The effect of discrimination on Mental Health in the Chilean Population

Introduction: Discrimination affects the health and well-being of those who experience it. The relationship between discrimination and mental health in migrant communities and in the Chilean child and youth population has been previously studied, however, there is little evidence regarding the effects of discrimination on the general population. Objective: To analyze the relationship between discrimination and the presence of anxious and depressive symptoms in the Chilean population. Methods: Prospective cross-sectional study evaluating 927 subjects in the cities of Arica, Antofagasta, and Santiago. To evaluate discrimination the Krieger Discrimination Experience Scale is used. To asses depressive and anxious symptomatology, the Beck scales for BDI Depression and BAI Anxiety were implemented. Results: The mean age of the sample is 33.9 years (Range 18-70 years; SD=13.13). 59.5% of the participants are female. 36% of the participants reported having experienced discrimination in some aspect of their lives. The highest perception of discrimination is associated with employment (42%) and the main reported causes are level of education or income, age, and gender. Experiences of discrimination exert statistically significant positive effects of moderate magnitude (b>.30) on depressive (b=.460, p<.001) and anxious (b=.480, p<.001) symptomatology, the latter being interrelated (b=.636, p<.001). Conclusions: More than a third of the population studied reported having been discriminated in some aspect of their lives. This perception is further accentuated in relation to employment. The perception of discrimination is associated with an increase in anxious and depressive symptoms in the Chilean population.

Introducción: La discriminación afecta la salud y el bienestar de las personas que la experimentan. Se ha estudiado ampliamente la relación entre discriminación y salud mental en comunidades migrantes y en población infanto-juvenil chilena, sin embargo, existe escasa evidencia respecto a los efectos de esta en la población general. Objetivo: Analizar la relación entre discriminación y la presencia de sintomatología ansiosa y depresiva en población chilena. Material y Método: Estudio transversal prospectivo evaluando 927 sujetos en las ciudades de Arica, Antofagasta y Santiago. Para evaluar discriminación se utiliza la escala de experiencias de discriminación de Krieger. Para evaluar sintomatología depresiva y ansiosa se utilizan las escalas de Beck para Depresión BDI y Ansiedad BAI. Resultados: La edad promedio de la muestra es de 33,9 años (Intervalo de 18 a 70 años; DE=13,13). El 59,5% de los participantes son mujeres. Un 36% de los participantes declara haber experimentado discriminación en algún aspecto de su vida. La mayor percepción de discriminación se asocia al empleo (42%) siendo las principales causas reportadas el nivel educacional o de ingresos, la edad y el sexo. Las experiencias de discriminación ejercen efectos positivos estadísticamente significativos de magnitud moderada (b>.30) sobre sintomatología depresiva (b=.460, p<.001) y ansiosa (b=.480, p<.001) estando las últimas interrelacionadas entre sí (b=.636, p<.001). Conclusión: Más de un tercio de la población estudiada reporta haber sido discriminada en algún aspecto de su vida. Esta percepción se agudiza en torno a la obtención de empleo. La percepción de discriminación se asocia a incremento en sintomatología ansiosa y depresiva en la población chilena.

The Effects of Social Determinants and Resilience on the Mental Health of Chilean Adolescents.

The aim of this research was to evaluate the effects of social determinants (i.e., gender, educational vulnerability, and socioeconomic status) and resilience on the mental health of Chilean adolescents in pre-, during, and post-COVID-19 pandemic contexts. The study included a group of 684 students, ranging in age from 12 to 18 years, who were attending educational institutions in the city of Arica. The Child and Adolescent Assessment System (SENA) was used to measure mental health problems, the Brief Resilience Scale for Children and Youth (CYRM-12) was used to measure resilience, and the Vulnerability Index of Educational Institutions was used to measure educational vulnerability. The results suggest increases in depressive, anxious, and social anxiety symptomatologies over time (wave by year, 2018, 2020, and 2021). In addition, multiple linear regression models showed predictive effects of the COVID-19 pandemic, gender, vulnerability index, socioeconomic status, and resilient behaviors on mental health problems. The worsening of mental health indicators over time requires the greater coordination and integration of mental health experts in the most vulnerable educational centers.

