Efficacy of Brief Intervention for Alcohol Consumption during Pregnancy in Argentinean Women: A Randomized Controlled Trial.

INTRODUCTION: Although Brief Intervention (BI) has proven to reduce alcohol consumption during pregnancy in high income countries, there is no evidence from the Southern Cone of America. Thus, we conducted a study to assess BI efficacy among Argentinean pregnant women. METHOD AND MATERIALS: We collected data on pregnant women receiving prenatal care at the public health system in Mar del Plata, Argentina. Women with less than 26 weeks of gestation (n = 486) were randomized to brief advice (BA) or BI. Three months later they were re-assessed; women with more than 26 weeks of gestation constituted a screening only control group (SC) (n = 154). Self-reported quantity and frequency of alcohol consumption, frequency of binge drinking, and related problems after three months were used as outcomes. We performed generalized estimating equations and clinical significance analyses. Also, we obtained newborn health indicators from the city's health system database to use as objective outcomes. Women who did not participate in any of the three former conditions were randomly selected to constitute a non-screening control group (NSC) (n = 150). We compared objective outcomes among BI, BA, and NSC groups using the Wilcoxon rank test. RESULTS: In comparison with SC, BI and BA reduced alcohol consumption, without differences between the latter two. Newborns of women who received BI and BA had better health indicators compared with the NSC group. CONCLUSIONS: performing either a BI or BA reduces alcohol consumption among Argentinean pregnant women and might lead to healthier newborns.

Normas sociales y consumo de alcohol en mujeres embarazadas de la Argentina / Social norms and alcohol consumption in pregnant women of Argentina

Resumen La exposición prenatal al alcohol puede derivar en un espectro de trastornos congénitos, dentro de los cuales el Síndrome Alcohólico Fetal (SAF) es el más severo. Esto es 100 % prevenible si no se consume alcohol durante la gestación, por lo que conocer los factores que determinan que una mujer consuma alcohol estando embarazada es fundamental. El objetivo de este trabajo es evaluar si características del entorno (como son las normas sociales prescriptivas o NSP) se relacionan con el consumo de alcohol durante la gestación en mujeres de la ciudad de Mar del Plata, Argentina. Para ello, se realizó un muestro probabilístico de 852 mujeres gestantes durante el año 2016 en los principales centros de atención primaria a la salud de la ciudad. Se evaluó el consumo de alcohol antes y durante la gestación a través del Test de Identificación de Trastornos por Consumo de Alcohol y las NSP con preguntas construidas ad hoc. El 87 % consideró que las otras gestantes consumen alcohol; de ellas, 53 % cree que el consumo es igual, 10 % cree que es mayor y el resto menor. El 90 % reconoció que las personas importantes para ellas desaprobarían el consumo durante la gestación. Las mujeres con un entorno favorable hacia el consumo se correspondieron con ingesta de alcohol en el embarazo, mientras que se observó lo contrario en los casos en los que el entorno era desfavorable. Estos resultados indican que podría ser beneficioso diseñar estrategias preventivas que se focalicen no solo en la gestante, sino en el entorno cercano.

