Analysis of the Calls Received during the COVID-19 Lockdown by the Mental Health Crisis Helpline Operated by the Professional College of Psychology of Aragon.

COVID-19 has had a direct impact on the physical and mental health of millions of people worldwide. Therefore, a Mental Health Crisis Helpline (MHCH) was set up and offered free of charge by the Professional College of Psychology of Aragon (COPPA) during the lockdown period. This research aims to study the reasons for the calls, to describe the population segments that used it, and to analyse the possible relationships between the variables studied. A total of 1411 calls were answered and 598 were registered. The main reasons for the calls were: anxiety symptoms, concern for a relative, previous mental health problems, conflicts, and depressive symptoms. Significantly more men called for anxiety symptoms (60.8% vs. 49.5%) versus more women calling regarding a chronic physical illness (3.5% vs. 0.7%), concern about a relative (22.7% vs. 12.4%), care guidelines (6% vs. 1.3%), and bereavement (6.2% vs. 2%). Calls regarding conflict increased slightly as the lockdown period progressed (p < 0.001; r = 0.15), in contrast with calls regarding previous psychological conditions and anxiety symptoms (p = 0.035; r = −0.09; p = 0.005; r = −0.12). These results highlight the intensive use of the MHCH, confirming the need for the implementation of specific psychological care resources in times of crisis.

Effectiveness and cost-effectiveness of a lifestyle modification programme in the prevention and treatment of subclinical, mild and moderate depression in primary care: a randomised clinical trial protocol.

INTRODUCTION: Major depression is a highly prevalent pathology that is currently the second most common cause of disease-induced disability in our society. The onset and continuation of depression may be related to a wide variety of biological and psychosocial factors, many of which are linked to different lifestyle aspects. Therefore, health systems must design and implement health promotion and lifestyle modification programmes (LMPs), taking into account personal factors and facilitators. The main objective of this protocol is to analyse the clinical effectiveness, cost-effectiveness and cost utility of an LMP and an LMP with information and communication technologies (ICTs) as adjunctive treatment for depression in primary care patients. The secondary objectives are to analyse the clinical effectiveness in the subgroup that presents comorbidity and to analyse the correlation between personal factors on health behaviour and lifestyle patterns. METHODS AND ANALYSIS: A randomised, multicenter pragmatic clinical trial with three parallel groups consisting of primary healthcare patients suffering from subclinical, mild or moderate depression. The following interventions will be used: (1) Usual antidepressant treatment with psychological advice and/or psychotropic drugs prescribed by the general practitioner (treatment as usual (TAU)). (2) TAU+LMP. A programme to be imparted in six weekly 90-minute group sessions, intended to improve the following aspects: behavioural activation+daily physical activity+adherence to the Mediterranean diet pattern+sleep hygiene+careful exposure to sunlight. (3) TAU+LMP+ICTs: healthy lifestyle recommendations (TAU+LMP)+monitoring using ICTs (a wearable smartwatch). The primary outcome will be the depressive symptomatology and the secondary outcomes will be the quality of life, the use of health and social resources, personal factors on health behaviour, social support, lifestyle patterns and chronic comorbid pathology. Data will be collected before and after the intervention, with 6-month and 12-month follow-ups. ETHICS AND DISSEMINATION: This study has been approved by the Clinical Research Ethics Committee of Aragón (approval number: C.P.-C.I. PI18/286) and the Research Ethics Committee of the Balearic Islands (IB3950/19 PI). Data distribution will be anonymous. Results will be disseminated via conferences and papers published in peer-reviewed, open-access journals. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03951350).

