Exploring child maltreatment and its relationship to alcohol and cannabis use in selected Latin American and Caribbean countries.

OBJECTIVES: Research from developed countries shows that child maltreatment increases the risk for substance use and problems. However, little evidence on this relationship is available from developing countries, and recognition of this relationship may have important implications for substance demand reduction strategies, including efforts to prevent and treat substance use and related problems. Latin America and the Caribbean is a rich and diverse region of the world with a large range of social and cultural influences. A working group constituted by the Inter-American Drug Abuse Control Commission and the Center for Addiction and Mental Health in June, 2010 identified research on this relationship as a priority area for a multinational research partnership. METHODS: This paper examines the association between self-reported child maltreatment and use in the past 12 months of alcohol and cannabis in 2294 university students in seven participating universities in six participating countries: Colombia, El Salvador, Jamaica, Nicaragua, Panama and Uruguay. The research also considers the possible impact of religiosity and minimal psychological distress as factors contributing to resiliency in these samples. RESULTS: The results showed that experience of maltreatment was associated with increased use of alcohol and cannabis. However, the effects differed depending on the type of maltreatment experienced. Higher levels of religiosity were consistently associated with lower levels of alcohol and cannabis use, but we found no evidence of an impact of minimal psychological distress on these measures. CONCLUSIONS: This preliminary study shows that the experience of maltreatment may increase the risk of alcohol and cannabis use among university students in Latin American and Caribbean countries, but that higher levels of religiosity may reduce that risk. More work to determine the nature and significance of these relationships is needed.

Interpersonal competence and sex risk behaviours among Jamaican adolescents.

OBJECTIVE: Of particular public health concern to the Jamaican authorities is the consistently high numbers of new HIV infections among adolescents and young adults. The thrust in HIV/AIDS prevention campaigns has largely been toward an increase in knowledge and attitudes as opposed to personality variables. However, it is widely believed that persons with high interpersonal skills may be less likely to engage in sex risk behaviours. This study investigated interpersonal competence as a personality characteristic associated with sexual risk-taking among Jamaican adolescents. METHODS: A cross-sectional survey of 500 adolescents, ages 13-18 years (250 males and 250 females) from nine randomly selected secondary government schools within Kingston and St Andrew was used. The sample ensured maximum variation in age groups. The BarOn EQ-i:YV(S) was utilized to provide a measure of interpersonal competence and the Sex Risk Scale from the Adolescent Risk Inventory acted as a measure of sex risk behaviours. The Spearman's rho correlational statistic was used to investigate the hypothesis. RESULTS: Of the students surveyed, 58.6% reported that they were sexually active; 31.8% reported having multiple sexual partners and 28.2% reporting inconsistent condom use. A significant, inverse relationship was observed between interpersonal competence and sex risk behaviours (p < 0.05). CONCLUSION: This research provided evidence that adolescents with high interpersonal skills are less likely to participate in risky sexual behaviours. Therefore, interventions aimed at reducing risky adolescent sexual practices might benefit from the inclusion of strategies to build interpersonal skills.

Interpersonal competence and sex risk behaviours among Jamaican adolescents / Competencia interpersonal y comportamientos de riesgo sexual entre los adolescentes Jamaicanos

OBJECTIVE: Of particular public health concern to the Jamaican authorities is the consistently high numbers of new HIV infections among adolescents and young adults. The thrust in HIV/AIDS prevention campaigns has largely been toward an increase in knowledge and attitudes as opposed to personality variables. However, it is widely believed that persons with high interpersonal skills may be less likely to engage in sex risk behaviours. This study investigated interpersonal competence as a personality characteristic associated with sexual risk-taking among Jamaican adolescents. METHODS: A cross-sectional survey of 500 adolescents, ages 13−18 years (250 males and 250 females) from nine randomly selected secondary government schools within Kingston and St Andrew was used. The sample ensured maximum variation in age groups. The BarOn EQ-i:YV(S) was utilized to provide a measure of interpersonal competence and the Sex Risk Scale from the Adolescent Risk Inventory acted as a measure of sex risk behaviours. The Spearman's rho correlational statistic was used to investigate the hypothesis. RESULTS: Of the students surveyed, 58.6% reported that they were sexually active; 31.8% reported having multiple sexual partners and 28.2% reporting inconsistent condom use. A significant, inverse relationship was observed between interpersonal competence and sex risk behaviours (p < 0.05). CONCLUSION: This research provided evidence that adolescents with high interpersonal skills are less likely to participate in risky sexual behaviours. Therefore, interventions aimed at reducing risky adolescent sexual practices might benefit from the inclusion of strategies to build interpersonal skills.