Barreras para la utilización de servicios de Atención Primaria de Salud en Personas migrantes internacionales / Barriers for the use of primary care services by international migrants

Objetivo: analizar las barreras que enfrentan las personas migrantes internacionales al utilizar los servicios de Atención Primaria de salud en la comuna de Antofagasta, Chile.Método: diseño de investigación cualitativa bajo un enfoque interpretativo fenomenológico-descriptivo. Se utilizó un muestreo por conveniencia y por bola de nieve hasta la saturación del discurso. La muestra se conformó por 42 personas mayores de 18 años (personal funcionario y personas migrantes). Se realizaron entrevistas individuales y grupales semiestructuradas. Para el análisis de los datos se llevó a cabo un análisis reflexivo temático, con codificación abierta para la posterior construcción de categorías. Como criterios de calidad se utilizó la triangulación, la confirmabilidad y la reflexividad.Resultados: desde el personal funcionario de salud se identificaron dimensiones como la aceptabilidad del otro, el idioma y la alteridad racializadora. Desde las personas migrantes internacionales se destacó el idioma, el trato discriminatorio y las dificultades en el acceso relacionadas con los procedimientos administrativos para afiliarse al seguro público de salud. Además, se identificaron barreras en las interacciones diarias entre los equipos de salud y las personas migrantes, en las cuales las interpretaciones mutuas de las acciones desempeñan un papel importante.Conclusiones: las barreras existentes en la utilización de los servicios de la Atención Primaria de Salud presentan componentes del sistema asociado a políticas y normativas que en las prácticas se relaciona a un segundo componente, el individual, en donde el personal funcionario y las personas migrantes estarían plasmados en las interacciones cotidianas durante el proceso de atención.(AU)

Objective: to analyse the barriers faced by international migrants when using Primary Care services in the commune of Antofagasta, Chile.Method: a qualitative research design with an interpretative phenomenological-descriptive approach. Convenience and snowball sampling was used until the saturation point was reached. The sample was formed by 42 >18-year-old persons (civil servants and migrants). Semi-structured individual and group interviews were conducted. Reflexive-thematic analysis was used for data analysis, with open coding for subsequent category building. The quality criteria used were triangulation, confirmability and reflectivity.Results: the dimensions identified by the health civil servants were: acceptability of the other, language, and racialization otherness. The international migrants highlighted language, discriminatory treatment, and difficulties for access associated with administrative procedures to enrol in the public health system. Moreover, barriers were detected in the daily interactions between health services and migrants, where mutual interpretations of actions played a major role.Conclusions: the current barriers for the use of Primary Care services presented system components associated with policies and rules which in practice are associated with a second component, the individual one, which would be reflected in the daily interactions by civil servants and migrants during the process of care.(AU)

Scale Measurement of Health Primary Service Utilization among the Migrant International Population.

In this article, we analyze the internal structure of the scale for experience in exercising the right to health care (EERHC), based on the focus from the World Health Organization (WHO) on the right to health care, from the perspective of international migrants, in Chile. The methodology was an instrumental study (n = 563) conducted to analyze the psychometric properties of the EERHC scale. Its reliability and internal consistency were evaluated, while the exploratory structural equation modeling (ESEM) model and confirmatory factor analysis (CFA) were used to identify the structure of relationships between the variables measured. The item-dimension correlations obtained present levels of r ≥ 0.3, and the Cronbach's α and McDonald's ω presented ranges >0.9, considered to be acceptable on all models. Results: the model was selected for presenting a good fit index χ2 = 24,850, df = 300, p = 0.000; RMSEA = 0.07; CFI = 0.97; TLI = 0.95; and SRMR = 0.03. The evidence obtained lets us conclude that the scale has forty-five items and four dimensions. The findings demonstrate a good internal structure and are useful to measure primary health care service utilization based on the framework.

Acculturation strategies and blood cortisol in colombian Migrants in Chile.

