Evidencias psicométricas de la Escala de Ideación Suicida de Roberts en adolescentes peruanos / Psychometric evidence of the Roberts Suicidal Ideation Scale in Peruvian adolescents

Resumen La ideación suicida consiste en pensamientos relacionados con la muerte, con o sin planificación del lugar o los métodos que se utilizarán. Se ha evidenciado que la ideación suicida es más prevalente en la adolescencia, una etapa crucial durante el desarrollo del ser humano. Identificar e intervenir estos problemas es de suma importancia y los instrumentos psicométricos de evaluación son una herramienta complementaria en la práctica clínica o investigación básica. El objetivo de este estudio fue presentar las fuentes de evidencias de validez de la Escala de Ideación Suicida de Roberts en adolescentes peruanos. El diseño fue instrumental y participaron 399 adolescentes residentes en Lima, el 59.4 % eran mujeres, la edad promedio fue 17.81 (DE = 1.03) en un rango de 15 a 19 años. Asimismo, se realizaron preguntas adicionales sobre el comportamiento suicida durante los últimos 12 meses, a las cuales el 2.8 % respondió que consideró suicidarse y el 2.5 % que hizo planes de suicidio o intentó suicidarse, pero no tuvo éxito. Por otro lado, los resultados de la investigación sugieren una estructura factorial unidimensional (CFI = .99; RMSEA = .04 [90 % CI; .00-.12], SRMR = .01, WRMR = .30), adecuada consistencia interna (ω = .84) y de constructo (H = .94), coherente relación con otras variables e invarianza de acuerdo con el sexo y la edad (ΔCFI < .01; ΔSRMR < .03). Los hallazgos permiten concluir que las puntuaciones de la escala para el uso específico en adolescentes peruanos y comparación de grupos (sexo y edad) son confiables y adecuadas.

Abstract Suicidal ideation are thoughts related to death, with or without planning the place or the methods that would be used to kill oneself. Suicidal ideation has been shown to be more prevalent in adolescence, a crucial stage during human development. Identifying and intervening these problems is of utmost importance to prevent suicidal behaviors and the comorbidity of other psychological problems that can worsen the mental and physical health of the adolescent. A complementary tool in clinical practice or basic research are psychometric instruments that allow evaluating non-observable constructs in the field of psychology, for example, suicidal ideation. Therefore, the objective of the study was to present the sources of validity evidence based on the content, internal structure and in the relationship with other variables of the Roberts Suicidal Ideation Scale in Peruvian adolescents. Suicidal ideation are thoughts related to death, with or without planning the place or the methods that would be used to kill oneself. Suicidal ideation has been shown to be more prevalent in adolescence, a crucial stage during human development. Identifying and intervening these problems is of utmost importance to prevent suicidal behaviors and the comorbidity of other psychological problems that can worsen the mental and physical health of the adolescent. A complementary tool in clinical practice or basic research are psychometric instruments that allow evaluating non-observable constructs in the field of psychology, for example, suicidal ideation. Therefore, the objective of the study was to present the sources of validity evidence based on the content, internal structure and in the relationship with other variables of the Roberts Suicidal Ideation Scale in Peruvian adolescents. The study has an instrumental and cross-sectional design. 399 adolescents residing in Lima participated, selected through convenience sampling and inclusion criteria: a) be between 10 and 19 years old, b) place of residence in Lima and c) have accepted informed consent. Adolescents who did not meet these criteria were excluded from the study. All participants answered three scales, which were: the Roberts Suicidal Ideation Scale, the Paykel Suicidal Ideation Scale and the Rosenberg Self-Esteem Scale. The last two scales have evidence of validity in the Peruvian adolescent population. In that sense, 237 (59.4 %) were women and 162 (40.6 %) were men. The mean age was 17.81 (SD = 1.03) in a range of 15 to 19 years. Likewise, additional questions were asked about suicidal behavior during the last 12 months, where 2.8 % considered seriously committing suicide, 2.5 % made suicide plans, and 2.5 % attempted suicide, but were unsuccessful. Regarding the results of the investigation. In principle, three Peruvian psychologists reviewed the content of the items and all considered that the items were representative and relevant to explain the construct. Likewise, through the modeling of structural equations, a confirmatory factor analysis (CFA) was applied to analyze the internal structure of the scale, where it was evidenced that the structure was essentially one-dimensional (CFI = .99; RMSEA = .04 [90 % CI; .00-.12], SRMR = .01, WRMR = .30) and presented factorial loads (λ) higher than .50. On the other hand, the internal consistency was acceptable ω = .84 [95 % CI: .81-.86] and reliability of the construct H = .94, showing that the items are homogeneous and coherent. The multigroup measurement invariance and its different conditions (configural, metric and strong) according to sex (women vs. men) and age (15 to 17 years vs. 18 to 19 years), was stable in the different restrictions and fulfilling the points of Suggested. Cut-off for the variation of the fit índices: (ΔCFI < .01; ΔSRMR < .03), showing that the internal structure of the instrument is the same for the sex and age groups. Finally, a positive relationship was found (r = .35; p = .01) with another instrument that assesses suicidal ideation (thoughts of death, suicidal ideation and suicide attempt) and negative relationships with the positive dimension (r = -.31; p = .01) and negative dimension (r = -.25; p = .01) of self-esteem. All correlations had a minimal effect size. The research results suggest a one-dimensional factorial structure, adequate internal and construct consistency, coherent relationship with other variables and invariance according to sex and age. The findings allow us to conclude and recommend of the Roberts Suicidal Ideation Scale scores for the specific use in Peruvian adolescents and comparison of groups (sex and age) are reliable and adequate.

