Impulsivity and sexual addiction: factor structure and criterion-related validity of the sexual addiction screening test in Mexican adults.

Sexual addiction is associated with serious health problems. Due to that fact, it is quite important to perform a comprehensive assessment. The Sex Addiction Screening Test (SAST-R) is a self-administered questionnaire with good psychometric properties used in several countries. Our study conducts a cross-cultural adaptation of the SAST-R on the Mexican population. The original version of the SAST-R was translated into Mexican Spanish, and we performed a pilot with 23 participants to be sure that the participants understood the meaning of the items. The final version was administered to 370 adults who completed the SAST-R, and measures of impulsivity (the Kirby questionnaire), reward/punishment responsivity (BIS-BAS scale), personality (BIG-Five), and psychological distress (SCL-90). The confirmatory factor analysis (CFA) with a five-factor model with one second-order factor model had the best fit. Reliability analysis suggests acceptable internal consistency (α = 0.80). The SAST-R scores exhibited significant correlations with several variables. Specifically, they showed a positive correlation with the neuroticism scale (r = 0.11, p < 0.05), a negative correlation with the conscientiousness scale (r = -0.21, p < 0.01), a negative correlation with the BIS scale (r = -0.11, p < 0.05), and a positive correlation with psychological distress (r = 0.34, p < 0.01). Notably, there were no significant correlations observed with variables that we initially expected to have a substantial association, such as impulsivity (r = -0.004, p > 0.05) and the three BAS subscales (p > 0.05). We found with an algorithm that psychological distress, impulsivity, neuroticism, and agreeableness were the good predictors to identify high scores of hypersexuality. Our results confirmed that the Mexican Spanish version of the SAST-R has good psychometric properties to be used in future research.

Individual and Combined Effect of MAO-A/MAO-B Gene Variants and Adverse Childhood Experiences on the Severity of Major Depressive Disorder.

BACKGROUND: Major depressive disorder (MDD) is a mood disorder with a high prevalence worldwide that causes disability and, in some cases, suicide. Although environmental factors play a crucial role in this disease, other biological factors may predispose individuals to MDD. Genetic and environmental factors influence mental disorders; therefore, a potential combined effect of MAO-A/MAO-B gene variants may be a target for the study of susceptibility to MDD. This study aimed to evaluate the effects of MAO-A and -B gene variants when combined with adverse childhood experiences (ACEs) on the susceptibility and severity of symptoms in MDD. METHODS: A case-control study was performed, including 345 individuals, 175 MDD cases and 170 controls. Genotyping was performed using real-time PCR with hydrolysis probes. The analysis of the rs1465107 and rs1799836 gene variants of MAO-A and -B, respectively, was performed either alone or in combination with ACEs on the severity of depression, as determined through specific questionnaires, including DSM-IV diagnostic criteria for MDD. RESULTS: According to individual effects, the presence of ACEs, as well as the allele G of the rs1465107 of MAO-A, is associated with a higher severity of depression, more significantly in females. Furthermore, the allele rs1799836 G of MAO-B was associated with the severity of depression, even after being adjusted by gene variants and ACEs (IRR = 1.67, p = 0.01). In males, the allele rs1799836 G of MAO-B was shown to interact with SNP with ACEs (IRR = 1.70, p < 0.001). According to combined effect analyses, the severity of depression was associated with ACEs when combined with either allele rs1465107 of MAO-A or allele rs17993836 of MAO-B, whereas SNP risk association was influenced by gender. CONCLUSIONS: The severity of depression is related to either individual or combined effects of temperamental traits and genetic susceptibility of specific genes such as MAO-A and MAO-B.

Anxiety, depression, perceived executive function and sugar sweetened beverages: a causal mediation analysis in Mexican young adults.

There is the notion that dysregulation of executive function (EF), which disrupts behavior and cognitive processes, may explain the emotional impairment which leads to increasing sugar sweetened beverages (SSBs) intake. We aimed to test whether anxiety and depression mediate the association between self-reported problems in EF and sugar sweetened beverage intake in Mexican adults between 18-40 years. An open survey advertised as a 'mental health and sugar sweetened beverages study' was conducted, participants were recruited through Facebook ads. Males and females, between 18-40 years, able to read and write, and currently residing in Mexico were included. We analyzed data using causal mediation analysis with latent variables using a structural equation modelling framework. Significant indirect effects were found for somatic symptoms of depression (ß = 6.601, SE = 2.657, p < .05) and anxiety (ß = .679, SE =.334, p < .05). In depression model no significant direct effects of EF were found in the depression model, however they were found in the anxiety model (ß = 1.335 SE =.566, p < .05). Somatic symptoms of depression were a total mediator, and anxiety a partial mediator. The results suggest that EF increased the probability of emotional symptoms, which led to a higher consumption of SBBs.

