Academic stress in college students: descriptive analyses and scoring of the SISCO-II inventory.

In a competitive and demanding world, academic stress is of increasing concern to students. This systemic, adaptive, and psychological process is composed of stressful stimuli, imbalance symptoms, and coping strategies. The SISCO-II Academic Stress Inventory (SISCO-II-AS) is a psychometric instrument validated in Chile. It evaluates stressors, symptoms, and coping, both individually and globally. For its practical interpretation, a scale is required. Therefore, this study aims to descriptively analyze the SISCO-II-AS and to obtain its corresponding scales. Employing a non-experimental quantitative approach, we administered the SISCO-II-AS to 1,049 second and third-year students from three Chilean universities, with a disproportionate gender representation of 75.21% female to 24.79% male participants. Through descriptive and bivariate analysis, we established norms based on percentiles. For the complete instrument and its subscales, significant differences by sex were identified, with magnitudes varying from small to moderate. For the full instrument and its subscales, bar scale norms by percentile and sex are presented. Each subscale (stressors, physical and psychological reactions, social behavioural reactions, total reaction, and coping) has score ranges defined for low, medium, and high levels. These ranges vary according to the sex of the respondent, with notable differences in stressors and physical, psychological, and social behavioural reactions. This study stands out for its broad and heterogeneous sample, which enriches the representativeness of the data. It offers a comprehensive view of academic stress in college students, identifying distinctive factors and highlighting the importance of gender-sensitive approaches. Its findings contribute to understanding and guide future interventions. By offering a descriptive analysis of the SISCO-II-AS inventory and establishing bar norms, this research aids health professionals and educators in better assessing and addressing academic stress in the student population.

Adaptation and validation of the Weight Efficacy Lifestyle Questionnaire (WEL) in a Chilean sample.

Self-efficacy is a cognitive-emotional factor that is consistently associated with behavioral change and, in particular, with changes in health behavior. Eating self-efficacy, understood as adopting and maintaining behaviors such as controlling one's weight and trusting in one's ability to control one's eating behavior, has been proposed for managing obesity. This study aimed to validate the Chilean version of the Weight Efficacy Lifestyle Questionnaire (WEL) in a sample of adults from the general population. Four hundred sixty-nine individuals (69.08% women, mean age = 38.02; SD = 10.31) participated in the study. An instrumental design was used geared toward developing tests and psychometric instruments, including adapting existing ones. Exploratory and confirmatory factor analyses were performed. The instrument version validated in Spain was applied in the study. The analysis obtained an instrument of 11 items with adequate psychometric properties allowing its use in clinical and research settings. It can help assess eating self-efficacy in the general population.

Increased academic stress is associated with decreased plasma BDNF in Chilean college students.

Introduction: Academic stress (AS) is a prevalent challenge faced by university students, potentially affecting molecular indicators such as brain-derived neurotrophic factor (BDNF) and global DNA methylation (G-DNA-M). These indicators could illuminate the physiological ramifications of academic stress. Study Design and Methods: This research followed a quantitative, non-experimental, longitudinal panel design spanning two academic semesters, observing phenomena in their natural context. Students from the Medical Technology program at Universidad de Concepción, Chile were involved, with assessments at the beginning and during heightened academic stress periods. Sample: Of the total participants, 63.0% were females, with an average age of 21.14 years at baseline, and 36.92% were males, averaging 21.36 years. By the study's conclusion, female participants averaged 21.95 years, and males 22.13 years. Results: Significant differences were observed between initial and final assessments for the SISCO-II Inventory of Academic Stress and Beck Depression Inventory-II, notably in stressor scores, and physical, and psychological reactions. Gender differences emerged in the final physical and psychological reactions. No significant changes were detected between the two assessments in plasma BDNF or G-DNA-M values. A refined predictive model showcased that, on average, there was a 3.56% decrease in females' plasma BDNF at the final assessment and a 17.14% decrease in males. In the sample, the G-DNA-M percentage at the final assessment increased by 15.06% from the baseline for females and 18.96% for males. Conclusions: The study underscores the physiological impact of academic stress on university students, evidenced by changes in markers like BDNF and G-DNA-M. These findings offer an in-depth understanding of the intricate mechanisms regulating academic stress responses and highlight the need for interventions tailored to mitigate its physiological and psychological effects.

Effectiveness of an intervention to reduce stigma towards people with a mental disorder diagnosis in university students of healthcare careers.

Students in healthcare careers present stigma towards people with psychiatric diagnoses, so the development of interventions to reduce it is essential. This study aimed to evaluate the effectiveness of an intervention to reduce stigma towards people diagnosed with mental disorders in healthcare students in Chile. A randomized clinical trial with a before and after measurement was carried out. The intervention was part of a compulsory course and combined educational and contact strategies. A total of 244 fourth-semester students of medicine, nursing, dentistry, obstetrics, psychology, and social work participated. The intervention was effective in reducing stigmatizing attitudes and the desire for social distance. For almost all variables, the magnitude of the stigma reduction depended on the initial level of stigma, not on the profession. The intervention had positive effects on all careers. In conclusion, incorporating a stigma reduction intervention into mandatory professional training, with the active participation of the teacher in charge and experts by experience, can be a valuable tool to promote humanized and non-stigmatizing treatment.