Abstract Prenatal alcohol exposure can lead to a spectrum of congenital disorders for the fetus with permanent consequences, known as fetal alcohol spectrum disorders (FASD), within which Fetal Alcohol Syndrome (SAF) is its most severe extreme. All FASD are 100 % preventable if no alcohol is consumed during pregnancy, so knowing the factors that determine that a woman decides to drink while pregnant is essential to develop effective prevention plans. Among these factors are the phenomena of social influence such as perceived social norms (PSN), both descriptive and prescriptive. The PSN are transmitted by social interaction and produced based on the perception of the beliefs or behaviors of others, beyond their real actions. It has been identified that PSN predict alcohol consumption in various populations, such as university students, but research is almost non-existent with pregnant women. The aim of this study is to assess whether environmental characteristics (such as PSN) are related to alcohol consumption during pregnancy in pregnant women in the city of Mar del Plata, Argentina. Method: a probabilistic sample of 852 pregnant women was carried out during 2016 in the main primary health care centers of the city of Mar del Plata. Alcohol consumption was assessed before and during pregnancy through the AUDIT and the PSN was assessed with five questions constructed ad hoc by specialists in the area of alcohol consumption. Descriptive analyses were performed to categorized social norms and the prescriptive ones were re-categorized into four groups: 1. It is bad for the health of the baby or the mother; 2. It is wrong for cultural or moral reasons; 3. consumption is accepted; 4. It does not know/does not matter. To describe them based on alcohol consumption, latent class analyses were performed. Models of two to four classes were estimated, reproduced 50 times to avoid local maximums, with the software R. Results: 87 % of pregnant women believed that others in their same condition consume alcohol. 53 % of them believed they consume the same as before pregnancy, 10 % believed they consume more and the rest that they reduced their consumption. The belief about the average amount that other pregnant women would consume is more than three drinks, the equivalent of one bottle of beer per occasion of consumption. 90 % recognized that people important to them would disapprove consumption during pregnancy because doing so would cause harm to the baby, the mother, pregnancy in general or because alcohol is considered harmful to health. 6 % considered that people important to them would approve consumption because few amounts are tolerated or because alcohol is good for breastfeeding. The latent class analysis indicated a better fit for the two-class model. Class 1 was made up of women who claimed that for their people, alcohol consumption during pregnancy was acceptable and they themselves consumed alcohol during pregnancy. Class 2 conglomerated women who thought that others would see their consumption as bad at this stage and there was a low probability that they themselves consumed during pregnancy. Conclusions: These results indicate that it could be beneficial to design preventive strategies that focus not only on the future mother, but on the nearby environment (couple, family, friends), and even throughout the community, where social norms are established and reproduced.

The Effectiveness of a Brief Intervention for Reducing Adolescent Alcohol Consumption / Efectividad de una intervención breve para reducir el consumo de alcohol en adolescentes / Efetividade de uma Intervenção breve para reduzir o consumo de álcool em adolescentes

Abstract Introduction: Although alcohol consumption affects more than half of all adolescents, there are no known studies to assess the effectiveness of interventions to prevent or reduce consumption at a local level. The aim of this randomized clinical trial was to determine the effectiveness and clinical significance of a brief intervention program to reduce the consumption of alcohol and related problems in an educational setting in Argentina. Materials and methods: Systematically selected high school students (N = 167) were randomly assigned to one of three conditions: two control groups (screening, screening and evaluation) and one experimental group (screening, assessment and intervention). With the approval of an Ethics Committee, we implemented a protocol based on international guidelines. The effectiveness measures used were reduction in usual quantity, in high-risk alcohol drinking or in alcohol-related problems. We performed descriptive analyses, linear and logistic regressions, estimates of relative and absolute risk reduction, and the number of patients needed to reduce an event. In the follow-up (N = 150), the quantity of consumption and high-risk consumption were higher in the control groups. Results: The intervention effectively reduced alcohol consumption and related problems in about one out of seven adolescents, with a minimal investment in training and implementation. However, we did not find significant differences in alcohol-related problems among the groups, which decreased under all conditions. Conclusion: Long-term studies could determine whether this change primarily affects the intervention group.

Resumen Introducción: A pesar de que el consumo de alcohol afecta a más de la mitad de los adolescentes, se desconoce la efectividad de intervenciones para evitarlo o reducirlo a nivel local. Este ensayo clínico aleatorizado se propuso determinar la efectividad y significancia clínica de un programa de intervención breve para reducir el consumo de bebidas alcohólicas y problemas relacionados en un contexto educativo de Argentina. Materiales y métodos: Los participantes, estudiantes de educación media seleccionados sistemáticamente (N = 167) fueron asignados aleatoriamente a una de tres condiciones: dos grupos control (tamizaje, tamizaje y evaluación) y uno experimental (tamizaje, evaluación e intervención). Con el aval de un Comité de Ética, se implementó un protocolo basado en lineamientos internacionales. Las medidas de efectividad utilizadas fueron disminución de la cantidad habitual, del consumo de alto riesgo, y de los problemas relacionados con el alcohol. Se realizaron análisis descriptivos, regresiones lineales y logísticas, y estimaciones de reducción relativa y absoluta del riesgo y del número de pacientes a tratar para reducir un evento. En la etapa de seguimiento (N = 150), la cantidad y el consumo de alcohol de alto riesgo fueron mayores en los grupos control. Resultados: la intervención redujo efectivamente el consumo de alcohol y sus problemas en aproximadamente uno de cada siete adolescentes, con una mínima inversión en entrenamiento y aplicación. Sin embargo, no se encontraron diferencias significativas en los problemas relacionados, que disminuyeron en todas las condiciones. Conclusión: Estudios a largo plazo podrían dilucidar si el cambio se sostiene mayormente en el grupo de intervención.