Sexismo, pensamientos distorsionados y violencia en las relaciones de pareja en estudiantes universitarios de Ecuador de áreas relacionadas con el bienestar y la salud / Sexism, Distorted Thoughts and Violence in Couple Relationships in Ecuadorian Universities with Students Related to Welfare and Health

Resumen Este estudio tiene como objetivo analizar las relaciones entre las actitudes sexistas, los pensamientos distorsionados sobre la mujer y el uso de la violencia y los comportamientos de violencia con la pareja, en universitarios ecuatorianos de ramas relacionas con el bienestar y la salud. La muestra está conformada por 646 alumnos de tres universidades (424 alumnas y 222 alumnos). Se aplicaron los siguientes instrumentos: Versión modificada de la Escala de Tácticas para los Conflictos, Inventario de Sexismo Ambivalente, Inventario de Pensamientos Distorsionados y Escala de Deseabilidad Social. Para la detección de diferencias estadísticamente significativas, se aplicó el test de Mann Whitney y el test de Kruskal Wallis. Para estimar el efecto de la deseabilidad social en las respuestas, se realizaron diferentes regresiones lineales. Los resultados identifican un alto nivel de sexismo y de violencia ejercida y sufrida en la muestra de universitarios, aunque estos parecen estar influidos por la deseabilidad social. Este hecho cobra especial relevancia debido al papel que juegan estos profesionales en la detección y tratamiento de violencia en la pareja. Los resultados obtenidos indican la oportunidad de trabajar en intervenciones educativas en población universitaria para minimizar los pensamientos sexistas que pueden ser fundamento de la violencia de género.

Abstract This study aims to analyze the relationships between sexist attitudes, distorted thoughts about women, the use of violence and violent behaviors in couples. The study was carried out in Ecuadorian universities with students related to Welfare and Health studies. There were 646 students from three universities (424 men and 222 women). The following tests were applied: Modified version of the Scale Conflict Tactics, Ambivalent Sexism Inventory, Inventory of Distorted Thoughts and Social Desirability Scale. The Mann-Whitney and Kruskal Wallis tests were applied to detect statistically significant differences. In order to estimate the effect of social desirability on responses it was performed different linear regressions. The results identify high levels of sexism and perpetrated and suffered violence, although these results seemed to be influenced by social desirability. This becomes especially important due to the role played by these professionals in the detection and treatment of intimate partner violence. The results show the importance to work on educational interventions in universities to minimize sexist thoughts that cause violence against women.

Responsive versus Treatment-Resistant Perpetrators in Batterer Intervention Programs: Personal Characteristics and Stages of Change.

This article aims to identify different personal characteristics in treatment-responsive and treatment-resistant perpetrators of intimate partner violence who completed a batterer intervention program (BIP). The sample consists of 105 perpetrators of intimate partner violence who were court-mandated to a community-based cognitive behavioral program. Perpetrators were classified by professionals as resistant or responsive to treatment based on the stage of change they reached upon completion of the program. The results show that before starting the intervention program, treatment-resistant perpetrators scored higher than treatment-responsive perpetrators in external responsibility attributions and attitudes toward violence in intimate relationships. No differences were found in personality disorders or psychological symptoms between the groups. However, longer program participation correlates with increasing differences between the two groups. The results suggest that targeting the personal characteristics which differentiate treatment-responsive perpetrators from treatment-resistant ones may help to increase the efficacy of BIPs.

Acción COST Femicide Across Europe, un espacio de cooperación trasnacional para el estudio y el abordaje del feminicidio en Europa / Femicide Across Europe COST Action, a transnational cooperation network for the study of and approach to femicide in Europe

El feminicidio o asesinato de mujeres por razones de género es ya un reconocido problema de salud pública, además de una grave vulneración de los derechos humanos. Todavía se desconoce con exactitud su magnitud en el mundo, dadas las dificultades metodológicas para diferenciar estos asesinatos de otros homicidios de mujeres. El Programa de la Unión Europea «Redes de Cooperación Europea en Ciencia y Tecnología» puso en marcha en 2013 la Acción COST Femicide across Europe, abriendo un marco europeo óptimo para la cooperación transnacional entre personas expertas que aborden grandes retos sociales y de salud pública como el feminicidio. En esta nota de campo se describen sus principales objetivos, los grupos de expertos y expertas que lo conforman, y los resultados obtenidos a medio plazo con dicha experiencia (AU)

Femicide or the murder of women because of their gender is a recognised public health problem as well as a serious violation of human rights. Its magnitude worldwide is still unknown, given the methodological difficulties to differentiate these murders from other female homicides. The European Union programme entitled «European Cooperation in Science and Technology» (COST) launched the «Femicide across Europe» COST Action in 2013, establishing an optimal European framework for transnational cooperation among experts addressing great social and public health challenges such as femicide. This field note describes the main objectives, the participating groups of experts and the mid-term results of this experience (AU)

[Femicide Across Europe COST Action, a transnational cooperation network for the study of and approach to femicide in Europe]. / Acción COST Femicide Across Europe, un espacio de cooperación trasnacional para el estudio y el abordaje del feminicidio en Europa.

