Measurement invariance between online and paper-and-pencil formats of the Launay-Slade Hallucinations scale-extended (LSHS-E) in the Chilean population: Invariance between LSHS-E formats.

Research on the multidimensionality of hallucination-like experiences (HLEs) can contribute to the study of psychotic risk. The Launay-Slade Hallucinations Scale-Extended (LSHS-E) is one of the most widely used tools for research in HLEs, but the correspondence of its paper and online formats has not been established yet. Therefore, we studied the factorial structure and measurement invariance between online and paper-and-pencil versions of LSHS-E in a Chilean population. Two thousand eighty-six completed the online version, and 578 students completed the original paper-and-pencil version. After matching by sex, age, civil status, alcohol and cannabis consumption, and psychiatric treatment received, we selected 543 students from each group. We conducted a confirmatory factor analysis of a four-factor model and a hierarchical model that included a general predisposition to hallucination, explaining the strong relationship between the different types of hallucinations. Both models showed a good fit to the data and were invariant between paper-and-pencil and online versions. Also, the LSHS-E has good reliability in both online and paper-and-pencil formats. This study shows that the online LSHS-E possesses psychometric properties equivalent to the paper-and-pencil version. It should be considered a valuable tool for research of psychosis determinants in the COVID-19 era. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-021-02497-7.

Bienestar Subjetivo en contextos de desigualdad y derrota social en jóvenes universitarios de Chile y Ecuador

Resumen Los estudios macroeconómicos evidencian que países con mayor desigualdad social presentan peores indicadores de salud mental y bienestar, sin embargo, otros mecanismos intervinientes no están del todo claro. Recientes investigaciones han propuesto que la percepción de derrota social configura una variable clave para comprender los impactos de las desigualdades. El objetivo de este estudio fue explorar el rol predictor de la derrota social en el bienestar subjetivo de estudiantes universitarios provenientes de países latinoamericanos que exhiben niveles de desigualdad social. Los participantes fueron 347 estudiantes universitarios de Chile y 246 de Ecuador, en los cuales se evaluó la percepción de derrota social, fatalismo, participación social, bienestar social, y bienestar subjetivo. Los resultados del modelo de regresión muestran que la predicción del bienestar subjetivo mejora al incluir las dimensiones de derrota social en el modelo (r2 = .38). Se propone la derrota social como una variable que ayuda a comprender cómo un contexto de desigualdad social puede impactar en el bienestar percibido de jóvenes universitarios.

Abstract Macroeconomic studies show that countries with greater social inequality have worse indicators of mental health and well-being; however, other intervening mechanisms are not entirely clear. Recent research has proposed that the perception of social defeat is a key variable in understanding the impacts of inequalities. The aim of this study was to explore the predictive role of social defeat in the subjective well-being of university students from Latin American countries that exhibit levels of social inequality. The participants were 347 university students from Chile and 246 from Ecuador, in whom the perception of social defeat, fatalism, social participation, social well-being, and subjective well-being were evaluated. The results of the regression model show that the prediction of subjective well-being improves when including the dimensions of social defeat in the model (r2 = .38) Social defeat is proposed as a variable that helps to understand how a context of social inequality can impact the perceived well-being of young university students.

Infusing the trauma-informed approach in youth suicide research: Lessons from the field.

Adolescent suicide is a serious public health problem in Chile. Given the high prevalence of suicidal behaviors and suicide, youth suicide researchers must approach participants, families, and communities with care. Special attention must be given to suicide-related trauma among survivors of suicidal behaviors and of suicide. In this article, we discuss how investigators can infuse the trauma-informed model in their work. Our discussion is organized around research stages and tasks: study design, recruitment, data collection and analysis, and care for the research team. We illustrate the integration of the trauma-informed (TI) model key elements and principles with examples from our work in youth suicide research. We posit that infusing the TI model in research aligns with the ethical mandate of beneficence. Our goal is to help other researchers reflect on how to design and implement TI informed research that is attuned to participants, staff, and communities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social defeat: Concept and measurement in a Hispanic population / Derrota social: Concepto y medición en población de habla hispana