Big Five personality factors predict self-rated cognitive reserve: a two-wave online study in a Mexican sample.

Introduction: One of the main contributors to cognitive reserve (CR) is the involvement in cognitively stimulating activities (CSAs), including education, work, leisure, social and physical activities. Personality traits are plausible determinants of CR, influencing the tendency to engage in CSAs. The goal of this study was to evaluate the association between personality and CR, operationalised as self-rated involvement in CSAs, in a sample of individuals aged 18-50 or more. Method: We collected two-wave non-probabilistic online data throughout Mexico. The instruments were the Big Five Inventory-2 for the baseline, its extra-short form for the follow-up and the Self-Rating of Cognitive Reserve (SRCR). Confirmatory factor analyses (CFAs) were performed to test the unifactorial structure of the SRCR, and multiple regressions were conducted with personality factors as predictors of CR. Results: For the baseline, 2025 participants were recruited, and 610 for the follow-up, most of them female and aged 18-40. CFAs showed excellent goodness-of-fit, and the regression analyses proved Negative Emotionality and Extraversion to be the main predictors of CR. Conclusions: Our study highlights the need to identify personality profiles at high risk of underdevelopment of CR in ages where it is still feasible to promote engagement in CSAs.

Factor structure, measurement invariance, and scoring practices of the strengths and weaknesses of ADHD-symptoms and normal behavior.

We investigate the factor structure, concurrent validity, internal consistency, measurement invariance (sex and parents' geographical/cultural background), and practical scoring practices of the Strengths and Weaknesses of Attention-deficit/Hyperactivity Disorder (ADHD)-Symptoms and Normal Behavior scale (SWAN) in junior high school students. With a sample of 650 parents of Mexican junior high school students (55.84% girls; mean age of 13.15 and SD = 0.97 years) who completed the SWAN scale, a bidirectional instrument, and the Barrios and Matute Questionnaire of ADHD symptoms (BMQ-ADHD), a traditional Mexican unidirectional instrument, we obtained SWAN' psychometric properties by a series of confirmatory factor analyses. Two and three-correlated factors of the SWAN and bifactor models fitted well to the data. The bifactor model with one general dimension and two specific dimensions (BF 2S) showed most favorable psychometric properties and was invariant regarding sex and cultural background. The analyses of the BF 2S revealed that only the general factor was sufficiently reliable for scoring. Percentiles divided by sex better approximated SWAN averaged-based scores to the general factor derived from the SWAN bifactor model, measuring the trait with acceptable precision for norms development. The study provides evidence that SWAN measures a trait best represented by a reliable general domain, that the average-based SWAN score is closer to the general SWAN trait when the score is segregated by sex, and that it is invariant with respect to sex and cultural background to be reliable in a culturally diverse population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Big Five Inventory-2: Confirmatory Factor Analysis and Latent Profiles in a Mexican Sample

Introduction: The Big-Five Inventory-2 is a recently developed instrument for the measurement of personality factors and facets, with good psychometric properties cross-culturally. We examined the validity of this test, test-retest reliability, and internal consistency in a Mexican sample. We also aimed to extract latent profiles in order to identify subgroups of individuals based on personality traits. Method: We recruited a two-wave non-probabilistic sample by way of chain referral through social networks. The BFI-2 (60-items version) was administered in the first wave, and the BFI-2-XS (15-items version) in the second wave. The Quality-of-Life Enjoyment and Satisfaction Questionnaire-Short Form was also administered. The baseline sample included 2,025 participants and the follow-up included 610. Results: Factor models of the BFI-2 and the BFI-2-XS evidenced satisfactory goodness-of-fit, reliability and nomological validity with demographics (e.g., higher negative emotionality in women) and with quality of life. We extracted five latent profiles from the BFI-2; those characterised by High Agreeableness/Low Open-mindedness, High Stability/Low Plasticity, and Average Stability/Plasticity, showed better quality of life. Conclusion: We recommend the use of facets, aiming to reduce measurement error. Further studies with more demographically balanced samples should be performed in order to test the replication of the latent profiles.

