Identifying Adolescents at Risk for Emotional Disorders with Latent Profile Analysis: A Personalized, Transdiagnostic Preventive Intervention.

It can be challenging to assign patients to the appropriate intervention programs, as risk and protective factors for developing emotional disorders are multiple and shared across disorders. This study aimed to provide a theoretical and empirical approach to identify and categorise adolescents into different levels of severity. The risk of developing emotional symptoms was assessed in 1425 Spanish adolescents (M = 14.34, SD = 1.76; 59.9% women). Latent Profile Analysis (LPA) was conducted to identify subgroups based on their emotional symptom severity, risk, and resilience factors. Results revealed four profiles: at low risk (emotionally healthy), moderate risk (for selective interventions), high risk (for indicated interventions), and severe risk (for clinical referral). Older age and especially female gender were predictors of higher risk clusters, and there were differences in the levels of psychopathology and health-related quality of life across clusters. Identification of at-risk adolescents for emotional disorders by means of LPA may contribute to designing personalised and tailored prevention programs that match adolescents' specific needs.

Sensory Overresponsivity and Symptoms Across the Obsessive-Compulsive Spectrum: Web-Based Longitudinal Observational Study.

BACKGROUND: Sensory overresponsivity (SOR) has emerged as a potential endophenotype in obsessive-compulsive disorder (OCD), but few studies have examined SOR in relation to the major symptom dimensions of OCD and to symptoms across the full obsessive-compulsive (OC) symptom spectrum. OBJECTIVE: This study had 2 main objectives. First, we examined the psychometric properties of the SOR Scales in a community-based sample of Spanish adolescents and adults. Second, we identified how SOR difficulties are related to symptoms across the full OC spectrum (eg, OC, body dysmorphic, hoarding, skin-picking, and hair-pulling symptoms), including the heterogeneity of OC symptoms. METHODS: We translated the SOR Scales into Spanish-a measure that assesses SOR across the 5 sensory modalities-and created a web-based version of the measure. A sample of 1454 adolescents and adults (mean age 23.84, SD 8.46 years) participated in the study, and 388 (26.69%) participants completed the survey twice (approximately 8 months apart). The survey also contained a web-based measure that assesses symptoms across the full OC spectrum: harm and checking, taboo obsessions, contamination or cleaning, symmetry and ordering, body dysmorphic, hoarding, hair-pulling, and skin-picking symptoms. RESULTS: The psychometric properties of the SOR Scales were excellent, and the test-retest reliability was adequate. All types of SOR were related to all major symptom dimensions of OCD and to all OC spectrum symptoms. CONCLUSIONS: SOR across the sensory modalities can be validly assessed using a web-based measure. SOR emerged as a pure transdiagnostic phenomenon in relation to symptoms across the OC spectrum, with no specific sensory modality being more strongly related to OC symptoms. SOR can shed much needed light on basic mechanisms that are important for the onset and maintenance of OC spectrum symptoms, and this study shows that large-scale web-based studies can aid in this endeavor. Future studies should examine whether SOR precedes or emerges alongside OC symptoms.

A 12-Month Follow-Up of PROCARE+, a Transdiagnostic, Selective, Preventive Intervention for Adolescents At-Risk for Emotional Disorders.

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.

Socio-emotional strengths against psychopathology and suicidal ideation in fear of COVID-19.

Coronavirus disease (COVID-19) has caused a global health crisis. It also leads to different types of psychosocial problems in society as a result of preventive health measures and the disease itself. Among others, psychopathological symptoms and suicide behaviors have increased. The PsicorecurSOS COVID-19 online protocol was designed. At baseline, 1020 Spanish adults were assessed, during confinement, for sociodemographics, fear of COVID-19, anxious-depressive symptoms, covitality, and suicidal ideation. Reliability, descriptive, and frequency analyses were carried out, and the computer tool SPSS PROCESS was used to carry out a conditional process analysis (model 59). A total of 595 participants were included (58.30% response rate from baseline; mean age = 37.18 [SD = 13.30]; 72.44% female). Regarding suicidal ideation, 12% responded differently to "never," 19.3% exceeded the cutoff point on the anxiety scale, and 24% on the depression scale. Moderate mediation analysis explained 27% of the variance in suicidal ideation. In addition, the indirect effect of moderate mediation was significant (b = -.004, SE = .002 with the presence of covitality; and b = .01, SE = .003 absence of covitality). Sex and age did not influence the overall outcome of the model. The data from this study can serve as a starting point for generating social and health treatment initiatives based on self-examination of anxiety-depressive symptoms and increasing socio-emotional skills in order to prevent and alleviate the psychosocial effects of the pandemic.

