"Social support and stressful life events: risk factors for antenatal depression in nulliparous and multiparous women".

Nulliparous (pregnant women who are giving birth for the first time) and multiparous (women who have multiple children) may have different concerns, which may be associated with risk of antenatal depression. This study aims to examine the role of social support and stressful life events as risk factors for antenatal depression in nulliparous and multiparous women. The sample included 1,524 pregnant women recruited from an obstetrics setting at the end of the first trimester of pregnancy from two Spanish tertiary-care public hospitals. The sample completed the Patient Health Questionnaire (PHQ-9), and the "social support" and "stressful life events" subscales of the Postpartum Depression Predictor Inventory-Revised (PDPI-R). Nulliparous women reported a lower prevalence of depressive symptoms (15.6 percent) compared to multiparous mothers (20.1 percent). In both groups, marriage/partner problems (NP: ß = 0.178, p < .01 vs MP: ß = 0.164, p < .01) and a perceived lack of instrumental support from friends (NP: ß = -0.154, p < .01 vs MP: ß = -0.154, p < .01) were significant risk factors for antenatal depression. However, nulliparous women have more risk factors such as unemployment (ß = 0.096, p < .05), job change (ß = 0.127, p < .01), financial problems (ß = 0.145, p < .01) and lack of instrumental support from partner (ß = -0187, p < .01). For multiparous women, moving (ß = 0.080, p < .05) and lack of instrumental support from family (ß = -0.151, p < .01) were risk factors. These results suggest the critical need for screening and designing preventive interventions adapted and taking into consideration parity to provide more effective health care during pregnancy.

Youth screening depression: Validation of the Patient Health Questionnaire-9 (PHQ-9) in a representative sample of adolescents.

BACKGROUND: Depression symptoms and mood disorders constitute one of the major public health challenges among youths. Thus, early prevention and intervention for depression should be a priority. The main goal of the present study was to validate the Patient Health Questionnaire-9 (PHQ-9) scores in a school-based sample of non-clinical adolescents. METHOD: Stratified random sampling was conducted. Participants were 2235 students (M = 14.49, SD =1.76, range= 12-18 years), 52.9 % were female, from 34 secondary schools in Spain. Several previously validated self-reported questionnaires of mental health and psychopathology were administrated. RESULTS: The unidimensional factorial model of the PHQ-9 items showed adequate goodness of fit indices. Strong measurement invariance across gender was found. Omega for the PHQ-9 total score was 0.87. The PHQ-9 total score was positively associated with anxiety symptoms and emotional and behavioral problems, and negatively associated with prosocial behavior and quality of life. CONCLUSIONS: The PHQ-9 is a brief, easy, and reliable tool for assessing self-reported depressive symptoms in both clinical and school settings. PHQ-9 may be used as a screening tool for universal early detection and monitorization of depression symptoms during adolescence.

Profesionales de la Psicología en Contextos Educativos: Una Necesidad Ineludible / Psychology Professionals in Educational Contexts: An Unavoidable Necessity

Los problemas de salud mental y las dificultades de ajuste psicológico entre los adolescentes se erigen como un desafío personal, familiar, educativo y socio-sanitario. Se hace necesario abordar este reto social emergente mediante el estudio y la implementación de estrategias de promoción del bienestar psicológico y prevención de los problemas de salud mental en contextos educativos. El objetivo del presente trabajo es poner de manifiesto, a la luz de los datos epidemiológicos derivados del proyecto PSICE (Psicología Basada en la Evidencia en Contextos Educativos), la importancia de abordar la salud mental en entornos educativos. En primer lugar, se realiza una introducción al estudio del comportamiento humano y los problemas de ajuste psicológico. En segundo lugar, se aborda la importancia de los centros educativos como el lugar natural donde promocionar el bienestar psicológico y la salud mental infanto-juvenil. En tercer lugar, se mencionan los resultados de prevalencia derivados del estudio PSICE. Se finaliza con un apartado de recapitulación señalando la ineludible necesidad de promover, proteger y cuidar la salud mental durante la infancia y la adolescencia en los entornos educativos. La promoción del bienestar psicológico y la prevención de los problemas de salud mental en contextos educativos supone la mejor inversión por parte de la sociedad, los gobiernos y las instituciones.(AU)