Introducción: El Big-Five Inventory-2 (BFI-2) es un instrumento para la medición de factores y facetas de la personalidad desarrollado recientemente y reportado con buenas propiedades psicométricas transculturalmente. Evaluamos la validez de esta prueba, la confiabilidad test-retest y la consistencia interna en una muestra mexicana. Además, obtuvimos perfiles latentes para identificar subgrupos de individuos en función de los rasgos de personalidad. Método: Reclutamos una muestra no probabilística de dos olas mediante muestreo por cadena por medio de redes sociales. El BFI-2 (versión de 60 ítems) se administró en la primera ola y el BFI-2-XS (versión de 15 ítems) en la segunda ola. Al mismo tiempo, aplicamos el cuestionario Quality of Life Enjoyment and Satisfaction-Short Form. La muestra inicial incluyó 2025 participantes y el seguimiento 610. Resultados: Los modelos factoriales del BFI-2 y el BFI-2-XS demostraron bondad de ajuste, confiabilidad y validez nomológica satisfactorias en relación con la demografía (e.g., mayor emocionalidad negativa en mujeres) y con la calidad de vida. Obtuvimos cinco perfiles latentes del BFI-2; aquellos caracterizados por alta amabilidad/baja apertura de mente, alta estabilidad/baja plasticidad y moderada estabilidad/plasticidad, mostraron mejor calidad de vida. Conclusiones: Recomendamos el uso de facetas, con el objetivo de reducir el error de medición. Se deben realizar más estudios con muestras más equilibradas demográficamente para probar la replicación de los perfiles latentes.

Epidemiological analysis of perinatal depression.

Perinatal depression is a commonly underdiagnosed problem which not only severely affects maternal mental and physical health, but also affects the newborn on a physical, mental and cognitive level with serious repercussions on adult life. Despite efforts to obtain useful information to dimension the problem, most experts in the field agree that this disorder is more frequent than estimated. Thus, the improvement in obtaining information on perinatal mental health will not only allow for a better dimensioning of the problem, but will also allow for better decision making in public mental health to reduce morbidity and mortality and the burden of disease associated with perinatal depression.

La depresión perinatal es un problema habitualmente subdiagnosticado que no sólo afecta de manera importante la salud mental y física materna, sino también al recién nacido en los aspectos físico, mental y cognitivo, con serias repercusiones en la vida adulta. A pesar de los esfuerzos para obtener información útil para dimensionar el problema, la mayoría de los expertos en el tema coinciden en señalar que este trastorno es más frecuente de lo que se estima. La mejora en la obtención de información en salud mental perinatal permitirá dimensionar mejor el problema y una adecuada toma de decisiones en salud mental pública para disminuir la morbimortalidad y la carga de la enfermedad asociada a la depresión perinatal.

Impact of Spirulina maxima Intake and Exercise (SIE) on Metabolic and Fitness Parameters in Sedentary Older Adults with Excessive Body Mass: Study Protocol of a Randomized Controlled Trial.

Life expectancy has increased unprecedentedly in recent decades, benefiting the longevity of the world's population. The most frequent pathological conditions presented in this age group include excessive body fat, frailty, and hypercholesterolemia. These pathological characteristics condition general health and autonomy in adults to carry out their usual activities. In this sense, the search for a healthy lifestyle is necessary, consisting in a healthy diet that includes supplementation with nutraceuticals and the daily practice of physical activity. This study protocol aims to evaluate the independent and synergistic effect of 12 weeks of Spirulina maxima intake (5 g/day), with or without an exercise program on metabolic and fitness parameters of 52 sedentary older adults with excessive body mass in a double-blind, randomized, crossover, controlled trial design. The main findings from this trial will provide novel evidence for future interventions designed for the elderly population and the result will be disseminated through peer-reviewed journals and international meetings. ClinicalTrials.gov identification number: NCT04658875 (Effect of Spirulina maxima and Exercise on General Fitness and Blood Lipids in Older Adults).

Individual Contribution of Youth Antisocial Symptoms to Suicide Behavior in Adults with Substance Use Disorders.