Short Form of the Pediatric Symptom Checklist-Youth Self-Report (PSC-17-Y): Spanish Validation Study.

BACKGROUND: The short form, 17-item version of the Pediatric Symptom Checklist-Youth Self-Report (PSC-17-Y) is a validated measure that assesses psychosocial problems overall (OVR) and in 3 major psychopathological domains (internalizing, externalizing, and attention-deficit/hyperactivity disorder), taking 5-10 min to complete. Prior research has established sound psychometric properties of the PSC-17-Y for English speakers. OBJECTIVE: This study extends psychometric evidence for the acceptability of the PSC-17-Y in a large sample of Spanish adolescents, providing proof of its reliability and structure, convergent and discriminant validity, and longitudinal and gender invariance. METHODS: Data were collected on 5430 adolescents, aged 12-18 years, who filled out the PSC-17-Y twice during 2018-2019 (7-month interval). We calculated the Cronbach alpha and the McDonald omega coefficients to test reliability, the Pearson correlation for convergent (distress) and criterion validity (well-being, quality of life, and socioemotional skills), confirmatory factor analysis (CFA) for structure validity, and multigroup and longitudinal measurement invariance analysis for longitudinal and gender stability. RESULTS: Within structural analysis for the PSC-17-Y, CFA supported a correlated 3-factor solution, which was also invariant longitudinally and across gender. All 3 subscales showed evidence of reliability, with coefficients near or above .70. Moreover, scores of PSC-17-Y subscales were positively related with convergent measures and negatively related with criterion measures. Normative data for the PSC-17-Y are presented in the form of percentiles (75th and 90th). CONCLUSIONS: This work provides the first evidence of the reliability and validity of the Spanish version of the PSC-17-Y administered over the internet to assess mental health problems among adolescents, maintaining the same domains as the long version.

Standard scores of the Repetitive Behavior Scale-Revised for people with autism and intellectual disability in Spain.

INTRODUCTION: Repetitive behavior is a transdiagnostic variable that is present in many neurodevelopmental disorders. The Repetitive Behavior Scale-Revised (RBS-R) by Bodfish is one of the tests most used to evaluate repetitive behaviors in people with autism and intellectual disability. MATERIALS AND METHODS: In the present article, we analyze the differences in repetitive behavior according to the diagnosis, the interaction effects between diagnoses and gender and/or age and display the standard scores of the RBS-R for a group of people with autism, a group of people with intellectual disability and another group of people with Autism and intellectual disability. RESULTS: The results indicate that there are differences in the repetitive behavior between the groups, being greater the severity of the repetitive behaviors in people with autism associated to intellectual disability, followed by autism, and finally intellectual disability. Finally, the RBS-R percentiles according to diagnostic groups are shown. CONCLUSIONS: The RBS-R has been shown to be a useful diagnostic tool for assessing some of the main neurodevelopmental disorders, such as autism spectrum disorders and intellectual disability.

Factor Structure, Reliability, and Validity of the Spanish Version of the Children's Florida Obsessive Compulsive Inventory (C-FOCI).

The Children's Florida Obsessive Compulsive Inventory (C-FOCI) is a promising self-report measure of the presence and severity of obsessive-compulsive symptoms in children and adolescents. Although initial research showed it to have adequate psychometric properties, only one study has been published to date, which dealt exclusively with children. The aim of this report was to examine the psychometric properties of the C-FOCI across clinical and community samples of children and adolescents. The sample consisted of 94 Spanish-speaking patients with obsessive-compulsive disorder (OCD) and 1068 healthy community controls, aged 8-19 years. Factor analysis supported two single and independent factors (severity and symptoms), as well as metric invariance across groups for the symptom checklist and the Severity Scale. Results also indicated good reliability in terms of internal consistency and temporal stability, significant and high correlations with other OCD measures, and acceptable sensitivity and specificity for detect OCD. In summary, the C-FOCI is a promising, brief measure of 22 items for screening OCD symptoms and severity in children and adolescents.

