Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study.

BACKGROUND: Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders' perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement. METHODS: A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. RESULTS: The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. CONCLUSIONS: Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.

PIUS-a: Problematic Internet Use Scale in adolescents. Development and psychometric validation.

Adolescents' use of the Internet is becoming a matter of great concern for different sectors of society. The psychological and behavioural consequences of problematic Internet use in young people demands quick and effective answers. One of the major challenges in this context is the development of empirically validated tools, which would facilitate early detection and screening for potential risk cases. This is precisely the aim of this paper. Based on a sample of 1,709 secondary-school students from Galicia (a region in northern Spain) aged 11 to 17 (M = 13.74, SD = 1.43), the analysis carried out permitted us to present a brief and simple tool (with just 11 items). It has substantial theoretical support, since both the existing background information and the views of experts from the academic and professional spheres were taken into account in the course of its development. The scale is adapted to the Spanish cultural context and to the language of young people. It has satisfactory psychometric properties in terms of reliability of the scores (α = .82), evidence of its internal structure (tested via a Confirmatory Factorial Analysis), sensitivity (81%), and specificity (82.6%). Moreover, its use enables the gradation of adolescents on a risk or problematic Internet use continuum. In our view, all of this lends it enormous applied potential in both the educational and clinical contexts.

[SBIRT model as a prevention strategy against addiction with and without substance in teenagers.] / El modelo SBIRT como estrategia de prevención de las adicciones con y sin sustancia en adolescentes.

A high prevalence of adolescent substance use, risky consumption patterns and the decrease in the age of initiation, together with the growth of non-substance addictions, represent a huge challenge for Public Health. This suggests the need for a change of focus in the work of the primary care settings, which must be more proactive in the early detection and intervention. Although there are some previous experiences in Spain, we do not have a duly standardised system, based on clinical practice and validated in consulting rooms, which could be used in a general, simple, and guaranteed manner. The SBIRT (Screening, Brief Intervention and Referral to Treatment) model, developed in the United States and conceived from a Public Health perspective, might represent such a paradigm shift. The aim of this paper was to provide researchers and professionals with a review of the available evidence in different countries, with a view to implementing it in Spain, where SBIRT remains a challenge. In addition, theoretical and technical foundations, and potential of the SBIRT are described. Not only its possible benefits and opportunities are put on the table, but also the shortcomings, limitations and needs that must be overcome for SBIRT implementation to be possible.

La alta prevalencia del consumo de sustancias entre los adolescentes, los preocupantes patrones de consumo y el descenso de las edades de inicio, junto al crecimiento de las adicciones sin sustancia, suponen uno de los grandes desafíos actuales en materia de Salud Pública. Ello sugiere la necesidad de un cambio de enfoque en la labor de los dispositivos de Atención Primaria (AP), que han de ser más proactivos en la detección e intervención precoz. Aunque en España existen algunas experiencias previas, no disponemos de una sistemática debidamente protocolizada, fundamentada clínicamente y validada en las consultas, que pueda ser utilizada de forma generalizada, sencilla y con garantías por los profesionales. El modelo SBIRT (Screening, Brief Intervention and Referral to Treatment), desarrollado en Estados Unidos y concebido desde un enfoque de Salud Púbica, representa ese cambio de paradigma. El objetivo de este trabajo, además de dar a conocer los fundamentos teóricos, técnicos y potencialidades del SBIRT, fue poner a disposición de investigadores y profesionales una revisión de la evidencia disponible en diferentes países, de cara a su posible implantación en España, donde a pesar de la existencia de experiencias precedentes puntuales, constituye todavía una cuenta pendiente. Se ponen sobre la mesa no sólo los posibles beneficios y oportunidades, sino también las carencias, limitaciones y necesidades que han de superarse para que la implementación del SBIRT sea posible.

Evaluation and early detection of problematic Internet use in adolescents.

BACKGROUND: Problematic Internet use in adolescents has become an issue of concern for a growing number of researchers and institutions over the past years. Behavioural problems, social isolation, school failure and family problems are some of the consequences of psychological and behavioural impact on teenagers. Taking into account the interest that this issue has generated at many levels, the aim of this paper is to develop a screening tool for early detection of problematic Internet use in teenagers. METHOD: A survey of Compulsory Secondary School students from Galicia involving a total of 2,339 individuals was carried out. RESULTS: The results obtained allow (1) gauging the magnitude of the problem, establishing the risk levels among the adolescents, and (2) presenting a new, simple and short screening instrument. CONCLUSIONS: The present scale has sufficient theoretical and empirical support, including good psychometric properties (a = .83; specificity = .81; sensitivity = .80; ROC curve = .90), making it an interesting applied tool.