BACKGROUND: migration is a worldwide phenomenon that is growing at an accelerated pace. When people who migrate come into contact with a new culture, they are immersed in a process called acculturation. In this process, people oscillate between maintaining their own culture or acquiring the culture and customs of the host country, resulting in the so-called acculturation strategies. According to Berry's proposal, there are four main acculturation strategies: assimilation, integration, marginalization and separation. The few existing studies of Latinos in an Anglo-Saxon country relate the use of the integration strategy (biculturalism) with lower cortisol levels. No studies have been found on the subject in Latino migrants in a Latino country. METHOD: a cross-sectional design was used to analyze the relationship between acculturation strategies and blood cortisol levels, based on the hypothesis that an integration strategy or biculturalism would be linked to lower cortisol levels. The study involved 314 Colombian migrants in Chile, who were evaluated with a scale of acculturation strategies according to the model proposed by Berry, in addition to providing blood samples to analyze cortisol levels. RESULTS: migrants who show a preference for leave behind the culture of the country of origin have higher levels of cortisol ng/ml in blood. According to multiple comparisons the mean cortisol value was significantly different between integrated and assimilated subjects, with the mean cortisol of the integrated being significantly lower than that of the subjects typed as marginalized. CONCLUSION: The patterns of the relationship between biculturalism and cortisol found in Latino migrants in Anglo-Saxon countries are repeated in Latino migrants in a Latino country. It is necessary to explore the influence of other variables in this relationship, since it seems that the best adaptive strategy, and therefore the cortisol response, will vary according to the socio-cultural context of the host country.

Optimism and Intolerance to Uncertainty May Mediate the Negative Effect of Discrimination on Mental Health in Migrant Population.

(1) Background: Migration causes effects on the people who migrate and on the societies that receive them, which can be positive or negative, depending on the characteristics of the interaction. One negative effect is the emergence of mental health disorders associated with the presence of discrimination, a relationship for which there is abundant evidence, although there is less research on factors that may alter this effect. (2) Objective: To evaluate the possible mediating role of optimism and intolerance to uncertainty in the relationship between discrimination and mental health. (3) Method: Nine hundred and nineteen adult Colombian migrants residing in Chile, 49.5% were men and 50.5% women, ages from 18 to 65 years, were evaluated. The Discrimination Experience Scale, BDI-IA Inventory, BAI, LOT-R and the Intolerance to Uncertainty Scale were applied. The effects were estimated using structural equation modeling. (4) Results: A mediating effect of both dispositional optimism and intolerance to uncertainty on the relationship between discrimination and mental symptomatology was observed. (5) Conclusions: The impact on individual suffering and the social cost of mental health problems require investigating variables on the relationship between discrimination and mental health, including mediators of this relationship, which turn out to be central elements in the development of future strategies for the reduction of anxiety and depression symptoms.

Pre and Post Pandemic Depressive and Anxious Symptoms in Children and Adolescents in Northern Chile.

The psychological effects of the COVID-19 pandemic still represent a focus of concern, especially in children and adolescents who are a group particularly vulnerable to the psychological consequences of the COVID-19 pandemic, mainly due to the loss of socialization and leisure spaces. The aim of the study is to determine the variation in the levels of depressive and anxious symptomatology in children and adolescents in the North of Chile. METHODS: A Repeated cross-sectional design (RCS) was used. The sample consisted of a total of 475 students aged 12 to 18 years (high school) from educational establishments in the city of Arica. To evaluate the changes in the mental health of students associated with the COVID-19 pandemic, the same mental health measures applied to students were compared in two waves (2018-2021). RESULTS: An increase in the symptomatology levels of depression, anxiety, social anxiety, and problems with the family, while a decrease in problems with school and peers was observed. CONCLUSIONS: The results show that there is an increase in mental health problems associated with the periods of time in which the COVID-19 pandemic transformed the social relation spaces and classrooms of secondary school students. The observed changes point to future challenges, which include that it may be important to improve the coordination and integration of mental health professionals in educational centers and schools.

Mental Health in Indigenous Children and Adolescents: The Contribution of Cultural Backgroud.

The purpose of this study is to describe and compare the prevalence of mental health problems in Aymara and non-Aymara children and adolescent. The study sample comprised 1839 students from 8 to 19 years, from educational institutions of Northern Chile. Forty-nine percent of students identified with the Aymara ethnic group. The Child and Adolescent Evaluation System was used to evaluate internal and external problems. In Elementary school, Aymara students showed significantly lower scores in externalized problems and in high school, there were significantly lower scores in interiorized, exteriorized and other problems than Non-Aymara students. It seems that the legacy of the Aymara culture has favored the development of protective factors in relation to the mental health of these students. In a context of growing recognition and appreciation of this culture, greater involvement with Aymara culture could promote better mental health of school children.