Psychometric Properties of the Gastrointestinal Symptom Severity Scale in a Sample of Adolescents and Young Adults.

Background: Functional gastrointestinal disorders (FGIDs) are a set of chronic or recurrent gastrointestinal symptoms (GS) with great psychobiological complexity. The appearance of FGIDs harms quality of life and drains medical resources. Methods: Psychometric properties of the Gastrointestinal Symptom Severity Scale (GSSS) based on Rome IV criteria were examined in a sample of 1247 individuals with typical development. Observations were randomly divided into two subsets, namely, subsample 1 (n = 624) and subsample 2 (n = 623). Exploratory factor analysis (EFA) was performed with data from subsample 1, whilst confirmatory factor analysis (CFA) was performed with data from subsample 2. Internal consistency of the scale was assessed for the whole dataset according to ordinal alpha, whilst four-week reliability was measured according to the intraclass correlation coefficient (ICC). Measurement invariance as a function of sex was also examined, and discriminant-convergent validity of the GSSS was examined through hypothesis testing. Results: EFA revealed a two-factor structure with a moderate percentage of explained variance (51.3%), whilst CFA exhibited an excellent fit of the data to the model. A one-factor CFA model demonstrated an acceptable but slightly lower fit. Internal consistency was moderate and test-retest reliability was deemed adequate. Metric invariance was demonstrated as a function of sex. Hypothesis testing demonstrated strong convergent-discriminant validity with measures of sensory sensitivity, obsessive-compulsive symptoms, and pain. Conclusions: The GSSS is a tool with acceptable and promising psychometric properties when administered to neurotypical adolescents and young adults. The self-report GSSS may promote better understanding of GS involvement in the gut microbiota-brain axis in the general population.

Sexual behaviour under the influence of alcohol among Spanish adolescents.

This paper aims to compare sexual behaviour and risk and protective factors between samples of adolescents who have sex under the influence of alcohol and those who do not, and to determine predictors factors for having had sex under the influence of alcohol. We analysed differences between these two groups in sexual practices, attitudes towards HIV, subjective norms and HIV knowledge. Drawing on survey data collected from 1216 Spanish adolescents aged 14-18 (M = 15.92; SD = .76), a subset of 297 sexually experienced participants was selected. Of these, 117 reported having had sex under the influence of alcohol in the past six months (51% girls). Adolescents who combined sex and alcohol engaged more in vaginal sex, oral sex and anal sex than those who did not. Having had sex under the influence of alcohol in the past six months was associated with negative attitudes towards condom use, when there are obstacles on using them, and less consistent condom use. There were no differences in knowledge about STIs/HIV between both groups. Adolescents who combined sex and alcohol showed further characteristics associated with sexual risk. Preventive measures must address the particular characteristics of this risk group. Further evidence is need about alcohol effects on sexual behaviour.

Measuring symptoms of obsessive-compulsive and related disorders using a single dimensional self-report scale.

Background: Obsessions and compulsions are heterogenous but can be classified into obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), hair-pulling disorder (HPD), and skin-picking disorder (SPD). OCD is in itself heterogenous, with symptoms clustering around four major symptom dimensions: contamination/cleaning, symmetry/ordering, taboo obsessions, and harm/checking. No single self-report scale captures the full heterogeneity of OCD and related disorders, limiting assessment in clinical practice and research on nosological relations among the disorders. Methods: To provide a single self-report scale of OCD and related disorders that respects the heterogeneity of OCD, we expanded the DSM-5-based Obsessive-Compulsive and Related Disorders-Dimensional Scales (OCRD-D) so that is also includes the four major symptom dimensions of OCD. A psychometric evaluation and an exploration of the overarching relations among the dimensions were conducted using an online survey which was completed by 1,454 Spanish adolescents and adults (age span = 15-74 years). Approximately 8 months after the initial survey, 416 participants completed the scale again. Results: The expanded scale showed excellent internal psychometric properties, adequate test-retest correlations, known groups validity, and correlations in the expected directions with well-being, depression/anxiety symptoms, and satisfaction with life. The higher-order structure of the measure indicated that harm/checking and taboo obsessions formed a common disturbing thoughts factor and that HPD and SPD formed a common body-focused repetitive behaviors factor. Conclusion: The expanded OCRD-D (OCRD-D-E) shows promise as a unified way to assess symptoms across the major symptom dimensions of OCD and related disorders. The measure may be useful in clinical practice (e.g., screening) and research, but more research on construct validity, incremental validity, and clinical utility is needed.

