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Few studies have reported long-term follow-up data on selective preventive interventions for adolescents. No follow-up selective preventive transdiagnostic studies for adolescents at-risk for emotional disorders, such as anxiety and depression, have been reported. To fill this gap, this study aims to provide the first follow-up assessment of a randomized controlled trial (RCT) studying selective transdiagnostic prevention in at-risk adolescents. A 12-month follow-up assessment was conducted with subjects who originally received either PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), PROCARE+, which includes the PROCARE protocol along with personalized add-on modules or an active control condition (ACC) based on emotional psychoeducation, and their respective booster session for each experimental condition. 80 subjects (47.5% girls) aged between 12 and 18 years (M = 14.62; SD 1.43) who completed these treatment conditions were available for the 12-month follow-up. The results demonstrate the superior long-term efficacy of the PROCARE+ intervention in mitigating emotional symptoms and obsessive-compulsive symptomatology compared to the PROCARE and ACC conditions, with effect sizes notably exceeding those commonly observed in preventive programs. While the three treatments demonstrated beneficial impacts, the pronounced results associated with PROCARE+ at the 12-month follow-up emphasized the importance of personalized treatment modules and the sustained benefits of booster sessions in the realm of preventive psychological interventions. The findings also highlight the potential role of add-on modules in enhancing the effects of the PROCARE+ condition.
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OBJECTIVE: Early detection of suicide attempts remains a handicap for suicide prevention. Most studies have focused on risk factors, but few have assessed protective factors that promote resilient outcomes, especially in subpopulations vulnerable to suicide re-attempts. This study aims to create and adapt a new Scale of Resilience to Suicide Attempts (SRSA), and to analyse its predictive validity and diagnostic capacity for the detection of suicide re-attempts at six months in people who have made a previous attempt.Design and main outcome measures: The psychometric properties and diagnostic capacity of the resulting SRSA-18 scale were assessed in 229 persons (where 133-58.1% were women, aged 18- to 76-year old) who had made a previous suicide attempt. RESULTS: Factor analyses (AFE and AFC) yielded a three-dimensional structure with excellent goodness-of-fit indices RMSEA, high levels of reliability and adequate convergent validity with the Suicide Resilience Inventory-25 (SRI-25) scale. Additionally, the SRSA-18 has significant diagnostic power on suicide re-attempts across months of follow-up. CONCLUSION: Reliable and valid protective factor-based instruments for the detection of future suicide re-attempts may help in the prevention of suicide-associated mortality in specific clinical subpopulations.
Assuntos
Prevenção do Suicídio , Tentativa de Suicídio , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Tentativa de Suicídio/prevenção & controle , Psicometria/métodos , Reprodutibilidade dos Testes , Fatores de RiscoRESUMO
Significant evidence does exist on the effectiveness of transdiagnostic interventions to improve emotional problems in clinical populations, and their application as universal and indicated prevention programs. However, no randomized controlled trials (RCT) studying selective transdiagnostic prevention intervention have been published. This is the first known RCT to evaluate the efficacy/effectiveness of an evidence-based selective prevention transdiagnostic program for emotional problems in adolescents. The impact of three different interventions was evaluated: (1) PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), which is a group-based, abbreviated version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), along with adding a booster session to reduce risk of onset of anxiety and depression, (2) PROCARE + , which includes the PROCARE protocol along with personalized add-on modules tailored to match adolescents' risk factors, and (3) an active control condition (ACC) based on emotional psychoeducation. In total, 208 adolescents (48.5% girls) evidencing high risk and low protective factors were randomized and allocated to PROCARE, PROCARE + or ACC. Data from 153 adolescents who completed all assessments in the different phases of the study were analyzed. Self- and parent-reported measures were taken at baseline, as well as after the intervention, a 6 month follow-up was carried out, together with a 1 month follow-up after the booster session. Differences between conditions were significant on most of the outcome measures, with superior effect sizes for PROCARE + in the short and long term. Interventions were acceptable in terms of acceptability, with good satisfaction rates. Tailored targeted selective transdiagnostic interventions focused on mitigating risk factors and promoting protective factors in vulnerable adolescents are promising.