Sintomatología Depresiva y Bienestar en Personas Mayores de Concepción, Chile: Rol moderador del apoyo social

Antecedentes: La población sobre 60 años va en aumento y es relevante tener más conocimiento sobre los factores que inciden en su bienestar y salud mental. Objetivo: Este estudio busca comprender la relación entre bienestar, apoyo social y sintomatología depresiva en personas mayores de la provincia de Concepción. Método: 538 adultos mayores fueron seleccionados aleatoriamente de 15 Centros de Salud Primaria de la provincia de Concepción, Chile. Se midieron sus niveles de bienestar (con el Pemberton Happiness Index), de apoyo Social (con la Escala Multidimensional de Percepción de Apoyo Social de Zimet) y de sintomatología depresiva (mediante el Patient Health Questionnaire-9). Resultados: Los adultos mayores mostraron un puntaje elevado (M=8,54; DE = 1,34) en bienestar, sin diferencias por sexo (t(536) = −1,065, p = 0,288 > 0,05). En los análisis de regresión lineal, el apoyo social (β =0,463, p<0,001) y la sintomatología depresiva (β =-1,585, p<0,001) aparecen como influyentes en el bienestar de las personas mayores; y el apoyo social actúa como un factor moderador (β=0,049, p=0,007, IC =0,021; 0,077) en la relación entre sintomatología depresiva y bienestar. Conclusiones: Las personas mayores muestran elevado bienestar. Los resultados refuerzan la relevancia del apoyo social como un factor protector en las personas mayores. Ello corrobora la importancia del fomento de este aspecto en los programas promocionales y preventivos destinados al bienestar y salud mental de adultos mayores.

Background: The population over 60 years of age is increasing. Aim: This research aims to understand the relationship between well-being, social support, and depressive symptoms in older Chilean people. Method: 538 older adults were randomly selected from 15 Primary Health Centers in the province of Concepción, Chile, 341 women and 197 men. Well-being was measured with the Pemberton Happiness Index, Social Support with the Zimet Multidimensional Scale of Perceived Social Support, and Depressive Symptomatology using the Patient Health Questionnaire-9. Results: Older adults showed a high mean score (M=8.54; SD=1.34) in well-being, with no differences by sex (t(536) = −1.065, p = .288 > .05.) In linear regression analyses, social support (β =0,463, p<0,001) and depressive symptomatology (β =-1,585, p<0,001) influence the well-being of the elderly, and social support acts as a moderating factor (β=0.049, p=0.007, CI =0.021; 0.077) in the relationship between social support and well-being. Conclusions: Older people show high well-being. The results reinforce the relevance of social support as a protective factor for the positive mental health of older adults. This corroborates the importance of including this aspect in promotional and preventive mental health programs for older adults.

Life satisfaction, positive affect, depression and anxiety symptoms, and their relationship with sociodemographic, psychosocial, and clinical variables in a general elderly population sample from Chile.

Background: This study aims to describe the relationship between life satisfaction, positive affect, depression and anxiety symptoms with sociodemographic, psychosocial and clinical variables, and to identify the relative importance of these predictor groups. Methods: We evaluated life satisfaction (SWLS), positive affect (PANAS), depressive (PHQ-9), and anxiety (GAI) symptoms and their association with sociodemographic, psychosocial and clinical variables in a multistage, random general population sample of fully functioning individuals aged 60-80 years from the Concepción province and Gran Santiago, Chile (n = 396). We performed weighted multiple regression analysis, considering the complex sample structure with age group, sex, and geographical area, complemented with general and conditional dominance analyses to estimate the relevance of the predictor groups. Results: We found significant associations with the geographical area, sex, age, education level, household members, having a partner, employment status, caregiver status, economic satisfaction, presence of chronic diseases, medication use, and alcohol use. Satisfaction with health was the most important predictor for positive affect (p < 0.001), depressive (p < 0.001), and anxiety (p < 0.001) symptoms, while alcohol use was the most significant predictor for life satisfaction (p < 0.001). Conclusion: Simultaneously studying the positive and negative dimensions of wellbeing and mental health in older adults allows for a more comprehensive perspective on the challenges faced during this stage of life. This study accounts for previously unknown associations and contributes to the identification of common and specific predictors in both dimensions.

Peripheral brain-derived neurotrophic factor (BDNF) and salivary cortisol levels in college students with different levels of academic stress. Study protocol.

INTRODUCTION: Brain-derived neurotrophic factor (BDNF) is essential for brain physiological processes influencing memory and learning. BDNF levels can be affected by many factors, including stress. Stress increase serum and salivary cortisol levels. Academic stress is of the chronic type. BDNF levels can be measure from serum, plasma or platelets, and there is still no standard methodology, which is relevant to ensure reproducibility and comparability between studies. HYPOTHESIS: (i) BDNF concentrations in serum show greater variability than in plasma. (ii) In college students with academic stress, peripheral BDNF decreases and salivary cortisol increases. GENERAL OBJECTIVE: To standardize plasma and serum collection for BDNF levels and to determine whether academic stress affects peripheral BDNF and salivary cortisol levels. DESIGN: Quantitative research, with a non-experimental cross-sectional descriptive design. PARTICIPANTS: Student volunteers. Under convenience sampling, 20 individuals will be included for standardization of plasma and serum collection and between 70 and 80 individuals to determine the effect of academic stress on BDNF and salivary cortisol. PERIPHERAL BLOOD AND SALIVARY CORTISOL SAMPLING, MEASUREMENTS: 12 mL of peripheral blood (with and without anticoagulant) will be drawn per participant, separated from plasma or serum and cryopreserved at -80°C. Additionally, they will be instructed in the collection of 1 mL of saliva samples, which will be centrifuged. Val66Met polymorphism will be performed by allele-specific PCR, while BDNF and salivary cortisol levels will be determined by ELISA. STATISTICAL ANALYSIS: (i) descriptive analysis of the variables, through measures of central tendency and dispersion, and the categorical variables through their frequency and percentage. (ii) Then a bivariate analysis will be performed comparing groups using each variable separately. EXPECTED RESULTS: We expect to (i) determine the analytical factors that allow a better reproducibility in the measurement of peripheral BDNF, and (ii) the effect of academic stress on BDNF and salivary cortisol levels.