Resumo Introdução: A pesar de que o consumo de álcool afeta a mais da metade dos adolescentes, desconhece-se a efetividade de intervenções para evitá-lo ou reduzi-lo no nível local. Este ensaio clínico aleatorizado se propôs determinar a efetividade e significância clínica de um programa de intervenção breve para reduzir o consumo de bebidas alcoólicas e problemas relacionados em um contexto educativo da Argentina. Materiais e métodos: Os participantes, estudantes de educação média selecionados sistematicamente (N = 167) foram assignados aleatoriamente a três condições: dois grupos controle (peneiração, peneiração e avaliação) e um experimental (peneiração, avaliação e intervenção). Com o aval de um Comitê de Ética, se implementou um protocolo baseado em diretrizes internacionais. As medidas de efetividade utilizadas foram diminuição da quantidade habitual, do consumo de alto risco, e dos problemas relacionados com o álcool. Realizaram-se análises descritivas, regressões lineais e logísticas e estimações de redução relativa e absoluta do risco e do número de pacientes a tratar para reduzir um evento. Na etapa de seguimento (N = 150), a quantidade e o consumo de álcool de alto risco foram maiores nos grupos controle. Resultados: A intervenção reduziu efetivamente o consumo de álcool e seus problemas em aproximadamente um de cada sete adolescentes, com um mínimo investimento em treinamento e aplicação. No entanto, não se encontraram diferenças significativas nos problemas relacionados, que diminuíram em todas as condições. Conclusão: Estudos a longo prazo poderiam dilucidar se a mudança se sustenta maiormente no grupo de intervenção.

Razones para reducir el consumo de alcohol en universitarios / Reasons to reduce alcohol consumption in university students

Las razones para reducir el consumo de alcohol pueden ser definidas como motivos que llevan a una persona a disminuir el consumo de alcohol o mantener la sobriedad. Este tema suele ser poco estudiado, particularmente en países latinoamericanos y en poblaciones en riesgo. El objetivo de esta investigación de diseño secuencial exploratorio fue explorar las razones para cambiar el consumo de alcohol en universitarios que lo hayan modificado (N = 100), de la ciudad de Mar del Plata, Argentina, con una pregunta abierta. A su vez, la descripción se realizó sobre la base de la experiencia previa de consumo excesivo episódico del alcohol, trastornos por uso de alcohol, y el sexo de los participantes. Los resultados indican que el motivo más frecuente es el disgusto o indiferencia por la sustancia en casi todos los grupos considerados. Sin embargo, cuando el trastorno por uso de alcohol fue grave o moderado, se observaron diferencias. Se discuten los aportes teóricos de la investigación, entre ellos, comprender qué lleva a cada grupo a cambiar su consumo alcohol, y las implicancias para el desarrollo de intervenciones específicas basadas en esta información.

The reasons to reduce alcohol consumption may be defined as the causes leading a person to decrease alcohol consumption or to stay sober. This topic is not often widely studied, particularly in Latin American countries and at-risk populations. The aim of this sequential exploratory research was to explore, through an open question, the reasons why university students (N = 100) of the city of Mar del Plata, Argentina, changed their alcohol consumption. Additionally, the description was based on previous heavy episodic alcohol consumption, disorders caused by alcohol use, and participants' gender. The results indicate that almost all studied groups reduced alcohol consumption due to their distaste or indifference for the substance. However, when disorders caused by alcohol use were severe or moderate, differences were observed. The theoretical contributions of this research are discussed, including the understanding of what leads each group to change its alcohol consumption, and the implications for the development of specific interventions based on this information.

Psychometric Properties of Brief Screening Tests for Alcohol Use Disorders during Pregnancy in Argentina / Propriedades psicométricas de instrumentos de triagem de consumo de álcool durante gestação na Argentina

Abstract Background Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders IdentificationTest- Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPSQF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity. Reliability (internal consistency) was low for all instruments, improving when optimal cut-off points were used, especially for the AUDIT, the AUDIT-C and the RAPS-QF. Conclusions In other cultural contexts, studies have concluded that T-ACE and TWEAK are the best instruments to assess pregnant women. In contrast, our results evidenced the low reliability of those instruments and a better performance of the AUDIT in this population.

