Psychometric evidence of the Acceptance and Action Questionnaire-II (AAQ-II): an item response theory analysis in university students from Chile.

BACKGROUND: Experiential avoidance (EA) is a psychological mechanism associated with several mental health disorders and is regarded as a relevant target by third-generation cognitive behavioral therapies. It has been mainly assessed through self-report questionnaires, and the AAQ-II is the most used tool. Its psychometric evidence has been mostly tested through the classical test theory (CTT) and very scarcely assessed through Item Response Theory (IRT). METHODS: We used the Graded Response Model to examine its psychometric properties in Spanish-speaking university students (n = 1503; women = 995 (66.2%), mean age = 19.29, SD = 2.45). We tested whether the empirical data fit the model's predictions and estimated the dispersion of persons and items along the experiential avoidance continuum. Moreover, we examined category probability curves to identify the response probability of each answer. Likewise, an item-person map was made where the measurement of persons and items, both on the same scale and along the experiential avoidance continuum, could be observed jointly. Finally, we tested the gender invariance of the scale. RESULTS: We found that the values of the individuals and the items were in the established range to be considered an adequate measure of EA. Additionally, we observed high discrimination indices for all items. The current version with seven answer options could not be optimal and should be tested in future studies. Finally, we found evidence of differential functioning by gender in one of the seven items of the instrument. CONCLUSIONS: Our results indicate that the AAQ-II is a suitable tool for measuring EA and accurately classifying and differentiating EA levels in university students.

Implementation strategies and outcomes of school-based programs for adolescent suicide prevention: A scoping review protocol.

OBJECTIVE: This scoping review aims to identify and map the empirical literature on the implementation strategies and outcomes of school-based programs for adolescent suicide prevention (SBASP). INTRODUCTION: School-based programs are preferred interventions for preventing suicide in adolescents, and their effectiveness has been well-systematized in several reviews. Implementation research is a growing field for prevention programs, making it possible to understand the nature of success or failure outcomes and maximize intervention benefits. However, there is a knowledge gap in the implementation research applied to adolescent suicide prevention in the educational context. We conduct a scoping review to provide the first overview of the scope of implementation research applied to adolescent suicide prevention programs in the school setting to know what implementation strategies and outcomes are reported by these programs and how they are evaluated. METHODS: The proposed scoping review will be conducted following six stages, including the definition of objectives. Studies must be empirical and address implementation strategies or implementation outcomes of school-based programs for adolescent suicide prevention. Studies that focused exclusively on clinical efficacy or effectiveness evaluation will be excluded. A preliminary search of PubMed was conducted to refine the initial search strings, followed by a final search of several other electronic databases. Finally, a gray literature search will identify unpublished literature and reduce location bias. There will be no limits to a specific date. Two independent reviewers will screen, select, and extract the retrieved records. The results will be presented using tabular forms and a narrative summary with attention to the review objectives and research questions and their implications for research and practice of school-based programs for adolescent suicide prevention.

Instrumentos para evaluar bienestar en adolescentes en Chile: una revisión exploratoria / Instruments to evaluate well-being in Chilean adolescent population: a scoping review

En la actualidad, el bienestar es un área de estudio fundamental para la psicología debido a su estrecha relación con la salud física y mental, especialmente en grupos adolescentes, que son considerados prioritarios en el cuidado de la salud. Sin embargo, aún no existe consenso en cuanto a cómo definir y medir el bienestar, lo que ha generado una gran variedad de instrumentos con diferentes bases teóricas. En Chile se han validado instrumentos para evaluar el bienestar, pero no se ha realizado una sistematización que permita identificar y describir los instrumentos en función de sus perspectivas teóricas y propiedades psicométricas, particularmente en población adolescente. Por este motivo se realizó un Scoping Review de los instrumentos utilizados para medir bienestar en este colectivo. Para ello se llevó a cabo una búsqueda sistemática de acuerdo con la declaración PRISMA. Los resultados arrojaron un total de 25 instrumentos validados en esta población que presentaron adecuadas propiedades psicométricas desde diversos constructos teóricos. Se concluye que existen diversos instrumentos validados en Chile para evaluar la multidimensionalidad que implica el concepto de bienestar en población adolescente.

Currently, well-being is a crucial study area for psychology due to its close relationship with physical and mental health, especially among adolescents, who are considered a priority in health care. However, there is still no consensus on how to define and measure wellbeing, which has resulted in the generation of various measurement instruments with different theoretical bases. In Chile, instruments have been validated to assess well-being. However, there has been no systematisation to identify and describe the instruments in terms of their theoretical perspectives and psychometric properties, particularly in the adolescent population. For this reason, a Scoping Review of the instruments used to measure well-being in adolescents was carried out using a systematic search according to the PRISMA statement. The results yielded 25 instruments validated in this population that presented adequate psychometric properties from different theoretical constructs. In conclusion, several validated instruments in Chile assess the multidimensionality implied by the concept of well-being in the adolescent population.