Predictors of Internalized Stigma in Patients with Schizophrenia in Northern Chile: A Longitudinal Study.

The study aim was to longitudinally assess internalized stigma in a sample of patients from Northern Chile with a diagnosis of schizophrenia along with indicators of patient recovery, including quality of life, psychotic symptomatology, social cognition, premorbid adjustment, and years of untreated psychosis. The 10-year follow-up of stigma measures and predictors were assessed at public outpatient mental health centers in the city of Arica, Chile, during the months of March-July 2012. A total of 26 patients successfully completed the evaluation. The results revealed that, with the exception of the self-stigma subdimension, no clinically significant changes were seen in the trajectories of internalized stigma ratings between baseline and 10-year follow-up, underscoring the importance of assessing global components such as quality of life and premorbid adjustment during the process of internalizing stigma.

Children's Mental Health: Discrepancy between Child Self-Reporting and Parental Reporting.

(1) Background: Discrepancies between children's self-reports and their parents' reports on mental health indicators are associated with measurement errors or informant bias. However, they are a valuable tool in understanding the course of child psychopathology. This study aims to determine the level of discrepancies between parents' perceptions and children's self-reports in mental health indicators in Northern Chile. (2) Methods: A System of Evaluation of Children and Adolescents self-report (Sistema de Evaluación de Niños y Adolescentes, SENA) was responded to by 408 students between 8 and 13 years old and their parents. (3) Results: Children reported a significantly higher frequency of emotional problems, defiant behavior, and executive functions as compared to their parents' responses. (4) Conclusions: There is a disjunction between the report of parents and children, which could originate in poor family communication.

Meanings and Practices in Intercultural Health for International Migrants.

In this article, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the city of Antofagasta in northern Chile. METHODOLOGY: The methodology was qualitative with a phenomenological descriptive design, through which discourses from health personnel in the public primary and secondary care system were explored (n = 23). Next, meanings and practices in intercultural health for international migrants in health establishments are described from the perspective of health personnel in the northern Chilean city of Antofagasta. RESULTS: The participants presented trees of thematic categories. There were three thematic categories overall: (1) The meaning of interculturality included features of understanding of the concept, with respect for culture being the transversal axis in all discourses. (2) Practices in health care, where voluntariness, references, and the adequacy or non-technicality of the language are fundamental axes. (3) Training in the intercultural approach, where there is often self-knowledge and lack of supply in the health system. CONCLUSIONS: The findings show essential elements to consider in the care of international migrants, including the training and awareness of staff about the intercultural approach through strategies following the local reality in which each health establishment exists.

Social Support as a Mediator of the Relationship between Identity Fusion and Psychological Well-Being in South-South Migrant Populations.

The present study provides evidence of how perceived social support is a mechanism by which identity fusion with the country of origin is associated with psychological well-being in a migrant population. The study design was cross-sectional. We use intentional sampling based on the accessibility of the participants and using the snowball strategy through an online survey. This study included 323 Venezuelan migrants, of whom 176 (54.5%) were women, all residents of the city of Santiago, Chile. The variables assessed were perceived social support, identity fusion, and psychological well-being. Structural equation modeling was used to estimate the proposed mediation model. The estimation method used was robust weighted least squares estimation. The estimated models indicated that perceived social support has a mediating effect on the positive relationship between identity fusion and psychological well-being of Venezuelan migrants residing in Chile. According to these results, feeling a sense of fusion with the country of origin and the perception of having sources of care and protection are factors that may help to improve the psychological well-being of Venezuelan migrants living in Chile. Implications and limitations of these results are discussed.