Let's Talk About Suicide Spectrum in Spanish Adolescents. "Prefer not to say": Missing Value or Clinical Data?

BACKGROUND: Suicide is the second leading cause of death in young people aged 15-29 in Spain. It is imperative to detect cases with suicidal risk for early intervention. The purpose of the study was to examine the self-reported presence of suicide spectrum indicators using a trichotomous rating scale: no, yes, prefer not to say . This last alternative was intended to safeguard the sensitive nature of the phenomenon and explore its clinical character. METHOD: 5,528 adolescents made up the definitive sample (12-18 years; M ± SD = 14.20 ± 1.53; 50.74% female). RESULTS: Prevalence reached 15.38% for ideation, 9.32% for planning, and 3.65% for previous suicide attempts. Girls' rates were twice those of men. Suicidality showed a tendency to increase with age. Adolescents with the presence of suicidal indicators (yes) and omission of response (prefer not to say) both had lower levels of socioemotional strength and subjective well-being, and higher levels of psychopathology than the group with the absence of markers (no). CONCLUSIONS: Prefer not to say is a response category that increases the sensitivity of the self-report, allowing more accurate identification of cases with a high suicidal risk that would go unnoticed by the traditional dichotomous system (no-yes).

Women Victims of Intimate Partner Violence and Intimate Partner Homicide: A Typology Based on Victimization Variables.

Intimate partner violence against women (IPVAW) and intimate partner homicide against women (IPHAW) are multidimensional phenomena. The aim of this study was to identify typologies of Spanish IPHAW and IPVAW victims, based on the differences between their characteristics and the determinants of aggression. The sample consisted of 381 cases from the Spanish Integral Monitoring System in Cases of Gender Violence. The instrument used was a semi-structured interview. Results showed differences between IPHAW and IPVAW victims, and latent class analysis suggested a three-profile solution: 1-fatal victims, with low neuroticism, low isolation, and feelings of loneliness, less reconciliation with the aggressor, lower perception of risk and low suicidal ideation; 2-non-fatal victims, with the loss of a loved one and the role of caregiver as stressors, low psychoticism and alcohol abuse, high feelings of loneliness, risk perception, and suicidal ideation; 3-mixed profile, with high neuroticism and psychoticism, alcohol abuse, isolation, and greater reconciliations with the aggressor, and absence of bereavement and caregiver role as stressors. Knowing the differences between IPHAW and IPVAW victims allows the design of more specific instruments for risk assessment and the design of more individualized prevention and treatment programs. This also facilitates police work in identifying victims and deploying more intense protection measures.

La violencia de pareja contra la mujer (violencia de género, VdG) y el homicidio de pareja contra la mujer (feminicidio) son fenómenos multidimensionales. El objetivo de este estudio fue identificar las tipologías de las víctimas españolas de feminicidio y VdG, basado en las diferencias entre sus características y los determinantes de la agresión. La muestra constaba de 381 casos del Sistema Español de Seguimiento Integral de Casos de Violencia de Género. El instrumento utilizado fue una entrevista semiestructurada. Los resultados mostraron diferencias entre las víctimas de VdG y las víctimas de feminicidios y el análisis de clases latentes sugirió tres perfiles: 1-víctimas mortales, con bajo neuroticismo, bajo aislamiento y sentimientos de soledad, menor reconciliación con el agresor, menor percepción de riesgo y baja ideación suicida; 2-víctimas no mortales, con la pérdida de un ser querido y el rol de cuidador como estresores, bajo psicoticismo y abuso de alcohol, sentimientos de soledad elevados, percepción de riesgo e ideación suicida; 3-perfil mixto, con neuroticismo y psicoticismo elevados, abuso de alcohol, aislamiento y una mayor reconciliación con el agresor y ausencia de duelo y del rol de cuidador como estresores. Conocer las diferencias entre víctimas de feminicidio y de VdG permite el diseño de instrumentos más específicos para la evaluación del riesgo y el diseño de programas de prevención y tratamiento más individualizados. También facilita la labor policial en la identificación de las víctimas y el despliegue de medidas de protección más intensas.