OBJETIVO: De interés particular para las autoridades jamaicanas de la salud pública es el número consistentemente alto de nuevas infecciones de VIH entre adolescentes y adultos jóvenes. El desempeño principal de las campañas de prevención del VIH/SIDA ha estado dirigido en gran parte hacia el aumento de conocimientos y actitudes, en vez de a variables de la personalidad. Sin embargo, existe la creencia ampliamente extendida de que las personas con buen desarrollo de sus habilidades interpersonales, serán menos propensas a involucrarse en conductas de riesgo sexual. Este estudio investigó la competencia interpersonal como una característica de personalidad asociada con riesgos sexuales entre adolescentes jamaicanos. MÉTODOS: Se llevó a cabo un estudio transversal de 500 adolescentes, con edades entre 13−18 años (250 varones, y 250 hembras) de nueve escuelas secundarias del gobierno, seleccionadas al azar en las áreas de Kingston y Saint Andrew. La muestra garantizó una máxima variación en los grupos de edad. Se usó el test BarOn EQ-i:YV (S) para obtener una medida de la competencia interpersonal, en tanto que la Escala de Riesgo Sexual del Inventario de Riesgo Adolescente actuó como una medida de los comportamientos de riesgo sexual. Las estadísticas correlaciónales de Spearman fueron utilizadas para investigar la hipótesis. RESULTADOS: De los estudiantes encuestados, 58.6% informó estar sexualmente activos; 31.8% informó tener múltiples parejas sexuales, y el 28.2%, reportó un uso sistemático del condón. Se observó una relación inversa significativa entre la competencia interpersonal y las conductas de riesgo sexual (p < 0.05). CONCLUSIÓN: Esta investigación proporcionó evidencia de que los adolescentes con alto desarrollo de habilidades interpersonales son menos propensos a participar en conductas sexuales riesgosas. Por lo tanto, las intervenciones destinadas a reducir las prácticas sexuales adolescentes riesgosas, podrían beneficiarse con la inclusión de las estrategias para desarrollar las habilidades interpersonales.

Validation of the Beck Depression Inventory II in HIV-positive patients / Validación del Inventario de Depresión de Beck II en los pacientes VIH-positivos

OBJECTIVE: Research on depression among HIV-positive patients has been limited by the lack of a valid and reliable measure of depression. This project addresses this problem by exploring the internal consistency reliability and the concurrent and discriminant validity of the Beck Depression Inventory- II (BDI-II) using HIV-positive patients in Jamaica. METHOD: Patients from three HIV clinics in Jamaica (n = 191 patients; 61% female, 39% male, mean age 40.5 ± 10 years) were administered the BDI-II along with the Centre for Epidemiological Studies - Depression Scale (CES-D) and the Social Provisions Scale. RESULTS: Overall, the BDI-II was found to have a high degree of reliability (a = 0.89). The scale also had good concurrent validity as evidenced by a high correlation with scores on the CES-D (r = 0.74) and acceptable discriminant validity as demonstrated through a moderate correlation with the Social Provisions Scale (r = -0.42). This pattern of scores suggests that the majority of the variance underlying the BDI-II assesses depression (55%) while a smaller degree of the variability (18%) measures a conceptually similar but distinct concept. CONCLUSION: The BDI-II is a sufficiently reliable and valid measure for assessing depression in HIV-positive patients.

OBJETIVO: La investigación sobre la depresión entre los pacientes VIH-positivos ha estado limitada por la falta de una medida válida y confiable de la depresión. Este proyecto aborda este problema explorando la confiabilidad de la consistencia interna, así como la validez discriminate y concurrente del Inventario de la Depresión de Beck II (BDI-II) usando pacientes VIH-positivos en Jamaica. MÉTODO: A los pacientes de tres clínicas de VIH en Jamaica (n = 191 pacientes; 61% hembras, 39% varones, edadpromedio 40.5 ± 10 anos) se les aplicó el BDI-IIjunto con la Escala de Depresión (CES D) y la Escala de Provisiones Sociales - Centro de Estudios Epidemiológicos. RESULTADOS: En general, se halló que el BDI-II posee un alto grado de confiabilidad (a = 0.89). La escala poseía también una buena validez concurrente, como quedó evidenciado por la elevada correlación con las puntuaciones del CES-D (r = 0.74), Igualmente, se constató que posee una validez discriminante aceptable como lo demuestran las correlaciones moderadas con la Escala de Provisiones Sociales (r = -0.42). Este patrón de puntuaciones sugiere que la mayor parte de la varianza que subyace en el BDI-II da la medida de la depresión (55%), en tanto que un grado menor de la variabilidad (18%) mide un concepto de naturaleza similar pero claramente definido. CONCLUSIÓN: El BDI-II constituye una medida suficientemente confiable y válida para evaluar la depresión en pacientes VIH positivos.