This study assesses the individual contribution of youth symptoms of antisocial personality disorder (before the age of 15) in past-month suicidal behavior in adults with substance use disorders. Youth antisocial symptoms and suicidal behavior were assessed using the Mini International Neuropsychiatric Interview. Indicators of youth antisocial symptoms were significantly associated with suicide outcomes; lack of remorse (OR = 2.68 CI 95% 1.37, 5.25), and sexual assault with planning, and destruction of property to attempt (OR = 4.22 CI 95% 1.29, 15.08). Our results suggest that specific antisocial indicators during adolescence could be associated with suicide in adulthood, even after controlling for major depressive disorder. Further implications for the research of antisocial symptoms and suicide behavior from a developmental perspective are discussed.

Psychometric Properties of the Self-efficacy Scale for a Healthy Diet in Individuals with Obesity / Propiedades psicométricas de la Escala de Autoeficacia para una Alimentación Saludable en Individuos con Obesidad

Abstract Background Self-efficacy refers to an individual's belief in his or her capacity to execute certain behaviors and determines changes in the lifestyle of persons with chronic diseases such as obesity. There is currently no instrument with optimal psychometric properties measuring self-efficacy for a healthy diet. HAPA is a theoretical framework that can describe, explain, and predict health behavior changes and its relationship with self-efficacy, and it that is useful for the development of interventions, particularly in the area of healthy diets. Objective The purpose of this study was to develop an instrument to measure self-efficacy for a healthy diet in Mexican population with obesity and the evaluation of the psychometric properties of the Self-Efficacy Scale for a Healthy Diet (SSHD). Method The sample included 202 participants receiving care in public obesity clinics. The SSHD applied is a Likert-type scale developed from the Health Action Process Approach containing 45 items. Omega coefficient and Confirmatory Factor Analyses were estimated to evaluate the psychometric properties. Results The scale has good measures of goodness of fit χ2 = 66.49; p < .001; χ2 SB/gl = 41; CFIS = .955; NFI = .893; RMSEAS = .056 (95% CI [.029, .079]) and total scale reliability of ω = .896 (CI 95% [.876, .915]). Discussion and conclusion The SSHD is a reliable, valid instrument for measuring the three types of self-efficacies proposed in HAPA in people with obesity who require changes to adhere to a healthier diet.

Resumen Antecedentes La autoeficacia es la creencia en las capacidades percibidas para realizar cualquier comportamiento; determina cambios en el estilo de vida de personas con enfermedades crónicas como la obesidad. Actualmente no existe un instrumento con propiedades psicométricas adecuadas que mida la autoeficacia para seguir una dieta saludable. El Modelo Procesual de Acciones en Salud (HAPA, por sus siglas en inglés) es un modelo teórico que describe, explica y predice cambios en la conducta y su relación con la autoeficacia, especialmente en el área de la alimentación saludable. Objetivo Desarrollar un instrumento que mida la autoeficacia para una alimentación saludable en población mexicana con obesidad. Con ello se obtuvieron las propiedades psicométricas de la Escala de Autoeficacia para una Alimentación Saludable (EAAS). Método La muestra incluyó 202 personas adultas con obesidad que se encontraban en tratamiento para reducir su peso corporal. Se aplicó la EAAS; ésta es una Escala tipo Likert desarrollada con base en el Modelo Procesual de Acciones en Salud (HAPA, por sus siglas en inglés) y consta de 45 reactivos. Se obtuvo la validez de constructo, se estimaron coeficiente omega y análisis factorial confirmatorio para obtener las propiedades psicométricas. Resultados La escala tiene buenas medidas de bondad de ajuste χ2 = 66.49; p < .001; χ2 S-B/gl = 41; CFIS = .955; NFI = .893; RMSEAS = .056 (IC 95% [.029, .079]) y de confiabilidad de la escala total ω = .896 (IC 95% [.876, .915]). Discusión y conclusión La EAAS es un instrumento válido y confiable para medir los tres tipos de autoeficacia que propone el modelo HAPA en personas con obesidad que requieren cambios en la conducta alimentaria.

Testing whether cognitive reserve as measured by self-rating of stimulating activities moderates the association of polysubstance use and neurocognitive disorder.