Resumo Introdução Considerando os problemas físicos, mentais e comportamentais relacionados à exposição fetal ao álcool, as orientações clínicas pré-natais sugerem uma breve avaliação do consumo de álcool durante a gravidez para detectar o consumo de álcool e ajustar as intervenções, se necessário. Ainda que qualquer uso de álcool deva ser considerado arriscado durante a gravidez, identificar as mulheres com transtornos de uso de álcool é importante, porque elas podem precisar de uma intervenção mais específica do que um simples conselho para se abster. A maioria dos testes de triagem tem sido desenvolvidos e validados em populações masculinas, e estão focados nas consequências em longo prazo do uso excessivo de álcool, de modo que eles podem ser inadequados para avaliar o consumo em mulheres grávidas. Objetivo Analisar a confiabilidade e a validade internas dos instrumentos de triagem de álcool Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPS-QF) e Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) para identificar transtornos por uso de álcool em mulheres grávidas. Método Um total de 641 puérperas foram entrevistadas pessoalmente durante as 48 horas após o parto. As curvas receiver operating characteristic (ROC), a sensibilidade e a especificidadede cada instrumento foramanalisadas utilizandodiferentespontosde corte. Resultados Todos os instrumentos mostraram áreas sob as curvas ROC acima de 0.80. Foram encontradas áreas maiores para o TWEAK e para o AUDIT. O TWEAK, o TACE e o AUDIT-C apresentaram maior sensibilidade, enquanto o AUDIT e o RAPS-QF apresentaram maior especificidade. A confiabilidade (consistência interna) foi baixa para todos os instrumentos, melhorando quando foram utilizados pontos de corte ótimos, especialmente para o AUDIT, o AUDIT-C e o RAPS-QF. Conclusões em outros contextos culturais, estudos concluíram que o T-ACE e o TWEAK são os melhores instrumentos para avaliar mulheres grávidas. Em contrapartida, nossos resultados evidenciaram baixa confiabilidade desses instrumentos e melhor desempenho do AUDIT nessa população.

Psychometric Properties of Brief Screening Tests for Alcohol Use Disorders during Pregnancy in Argentina.

Background Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPS-QF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity. Reliability (internal consistency) was low for all instruments, improving when optimal cut-off points were used, especially for the AUDIT, the AUDIT-C and the RAPS-QF. Conclusions In other cultural contexts, studies have concluded that T-ACE and TWEAK are the best instruments to assess pregnant women. In contrast, our results evidenced the low reliability of those instruments and a better performance of the AUDIT in this population.

Introdução Considerando os problemas físicos, mentais e comportamentais relacionados à exposição fetal ao álcool, as orientações clínicas pré-natais sugerem uma breve avaliação do consumo de álcool durante a gravidez para detectar o consumo de álcool e ajustar as intervenções, se necessário. Ainda que qualquer uso de álcool deva ser considerado arriscado durante a gravidez, identificar as mulheres com transtornos de uso de álcool é importante, porque elas podem precisar de uma intervenção mais específica do que um simples conselho para se abster. A maioria dos testes de triagem tem sido desenvolvidos e validados em populações masculinas, e estão focados nas consequências em longo prazo do uso excessivo de álcool, de modo que eles podem ser inadequados para avaliar o consumo em mulheres grávidas. Objetivo Analisar a confiabilidade e a validade internas dos instrumentos de triagem de álcool Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test ­ Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen ­ Quantity Frequency (RAPS-QF) e Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) para identificar transtornos por uso de álcool em mulheres grávidas. Método Um total de 641 puérperas foram entrevistadas pessoalmente durante as 48 horas após o parto. As curvas receiver operating characteristic (ROC), a sensibilidade e a especificidade de cada instrumento foram analisadas utilizando diferentes pontos de corte. Resultados Todos os instrumentos mostraram áreas sob as curvas ROC acima de 0.80. Foram encontradas áreas maiores para o TWEAK e para o AUDIT. O TWEAK, o T-ACE e o AUDIT-C apresentaram maior sensibilidade, enquanto o AUDIT e o RAPS-QF apresentaram maior especificidade. A confiabilidade (consistência interna) foi baixa para todos os instrumentos, melhorando quando foram utilizados pontos de corte ótimos, especialmente para o AUDIT, o AUDIT-C e o RAPS-QF. Conclusões em outros contextos culturais, estudos concluíram que o T-ACE e o TWEAK são os melhores instrumentos para avaliar mulheres grávidas. Em contrapartida, nossos resultados evidenciaram baixa confiabilidade desses instrumentos e melhor desempenho do AUDIT nessa população.

