Exploring Self-efficacy for Condom Use in Spanish People: A Trend Analyses by Gender from 2004 to 2020.

Self-efficacy seems to be one of the most important resources for the different stages underlying condom use and STI prevention. For this reason, this study evaluates trends in self-efficacy by gender, from 2004 to 2008, 2013 and 2020 in Spain. Throughout these years, 6,698 people ranging from 17 to 40 years old, participated filling the Brief scale of condom use self-efficacy. According to our findings, despite the slight improvement in the recent years, self-efficacy still maintains a risky profile for safe sex, especially among the youngest people. Moreover, most of the traditional gender differences continue over the years with women reporting lower scores for condom purchase and men for putting them. However, these differences are not relevant in other dimensions such as using condoms despite drug consumption where women reveal worse results over the years. Therefore, our findings reaffirm the need of intensifying gendered preventive efforts aimed at Spanish people and, particularly, among the youngest.

RESUMEN: La autoeficacia parece ser uno de los recursos más importantes para las diferentes etapas que subyacen al uso del preservativo y la prevención de las ITS. Por ello, este estudio evalúa la tendencia de la autoeficacia por género, desde 2004 a 2008, 2013 y 2020 en España. A lo largo de estos años, 6.698 personas con edades comprendidas entre los 17 y los 40 años participaron cumplimentando la Escala Breve de autoeficacia en el uso del preservativo. Según nuestros hallazgos, a pesar de la ligera mejoría en los últimos años, la autoeficacia aún mantiene un perfil de riesgo para el sexo seguro, especialmente entre los más jóvenes. Además, la tradicional diferencia de género continúa a lo largo de los años: las mujeres informan puntuaciones más bajas en la compra de condones y los hombres en ponérselo. Sin embargo, estas diferencias no son relevantes en otras dimensiones como el uso del preservativo a pesar del consumo de drogas donde las mujeres muestran peores resultados a lo largo de los años. Por tanto, nuestros hallazgos reafirman la necesidad de intensificar los esfuerzos preventivos de género dirigidos a los españoles y, en particular, a los más jóvenes.

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS).

INTRODUCTION: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. AIMS: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. METHODS: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. RESULTS: A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. CONCLUSIONS: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.

Factors Associated With Resilience During Long-Term Hemodialysis.

BACKGROUND: Resilience has been associated with greater adherence to treatment, better outcomes, and improved quality of life (QOL) in people with chronic health conditions. This study aimed to identify sociodemographic, treatment accessibility-related, clinical, and psychological variables associated with resilience in patients with advanced chronic kidney disease (CKD) undergoing long-term hemodialysis (>6 months). METHODS: This was a multicenter, cross-sectional, and correlational study. The instruments used were the Spanish versions of the Connor-Davidson Resilience Scale, the Perceived Stress Scale-10, and the Kidney Disease Quality of Life-36. The participants were categorized as resilient (with a score of ≥49.37 on the Connor-Davidson Resilience Scale) or nonresilient. Binary logistic regression analysis was performed to identify variables with predictive power for the group with the resilient profile. RESULTS: Perceived stress, general QOL, and subcomponents of QOL, such as the physical component and burden of kidney disease, were identified as factors related to the resilient profile. DISCUSSION: Identifying the factors related to resilient adjustment in patients with advanced CKD may assist health caregivers in improving adherence to treatment, treatment outcomes, and QOL.

Atypical Sexual Interests in Compulsive Sexual Behavior: Results From a Phallometric Study.

The link between Compulsive Sexual Behavior (CSB) and atypical sexual interests is elusive. This study aimed to provide preliminary insights into the relationship between both aspects. The study sample comprised 61 self-identified straight men. CSB was measured through a composite self-report index assessing symptoms of CSB, whereas sexual interests -atypical and normophilic- were assessed objectively through penile plethysmography. The CSB index had small, non-significant correlation with greater sexual response to different sexual stimuli (rgeneral sexual responsiveness=.127 [95% CI: -.137, .384]). In terms of overall sexual interest, increased scores on the CSB index had small, non-significant correlation with a higher preference for younger sexual stimuli (r = -.098 [95% CI: -.499, .215]) and persuasive sex (r = .10 [95% CI: -.168, .316]). Finally, CSB had a moderate correlation with sexual response when presented with stimuli depicting "female toddler coercive" (r = .27 [95% CI: -.083, .544]). We conclude that our findings do not support the hypotheses that CSB is significantly related to an increased arousability across sexual stimuli. The study findings also suggest that CSB may be, to a small degree, predisposed to experience sexual attraction toward children. Given the preliminary nature of the study, these conclusions warrant further research. Alternative explanations for the study findings related to the particular components of CSB that may be related to typical and atypical sexual interests are also considered.

