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This study aimed to evaluate the psychometric properties of the Grief Impairment Scale (GIS) using a network psychometric model. A total of 1048 individuals from Peru and El Salvador participated. A network psychometric model was used to determine internal structure, reliability, and cross-country invariance. The results indicate that the GIS items were grouped into a single network structure through Exploratory Graph Analysis. Reliability was estimated by structural consistency, and it was found that when replicating the network structure within an empirical dimension, a single network structure was consistently obtained, and all items remained stable. Furthermore, the network structure was invariant, thus functioning similarly across the different country groups. In conclusion, the GIS presented solid psychometric evidence of validity based on its internal structure, reliability, and cross-country invariance. Therefore, the GIS is a psychometrically sound measure of functional impairment symptoms due to grief for Peruvian and Salvadoran individuals.
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BACKGROUND: A meta-analysis of randomized controlled trials has suggested a bidirectional relationship between sleep problems and mental health issues. Despite these findings, there is limited conclusive evidence on the relationship between sleep quality, depression, anxiety, and burnout. OBJECTIVE: The current study aimed to evaluate the relationships between sleep quality symptoms, anxiety, depression, and burnout in samples of adult individuals from two Latin American countries, Peru and El Salvador, through network analysis and to identify key symptoms that reinforce the correlation and intensify the syndromes. METHODS: A total of 1012 individuals from El Salvador and Peru participated, with an average age of 26.5 years (SD = 9.1). Symptom networks were constructed for both countries based on data from the Jenkins Sleep Scale, Patient Health Questionnaire-2, General Anxiety Disorder-2, and a single burnout item. RESULTS: The results indicated that Depressed Mood, Difficulty Falling Asleep, and Nervousness were the most central symptoms in a network in the participating countries. The strongest conditional associations were found between symptoms belonging to the same construct, which were similar in both countries. Thus, there is a relationship between Nervousness and Uncontrollable Worry, Anhedonia and Depressed Mood, and Nighttime Awakenings and Difficulty in Staying Asleep. It was observed that burnout is a bridge symptom between both countries and presents stronger conditional associations with Tiredness on Awakening, Depressed Mood, and Uncontrollable Worry. Other bridge symptoms include a Depressed Mood and Nervousness. The network structure did not differ between the participants from Peru and El Salvador. CONCLUSION: The networks formed by sleep quality, anxiety, depression, and burnout symptoms play a prominent role in the comorbidity of mental health problems among the general populations of Peru and El Salvador. The symptom-based analytical approach highlights the different diagnostic weights of these symptoms. Treatments or interventions should focus on identifying central and bridge symptoms.
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This study aimed to characterize the network structure of pandemic grief symptoms and suicidal ideation in 2174 people from eight Latin American countries. Pandemic grief and suicidal ideation were measured using the Pandemic Grief Scale and a single item, respectively. Network analysis provides an in-depth characterization of symptom-symptom interactions within mental disorders. The results indicated that, "desire to die," "apathy" and "absence of sense of life" are the most central symptoms in a pandemic grief symptom network; therefore, these symptoms could be focal elements for preventive and treatment efforts. Suicidal ideation, the wish to die, and the absence of meaning in life had the strongest relationship. In general, the network structure did not differ among the participating countries. It identifies specific symptoms within the network that may increase the likelihood of their co-occurrence and is useful at the therapeutic level.
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Introduction: Enneagram typologies may impact psychological well-being and stressful situations in college students. However, the literature is still limited in the study of dynamic personality models such as the Enneagram in Spanish-speaking university students, and a better understanding is needed. Objective: To analyze network associations and centrality measures of Enneagram personality typologies in Peruvian university students. Methods: A total of 859 Peruvian university students responded to two instruments assessing: The Pangrazzi's Enneagram personality types and healthy personality to psychosocial stress. All instruments showed good psychometric values (validity and consistency). A regularized cross-sectional network structure was estimated with Gaussian graphical model and the graphical LASSO. Results: Enneagram types 4, 5, and 6 presented the highest and positive associations in the network structure. Type 6 emerged as the node with the highest predictability. The healthy personality and type 7 acted as bridges between the communities, with types 6, 7, and 8 being the most central nodes. Conclusion: The findings suggest that Enneagram type 7 with healthy personality to psychosocial stress plays an important role in the development of the causal activation of the network model. The network shows causal associations between psychosocial stress and types 6, 7, 8, and 9.