Calidad global de la alimentación y preferencias alimentarias en escolares chilenos y migrantes residentes en el norte de Chile

RESUMEN Durante las últimas décadas la migración aumentó considerablemente en Chile generando preocupación por la salud de los migrantes. Respecto de la alimentación en escolares, la evidencia no es concluyente, por un lado, las preferencias alimentarias orientadas al territorio de acogida han sido asociadas a una menor calidad de la alimentación sumado a indicadores de malnutrición y por otro, escolares migrantes que presentaron menor riesgo de malnutrición por exceso. El objetivo de esta investigación fue comparar la calidad global de la alimentación y las preferencias alimentarias de escolares chilenos y migrantes residentes en Chile. Se realizó un estudio transversal de tipo descriptivo, el cual incluyó una muestra de 534 escolares migrantes y no migrantes, de ambos sexos, los cuales fueron seleccionados por conveniencia, completando un cuestionario sobre calidad de la alimentación y preferencias alimentarias. Se analizaron distribuciones de frecuencias mediante la prueba de Chi2 por grupos. Escolares migrantes reportaron una mejor calidad global de la alimentación que escolares chilenos (p= 0,002), con mejores indicadores. Respecto a la calidad global de la alimentación por tiempo de residencia, se observaron diferencias estadísticamente significativas (p= 0,025) en favor de aquellos migrantes con más de 5 años de residencia. La calidad global de la alimentación aumentó en migrantes cuando las preferencias alimentarias estuvieron orientadas al territorio de origen. En escolares chilenos la calidad global de la alimentación aumentó, cuando prefirieron alimentos que no son tradicionales de Chile. En conclusión, escolares migrantes reportaron una mayor calidad global de la alimentación que chilenos, y esta aumenta cuando el tiempo de residencia es de 5 o más años. Es necesario seguir indagando sobre la calidad global de la alimentación y las preferencias alimentarias en escolares migrantes.

ABSTRACT During the last decades, migration increased considerably in Chile, generating concern for the health of migrants. On the one hand, food preferences oriented to the host territory have been associated with lower food quality and indicators of malnutrition; on the other hand, migrant schoolchildren present a lower risk of excess malnutrition. The objective of this research was to compare the overall food quality and food preferences of Chilean and migrant schoolchildren residing in Chile. A descriptive cross-sectional study was carried out, which included a sample of 534 migrant and non-migrant schoolchildren, of both sexes, who were selected by convenience, completing a questionnaire on food quality and food preferences. Frequency distributions were analyzed using the chi-square test by groups. Migrant schoolchildren reported better overall food quality compared to Chilean schoolchildren (p= 0.002), with better indicators in the dimensions of healthy, unhealthy food, and meal times. We observed statistically significant differences in overall food quality by time of residence (p= 0.025) in favor of those migrants with more than 5 years of residence. It is noteworthy that the healthy category reached its highest proportion (41.4%) among those with five or more years of residence in Chile. The overall quality of food increased in migrants when food preferences were oriented to the territory of origin. In Chilean schoolchildren, overall food quality increased when they preferred foods not characteristic of Chile. In conclusion, migrant schoolchildren reported a higher overall food quality compared to Chilean schoolchildren, and this increased when the time of residence was 5 or more years. Further research is needed on the overall food quality and food preferences of migrant schoolchildren.

Validación de la escala GEOPTE de cognición social para psicosis en pacientes con esquizofrenia en Latinoamérica / Validation of the GEOPTE scale of social cognition for psychosis in patients with schizophrenia in Latin America

El propósito de este estudio fue validar la escala GEOPTE de cognición socialpara su uso en pacientes con diagnóstico de esquizofrenia en paísesLatinoamericanos. Participaron 253 pacientes con un diagnóstico de esquizofreniay 253 cuidadores principales provenientes de los servicios públicos de salud mentalde Bolivia, Chile y Perú. Las propiedades psicométricas de la escala GEOPTE fueronobtenidas mediante análisis factoriales confirmatorios (CFA), CFA-multigrupo,coeficientes de fiabilidad y correlación de Pearson. El CFA mostró la adecuaciónentre la estructura factorial teórica original con la establecida en este estudio devalidación. La escala evidenció satisfactorios indicadores de fiabilidad, presentóasociaciones significativas con la “Escala de los síndromes positivo y negativo”(PANSS) y sólo mostró invarianza débil según el sexo. La escala GEOPTE poseepruebas de validez y fiabilidad suficiente para su uso en pacientes con diagnósticode esquizofrenia en países Latinoamericanos. (AU)

