Professional quality of life and fear of COVID-19 among Spanish nurses: A longitudinal repeated cross-sectional study.

AIM AND OBJECTIVES: To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign. BACKGROUND: The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential. DESIGN: A repeated cross-sectional design was carried out with a time-lapse of 12 months. METHODS: A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies. RESULTS: The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = - .16, p = .001; r = - .22, p ≤ .001). RELEVANCE TO CLINICAL PRACTICE: Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care. PATIENT OR PUBLIC CONTRIBUTION: The nurses collaborated by participating in the present study anonymously and disinterestedly.

Environmental and psychopathological predictors of clinical high-risk of psychosis in adolescence.

OBJECTIVES: Clinical high-risk psychosis (CHRp) samples can be heterogeneous, consisting essentially of people with not only psychotic-like experiences but also nonspecific symptoms that may reflect common mental disorders such as depression, anxiety, or substance abuse pathologies. Few studies have attempted to analyze and understand psychosis risk in relation to both environmental (ER) and psychopathological risk (PsR) factors. This study aimed to determine the clinical risk of psychosis in adolescents. METHODS: A representative sample of 1824 Spanish adolescents from the general population was evaluated using different scales to thoroughly examine the possible interaction of CHRp with various ER and PsR factors. Partial correlations were calculated to assess the relationships between the variables. A series of hierarchical linear regression models were then used to obtain a CHRp predictor model. RESULTS: The CHRp predictor model indicated that PsR was the most significant determining factor, explaining 22% of the total associated variance of CHRp. However, the ER factor also emerged as a significant predictor of high-risk psychosis (accounting for 9% of the variance). CONCLUSIONS: A predictive model for CHRp in adolescents was found, in which common psychological problems were presented as more determinant risk factors than ER disruptors. Furthermore, certain transdiagnostic processes, such as psychological inflexibility, may play a central role in the development of mental health problems, including psychosis. Specifying the mechanisms underlying the emergence of CHRp in adolescence is the key to optimizing the focus of preventive therapeutic interventions in these early stages.

The role of nurses' professional values during the COVID-19 crisis.

BACKGROUND: The COVID-19 pandemic has produced high stress in nurses, affecting their professional quality of life. Different variables affect psychological stress response and professional quality of life. In this context, the role of professional values represents an interesting object of research. OBJECTIVES: To analyze the relationship between professional values, perceived stress, and professional quality of life among nurses during the COVID-19 crisis. RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT: Descriptive cross-sectional study. Participants were 439 registered nurses from the public health system. Perceived stress, professional quality of life, and professional values were evaluated by using measuring instruments adapted and validated in the geographic context of research. Data were collected online in December 2020 during the second wave of the COVID-19 pandemic in Spain. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee on Clinical Research of the Principality of Asturias. FINDINGS: Within professional values, ethics obtained higher scores showing the primacy of ethical values among nurses. Moderate correlations between ethics, mastery, expertise, and compassion satisfaction were found. Frontline nurses informed high perceived stress. The correlations between professional values and compassion satisfaction were higher in non-frontline nurses. A moderate negative correlation between perceived stress and compassion satisfaction was found in both groups, which implies that the higher the stress, the lower the satisfaction in the helping relationship. CONCLUSION: Professional values positively influence compassion satisfaction during the COVID-19 pandemic. Compassion satisfaction presents a negative correlation with fatigue compassion and burnout in frontline and non-frontline nurses. Given the functionality of values both to guide clinical practice professionally and ethically, and prevent dissatisfaction with one's professional quality of life by reinforcing compassion satisfaction, it is necessary to reinforce them with an intensive and cross-sectional learning during the university training.

Acceptance and commitment therapy versus cognitive behavioral therapy in the treatment of substance use disorder with incarcerated women.