Patterns of depressive symptoms among patients with HIV infection / Patrones de síntomas depresivos entre pacientes con infección por VIH

OBJECTIVE: To identify the level of depressive symptoms among patients with HIV infection and to examine the reported patterns of depressive symptoms not confounded by the physical manifestations of HIV-infection. METHOD: A total of 191 patients with HIV infection (75 males (39%) and 116 females (61%), mean age 40.48 ± 10 years), from three HIV clinics were administered the Beck Depression Inventory - II as well as a demographic questionnaire as part of a larger study. RESULTS: Moderate to severe depressive symptoms were reported by 17.3% of the HIV-infected patients with females reporting significantly higher levels of depressive symptoms than males. A principal components analysis identified three clusters of depressive symptoms: cognitive-affective, negative cognitions and somatic symptoms. The HIV-infected patients were found to display mainly cognitive-affective symptoms of depression. CONCLUSION: HIV-infected patients, especially female patients, may be at an increased risk of experiencing high levels of depressive symptoms. It is recommended that HIV-infected patients be routinely screened for depression, particularly cognitive-affective symptoms of depression.

OBJETIVO: Identificar el nivel de sintomas depresivos entre pacientes con infección por VIHy examinar los patrones reportados sobre los sintomas de depresión, no confundidos por las manifestaciones físicas de la infección por VIH. MÉTODO: A un total de 191 pacientes con infección por VIH (75 varones (39%) y 116 hembras (61%), con edadpromedio 40.45 ± 10 anos), de tres clinicas de VIH, se les aplicó el Inventario de Depresión de Beck II, asi como una encuesta demográfica como parte de un estudio más grande. RESULTADOS: Un 17.3% de los pacientes infectados por VIH, informaron sintomas depresivos de moderados a severos, reportando las hembras niveles de sintomas de depresión significativamente más altos que los varones. Un análisis de los componentes principales identificó tres grupos de sintomas depresivos: cognitivos afectivos, cogniciones negativas y sintomas somáticos. Se halló que los pacientes infectados por VIHpresentaban principalmente sintomas afectivos cognitivos de depresión. CONCLUSIÓN: Los pacientes infectados con VIH, especialmente las hembras, pueden hallarse en un mayor riesgo de experimentar niveles altos de sintomas depresivos. Se recomienda que los pacientes infectados con VIHsean sometidos deforma rutinaria a tamizajes de depresión, particularmente de los sintomas de depresión cognitivos afectivos.

Validation of the Beck Depression Inventory II in HIV-positive patients.

OBJECTIVE: Research on depression among HIV-positive patients has been limited by the lack of a valid and reliable measure of depression. This project addresses this problem by exploring the internal consistency reliability and the concurrent and discriminant validity of the Beck Depression Inventory-II (BDI-II) using HIV-positive patients in Jamaica. METHOD: Patients from three HIV clinics in Jamaica (n = 191 patients; 61% female, 39% male, mean age 40.5-10 years) were administered the BDI-II along with the Centre for Epidemiological Studies -Depression Scale (CES-D) and the Social Provisions Scale. RESULTS: Overall, the BDI-II was found to have a high degree of reliability (alpha = 0.89). The scale also had good concurrent validity as evidenced by a high correlation with scores on the CES-D (r = 0.74) and acceptable discriminant validity as demonstrated through a moderate correlation with the Social Provisions Scale (r = -0.42). This pattern of scores suggests that the majority of the variance underlying the BDI-II assesses depression (55%) while a smaller degree of the variability (18%) measures a conceptually similar but distinct concept. CONCLUSION: The BDI-II is a sufficiently reliable and valid measure for assessing depression in HIV-positive patients.

Patterns of depressive symptoms among patients with HIV infection.

OBJECTIVE: To identify the level of depressive symptoms among patients with HIV infection and to examine the reported patterns of depressive symptoms not confounded by the physical manifestations of HIV-infection. METHOD: A total of 191 patients with HIV infection (75 males (39%) and 116 females (61%), mean age 40.48 +/- 10 years), from three HIV clinics were administered the Beck Depression Inventory-II as well as a demographic questionnaire as part of a larger study. RESULTS: Moderate to severe depressive symptoms were reported by 17.3% of the HIV-infected patients with females reporting significantly higher levels of depressive symptoms than males. A principal components analysis identified three clusters of depressive symptoms: cognitive-affective, negative cognitions and somatic symptoms. The HIV-infected patients were found to display mainly cognitive-affective symptoms of depression. CONCLUSION: HIV-infected patients, especially female patients, may be at an increased risk of experiencing high levels of depressive symptoms. It is recommended that HIV-infected patients be routinely screened for depression, particularly cognitive-affective symptoms of depression.