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Background: Globally, arterial hypertension (AH) has increased by 90% over the last four decades, and has increased by 1.6% in Peru over the previous four years. Scientific evidence indicates the prevalence of depressive symptoms in patients with AH and its importance in the comprehensive evaluation of the adult for adherence to clinical treatment. Previous studies carried out in the Peruvian population with AH mostly report the prevalence and associations, but do not indicate which depressive symptoms are more relevant in patients with AH. This study involved a network analysis of depressive symptomatology in Peruvian patients with AH using network estimation. Network analysis is used in this study for analysis, control, and monitoring purposes. Method: A representative cross-sectional study at the national level, using secondary data from 2019 Demographic and Family Health Survey (ENDES) was performed. The sample used included men and women of age over 17 years diagnosed with AH and was able to respond to Patient Health Questionnaire-9 (PHQ-9). Results: The symptoms of depressive mood (bridging force and centrality) and energy fatigue or loss (bridge centrality) play an essential role in the network structure, as does the feeling of uselessness in terms of closeness and intermediation. Conclusion: The study highlighted the symptoms related to depressive mood and energy fatigue or loss as bridging symptoms, which could trigger a depressive episode in patients diagnosed with AH. The results will contribute to developing personalized treatments aimed at patients with specific depressive symptoms who have also been diagnosed with AH. The study analysis presents statistical coefficients of effect size (≤ 0,1 = small; > 0,1 to < 0,5 = moderate; ≥ 0,5 = large) to determine network connections.
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El suicidio es un problema social y de salud pública persistente; cada año representa una crisis global que afecta a las sociedades contemporáneas. Una perspectiva psicopatológica dominante resume la comprensión actual. Sin embargo, la evidencia empírica sugiere que el suicidio es un fenómeno complejo, ambivalente y multidimensional, que implica aspectos sociales, económicos, culturales y educativos. Cada muerte por suicidio es un fracaso de la sociedad y políticas públicas. El propósito de este trabajo es ofrecer algunas razones para conceptualizar el suicidio como un problema social.
Suicide is a persistent social and public health problem; every year represents a global crisis that affects contemporary societies. A dominant psychopathological perspective summarizes current understanding. However, empirical evidence suggests that suicide is a complex, ambivalent and multidimensional phenomenon, involving social, economic, cultural and educational aspects. Every death by suicide is a failure of society and public policies. The purpose of this work is to offer some reasons to conceptualize suicide as a social problem.
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Introducción: El maltrato infantil es un problema psicológico frecuente en niños y adolescentes de todo el mundo. La exposición a diversos tipos de maltrato puede conducir a otros problemas psicológicos y físicos, siendo necesario identificar qué tipo de maltrato repercute con mayor probabilidad en hombres y mujeres. Objetivo: Analizar las diferencias del maltrato infantil según sexo en adolescentes peruanos. Método: Estudio transversal, enfoque cuantitativo y comparativo realizado en los meses de julio y agosto de 2022. Se analizó una muestra por conveniencia de 1 376 adolescentes, los cuales respondieron un autoinforme sobre maltrato infantil. Para comparar ambos grupos, se utilizó la prueba U de Mann-Whitney de muestras independientes bayesianas. Resultados: Entre los diversos tipos de maltrato infantil, solo se encontró evidencia a favor de la hipótesis alternativa en el maltrato emocional (BF10=190,38; δ=0,31; IC 95 %: 0,20-0,48), con una evidencia muy fuerte. Esta diferencia fue superior en mujeres (M=8,28) en comparación con los hombres (M=7,09). En la negligencia emocional y física, se reportó evidencia fuerte para la hipótesis nula. El análisis robusto del factor Bayes confirmó los mismos resultados. Conclusiones: El maltrato emocional se presenta mayormente en mujeres adolescentes, siendo el género que requiere mayor apoyo psicológico en este tipo de maltrato infantil. En los otros tipos de maltrato, no se encontró diferencias respecto al sexo. En consecuencia, los profesionales de la salud deben considerar el rol del género en el maltrato emocional, pero no descuidar los otros tipos de maltrato infantil, enfatizando en las particularidades específicas de cada caso.