OBJECTIVES: This randomized controlled study compared acceptance and commitment therapy (ACT), cognitive-behavioral therapy (CBT), and a control group. METHOD: The participants were 50 incarcerated women diagnosed with current substance use disorder. Two psychologists carried out pre- and posttreatment assessment and a 6-month follow-up assessment using the following instruments: Anxiety Sensitivity Index, Addiction Severity Index-6, Mini International Neuropsychiatric Interview, and Acceptance and Action Questionnaire. RESULTS: The study shows that the women who received treatment benefited differentially from the interventions. At posttreatment, CBT was more effective than ACT in reducing anxiety sensitivity; however, at follow-up, ACT was more effective than CBT in reducing drug use (43.8 vs. 26.7%, respectively) and improving mental health (26.4% vs. 19.4%, respectively). CONCLUSION: ACT may be an alternative to CBT for treatment of drug abuse and associated mental disorders. In fact, at long-term, ACT may be more appropriate than CBT for incarcerated women who present serious problems.

Experiences of Self-Stigma in People with Chronic Psychosis: A Qualitative Study.

We present the results of a phenomenological study understanding the personal meaning of self-stigma in people with chronic psychosis. Self-stigma is a frequent phenomenon in the lives of people with psychosis and their families and it functions as a barrier to recovery. Semi-structured in-depth interviews were conducted with fourteen outpatients that suffer from chronic psychosis during January 2020. Data analysis was carried out using an inductive approach as described by Graneheim and Lundman through the MAXQDA 2022 program. The themes observed were: "Contextual Stigma", "Components of Self-Stigma", "Skills Loss" and "Coping with Self-Stigma". The main categories and subcategories were avoidance and escape behaviours from their social environment, labelling, loss of social relationships, negative impact and self-concealment of the diagnosis. Our results revealed influence on each other, forming a looping effect that explains and amplifies the lived experience of self-stigma. These findings highlight the need to implement strategies in nursing practice aimed at training the acceptance and distancing necessary to minimize the impact of self-stigma on people with chronic psychosis. This study adheres to the EQUATOR guidelines for the Consolidated Criteria for Reporting Qualitative Research (COREQ).

What predicts retention on an in-prison drug treatment program?

UNLABELLED: The effectiveness of treatments for substance use disorders is strongly related to retention, since early dropout from treatment is associated with greater likelihood of relapse. The purpose of this prospective, ex post facto study is to analyze the effect of individual variables on retention in a treatment program carried out in a prison drug-free unit. The Addiction Severity Index, motivation and personality profile of fifty inmates were assessed on entry to the prison. Inmates were monitored for a year to identify length of stay. RESULTS: Motivation variables at intake play a vital role in the prediction of retention in a prison drug-free unit; scores on the Aggressive-Sadistic and Narcissistic scales are also strong predictors of treatment retention.

A new Algorithm for Detecting Clinical High Risk of Psychosis in Adolescents.

BACKGROUND: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings. METHOD: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit. RESULTS: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm. CONCLUSIONS: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.

[Need for the assessment of dual diagnosis in prisons]. / Necesidad de evaluación de la patología dual en contexto penitenciario.

INTRODUCTION: Data show that 92.5% of prison inmates report drug or alcohol use. In spite of this, only 2% of dual diagnosis research has been carried out in the prison context. Therefore, the aim of this descriptive cross-sectional study was to analyze the profiles of dual diagnosis in a Spanish prison and test the feasibility of two assessment instruments. METHOD: The sample was made up of 152 drug-addicts imprisoned in the Villabona Penitentiary Center (Asturias, Spain) who volunteered to be interviewed. The sixth version of the Addiction Severity Index and the International Neuropsychiatric Interview - MINI- were used for the assessment of inmates' psychopathological status and drug problems. RESULTS: The results show that, in general, the offender's profile is: male, 34 years old, unmarried, with children and with an average time spent in prison of approximately five years. Only 4.5% of respondents did not use drugs at the time of the study. In the remainder, the most widely used substances are cocaine (37.6%), heroin (29.9%) and alcohol (10.8%), with 52.7% reporting having used drugs in the last month. With regard to psychopathological state, only 12.9% have no associated disorders, and the most prevalent symptoms correspond to antisocial personality disorder (65.6%), risk of suicide (45.2%), depression (35.9%) and anxiety (25.5%). CONCLUSION: The instruments proposed (ASI-6 and MINI) are feasible tools for detecting addiction severity and associated psychopathology in this context.