Psychometric Properties of the Alcohol Expectancy Questionnaire (AEQ-A) in psychology students from Mar del Plata, Argentina / Propriedades psicométricas do Questionário de Expectativas para o Consumo de Álcool (AEQ-A) em Estudantes de Psicologia de Mar del Plata, Argentina / Propiedades psicométricas del cuestionario de expectativas hacia el consumo de alcohol (AEQ-A) en estudiantes de psicología de Mar del Plata, Argentina

Abstract The aim of this article was to analyze the psychometric properties of an adapted version of the Alcohol Expectancy Questionnaire Adolescent (AEQ-A) in university students from Mar del Plata city, Argentina. Expectancies about the effects of alcohol refer to the beliefs that people hold about the consequences of alcohol consumption on behavior. Expectancies have been related to drinking initiation and maintenance, and to habitual drinking patterns. Although several questionnaires have been developed to measure expectancies, the AEQ-A has been one of the most frequently used. Studies in different cultural that, given expectancies' cultural variability, the questionnaire must be adapted to each particular context. A version of the AEQ-A previously validated in Mar del Plata, Argentina, was used, consisting of 40 items measured on a (true / false) dichotomous scale. The sample consisted of 1076 psychology students from the National University of Mar del Plata, Argentina. Exploratory and confirmatory factor analyzes were performed. The factorial analysis resulted in six factors containing 37 items. Internal consistency of each subscale was adequate. Concurrent validity was satisfactory inasmuch as scores on the subscales about beliefs associated with positive effects of consumption in social situations relate to heavy episodic drinking. Instruments like this one to evaluate expectancies, will allow the study of psychosocial factors associated with consumption and provide useful information to develop prevention strategies.

Resumo O objetivo do presente trabalho foi analisar as propriedades psicométricas (estrutura fatorial, consistência interna e validade concorrente) de uma versão adaptada do Alcohol Expectancy Questionnaire Adolescents (AEQ-A) em estudantes universitários da cidade de Mar del Plata, Argentina. As expectativas para os efeitos do álcool referem-se às crenças que as pessoas têm sobre os efeitos que produz o consumo de álcool no comportamento, e têm sido relacionadas com o início, a manutenção e os padrões de consumo. Embora tenham sido desenvolvidos vários instrumentos para sua medida, o AEQ-A tem sido um dos mais utilizados; no entanto devido à variabilidade cultural das expectativas, é recomendável realizar adaptações deste aos contextos particulares em estudo. Para este trabalho, utilizou-se uma versão do AEQ-A previamente validada em Mar del Plata, Argentina, que consta de 40 itens medidos numa escala dicotômica (verdadeiro/falso). A amostra esteve composta por 1076 estudantes de Psicologia da Universidad Nacional de Mar del Plata. Realizaram-se análises fatoriais exploratórias e confirmatórias, nas quais se encontrou uma estrutura de seis fatores que reuniram 37 itens. A consistência interna de cada subescala foi adequada e a validade concorrente foi satisfatóriajá que as pontuações nas subescalas de crenças sobre os efeitos positivos do consumo em situações sociais relacionaram-se com o consumo excessivo episódico. Concluiu-se que contar com instrumentos de avaliação das expectativas permitirá estudar os fatores psicossociais associados ao consumo e dar informação útil para a elaboração de intervenções.

Resumen El objetivo del presente trabajo fue analizar las propiedades psicométricas (estructura factorial, consistencia interna y validez concurrente) de una versión adaptada del Alcohol Expectancy Questionnaire Adolescents (AEQ-A) en estudiantes universitarios de la ciudad de Mar del Plata, Argentina. Las expectativas hacia los efectos del alcohol se refieren a las creencias que las personas tienen sobre los efectos que produce el consumo de alcohol en el comportamiento, y han sido relacionadas con el inicio, el mantenimiento y los patrones de consumo. Si bien se han desarrollado varios instrumentos para su medición, el AEQ-A ha sido uno de los más utilizados; sin embargo debido a la variabilidad cultural de las expectativas, es recomendable realizar adaptaciones del mismo a los contextos particulares en estudio. Para este trabajo se utilizó una versión del AEQ-A previamente validada en Mar del Plata, Argentina, que consta de 40 ítems medidos en una escala dicotómica (verdadero/falso). La muestra estuvo compuesta por 1076 estudiantes de Psicología de la Universidad Nacional de Mar del Plata. Se realizaron análisis factoriales exploratorios y confirmatorios, en los cuales se encontró una estructura de seis factores que reunieron 37 ítems. La consistencia interna de cada subescala fue adecuada y la validez concurrente fue satisfactoria ya que los puntajes en las subescalas de creencias sobre los efectos positivos del consumo en situaciones sociales se relacionaron con el consumo excesivo episódico. Se concluyó que contar con instrumentos de evaluación de las expectativas permitirá estudiar los factores psicosociales asociados al consumo y brindar información útil para el diseño de intervenciones.