Salud mental en estudiantes de educación superior en Chile: una revisión de alcance con meta-análisis / Mental Health of Higher Education Students in Chile: Scoping Review and Meta-Analysis

Resumen Realizamos una revisión de alcance sobre la prevalencia de síntomas psicológicos, factores asociados a la salud mental, barreras y facilitadores para la búsqueda de ayuda, y la efectividad de intervenciones de salud mental en estudiantes de educación superior en Chile. Buscamos reportes indexados hasta el 15 de octubre de 2019 en las bases de datos CINAHL, Google Scholar, PubMed, Virtual Health Library/BIREME y Web of Science. Evaluamos la calidad de los estudios de prevalencia y exploramos la prevalencia combinada de síntomas psicológicos mediante meta-análisis. Incluimos 32 estudios publicados, 20 sobre prevalencia de síntomas - 10 con la calidad suficiente para ser incluidos en el meta-análisis. Observamos una heterogeneidad sustantiva en la exploración de prevalencia combinada de síntomas, con rangos entre 22,9% a 40,7% para malestar psicológico, 16,5% a 38,8% para síntomas depresivos, 16,5% a 23,7% para síntomas ansiosos, 19,7% a 29,7% para consumo de cannabis en los últimos 12 meses, y 84,0% a 92,6% para consumo de alcohol en los últimos 12 meses. El sexo femenino se asoció consistentemente con problemas de salud mental. Es necesario realizar más estudios que evalúen el acceso a tratamiento, facilitadores y barreras para la búsqueda de ayuda, e intervenciones para mejorar la salud mental de la población objetivo.

Abstract We conducted a scoping review on the prevalence of psychological symptoms, factors associated with mental health, barriers and facilitators to help-seeking, and effectiveness of mental health interventions in higher education students in Chile. We searched for indexed reports up to October 15, 2019, in CINAHL, Google Scholar, PubMed, Virtual Health Library/BIREME, and Web of Science databases. We assessed the quality of prevalence studies and explored the pooled prevalence of psychological symptoms using meta-analyses. We included 32 published studies, 20 on the prevalence of psychological symptoms - 10 of sufficient quality to be included in meta-analyses. We observed substantial heterogeneity in the exploration of combined prevalence of psychological symptoms, with ranges from 22.9% to 40.7% for psychological distress, 16.5% to 38.8% for depressive symptoms, 16.5% to 23.7% for anxious symptoms, 19.7% to 29.7% for cannabis use in the past 12 months, and 84.0% to 92.6% for alcohol use in the past 12 months. Female sex was consistently associated with mental health problems. More studies evaluating access to treatment, help-seeking barriers and facilitators, and interventions to improve the mental health of the target population are needed.

Impacto de la pandemia por COVID-19 en la salud mental de estudiantes universitarios en Chile / Impact of the COVID-19 pandemic on the mental health of university students in Chile

La pandemia por COVID-19 ha tenido un impacto negativo en el bienestar psicológico de la población. El objetivo de este estudio fue evaluar el impacto de la pandemia por COVID-19 en la salud mental de estudiantes universitarios(as) en Chile, explorando el rol de los acontecimientos adversos en el núcleo familiar y las experiencias negativas relacionadas. Contestaron una encuesta en línea 2.411 estudiantes de primer año de una universidad en Chile. Tres de cada cuatro estudiantes reportaron que su estado de ánimo era peor o mucho peor en comparación con el contexto pre-pandémico. Las estudiantes mujeres presentaron significativamente mayores niveles de sintomatología depresiva y ansiosa y reportaron de forma significativa una mayor percepción de empeoramiento del estado de ánimo. Los hallazgos de este estudio refuerzan la necesidad de implementar intervenciones y estrategias orientadas a favorecer una mejor salud mental de los(as) estudiantes universitarios(as) en Chile.

Abstract. The COVID-19 pandemic has had a negative impact on the psychological well-being of the population. The objective of this study was to evaluate the impact of the COVID-19 pandemic on the mental health of university students in Chile, exploring the role of adverse events in the family and related negative experiences. An online survey was answered by 2,411 first-year students from a university in Chile. Three out of four students reported that their mood was worse or much worse compared to the pre-pandemic context. Female students presented significantly higher levels of depressive and anxious symptoms and reported significantly greater perception of worsening mood. The findings of this study reinforce the need to implement interventions and strategies aimed at promoting better mental health for university students in Chile.

Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review.

