial for girls. Conclusions: Differences between genders and the importance of the adolescent-context interrelations in the explanation of their aggressive behaviour at school were discussed.

Antecedentes/Objetivo: El propósito del presente estudio fue analizar el papel de los entornos familiares y del aula en el desarrollo de características particulares del adolescente, incluyendo el nivel de empatía, la actitud hacia la autoridad institucional y la reputación social percibida, y el papel mediador que estas características pueden desempeñar en la agresión escolar. Las relaciones entre las variables se analizaron en función del género. Método: Los participantes fueron 1.494 adolescentes mexicanos de 12 a 18 años, 45% varones, procedentes de seis escuelas secundarias. Se calcularon modelos de ecuaciones estructurales para probar efectos mediadores entre las variables. Resultados: Los resultados obtenidos indicaron que el nivel de empatía, la reputación social y la actitud hacia la autoridad mediaron la relación entre el ambiente percibido por los chicos adolescentes en la familia y en el aula y su comportamiento agresivo en la escuela. Esta mediación fue parcial para las chicas. Conclusiones: Se discuten las diferencias encontradas en función del género y la importancia de las interrelaciones adolescente-contexto en la explicación de su comportamiento agresivo en la escuela.

Spanish Validation of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y).

Psychological inflexibility (PI) refers to the overarching and nonadaptive avoidance of thoughts and feelings. PI is a transdiagnostic process that is present in numerous psychopathologies, such as anxiety and mood disorders, addictive behaviors, and chronic pain, as presented by American adults and adolescents. Despite the high rates of depression and depressed mood among Spanish and Latino adolescents and the observed relation between PI and adjustment problems at this age, an instrument assessing PI in Spanish-speaking adolescents is lacking. In this study, we assessed the psychometric properties of a Spanish adaptation of the Avoidance and Fusion Questionnaire for Youth with 483 students from Spain (mean age 13.89 years). The Spanish Avoidance and Fusion Questionnaire for Youth proved to be a two-factor psychometrically sound instrument. Total PI scores correlated positively with depression and negatively with satisfaction with life. The predictive validity results showed cognitive fusion and experiential avoidance to be two interrelated but distinct processes that characterize PI.

An analysis of the relationship between victimization and violent behavior at school.

Previous studies have identified two subgroups of school violence victims: submissive and aggressive. Submissive victims are characterized by their withdrawal in violent situations, while aggressive victims combine hostile behavior with victimization. This study focuses on the second subgroup and aims to analyze possible factors influencing the transition from passive victimization to involvement in aggressive behaviors within the school context. To test these relationships, 1319 adolescents between 12 and 16 years of age were recruited from seven secondary schools in various Spanish provinces. Structural equation modeling techniques were used to analyze the data. Results supported Emler's theory, which posits that the victim's helplessness in situations of intimidation, along with disappointment resulting from a lack of expected protection from adult authority figures, may result in adolescents searching and developing an antisocial and non-conformist reputation that helps them defend themselves against future attacks. Practical implications of these results are further discussed.

[Family functioning, self-esteem and substance use in adolescents: a mediational model]. / Funcionamiento familiar, autoestima y consumo de sustancias en adolescentes: un modelo de mediación.

OBJECTIVE: This research analyzes the direct and indirect relationships among family functioning, multidimensional self-esteem (family, academic, social, and physical self-esteem) and substance use. MATERIALS AND METHODS: The study participants were composed of two independent samples of Spanish adolescents who provided information during the 2003-2004 academic year (n1 = 414, Castilla and León; n2 = 625, Comunidad Valenciana). The statistical analyses were carried out using structural equation modelling and the procedure of mediation effects analysis (Holmbeck, 1997). RESULTS: Results showed a significant mediational effect of self-esteem on the relation between family functioning and adolescent substance use. Moreover, results showed, on the one hand, a protection effect of family and academic self-esteem in the face of substance use and, on the other hand, a risk effect of social and physical self-esteem. CONCLUSIONS: It is necessary to adopt a multidimensional perspective when analyzing the self-esteem of adolescents with substance use and to prevent the over-valuation of social and physical dimensions.

Funcionamiento familiar, autoestima y consumo de sustancias en adolescentes: un modelo de mediación / Family functioning, self-esteem and substance use in adolescents: a mediational model

OBJETIVO: Analizar las relaciones directas e indirectas entre el funcionamiento familiar, la autoestima considerada desde una perspectiva multidimensional (autoestima familiar, escolar, social y física) y el consumo de sustancias. MATERIAL Y MÉTODOS: Los datos se recogieron durante el año escolar 2003-2004 y corresponden a dos muestras independientes de adolescentes españoles (n1= 414, Castilla y León; n2= 625, Comunidad Valenciana). Para el análisis de datos se utilizó la técnica estadística de ecuaciones estructurales y se siguió el procedimiento de análisis de efectos mediadores de Holmbeck (1997). RESULTADOS: La autoestima media significativamente la influencia del funcionamiento familiar en el consumo de sustancias de los adolescentes. Además, se observa, por un lado, un efecto protector de las autoestimas familiar y escolar frente a la implicación en el consumo de sustancias y, por otro, un efecto de riesgo de las autoestimas social y física. CONCLUSIONES: Parece necesario adoptar una perspectiva multidimensional en el estudio de la autoestima de adolescentes consumidores y prevenir la sobrevaloración en las dimensiones social y física.

OBJECTIVE: This research analyzes the direct and indirect relationships among family functioning, multidimensional self-esteem (family, academic, social, and physical self-esteem) and substance use. MATERIALS AND METHODS: The study participants were composed of two independent samples of Spanish adolescents who provided information during the 2003-2004 academic year (n1= 414, Castilla & León; n2= 625, Comunidad Valenciana). The statistical analyses were carried out using structural equation modelling and the procedure of mediation effects analysis (Holmbeck, 1997). RESULTS: Results showed a significant mediational effect of self-esteem on the relation between family functioning and adolescent substance use. Moreover, results showed, on the one hand, a protection effect of family and academic self-esteem in the face of substance use and, on the other hand, a risk effect of social and physical self-esteem. CONCLUSIONS: It is necessary to adopt a multidimensional perspective when analyzing the self-esteem of adolescents with substance use and to prevent the over-valuation of social and physical dimensions.