Afectividad y problemas por uso de alcohol en estudiantes universitarios / Affectivity and alcohol use problems among college students

La estructura afectiva estaría constituida por dos dimensiones llamadas afectividad negativa (AN ) y afectividad positiva (AP ), que se relacionarían con distintos trastornos mentales. Asimismo, la afectividad tendría un rol en la explicación de los problemas por uso de sustancias. Objetivo: Describir la relación de la AN y AP con el consumo y problemas por uso de alcohol en estudiantes universitarios. Método: Se administró una adaptación del PANAS y el AUDIT a una muestra de 205 estudiantes universitarios de la ciudad Mar del Plata, Argentina. Análisis: Se realizaron análisis bivariados y multivariados (regresiones lineales y logísticas) entre el puntaje total del AUDIT , la AN y AP. Estos modelos se repitieron estratificados por género. También se estimó la probabilidad de presentar cada uno de los problemas por uso de alcohol listados en el AUDIT en función de la AN y AP. Resultados: No hubo asociación entre la AP y el puntaje total del AUDIT, y lo mismo sucedió con cada ítem. La AN aumentó la probabilidad de una mayor cantidad de alcohol consumida, imposibilidad de controlar el consumo, incumplimiento de obligaciones, remordimiento o culpa por la ingesta de alcohol, olvido de hechos ocurridos mientras bebían, y lesiones bajo los efectos del alcohol. No se hallaron diferencias de género. Discusión: Algunas de las observaciones pueden explicarse por el contexto; sin embargo, en general, se halló una concordancia con estudios anteriores. La AN podría resultar un campo interesante para la investigación e intervención en adicciones

Introduction: The affective structure consists of two dimensions: positive affectivity (PA ) and negative affectivity (NA ), which would be related to various mental disorders and may also have a role in explaining substance use problems. Aims: To describe the relationship between NA and PA with alcohol consumption and alcohol use problems in college students. Method: an adaptation of the PANAS and AUDIT was administered to a sample of 205 college students from the city of Mar del Plata, Argentina. Analysis: bivariate and multivariate analysis (linear and logistic regressions) were performed between the total AUDIT score, NA and PA , and were then repeated stratified by gender. The probability of presenting an alcohol use disorder listed by the AUDIT , according to the PA and NA , was also estimated. Results: There was no association between the PA and the total AUDIT score, and the same thing occurred with each item. NA increases the likelihood of consuming more alcohol, inability to control consumption, failure to comply with obligations, remorse or guilt at alcohol consumption, forgetting events while drinking, and injury under the effects of alcohol. No gender differences were found. Discussion: Although results are consistent with previous studies, some of the observations can be explained by the context. NA could be an interesting field in research into addictions

Investigación en intervención breve y consumo de alcohol durante la gestación: productividad e impacto

Objetivo: Describir la producción científica de las Intervenciones Breves (IB) para disminuir el consumo de alcohol durante la gestación y cuantificarla mediante indicadores bibliométricos. Método: Se realizó un estudio de investigación secundaria con un diseño de revisión estructurada que consistió en búsquedas sistemáticas en las bases de datos Lilacs, PsycINFO, PubMed, Scielo y Scopus. Para el análisis se accedió al documento completo y se registraron características y procedimientos de aplicación de IB de los documentos seleccionados. Resultados: Se analizaron 45 artículos, la mayoría de los Estados Unidos. La primera publicación fue en 1999 registrándose un incremento progresivo hasta la actualidad. La revista con más publicaciones fue Obstetrics and Gynecology y el idioma predominante el inglés. El 52% de los artículos corresponden a trabajos empíricos, y el resto a trabajos de reflexión y revisiones que en su mayoría, promueven la abstinencia durante la gestación. En los trabajos experimentales se compararon dos grupos, intervención y control, y se registraron dos modalidades: vía web y cara a cara (71%). Para tamizar consumo de alcohol el T-ACE fue el instrumento más recomendado y utilizado, junto con preguntas de cantidad y frecuencia. Conclusiones: La necesidad de contar con estrategias efectivas para evitar el consumo de alcohol durante la gestación está siendo cada vez más reconocida. Se espera que en los próximos años el crecimiento del número de publicaciones impacte en nuestro contexto latinoamericano donde hay escasez de publicaciones, aparentemente nulas en habla hispana, y donde existe una relevante necesidad de evidencia sobre estrategias efectivas en esta población.