Suicidal Risk During Adolescence: Could Covitality Be Part of the Solution?

OBJECTIVE: The covitality model suggests that the co-disposition and synergy of core psychosocial assets (i.e., covitality) buffer the negative impact of stressful events and prevent the emergence of mental health problems during adolescence. At this stage of development, suicide already constitutes the leading cause of unnatural death in Europe. The present study aimed to examine how covitality relates to bidimensional mental health status (i.e., psychopathology and subjective well-being) and suicidal risk. METHOD: Participants were 5,296 Spanish students ages 12 to 18 years (Mage ± SD = 14.19 ± 1.53), 50.2% male. RESULTS: In a structural equation mediational model, covitality acted as a powerful shield of psychosocial strengths against suicidality, via an indirect effect entirely mediated by its impact on bidimensional mental health. The total variance in suicidal risk explained by the set of independent variables was 61.8%, while the total variance of psychopathology and subjective well-being explained by covitality was 54.1% and 75.6%, respectively. CONCLUSIONS: These preliminary findings highlight the need for further study of covitality as a defense strategy against adolescent suicide. HIGHLIGHTSCovitality promote subjective well-being and prevent psychopathological symptoms.These self-perceived psychosocial strengths do not have direct effect on suicidality.Covitality is related to lower suicidal risk through indirect mechanisms: via bidimensional approach to mental health status (BMH).

Civic Engagement and Personality: Associations with the Big Five and the Dark Triad.

Several studies have analyzed the relationship between general personality traits and attitudes and behaviors, indicating that a person is more committed to the community. After raising the question of whether malevolent traits might also be related, the aim was to analyze the relationship between civic engagement and personality, delving into the contribution of the Dark Triad (narcissism, Machiavellianism, and psychopathy) and controlling for the association with the Big Five. The Civic Engagement Questionnaire, the Short Dark Triad, and the Big Five Inventory-10 were administered to 1175 Spanish students (convenience sampling). After performing statistical analyses using SPSS statistical software, it was obtained that the three Dark Triad traits explained 11% of the total explained variance of civic engagement, while 19% was reached when the Big Five were included. Narcissism and openness were the factors most strongly associated with engagement. The positive relationship between narcissism and general personality traits could explain why narcissistic people have more favorable attitudes. Furthermore, people with narcissistic traits may display these attitudes for their own benefit. This study provides further evidence of how the narcissistic personality trait differs from the other two malevolent traits. Given that these traits are also associated with maladaptive behaviors, knowing all their characteristics could facilitate the design of prevention programs aimed at reducing such maladaptive behaviors.

Assessing Emotional Distress in Adolescents: Psychometrics of the Spanish Version of the Social Emotional Distress Scale-Secondary.

Background: The Social Emotional Distress Scale-Secondary (SEDS-S) is a short measure designed for comprehensive school-based mental health screening, particularly for using very brief self-reported measures of well-being and distress. Whereas prior studies have shown validity and reliability evidence for the English version, there is a lack of literature about its psychometric properties for Spanish-speaking youths. Objective: To examine the psychometric properties of the SEDS-S in a large sample of Spanish adolescents, providing evidence of its reliability, structure, convergent and discriminant validity, longitudinal and gender measurement invariance, and normative data. Methods: Participants were 5550 adolescents aged 12-18 years old. Test-retest reliability was examined using Cronbach's alpha and McDonald's omega coefficients, and evidence for convergent and discriminant validity was measured using Pearson's correlation. Confirmatory factor analysis (CFA) was used to examine structure validity, while multigroup and longitudinal measurement invariance analysis was conducted for longitudinal and gender latent structure stability. Results: The CFA supported a unidimensional latent structure, which was also observed to be invariant between gender groups and over time. The scale showed evidence of reliability, with coefficients above .85. In addition, the SEDS-S score was positively related to measures assessing distress and negatively related to measures assessing well-being, thereby providing convergent/discriminant validity of the total scores. Conclusion: This study provides the first evidence of the reliability and validity of the Spanish version of the SEDS-S for assessing emotional distress among adolescents, cross-sectionally and longitudinally. Furthermore, findings indicated that SEDS-S could be a suitable assessment tool for screening and program evaluation purposes at different contexts beyond the school setting.