Introduction: Child maltreatment is a common psychological problem of children and adolescents around the world. Presence of various form of abuse can lead to other psychological and physical problems, so, it is necessary to identify which form of abuse is more likely to affect men and women. Objective: To analyze the differences observed in child maltreatment according to sex in Peruvian adolescents. Method: A cross-sectional, and quantitative and comparative approach study was carried out in the months of July and August 2022. A convenience sample of 1.376 adolescents who responded to a self-report on child abuse was analyzed. To compare both groups (men and women), the Mann-Whitney U-test for Bayesian independent samples was used. Results: Among the various forms of child maltreatment, only was found in favor and with high evidence as alternative hypothesis, the emotional maltreatment (BF10=190.38; δ=0.31; 95 % CI: 0.20-0.48). This difference was higher in females (M=8.28) compared to males (M=7.09). In emotional and physical neglect, strong evidence was reported for the null hypothesis. Robust Bayes factor analysis confirmed the same results. Conclusions: Emotional maltreatment occurs mostly in adolescent females, being the gender that requires more psychological support. In the other forms of maltreatment, no differences were found in correspondence with gender. Consequently, health professionals should consider the role of gender in emotional maltreatment, but should not neglect the other forms of child maltreatment, emphasizing the specific particularities of each case.
Introdução: O abuso infantil é um problema psicológico frequente em crianças e adolescentes em todo o mundo. A exposição a vários tipos de abuso pode levar a outros problemas psicológicos e físicos, tornando-se necessário identificar qual tipo de abuso tem maior probabilidade de afetar homens e mulheres. Objetivo: Analisar as diferenças no abuso infantil de acordo com o sexo em adolescentes peruanos. Método: Estudo transversal, abordagem quantitativa e comparativa realizado nos meses de julho e agosto de 2022. Foi analisada uma amostra de conveniência de 1.376 adolescentes, que responderam a um autorrelato sobre abuso infantil. Para comparar os dois grupos, foi utilizado o teste U de Mann-Whitney para amostras independentes bayesianas. Resultados: Entre os vários tipos de abuso infantil, foram encontradas evidências a favor da hipótese alternativa apenas no abuso emocional (BF10=190,38; δ=0,31; IC 95%: 0,20-0,48), com evidências muito fortes. Essa diferença foi maior nas mulheres (M=8,28) em relação aos homens (M=7,09). Na negligência emocional e física, fortes evidências foram relatadas para a hipótese nula. A análise fatorial robusta de Bayes confirmou os mesmos resultados. Conclusões: O abuso emocional ocorre maioritariamente em mulheres adolescentes, sendo o género que mais requer apoio psicológico neste tipo de abuso infantil. Nos outros tipos de abuso, não foram encontradas diferenças quanto ao sexo. Consequentemente, os profissionais de saúde devem considerar o papel do gênero no abuso emocional, mas não negligenciar outros tipos de abuso infantil, enfatizando as especificidades de cada caso.
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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.
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Introducción: El maltrato infantil es considerado un importante problema de salud pública debido a su impacto perjudicial en la salud física y psicológica de los adolescentes. La exposición a diversos tipos de maltrato puede conducir a otros problemas psicológicos, incluido la ideación suicida y es necesario identificar qué tipo de maltrato evidencia mayor asociación. Objetivo: Analizar la asociación entre el maltrato infantil y la ideación suicida en adolescentes peruanos de población general. Métodos: Estudio transversal cuantitativo. Participaron 1 379 adolescentes peruanos que contestaron instrumentos sobre maltrato infantil e ideación suicida. Se estimó un modelo de red gaussiano y se calcularon sus propiedades globales y locales. Además, para la comparación de grupos, se realizó la invarianza de estructura, fuerza global y aristas. Resultados: El maltrato emocional presentó mayor asociación con la ideación suicida y maltrato físico. Además, la ideación suicida se asoció de manera directa con el maltrato sexual y en menor magnitud con el maltrato físico. La mayor centralidad en la red fue para el maltrato emocional e ideación suicida. Tanto para hombres y mujeres, el maltrato emocional fue el nodo con mayor centralidad, aunque la diferencia surge en las mujeres con la presencia de ideación suicida y en los hombres el maltrato físico. Conclusiones: Los resultados confirman la importancia de evaluar los distintos tipos de maltrato infantil en adolescentes de población general, aunque de manera específica se destaca la valoración del maltrato emocional debido a su fuerte asociación con la ideación suicida, independientemente de si son hombres o mujeres.