Femicide or the murder of women because of their gender is a recognised public health problem as well as a serious violation of human rights. Its magnitude worldwide is still unknown, given the methodological difficulties to differentiate these murders from other female homicides. The European Union programme entitled «European Cooperation in Science and Technology¼ (COST) launched the «Femicide across Europe¼ COST Action in 2013, establishing an optimal European framework for transnational cooperation among experts addressing great social and public health challenges such as femicide. This field note describes the main objectives, the participating groups of experts and the mid-term results of this experience.

Miedo, conformidad y silencio. La violencia en las relaciones de pareja en áreas rurales de Ecuador / Fear, conformity and silence. Intimate partner violence in rural areas of Ecuador

La situación de la violencia dentro de la pareja en Latinoamérica es un problema complejo que provoca graves consecuencias para miles de mujeres. En este estudio se analizan los factores y dinámicas involucradas en este tipo de violencia en un contexto de pequeñas comunidades rurales. Para ello, a partir de un marco ecológico de análisis se ha desarrollado un estudio cualitativo en comunidades rurales de la provincia de Imbabura, en Ecuador. Se realizaron 7 grupos focales en los que participaron un total de 63 personas. Los resultados muestran: a) la importancia del entorno comunitario y de las interacciones de víctima y agresor con la familia, vecindario y agentes de intervención; b) la influencia de la estructura del territorio y la actuación del Estado en el manejo de las situaciones de violencia dentro de la pareja, y c) los efectos que la presión ejercida por los distintos miembros de la comunidad pueden tener para la víctima y sus opciones de denunciar la situación. Finalmente, se apunta la posibilidad de que los factores identificados puedan ser elementos explicativos y esclarecedores de las dinámicas de violencia en contextos similares al caso estudiado

The situation of intimate partner violence in Latin America is a complex problem that has serious consequences for thousands of women. In this study the factors and dynamics involved in such violence in a context of small rural communities are analyzed. To do this from an ecological framework of analysis, we have developed a qualitative study in rural communities of the province of Imbabura, in Ecuador. Seven focus groups involving a total of 63 people were held. The results show: (I) the importance of community environment and interactions of victim and perpetrator to the family, neighborhood and police intervention; (II) the way that the territory structure and state action affect the handling of situations of intimate partner violence, and (III) the effects of the pressure exerted by the various members of the community can have on the victim and their ability to report the situation. Finally, the possibility that the identified factors can be explanatory and illuminating elements of the dynamics of violence in similar contexts to the case study is targeted

Quality of Life, Emotional Wellbeing and Family Repercussions in Dermatological Patients Experiencing Chronic Itching: A Pilot Study.

A better understanding of the psychosocial impact of chronic itching could lead to improved intervention strategies. The aim of this study is to examine the prevalence and characteristics of chronic itching in dermatological patients. The Itch Severity Scale (ISS) was completed by a sample of 201 patients from a Dermatology Outpatient Clinic in Spain and 61.69% (n = 124) of participants recorded a positive score (X = 8.89, DT = 4.06). The results indicate that chronic itching has significant psychosocial repercussions. The Dermatology Life Quality Index (DLQI) showed that the negative impact on quality of life was significantly greater for the group that experienced chronic itching (p < 0.001). Scores on the Anxiety and Depression Scale (HADS) revealed that the group with chronic itching had more symptoms associated with anxiety (p = 0.001). The Family APGAR found no statistically significant differences between the groups with regards to repercussions on the family dynamic.