Análisis de red de la comorbilidad entre síntomas de ansiedad e insomnio en adultos / Network analysis of comorbidity between anxiety symptoms and insomnia in adults

RESUMEN Introducción: La comorbilidad entre los síntomas de ansiedad e insomnio es frecuente y a menudo se entiende porque los síntomas comparten una causa común. La teoría de redes conceptualiza las alteraciones emocionales a nivel de síntomas y es una alternativa contemporánea para comprender la comorbilidad psicopatológica. Objetivo: Explorar la comorbilidad entre los síntomas de ansiedad e insomnio en adultos peruanos. Métodos: La muestra estuvo conformada por 567 adultos (75,1 % mujeres) que respondieron autoinformes de ansiedad e insomnio. Se estimó una red gráfica gaussiana con medidas de centralidad, predictibilidad, estabilidad, precisión y comparación. Para identificar los síntomas que impulsaban la comorbilidad, se analizaron los síntomas puente en la estructura de red. Resultados: Todas las conexiones en la red fueron positivas. Se identificó que los problemas para relajarse y la calidad general del sueño eran los síntomas puente entre la ansiedad y el insomnio. Las puntuaciones más altas en centralidad y predictibilidad para la ansiedad fueron los problemas para relajarse y preocupación, mientas que para el insomnio fue la calidad general del sueño y su duración. La red fue robusta y estable (CS = 0,672). Conclusiones: Los problemas para relajarse y la calidad general del sueño se identificaron como síntomas puente entre la ansiedad y el insomnio. Se necesitan más investigaciones para comprobar si la intervención en aquellos síntomas podría disminuir la comorbilidad entre ambos problemas.

ABSTRACT Introduction: Comorbidity between anxiety and insomnia symptoms is frequent and often it is understood because the symptoms share a common cause. Network theory conceptualizes emotional disorders at symptoms level and is a contemporary alternative for comprehend ​psychopathological comorbidity. Objective: To explore the comorbidity between anxiety and insomnia symptoms in Peruvian adults. Methods: The sample was made up of 567 adults (75,1 % women) who responded to self-reports of anxiety and insomnia. A Gaussian graphical network was estimated with measures of centrality, predictability, stability, precision and comparative. To identify symptoms driving comorbidity, bridge symptoms were analyzed in the network structure. Results: All network connections were positive. Trouble relaxing and general sleep quality were identified as the bridge symptoms between anxiety and insomnia. The highest centrality and predictability scores for anxiety were trouble relaxing and worrying, while for insomnia it was overall sleep quality and sleep duration. The network was robust and stable (CS = 0,672). Conclusions: Trouble relaxing and overall sleep quality were identified as bridge symptoms between anxiety and insomnia. Further research is needed to test whether intervention in those symptoms could decrease comorbidity between both emotional disorders.

Análisis de redes de las conductas suicidas en adultos peruanos / Network analysis of the suicidal behaviors in Peruvian adults

Introducción: En el estudio de la conducta humana, el suicidio es un problema de salud pública emergente. Dado que la mayoría de las personas que presentan conductas suicidas no lo comunican, es necesario explorar las conductas que son determinantes. Objetivo: Analizar las conductas suicidas mediante el análisis de redes en la población general de adultos peruanos. Métodos: Estudio transversal y de enfoque cuantitativo. Participaron 408 adultos peruanos seleccionados mediante muestreo por conveniencia y criterios de inclusión. Se aplicó un instrumento para evaluar la conducta suicida y se estimó una red de correlación parcial regularizada. Asimismo, se analizaron los índices de centralidad (fuerza e influencia esperada) y la predictibilidad de los nodos. También se evaluó la estabilidad y precisión de la red. Resultados: El modelo de red de conducta suicida estuvo conformado por bordes positivos. Las correlaciones más fuertes surgieron entre pensamientos suicidas e intención de suicidio. El nodo con mayor fuerza e influencia esperada fue considerar quitarse la vida. La predictibilidad promedio fue 42 por cientoy el nodo con mayor predicción fue desear estar muerto. La precisión de la red fue adecuada y su estabilidad también (CS = 0,596). Conclusiones: Los resultados indican que los pensamientos suicidas y la intención de suicidarse son aspectos importantes para comprender las conductas suicidas en población general de adultos peruanos. Por ello, identificar estas conductas mediante los instrumentos de evaluación y entrevista clínica, es una práctica recomendable para la detección de personas en riesgo de conductas suicidas y prevención del suicidio(AU)