Mental health problems and psychological adjustment difficulties among young people are emerging as a personal, family, educational, social, and health challenge. It is necessary to address this rising social challenge by studying and implementing strategies to promote emotional well-being and prevent psychological problems in natural contexts. The aim of this work is to highlight, based on the epidemiological data derived from the PSICE (Evidence-based Psychology in Educational Contexts) project, the importance of addressing mental health in school settings. Firstly, an introduction to the study of human behavior and psychological adjustment problems is presented. Secondly, the importance of schools as the natural place to promote the psychological well-being and mental health of children and adolescents is discussed. Thirdly, the prevalence results derived from the PSICE study are mentioned. To conclude, a summary section underscores the imperative need to promote, protect, and care for mental health during childhood and adolescence in educational settings. The promotion of psychological well-being and the prevention of mental health problems in educational contexts is the best investment on the part of societies, governments, and institutions.(AU)

Dual alcohol and cannabis use in male and female adolescents: Relationships with family variables.

Family dynamics influence adolescents' use of alcohol and other substances, such as cannabis. The aim of this study was to understand the relationship between family variables and alcohol use, dual use of alcohol and cannabis, and non-use in adolescents according to sex. A cross-sectional study was conducted. The sample comprised 879 adolescents (56.4 % boys; M(SD)age = 14.25 (1.88) years). Multinomial regression analysis showed that for boys, the presence of family conflict increased the likelihood of being an alcohol (OR = 1.19) and dual (OR = 1.23) user rather than a non-user. For girls, communication reduced the probability of being an alcohol user (OR = 0.88), and the presence of consequences for breaking rules reduced the probability of being a dual user rather than a non-user (OR = 0.83) or an alcohol user (OR = 0.84). These findings highlight the importance of family prevention of adolescents' substance use, bearing in mind the participants' sex.

PSICE Project Protocol: Evaluation of the Unified Protocol for Transdiagnostic Treatment for Adolescents with Emotional Symptoms in School Settings / El protocolo del Proyecto PSICE: evaluación del protocolo unificado transdiagnóstico para adolescentes con síntomas emocionales en contextos educativos

Background: The aim of the PSICE (Evidence-based Psychology in Educational Contexts) Project is to examine the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Adolescents (UP-A) with symptoms of anxiety and depression in school settings. The goal is to prevent emotional problems and to improve adolescents’ socioemotional adjustment, learning processes, and academic performance. Method: A randomized controlled trial with two groups will be performed: active control (progressive relaxation training) and experimental (UP-A). After screening, participants with subclinical emotional symptomatology will be selected for pre- and post-test evaluation and follow-up at 6, 12, and 18 months. Results: The impact of different indicators at behavioral, cognitive, affective, social and academic functioning levels will be analyzed, as well as their effects in the short, medium and long term. Conclusions: Examining the effectiveness of the UP-A in the Spanish educational context will, among other things, provide data for informed decision-making in the field of educational psychology. In addition, it will ensure that such interventions, using standardized protocols, are accessible to a large population at such an important stage of human development as adolescence. The PSICE project will provide leadership and guidance on the importance of psychology in schools. (AU)

Antecedentes: El objetivo del Proyecto PSICE (Psicología basada en la evidencia en contextos educativos) es examinar la efectividad del protocolo unificado para el tratamiento transdiagnóstico de síntomas de ansiedad y depresión en adolescentes (UP-A) en contextos educativos. El objetivo es prevenir los problemas emocionales, así como mejorar el ajuste socioemocional, los procesos de aprendizaje y el rendimiento académico de los adolescentes. Método: Se implementa mediante un ensayo controlado aleatorizado con dos grupos: control activo (entrenamiento en relajación progresiva) y experimental (UP-A). Tras un cribado, se seleccionarán participantes con síntomas emocionales subclínicos a los que se realizará evaluación pretest, postest y seguimiento a los 6, 12 y 18 meses. Resultados: Se analizará el impacto de diferentes indicadores a nivel comportamental, cognitivo, afectivo y de funcionamiento social y académico, así como sus efectos a corto, medio y largo plazo. Conclusiones: Examinar la efectividad del UP-A en el contexto educativo español permitirá, entre otras cuestiones, disponer de datos en el campo de la psicología educativa de cara a la toma de decisiones informadas, además de garantizar que dichas intervenciones sean accesibles, empleando protocolos estandarizados, para un gran conjunto de la población y en una etapa del desarrollo humano tan relevante como es la adolescencia. El proyecto PSICE proporcionará liderazgo y orientación sobre la importancia de la Psicología en el contexto educativo. (AU)

Protocol for a Trial Assessing the Efficacy of a Universal School-Based Prevention Program for Addictive Behaviors.