Analyzing the role of resilience and life satisfaction as mediators of the impact of COVID-19 worries on mental health.

The aim of this study was to test whether resilience and life satisfaction (two traditional protective factors) mediate between COVID-19 related worries and the development of symptoms of depression, anxiety, and stress in adolescents and young adults. Participants involved 392 adolescents and young adults (70.20% female) aged between 12 and 25 years (M = 17.05 years, SD = 3.08). Participants completed the COVID-19 related worries scale, the CD-RISC to analyse resilience, the Satisfaction with Life Scale, and the Depression, Anxiety, and Stress Scales-21 to study emotional symptoms. Descriptive analyses and Pearson correlations were conducted, together with a structural equation modeling testing a mediational model and multigroup invariance. Results show that resilience and life satisfaction play a mediating role in the relation between the COVID-19 related worries and emotional symptoms (depression, anxiety, and stress). This study highlights the role of protective factors on adolescents' and young adults' emotional symptoms during the COVID-19 pandemic.

A Trend Analysis of Condom use in Spanish Young People over the Two Past Decades, 1999-2020.

HIV exposure is one of the greatest sexual risks in young people, and condom use is the best protective measure. Despite the preventive efforts, trend in condom use is still unclear. This study examines the trend of condom use by gender in Spanish young people, in different sexual practices (vaginal, oral and anal), relationships (regular and casual) and having sex after drugs consumption during the two past decades (from 1999 to 2020). For this, 14,472 people who ranged from 17 to 40 years old (63.5% women) filled the AIDS Prevention Questionnaire in each year. In general, low condom use remains stable and even gets worse regardless of the type of sexual practice, relationship and the substance consumption. Regarding gender, this trend is worse in women who have been less likely to report condom use than men have. Moreover, older people have reported a minor frequency of condom use than the youngest people have done, except for anal sex. Therefore, it is necessary to analyze why, despite preventive efforts, condom use seems to decrease over time.

RESUMEN: El VIH es uno de los mayores riesgos en la sexualidad de la juventud, y el uso del preservativo la mejor medida de protección. A pesar de los esfuerzos preventivos, la tendencia en su uso es indeterminada. Este estudio examina la evolución del uso del preservativo según género en jóvenes españoles, en diferentes prácticas sexuales (vaginal, oral y anal), relaciones (estable y esporádica) y al practicar sexo tras consumir drogas, durante las dos últimas décadas (de 1999 a 2020). Para ello, 14.472 personas entre 17 y 40 años (63,5% mujeres) cumplimentaron el Cuestionario de Prevención del Sida cada año. En general, el bajo uso del preservativo se mantiene estable e incluso empeora con independencia del tipo de práctica sexual, relación y consumo de sustancias. Según el género, las mujeres muestran peor tendencia, al informar menor uso que los hombres. Además, las personas más mayores informan menor frecuencia de uso que los más jóvenes, excepto para el sexo anal. Por tanto, es necesario analizar por qué, a pesar de los esfuerzos preventivos, el uso del preservativo parece disminuir con el tiempo.

Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet.

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.

Cross-cultural validation of the Worries about COVID-19 and its consequences Scale (W-COV) in adolescents and young people.