Abstract Introduction Social defeat (SD) is defined as a feeling of having lost the fight leading to a loss of valuable status or of important personal goals, and has been associated to depression and suicidal behavior, among other disorders. Furthermore, it has been proposed as a mediating variable between social and clinical elements. Objective To adapt and validate a Spanish version of the Defeat Scale. Method A back translation into Spanish was carried out. SD, hopelessness, and social well-being were measured in 546 university students (Mean age = 20.93 years, SD = 2.98; 68.7% females). Results An exploratory factor analysis offered a two-dimension structure in the scale made up by the dimension defeat and triumph. A confirmatory factor analysis found good fit indicators for the two-dimension model (df = 89; χ2 = 188.96; CFI = .942; RMSEA = .061; IFI = .943). Both dimensions present good internal consistency (Cronbach's alpha > .70). SD was associated to higher levels of hopelessness and lower levels of social well-being. Discussion and conclusion The Spanish version of the Defeat Scale presents good psychometric properties. Its use can help deepen the understanding of psychopathological phenomena and their link to social elements within the context of Spanish speaking countries.

Resumen Introducción La derrota social (DS) se define como la sensación de lucha fallida en relación con una pérdida de estatus valioso o de metas personales importantes, y se ha relacionado con depresión y conducta suicida, entre otros trastornos. Además, ha sido propuesta como una variable mediadora entre elementos sociales y clínicos. Objetivo Adaptar y validar al español la Defeat Scale. Método Se realizó una traducción inversa para obtener la versión al español de la escala. Con la participación de 546 estudiantes universitarios (M = 20.93 años, DS = 2.98; 68.7% mujeres), se evaluaron DS, desesperanza y bienestar social. Resultados El análisis factorial exploratorio encontró una estructura de dos dimensiones, compuesta por una dimensión de derrota y otra de triunfo. El análisis factorial confirmatorio encontró buenos indicadores de ajuste para el modelo de dos dimensiones (df = 89; χ2 = 188.96; CFI = .942; RMSEA = .061; IFI = .943). Ambas dimensiones presentaron buena consistencia interna (α > .70). La DS se asoció con mayores niveles de desesperanza y menores niveles de bienestar social. Discusión y conclusión La versión al español de la Defeat Scale presenta buenas propiedades psicométricas. Su uso puede ayudar a profundizar la comprensión de psicopatologías y su relación con elementos sociales en países de habla hispana.

A Cross-National Investigation of Hallucination-Like Experiences in 10 Countries: The E-CLECTIC Study.

Hallucination-like experiences (HLEs) are typically defined as sensory perceptions in the absence of external stimuli. Multidimensional tools, able to assess different facets of HLEs, are helpful for a better characterization of hallucination proneness and to investigate the cross-national variation in the frequencies of HLEs. The current study set out to establish the validity, factor structure, and measurement invariance of the Launay-Slade Hallucinations Scale-Extended (LSHS-E), a tool to assess HLEs. A total of 4419 respondents from 10 countries were enrolled. Network analyses between the LSHS-E and the 3 dimensions of the Community Assessment of Psychic Experiences (CAPE) were performed to assess convergent and divergent validity of the LSHS-E. Confirmatory factor analysis was used to test its measurement invariance. The best fit was a 4-factor model, which proved invariant by country and clinical status, indicating cross-national stability of the hallucination-proneness construct. Among the different components of hallucination-proneness, auditory-visual HLEs had the strongest association with the positive dimension of the CAPE, compared with the depression and negative dimensions. Participants who reported a diagnosis of a mental disorder scored higher on the 4 LSHS-E factors. Small effect size differences by country were found in the scores of the 4 LSHS-E factors even after taking into account the role of socio-demographic and clinical variables. Due to its good psychometric properties, the LSHS-E is a strong candidate tool for large investigations of HLEs.