[Addictive, criminal and psychopathological profile of a sample of women in prison]. / Perfil adictivo, delictivo y psicopatológico de una muestra de mujeres en prisión.

This study examines the addictive, criminal and psychopathological profile of a sample of 59 women incarcerated in the Villabona prison in Asturias (a region in northern Spain). The instruments administered were the EuropASI, the SCL-90-R and a semi-structured interview. Results showed that the profile is a young, single women with family dependents serving an average of 5 years' imprisonment. Of the total sample, 64.4% met criteria for a substance abuse disorder. We found a statistically significant relationship between the variables use-nonuse and type of crime: women who used substances had committed the most crimes against property and against the socioeconomic order. As regards psychopathology, 44.06% of the sample fulfilled the requirements for clinical case according to Derogatis' (1994) criteria. The results of the SCL-90-R showed that the predominant psychological disorders were, in the following order, depression, somatization, obsessive-compulsive disorder and paranoid ideation. Moreover, in the group of female users, 47.4% had dual pathology. Our results revealed a statistically significant relationship between clinical case and substance use. Finally, statistically significant differences were found between the user and nonuser groups in the EuropASI severity profile. Highest scores were found for the medical, psychiatric and family areas in the user group.

Psychological Inflexibility in People with Chronic Psychosis: The Mediating Role of Self-Stigma and Social Functioning.

Psychosis is associated with self-stigmatization and loss of social functioning that increase the severity of the disorder. Psychological inflexibility (PI)-an individual's tendency to suppress undesirable private events-plays a fundamental role in the emergence and worst prognosis of psychosis. The main objective of this study was to analyze whether self-stigma and social functioning mediate the association of PI with the severity of psychosis in adults with chronic schizophrenia. The study was carried out with a sample of 103 outpatients. The Acceptance and Action Questionnaire, the Internalized Stigma of Mental Illness Scale, and the Social Functioning Scale were used for clinical assessments. Data analyses were performed by using the PROCESS macro for SPSS. Results showed that the link between PI and the severity of psychosis is not direct, but is better explained by mediation of the self-stigma and social functioning of those assessed. PI also predicts worse social functioning without the need to take self-stigma into account. Moreover, self-stigma alone does not predict the severity of psychotic symptoms; this relationship has to be mediated by social functioning. These findings suggest that interventions designed to increase psychological flexibility, such as Acceptance and Commitment Therapy (ACT), may offer an alternative to attenuate the negative impact of self-stigma and to improve the social functioning.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

[Acceptance of chronic pain in fibromyalgia patients: adaptation of Chronic Pain Acceptance Questionnaire (CPAQ) in a Spanish population]. / Aceptación del dolor crónico en pacientes con fibromialgia: adaptación del Chronic Pain Acceptance Questionnaire (CPAQ).

Acceptance of chronic pain appears as an important factor in the personal ability to restore functioning in the presence of chronic pain. The Chronic Pain Acceptance Questionnaire (CPAQ) is currently the only instrument used to assess the acceptance of pain in people who suffer chronic pain. The revised 20-item version of McCracken and cols. (2004) showed satisfactory psychometric properties. Nevertheless, the CPAQ has not been used in Spain in fibromyalgia patients. The first goal of the study is to examine the Spanish translation of the CPAQ and assess its psychometric properties in a sample of 145 subjects with a diagnosis of fibromyalgia. The second purpose was to analyze the relationships between the CPAQ and other important measures of pain adjustment. Results of exploratory factor analysis indicated that the two-factor model, in a 15-item test, provided a good fit to the data in fibromyalgia patients. Regression analyses showed strong relations with criteria variables (pain intensity, anxiety, depression, etc.) though the subscale Activity Engagement contributed more than Pain Willingness to the prediction of criteria variables.