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Significant evidence does exist on the effectiveness of transdiagnostic interventions to improve emotional problems in clinical populations, and their application as universal and indicated prevention programs. However, no randomized controlled trials (RCT) studying selective transdiagnostic prevention intervention have been published. This is the first known RCT to evaluate the efficacy/effectiveness of an evidence-based selective prevention transdiagnostic program for emotional problems in adolescents. The impact of three different interventions was evaluated: (1) PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), which is a group-based, online-delivered, abbreviated version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), along with adding a booster session, to reduce risk of onset of anxiety and depression, (2) PROCARE + , which includes the PROCARE protocol along with personalized add-on modules tailored to match adolescents' risk factors, and (3) an active control condition (ACC) based on emotional psychoeducation. In total, 286 adolescents (53.3% girls) evidencing high risk and low protective factors were randomized and allocated to PROCARE, PROCARE + or ACC. Self- and parent-reported measures were taken at baseline, as well as after the intervention, a 6-month follow-up was carried out, together with a 1-month follow-up after the booster session. Differences between conditions were significant on most of the outcome measures, with superior effect sizes for PROCARE +. Interventions were excellent in terms of acceptability, with good satisfaction rates. Tailored selective transdiagnostic interventions focused on mitigating risk factors and promoting protective factors in vulnerable adolescents are promising.
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Despite the availability of efficacious treatment and screening protocols, social anxiety disorder (SAD) in adolescents is considerably under-detected and undertreated. Our main study objective was to examine a brief, valid, and reliable social anxiety measure already tested to serve as self-report child measure but administered via Internet aimed at listening to the ability of his or her parent to identify social anxiety symptomatology in his or her child. This parent version could be used as a complementary measure to avoid his or her overestimation of children of social anxiety symptomatology using traditional self-reported measures. We examined the psychometric properties of brief and valid social anxiety measure in their parent format and administered via the Internet. The sample included 179 parents/legal guardians of adolescents (67% girls) with a clinical diagnosis of SAD (mean age: 14.27; SD = 1.33). Findings revealed good factor structure, internal consistency, and construct validity. Data support a single, strength-based factor on the SPAIB-P, being structure largely invariant across age and gender. The limited number of adolescents with a performance-only specifier prevented examining the utility of scale to screen for this recently established specifier. It is crucial to evaluate if these results generalize to different cultures and community samples. The findings suggest that the SPAIB-P evidences performance comparable with child-reported measure. Parents can be reliable reports of the social anxiety symptomatology of the adolescent. The SPAIB-P may be useful for identifying clinically disturbed socially anxious adolescents.
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The objective of this work was to construct and validate an instrument for assessing resilience to suicide attempts in a Spanish clinical population that has made a previous attempt, and to verify its efficacy for predicting future suicide reattempts at 6 months. For the construction of a Scale of Resilience to Suicide Attempts (SRSA) the theoretical-rational strategy was used. The constructed SRSA-18 consisted of 18 items and 3 subdimensions (internal and external protection and emotional stability), had high internal consistency (α = 0.88; ω = 0.89) and a high positive correlation with the Suicide Resilience Inventory-25, SRI-25 (r = 0.91; p < 0.01), and to a lesser extent with general resilience scales such as the Connor-Davidson Resilience Scale, CD-RISC (r = 0.79; p < 0.01) and the Resilience Scale of 14 items, RS-14 (r = 0.76; p < 0.01). Additionally, a specific SRSA-18 score predicted future suicide reattempts 6 months after the first attempt. This new scale (SRSA-18) assesses in a brief and rapid way, through protective factors rather than risk factors, the level of resilience to the suicide attempt in specific clinical subpopulations in hospital emergency services, being able to prevent suicide reattempts with higher lethality.
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Expressed emotion (EE) is an index of significant others' attitudes, feelings, and behavior toward an identified patient. EE was originally conceptualized as a dichotomous summary index. Thus, a family member is rated low or high on how much criticism, hostility, and emotional overinvolvement (EOI) s/he expresses toward an identified patient. However, the lack of brief, valid measures is a drawback to assess EE. To cover this gap, the E5 was designed. The objective of this study is to provide psychometric properties of a recent measured in adolescents to be used to tap perceived high levels of EE. The sample was composed by 2,905 adolescents aged from 11-19years; 57% girls. Results demonstrate good factor structure, reliability, construct validity and invariance across gender and age revealed a good fit. As a result, E5 is a brief, valid and reliable measure for assessing expressed emotion in parents of adolescent children.