Impact of attachment style on the 1-year outcome of persons with an at-risk mental state for psychosis.

Attachment theory provides key elements for understanding the psychosocial vulnerability for and response to the emergence of psychosis. This study examined (1) whether pre-treatment attachment styles are differentially associated with clinical and functional outcome in at-risk mental state (ARMS) for psychosis patients across one year of psychosocial treatment, and (2) whether clinical change is associated with changes in attachment ratings beyond the effect of baseline symptom severity. Thirty-eight ARMS patients (mean age=16.7, S.D.=5.9) identified from a psychosocial needs-adapted treatment were evaluated with the Positive and Negative Syndrome Scale, the Global Assessment of Functioning, and the Relationships Questionnaire. Lower levels of insecure-avoidant attachment predicted better clinical outcomes, whereas higher levels of secure attachment predicted improvement in functioning. A decrease in preoccupied-anxious attachment was associated with symptom amelioration. The findings suggest that the intensity of insecure attachment plays a significant role in the clinical outcome of ARMS patients involved in psychosocial treatment. Reducing the levels of insecure attachment in the therapeutic setting probably favors a better course in the early phases of psychosis. Furthermore, the finding that negative models of the self and others were associated with symptom outcome is consistent with current psychosocial models of psychosis.

Attachment style predicts 6-month improvement in psychoticism in persons with at-risk mental states for psychosis.

AIM: Insecure attachment may influence vulnerability to and outcome of psychotic symptomatology. The present study examined whether attachment style predicted symptoms and functioning of at-risk mental state (ARMS) patients after 6 months of psychosocial intervention, over and above the effects of initial clinical severity and premorbid social adjustment (PSA). METHODS: Symptoms and functioning were assessed at baseline and 6 months later in 31 ARMS patients (mean age = 15.7). No patient received antipsychotic medication, but all engaged in intense psychosocial needs-adapted treatment. Clinicians (unaware of the aims of the study) rated attachment, PSA, symptoms, and functioning. RESULTS: Attachment was not related to baseline clinical severity. However, improvement in psychoticism was predicted by attachment (in particular by secure, preoccupied and dismissing) beyond the effects of baseline clinical severity and PSA. Secure attachment also predicted improvements in disorganization and functioning. Poor PSA predicted less improvement in disorganization and negative symptoms but did not impact psychoticism. CONCLUSIONS: The three attachment prototypes that predicted improvement in psychoticism (secure, preoccupied and dismissing) share the existence of at least one positive psychological model (either about self or about others). It may be that the psychosocial intervention helped ARMS patients to disconfirm negative models and/or reinforce positive ones. Patients' attachment styles were not related to baseline clinical severity but impacted improvement of positive symptoms. These findings appear consistent with evidence that impaired self-esteem and dysfunctional self and others schemas constitute risk factors for reality distortion.

At-risk mental state (ARMS) detection in a community service center for early attention to psychosis in Barcelona.

AIM: To describe the strategy and some results in at-risk mental state (ARMS) patient detection as well as some of the ARMS clinical and socio-demographical characteristics. The subjects were selected among the patients visited by an Early Care Equipment for patients at high risk of psychoses, in Barcelona (Spain) during its first year in operation. METHODS: Descriptive study of the community-team relations, selection criteria and intervention procedure. Description of patient's socio-demographic and symptomatic characteristics according to the different instruments used in detection and diagnoses, taking account of four principal origins of referrals: mental health services, primary care services, education services and social services. RESULTS: Twenty of 55 referred people fulfilled the at-risk mental state criteria, showing an incidence of 2.4 cases per 10,000 inhabitants. They were mainly adolescent males referred from health, education and social services. Overall, negative symptoms were predominant symptoms and the more frequent specific symptoms were decrease of motivation and poor work and school performance, decreased ability to maintain or initiate social relationships, depressed mood and withdrawal. CONCLUSIONS: It is possible to detect and to provide early treatment to patients with prodromal symptoms if the whole matrix of the community--including the social services--contributes to the process. The utilization of a screening instrument and a two-phase strategy--the second carried out by the specialized team--seems to be an appropriate approach for early psychosis and ARMS detection.