Introduction: The objectives were to identify a latent factor of cognitive reserve (CR) assessed by self-rating of cognitively stimulating activities, to analyze the association between this factor and educational attainment, and to test whether CR moderates the association between polysubstance use and neurocognitive disorder (NCD). Methods: Cross-sectional data of 753 participants was collected in Mexico City. A questionnaire for self-rating of stimulating activities (work/education, leisure, physical, social, usual- and current environments) was designed. Confirmatory factor analysis was performed to test unifactoriality. This CR factor was then used within a structural equation model of moderation between recent- and years of substance use and indicators of NCD (Montreal Cognitive Assessment and an interview for subjective cognitive deficits). Results: We found acceptable goodness-of-fit values for the unifactorial model, but no association of this factor with educational attainment, nor with recent- and years of substance use (suggesting independence of CR and severity of neuropathology). We did not find a moderation effect of CR between substance use and indicators of NCD; CR was negatively associated with subjective cognitive deficits only. Conclusions: Moderation effect of self-rated CR should be further tested using direct measures of substance-induced neuropathology. Measurement of self-rated CR may complement self-reported cognitive examination.

Development of an evidence-based model of rapid testing, counseling and referral patients with HIV, HVC and other STDs in Mexican addiction treatment centers / Desarrollo de un modelo basado en evidencia de pruebas rápidas, orientación y derivación de pacientes con VIH, VHC y otras ITS en centros mexicanos de tratamiento de adicciones

Abstract Introduction Efforts to identify new cases of HIV, HVC and other STIs, through the application of quick tests, focus on people who inject drugs, without taking into account the fact that the use of alcohol and other drugs of abuse inhibits decision making, increasing the transmission of STIs through risky sexual practices. Accordingly, it is necessary to have detection algorithms that consider people who use multiple drugs to improve the identification of new cases and their subsequent linkage with health services. Objective This paper describes the development process of the OPB-APR model for the detection, counseling and referral of people with HIV and other STIs at addiction treatment centers. Method The procedure is divided into three phases: 1. A literature review to identify the basic concepts of HIV and other STIs, substance use, risky sexual behaviors, quick tests, and specialized psychological counseling; 2. A feasibility study in which a health professional is trained to implement the OPB-APR model; 3. Drafting of the final version. Results The final version of the OPB-APR model was obtained, which describes standardized procedures for detection, counseling and referral to health services. Discussion and conclusions The OPB-APR model aims to strengthen the public health system by increasing the coverage of services for the detection of HIV, HCV and other STIs. The above through the implementation of standardized procedures among specialized and non-specialized health professionals of addiction care centers.

Resumen Introducción Los esfuerzos para la identificación de nuevos casos de VIH, VHC y otras ITS, mediante la aplicación de pruebas rápidas, se centra en personas que se inyectan drogas, sin considerar que el consumo de alcohol y otras drogas de abuso inhiben la toma de decisiones incrementando el riesgo de contagio de ITS durante prácticas sexuales de riesgo. Por este motivo, es necesario contar con algoritmos de detección que consideren a personas con múltiples consumos para incrementar la identificación de nuevos casos y su posterior vinculación a servicios de salud. Objetivo Describir el proceso de desarrollo del modelo OPB-APR para la detección, orientación y referencia de personas con VIH y otras ITS en centros de tratamiento de adicciones. Método El procedimiento se dividió en tres fases: 1. Revisión de literatura para identificar conceptos básicos sobre el VIH y otras ITS, consumo de sustancias, conductas sexuales de riesgo, pruebas rápidas, y orientación psicológica especializada; 2. Estudio de factibilidad en el que se entrenó a profesionales de la saludpara implementar el modelo OPB-APR; 3. Integración de la versión final. Resultados Se obtuvo la versión final del modelo OPB-APR el cual describe procedimientos estandarizados para la detección, orientación y referencia a servicios de salud. Discusión y conclusión El modelo OPB-APR pretende fortalecer al sistema público de salud al incrementar la cobertura de servicios para la detección del VIH, VHC y otras ITS. Lo anterior mediante la implementación de procedimientos estandarizados entre los profesionales de la salud especializados y no especializados de centros para la atención de adicciones.

Multidimensional Patterns of Sexual Risk Behavior and Psychiatric Disorders in Men with Substance Use Disorders.

Previous evidence links substance use disorders (SUD) to STI/HIV risk and suggests that comorbid psychiatric disorders increase the probability to engage in sexual risk behaviors. This study had two aims: (1) to identify subgroups based on sexual risk behavior using a person-centered approach in a sample of substance users and (2) to measure the association of psychiatric and SUD with subgroup membership. We assessed 402 male adults with SUD, reporting sexual intercourse in the previous 12 months using the HIV-Risk Behavior Scale and the Mini International Neuropsychiatric Interview. Latent class analysis was performed to determine multidimensional patterns of sexual risk behaviors and multinomial logistic regression was utilized to associate classes with disorders. The three-class model showed the best fit, and the classes were labeled: Relationship-Based (31.34% of the sample), Condom-Based (39.55%), and Multiple Risks (29.10%). Controlling for age and marital status, major depressive disorders, antisocial personality disorder, and any psychiatric disorder were associated with the Multiple Risks class. Results stress the importance of developing a personalized assessment and counseling for sexual risk behaviors in individuals with SUD, particularly when they endorse criteria for comorbid psychiatric disorders. Future studies should focus on evaluating differential response to preventive interventions.

