Sleep and Perceived Stress: An Exploratory Mediation Analysis of the Role of Self-Control and Resilience among University Students.

BACKGROUND: High levels of stress are frequent in university education, and a lack of sleep has been reported to make students more vulnerable to stress. The mechanisms through which sleep harms students have not been sufficiently clarified; therefore, this study aimed to explore the mediating role of self-control and resilience in the relationship between sleep quality and duration and perceived stress. METHODS: Of 32 first-year college students, 21 (78%) were women, with a mean age of 18.47 (±0.84). They responded to a self-administered survey that included questions on stress, resilience, and sleep quality and recorded their daily sleep duration using a wristband for six days. RESULTS: Perceived stress was significantly correlated with resilience (r = -0.63), self-control (r = -0.46), sleep duration (r = -0.35), and lower sleep quality (r = 0.57). Path analysis revealed that self-control and resilience were partially mediated by sleep quality (R2 = 0.62; p < 0.01) and completely mediated by sleep duration (R2 = 0.46; p < 0.01). In both models, self-control had a direct effect on resilience and had a good-fit index. CONCLUSION: Being resilient seems to play a mediating role in the relationship between sleep and perceived stress; this ability can be favored by self-control, which is directly influenced by sleep.

[Controversies between mental health and disability standards in Mexico]. / Controversias entre los estándares de salud mental y de discapacidad en México.

There are controversies between the practice of psychiatry, current international standards and mental disorders or conditions with disabilities, framed in social care models. The objective of this work is to provide evidence and analyze the main gaps in mental health such as: the invisibility of some people with disabilities for the design of policies, legislation, or public programs; the predominance of the medical model, in which the substitution of decision-making in informed consent prevails, which violates the rights of legal personality, equality, freedom, security and respect for personal integrity, among others. This analysis highlights the importance of: a) integrating the legal provisions on health and disability to international standards, and complying with the Human Rights framework of the Political Constitution of the United States of Mexico, especially the pro personae principle and to the conforming interpretation clause; b) reform the General Health Law in matters of mental health and general health, in order to change the paradigm of asylum care to move towards that of community care with a focus on primary health care, adjacent to the services of the National System of Health; c) prohibit the institutionalization of people with mental disorders, as well as coercive measures as containment measures, and instead train and encourage verbal de-escalation techniques.

Existen controversias entre la práctica de la psiquiatría, los estándares internacionales vigentes y los trastornos o condición mental con discapacidad, enmarcados en los modelos de atención social. El objetivo de este trabajo es aportar evidencia y analizar las principales brechas en materia de salud mental como: la invisibilidad de algunas personas con discapacidad para el diseño de políticas, legislación o programas públicos; el predominio del modelo médico, en el que prevalece la sustitución de toma de decisión en el consentimiento informado, lo que viola los derechos de personalidad jurídica, igualdad, libertad, seguridad y respeto a la integridad personal, entre otros. El presente análisis resalta la importancia de: a) integrar las disposiciones legales en materia de salud y discapacidad a los estándares internacionales, y cumplir con el marco de los Derechos Humanos de la Constitución Política de los Estados Unidos Mexicanos, en especial al principio pro persona y a la cláusula interpretación conforme; b) reformar la Ley General de Salud en materia de salud mental y salubridad general, a fin de cambiar el paradigma de atención asilar para transitar hacia el de atención comunitaria con enfoque de atención primaria de la salud, adyacente a los servicios del Sistema Nacional de Salud; c) prohibir la institucionalización de las personas con trastornos mentales, así como las medidas coercitivas como medidas de contención, y en su lugar capacitar e incentivar técnicas de desescalamiento verbal.