Adaptación y validación del Test de Alfabetización en Salud Mental Canadiense (tmhhscg) en estudiantes chilenos / Adaptation and Validation of the Canadian Mental Health Literacy Test (tmhhscg) in Chilean Students / Adaptação e validação do Teste de Alfabetização em Saúde Mental Canadense (tmhhscg) em estudantes chilenos

la alfabetización en salud mental (ASM) se define como el conocimiento y las creencias sobre los trastornos mentales que ayudan a su reconocimiento, manejo y prevención. Se buscó traducir, adaptar y validar el instrumento canadiense Test Mental Health & High School Curriculum Guide (TMHHSCG) en estudiantes de secundaria y universitarios chilenos. Materiales y métodos: estudio de diseño instrumental en adolescentes (n = 454) y jóvenes (n = 434). Se llevó a cabo un proceso de adaptación compuesto por traducción y retrotraducción, y entrevistas cognitivas y de validación a través de análisis factorial para la validez de criterio y de constructo, análisis de validez convergente y divergente y análisis de invarianza factorial. Resultados: las dimensiones del TMHHSCGCL que conforman la ASM (conocimiento sobre trastornos mentales y salud mental, estigma hacia las personas con trastorno mental y búsqueda de ayuda) cumplieron con el requisito de un factor superior o igual 0.3. Hubo niveles de correlación moderada, positiva y significativa entre las dimensiones del test y entre este y las tres escalas utilizadas para probar la validez de criterio, tuvo buena consistencia interna y validez de constructo, convergente y discriminante. El análisis de invarianza de medición comparó modelos de manera progresiva y mostró una buena invarianza factorial. Conclusión: el TMHHSCGCL muestra adecuadas propiedades psicométricas que incorpora todos los componentes de la ASM. Ello permitirá medir el nivel de ASM para desarrollar intervenciones de prevención y promoción en salud mental en estudiantes de educación secundaria y universitaria.

Mental Health Literacy (mhl) is defined as knowledge and beliefs about mental disorders that aid in their recognition, management and prevention. We sought to translate, adapt and validate the Canadian instrument Test Mental Health & High School Curriculum Guide (tmhhscg) in Chilean high school and university students. Materials and methods: Instrumental design study in adolescents (n = 454) and young adults (n = 434). An adaptation process consisting of translation and back-translation, and cognitive and validation interviews was carried out by means of factor analysis for criterion and construct validity, convergent and divergent validity analysis, and factorial invariance analysis. Results: The dimensions of the tmhhscg-cl that compose the mhl (knowledge about mental disorders and mental health, stigma towards people with mental disorders, and help-seeking) met the requirement of a factor greater than or equal to 0.3. There were moderate, positive and significant levels of correlation between the test dimensions and between the test and the three scales used to test criterion validity, had good internal consistency and construct, convergent and discriminant validity. The measurement invariance analysis compared the models progressively and showed good factorial invariance. Conclusion: The tmhhscg-cl shows adequate psychometric properties incorporating all the components of mhl. This will allow measuring the level of mhl, in order to develop prevention and promotion interventions in mental health in high school and university students.

a alfabetização em saúde mental (asm) é definida como o conhecimento e as crenças sobre perturbações mentais que ajudam no seu reconhecimento, gestão e prevenção. Procurámos traduzir, adaptar e validar o instrumento canadiano Test Mental Health & High School Curriculum Guide (tmhhscg) em estudantes chilenos do ensino secundário e universitários. Materiais e métodos: estudo de concepção instrumental em adolescentes (n = 454) e jovens adultos (n = 434). Foi realizado um processo de adapta-ção que consiste na tradução e retrotradução, entrevistas cognitivas e validação através da análise de fatores para critérios e construção de validade, análise de validade convergente e divergente, e análise de invariância fatorial. Resultados: as dimensões tmhhscg-cl que compreendem o asm (conhecimento sobre perturbações mentais e saúde mental, estigma para pessoas com perturbações mentais, e procura de ajuda) cumpriram a exigência de um fator maior ou igual a 0,3. Havia níveis moderados, positivos e significativos de correlação entre as dimensões do teste e entre o teste e as três escalas utilizadas para testar a validade dos critérios, boa consistência interna e validade construtiva, convergente e discrimi-nante. A análise da invariância das medições comparou progressivamente os modelos e mostrou uma boa invariância fatorial. Conclusão: o tmhhscg-cl mostra propriedades psicométricas adequadas incorpo-rando todos os componentes da asm. Isto permitir-nos-á medir o nível de asm a fim de desenvolver inter-venções de prevenção e promoção da saúde mental em estudantes do ensino secundário e universitário.

Relationships between Individual and Social Resources, Anxiety and Depression in the Early Lockdown Stage by the COVID-19 in Chile.