BACKGROUND: "Juego de Llaves" [ Set of Keys ] is a universal school-based prevention program for adolescents aged 12-15. It is aimed at reducing drug use and other addictive behaviors. This paper describes the full protocol for the evaluation design, instruments, randomization procedure, follow-ups, and primary outcomes. METHOD: Non-Randomized Control Cluster Trial in a set of Spanish secondary schools, with follow-ups at 12-, 24- and 36-months. Participants will be allocated to an experimental or control group. Using a digital application designed for the study, a battery of instruments will be used to assess addictive behaviors, sociodemographic variables, school climate and other transdiagnostic psychological variables. RESULTS: A pilot test will be carried out to test the implementation protocol and to calculate the sample size needed for outcome evaluation. After implementing the program, longitudinal statistical approaches will be used to report intervention efficacy and potential moderators and mediators. CONCLUSIONS: There is a lack of assessments on the effectiveness of school prevention programs, and this paper is expected to improve monitoring and ongoing evaluation in prevention.

Protocol for a Trial Assessing the Efficacy of a Universal School-Based Prevention Program for Addictive Behaviors / Protocolo de un Ensayo Para Evaluar la Eficacia de un Programa Escolar dePrevención Universal de Conductas Adictivas

Background: “Juego de Llaves” [Set of Keys] is a universal school-based prevention program for adolescents aged 12-15. It is aimed at reducing drug use and other addictive behaviors. This paper describes the full protocol for the evaluation design, instruments, randomization procedure, follow-ups, and primary outcomes. Method: Non-Randomized Control Cluster Trial in a set of Spanish secondary schools, with follow-ups at 12-, 24- and 36-months. Participants will be allocated to an experimental or control group. Using a digital application designed for the study, a battery of instruments will be used to assess addictive behaviors, sociodemographic variables, school climate and other transdiagnostic psychological variables. Results: A pilot test will be carried out to test the implementation protocol and to calculate the sample size needed for outcome evaluation. After implementing the program, longitudinal statistical approaches will be used to report intervention efficacy and potential moderators and mediators. Conclusions: There is a lack of assessments on the effectiveness of school prevention programs, and this paper is expected to improve monitoring and ongoing evaluation in prevention.(AU)

Introducción: “Juego de Llaves” es un programa de prevención escolar universal para adolescentes entre 12 y 15 años. Tiene como objetivo reducir el uso de drogas y la implicación en otras conductas adictivas. Se describe un protocolo completo del diseño de evaluación, los instrumentos, el procedimiento de aleatorización, los seguimientos y las variables de resultado. Método: ensayo por conglomerados no aleatorizado en centros escolares españoles de educación secundaria obligatoria con seguimientos a los 12, 24, y 36 meses. Los participantes serán asignados a un grupo experimental o control. A través de una app específicamente diseñada para este estudio, se utilizará una batería de instrumentos de evaluación para conductas adictivas, variables sociodemográficas, clima escolar y otras variables psicológicas transdiagnósticas. Resultados: Se realizará una aplicación piloto para probar el protocolo diseñado y calcular el tamaño muestral necesario para la evaluación de resultados. Posteriormente, se aplicará el programa y se realizarán análisis de datos de tipo longitudinal para informar de la eficacia de la intervención y de los posibles moderadores y mediadores. Conclusiones: Existen pocas evaluaciones de la efectividad de los programas de prevención escolar y se espera que este artículo contribuya, como modelo, a fomentar la cultura de la evaluación.(AU)

Conducta suicida en adolescentes a revisión: creando esperanza a travésde la acción / Suicidal behavior in adolescents under review: Fostering hope through action