The purpose of this study was to validate the GEOPTE scale of social cognitionfor its use in patients diagnosed with Schizophrenia in Latin American countries.The participants were 253 patients with a diagnosis of Schizophrenia and 253 maincaregivers from mental health services in Bolivia, Chile and Peru. The psychometricproperties of the GEOPTE scale were obtained through confirmatory factor analysis(CFA), CFA-multigroup, reliability coefficients and Pearson's correlation. The CFAshowed the adequacy between the original theoretical factor structure and the oneestablished in this validation study. The scale showed satisfactory reliabilityindicators, presented significant associations with the Positive and NegativeSyndrome Scale (PANSS) and showed only weak invariance according to gender.The GEOPTE scale has sufficient evidence of validity and reliability for its use inpatients diagnosed with Schizophrenia in Latin American countries. (AU)

How Do Health Teams Perceive International Migrant Users of Primary Care?

The following study aims to describe the perception of international migrants who use the primary level of care by health personnel and to explore how this perception can affect the care process in the commune of Antofagasta, north of Chile. Methodology: The methodology was qualitative using a phenomenological descriptive design, through which the discourses of the health personnel of three primary health care centers (n = 14) were explored. Results: The participants presented two thematic categories. The first one related to experiences during delivery of care to migrants and included perceptions and beliefs, factors associated with using services, and reasons for consultation. The second category related to stereotypes towards migrants, including prejudices, beliefs about their lives and reasons for migration. Conclusions: The therapeutic relationship with migrants in primary care depends on the health care personnel's acceptability of this population, hence, allowing the delivery of care based on respect for their culture and rights.

Mental health in the Chilean LGBT population in times of COVID-19 / Salud mental en población LGBT chilena en tiempos de la COVID-19

Abstract Introduction There are few reports on mental health among the lesbian, gay, bisexual, and transgender (LGBT) population in the context of COVID-19, especially in South America. Objective To describe the prevalence of symptoms associated with mental health disorders, as well as to analyze the risk of their occurrence, in different groups of the Chilean LGBT population in the context of COVID-19. Method A total of 1,181 LGBT people, ranged from 18 to 64 years participated in an online survey, using the Depression Anxiety Stress Scales-DASS-21. The central tendency measures were analyzed, then cut-off points were used to establish prevalence according to sex and sexual orientation. Finally, the probability of symptoms was analyzed using odds ratio. Results Lower levels of mental health were identified among the bisexual and other sexual orientations (pansexual, demisexual, asexual, etc.) population as compared with gays and lesbians, finding a greater presence of depressive symptoms (p = .000), anxious (p = .000) and related to stress (p<.001). Similarly, bisexual women are more likely to present symptoms associated with mental health disorders than men, as lesbians do, as compared with gays in the case of anxiety. Gays are at a higher risk of stress than lesbians. Discussion and conclusion Even though the pandemic affected the entire population, results give evidence of disparities among the various LGBT communities, showing the need to focus on preventive interventions and the implications of increased risk in bisexual population, particularly women, who are affected by various cross discriminations.

Resumen Introducción Existen pocos reportes sobre la salud mental en poblaciones de lesbianas, gays, bisexuales y transexuales (LGBT) en el contexto del COVID-19, especialmente en Sudamérica. Objetivo Describir la prevalencia de síntomas asociados a problemas de salud mental, así como analizar su riesgo de ocurrencia en diferentes grupos de población LGBT chilena en el contexto de la pandemia del COVID-19. Método Participaron en una encuesta en línea un total de 1,181 personas LGBT, con edades comprendidas entre los 18 y los 64 años, quienes completaron el cuestionario DASS-21 (del inglés Depression Anxiety Stress Scales). Primero se analizaron las medidas de tendencia central, luego se estableció la prevalencia según sexo y orientación sexual y finalmente se analizó la probabilidad de presentar síntomas mediante el odss ratio. Resultados Se identificaron menores niveles de salud mental en la población bisexual y otras orientaciones sexuales (pansexual, demisexual, asexual, etc.), en comparación con gays y lesbianas, debido a una mayor presencia de sintomatología depresiva (p = .000), ansiosa (p = .000) y vinculada al estrés (p<.001). Asimismo, las mujeres bisexuales fueron más propensas que los hombres a presentar síntomas asociados a trastornos de salud mental, al igual que las lesbianas, en comparación con los gays en el caso de la ansiedad. Los gays tienen un mayor riesgo de estrés que las lesbianas. Discusión y conclusión Aun cuando la pandemia afectó a toda la población, los resultados evidencian las disparidades entre las distintas comunidades LGBT, mostrando la necesidad de centrarse en las intervenciones preventivas y las implicaciones de un mayor riesgo en la población bisexual, especialmente en las mujeres, que se ven afectadas por diversas discriminaciones cruzadas.