Neuropsychiatric characterization of individuals with inhalant use disorder and polysubstance use according to latent profiles of executive functioning.

BACKGROUND: Inhalant use disorder (IUD) is associated with deficits in executive functions (EFs). We described latent profiles of EFs and distribution of neuropsychiatric disorders and patterns of severity of use across these profiles. METHODS: Individuals with IUD were recruited at community-based residential facilities for substance use treatment in Mexico City. Latent profile analysis was conducted with the following tasks: self-ordered pointing, Stroop, Iowa gambling, Wisconsin Card Sorting and Tower of Hanoi. RESULTS: Three latent profiles were extracted from n = 165: lowest performances of inhibition of response and processing speed; lowest performance of self-monitoring, intermediate performance of inhibition of response and relatively spared processing speed; and intermediate performance of processing speed and self-monitoring, and relatively spared inhibition of response. CONCLUSION: Between-group differences were observed mainly for antisocial personality disorder and lifetime suicidal. Findings remark the need for identifying distinct profiles of EFs within these populations to better understand the transdiagnostic heterogeneity of EFs.

Latent Impulsivity Subtypes in Substance Use Disorders and Interactions with Internalizing and Externalizing Co-Occurring Disorders.

This study explored the clinical importance of latent impulsivity subtypes within a sample of individuals with substance use disorders (SUDs) and high rates of co-occurring disorders (CODs) receiving residential treatment, aiming to assess the heterogeneity of the associations between SUDs and CODs across such impulsivity subtypes. The abbreviated Barratt impulsiveness scale was used to assess motor and cognitive (attentional and nonplanning) impulsivity, a structured interview for diagnosis of SUD and CODs, and other clinimetric measures for severity of substance use. Latent class analysis was conducted to extract subgroups of impulsivity subtypes and Poisson regression to analyze effects of interactions of classes by CODs on severity of substance use. 568 participants were evaluated. Results featured a four-class model as the best-fitted solution: overall high impulsivity (OHI); overall low impulsivity; high cognitive-low motor impulsivity; and moderate cognitive-low motor impulsivity (MC-LMI). OHI and MC-LMI concentrated on most of the individuals with CODs, and individuals within OHI and MC-LMI showed more severity of substance use. The expression of this severity relative to the impulsivity subtypes was modified by their interaction with internalizing and externalizing CODs in very heterogeneous ways. Our findings suggest that knowing either the presence of trait-based subtypes or CODs in individuals with SUDs is not enough to characterize clinical outcomes, and that the analysis of interactions between psychiatric categories and behavioral traits is necessary to better understand the expressions of psychiatric disorders.

Latent class profile of psychiatric symptoms and treatment utilization in a sample of patients with co-occurring disorders

Objective: To identify symptom-based subgroups within a sample of patients with co-occurring disorders (CODs) and to analyze intersubgroup differences in mental health services utilization. Methods: Two hundred and fifteen patients with COD from an addiction clinic completed the Symptom Checklist 90-Revised. Subgroups were determined using latent class profile analysis. Services utilization data were collected from electronic records during a 3-year span. Results: The five-class model obtained the best fit (Bayesian information criteria [BIC] = 3,546.95; adjusted BIC = 3,363.14; bootstrapped likelihood ratio test p < 0.0001). Differences between classes were quantitative, and groups were labeled according to severity: mild (26%), mild-moderate (28.8%), moderate (18.6%), moderate-severe (17.2%), and severe (9.3%). A significant time by class interaction was obtained (chi-square [χ2[15]] = 30.05, p = 0.012); mild (χ2[1] = 243.90, p < 0.05), mild-moderate (χ2[1] = 198.03, p < 0.05), and moderate (χ2[1] = 526.77, p < 0.05) classes displayed significantly higher treatment utilization. Conclusion: The classes with more symptom severity (moderate-severe and severe) displayed lower utilization of services across time when compared to participants belonging to less severe groups. However, as pairwise differences in treatment utilization between classes were not significant between every subgroup, future studies should determine whether subgroup membership predicts other treatment outcomes.