The coronavirus disease has exposed the population to psychosocial threats that could increase mental health problems. This research analyzed the relationships between emotional states (negative [−EWB] and positive [+EWB] experienced well-being), personal resources (resilient coping [RC]), dispositional resources (control beliefs about stress [BAS]), and social resources (social support [SS]), and anxiety and depressive symptoms in a sample of the Chilean population (n = 592), who answered an online questionnaire. Multiple and moderated multiple regression analyses were carried out. Depressive symptoms showed a positive relationship with −EWB (ß = 0.805; p < 0.001) and negative relationship with +EWB (ß = −0.312; p < 0.001), RC (ß = −0.089; p < 0.01), BAS (ß = −0.183; p < 0.001) and SS (ß = −0.082; p < 0.001). Anxiety symptoms showed a positive relationship with −EWB (ß = 0.568; p < 0.001), and a negative relationship with +EWB (ß = −0.101; p < 0.03) and BAS (ß = −0.092; p < 0.001). BAS moderated the relationship between experienced well-being and depression symptoms, and RC moderated the relationship between experienced well-being with both depression and anxiety symptoms. Findings confirm the buffering effect of personal and dispositional resources when facing a sanitary and social crisis. Moreover, they help to understand the role of internal psychological processes during a crisis and how to cope with life-threatening events.

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.

Autorregulación y autocompasión en conductas promotoras de salud y de riesgo en estudiantes universitarios

RESUMEN La Autorregulación (AR) y la Autocompasión (AC) emergen como recursos psicológicos efectivos para la promoción de salud. Objetivo: Describir conductas promotoras de salud y conductas de riesgo de universitarios en Chile y establecer su asociación con la AR y AC. Material y Método: Estudio de carácter correlacional descriptivo, de corte transversal. Una muestra de estudiantes universitarios chilenos de pregrado (n=544) respondió un cuestionario sobre conductas de salud y de riesgo, y las escalas Short Self-Regulation Questionnaire y Self-Compassion Scale. Resultados: Se observó baja frecuencia de conductas promotoras de salud y presencia de conductas de riesgo como consumo de tabaco (22,6%), de drogas (41,3%) y consumo problemático de alcohol (20,3%). El control de impulsos de la AR se asoció a mayor probabilidad de conducta alimentaria saludable (OR=1,56; IC 95%: 1,12-2,19; p< 0,01) y mejor calidad de sueño (OR=1,7; IC: 1,24-2,38; p<0,01). El mindfulness, componente de la AC, se asoció a menor actividad física regular (OR=0,69; IC:0,49-0,95; p<0,05) y menor consumo de medicamentos sin prescripción (OR=0,54; IC:0,32-0,91; p<0,05), y el autojuicio a mayor consumo de medicamentos sin prescripción (OR=1,83; IC: 1,03-3,28; p< 0,05). Conclusión: El control de impulsos se asocia a la regulación de la alimentación y sueño, ambos dominios alterados en la etapa universitaria; la AC se relaciona con menor probabilidad de consumo de medicamentos sin prescripción. Tanto la AR como la SC emergen como recursos potencialmente útiles hacia la promoción de hábitos saludables y prevención de conductas de riesgo para la salud.

ABSTRACT Self-regulation (SR) and Self-compassion (SC) emerge as effective psychological resources for promoting health. Objective: To describe health-promoting and risk-taking behaviors of university students in Chile and establish their relationship with SR and SC. Materials and Methods: Cross-sectional descriptive correlational study. A sample of Chilean undergraduate students (n=544) responded to a health questionnaire and the Short Self-Regulation Questionnaire and Self-Compassion Scale. Results: Low frequency of health-promoting behaviors and presence of risk-taking behaviors such as tobacco use (22.6%), drug use (41.3%) and problematic alcohol use (20.3%) were observed. SR impulse control was associated with a higher probability of healthy eating behavior (OR=1.56; CI 95%: 1.12-2.19; p <0.01) and better sleep quality (OR=1,7; CI: 1.24-2.38; p <0.01). Mindfulness, a component of SC, was associated with less regular physical activity (OR=0.69; CI: 0.49-0.95; p <0.05) and lower consumption of non-prescription drugs (OR=0.54; CI: 0.32-0.91; p <0.05), and self-judgment was related to a higher consumption of non-prescription drugs (OR=1.83; CI: 1.03-3.28; p <0.05). Conclusion: Impulse control influences both eating and sleep regulation, which are domains that tend to be altered among university students. SC is related to a lower probability of consuming non-prescription drugs. Both SR and SC emerge as potentially useful resources for promoting healthy habits and preventing risk behaviors.

