Rapid Response Unit for Children and Adolescents at Risk of Suicide: Promoting Therapeutic Linkage and Reducing the Risk of Relapse.

INTRODUCTION: The increase in suicidal behavior among adolescents under 17 years of age in Catalonia between 2019 and 2022 has gone from 473 to 1425 cases, which entails a new healthcare challenge. The objective of the article is to explain the procedure and intervention of the Rapid Response Unit (RRU) for children and adolescents at risk of suicide. The RRU is a multidisciplinary unit designed to prevent relapse and increase link-up to treatment. The cases attended in its 14 months of operation are described. METHODOLOGY: 24 patients, 18 females and 6 males aged between 12 and 17 years, attended for the first time at the Child and Adolescent Health Centre of Cornellà for activation of the Suicide Risk Code (CRS) in hospital emergency departments during the period studied. RESULTS: After the intervention, high suicidal risk decreased from 29.17% to 0%, medium risk decreased from 37.5% to 20.83% and low risk increased from 33.33% to 79.17%. In addition, there was only one new CRS activation in the 3 months following the first activation. In the RRU, care was intensive: 52.7% of cases with visits once a week and more than once a week in 24.9%. During the intervention months 100% of cases were linked and no interruptions occurred. CONCLUSIONS: Rapid Response Unit (RRU) decreases the risk of recurrence of suicidal behavior and ensures therapeutic linkage.

Rapid Response Unit for Children and Adolescents at Risk of Suicide: Promoting Therapeutic Linkage and Reducing the Risk of Relapse

Introduction: The increase in suicidal behavior among adolescents under 17 years of age in Catalonia between 2019 and 2022 has gone from 473 to 1425 cases, which entails a new healthcare challenge. The objective of the article is to explain the procedure and intervention of the Rapid Response Unit (RRU) for children and adolescents at risk of suicide. The RRU is a multidisciplinary unit designed to prevent relapse and increase link-up to treatment. The cases attended in its 14 months of operation are described. Methodology: 24 patients, 18 females and 6 males aged between 12 and 17 years, attended for the first time at the Child and Adolescent Health Centre of Cornellà for activation of the Suicide Risk Code (CRS) in hospital emergency departments during the period studied. Results: After the intervention, high suicidal risk decreased from 29.17% to 0%, medium risk decreased from 37.5% to 20.83% and low risk increased from 33.33% to 79.17%. In addition, there was only one new CRS activation in the 3 months following the first activation. In the RRU, care was intensive: 52.7% of cases with visits once a week and more than once a week in 24.9%. During the intervention months 100% of cases were linked and no interruptions occurred. Conclusions: Rapid Response Unit (RRU) decreases the risk of recurrence of suicidal behavior and ensures therapeutic linkage. (AU)

Validation of the post-traumatic stress disorder subscale of the child behaviour checklist (PTSD-CBCL): screening for post-traumatic stress disorder or attention deficit/hyperactivity disorder?

PURPOSE: Almost 20% of children and adolescents who attend in mental health centres are witnesses of domestic violence (WDVs). It would therefore be clinically useful to have an appropriate screening instrument for this population, such as the PTSD-CBCL. Our aim here was thus to assess the psychometric properties of relevant tools by determining their internal consistency, sensitivity/specificity, and positive/negative predictive values in our centre's population. METHODS: We recruited 194 parents of children aged 4-16 at the Child and Adolescent Mental Health Service of the Hospital Sant Joan de Déu and Els Pins primary school. This sample was divided into: (1) a WDV group (n = 104); (2) an ADHD diagnosis group (n = 28); and (3) a general population (GP) primary school group (n = 62). RESULTS: The PTSD-CBCL total reliability score was high (Cronbach's alpha = 0.87). We found significant mean difference for WDV vs. GP (MD = 8.57; p < 0.001) with significantly higher mean scores in WDV than in GP. We also found significant differences for ADHD vs. GP (MD = 6.91; p < 0.001) with higher mean scores in ADHD than in GP. We observed good discriminatory power indices in the following group comparisons: WDV vs. GP, ADHD vs. GP, WDV vs. ADHD + GP, and GP vs. WDV + ADHD. Nevertheless, the PTSD-CBCL did not discriminate WDV vs. ADHD. CONCLUSIONS: Thus, we conclude that the PTSD-CBCL instrument has good discriminatory power in general and clinical populations, and could be implemented in the context of prevention and early intervention after trauma.