La violencia en la pareja desde tres perspectivas: Víctimas, agresores y profesionales / Partner violence from three perspectives: Victims, abusers, and professionals

La investigación de problemas sociales complejos como la violencia contra las mujeres dentro de la pareja obliga a buscar mecanismos de observación, análisis e interpretación que sean capaces de explicar acontecimientos ya sucedidos y de anticipar escenarios futuros. El objetivo de este artículo es analizar desde una perspectiva relacional, ecológica y sistémica de la violencia dentro de la pareja los discursos proporcionados por los hombres, las mujeres y los profesionales que intervienen. Para ello se ha planteado un estudio de carácter cualitativo en el que han participado 41 personas (9 víctimas, 18 agresores y 14 profesionales). Los resultados muestran a) la diversidad en las características de hombres y mujeres involucrados en situaciones violentas y en el tipo de relación que establecen, b) la percepción de los participantes del tratamiento diferenciado que las instituciones parecen otorgar a hombres y mujeres, c) la necesidad de revisar algunos de los procedimientos jurídicos y de intervención y d) la importancia de los estados emocionales y su influencia en los comportamientos de victimas, agresores y profesionales. Finalmente se plantean algunas propuestas dirigidas a mejorar los diseños de investigación y las estrategias de intervención (AU)

Researching complex social problems, such as violence against women within the couple, requieres that we seek mechanisms of observation, analysis, and interpretation that allow us both to explain events and succeed in anticipating future scenarios. The aim of this study is to analyze, from a relational and systemic perspective of violence within the couple, the discourse provided by men, women, and relevant professionals. We have planned a qualitative study in which 41 people participated (9 victims, 18 offenders, and 14 professionals). The results show a) the diversity in the characteristics of men and women involved in violent situations and the type of relationship established, b) that participants perceived the differential treatment given by institutions according to gender, c) the need to review some of the legal and intervention procedures, and d) the importance of emotional states and their influence on behaviors of victims, perpetrators, and professionals. Finally, some suggestions are given for improving research design and intervention strategies (AU)

Estado actual y retos futuros de los programas para hombres condenados por violencia de género en España / Current status and future challenges of programs for men convicted of gender violence in Spain

En el contexto internacional son numerosos los debates en relación con los programas dirigidos a hombres condenados por violencia dentro de la pareja. Algunos de los temas más controvertidos son: a) el enfoque teórico de partida, b) la posibilidad de realizar tratamientos específicos en función de las características de los hombres o c) la necesidad de atender a aspectos externos e internos al programa como la coordinación institucional o la especificidad del proceso terapéutico (el contexto, la alianza terapéutica, la motivación de los penados y el terapeuta). El objetivo de este artículo es revisar los principales temas que son objeto de debate en el contexto internacional y valorar su impacto en las investigaciones y principales programas de tratamiento que se dirigen a hombres condenados por violencia de género en el Estado español. Las conclusiones indican que la investigación española está incorporando progresivamente los temas identificados a nivel internacional, como la eficacia de los programas en distintos contextos, la existencia de tipologías, aspectos motivacionales, análisis del abandono, factores de riesgo, aspectos culturales o adicciones de los agresores. Sin embargo, parece necesaria una mayor adaptación de los programas a las características de los agresores (AU)

Programmes involving men convicted of intimate partner violence are subject to a wide range of discussions these days. There are numerous international debates regarding programmes aimed at men convicted of intimate partner violence. Some of the most controversial issues are: a) intervention approaches, b) the possibility of performing specific treatments according to the offender's characteristics, or c) the need to take account of external factors such as institutional coordination or the specifics of the therapeutical process (context, therapeutical alliance, motivation of the convict, and the therapist). The aim of this article is to review the main themes that are the focus of this international debate and weigh their impact on the research and the principal programmes that exist in Spain for men convicted of gender violence. The conclusions show that research in Spain is gradually incorporating the topics identified internationally such as the efficacy of programmes in different contexts, the existence of typologies, motivational aspects, analysis of dropouts, risk factors, cultural aspects, or offenders' addictions problems. Nevertheless, it appears necessary to more closely align the programmes with the characteristics of the aggressor (AU)

Context of treatment and therapeutic alliance: critical factors in court-mandated batterer intervention programs.