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An association between severe iodine deficiency and poor mental development has been found in many studies. We examined the relationship between moderate or mild iodine deficiency and intellectual capacity in order to determine whether problems common to severe iodine deficiency (including mental retardation) also emerge in a more subtle form. We also wished to know whether the classic methodology (comparing iodine-deficient zones with nondeficient zones) is the most adequate, and propose to combine this grouping by zones with urinary iodine presented by individuals in each zone. We measured IQ, manipulative and verbal capacity, attention, visual motor ability and disruptive behaviour, variables that have barely been studied in this kind of investigations. The sample comprised 760 schoolchildren from the province of Jaén (southern Spain). Our results show that children with low levels of iodine intake and with urinary iodine concentration lower than 100 microg/litre had a lower IQ and displayed more disruptive behaviour than children with high levels of the criteria. The other variables were not associated with iodine deficiency.
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Transtornos Cognitivos/epidemiologia , Deficiência Intelectual/epidemiologia , Inteligência , Iodo/deficiência , Adolescente , Área Programática de Saúde , Criança , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Índice de Gravidade de Doença , Espanha/epidemiologiaRESUMO
The aim was to identify and describe socio demographic and clinical variables in individuals who have made a suicide attempt. An analysis of electronically stored records on persons admitted to the emergency departments of a northern health district during the period 2009-2011 for mental disorders was conducted. The records of 826 patients (30.1% of the total), where 485 (58.7%) were female, aged between 14 and 94 years (M = 49.3; SD = 12.7), were selected. This amounted to 412 individuals (49.9%) who had made a suicide attempt, and were compared with others without prior suicide attempt. A binary logistic regression analysis was performed to examine the strongest predictors of suicide attempt. The results show that the risk of making a suicide attempt increases with age, those most at risk being aged 34 to 53 years (p < 0.01; OR = 6.99), female (p < 0.05; OR = 2.70) and unemployed (p < 0.05; OR = 4.98). The most predictive psychopathological diagnoses for suicide attempt were anxiety disorders (p < 0.01; OR = 3.95) and impulse control disorders/addictions (p < 0.01; OR = 3.76). The importance of creating specific risk and protection profiles when implementing contextualized health policies on suicide attempt prevention is discussed.
Se trató de detectar y describir variables socio-demográficas y clínicas en personas que han realizado una tentativa suicida. Se llevó a cabo un análisis de los registros telemáticos sobre personas admitidas en los servicios de Urgencias del distrito sanitario norte durante el periodo 2009-2011 por trastornos mentales. Se seleccionaron 826 registros de personas, donde 485 eran mujeres, entre 14 y 94 años. Del total, 412 habían realizado un intento de suicidio, y fueron comparadas con otras personas sin tentativa suicida previa. Se aplicó un análisis de regresión logística binaria para examinar los factores más predictivos del intento de suicidio. Los resultados muestran que el riesgo de realizar un intento de suicidio aumenta con la edad, donde el periodo de mayor riesgo es el de 34 a 53 años (p < 0,001; OR = 6,99), ser de género femenino (p < 0,05; OR = 2,70) y encontrarse desempleada (p < 0,05; OR = 4,98). Los diagnósticos psicopatológicos más predictivos para la tentativa suicida fueron los trastornos de ansiedad (p < 0,01; OR = 3,95) y los trastornos del control de impulsos/adicciones (p < 0,01; OR = 3,76). Se discute la importancia de crear perfiles de riesgo y protección concretos para la puesta en marcha de políticas sanitarias contextualizadas de prevención de la tentativa suicida.