RESUMO A Autorregulação (AR) e a Autocompaixão (AC) surgem como recursos psicológicos eficazes para a promoção da saúde. Objetivo: Descrever os comportamentos promotores da saúde e os comportamentos de risco de estudantes universitários no Chile e estabelecer sua relação com o AR e AC. Materiais e Método: Estudo correlacional descritivo transversal. Uma amostra de estudantes universitários chilenos (n = 544) respondeu a um questionário sobre saúde e aos Self-Regulation Questionnaire e Self-Compassion Scale. Resultados: Observou-se baixa frequência de comportamentos promotores de saúde e presença de comportamentos de risco como o consumo de tabaco (22,6%), uso de drogas (41,3%) e uso problemático de álcool (20,3%). O controle do impulso da AR foi associado a uma maior probabilidade de comportamento alimentar saudável (OR = 1,56; IC 95%: 1,12-2,19; p <0,01) e melhor qualidade do sono (OR = 1,7; IC: 1,24-2,38; p < 0,01). O componente mindfulness da AC foi associado a menor atividade física regular (OR = 0,69; IC: 0,49-0,95; p <0,05) e menor consumo de medicamentos não prescritos (OR = 0,54; IC: 0,32-0,91; p <0,05), e o autojulgamento foi relacionado a um maior consumo de medicamentos não controlados (OR=1,83; IC: 1,03-3,28; p <0,05). Conclusão: O controle dos impulsos influencia a regulação da alimentação e do sono, que são domínios que tendem a ser alterados na fase universitária. A AC está relacionada a uma menor probabilidade de consumir medicamentos sem receita médica. Tanto a AR como a AC surgem como recursos potencialmente úteis para a promoção de hábitos saudáveis e prevenção de comportamentos de risco para a saúde.

Effectiveness of an intervention to reduce stigma towards people with a severe mental disorder diagnosis in primary health care personnel: Programme Igual-Mente.

This study assessed the effectiveness of a program (called Igual-Mente, Equal-Mind) designed to reduce stigma in primary health care personnel. A random clinical trial was performed (ISRCTN46464036). There were 316 primary care professionals and technicians who were randomized and assigned to the experimental or control group. The program considered as strategies the education, the contact and the development of skills. There were six sessions with the primary care staff and two sessions with the managers of the health centers. It was executed by two facilitators, a professional psychologist and an expert by experience, i.e., a person diagnosed with a severe mental disorder (SMD). Attitudes, social distance, and humane treatment behaviors toward people with SMD were assessed. The intervention was effective in reducing stigma attitudes y social distance towards people diagnosed with SMD. The magnitude of the changes ranged from moderate to high in all these variables and the effects were maintained for four months after the end of the program. Regarding humane treatment behaviors, the effects were less clear. This study shows good results indicating that well-designed interventions can effectively reduce stigma towards people diagnosed with SMD, which is one of the main challenges of health systems.

Subjective Well-Being and Parenthood in Chile.

Being a parent plays an important role in people's life trajectory and identity. Though the general cultural perception is that having children is a source of subjective well-being, there is evidence that, at least in some societies, the subjective well-being of those who are parents is worse, in some aspects, than that of those who are not. This gap has been the object of interest and controversy. The aim of this study was to compare Chilean adults with and without children in a broad set of well-being indicators, controlling for other sociodemographic variables. A public national probabilistic database was used. The results show that, in terms of positive and negative affect, those who are not parents achieve greater well-being than those who have children. Other results also pointed in that direction. The implications of the social context and gender, which are aspects that pose a burden for the exercise of parenthood in Chile, are discussed.

A multicentric study on stigma towards people with mental illness in health sciences students.

BACKGROUND: There is evidence of negative attitudes among health professionals towards people with mental illness but there is also a knowledge gap on what training must be given to these health professionals during their education. The purpose of this study is to compare the attitudes of students of health sciences: nursing, medical, occupational therapy, and psychology. METHODS: A comparative and cross-sectional study in which 927 final-year students from health sciences university programmes were evaluated using the Mental Illness: Clinicians' Attitudes (both MICA-2 and MICA-4) scale. The sample was taken in six universities from Chile and Spain. RESULTS: We found consistent results indicating that stigma varies across university programmes. Medical and nursing students showed more negative attitudes than psychology and occupational therapy students in several stigma-related themes: recovery, dangerousness, uncomfortability, disclosure, and discriminatory behaviour. CONCLUSIONS: Our study presents a relevant description of the attitudes of each university programme for education against stigma in the formative years. Results show that the biomedical understanding of mental disorders can have negative effects on attitudes, and that education based on the psychosocial model allows a more holistic view of the person over the diagnosis.

Evaluación de la discapacidad en población con trastornos mentales graves atendida en el Distrito Metropolitano de Quito (Ecuador) / Disability Assessment of Severe Mental Disorders in Metropolitan District of Quito-Ecuador Population / Avaliação da deficiência em população com transtornos mentais graves atendidas no distrito metropolitano de Quito-Equador

Resumen Introducción: en Ecuador existen parámetros de calificación de discapacidad basados en la Clasificación Internacional del Funcionamiento de la Discapacidad y la Salud; sin embargo, los avances en investigación en el ámbito de la psiquiatría y la salud mental aún son escasos. Se empleó la Escala de Evaluación de Discapacidad de la Organización Mundial de la Salud para determinar el grado de discapacidad en población consultante. Materiales y métodos : estudio observacional, de corte transversal y correlacional. Usando un muestreo por conveniencia, se recogió información sobre discapacidad en una muestra de 297 adultos con trastornos mentales graves en contacto con servicios ambulatorios de psiquiatría. Se estimó un modelo de regresión lineal que determinó el aporte de variables sociodemográficas, clínicas y sociales. Resultados: el 89.2 % de la muestra presentó algún grado de discapacidad. El modelo multivariado final para el total de la muestra incluyó las variables explicativas edad (p = -0.234), escolaridad (p = -0.552), ser pensionado (p = 39.44), presencia de episodio depresivo actual (p = 21.654) y tener cuidador (p = 9.574), que explican el 37.46 % de la discapacidad de las personas con trastornos mentales graves atendidas en servicios de psiquiatría y salud mental en Quito. Conclusión: la discapacidad en personas con trastornos mentales graves que están en contacto con servicios de salud de Quito (Ecuador) involucra cambios en el desempeño de actividades en escenarios familiares y comunitarios. Se identificó una proporción de discapacidad moderada y severa que demanda respuestas institucionales que incluyan el acompañamiento de cuidadores y aborden barreras actitudinales.