The pandemic context presents remarkable psychological challenges for adolescents and young adults. The aim of the present work was to construct and study the psychometric properties of a scale in Spanish language (W-COV) to measure their worries related to the pandemic. Participants were 5559 people aged between 14 and 25 years old (M = 19.05; SD = 3.28). Self-report data were collected using a cross-sectional and cross-cultural design. Participants were from 5 Spanish-speaking countries. Instruments were W-COV to assess worries about COVID-19 and its consequences; DASS-21 for anxiety, depression and stress; and SWLS for life satisfaction. Exploratory, confirmatory and multi-group factor analyses were conducted to determine the factorial structure of the W-COV and its measurement invariance (configural, metric, scalar and error variance). Correlational and regression analyses were also performed to study convergent and predictive validity. The results suggest that W-COV presents a bifactorial structure: (1) a general factor of worries about COVID-19; and (2) three different factors: worries about health, economic and psychosocial consequences from COVID-19. The internal reliability indices Cronbach's α and Omega were adequate. With respect to the invariance results, the instrument can be used interchangeably in the five countries considered, in both genders and in two different age groups (12-17 and 18-25). Regarding validity, W-COV factors were positively associated with anxiety, depression and stress, and negatively predicted life satisfaction. In conclusion, W-COV is a reliable and valid instrument for researchers and health care professionals to assess the psychological impact of the pandemic on mental health of young Ibero-Americans.

Development and psychometric properties of an instrument for the Assessment of Sexual Behaviour and Knowledge of people with Intellectual Disability.

BACKGROUND: This paper presents psychometric properties of an instrument for the Assessment of Sexual Behaviour and Knowledge of people with Intellectual Disability (ASBKID), other-reported by professionals who are in daily contact with them. METHODS AND PROCEDURES: Assessments of 236 individuals with intellectual disability were obtained from 100 professionals. RESULTS: Confirmatory factor analysis revealed a four-factor structure: concern about the user's inappropriate or uninhibited sexual behaviour; perception of the user's knowledge about privacy and social norms; perception of the user's knowledge about sexuality; and concerns about the user's sexuality. A multi-group CFA was also conducted in men and women, confirming the adequacy of this four-factor structure by gender. The reliability of the factors ranged from 0.74 to 0.92. CONCLUSIONS: The psychometric results obtained support the use of the ASBKID as a valid and reliable measure for the assessment of sexual behaviour and knowledge in both men and women with intellectual disability.

Estimating sexual knowledge of people with mild intellectual disability through a valid and reliable assessment scale: The ISK-ID.

BACKGROUND: Despite the relevance of assessing sexual knowledge in people with Intellectual Disability, there is a lack of appropriate assessment tools to measure this domain. The current study tests the psychometric properties of the new 'Inventory of Sexual Knowledge of people with Intellectual Disability' (ISK-ID). METHOD: 345 individuals with mild intellectual disability completed the ISK-ID before and after the implementation of a sexual education program. Psychometric properties of the ISK-ID were analysed according to Multidimensional Item Response Theory (MIRT). RESULTS: Its underlying factorial structure, along with parameters derived from the MIRT (item discrimination, difficulty, and participant's ability), support the use of the ISK-ID as a measure of sexual knowledge. Moreover, the ISK-ID was able to detect changes in the level of sexual knowledge resulting from educational interventions (i.e., responsiveness). CONCLUSIONS: The ISK-ID is an appropriate assessment tool to measure sexual knowledge in men and women with mild intellectual disability.

Preventing problematic internet use during the COVID-19 pandemic: Consensus guidance.

As a response to the COVID-19 pandemic, many governments have introduced steps such as spatial distancing and "staying at home" to curb its spread and impact. The fear resulting from the disease, the 'lockdown' situation, high levels of uncertainty regarding the future, and financial insecurity raise the level of stress, anxiety, and depression experienced by people all around the world. Psychoactive substances and other reinforcing behaviors (e.g., gambling, video gaming, watching pornography) are often used to reduce stress and anxiety and/or to alleviate depressed mood. The tendency to use such substances and engage in such behaviors in an excessive manner as putative coping strategies in crises like the COVID-19 pandemic is considerable. Moreover, the importance of information and communications technology (ICT) is even higher in the present crisis than usual. ICT has been crucial in keeping parts of the economy going, allowing large groups of people to work and study from home, enhancing social connectedness, providing greatly needed entertainment, etc. Although for the vast majority ICT use is adaptive and should not be pathologized, a subgroup of vulnerable individuals are at risk of developing problematic usage patterns. The present consensus guidance discusses these risks and makes some practical recommendations that may help diminish them.

Development and Psychometric Properties of the Detection of Sexual Abuse Risk Screening Scale (DSARss).