Introduction: In the study of human behavior, suicide is an emerging public health problem. Given that the majority of people who present suicidal behavior do not communicate it, it is necessary to explore the behaviors that are decisive. Objective: To analyze the suicidal behaviors by means of the analysis of networks in general population of Peruvian adults. Methods: Cross-sectional study and of quantitative approach. 408 Peruvian adults selected by means of convenience sampling and inclusion criteria participated. An instrument was applied to evaluate suicidal behavior and a regularized partial correlation network was estimated. Likewise, the centrality indices (strength and expected influence) and the predictability of the nodes were analyzed. The stability and precision of the network was also evaluated. Results: The network model of suicidal behavior was made up of positive edges. The strongest correlations emerged between suicidal thoughts and suicide intention. The node with greatest strength and influence expected was considering taking his own life. The average predictability was 42 percent and the node with greatest was prediction was wishing to be dead. The precision of the network was adequate and its stability as well (CS=0,596). Conclusions: The results indicate that suicidal thoughts and the intention to commit suicide are important aspects to understand suicidal behaviors in general population of Peruvian adults. For it, identifying these behaviors be means of the evaluation instruments and clinical interview is a recommended practice for detecting people at risk of suicidal behaviors and suicide prevention(AU)

Inventario de Frecuencia de Ideación Suicida: evidencias psicométricas en adultos peruanos / Frequency of Suicidal Ideation Inventory: Psychometric evidence in Peruvian adults / Inventário de Frequência de Ideação Suicida: evidências psicométricas em adultos peruanos

RESUMEN Introducción: Estudios recientes indican la prevalencia de ideación suicida en la población general. En el Perú, el aumento de suicidios consumados y la falta de instrumentos de evaluación basados en evidencias, es un problema a considerar. La evaluación de la ideación suicida es esencial para la prevención del suicidio y es recomendable contar con instrumentos confiables para la interpretación e inferencias fundadas de las puntuaciones obtenidas. Objetivo: Analizar las propiedades psicométricas del Inventario de Frecuencia de Ideación Suicida (IFIS) en población general adulta peruana. Método: Diseño de investigación instrumental y transversal, donde participaron 376 adultos peruanos. Se analizó la evidencia basada en el contenido, estructura interna, confiabilidad, invarianza de medición según sexo y edad, y evidencia en la relación con otras variables. Resultados: El IFIS es una medida unidimensional (CFI=0,99, RMSEA=0,03 [IC del 90 %: 0,00-0,08], SRMR=0,03, WRMR= 0,37), con adecuada confiabilidad (ω=0,80 y H= 0,91) e invarianza según sexo y edad (ΔCFI< 0,010; ΔSRMR<0,030). Asimismo, las puntuaciones del IFIS se correlacionaron con la depresión (r=0,67; p=0,001), presentando un tamaño del efecto fuerte. Los revisores expertos consideraron todos los ítems relevantes. Conclusiones: El IFIS es un instrumento unidimensional con aceptables valores de confiabilidad y diferentes fuentes de evidencias de validez. Por lo tanto, se recomienda utilizar el IFIS como herramienta adicional para la evaluación de la ideación suicida en población general adulta peruana.

ABSTRACT Introduction: Updated research reveals permanence of suicidal ideation in the Peruvian population. In Peru the significant increases of completed suicides and the lack of evidence-based assessment instruments are problem to be considered. The assessment of suicidal ideation is essential for suicide prevention and it is advisable to have confidence instruments for the correct interpretation and informed inferences of the scores obtained. Objective: To assess the psychometric properties of the Frequency of Suicidal Ideation Inventory (FSII) in the Peruvian adult population. Method: An instrumental and cross-sectional research was designed, involving in it 376 Peruvian adults. Content-based evidence, internal structure, confidence, not invariant measurement according sex and age, and evidence of the relationship among other variables. Results: FSII is a unidimensional measurement (CFI=0.99, RMSEA=0,03 [90% confidence interval (CI): 0.00 to 0.08], SRMR=0.03, WRMR=0.37), with an adequate confidence (ω=0.80 and H= 0.91) and invariant measurement according sex and age (ΔCFI<0.010; ΔSRMR<0.030). At the same time, the FSII scores were correlated with depression stages (r=0.67; p=0.001) presenting a strong effect size. The expert reviewers considered all items as relevant. Conclusions: The FSII is a unidimensional tool with an adequate confidence values and different sources which can provide valid evidence. Therefore, it is recommended to use the FSII as an additional tool for the assessment of suicidal ideation in the general Peruvian adult population.