Abstract Introduction: In Ecuador, there are disability qualification parameters based on the International Classification of the Functioning of Disability and Health; however, advances in the research fields of psychiatry and mental health are still scarce. For this particular study, The World Health Organization Disability Assessment Scale was used to determine the degree of disability in the consulting population. Materials and methods: The study design was an observational, cross-sectional and correlational study. Using convenience sampling, disability information was collected from a study population of 297 adults with severe mental disorders who were in contact with outpatient psychiatric services. A linear regression model was used to determine the contribution of sociodemographic, clinical, and social variables. Results: It was observed that 89.2% of the sample presented some degree of disability. The final multivariate model for the total sample included the explanatory variables of age (p = -0.234), schooling (P = -0.552), being retired (p = 39.44), presence of current depressive episode (p = 21.654), and having a caregiver (p = 9.574), which explained 37.46% of disability in people with serious mental disorders who were treated in psychiatric and mental health services in Quito. Conclusion: Disabilities in people with severe mental disorders who are in contact with health services in Quito (Ecuador) may involve changes in the performance of activities among family and community settings. We identified a proportion of moderate and severe disabilities that demand institutional responses, which includes the accompaniment of caregivers and also addresses attitudinal barriers.

Resumo Introdução: no Equador, existem parâmetros de qualificação de deficiência com base na Classificação Internacional do Funcionamento da Deficiência e da Saúde; no entanto, avanços em pesquisas no âmbito da psiquiatria e saúde mental ainda são escassos. Empregou-se a Escala de Avaliação da Deficiência da Organização Mundial da Saúde, para se determinar o grau de deficiência na população avaliada. Materiais e métodos: estudo observacional, de corte transversal e correlacional. Usando uma amostragem por conveniência coletou-se informação sobre deficiência em uma amostra de 297 adultos com transtornos mentais graves em contato com serviços ambulatórios em psiquiatria. Estimou-se um modelo de regressão linear que determinou a contribuição de variáveis sociodemográficas, clínicas e sociais. Resultados: 89.2% da amostra apresentou algum grau de deficiência. O modelo multivariado final para o total da amostra incluiu as variáveis explicativas idade (p=-0,234), escolaridade (p=-0,552), ser aposentado (p=39,44), presença de episódio depressivo atual (p=21,654) e, ter cuidador (p=9,574), explicando 37,46% da deficiência em pessoas com transtornos mentais graves atendidas em serviços de psiquiatria e saúde mental em Quito. Conclusão: A deficiência em pessoas com transtornos mentais graves que estão em contato com serviços de saúde em Quito (Equador) envolve mudanças no desempenho de atividades em cenários familiares e comunitários. Identificou-se uma proporção de deficiência moderada e severa que demandam respostas institucionais que inclua o acompanhamento de cuidadores e abordem barreiras de atitude.

Modelo explicativo de discapacidad en población con trastornos mentales graves: un estudio multicéntrico en tres países de Sudamérica / Explanatory Model of Disability in a Population with Severe Mental Disorders: A Multicenter Study in Three Countries of South America / Modelo explicativo da deficiência em uma população com transtornos mentais graves: um estudo multicêntrico em três países da América do Sul

Introducción: en el contexto latinoamericano se está generando evidencia sobre el empleo de instrumentos derivados de la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud en psiquiatría y salud mental. Este estudio corresponde a la primera investigación de carácter explicativo en población con trastornos mentales graves en tres países de Sudamérica. El objetivo es determinar un modelo explicativo de discapacidad en una muestra de personas con trastornos mentales graves en contacto con servicios ambulatorios de psiquiatría en Chile, Colombia y Ecuador. Materiales y métodos: se llevó a cabo un estudio multicéntrico, observacional, correlacional, de corte transversal, a partir de un muestreo probabilístico en Colombia y un muestreo por conveniencia en Chile y Ecuador. En total, participaron 803 adultos con trastornos mentales graves, en contacto con servicios ambulatorios de psiquiatría en Concepción (Chile), Cali (Colombia) y Quito (Ecuador). Resultados: el 91.3 % de la muestra presentó algún grado de discapacidad. El modelo multivariado final incluyó las variables explicativas país (Colombia; ß = 6.724); edad (ß = −0.163); escolaridad (ß = −0.5029); síntomas actuales de depresión (ß = 23.26); episodio psicótico (ß = 4.795); episodio hipomaniaco/maniaco (ß = 7.498; t = 3.711); tener práctica religiosa (ß = −2.834), y tener cuidador (ß = 10.363). Obtuvo un coeficiente de determinación de 0.3275 (F [23, 760] = 16.09; p < 0.001, R²∆ = 30.71), que explica el 32.75 % de la discapacidad de las personas de la muestra de los tres países participantes. Conclusiones: en un modelo multivariado de discapacidad para trastornos mentales graves, los síntomas actuales y la presencia de cuidador son las principales variables explicativas de discapacidad

