Efficacy of an Early Cognitive-Behavioral Intervention for Acute Stress Disorder in Mexican Earthquake Victims.

Acute stress disorder (ASD) refers to the symptoms associated with posttraumatic stress disorder (PTSD) within the first four weeks following the traumatic event. Recent theoretical models suggest that early detection of ASD provides an opportunity to implement early interventions to prevent the development of PTSD or ameliorate its symptomatology. The aim of the present study was the evaluation of the efficacy of an ASD treatment for earthquake victims, which would serve as an early intervention for PTSD. A single-case (n = 1) quasi-experimental design was used, with pre and post-assessments, as well as one, three and six-month follow-ups, with direct treatment replications. Fourteen participants completed the treatment and the follow-up measurements. The results obtained using a single-case analysis showed significant clinical improvement and clinically significant change when employing a clinical significance analysis and the reliable index of change. Statistical analyses of the dataset displayed statistically significant differences between the pre and post-assessments and the follow-up measures, as well as large effect sizes in all clinical measures. These results suggest that the treatment was an efficacious early intervention for PTSD during the months following the traumatic event, although some relevant study limitations are discussed in the text.

Adaptación de la Lista Checable de Trastorno por Estrés Postraumático para DSM-5 en Población Mexicana / Adaptation of the Posttraumatic Stress Disorder Checklist for DSM-5 in Mexican Population

Resumen La Lista Checable de Trastorno por Estrés Postraumático (PCL) ha sido una de las escalas más aplicadas en el ámbito clínico, misma que ha sido adaptada recientemente a los criterios del DSM-5 (PCL-5). Considerando la problemática que representa el TEPT en la población y los cambios recientes propuestos en el DSM-5, resulta importante contar con escalas validadas en México con base a los nuevos criterios diagnósticos descritos. El presente trabajo describe las propiedades psicométricas para la validación en población mexicana de la PCL-5, donde se contó con 204 estudiantes universitarios del sistema abierto de la UNAM, de 18 a 59 años, reclutados a través de una plataforma virtual. Los resultados mostraron una adecuada consistencia interna (.97), así como una validez convergente apropiada (rs = .58 a .88). A su vez, se realizaron distintos análisis factoriales exploratorios y confirmatorios donde se obtuvieron ajustes adecuados a los modelos planteados en el DSM-5 y estudios previos de la escala original. Se concluye que la escala es válida y confiable en población mexicana, lo que la convierte en el único instrumento adaptado al DSM-5 para la evaluación del TEPT en dicho contexto. Sin embargo, se recomiendan estudios adicionales con un mayor control sobre distintos tipos de trauma para mejor descripción del constructo.

Abstract The Posttraumatic Stress Disorder Checklist (PCL) has been one of the most applied scales in the clinical field, which has been recently adapted to the DSM-5 criteria (PCL-5). Considering the problems posed by PTSD in the population and the recent changes proposed in the DSM-5, it is important to have validated scales in Mexican population based on the new diagnostic criteria described. The present work describes the psychometric properties for the validation in Mexican population of the PCL-5, where 204 students from open and distance learning university between 18 and 59 years old participated, recruited through a virtual platform. The results showed an adequate internal consistency (.97), as well as an appropriate convergent validity (rs=.58 to .88). At the same time, different exploratory and confirmatory factor analyses were conducted, where appropriate adjustments to the models proposed in the DSM-5 and previous studies of the original scale were obtained. We conclude that the scale is valid and reliable in the Mexican population, which makes it the only instrument adapted to the DSM-5 for the evaluation of PTSD in this context. However, additional studies with greater control over different types of trauma are recommended for a better description of the construct.

Gender, Sexuality, and Relationships in Young Hispanic People.

This study explores the relation between gender differences and sexuality among young Hispanic people. Eight hundred and forty young people from Spain and Mexico filled out a self-administered questionnaire about sexuality (sexual experience, sexual orientation, and sexual relationships) and gender (self-identification). Men in both Spain and Mexico more commonly report the practice of masturbation and vaginal sex, and are more likely to be unfaithful than women. Women in both countries report more steady partners and longer length of relationships. There were greater gender differences for Mexican men and women than for Spanish men and women in terms of sexual frequency, sexual orientation, and infidelity. Therefore, gender may play an important role in young people's sexuality, more so in Mexico than in Spain.