Consumo de tabaco y autoestima en adolescentes con y sin Trastorno por Déficit de Atención con Hiperactividad (TDAH): propuestas para una mejor prevención / Tobacco use and self-esteem in adolescents with and without attention deficit disorder with hyperactivity (adhd): proposals for better prevention

El TDAH es el trastorno del neurodesarrollo más diagnosticado en la infancia. En España los índices de prevalencia fluctúan entre el 4% y el 7%. La comorbilidad entre el TDAH y otros trastornos es muy alta, destacando entre ellos el consumo de drogas. En este artículo se analiza la relación entre el consumo de tabaco, la autoestima y el TDAH. Para ello se utiliza una muestra de 1547 estudiantes de 6º curso de Educación Primaria -EPO- y 1º Educación Secundaria -ESO-, con una media de edad de 11,93 (DT = 0,88) de 26 centros escolares. Resultados: el 5,8% de los participantes estaban diagnosticados con TDAH, los cuales presentan unos niveles de autoestima más bajos que sus compañeros no diagnosticados. El consumo de tabaco parece jugar un papel importante en la mediación de la autoestima social. Teniendo en cuenta estos resultados, se proponen distintas estrategias para mejorar los programas preventivos de drogodependencias

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly-diagnosed neurodevelopmental disorder in childhood. In Spain prevalence rates fluctuate between 4% and 7%. Comorbidity between ADHD and other disorders is very high, with the consumption of drugs standing out among these. This article discusses the relationship between smoking, self-esteem and ADHD. For this purpose, a sample of 1,547 students in 6th grade of primary education and 1st year compulsory secondary education from 26 schools was used, with an average age of 11.93 (SD = 0.887). Results: 5.8% of the participants were diagnosed with ADHD, displaying lower levels of self-esteem than their undiagnosed peers. Tobacco use seems to play an important role in mediating social self-esteem. Taking into account these results, different strategies are proposed to improve drug prevention programs

La práctica del botellón en adolescentes gallegos: prevalencia, implicaciones y variables asociadas / Binge drinking in Galician adolescents: Prevalence, implications and related variables

El fenómeno del botellón ha contribuido a la expansión y consolidación de un patrón de consumo de alcohol preocupante en forma de atracón. Pese a ello existen pocos estudios que lo analicen, siendo éste precisamente el objetivo del presente trabajo. Los resultados obtenidos con una muestra de 3.419 adolescentes de entre 12 y 18 años (M=14,94; DT= 1,89) sitúan la prevalencia del botellón en un 38,4%. Su práctica implica tasas de consumo de otras sustancias significativamente mayores, siendo hasta 16 veces superior en el caso del consumo intensivo (binge drinking), así como mayores tasas de consumo de riesgo. Asimismo, se asocia con numerosas prácticas de riesgo, como peleas, accidentes o sexo sin protección. Las expectativas, el consumo de los iguales, la hora de llegada a casa o el dinero disponible se han mostrado asociadas con esta práctica. Todo ello refuerza la conveniencia de desarrollar una labor preventiva integral que contemple tanto variables de naturaleza personal como aquellas más estrechamente relacionadas con el establecimiento de normas y límites por parte de los padres

The phenomenon of botellón (binge drinking) among adolescents has contributed to the expansion and consolidation of a worrying pattern of alcohol consumption. However, there are few studies that analyze it, being this the objective of the paper. The results obtained with a sample of 3,419 adolescents aged between 12 and 18 years (M= 14.94, SD= 1.89) put the prevalence of botellón at 38.4%. Its practice involves consumption rates of other substances significantly higher, being up to 16 times higher in the case of binge drinking, as well as higher risk consumption levels. Likewise, it is associated with several highrisk practices such as fights, accidents or unprotected sex. Variables such as expectations, peers consumption, curfew or spending money have been shown to be associated with this practice. All this reinforces the convenience of developing comprehensive preventive work that includes both variables of a personal nature and those more closely related to the establishment of norms and limits by the parents

EUPI-a: Escala de Uso Problemático de Internet en adolescentes. Desarrollo y validación psicométrica / PIUS-a: Problematic Internet Use Scale in adolescents. Development and psychometric validation

El uso que los adolescentes hacen de Internet viene suscitando una enorme preocupación en diferentes sectores de la sociedad. Las consecuencias a nivel psicológico y conductual que el uso problemático de la Red provoca entre los más jóvenes demandan una respuesta tan rápida como eficaz. Uno de los grandes retos en este contexto es el desarrollo de herramientas validadas empíricamente, que permitan hacer un cribado o detección precoz de posibles casos de riesgo. Ese es precisamente el objetivo de este trabajo. A partir de una muestra de 1709 escolares de Enseñanza Secundaria Obligatoria de la comunidad gallega, de edades comprendidas entre los 11 y los 17 años (M = 13,74; DT = 1,43), los análisis realizados permiten presentar una herramienta breve y sencilla (compuesta por solo 11 ítems), que goza de un importante aval teórico, ya que para su elaboración se tuvieron en cuenta tanto los antecedentes existentes en la literatura, como las opiniones de expertos del ámbito académico y profesional. Dicha escala, además de estar adaptada al contexto cultural español y al lenguaje de los adolescentes, presenta unas propiedades psicométricas satisfactorias, tanto en términos de fiabilidad de las puntuaciones (α = ,82) y evidencias de su estructura interna (probada a través de un Análisis Factorial Confimatorio), como de sensibilidad (81%) y especificidad (82,6%), permitiendo 'escalar' a los adolescentes en un continuum de riesgo o uso problemático de Internet. Todo ello le confiere, a nuestro modo de ver, un notable potencial a nivel aplicado, tanto en el contexto educativo como clínico