Introduction: Child abuse is considered an important public health problem due to its detrimental impact on physical and psychological health in adolescents. Exposure to various types of abuse can lead to other psychological problems, including suicidal ideation, which is necessary to identify which type of maltreatment evidence more association. Objective: To analyze the association between child abuse and suicidal ideation in Peruvian adolescents from general population. Methods: Cross-sectional study with a quantitative approach. A total of 1 379 Peruvian adolescents participated, answered instruments about child abuse and suicidal ideation. A Gaussian network model was estimated, calculating its global and local properties. In addition, for the comparison of groups, structure invariance, global strength and edges were performed. Results: Emotional abuse present stronger partnership with suicidal ideation and physical abuse. In addition, suicidal ideation was directly associated with sexual abuse and to a lesser extent with physical abuse. The greatest centrality in the network was for emotional abuse and suicidal ideation. For both men and women, emotional abuse was the node with the highest centrality, although the difference arises in women with the presence of suicidal ideation and in men with physical abuse. Conclusions: The results confirm the importance of assessing the various types of child abuse in adolescents in general population, although the assessment of emotional abuse is specifically highlighted due to its strong association with suicidal ideation, regardless of whether if they are male or female.
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Fundamento las autolesiones no suicidas se consideran un problema de salud pública y social durante la última década, el cual afecta en mayor medida a los adolescentes. La ansiedad generalizada y el bullying pueden ser factores desencadenantes para su desarrollo. Objetivo analizar un modelo explicativo de la ansiedad generalizada y el bullying como predictores de autolesiones no suicidas en adolescentes peruanos. Métodos estudio de diseño explicativo, transversal, con participación de 1 249 adolescentes peruanos, de edad promedio de 15 años (desviación estándar = 1,49) quienes respondieron escalas sobre ansiedad generalizada, bullying y autolesiones no suicidas. Para el análisis de datos, se aplicó la potencia estadística, la correlación y un modelo de regresión estructural basado en covarianzas para confirmar el modelo explicativo. Resultados las variables psicológicas se correlacionaron de manera positiva y estadísticamente significativa. El modelo propuesto presentó índices de ajuste adecuados (CFI = 0,94; RMSEA = 0,03 [IC del 90 %: 0,02-0,03] y SRMR = 0,04) y se evidenció que la ansiedad generalizada (β = 0,26, p = 0,001) y las dimensiones del bullying, como la agresión (β = 0,25, p = 0,001) y la victimización (β = 0,21, p = 0,003) predijeron de manera estadísticamente significativa las autolesiones no suicidas. Conclusiones los hallazgos sugieren que tanto la ansiedad generalizada como el bullying predicen las autolesiones no suicidas en adolescentes. La evidencia proporciona información útil para desarrollar y evaluar programas de prevención basados en estas variables psicológicas, con vistas a disminuir el riesgo de las autolesiones no suicidas.
Background non-suicidal self-harm has been considered a public and social health problem during the last decade, which affects adolescents to a greater extent. Generalized anxiety and bullying can be trigger factors for its development. Objective to analyze a generalized anxiety and bullying explanatory model as non-suicidal self-harm predictors in Peruvian adolescents. Methods cross-sectional, explanatory design study, with 1,249 Peruvian adolescents, average age 15 years old (standard deviation = 1.49), who answered scales on generalized anxiety, bullying, and non-suicidal self-harm. For data analysis, statistical power, correlation, and a structural regression model based on covariances were applied to confirm the explanatory model. Results the psychological variables were positively and statistically significantly correlated. The proposed model had adequate fit indices (CFI = 0.94; RMSEA = 0.03 [90% CI: 0.02-0.03] and SRMR = 0.04) and it was evidenced that generalized anxiety (β = 0.26, p = 0.001) and bullying dimensions such as aggression (β = 0.25, p = 0.001) and victimization (β = 0.21, p = 0.003) statistically significantly predicted self-harm not suicidal. Conclusions The findings suggest that both generalized anxiety and bullying predict non suicidal self-harm in adolescents. The evidence provides useful information for developing and evaluating prevention programs based on these psychological variables, to reduce the non-suicidal self-harm risks.
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La educación sanitaria implica a los profesionales y población general en la alfabetización en salud mental y física para aumentar la búsqueda de ayuda y reducir el estigma. El suicidio es un problema frecuente en población general que afecta a los familiares, red social y profesionales de la salud, siendo necesario una mayor alfabetización sobre las conductas suicidas. El objetivo del estudio fue realizar la traducción al español y validación del Literacy of Suicide Scale Short Form (LOSS-SF) en adultos peruanos de población general. La investigación es de tipo instrumental y participaron 1020 adultos. La traducción inversa se utilizó para la versión en español. Se estimó un modelo Rasch y funcionamiento diferencial del ítem (DIF). En promedio, los participantes tuvieron mayor dificultad con los ítems asociados con los factores de riesgo (26.6% de aciertos) y signos o indicadores del suicidio (26.9% de aciertos), y la menor dificultad con el tratamiento y prevención (57.7% de aciertos). Se evidenció una adecuada validez de contenido (V > .70) y los ítems 11 y 12 tuvieron el mayor parámetro de discriminación. Además, no hubo evidencia de DIF según sexo y el LOSS-SF es más útil en niveles medios y altos del constructo. En conclusión, la versión en español del LOSS-SF presenta fuentes de evidencias de validez basadas en el contenido, estructura interna, confiabilidad e invarianza según sexo. Se recomienda su uso en población general adulta y comparaciones según sexo, siendo útil en programas de prevención y actividades de concientización sobre el suicidio.