Psychometric Properties of the Fagerström Test for Nicotine Dependence in a Sample of Mexican Smokers.

INTRODUCTION: The Fagerström Test for Nicotine Dependence (FTND) is a widely used six-item questionnaire, often used as a measure of physical dependence on nicotine, although evidence of its validity in Spanish-language studies is scarce. AIM: The aim of this study was to assess the psychometric properties of FTND in Spanish speakers. METHOD: We recruited 136 regular adult smokers to answer the FTND. We assessed the internal consistency of the FTND with a Cronbach's alpha and convergent and divergent validity with the Pearson product-moment coefficient between variables of external criteria, both measure and nonmeasure related; the FTND items, and the total score. We performed a binary logistic regression model to determine predictive validity of the questionnaire, using the FTND total scores as an independent variable and cessation as the outcome. We performed a confirmatory factor analysis to assess the robustness of a single-factor model. RESULTS: The internal consistency had a lower coefficient than current standards. The FTND was unable to predict cessation at any assessed time point. The FTND total score showed significant correlation with exhaled carbon monoxide, urinary cotinine, and self-report of cigarettes smoked per day. However, Items 5 (smoke in the first hours) and 6 (smoke if ill) failed to obtain a significant correlation with biological biomarkers. DISCUSSION: Although the FTND showed an adequate construct validity, the results suggest that its convergent and predictive validity is limited; therefore, it might not be suitable for the Mexican population. More studies in other populations are needed to establish the generalizability of these findings.

Effect of substance use on condom use in the Theory of Planned Behavior: Analysis of differential item functioning / Efecto del consumo de sustancias en la Teoría de la Conducta Planeada en Uso de Condón: Análisis del funcionamiento diferencial de los ítems

Abstract Introduction. Substance use is one of the factors associated with lower condom use in young adults, which increases the likelihood of HIV infection. The Theory of Planned Behavior (TPB) is one of the most useful models for explaining this phenomenon since it considers the aim of engaging in a behavior based on attitudes, subjective norms and self-efficacy. Objective. To develop a questionnaire and to evaluate the Differential Item Functioning (DIF) caused by substance use in TPB indicators, using the Multiple Indicators Multiple Causes Analysis (MIMIC). Method. The study was conducted in two phases with Mexico City college students age 18 to 25. Results. Adequate goodness of fit was obtained in all three models of the TPB: attitudes χ2S-B(2) = 3.902, p < .001; CFIs = .999; TLIs = .996; RMSEAs = .037, 90% CI ≤ .001-.095; subjective norms χ2S-B(7) = 9.103, p < .245; CFIs = .999; TLIs = .998; RMSEAs = .022, 90% CI ≤ .001-.056; and self-efficacy χ2S-B(25) = 65.115, p < .001; CFIs = .982; TLIs = .974; RMSEAs = .050, 90% CI = .036-.066; in one item in attitudes and two items in subjective norms a DIF effect was observed, while no item proved significant regarding self-efficacy. Discussion and conclusion. There is little evidence in the detection of DIF due to substance use in TPB indicators in condom use, and this is the first study to conduct this type of analysis. Items presenting DIF open the door to future research due to the importance of assessing how the indicator behaves with a population displaying a particular trait.

Resumen Introducción. El consumo de sustancias es uno de los factores asociados a un menor uso de condón en jóvenes adultos, lo cual aumenta la probabilidad de contagio de VIH. La Teoría de la Conducta Planeada (TCP) es uno de los modelos más útiles para explicar este fenómeno ya que considera la intención de llevar a cabo una conducta basándose en actitudes, normas subjetivas y autoeficacia. Objetivo. Desarrollar un cuestionario y evaluar el Funcionamiento Diferencial de los Ítems (DIF) ocasionado por el consumo de sustancias en los indicadores de la TCP, utilizando el análisis Múltiples Ítems Múltiples Causas (MIMIC). Método. El estudio se llevó a cabo en dos etapas con estudiantes universitarios de 18 a 25 años de la Ciudad de México. Resultados. Se obtuvo una adecuada bondad de ajuste en los tres modelos de la TCP: actitudes χ2S-B(2) = 3.902, p < .001; CFIs = .999; TLIs = .996; RMSEAs = .037, 90% IC ≤ .001-.095; normas subjetivas χ2S-B(7) = 9.103; p < .245; CFIs = .999; TLIs = .998; RMSEAs = .022, 90% IC ≤ .001-.056; y autoeficacia χ2S-B(25) = 65.115; p < .001; CFIs = .982; TLIs = .974; RMSEAs = .050, 90% IC = .036-.066; un ítem en actitudes y 2 ítems en normas subjetivas se observó un efecto DIF, y en autoeficacia ningún ítem salió significativo. Discusión y conclusión. Existe poca evidencia en la detección de DIF por uso de sustancias en los indicadores de la TCP en uso de condón, siendo éste el primer estudio que lleva a cabo este tipo de análisis. Los ítems que presenten DIF abren la puerta a futuras investigaciones, debido a la importancia de evaluar cómo se comporta el indicador con una población que tenga un rasgo en particular.