Adolescents' use of the Internet is becoming a matter of great concern for different sectors of society. The psychological and behavioural consequences of problematic Internet use in young people demands quick and effective answers. One of the major challenges in this context is the development of empirically validated tools, which would facilitate early detection and screening for potential risk cases. This is precisely the aim of this paper. Based on a sample of 1,709 secondaryschool students from Galicia (a region in northern Spain) aged 11 to 17 (M = 13.74, SD = 1.43), the analysis carried out permitted us to present a brief and simple tool (with just 11 items). It has substantial theoretical support, since both the existing background information and the views of experts from the academic and professional spheres were taken into account in the course of its development. The scale is adapted to the Spanish cultural context and to the language of young people. It has satisfactory psychometric properties in terms of reliability of the scores (α = .82), evidence of its internal structure (tested via a Confirmatory Factorial Analysis), sensitivity (81%), and specificity (82.6%). Moreover, its use enables the gradation of adolescents on a risk or problematic Internet use continuum. In our view, all of this lends it enormous applied potential in both the educational and clinical contexts

Evaluation and early detection of problematic Internet use in adolescents / Evaluación y detección precoz del uso problemático de Internet entre adolescentes

BACKGROUND: Problematic Internet use in adolescents has become an issue of concern for a growing number of researchers and institutions over the past years. Behavioural problems, social isolation, school failure and family problems are some of the consequences of psychological and behavioural impact on teenagers. Taking into account the interest that this issue has generated at many levels, the aim of this paper is to develop a screening tool for early detection of problematic Internet use in teenagers. METHOD: A survey of Compulsory Secondary School students from Galicia involving a total of 2,339 individuals was carried out. RESULTS: The results obtained allow (1) gauging the magnitude of the problem, establishing the risk levels among the adolescents, and (2) presenting a new, simple and short screening instrument. CONCLUSIONS: The present scale has sufficient theoretical and empirical support, including good psychometric properties (a= .83; specificity = .81; sensitivity = .80; ROC curve = .90), making it an interesting applied tool

ANTECEDENTES: el uso problemático de Internet entre los adolescentes preocupa cada vez más a investigadores e instituciones. Problemas de conducta, aislamiento social, fracaso escolar y problemas familiares son algunas de las consecuencias del impacto a nivel psicológico y conductual que ello produce. Habida cuenta del interés que el tema suscita a diferentes niveles, el objetivo de este trabajo es desarrollar una herramienta de screening para la detección precoz de uso problemático de Internet entre adolescentes. MÉTODO: se realizó una encuesta a escolares de Enseñanza Secundaria Obligatoria de la comunidad gallega, en la que participaron un total de 2.339 individuos. RESULTADOS: los resultados obtenidos permiten: (1) evaluar la magnitud del problema, permitiendo conocer los niveles de riesgo existente, y (2) presentar un nuevo instrumento de screening o cribado, breve y sencillo. CONCLUSIONES: la presente escala cuenta con suficiente aval teórico y empírico y con unas buenas propiedades psicométricas (a= ,83; especificidad = ,81; sensibilidad = ,80; Curva COR = ,90), lo cual la convierte en una herramienta de interés a nivel aplicado

Diferencias de sexo en el uso de internet en adolescentes españoles / Gender differences in the use of the Internet in Spanish adolescents

El uso de internet entre los adolescentes constituye una oportunidad de desarrollo personal, pero también una fuente potencial de problemas y riesgos. Los aspectos sociales y culturales asociados al sexo pueden condicionar tanto a priori los patrones de uso de internet, como las consecuencias derivadas. El objetivo del presente trabajo fue explorar las diferencias de sexo en los hábitos y motivos de uso de la red, en distintas prácticas online de riesgo, en el uso problemático de internet o en el papel ejercido por los padres y madres. Para ello se utilizó una muestra de 40.955 estudiantes de secundaria de España (12-17 años). Los resultados obtenidos constatan importantes diferencias de sexo en los motivos de uso, la utilización de las redes sociales, el teléfono móvil y la mensajería instantánea. También se encontraron diferencias en la prevalencia de uso problemático o de prácticas de riesgo como el ciberacoso y en el papel de los progenitores. Estos hallazgos permiten discutir ciertas claves interpretativas desde la perspectiva de género

The use of the internet among adolescents is an opportunity for personal development, but also a potential source of problems and risks. Social and cultural aspects related to gender could, a priori, determine patterns of internet and social networks usage, as well as the resulting consequences. The aim of the present study was to explore the possible gender differences regarding internet usage habits, reasons for its use, online risky behaviors, problematic internet use (PIU) and parental role. To achieve this goal, a sample of 40,955 Spanish Compulsory Secondary School students aged 12-17 was analyzed. The results obtained confirmed relevant gender differences in the reasons for using it, in social networks, mobile phone and instant messaging use. Differences in prevalence of PIU, in risky practices such as cyberbullying and in parental role were also detected. These findings allow for discussing some interpretative keys from a gender perspective