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Serviço Hospitalar de Emergência , Transtornos Mentais/epidemiologia , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia , Desemprego/estatística & dados numéricos , Adulto JovemRESUMO
Social Anxiety Disorder (SAD) is a very common disorder in childhood and adolescence. Many studies have examined various types of CognitiveBehavioral Therapy (CBT), meaning there is a need for a study exploring the efficacy of CBT. The objectives of this study are to determine whattreatments and factors can improve treatment outcomes for SAD. We performed an umbrella review of the effectiveness of psychological interventions in treating SAD in children and adolescents. Nine databases were searched using a combination of keywords. Risk of bias was assessed usingAMSTAR-2. Six systematic reviews and meta-analysis were selected and reported. All of those studies assessed the efficacy of CBT in children andadolescents with SAD, demonstrating its short- and long-term effectiveness. The components that seem to be most effective are exposure in anymodality and social skills training. Other considerations to take into account are addressed in the discussion. (AU)
El Trastorno de Ansiedad Social (TAS) es un trastorno muy común en la infancia y adolescencia. Muchos estudios han analizado los diferentes tipos de TerapiaCognitivo-Conductual (TCC) para dicho trastorno, pero ello hace necesario estudiar la eficacia de TCC. El objetivo de esta revisión de revisioneses determinar que tratamientos y que factores son más eficaces para el TAS en población infanto-juvenil. Se realizó una revisión de revisiones sobrela efectividad de las intervenciones psicológicas para tratar el TAS en niños y adolescentes. Para ello, se realizó una búsqueda en nueve bases dedatos utilizando una combinación de palabras clave. El riesgo de sesgo se evaluó mediante la herramienta AMSTAR-2. Se seleccionaron y analizaronseis revisiones sistemáticas y meta-análisis. Todos los estudios seleccionados evaluaron la eficacia de la TCC en niños y adolescentes con SAD,demostrando su efectividad a corto y largo plazo. Los componentes que parecen ser más efectivos son la exposición en cualquier modalidad y elentrenamiento en habilidades sociales. Otras consideraciones a tener en cuenta se abordan en la discusión. (AU)
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Humanos , Fobia Social/psicologia , Fobia Social/terapia , Resultado do Tratamento , Terapêutica , Criança , Psicologia do AdolescenteRESUMO
Social anxiety disorder is a highly prevalent psychiatric disorder, with elevated comorbidity rates with other mental health disorders and may cause severe negative consequences. In adolescence, there is a lack of research on how comorbid disorders to social anxiety tends to form particular associations. With a large sample of adolescents with a clinical diagnosis of social anxiety disorder, data have revealed that certain disorders are more frequent and tend to dwell on concrete aggregates. Thus, it may be particularly useful and efficient for mental health providers, pediatricians and school counselors to screen for generalized anxiety disorder and specific phobia when assessing SAD in youth. Overall, findings stress the presence of comorbidity being the rule rather than the exception in adolescents with social anxiety disorder, and the need for further examination of its impact on assessment and differential diagnosis on this psychiatric disorder.
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Emotional states, attitudes and intentions are often conveyed by modulations in the tone of voice. Impaired recognition of emotions from a tone of voice (receptive prosody) has been described as characteristic symptoms of schizophrenia. However, the ability to express non-verbal information in speech (expressive prosody) has been understudied. This paper describes a useful technique for quantifying the degree of expressive prosody deficits in schizophrenia, using a semi-automatic method, and evaluates this method's ability to discriminate between patient and control groups. Forty-five medicated patients with a diagnosis of schizophrenia were matched with thirty-five healthy comparison subjects. Production of expressive prosodic speech was analyzed using variation in fundamental frequency (F0) measures on an emotionally neutral reading task. Results revealed that patients with schizophrenia exhibited significantly more pauses (p < .001), were slower (p < .001), and showed less pitch variability in speech (p < .05) and fewer variations in syllable timing (p < .001) than control subjects. These features have been associated with «flat¼ speech prosody. Signal processing algorithms applied to speech were shown to be capable of discriminating between patients and controls with an accuracy of 93.8%. These speech parameters may have a diagnostic and prognosis value and therefore could be used as a dependent measure in clinical trials.