La conducta suicida es un problema socio-sanitario de primer orden. El objetivo general de este trabajo es realizaruna revisión narrativa de la conducta suicida en adolescentes. Básicamente, se trata de introducir este tópico a losprofesionales de la Psicología y a la sociedad en su conjunto de cara a su formación, información, sensibilizacióny concienciación. Con este fin, en primer lugar, se realiza una delimitación conceptual de la conducta suicida. Acontinuación, se abordan cuestiones epidemiológicas. En tercer lugar, se introducen los modelos psicológicos másrelevantes. En cuarto lugar, se abordan los factores de riesgo y protección de la conducta suicida en adolescentes.Seguidamente, se explican algunas de las herramientas de evaluación disponibles en español para este sectorde la población. Posteriormente, se comentan los principales modelos de prevención focalizando el discurso enla importancia de los entornos educativos. También se introducen los tratamientos psicológicos empíricamenteapoyados para el abordaje de la conducta suicida en adolescentes. Finalmente, se comentan líneas de investigaciónfuturas y se realiza una breve recapitulación a modo de conclusión.(AU)

Suicide is a serious public health problem. The main goal of this paper is to carry out a narrative review of suicidalbehavior in adolescents. Basically, the aim is twofold: to provide updated information and to introduce mental healthprofessionals and society to this topic for their training and knowledge. To this end, first, a conceptual delimitationof suicidal behavior is produced. Second, epidemiological issues are addressed. Third, psychological models ofsuicidal behavior are presented, along with the possible explanations underlying this phenomenon. Fourth, the riskand protective factors for suicidal behavior are mentioned. Next, assessment tools for this sector of the populationare introduced. Subsequently, prevention strategies are discussed, focusing on the importance of educationalenvironments. Empirically supported psychological treatments for dealing with suicidal behavior are also proposed.Finally, future lines of research are discussed, and a brief summary is made.(AU)

Mindfulness on Daily Life Coping in People Experiencing Psychosis: A Randomized Controlled Trial

ResumenAntecedentes/Objetivo: La Terapia Cognitivo-Conductual para la psicosis (TCCp) es un trata-miento eficaz mediado por el afrontamiento del estrés. Las Intervenciones Basadas en Min-dfulness (IBM) han demostrado efectos positivos en psicosis por lo que combinarlas con TCCp podría mejorar el afrontamiento. El estudio compara el efecto de la TCCp con TCCp+IBM sobre el afrontamiento en psicosis. Método: Cincuenta y seis participantes con psicosis fue-ron reclutados y asignados aleatoriamente a TCCp o TCCp+IBM. Los protocolos fueron sincro-nizados con las rutinas de los participantes. Las medidas incluyeron la entrevista PANSS y el inventario COPE. Los datos se analizaron con ANOVA de medidas repetidas y se calculó el RCI. Resultados: No hubo diferencias estadísticamente significativas entre grupos en el pre-trata-miento, sí las hubo en la interacción Tratamiento x Tiempo en Desconexión mental (F = 5,65, p = 0,021, η2 = 0,102), Aceptación (F = 7,69, p = 0,008, η2 = 0,133) y Supresión de distractores (F = 4,62, p = 0,037, η2 = 0,085). Conclusiones: La IBM fomenta estilos de afrontamiento en psicosis que la TCCp en solitario no. TCCp+IBM mejoró la aceptación del estresor y redujo la desconexión mental. La intervención es eficaz y viable en un contexto asistencial.

AbstractBackground/Objective: Cognitive Behavior Therapy for psychosis (CBTp) is a recommended treatment for psychoses whose effect is mediated by coping. Mindfulness (MBI) have shown positive effects in psychosis. This study examines the hypothesis that combining CBTp+MBI could improve coping with day-to-day life in psychosis better than CBTp alone in people attending a public community rehabilitation center. Method: Fifty-six outpatients were recruited and randomly allocated either to CBTp or CBTp+MBI. Measures Halabícomprised PANSS interview and COPE Inventory. Data were analyzed using a repeated measures ANOVA and RCI calculation. Results: There were no statistical differences between groups at pre-treatment. Significant statistical differences were found for the interaction Treatment x Time in Mental disengagement (F = 5.65, p = .021, η2 = .102), Acceptance (F = 7.69, p = .008, η2 = .133), and Suppressing competing activities (F = 4.62, p = .037, η2 = .085). Conclusions: MBI promotes specific coping styles in people who experience psychosis that otherwise are not improved with CBTp. Only the MBI group improved acceptance of the presence of the stressor and reduced mental disengagement from the context. The intervention is feasible and effective for public healthcare settings.