Health education involves professionals and the general population on mental and physical health literacy to increase help-seeking and reduce stigma. Suicide is a frequent problem in the general population that affects family members, social network and health professionals, being a need for increased literacy about suicidal behaviors. The objective of the study was make the translation into Spanish and validation of the Literacy of Suicide Scale Short Form in Peruvian adults from the general population. The research was instrumental and 1020 adults participated in the study. Back translation was used for the Spanish version. A Rasch model and differential item functioning (DIF) were estimated. On average, participants had the greatest difficulty with the items associated with risk factors (26.6% correct) and signs or indicators of suicide (26.9% correct), and the least difficulty with treatment and prevention (57.7% correct). There was evidence of adequate content validity (V > .70) and items 11 and 12 had the more discrimination parameter. In addition, there was no evidence of DIF according to sex and the LOSS-SF is more useful at medium and high levels of the construct. In conclusion, the Spanish version of the LOSS-SF presents sources of evidence of validity based on content, internal structure, reliability and invariance by sex. Its use is recommended in the general adult population and comparisons according to sex, being useful in prevention programs and suicide awareness activities.
A educação sanitária envolve profissionais e a população em geral em alfabetização em saúde mental e física para aumentar a procura de ajuda e reduzir o estigma. O suicídio é um problema freqüente na população em geral que afeta membros da família, redes sociais e profissionais de saúde, e há uma necessidade de maior alfabetização sobre os comportamentos suicidas. O objetivo do estudo era traduzir para o espanhol e validar a Literatura de Escala Curta de Suicídio (LOSS-SF) em adultos peruanos da população em geral. A pesquisa foi instrumental e participaram 1020 adultos. A tradução de volta foi utilizada para a versão em espanhol. Foi estimado um modelo Rasch e o funcionamento do item diferencial (DIF). Em média, os participantes tiveram a maior dificuldade com itens associados a fatores de risco (26.6% correto) e sinais ou indicadores de suicídio (26.9% correto), e a menor dificuldade com tratamento e prevenção (57.7% correto). Havia uma validade de conteúdo adequada (V > .70) e os itens 11 e 12 tinham o maior parâmetro de discriminação. Além disso, não havia evidência de DIF por sexo e a LOSS-SF é mais útil em níveis médios e altos da construção. Em conclusão, a versão espanhola da LOSS-SF apresenta fontes de evidência de validade baseada em conteúdo, estrutura interna, confiabilidade e invariância de sexo. É recomendado para uso na população adulta em geral e comparações por sexo, sendo útil em programas de prevenção de suicídios e atividades de conscientização de suicídios.
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Introducción: El estigma hacia las personas que mueren por suicidio o presentan conductas suicidas se considera una barrera para la búsqueda de apoyo profesional y porque tiene efectos en el bienestar psicológico, físico y social. La sociedad cumple un rol importante en la prevención y tratamiento del suicidio, siendo un apoyo necesario para las personas. Objetivo: Traducir al español y validar la Stigma of Suicide Scale Short Form en adultos peruanos de la población general. Métodos: Estudio transversal de enfoque cuantitativo e instrumental. Participaron 1013 adultos peruanos que respondieron la Escala de Estigma del Suicidio - Forma corta (SOSS-SF). El método de traducción inversa se utilizó para la versión de inglés al español. Los análisis se realizaron a partir de la teoría clásica de los test y teoría de respuesta al ítem. Resultados: Los participantes estuvieron de acuerdo en que las personas que mueren por suicidio eran solitarias (39,4 %), aisladas (39,3 %), cobardes (35,2 %) e irresponsables (35 %). La estructura de 3 factores fue adecuada, presentó buena confiabilidad (ωbayes > 0,77, H > 0,83) e invarianza según sexo. Además, todos los ítems discriminaron adecuadamente; el ítem 10 fue el más preciso para medir el estigma hacia el suicidio. Conclusiones: La versión en español del SOSS-SF presenta evidencias de validez basadas en el contenido, estructura interna, confiabilidad, invarianza y respuestas del ítem. Se recomienda su uso para la interpretación e inferencia de sus puntuaciones en la evaluación del estigma hacia el suicidio en población general adulta peruana.