This paper deals with the influence of the therapeutic context in batterer intervention programs. We conducted 2 complementary studies: a descriptive analysis (Study 1) and a qualitative study (Study 2) analyzing the aspects that may help to improve the operation and effectiveness of treatment in a group of men (N = 27) who participated in a program for convicted perpetrators of intimate partner violence. The results show a statistically significant relationship between the therapeutic alliance and the assessment of the usefulness of the program attended by offenders (r = .69, p < .01), and between the therapeutic alliance and the assessment of the usefulness of the program content (r = .43, p < .05). Furthermore, the results of the qualitative analysis show that aspects of the therapeutic context may play an important role for the adhesion of offenders to treatment, increasing their motivation and improving results. It is proposed that future research should provide more in-depth analysis of the elements related to the context of the intervention and therapists' skills as facilitators of change.

Anxiety, depression, quality of life and patient satisfaction in acne patients treated with oral isotretinoin.

Oral isotretinoin is effective in the clinical control of acne, but the relationship between this treatment and its psychosocial impact on the patient has not been completely clarified. The aim of this study was to determine if the use of oral isotretinoin in total accumulated doses of 120 mg/kg in a sample of 346 patients with moderate acne was useful in controlling symptoms of anxiety and/or depression and improving quality of life. A further objective was to ascertain the level of patient satisfaction with the treatment. After 30 weeks, there was a significant reduction in clinical symptoms (p < 0.001). The negative impact on quality of life, measured with the Dermatology Life Quality Index and the Health Survey Short-Form-36 (p < 0.001), showed a significant reduction, as did the Hospital Anxiety and Depression Scale scores for anxiety (p < 0.001) and depression (p < 0.005). At the end of the study, the mean level of patient satisfaction with improvement of symptoms was 84.4%.

Male abuser: type of violence and perception of the relationship with the victim.

This article explores violent behavior within a relationship from the male abuser's perspective. A systemic approach was used, combining qualitative and quantitative information in two parallel studies. The first (Study 1) is a descriptive analysis of a group of men (N = 220) who participated in a program to address violence within the couple. In the second (Study 2), a subgroup of 8 participants was interviewed in-depth for describing and analyzing their perceptions of violence. The data analysis suggest that relationship violence (a) begins in the early stages of the relationship, (b) is long-term, (c) rarely includes serious physical aggression, (d) is dominated by a growing hostility and isolation, (e) is characterized by a lack of awareness and responsibility for the violent behavior, and (f) includes intentional and strategic use of violent behavior.

Tipología de hombres condenados por violencia de género en un contexto de intervención psicológica en la comunidad / Typology of Men Convicted of Intimate Partner Violence in Psychological Treatment in a Community Setting

Este estudio analiza una muestra de 61 hombres que participaron en un programa de intervención psicológica en la comunidad dirigido a sujetos condenados por un delito de violencia de género. El objetivo es clasificar a los participantes en grupos homogéneos con el fin de detectar sus diferencias y semejanzas, y en particular determinar si valoran de manera distinta el programa de intervención. La información sobre los integrantes de la muestra ha sido obtenida a través de una entrevista semiestructurada, una valoración de sus expectativas ante el tratamiento y la utilidad de éste, y mediante la aplicación de los cuestionarios SCL-90-R, IRI, BDHI, IPDMV, MCMI-II y CTS-2. La clasificación de los sujetos se ha realizado mediante análisis clúster y los resultados evidencian la existencia de 2 grupos con una fuerte cohesión interna. Uno lo forman individuos más estables emocionalmente, con menor consumo de sustancias y una expresión de la violencia de menor intensidad. El otro lo constituyen sujetos que reconocen un mayor número de agresiones físicas menores (CTS-2) y que obtienen puntuaciones significativamente superiores en las escalas de personalidad antisocial, pasivo-agresiva y esquizotípica y en las de abuso de sustancias (MCMI-II). Sin embargo, no se observan diferencias significativas entre ambos grupos respecto a su valoración del programa de intervención psicológica.