People with intellectual disability (ID) are more vulnerable to being victims of sexual abuse (SA) because, in most cases, they are not able to detect the warning signs that abuse could occur. However, there is a lack of appropriate assessment tools to determine their vulnerability. To address this limitation, the current study tests the psychometric properties of the Detection of Sexual Abuse Risk Screening Scale (DSARss), a new scale developed to assess the ability of individuals with mild or moderate ID to detect the risk of SA. In all, 246 individuals with mild or moderate ID (55.3% males) completed the DSARss, along with other scales assessing related dimensions (e.g., psychopathological symptoms, quality of live). Exploratory factor analysis (EFA) yielded a four-factor structure explaining 65.34% of the total variance in the DSARss. Two independent EFAs in males and females were also performed to confirm the suitability of this four-factor structure according to gender. The reliability of the total score and subscales ranged between .70 and .93. Likewise, correlations with other related scales were positive and significant. Temporal stability 6 months after the first application was .47. Finally, we explored the criterion-related validity of the DSARss across different SA indicators. These results, along with the absence of sound questionnaires to assess the risk of SA in people with ID, justify the use of the DSARss to assess this construct in both men and women.

A Validation Study of the Spanish Version of the Hypersexual Behavior Inventory (HBI): Paper-and-Pencil Versus Online Administration.

Hypersexuality is a problematic behavior characterized by the combination of an excessive sexual desire and the pathological inability to control it. This study presents the psychometric properties of the Spanish paper-and-pencil and online versions of the Hypersexual Behavior Inventory (HBI), one of the most popular scales to assess this issue. A total of 2,250 participants (1,070 men) completed a translated version of the HBI (1,450 in paper-and-pencil; 800 online). The exploratory factor analysis yielded three factors that explained 67.53% of total variance for the HBI paper-and-pencil version. This factor structure was confirmed in the HBI online version through confirmatory factor analysis (CFA). Factorial, structural, scalar and error variance-invariance according to gender was also confirmed through multigroup CFA. Reliability of the total score and subscales ranged between .89 and .96. Likewise, correlations with other related scales were positive and significant (r between .511 and .743). Temporal stability one year after the first application was .77 (paper-and-pencil format) and .68 (online version). These results support the reliability and validity of the HBI and justify its use in the assessment of hypersexuality in Spanish-speaking countries.

Cybersex Addiction: A Study on Spanish College Students.

The aim of this study was to determine the type and frequency of online sexual practices among Spanish college students, the prevalence of risk and pathological cybersex use profiles, and the correlates/predictors of this behavior. Participants were 1,557 males and females between 18 and 25 years old. Results showed that cybersex use is not as frequent as that documented in other Western countries. However, a significant percentage of participants with a risky (8.6%) or pathological (1.7% in men and 0.1% in women) profile was identified. Finally, we found a set of variables that, in interaction with gender, explains 58% of the variance for cybersex addiction scores.

HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People.

The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people.

Sexual sensation seeking in Spanish young men and women with different sexual orientations.

This study analyzes the relation of sexual orientation and gender to sexual sensation seeking. Participants were 382 individuals (200 men, 182 women) between 17 and 29 years old who completed the Sexual Sensation Seeking Scale. Of the 382 participants, 52.46% self-reported heterosexual orientation, and 47.64% self-reported homosexual orientation. The results showed differences with Sexual Sensation Seeking being more frequent among heterosexuals and men. There were no differences between heterosexual and homosexual men. Heterosexual women had higher sexual sensation seeking scores than did homosexual women. These results and their possible implications for the effective development of prevention and intervention programs in affective-sexual education are discussed.

Relationship status as an influence on cybersex activity: cybersex, youth, and steady partner.

The authors focus on the influence of participants' having or not having a steady partner when reference to cybersex use. Participants were 1,239 young, Spanish individuals who completed the Internet Sex Screening Test. Results showed the influence of being in a relationship on certain consumption dimensions of cybersex; the influence was found to be greater in men than in women. In general, cybersex activity was higher for single participants, although it was also significant for participants with a steady partner. The authors' findings facilitate the comprehension of the effect of new technologies in intimate human relationships.

Cross-cultural validation and measurement invariance of anxiety and depression symptoms: A study of the Brief Symptom Inventory (BSI) in 42 countries.