Introduction: Stigma towards people who die by suicide or present suicidal behaviors, is considered a barrier for the search professional support and because it has effects on psychological, physical and social well-being. Society complies an important role in suicide prevention and treatment, being a necessary support for individuals. Objective: To translate into Spanish and validate the Stigma of Suicide Scale Short Form in Peruvian adults from the general population. Methods: Cross-sectional study of quantitative and instrumental approach. A total of 1013 Peruvian adults who responded the Suicide Stigma Scale - Short Form (SOSS-SF) participated. The reverse translation method was used for the English to Spanish version. Analyses were performed as from classical test theory and item response theory. Results: Participants agreed that people who die by suicide were lonely (39,4%), isolated (39,3%), cowardly (35,2%), and irresponsible (35%). The 3-factor structure was adequate, presented good reliability (ωbayes > 0,77, H > 0,83) and gender invariance. In addition, all items discriminated adequately, with item 10 being more accurate in measuring suicide stigma. Conclusions: The Spanish version of the SOSS-SF presents sources of evidence of validity based on content, internal structure, reliability, invariance and item responses. Its use is recommended for the interpretation and inference of its scores in the assessment of stigma towards the suicide in the general adult Peruvian population.
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RESUMEN La medicina conductual es un campo interdisciplinario que involucra a las ciencias del comportamiento y ciencias biomédicas orientadas al estudio de la conducta, con el objetivo de prevenir y tratar enfermedades físicas, mejorando así la salud del ser humano. En el desarrollo del manuscrito, se precisa la evolución de los conceptos de salud y enfermedad a lo largo del siglo pasado. En este proceso, se mencionan los eventos que contribuyeron al surgimiento de la medicina conductual y posteriormente los que le sucedieron en sus primeros años de consolidación. Se describe y explica su actual desarrollo en entornos físicos y digitales, basados en evidencias, y el interés e importancia de cómo utilizar estas evidencias en la formulación de políticas de salud pública. El propósito de esta revisión es extender los principios y la práctica de la medicina conductual en la comunidad de habla hispana y resaltar la relevancia de esta disciplina en el campo de la salud pública.
SUMMARY Behavioral medicine is an interdisciplinary field that involves behavioral and biomedical sciences towards the study of behavior, with the aim of preventing and treating physical illnesses and improve the human being's health levels. The manuscript examines the evolution of the concepts of health and disease throughout the last century is indicated in principle. In this process, the events that contributed to the emergence of behavioral medicine and those that happened during its first years of consolidation, are mentioned. Its current development, substantiated in evidence-based physical and digital environments, and the interest in and relevance of how to translate this evidence in the formulation of public health policies, are also explained. The purpose of this review is to extend the principles and practice of behavioral medicine in the Spanish-speaking community, exposing the relevance of this discipline in the public health field.
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RESUMEN Fundamento los síntomas depresivos y de ansiedad son desórdenes emocionales frecuentes en adultos de población general. La comorbilidad de ambos grupos de síntomas afecta la salud considerablemente, y la literatura refiere que son factores de riesgo para el desarrollo de ideas suicidas. Objetivo evaluar un modelo explicativo de la depresión y la ansiedad como predictores de ideación suicida en adultos peruanos. Métodos estudio descriptivo, transversal, de diseño predictivo, con una muestra de 566 adultos peruanos que accedieron a responder medidas de autoinforme sobre depresión, ansiedad e ideación suicida. Se realizó un modelo de ecuaciones estructurales para evaluar el modelo explicativo. Se aplicaron el Patient Health Questionnarie-2, el Generalized Anxiety Disorder-2, y el Inventario de Frecuencia de Ideación Suicida. Para evaluar el ajuste del modelo se utilizó el modelamiento de ecuaciones estructurales y estimador robusto de mínimos cuadrados ponderados ajustados a la media y la varianza. Resultados la depresión (β = 0,52, p = 0,01) y la ansiedad (β = 0,23, p = 0,03), predicen de manera estadísticamente significativa la ideación suicida. El modelo propuesto presentó adecuados valores en cuanto a índice de ajuste comparativo (0,97), error medio cuadrático de aproximación (0,03) [IC del 90%: 0,01-0,05] y error medio cuadrático estandarizado (0,02). Conclusión los síntomas de depresión y ansiedad predicen el desarrollo de la ideación suicida. La evaluación y seguimiento de ambos podría ayudar a disminuir el riesgo de ideación suicida, especialmente cuando existe una comorbilidad.