Emotion Regulation and Interpersonal Group Therapy for Children and Adolescents Witnessing Domestic Violence: A Preliminary Uncontrolled Trial.

Around 19% of the patients who turn to childhood mental health centers are witnesses to domestic violence. The aim of this study was to evaluate the efficacy of Emotion Regulation and Interpersonal Group Therapy (ERIGT) in a multidisciplinary community program. Specifically, this program addresses domestic violence in reducing post-traumatic and depressive symptoms in children and adolescents who are witnesses to domestic violence. ERIGT was used with 24 patients ranging from 7 to 16 years old. We evaluated at three time points: before treatment, after treatment, and at 3 months following the end of treatment. We observed a reduction in the post-traumatic and depressive symptoms. This was a pilot study carried out with a small sample, but it indicates that ERIGT has the potential to be effective in the treatment of these symptoms.

The relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical adolescents / Relación entre los estilos de apego y los síntomas externalizantes e internalizantes en adolescentes clínicos y no clínicos

Studies regarding the relationship between attachment and psychopathology during adolescence have been performed separately for clinical and nonclinical adolescents and have used different assessment measures, which together might produce a methodological bias that increases the association between attachment and psychopathology. With the aim of avoiding this bias, the present study used identical measures to explore the relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical samples of adolescents. The sample consisted of 258 adolescents, 129 clinical and 129 nonclinical, aged between 14 and 18 years. The adolescents in each sample were matched for age, gender, and socioeconomic status. Attachment was assessed using the CaMir Q-sort, and psychopathological symptoms were assessed by means of the Youth Self Report (YSR). The relationships between attachment and psychopathology were similar for clinical and nonclinical adolescents. A preoccupied attachment style predicted internalizing and externalizing symptoms, somatic complaints, anxious-fearful behavior, verbal aggression, attention-seeking behavior, and thinking problems. Compared to previous studies, this research has made it possible to identify broader, stronger, and more specific associations between preoccupied attachment style and psychopathological symptoms in adolescents

Los estudios sobre la relación entre apego y psicopatología durante la adolescencia, se han realizado separadamente en muestras clínicas y no clínicas de adolescentes y han utilizado instrumentos de evaluación diferentes, lo que en conjunto ha podido dar lugar a un sesgo metodológico que ha incrementado la asociación entre apego y psicopatología. Con objeto de evitar este sesgo, en el presente estudio se utilizaron las mismas medidas para explorar la relación entre estilos de apego y síntomas internalizantes y externalizantes en grupos clínicos y no clínicos de adolescentes. La muestra estuvo formada por 248 adolescentes, entre 14 y 18 años de edad. Los adolescentes de cada grupo se emparejaron en edad, sexo y nivel socioeconó- mico. El apego se valoró con el cuestionario CaMir y los síntomas psicopatológicos con el Youth Self Report. Las relaciones entre apego y psicopatología fueron similares en adolescentes clínicos y no clínicos. El estilo de apego preocupado predijo síntomas internalizantes y externalizantes, quejas somáticas, conducta fóbico-ansiosa, agresividad verbal, conducta de búsqueda de atención y problemas de pensamiento. En comparación con estudios previos, esta investigación ha permitido identificar asociaciones más amplias, más fuertes y más específicas entre el estilo de apego preocupado y los síntomas psicopatológicos en adolescentes

Guía para la aplicación e interpretación del cuestionario de apego CaMir-R / Guide to application and interpretation of the CaMir-R attachment questionnaire / Guia per a L'aplicació I interpretación del qüestionari d'aferrament Ca-Mir-R

El CaMir-R es un instrumento para la evaluación del apego que cuenta con buenas propiedades psicométricas, para su aplicación en el ámbito clínico y de la investigación con adolescentes y adultos. Las dimensiones del CaMir-R pueden utilizarse tanto para describir las representaciones de apego de la persona como para estimar los estilos de apego a partir de dichas dimensiones. En el presente trabajo se realiza una descripción pormenorizada del instrumento y de su aplicación. Además, se explicanlas pautas de interpretación de las dimensiones de apego que evalúa el instrumento, así como el procedimiento para estimar el estilo de apego a partir de las puntuaciones obtenidas en dichas dimensiones (AU)