Psicosis y diferencias sociales: comparando la prevalencia de las psicosis en dos medios urbanos diferenciados / Psychosis and social differences: comparing psychosis prevalence between two socially differentiated urban settings

Objetivos: Contribuir a la reflexión sobre la etiología y/o los factores de riesgo para las psicosis comparando la prevalencia en población general y población de riesgo de la esquizofrenia y otras psicosis en dos barrios de Barcelona (España). Método: Nuestras aportaciones en este trabajo se apoyan sobre todo en un estudio descriptivo transversal de todos los pacientes con psicopatología detectados en la USM de Sant Martí-La Mina: un territorio geodemográfica y asistencialmente delimitado formado por 5 Áreas Básicas de Salud (103.615 habitantes. Resultados: Sobre un total de 21.536 pacientes con registro de casos abierto desde el año 1982 hasta el año 2000, se halló que 838 cumplían los criterios restrictivos para ser diagnosticados como «esquizofrénicos» (N=476) o «afectados por otras psicosis» (N=362). Sin embargo, las prevalencias de esquizofrenia y otras psicosis en el barrio sujeto a más factores de riesgo psicosociales eran alrededor de 2 veces mayores que las encontradas en el barrio colindante por el mismo equipo y en el mismo período temporal. Conclusión: Es necesario tener en cuenta el gran peso de los factores de sociales y psicosociales para poderse explicar las diferencias de prevalencia de la esquizofrenia y otras psicosis entre diferentes poblaciones (AU)

Objectives: To contribute to the discussion about aetiology and risk factors of psychosis comparing the prevalence in general population and in «age of risk population» for schizophrenias and other psychoses on two neighbourhoods of Barcelona (Spain). Method: We base our reflections in a transversal study about the results of an informatized case register of all the patients' with detected psychopathology in this geodemographic and assistencially differentiated area: 5 Basic Areas of Health (103.615 inhabitants). Results: The total «psychopathological patients» detected were 21.536. From them, 838 completed the restrictive criteria to be diagnosed as «schizophrenics» (476) or «affected by other psychoses» (362). Among the neighborhood charged with psychosocial risk factors and the other 4 adjacent basic areas of health, assisted for the same team, so much clinical as investigator, the incidence and the prevalence of the schizophrenia and other psychoses is twice as much, almost in each group diagnosis. Conclusion: It seems necessary to keep in mind the great weight of the social and psychosocial factors to explain those differences of incidence and prevalence of the schizophrenia and the psychoses in different populations (AU)

Neighborhood differences in psychoses: prevalence of psychotic disorders in two socially-differentiated metropolitan areas of Barcelona.

INTRODUCTION: The prevalence of schizophrenia and other psychoses can vary between close geographic locations and can be biased by the use of epidemiological designs. With data derived from a public mental health centre with close relations to primary care teams we have compared the distribution of psychotic disorders in two neighborhoods in Barcelona with marked psycho-social differences. METHODS: Using a computerized database from Barcelona's National Health Service covering 5 basic health-care areas with a total population of 103,615 inhabitants, we have accessed case records showing any psycho-pathology between the years of 1982 and 2000. RESULTS: From the case records of 21,536 registered patients showing any psycho-pathology, and using strict diagnostic, clinical and assistance criteria, we found that there were 476 patients diagnosed as "schizophrenic" and 362 that were "affected by other psychoses." Despite being evaluated by the same mental health personal, the same research team using identical criteria and over the same period of time (thus precluding operator and selection bias) the prevalence of these disorders was twice as high in La Mina (a district with a marked accumulation of psycho-social risk-factors) as compared to the neighboring district of La Verneda. CONCLUSIONS: When assessing prevalence of psychoses, it is necessary to consider the impact of social and psycho-social factors, even in neighboring communities.