Dual Diagnosis in Prisoners: Childhood Sexual and Physical Abuse as Predictors in Men and Women.

The study aims to determine the rate of dual diagnosis (DD), examine the most common mental disorders, and determine whether a history of childhood sexual/physical abuse (CSA/CPA) is associated with this phenomenon. One-hundred and eighty inmates from a Spanish prison were assessed using the Mini International Neuropsychiatric Interview and the Addiction Severity Index-6. The data showed that 46.8% of the males and 65.1% of the females had a substance use disorder. With regard to CPA, similar percentages were found in both genders. Nevertheless, rates of CSA were highest in females. Logistic regression analysis was performed by gender. CPA was predictor of DD for males, and CSA was predictor of DD for females, showing the greatest weight. In addition, in both cases, the number of drugs of abuse was an adequate predictor. We can state that these forms of maltreatment are risk factors for the development of a broad range of psychopathological problems.

Acceptance and Commitment Therapy for drug abuse in incarcerated women.

BACKGROUND: Acceptance and Commitment Therapy is the third wave therapy with the greatest empirical evidence in the treatment of drug abuse. METHOD: Thirty-one women with substance use disorder (SUD) were randomly assigned to two conditions, an intervention based on Acceptance and Commitment Therapy (ACT) and a control group on a waiting list. All participants were assessed three times (before treatment, at the end, and at a six-month follow-up) using urinalysis, the Mini International Neuropsychiatric Interview (MINI), the Addiction Severity Index (ASI-6), the Anxiety Sensitivity Index, and the Acceptance and Action Questionnaire (AAQ-II). RESULTS: After 16 ACT intervention sessions, abstinence rates of 27.8% were observed, increasing to 43.8% after six months. The treatment also promoted improvements in other areas, such as reductions in the percentage of comorbid psychopathology and anxiety sensitivity, and the increase of psychological flexibility, which, in general, were not documented in the comparison group. CONCLUSIONS: Clinical gains were achieved, and we consider ACT to be an effective and appropriate treatment to be applied in the prison context.

Predictors of retention in a drug-free unit/substance abuse treatment in prison.

The high rate of dropout from treatment programs is a recurring problem in the field of drug dependence. The purpose of this study was to identify the predictors of retention in a prison-based drug-free unit (DFU). The relationships among subscales of the Addiction Severity Index (ASI) as well as motivation and personality profiles and length of stay in a DFU, of 57 prisoners admitted for the first time to the program were analyzed. The mean dropout rates were 52.9% at six months and 67.8% at one year. The mean length of stay was 195.05 days. Predictors of retention at six months included the ASI Family Composite Score, the motivation subscale Taking Steps, and Narcissistic personality trait score. Predictors of retention at one year included lower ASI Psychological Composite Score, higher scores on the motivation subscale Ambivalence, and higher number of charges pending at the time of admission to the program. Identification of these predictor variables may be useful for developing strategies to increase retention in the context of in-prison substance abuse treatment.

[Evaluation of the effectiveness of a prison-based drug treatment]. / Evaluación de la efi cacia de un tratamiento libre de drogas intrapenitenciario.

The present study evaluated the effectiveness of a drug-free unit (DFU) in reducing the use of substances by incarcerated adult offenders, and to analyze changes in the addiction severity index, motivation, and personality caused by the program. This is an external evaluation, with an ex post facto design with repeated measures. Eighty-seven prisoners from the DFU were evaluated during the first year of residence in the program. Most are young men, polydrug addicts and mainly serving sentences for public health crimes and property offenses. There is need of psychiatric treatment at the baseline, with 85% comorbid personality disorders. Motivation for treatment is low, and remains stable over 12 month's duration of the study. The DFU was found to have a significant effect in reducing the use of drugs by offenders and to improve the drug and family composite scores, also reducing scores on personality scales. However, it fails to change medical and psychiatric scores, so that the need for intervention in these areas is underscored.