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Esquizofrenia/diagnóstico , Acústica da Fala , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Linguagem do Esquizofrênico , Psicologia do EsquizofrênicoRESUMO
The role that parents' involvement may play in improving their child's social anxiety is still under debate. This paper aimed to investigate whether training parents with high expressed emotion (EE) could improve outcomes for adolescent social anxiety intervention. Fifty-two socially anxious adolescents (aged 13-18 years), whose parents exhibited high levels of expressed emotion, were assigned to either (a) a school-based intervention with an added parent training component, or (b) a school-based program focused solely on intervening with the adolescent (no parental involvement). Post-treatment and 12-month follow-up findings showed that school-based intervention with parent training was superior to the adolescent-specific program, yielding significant reductions in diagnosis remission, social and depressive symptomatology, particularly when the EE status of parents changed. Overall, the findings suggest that high-EE parents of children with social anxiety need to be involved in their child's therapy.
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Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Emoções Manifestas , Poder Familiar , Pais/educação , Adolescente , Análise de Variância , Ansiedade/psicologia , Depressão/terapia , Terapia Familiar/métodos , Feminino , Humanos , Masculino , Pais/psicologia , Serviços de Saúde Escolar , Resultado do TratamentoRESUMO
Resumen Se trató de detectar y describir variables socio-demográficas y clínicas en personas que han realizado una tentativa suicida. Se llevó a cabo un análisis de los registros telemáticos sobre personas admitidas en los servicios de Urgencias del distrito sanitario norte durante el periodo 2009-2011 por trastornos mentales. Se seleccionaron 826 registros de personas, donde 485 eran mujeres, entre 14 y 94 años. Del total, 412 habían realizado un intento de suicidio, y fueron comparadas con otras personas sin tentativa suicida previa. Se aplicó un análisis de regresión logística binaria para examinar los factores más predictivos del intento de suicidio. Los resultados muestran que el riesgo de realizar un intento de suicidio aumenta con la edad, donde el periodo de mayor riesgo es el de 34 a 53 años (p < 0,001; OR = 6,99), ser de género femenino (p < 0,05; OR = 2,70) y encontrarse desempleada (p < 0,05; OR = 4,98). Los diagnósticos psicopatológicos más predictivos para la tentativa suicida fueron los trastornos de ansiedad (p < 0,01; OR = 3,95) y los trastornos del control de impulsos/adicciones (p < 0,01; OR = 3,76). Se discute la importancia de crear perfiles de riesgo y protección concretos para la puesta en marcha de políticas sanitarias contextualizadas de prevención de la tentativa suicida.
Abstract The aim was to identify and describe socio demographic and clinical variables in individuals who have made a suicide attempt. An analysis of electronically stored records on persons admitted to the emergency departments of a northern health district during the period 2009-2011 for mental disorders was conducted. The records of 826 patients (30.1% of the total), where 485 (58.7%) were female, aged between 14 and 94 years (M = 49.3; SD = 12.7), were selected. This amounted to 412 individuals (49.9%) who had made a suicide attempt, and were compared with others without prior suicide attempt. A binary logistic regression analysis was performed to examine the strongest predictors of suicide attempt. The results show that the risk of making a suicide attempt increases with age, those most at risk being aged 34 to 53 years (p < 0.01; OR = 6.99), female (p < 0.05; OR = 2.70) and unemployed (p < 0.05; OR = 4.98). The most predictive psychopathological diagnoses for suicide attempt were anxiety disorders (p < 0.01; OR = 3.95) and impulse control disorders/addictions (p < 0.01; OR = 3.76). The importance of creating specific risk and protection profiles when implementing contextualized health policies on suicide attempt prevention is discussed.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Tentativa de Suicídio/estatística & dados numéricos , Serviço Hospitalar de Emergência , Transtornos Mentais/epidemiologia , Espanha/epidemiologia , Desemprego/estatística & dados numéricos , Modelos Logísticos , Fatores Sexuais , Fatores de Risco , Fatores Etários , Pessoa de Meia-IdadeRESUMO
Suicide is a serious global public health problem in both developed and developing countries. The results of the research reviewed here reveal that, in Europe, one person dies by suicide every nine minutes, and that in Spain it is currently the leading external cause of death after road traffic accidents. This review presents the latest findings on effective suicide prevention strategies in the general population as well as the most appropriate instruments for assessing the level of risk for suicidal behavior in a clinical population. The treatments that scientific literature reports to be most effective in the fight against suicide are also included. The most significant results in terms of both prevention and treatment are discussed and several limitations to this study are also raised, which may be considered for future work by practitioners and researchers interested in this field