The CaMir-R presents adequate psychometric properties for assessing attachment in clinical and research context with adolescents and adults. The dimensions of CaMir-R can be used both to describe the attachment representations of the person as well as to identify attachment styles using these dimensions. This work presents a detailed description of the CaMir-R and its application. Furthermore, guidelines for interpreting the dimensions of attachment that the instrument evaluates and the procedure for identifying the attachment style from the scores on these dimensions are explained (AU)

El CaMir-R és un instrument per a l’avaluació de l’aferrament que compta amb bones propietats psicomètriques, per a la seva aplicació en l’àmbit clínic i de la investigació amb adolescents i adults. Les dimensions del CaMir-R poden utilitzar-se tant per descriure les representacions de l’aferrament de la persona com per estimar els estils de l’aferrament a partir d’aquestes dimensions. En el present treball, es realitza una descripció detallada de l’instrument i de la seva aplicació. A més, s’expliquen les pautes d’interpretació de les dimensions de l’aferrament que avalua l’instrument, així com el procediment per estimar l’estil d’aferrament a partir de les puntuacions obtingudes en aquestes dimensions

Versión reducida del cuestionario CaMir (CaMir-R) para la evaluación del apego / Short version of CaMir questionnaire (CaMir-R) to assess attachment

El CaMir es un cuestionario que mide las representaciones de apego. Se fundamenta en las evaluaciones que realiza el sujeto sobre las experiencias de apego pasadas y presentes y sobre el funcionamiento familiar. Es un instrumento ampliamente utilizado tanto en el ámbito de la investigación como en el ámbito clínico. El objetivo del presente estudio consistió en desarrollar una versión reducida del CaMir en lengua castellana (CaMir-R) y en obtener evidencias acerca de su validez y de su fiabilidad en una muestra de 676 adolescentes (364 mujeres y 312 varones) pertenecientes a distintos colectivos (muestra clínica, muestra de maltratados y muestra comunitaria) con un rango de edad que oscilaba entre 13 y 19 años (M= 15,62; SD= 1,49). Se examinó su estructura interna, su validez convergente y de decisión, la relación entre sus dimensiones y los síntomas psicopatológicos, así como su consistencia interna y su estabilidad temporal. Se obtuvieron 7 dimensiones, cuyos índices de consistencia interna oscilaron entre 0,60 y 0,85. Exceptuando la dimensión de «Permisividad parental», que no mostró una buena fiabilidad, los resultados sugieren que el CaMir-R permite evaluar las representaciones de apego y la concepción acerca del funcionamiento familiar de forma válida y fiable (AU)

The CaMir is a questionnaire aimed at measuring attachment cognitions. It is based on subjects’ evaluations of past and present attachment experiences and family functioning. It is a widely used tool both in research and in clinical settings. The aim of this study was to develop a short version of CaMir in Spanish (CaMir-R) and to obtain evidence about its validity and reliability in a sample of 676 adolescents (364 female and 312 male) belonging to different groups (clinical, maltreated, and community samples) with an age range between 13 and 19 years (M= 15.62, SD= 1.49). We examined its internal structure, convergent, and decision validity, the relationship between its dimensions and psychopathological symptoms, as well as its internal consistency and temporal stability. The CaMir-R included 7 factors whose internal consistency indexes ranged between 0.60 and 0.85. With the exception of the «Parental Permissiveness» dimension, which did not show good reliability, the results suggest that the CaMir-R provides a valid and reliable assessment of attachment representations and of the conception of family functioning (AU)

[Short version of CaMir questionnaire (CaMir-R) to assess attachment]. / Versión reducida del cuestionario CaMir (CaMir-R) para la evaluación del apego.

The CaMir is a questionnaire aimed at measuring attachment cognitions. It is based on subjects' evaluations of past and present attachment experiences and family functioning. It is a widely used tool both in research and in clinical settings. The aim of this study was to develop a short version of CaMir in Spanish (CaMir-R) and to obtain evidence about its validity and reliability in a sample of 676 adolescents (364 female and 312 male) belonging to different groups (clinical, maltreated, and community samples) with an age range between 13 and 19 years (M = 15.62, SD = 1.49). We examined its internal structure, convergent, and decision validity, the relationship between its dimensions and psychopathological symptoms, as well as its internal consistency and temporal stability. The CaMir-R included 7 factors whose internal consistency indexes ranged between 0.60 and 0.85. With the exception of the «Parental Permissiveness¼ dimension, which did not show good reliability, the results suggest that the CaMir-R provides a valid and reliable assessment of attachment representations and of the conception of family functioning.