Latent class profile of psychiatric symptoms and treatment utilization in a sample of patients with co-occurring disorders.

OBJECTIVE: To identify symptom-based subgroups within a sample of patients with co-occurring disorders (CODs) and to analyze intersubgroup differences in mental health services utilization. METHODS: Two hundred and fifteen patients with COD from an addiction clinic completed the Symptom Checklist 90-Revised. Subgroups were determined using latent class profile analysis. Services utilization data were collected from electronic records during a 3-year span. RESULTS: The five-class model obtained the best fit (Bayesian information criteria [BIC] = 3,546.95; adjusted BIC = 3,363.14; bootstrapped likelihood ratio test p < 0.0001). Differences between classes were quantitative, and groups were labeled according to severity: mild (26%), mild-moderate (28.8%), moderate (18.6%), moderate-severe (17.2%), and severe (9.3%). A significant time by class interaction was obtained (chi-square [χ2[15]] = 30.05, p = 0.012); mild (χ2[1] = 243.90, p < 0.05), mild-moderate (χ2[1] = 198.03, p < 0.05), and moderate (χ2[1] = 526.77, p < 0.05) classes displayed significantly higher treatment utilization. CONCLUSION: The classes with more symptom severity (moderate-severe and severe) displayed lower utilization of services across time when compared to participants belonging to less severe groups. However, as pairwise differences in treatment utilization between classes were not significant between every subgroup, future studies should determine whether subgroup membership predicts other treatment outcomes.

Co-Occurring Disorders: A Challenge for Mexican Community-Based Residential Care Facilities for Substance Use.

OBJECTIVE: In Mexico, specialized treatment services for people with co-occurring disorders are limited within public health services, while private options are deemed too costly. More than 2,000 community-based residential care facilities have risen as an alternative and are the main source of treatment for individuals with substance use disorders; however, suboptimal practices within such facilities are common. Information on the clinical characteristics of patients receiving care in these facilities is scarce and capacity to provide high-quality care for co-occurring disorders is unknown. The aims of this study were to examine the prevalence of co-occurring disorders in patients receiving treatment for substance use in these community-based residential centers and to assess whether the presence of co-occurring disorders is associated with higher severity of substance use, psychiatric symptomatology, and other health risks. METHODS: This study was conducted with 601 patients receiving treatment for substance use disorders at 30 facilities located in five Mexican states, recruited in 2013 and 2014. Patients were assessed with self-report measures on substance use, service utilization, suicidality, HIV risk behaviors, psychiatric symptomatology, and psychiatric disorder diagnostic criteria. RESULTS: The prevalence of any co-occurring disorder in this sample was 62.6%. Antisocial personality disorder was the most prevalent (43.8%), followed by major depressive disorder (30.9%). The presence of a co-occurring disorder was associated with higher severity of psychiatric symptoms (aB = .496, SE = .050, p < .05); more days of substance use (aB = .219, SE = .019, p < .05); current suicidal ideation (aOR = 5.07, 95% CI [2.58, 11.17]; p < .05), plans (aOR = 5.17 95% CI [2.44, 12.73]; p < .05), and attempts (aOR = 6.43 95% CI [1.83, 40.78]; p < .05); more sexual risk behaviors; and more contact with professional services (aOR = 1.77, 95% CI [1.26, 2.49], p < .05). CONCLUSIONS: Co-occurring disorders are highly prevalent in community-based residential centers in Mexico and are associated with significantly increased probability of other health risks. This highlights the need to develop care standards for this population and the importance of clinical research in these settings.