El suicidio es un grave problema de salud pública mundial, tanto en países desarrollados como en vías de desarrollo. Los resultados de las investigaciones analizadas muestran que en Europa muere una persona cada nueve minutos debido a esta causa y que, actualmente, en España el suicidio es la primera causa de muerte externa por encima de los accidentes de tráfico. Se presenta una revisión de las últimas conclusiones sobre acciones eficaces de prevención de este tipo de conductas en población normal, así como los instrumentos más adecuados para evaluar el nivel de riesgo para cometer una conducta suicida en población clínica. También se ofrecen los tratamientos, que la literatura científica, ha detectado más eficaces en la lucha contra el suicidio. Se discuten los resultados más destacados en la prevención y tratamiento del suicidio, y también se plantean diversas limitaciones de este estudio, que podrían ser consideradas líneas futuras de investigación para profesionales e investigadores interesados en esta temática
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Humanos , Tentativa de Suicídio/psicologia , Ideação Suicida , Suicídio/psicologia , Fatores de Risco , Suicídio/prevenção & controle , Avaliação de Eficácia-Efetividade de IntervençõesRESUMO
Siendo el suicidio la segunda causa de muerte entre los estudiantes universitarios, este artículo examinó las diferencias en algunas variables psicológicas asociadas a estudiantes universitarios (21-34 años) de Psicopedagogía con magisterio y con alta ideación suicida (BDI >10). Se valoró la existencia de ideación suicida en estos estudiantes (n= 40, 70% mujeres, edad media de 23,9 años y DT= 3,003) en relación con el control de impulsos, la depresión y la desesperanza. Los resultados mostraron que los estudiantes con alta desesperanza son más propensos a presentar ideación suicida, siendo el nivel de control de impulsos el que evita el tránsito de la ideación a otras fases más graves del suicidio. La identificación de los factores psicológicos asociados con la ideación suicida en universitarios, puede ayudar a evitar el tránsito de la idea de suicidio a la primera tentativa suicida (AU)
Suicide being the second leading cause of death among college students, this article examined differences in psychological variables related to college students (21-34 years) in Psychology with teaching and with high suicidal ideation (BDI> 10). We evaluated the presence of suicidal ideation in these students (n= 40, 70% female, mean age 23.9 years, SD= 3,003) regarding impulse control, depression and hopelessness. The results showed that students with high hopelessness are more likely to have suicidal ideation, and the level of impulse control that prevents the transition from ideation to other more serious stages of suicide. The identification of psychological factors associated with suicidal ideation in college, can help prevent the transition from suicidal ideation to first suicide attempt (AU)
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Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Ideação Suicida , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Suicídio/prevenção & controle , Fatores de Risco , Estudantes/estatística & dados numéricos , Alienação Social , Psicometria/instrumentaçãoRESUMO
La literatura científica ha mostrado que la inhibición conductual (IC) se caracteriza por la presencia de ansiedad ante estímulos desconocidos, lo que conlleva conductas de retraimiento y evitación social. El presente estudio realiza una revisión bibliográfica sobre la IC y su relación con los trastornos de ansiedad en la infancia. Dado que la IC puede observarse en edades muy tempranas, la literatura ha examinado su papel predictor en el desarrollo de trastornos de ansiedad. Pese a ello, los estudios revisados apuntan a que no todos los niños ansiosos muestran un comportamiento inhibido ni todos los niños con IC sufren trastornos de ansiedad. Dada esta disparidad, sería necesario estudiar qué otros factores están implicados. Asimismo, los datos apuntan a que una detección precoz de la IC permitiría desarrollar programas de prevención de los trastornos de ansiedad en la infancia.
The literature has revealed that Behavioral inhibition (BI) is characterized by the presence of anxiety to unknown stimuli, which leads to withdrawal behaviors and social avoidance. The present study is aimed at revising the state-of-the-art on BI and examining its role that plays of childhood anxiety disorders. As the IB can be observed at very early ages, the literature has examined its predictive role in the development of anxiety disorders. Despite this, the reviewed studies suggest that not all anxious children show comorbid BI nor all inhibited children have anxiety disorders. Given this disparity, it would be necessary to consider what other factors are involved in the anxiety disorders. Furthermore, the data suggest that early detection of the BI would contribute to develop prevention programs for anxiety disorders in childhood.