BACKGROUND/OBJECTIVES: While it is acknowledged that minority ethnic (ME) groups across international settings face barriers to accessing care for dementia, it is not clear whether ME groups access services less frequently as a result. The objective of this review is to examine whether ME groups have longer delays before accessing dementia/memory services, higher use of acute care and crisis services and lower use of routine care services based on existing literature. We also examined whether ME groups had higher dementia severity or lower cognition when presenting to memory services. DESIGN: Systematic review with narrative synthesis. SETTING: Nonresidential medical, psychiatric, memory, and emergency services. PARTICIPANTS: Twenty studies totaling 94,431 older adults with dementia or mild cognitive impairment. MEASUREMENTS: We searched Embase, Ovid MEDLINE, Global Health, and PsycINFO from inception to November 2018 for peer-reviewed observational studies which quantified ethnic minority differences in nonresidential health service use in people with dementia. Narrative synthesis was used to analyze findings. RESULTS: Twenty studies were included, mostly from the U.S. (n = 13), as well as the UK (n = 4), Australia (n = 1), Belgium (n = 1), and the Netherlands (n = 1). There was little evidence that ME groups in any country accessed routine care at different rates than comparison groups, although studies may have been underpowered. There was strong evidence that African American/Black groups had higher use of hospital inpatient services versus U.S. comparison groups. Primary care and emergency services were less well studied. Study quality was mixed, and there was a large amount of variability in the way ethnicity and service use outcomes were ascertained and defined. CONCLUSION: There is evidence that some ME groups, such as Black/African American groups in the U.S., may use more acute care services than comparison populations, but less evidence for differences in routine care use. Research is sparse, especially outside the U.S.

Calidad de vida relacionada con la salud en estudiantes universitarios de primer año / Health-related quality of life of first-year university Students

OBJETIVO: Calidad de Vida Relacionada con la Salud (CVRS) en estudiantes universitarios de primer año. MATERIAL Y MÉTODO: Estudio observacional, transversal y analítico en estudiantes de 17 a 18 años de primer año de 14 Facultades, 2 Institutos y 1 Programa de Bachillerato. Se aplicó el test Kidscreen-52, enviado por correo electrónico a 3.738 estudiantes. Contestaron 1.277 (34,16%). Análisis con programa WINSTEPS y expresión con puntajes Rasch. RESULTADOS: Las dimensiones Bienestar Físico, Estado de Ánimo y Emociones y Autonomía con menos de 42 puntos Rasch, y otras dos, Bienestar Psicológico, Amigos y Apoyo Social tuvieron puntajes significativamente menores a lo encontrado en adolescentes chilenos de edad comparable, en mujeres, escolares de establecimientos municipales de bajo nivel socioeconómico, con Índice de Vulnerabilidad Escolar (IVE) o con discapacidad o problema de salud o enfermedad crónica. Las diferencias son mayores en Facultades con más demanda académica. Este primer estudio revela información no conocida, trascendente para estudiantes, académicos y sus autoridades. Se sospecha que posiblemente ocurre en otras universidades. CONCLUSIONES: Los estudios de Calidad de Vida estudiantil son factibles de aplicar en instituciones de educación superior en beneficio de educandos y educadores. Este estudio es un insumo para diagnóstico y evaluación de las políticas salud y apoyo estudiantil y aporta a la orientación de la docencia. En el futuro podrían aplicarse instrumentos de medición de la Calidad de Vida en estudiantes de otras edades y en otros estamentos universitarios con test validados en Chile, combinado con estudios de Factores de Riesgo.

OBJETIVE: To evaluate the health-related quality of life (HRQoL) of first-year university students at the University of Chile in 2015 MATERIAL AND METHOD: Observational, transversal, and analytical study of first year students, 17 to 18 years of age, attending 14 Faculties, 2 Institutes, and 1 Bachelor Program of the University of Chile. Delivery of Kidscreen-52 test by email to 3,738 students, of which 1,277 replied (34.16%). The Winsteps program model and Rasch punctuation were used. RESULTS: The dimensions Physical Well-being, State of Mood and Emotions, and Autonomy scored less than 42 Rasch points, and the other two dimensions ­ Psychological Well-being and Friends and Social Support - had significantly lower scores than those found in Chilean adolescents of a comparable age, in women, in students of lower socio-economical levels in municipal public schools with a Scholar Vulnerability Index, or those with a disability, health problem, or chronic illness. The differences are greater in Faculties with heavier academic demands. Discussion: This first study gives new information in an area seldom studied, which is important for students, academics, and authorities. It is suspected that similar results would be found in other university settings. CONCLUSIONS: HRQoL studies are feasible to apply in institutions of higher education, to benefit both students and educators. This study contributes to the diagnosis and evaluation of public policies on student support, and for teaching strategies. In the near future, HRQoL instruments could be applied with other students and other members of the university community, in combination with studies on risk factors