Relationship between Cognitive Strategies of Emotion Regulation and Dimensions of Obsessive-Compulsive Symptomatology in Adolescents.

Cognitive emotion regulation refers to the management of one's emotions through cognitive strategies. Studies have found that individuals with obsessive-compulsive symptoms utilize emotion regulation strategies differently compared to those without these symptoms. This study aims to investigate the relationship between cognitive strategies for emotion regulation and specific dimensions of obsessive-compulsive symptoms in adolescents. A cross-sectional descriptive study was conducted with 307 adolescents between 12 and 18 years old. Associations between sociodemographic variables, obsessive-compulsive symptoms, and emotion regulation strategies were examined using regression and network analyses. Regression results indicated that emotion regulation strategies and gender accounted for 28.2% of the variation in overall obsessive-compulsive symptoms (p < 0.001) and that emotion regulation explained most variance in the symptom dimension of obsessing. Network analysis showed that self-blame and catastrophizing were uniquely linked to overall obsessive-compulsive symptoms, while several strategies were uniquely linked to specific symptom dimensions. The adaptive strategy that demonstrated the strongest association with obsessive-compulsive symptoms was refocus on planning, while maladaptive strategies included catastrophizing, self-blame, and rumination. In conclusion, the results support the relationship between cognitive strategies for emotion regulation and dimensions of obsessive-compulsive symptoms in adolescents, though these relations appear complex and require further investigation. Addressing emotion regulation in the prevention of obsessive-compulsive symptoms may be warranted, but prospective studies are needed.

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders.

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.

Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders.

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.

Experience sampling methods for the personalised prediction of mental health problems in Spanish university students: protocol for a survey-based observational study within the PROMES-U project.

INTRODUCTION: There is a high prevalence of mental health problems among university students. Better prediction and treatment access for this population is needed. In recent years, short-term dynamic factors, which can be assessed using experience sampling methods (ESM), have presented promising results for predicting mental health problems. METHODS AND ANALYSIS: Undergraduate students from five public universities in Spain are recruited to participate in two web-based surveys (at baseline and at 12-month follow-up). A subgroup of baseline participants is recruited through quota sampling to participate in a 15-day ESM study. The baseline survey collects information regarding distal risk factors, while the ESM study collects short-term dynamic factors such as affect, company or environment. Risk factors will be identified at an individual and population level using logistic regressions and population attributable risk proportions, respectively. Machine learning techniques will be used to develop predictive models for mental health problems. Dynamic structural equation modelling and multilevel mixed-effects models will be considered to develop a series of explanatory models for the occurrence of mental health problems. ETHICS AND DISSEMINATION: The project complies with national and international regulations, including the Declaration of Helsinki and the Code of Ethics, and has been approved by the IRB Parc de Salut Mar (2020/9198/I) and corresponding IRBs of all participating universities. All respondents are given information regarding access mental health services within their university and region. Individuals with positive responses on suicide items receive a specific alert with indications for consulting with a health professional. Participants are asked to provide informed consent separately for the web-based surveys and for the ESM study. Dissemination of results will include peer-reviewed scientific articles and participation in scientific congresses, reports with recommendations for universities' mental health policy makers, as well as a well-balanced communication strategy to the general public. STUDY REGISTRATION: osf.io/p7csq.

Relationships Between Emotion Regulation, Social Communication and Repetitive Behaviors in Autism Spectrum Disorder.

The relationship between emotion regulation, social interaction and different types of restricted and repetitive behaviors is poorly understood. In the present study, structural equation modeling based on information about 239 individuals with autism was used to examine whether emotion regulation and social communication were associated with self-injury and stereotyped behaviors. Results showed that poor emotion regulation had a unique association with self-injury while difficulties with social communication was uniquely associated with stereotyped behaviors. Emotion regulation and social communication were strongly associated and self-injury and stereotyped behaviors moderately associated. This implies that these types of behaviors are often expressions of broader negative emotional states in autism. Treatments that help improve coping and social communication strategies may benefit individuals with autism.