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Humanos , Criança , Inibição Psicológica , Transtornos de AnsiedadeRESUMO
Emotional states, attitudes and intentions are often conveyed by modulations in the tone of voice. Impaired recognition of emotions from a tone of voice (receptive prosody) has been described as characteristic symptoms of schizophrenia. However, the ability to express non-verbal information in speech (expressive prosody) has been understudied. This paper describes a useful technique for quantifying the degree of expressive prosody deficits in schizophrenia, using a semi-automatic method, and evaluates this methods ability to discriminate between patient and control groups. Forty-five medicated patients with a diagnosis of schizophrenia were matched with thirty-five healthy comparison subjects. Production of expressive prosodic speech was analyzed using variation in fundamental frequency (F0) measures on an emotionally neutral reading task. Results revealed that patients with schizophrenia exhibited significantly more pauses (p < .001), were slower (p < .001), and showed less pitch variability in speech (p < .05) and fewer variations in syllable timing (p < .001) than control subjects. These features have been associated with «flat» speech prosody. Signal processing algorithms applied to speech were shown to be capable of discriminating between patients and controls with an accuracy of 93.8%. These speech parameters may have a diagnostic and prognosis value and therefore could be used as a dependent measure in clinical trials (AU)
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Feminino , Humanos , Masculino , Adulto , Esquizofrenia/diagnóstico , Acústica da Fala , Estudos de Casos e Controles , Linguagem do Esquizofrênico , Psicologia do Esquizofrênico , Estudos Retrospectivos , Estudos TransversaisRESUMO
Justificación: La diabetes es una elevación crónica de glucosa en sangre. En niños, el tratamiento no es administrado por el paciente sino por su cuidador. Así, las características personales que aseguren la adherencia al tratamiento dependen de otra persona. Objetivo Principal: Identificar qué características personales y ambientales del cuidador favorecen o interfieren la adherencia al tratamiento. Diseño y Metodología: Participaron 60 cuidadores principales de niños diabéticos (edad: 1-15 años). Evaluándose optimismo, autoeficacia, neuroticismo, estrategias de afrontamiento, estilos educativos, apoyo social (del cuidador), así como adherencia objetiva en los niños (análisis sanguíneo), además de variables demográficas y familiares de ambos. Se realizaron correlaciones y diferencias entre grupos utilizando variables de agrupamiento como tener o no adherencia al tratamiento, entre otras. El estudio duró un año durante el cual los cuidadores asistieron a sesiones psicoeducativas sobre la enfermedad. Resultados: Principales y Conclusiones. El perfil del cuidador con mejor adherencia objetiva: alguien con buenos conocimientos sobre la enfermedad, temor ante las consecuencias de no seguir el tratamiento, acostumbrado a afrontar problemas buscando soluciones, con una actitud y motivación positivas y sin sentirse culpable. En su relación con los pacientes muestra un alto grado de control y de afecto (cuidador democrático)
Justification: Diabetes is a chronic elevation of glucose in the blood. In the case of children, treatment is not administrated by the patient but their caregivers. In this sense, personal characteristics that increase treatment compliance are not dependent on oneself but on other people. Main Aim: To find personal and environmental characteristics that may increase or decrease objective treatment compliance. Design and Method: Participants in this study were 60 principal caregivers of diabetic children (aged: 1-15 years). Optimism, self-efficacy, neuroticism, copying styles, parental styles, social support, demographic and family variables of caregivers were evaluated. Objective adherence, demographic and family variables of children were also measured. Analyses of data included means, correlations and differences between groups. Caregivers assisted to some psychoeducational sessions during the study, that lasted one year. Results and Conclusions: Caregivers with higher objective adherence are characterized by having a thorough knowledge of diabetes, and being afraid of consequences of bad treatment compliance; they usually use problem-solving copying strategies, they show a positive motivation and attitude and they do not feel guilty. Finally, they exhibit a high level of control and affect in their parent-son relationships (democratic parental style)