Latent Profiles of Premorbid Adjustment in Schizophrenia and Their Correlation with Measures of Recovery.

Premorbid adjustment (PA) has classically been defined as psychosocial functioning in the areas of education, occupation, social and interpersonal relationships prior to evidence of characteristic positive symptomatology. It is a concept which possesses ample evidence regarding its predictive nature for the course of Schizophrenia. The study aimed to analyze the latent profiles of premorbid adjustment and their relationship with symptomatology, functionality, subjective recovery, stigma resistance and years of untreated psychosis. Latent class analysis (LCA) was used to elaborate a solution of three premorbid adjustment profiles in a sample of 217 patients diagnosed with Schizophrenia from Public Mental Health Centers in the city of Arica, Chile. The results show that premorbid adjustment was significantly correlated with recovery indicators and that latent profiles of better premorbid adjustment predict better outcomes in subjective recovery and stigma resistance. The results show that premorbid adjustment not only has implications for the severity of the disorder, but that psychosocial functioning prior to psychosis affects the patient's subjectivity, the representation of the disorder and the recovery process.

The Mediating Role of Contextual Problems and Sensation Seeking in the Association between Substance Use and Mental Health in Adolescents from Northern Chile.

Substance use is a risk behavior that has been associated with adverse mental health outcomes in adolescence. The aim of this study was to determine the relation between behavioral problems, emotional problems, and substance use as well as the mediating role of contextual problems and sensation seeking in this relation. A cross-sectional study of 2277 adolescents from Northern Chile was conducted. The System for the Evaluation of Children and Adolescents (SENA) was used to assess substance use, contextual problems, sensation seeking, and emotional and behavioral problems. Through a mediational model, it was observed that substance use has a positive indirect effect on emotional and behavioral problems when both contextual problems and sensation seeking act as mediating variables. An indirect effect of substance use on contextual problems with sensation seeking as a mediator was also observed. The results suggests that context and sensation seeking are a relevant source of information in understanding adolescents and their propensity to use drugs. Interventions based on addressing contextual problems (problems with school, peers, and family) and enhancing personal resources should be implemented in order to reduce substance use in adolescents as well as the consequences it can generate in the short, medium, and long term.

Effect of Ethnic Identity on the Relationship Between Acculturation Stress and Abnormal Food Behaviors in Colombian Migrants in Chile.

BACKGROUND: Acculturation stress may influence the development of abnormal eating behaviors. However, some mental health indicators, such as ethnic identity, may have a protective effect on this relationship. This study's main objective is to analyze the mediating effect of ethnic identity on the relationship between acculturation stress and abnormal eating behaviors in Colombian migrants living in Chile. METHODS: We obtained data on 976 Colombian migrants who were recruited with the help of the Department of Foreign Affairs, the Colombian Consulate in Chile, and self-managed groups of migrants residing in Chile. The mediation model was analyzed using Mplus 8.2 software, using the robust weighted least squares (WLSMV) estimation method. RESULTS: The most common abnormal eating behaviors were eating until you feel full and eating large amounts of food. The mediation model was adapted to the data. The effects indicate that ethnic identity only had an indirect effect on the problems of social relations with other migrants (indirect effect = .17, p = .01) and on the distance from the origin (indirect effect = -. 06, p = .01) on the abnormal eating behaviors. On the other hand, the ethnic identity presented a direct and indirect effect on the relationship between citizenship and legality problems, and abnormal behaviors (indirect effect = -.06, p = .04; direct effect = -.35, p = .01). DISCUSSION: Ethnic identity could be fundamental in the relationship between acculturation stress and abnormal eating behaviors, considering that post-migration eating practices are associated with unhealthy eating habits.