ABSTRACT Background Depressive and anxiety symptoms are frequent emotional disorders in general population adults. The comorbidity of both groups of symptoms considerably affects health, and the literature refers that they are risk factors for the development of suicidal ideation. Objective Evaluate an explanatory model of depression and anxiety as suicidal ideation predictors in Peruvian adults. Methods a descriptive, cross-sectional study with a predictive design, with a sample of 566 Peruvian adults who agreed to answer self-report measures on depression, anxiety and suicidal ideation. A structural equation model was performed to evaluate the explanatory model. The Patient Health Questionnaire-2, the Generalized Anxiety Disorder-2, and the Suicidal Ideation Frequency Inventory were applied. To assess the fit of the model, structural equation modeling and a robust weighted least squares estimator adjusted for mean and variance were used. Results depression (β = 0.52, p = 0.01) and anxiety (β = 0.23, p = 0.03) predict suicidal ideation in a statistically significant way. The proposed model presented adequate values in terms of comparative fit index (0.97), mean square error of approximation (0.03) [90% CI: 0.01-0.05] and standardized mean square error (0 .02). Conclusion Symptoms of depression and anxiety predict the development of suicidal ideation. The evaluation and monitoring of both could help reduce the risk of suicidal ideation, especially when there is comorbidity.
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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.
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RESUMEN Introducción: las personas que experimentan síntomas depresivos generalmente informan problemas emocionales y físicos que complican su estado de salud. Los esfuerzos de prevención son necesarios para un tratamiento temprano y resulta relevante identificar qué síntomas son más importantes para las estrategias de prevención e intervención en población general. Objetivo: analizar la interrelación y síntomas depresivos centrales en una población general de adultos peruanos mediante el análisis de redes. Metodología: participaron 275 adultos peruanos que fueron evaluados con el Patient Health Questionnaire-9. Se estimó una estructura de red transversal de correlación parcial regularizada. Específicamente se analizó el índice de centralidad de fuerza, predictibilidad, estabilidad y pruebas de diferencias de los pesos de bordes y fuerza. Este estudio respetó los aspectos éticos, como la confidencialidad de la información, el anonimato y el consentimiento informado. Resultados: se evidenció que todos los nodos de la estructura de red se asociaron positivamente, donde los pensamientos de muerte se relacionaron con los problemas psicomotores, sentimientos de inutilidad y cambios en el apetito. La predictibilidad media fue de 30% y los síntomas depresivos más centrales fueron los pensamientos de muerte y las dificultades de concentración. La estimación de la fuerza fue estable (0,59) y las pruebas post-hoc mostraron diferencias significativas en los pesos de los bordes y fuerza. Conclusiones: los hallazgos del estudio sugieren que los pensamientos de muerte y las dificultades de concentración desempeñan un papel importante en la estructura de red en población general de adultos peruanos. Por lo tanto, estos síntomas podrían ayudar a los profesionales de la salud a identificar a las personas más vulnerables a desarrollar síntomas depresivos y, en consecuencia, pueden ser objetivos importantes de pronóstico, intervención y estrategias de prevención en la atención primaria de salud mental.
ABSTRACT Introduction: People who experience depressive symptoms, generally inform emotional and physical problems that complicate their state health. Prevention efforts are necessary for early intervention and it is relevant to identify the most important symptoms for prevention and intervention strategies in the general population. Objective: To analyze the interrelation and central depressive symptoms in the general population of Peruvian adults by means of a network analysis. Methodology: Two hundred seventy-five Peruvian adults participated and were evaluated with the Patient Health Questionnaire-9. A regularized partial correlation cross-sectional network structure was estimated. Specifically, the force centrality index, predictability, stability and tests of differences of the edge weights and force were analyzed. This study respected ethical aspects, such as confidentiality of information, anonymity and informed consent. Results: It was evidenced that all nodes of the network structure were positively associated, where thoughts of death were associated with psychomotor problems, feelings of worthlessness and changes in appetite. The mean predictability was 30% and the most common central depressive symptoms were thoughts of death and concentration difficulties. The force estimate was stable (0.59) and the post-hoc tests showed significant differences in the edge weights and force. Conclusions: The study findings suggest that thoughts of death and concentration difficulties perform an important role in the network structure in the Peruvian general adult population. Hence, these symptoms could help health professionals to identify the most vulnerable people to develop depressive symptoms and, consequently, they can be important targets for prognosis, intervention, and prevention strategies in primary mental health care.