This paper presents the study a sample of 61 convicted male batterers who participated in a psychological intervention program provided in the community. The aim is to classify the participants in homogeneous groups in order to detect their differences and similarities and, in particular, those concerning their evaluation of the intervention program. Data from the participants were collected by means of a semi-structured interview, an evaluation based on their expectations and the usefulness of the program, together with the administration of the following instruments: SCL-90-R, IRI, BDHI, IPDMV, MCMI-II and CTS-2. The batterers were classified using cluster analysis and the results suggest the existence of 2 clusters with a strong internal consistency. One cluster is composed by male batterers who are emotionally more stable, with lower drug use rates and a less intense expression of violence. The other group is composed by men who recognized a higher number of minor physical aggressions (CTS-2), with highest scores in the antisocial, passive-aggressive and schizotypal personality dimensions, and also the highest scores in drug use (MCMI-II). However, we have not found statistically significant differences between both clusters with respect to their assessment of the psychological intervention program.

Intervención psicológica en la comunidad en hombres condenados por violencia de género / Efficacy of different treatment modalities in men convicted of intimate partner violence

En este trabajo se presentan los resultados obtenidos en un programa de intervención psicológica dirigido a hombres condenados por violencia contra la pareja. La muestra se compone de 62 hombres que se distribuyen en tres condiciones de tratamiento: Terapia Grupal Abierta (N = 15); Terapia Grupal Estructurada (N = 16); Terapia Individual (N = 16) y un grupo de control (N = 15). La evaluación del efecto del programa se lleva a cabo mediante un diseño cuasi experimental y medidas antes y después de la intervención. En relación con las variables analizadas, los resultados no son concluyentes, si bien se identifican diferencias entre las condiciones de tratamiento. Los resultados muestran diferencias pre y post-tratamiento en la valoración de los logros de los participantes entre los formatos individual y grupal. En el formato grupal, la condición de Terapia Grupal Estructurada muestra valores de cambio más significativos en los cuestionarios administrados. Por otra parte, en el post-tratamiento, aumentan en la condición de Terapia Individual las medias en las siguientes variables del SCL-90-R (Sensibilidad interpersonal, Depresión, Hostilidad, IGS, PSDI y TP). Se discute la pertinencia del uso de cuestionarios de autoinforme en la evaluación de este tipo de programas (AU)

The results obtained in a psychological intervention program for men convicted of intimate partner violence are presented in this study. The sample consists of 62 men distributed into three treatment modalities: un-structured group therapy (N = 15); structured group therapy (N = 16); individual therapy (N = 16), and control group (N = 15). A quasi-experimental design with pre and post intervention assessment is used to measure the effect of the treatment modality. Although the results obtained are not conclusive in the variables analysed, some differences between treatment options are observed. Pre and post differences are observed between individual and group therapy regarding participants’ goal achievements. When comparing the two group formats, the structured therapy group shows more significant values of change in the administered questionnaires. In the individual therapy format, post treatment measures show higher values in the following scores of the SCL-90-R (Interpersonal Sensitivity, Depression, Hostility, GSI, PSDI and PST). We discuss the relevance of using self-report questionnaires in evaluating such programs (AU)

Context of treatment and therapeutic alliance: critical factors in court-mandated batterer intervention programs

This paper deals with the influence of the therapeutic context in batterer intervention programs. We conducted 2 complementary studies: a descriptive analysis (Study 1) and a qualitative study (Study 2) analyzing the aspects that may help to improve the operation and effectiveness of treatment in a group of men (N = 27) who participated in a program for convicted perpetrators of intimate partner violence. The results show a statistically significant relationship between the therapeutic alliance and the assessment of the usefulness of the program attended by offenders (r = .69, p < .01), and between the therapeutic alliance and the assessment of the usefulness of the program content (r = .43, p < .05). Furthermore, the results of the qualitative analysis show that aspects of the therapeutic context may play an important role for the adhesion of offenders to treatment, increasing their motivation and improving results. It is proposed that future research should provide more in-depth analysis of the elements related to the context of the intervention and therapists’ skills as facilitators of change (AU)

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