Introduction: Currently, evidence is being generated on the use of the International Classification of Functioning, Disability, and Health-derived tools in psychiatry and mental health. This study corresponds to the first investigation of explanatory character about a wide range of persons with severe mental disorders in three countries of South America. Aim: This study aims to determine an explanatory model of disability in a population with severe mental disorders in contact with outpatient psychiatry services in Chile, Colombia, and Ecuador. Materials and methods: A multicenter, observational, correlational, cross-sectional study was carried out based on a probabilistic sampling in Colombia and a convenience sampling in Chile and Ecuador. A total of 803 adults with severe mental disorders participated, who were in contact with outpatient psychiatry services in Concepción (Chile), Cali (Colombia), and Quito (Ecuador). Results: Some degree of disability was presented by 91.3% of participants. The final multivar-iate model included the explanatory variables country (Colombia; ß = 6.724); age (ß = −0.163); schooling (ß = −0.5029); current depression symptoms (ß = 23.26), psychotic episode (ß = 4.795); hypomanic/manic episode (ß = 7,498; t = 3,711); to have religious practice (ß = −2.834); and to have a caregiver (ß = 10.363); a coefficient of determination of 0.3275 (F [23, 760] = 16.09; p < 0.001M R2∆ = 30.71) was obtained, explain-ing a 32.75% disability in participants from the three participating countries. Conclusions: Current symp-toms and the presence of a caregiver are the main explanatory variables of the disability burden in a multivariate model of disability for severe mental disorders

Introdução: atualmente, no contexto latino-americano, estão sendo geradas evidências sobre o uso de instrumentos derivados da Classificação Internacional de Funcionalidade, da Deficiência e da Saúde em psiquiatria e saúde mental. Este estudo corresponde à primeira pesquisa explicativa em uma popula-ção com transtornos mentais graves em três países da América do Sul. Objetivo: determinar um modelo explicativo da deficiência em uma amostra de pessoas com transtornos mentais graves em contato com serviços psiquiátricos ambulatoriais no Chile, Colômbia e Equador. Materiais e métodos: foi realizado um estudo multicêntrico, observacional, correlacional, transversal, a partir de uma amostra probabilística na Colômbia e uma amostra de conveniência no Chile e Equador. No total participaram 803 adultos com transtornos mentais graves, em contato com serviços psiquiátricos ambulatoriais em Concepción (Chile), Cali (Colômbia) e Quito (Equador). Resultados: 91,3% da amostra apresentou algum grau de deficiência. O modelo multivariado final incluiu as variáveis explicativas país (Colômbia; ß = 6,724); idade (ß = −0,163); escolaridade (ß = −0,5029); sintomas atuais de depressão (ß = 23,26); episódio psicótico (ß = 4,795); episódio hipomaníaco/maníaco (ß = 7,498; t = 3,711); ter prática religiosa (ß = −2,834), e ter cuidador (ß= 10,363). Obteve coeficiente de determinação de 0,3275 (F[23, 760] = 16,09; p < 0,001; R2∆ = 30,71), explicando 32,75% da deficiência das pessoas da amostra dos três países participantes. Conclusões: em um modelo multiva-riado de deficiência para transtornos mentais graves, os sintomas atuais e a presença de um cuidador são as principais variáveis explicativas da deficiência

Psychometric Properties of the Patient Health Questionnaire-9 in Elderly Chilean Primary Care Users.

Background: This study aimed to assess the measurement properties (reliability, factor structure, and criterion validity) of the Patient Health Questionnaire (PHQ-9) as an instrument for screening major depressive disorder (MDD) in elderly primary care users in Chile. Method: About 582 participants aged between 65 and 80 years were enrolled from primary care centers. They completed the Composite International Diagnostic Interview (CIDI), a survey with sociodemographic characteristics and the PHQ-9. Results: The PHQ-9 revealed an acceptable internal consistency (ω = 0.79 [95% CI: 0.75-0.80] and α = 0.78 [95% CI: 0.75-0.81]); confirmatory factor analysis demonstrated a good fit for both 1- and 2-factor solutions. The chi-square difference test (χ2 = 0.61, gl = 1, p = 0.43) and correlation between the somatic and the cognitive-effective latent factors were very high (r = 0.97, p < 0.001), indicating that the 1 factor model was more parsimonious. Utilizing the CIDI as the gold standard, the area under the curve (AUC) was 0.88 (SE = 0.04, 95% CI: 0.84-0.90). The optimal cut-off score of ≥ 6 yielded good sensitivity and specificity for detecting MDD (0.95 and 0.76, respectively). However, considering the clinical utility index, the cut-off score of ≥9 proved to be a more effective marker for discarding cases of MDD. Conclusion: The PHQ-9 has adequate psychometric properties for elderly primary care users. In clinical settings, it showed its greatest utility in ruling out the presence of an MDD, however, its clinical value for identifying possible cases of MDD is limited. In cases above the cut-off point, it is recommended to perform a more thorough evaluation.

Etifoxine is non-inferior than clonazepam for reduction of anxiety symptoms in the treatment of anxiety disorders: a randomized, double blind, non-inferiority trial.