Evaluación de la depresión en pacientes con cáncer terminal y su aplicación en el contexto mexicano: Una revisión / Assessment of depression in patients with terminal cancer and its aplication in the Mexican context: A review

La depresión es uno de los problemas emocionales más frecuentes en pacientes con cáncer terminal. Debido a la evolución de la enfermedad, varios síntomas físicos presentes en los pacientes se pueden yuxtaponer y confundir con los síntomas que permiten identificar de manera taxonómica la depresión, lo cual dificulta la evaluación del problema. El objetivo de este artículo es realizar una revisión de los principales instrumentos utilizados para evaluar la depresión en pacientes con cáncer terminal, junto con sus implicaciones en el contexto mexicano. Con base en la información recabada se puede decir que es más pertinente realizar una evaluación de la depresión enfocada en los aspectos emocionales que en los somáticos. Actualmente existe una gran cantidad de instrumentos para evaluar la depresión que dan mayor énfasis a los aspectos de la anhedonia y las emociones que a los aspectos somáticos de la depresión. En México existe un enorme rezago en el desarrollo de instrumentos que permitan identificar estos síntomas. Se concluye señalando instrumentos alternativos para evaluar la depresión en pacientes con cáncer terminal, estos instrumentos podrían ser evaluados y considerados en un futuro en el contexto de la medicina paliativa.

Depression is one of the most common emotional problems in palliative patients. Due to the advanced nature of the disease, several physical symptoms presented by patients overlap with symptoms of depression, making it difficult to evaluate and diagnose the problem. The aim of this paper was to conduct a narrative review of the main instruments used to assess depression when it is present in palliative patients, with a special consideration of the Mexican context. Based on the available data and the scholarly literature, it is more appropriate to conduct an assessment of depression focused on emotional aspects than somatics aspects in palliative patients. Internationally, a number of depression assessments place greater emphasis on anhedonia and emotions, such as hopelessness, than on somatic aspects of depression. In Mexico, a considerable gap remains in the development of instruments to identify depression in the palliative setting. Finally, we describe alternative assessments of depression, which could be evaluated and considered in the future in the palliative care setting.

Virtual reality for improving body image disorders and weight loss after gastric band surgery: a case series.

Laparoscopic Adjustable Gastric Banding (LAGB) is a common surgery method used to help obese patients to lose weight. However, even if LAGB is able to produce a durable and relevant weight loss, it is less effective in improving body image: as demonstrated by a recent study, obese patients with a body image disorder in the pre-operative stage continue to show this even 13 months after the operation. In this presentation we will discuss the possible role of virtual reality (VR) in addressing this problem within an integrated cognitive behavioral approach. To test this approach, a case series of three LAGB patient who experienced body dissatisfaction even after a >30/40% excess body weight loss, is presented and discussed. At the end of the 6-week protocol the patients experienced a 15%-20% further reduction of their weight. This reduction was also matched by a general improvement of the psychological state. Both the weight loss and the level of well-being were further improved after a three-month follow-up.

Culture as an influence on the perceived risk of HIV infection: a differential analysis comparing young people from Mexico and Spain.

This study analyzes risk behaviors and attitudes related to HIV-AIDS transmission between young people from two Hispanic/Latino culture and origin (Mexico and Spain). For this purpose, 840 participants filled out the AIDS Prevention Questionnaire (Ballester et al., El "Cuestionario de Prevención del Sida (CPS)": Análisis de la fiabilidad y validez. Sociedad Española Interdisciplinaria del Sida, San Sebastián, 2007). From the Theory of reasoned action, our results revealed differences between the risk behaviour profiles of young people depending on their origin or gender, in terms of attitudes and behaviours. For example, Mexican participants have exhibited more levels of perceived risk or severity of HIV while for Spaniards, the fear of HIV was higher. Regarding the perception of condom use, loss of pleasure seems to be an important barrier for both groups of Mexican and Spanish young although others, such as lack of information would be reported only for Mexican women. Regarding self-efficacy, there are no significant differences in general but, in specific cases, we found them: Spanish participants seem to be more comfortable with putting on a condom while Mexican participants are more confident when it comes to buying it. However, these Spanish young people have reported more behavioural intention and present condom use in all sexual practices. In general, predictors of condom use are different depending on gender and origin. Thus, in order to develop effective strategies in AIDS prevention, cultural differences for HIV transmission should be considered even inside the group of Hispanic/Latino young people.