Aims: To describe the scientific production of the Brief Interventions (BI) to reduce alcohol consumption during pregnancy and quantify it by bibliometric indicators. Method: A secondary research study was conducted with a structured design review. A systematic search of Lilacs, PsycINFO, PubMed, Scopus and Scielo databases was made. For the analysis, we accessed to the full document and then concentrated on the application and procedures of the BI characterized in the articles. Results: Forty-five articles, most from the United States were analyzed. In 1999 was the first publication and it has been a gradual increase until today. The journal which published more was Obstetrics and Gynecology and the language of all publications was above all English. Half of the articles were empirical works, and the rest, opinion articles, and reviews. Most of them promote alcohol abstinence during pregnancy. In all experimental works, two groups were compared: intervention and control and the BI was implemented by two procedures: via web or face to face (71%). Among all the alcohol consumption screening instruments, the most recommended and used was the T-ACE, along with quantity and frequency questions. Conclusions: The need for effective strategies to prevent alcohol consumption during pregnancy is being increasingly recognized. It is expected that in coming years the growth in the number of publications have an impact on our Latin American context, where there is a lack of publications, apparently null in Spanish speaking, and where there is a significant need for evidence on effective strategies in this population.

Presentación de una guía para la observación y clasificación de la conducta verbal de los Terapeutas / Presentation of an observation and classification guide of therapists' verbal behavior

El artículo presenta una guía de observación y clasificación de la conducta verbal de los terapeutas, la Guía de Observación de Terapeutas Aiglé (GOTA-v). Se revisan los estudios sobre la variable del terapeuta, especialmente el Estilo Personal y sus procedimientos de evaluación. Este nuevo instrumento fue aplicado a la transcripción de 44 sesiones de 12 terapeutas de Argentina con diferente orientación teórico-técnica y distinto grado de experiencia (bajo, medio y alto). Se delimitaron los textos de las sesiones en unidades de análisis y se clasificaron esas unidades con categorías pertenecientes a tres clases de actos de habla: Preguntas, afirmaciones e indicaciones. Se calculó el índice de acuerdo inter jueces de Kappa para cada clase. Se discuten los alcances y limitaciones del instrumento y sus posibilidades para la investigación en psicoterapia.

The article presents an observation and classification guide of therapists' verbal behavior, the Aiglé Therapists Observation Guide (ATOG-v). Studies on the therapist variables together with the assessment procedures are revisited. This new instrument was applied to the transcription of 44 sessions of 12 therapists in Argentina with different theoretical-technical orientation and different levels of experience (low, moderate and high). The session texts were delimited into analysis units and these units were classified with categories pertaining three types of speech acts: questions, statements and indications. The Kappa inter-judges index was applied for each class. The scope and limitations of the instrument and its possibilities for psychotherapy research are presented.

Validez de los cuestionarios de expectativas hacia el consumo de alcohol / Validity of alcohol expectancy questionnaires

Introducción: las expectativas hacia el consumo de alcohol se definen como creencias de los efectos del alcohol sobre el comportamiento y podrían predecir su consumo. El objetivo de este trabajo es resumir la información disponible sobre los cuestionarios que las miden y su validez. Métodos: se realizaron búsquedas en las bases de datos Pubmed, Scopus, PsycINFO, Lilacs y Scielo, seleccionando estudios sobre la validez de los cuestionarios. La calidad del material se evaluó con la guía CASP y la síntesis de datos fue cualitativa. Resultados: de las 133 referencias resultantes, 56 se eliminaron por repetirse, 52 por no ser de la temática/objetivo, y se agregaron 7 de otras fuentes. Se hallaron 16 instrumentos con buenos índices de fiabilidad y validez, algunos de ellos utilizados eficazmente para predecir el consumo de alcohol. Conclusión: los cuestionarios de expectativas hacia el consumo de alcohol podrían constituir una herramienta útil para la investigación, evaluación clínica y tamizaje.