RESUMO Introdução: Estudos recentes indicam a prevalência de ideação suicida na população em geral. No Peru, o aumento de suicídios consumados e a falta de instrumentos de avaliação baseados em evidências é um problema a ser considerado. A avaliação da ideação suicida é essencial para a prevenção do suicídio e é aconselhável contar com instrumentos confiáveis para a interpretação e inferências fundamentadas dos escores obtidos. Objetivo: Analisar as propriedades psicométricas do Inventário de Frequência de Ideação Suicida (IFIS) na população adulta peruana em geral. Método: Desenho de pesquisa instrumental e transversal, onde participaram 376 adultos peruanos. Foram analisadas as evidências baseadas no conteúdo, estrutura interna, confiabilidade, invariância das medidas segundo sexo e idade e evidências em relação às demais variáveis. Resultados: IFIS é uma medida unidimensional (CFI=0,99, RMSEA=0,03 [90% CI: 0,00-0,08], SRMR=0,03, WRMR=0,37), com confiabilidade adequada (ω=0,80 e H=0,91) e invariância de acordo com sexo e idade (ΔCFI<0,010; ΔSRMR<0,030). Da mesma forma, os escores do IFIS se correlacionaram com a depressão (r=0,67; p=0,001), apresentando um forte tamanho de efeito. Os revisores especialistas consideraram todos os itens relevantes. Conclusões: O IFIS é um instrumento unidimensional com valores de confiabilidade aceitáveis e diferentes fontes de evidências de validade. Portanto, é recomendado o uso do IFIS como uma ferramenta adicional para a avaliação da ideação suicida na população adulta peruana em geral.

Escala de Insomnio de Atenas: evidencias psicométricas en adultos peruanos / Athens Insomnia Scale: Psychometric Evidence in Peruvian Adults

Resumen Antecedentes: el insomnio es la alteración del sueño más frecuente en población adulta y en los últimos años se ha destacado como un importante problema de salud pública. La evidencia empírica sugiere que el insomnio se relaciona con problemas de salud mental y física. Por ello, resulta necesario identificar e intervenir este problema y disponer de instrumentos prácticos y confiables para su evaluación. Objetivos: analizar las propiedades psicométricas de la versión breve de la Escala de Insomnio de Atenas en adultos peruanos. Método: participaron 367 adultos peruanos seleccionados mediante muestreo por conveniencia y criterios de inclusión. Desde la Teoría Clásica de los Test (TCT) y la Teoría de Respuesta a los Ítems (TRI), se analizó las fuentes de evidencias de validez del instrumento. Resultados: el 65.9% indicó que tuvo dificultades para dormir durante el último mes. La escala evidencia una estructura unidimensional, aceptable confiabilidad, invarianza según el sexo y relación moderada con otra variable. Asimismo, los parámetros a y b fueron aceptables y la escala resulta ser más precisa en niveles altos de insomnio. Conclusiones: los hallazgos sugieren que la escala presenta adecuadas evidencias psicométricas y se recomienda su uso para evaluar el insomnio en población adulta peruana.

Abstract Background: Insomnia is the most frequent sleep disturbance in the adult population and, in recent years, it has been highlighted as an important public health problem. Empirical evidence suggests that insomnia is related to mental and physical health problems. Therefore, it is necessary to identify and intervene in this problem and have practical and reliable instruments for its evaluation. Objectives: To analyze the psychometric properties of the short version of the Athens insomnia scale in Peruvian adults. Method: Three hundred sixty-seven (367) Peruvian adults selected by convenience sampling and inclusion criteria participated in the study. Based on the classical test theory (CTT) and item response theory (IRT), the sources of validity evidence of the instrument were analyzed. Results: Sixty-five point nine percent (65.9%) of the study population indicated that they had difficulty sleeping during the last month. The scale evidences a one-dimensional structure, acceptable reliability, invariance according to sex and moderate relationship with another variable. Likewise, parameters a and b were acceptable, and the resulting scale was more accurate at high levels of insomnia. Conclusions: The findings suggest that the scale presents adequate psychometric evidence, and its use is recommended to evaluate insomnia in the Peruvian adult population.