BACKGROUND: Depression and anxiety are among the most prevalent mental health issues experienced worldwide. However, whereas cross-cultural studies utilize psychometrically valid and reliable scales, fewer can meaningfully compare these conditions across different groups. To address this gap, the current study aimed to psychometrically assess the Brief Symptomatology Index (BSI) in 42 countries. METHODS: Using data from the International Sex Survey (N = 82,243; Mage = 32.39; SDage = 12.52; women: n = 46,874; 57 %), we examined the reliability of depression and anxiety symptom scores of the BSI-18, as well as evaluated evidence of construct, invariance, and criterion-related validity in predicting clinically relevant variables across countries, languages, genders, and sexual orientations. RESULTS: Results corroborated an invariant, two-factor structure across all groups tested, exhibiting excellent reliability estimates for both subscales. The 'caseness' criterion effectively discriminated among those at low and high risk of depression and anxiety, yielding differential effects on the clinical criteria examined. LIMITATIONS: The predictive validation was not made against a clinical diagnosis, and the full BSI-18 scale was not examined (excluding the somatization sub-dimension), limiting the validation scope of the BSI-18. Finally, the study was conducted online, mainly by advertisements through social media, ultimately skewing our sample towards women, younger, and highly educated populations. CONCLUSIONS: The results support that the BSI-12 is a valid and reliable assessment tool for assessing depression and anxiety symptoms across countries, languages, genders, and sexual orientations. Further, its caseness criterion can discriminate well between participants at high and low risk of depression and anxiety.

Why Do People Watch Pornography? Cross-Cultural Validation of the Pornography Use Motivations Scale (PUMS) and Its Short Form (PUMS-8).

Motivations for pornography use may vary across gender identities, sexual orientations, and geographical regions, warranting examination to promote individual and public health. The aims of this study were to validate the Pornography Use Motivations Scale (PUMS) in a diverse, multicultural sample, and develop a short form (PUMS-8) that can assess a wide range of pornography use motivations. Using data from 42 countries (N = 75,117; Mage = 32.07; SDage = 12.37), enabled us to thoroughly evaluate the dimensionality, validity, and reliability of the Pornography Use Motivations Scale (PUMS), leading to the development of the more concise PUMS-8 short scale. Additionally, language-, nationality-, gender-, and sexual-orientation-based measurement invariance tests were conducted to test the comparability across groups. Both the PUMS and the PUMS-8 assess eight pornography use motivations, and both demonstrated excellent psychometric properties. Sexual Pleasure emerged as the most frequent motivation for pornography use across countries, genders, and sexual orientations, while differences were observed concerning other motivations (e.g. self-exploration was more prevalent among gender-diverse individuals than men or women). The motivational background of pornography use showed high similarity in the examined countries. Both the PUMS and the PUMS-8 are reliable and valid measurement tools to assess different types of motivations for pornography use across countries, genders, and sexual orientations. Both scales are recommended for use in research and clinical settings.

Cross-Cultural Adult ADHD Assessment in 42 Countries Using the Adult ADHD Self-Report Scale Screener.

OBJECTIVE: We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener. METHOD: Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,627, 57% women, Mage=32.84; SDage=12.57). RESULTS: The ASRS Screener demonstrated good reliability and validity, along with partial invariance across different languages, countries, and genders. The occurrence of being at risk for adult ADHD was relatively high (21.4% for women, 18.1% for men). The highest scores were obtained in the US, Canada, and other English-speaking Western countries, with significantly lower scores among East Asian and non-English-speaking European countries. Moreover, ADHD symptom severity and occurrence were especially high among gender-diverse individuals. Significant associations between adult ADHD symptoms and age, mental and sexual health, and socioeconomic status were observed. CONCLUSIONS: Present results show significant cross-cultural variability in adult ADHD occurrence as well as highlight important factors related to adult ADHD. Moreover, the importance of further research on adult ADHD in previously understudied populations (non-Western countries) and minority groups (gender-diverse individuals) is stressed. Lastly, the present analysis is consistent with previous evidence showing low specificity of adult ADHD screening instruments and contributes to the current discussion on accurate adult ADHD screening and diagnosis.