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Introducción: La ideación suicida es un término amplio para describir una variedad de contemplaciones, deseos y preocupaciones sobre la muerte. Es uno de los principales factores de riesgo de muerte por suicidio, aunque se refieren diferencias en cuanto al sexo. Objetivo: Analizar las diferencias según el sexo respecto a la ideación suicida en adultos peruanos. Métodos: Se efectuó un estudio comparativo, transversal y no experimental, durante abril del 2021, de 366 adultos peruanos de la población general, seleccionados mediante muestreo por conveniencia a través de criterios de inclusión y exclusión. A tal efecto, se utilizaron el inventario de frecuencia de ideación suicida y, en el análisis estadístico, la prueba de la U de Mann-Whitney de muestras independientes bayesianas. Resultados: El promedio de edad fue de 29,64 años y existió una mayor participación del sexo femenino (55,5 %). El análisis bayesiano demostró que los datos observados eran más probables bajo la hipótesis alternativa (BF10=53,477; δ=0,411; IC 95 %: 0,181-0,635), con una evidencia muy fuerte. Esta diferencia fue superior en las mujeres (M=6,46) en comparación con los hombres (M=5,83). Conclusiones: Los hallazgos demostraron que la ideación suicida se presenta principalmente en las mujeres, de manera que resulta el grupo más vulnerable y, por ende, necesita una mayor atención por parte de los profesionales de la salud. Al respecto, los psicólogos y psiquiatras desempeñan un papel importante en identificar a las personas en riesgo y proporcionar anticipadamente la ayuda necesaria para su intervención.
Introduction: The suicidal idea is a wide term to describe a variety of views, desires and concerns about death. It is one of the main risk factors of suicidal death, although they refer differences as for sex. Objective: To analyze the differences according to sex regarding the suicidal ideation in Peruvian adults. Methods: A comparative, cross-sectional and non-experimental study was carried out, in April, 2021, of 366 Peruvian adults from the general population, selected by means of sampling by convenience with inclusion and exclusion criteria. To such an effect, the frequency inventory of suicidal ideation, and in the statistical analysis, the Mann-Whitney U-test of independent bayesian samples were used. Results: The average age was 29.64 and there a higher participation of the female sex (55.5 %). The bayesian analysis demonstrated that the observed data were more probable under the alternative hypothesis (BF10=53.477; δ=0.411; IC 95 %: 0.181-0.635), with a very strong evidence. This difference was higher in women (M=6.46) in comparison with men (M=5.83). Conclusions: The findings demonstrated that suicidal ideation is mainly presented in women, so that it is the most vulnerable group, reason why it needs a higher care of health professionals. In this respect, psychologists and psychiatrists play an important role to identify people at risk and provide the necessary help in advance for their intervention.
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Bayes Theorem , Adult , Suicidal Ideation , Peru , Risk FactorsABSTRACT
RESUMEN El suicidio por arma de fuego es uno de lo métodos más letales y de uso frecuente en niños, adolescentes y adultos mayores. Un historial de intentos de suicidio o discusiones previas sobre la posibilidad de suicidarse, aumenta el riesgo de suicidio. Este resulta un problema de salud pública que requiere de mayor atención y comprensión; por ello, el objetivo del estudio es reflexionar sobre el suicidio por arma de fuego y las estrategias de prevención que pueden utilizarse para reducir su incidencia.Se enfatiza en los métodos de suicidio utilizados frecuentemente, los factores de riesgo asociados y la influencia del contexto sociocultural.Las autoridades y la sociedad en general juegan un papel importante en la prevención de este tipo de eventos, y por tanto, en la reducción de las muertes por esta causa.
ABSTRACT Suicide by fire arm is one of the most lethal and frequently used methods in children, adolescents, and older adults. A history of suicide attempts or previous discussions about the possibility of suicide increases the risk of suicide. This is a public health problem that requires greater attention and understanding; therefore, the objective of the study is to reflect on suicide by firearm and the prevention strategies that can be used to reduce its incidence. It emphasizes frequently used suicide methods, associated risk factors and the influence of the sociocultural context. The authorities and society in general play an important role in preventing these types of events, and therefore, in reducing deaths from this cause.
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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.
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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)