OBJECTIVE: To determine whether etifoxine, a non-benzodiazepine drug of the benzoxazine family, is non-inferior compared with clonazepam in the treatment of anxiety disorders. METHOD: A randomized controlled double blind trial with parallel groups was conducted. A total of 179 volunteer patients with a diagnosis of anxiety disorder (DSM-IV), between 18 and 64 years of age, participated in this study. The experimental group received 150 mg/day of etifoxine and the control 1 mg/day of clonazepam, both in three daily doses for 12 weeks. This treatment was completed by 87 participants, and 70 were available for follow-up at 24 weeks from start of treatment. The primary objective was a non-inferiority comparison between etifoxine and clonazepam in the decrease of anxiety symptoms (HAM-A) at 12 weeks of treatment. Secondary outcomes included the evaluation of medication side effects (UKU), anxiety symptoms at 24 weeks of treatment, and clinical improvement (CGI). Data analysis included multiple imputation of missing data. The effect of etifoxine on the HAM-A, UKU, and CGI was evaluated with the intention of treatment, and a sensitivity analysis of the results was conducted. Non-inferiority would be declared by a standardized mean difference (SMD) between clonazepam and etifoxine not superior to 0.31 in favour of clonazepam. RESULTS: Using imputed data, etifoxine shows non-inferiority to clonazepam on the reduction of anxiety symptoms at the 12-week (SMD = 0.407; 95% CI, 0.069, 0.746) and 24-week follow-ups (SMD = 0.484; 95% CI, 0.163, 0.806) and presented fewer side effects (SMD = 0.58; 95% CI, 0.287, 0.889). LOCF analysis shows that etifoxine is non-inferior to clonazepam on reduction of anxiety symptoms and adverse symptoms even when no change was assigned as result to participant whom withdrew. Non-inferiority could be declared for clinical improvement (SMD = 0.326; 95% CI, - 0.20, 0.858). CONCLUSION: Etifoxine was non-inferior to clonazepam on reduction of anxiety symptoms, adverse effects, and clinical improvement.

Porcentaje de peso perdido y su recuperación en pacientes bariátricos: un análisis desde la perspectiva temporal / Percentage of total weight loss and weight regain in bariatric patients: a time perspective analysis

RESUMEN La perspectiva temporal se ha asociado a hábitos relacionados con salud. Específicamente, el futuro ha sido asociado a cambios en el estilo de vida como la incorporación de ejercicio físico. En cambio, el presente hedonista se ha asociado a la perdida sub-óptima de peso en pacientes bariátricos. Objetivo: Evaluar la relación entre las variables de la perspectiva temporal y el porcentaje de peso total perdido; su mantención o re-ganancia desde el nadir, en pacientes bariátricos. Material y métodos: Se aplicó a 97 pacientes bariátricos el Inventario de la Perspectiva Temporal de Zimbardo y Boyd, y un cuestionario de estilo de vida construido para esta investigación. Resultados: Un mayor porcentaje de peso total perdido se asoció significativamente a futuro (r= 0,221; p<0,05) y desviación del perfil temporal negativo (r= 0,324; p<0,05). La pérdida de peso insuficiente estuvo asociada al presente fatalista (t= −2,16; p= 0,033) y desviación del perfil temporal balanceado (t= −2,81; p= 0,006). La re-ganancia del %PTP se asoció significativamente a la desviación del perfil temporal balanceado (t= −2,09; p= 0,045) y al consumo de dulces (X2= 13,42; p= 0,009). Conclusiones: Una mayor desviación de la perspectiva temporal balanceada y un mayor consumo de dulces se asociaron a una pérdida de peso insuficiente y a la recuperación desde el nadir.

ABSTRACT Background: A person's perspective of time has been associated with health-related habits. Specifically, future has been associated with changes in lifestyle as well the incorporation of physical exercise. In contrast, current hedonism is associated with sub-optimal weight loss in bariatric patients. Aim: To evaluate the relationship between seven variables of a time perspective and percentage of total weight loss; maintenance or weight regain among bariatric patients. Material and Methods: A sample of 97 bariatric patients answered the Inventory of Temporary Orientation and lifestyle questionnaires. Results: A greater percentage of total weight loss was significantly associated with future (r= 0.221; p<0.05) and deviations from negative time profile (r= 0.324; p<0.05). Insufficient weight loss was associated with a fatalistic present (t= −2.16, p= 0.033) and deviations from a balanced time perspective (t= −2.81; p= 0.006). Regaining weight was significantly associated to deviations from a balanced time perspective (t= −2.09; p=0.045) and consumption of sweets (X2= 13.42; p= 0.009). Conclusions: Deviations from a balanced time perspective and consumption of sweets are associated with sub-optimal weight loss and regaining weight.

Randomized cluster trial of a parenting program in Chile: Key mediators in the decrease in behavior problems in preschool children.

BACKGROUND: Parenting training is a proven strategy for the promotion of positive parenting practices and for the prevention and treatment of behavior problems in children. The processes that explain this efficacy are less clear. The aim of this study was to assess the mediating role of parenting practice modification, encouraged through the implementation of a universal parenting training program, for the decrease of behavior problems in 3- to 6-year-old children. METHOD: A cluster randomized trial was carried out in 19 educational centers in low and middle socioeconomic areas. A total of 178 families received the program and 154 of them were the control group. The following parenting practices were assessed: positive reinforcement, involvement, inconsistency, unsuitable treatment behaviors and physical punishment, as well as hostility and humiliation behaviors. Parent-child interaction was also assessed using an observational instrument. A multiple mediation analysis was carried out, identifying the indirect effects. RESULTS: Reduction of harsh discipline and physical punishment, and parental inconsistency mediated the effects observed in the reduction of child behavior problems during the program. CONCLUSION: Within Chilean families, harsh discipline, physical punishment, and parental inconsistency are important aspects to be considered in the implementation of universal parenting training programs.