Quality of Life and the International Convention on the Rights of Persons With Disabilities: Consensus Indicators for Assessment.

BACKGROUND: The quality of life construct provides an ideal conceptual framework for translating such abstract concepts as self-determination, equity, accessibility, and inclusion. Through consultation with expert raters, we sought to develop and validate a bank of indicators and items, based on the quality of life conceptual framework, to be used as a means of evaluating and implementing the Articles of the Convention on the Rights of Persons with Disabilities (CRPD). METHOD: Thirty-two experts in the field of intellectual and developmental disabilities participated, rating the suitability, importance, and clarity of a bank of 296 items, as well as the relevance of controlling for 70 sociodemographic variables. RESULTS: After qualitative and quantitative analysis of the data, the final selection comprised 60 sociodemographic variables and 153 items that scored highly on all criteria and produced an excellent level of agreement between the experts. CONCLUSIONS: This bank of items and set of sociodemographic variables constitute the pilot version of a CRPD assessment and monitoring instrument with sufficient evidence of content validity, which may be useful in developing evidence-based practices and in detecting rights violations.

Atención plena (mindfulness): por qué es posible que funcione y por qué es seguro que triunfe / [Mindfulness: Why It Might Work and Why It's Sure to Succeed]

La atención plena (mindfulness) ha desbordado el ámbito clínico y comienza a aplicarse con entusiasmo en la escuela, el deporte o la empresa. La sospecha de que estamos ante una intervención que, aunque probablemente eficaz, tenga un tamaño de efecto pequeño, lo que obliga a realizar investigaciones con gran rigor. Así, solo conociendo los procesos psicológicos implicados en la atención plena podremos tener una visión más realista de su utilidad ante los diferentes problemas. Ante esto, ¿cómo explicar el extraordinario éxito que está obteniendo en Occidente la atención plena, tanto a nivel académico como mundano? Se presentan tres principios conductuales que se practican durante el entrenamiento en atención plena y se denuncia su uso ideológico, que aparece enmarcado, no en la mística existencial ni en el conductismo contextual, sino en la psicología positiva y su agenda neoliberal.

Mindfulness has gone beyond clinical applications and is beginning to be enthusiastically applied in schools, sport, and business settings. It seems to be a type of intervention that, while probably effective, has a small effect size, which calls for rigorous research. Understanding the psychological processes involved in mindfulness is essential in order to achieve a more realistic picture of its usefulness for some behavioral disorders. How can we explain the extraordinary success of mindfulness in western societies, both in academia and in popular culture? We present three behavioral principles and ideological reasons for applying mindfulness. Nowadays, mindfulness is framed not by mystical existentialism or contextual behaviorism, but by positive psychology and its neoliberal agenda.

Mindfulness on Daily Life Coping in People Experiencing Psychosis: A Randomized Controlled Trial.

Background/Objective: Cognitive Behavior Therapy for psychosis (CBTp) is a recommended treatment for psychoses whose effect is mediated by coping. Mindfulness (MBI) have shown positive effects in psychosis. This study examines the hypothesis that combining CBTp+MBI could improve coping with day-to-day life in psychosis better than CBTp alone in people attending a public community rehabilitation center. Method: Fifty-six outpatients were recruited and randomly allocated either to CBTp or CBTp+MBI. Measures comprised PANSS interview and COPE Inventory. Data were analyzed using a repeated measures ANOVA and RCI calculation. Results: There were no statistical differences between groups at pre-treatment. Significant statistical differences were found for the interaction Treatment x Time in Mental disengagement (F = 5.65, p = .021, η2 = .102), Acceptance (F = 7.69, p = .008, η2 = .133), and Suppressing competing activities (F = 4.62, p = .037, η2 = .085). Conclusions: MBI promotes specific coping styles in people who experience psychosis that otherwise are not improved with CBTp. Only the MBI group improved acceptance of the presence of the stressor and reduced mental disengagement from the context. The intervention is feasible and effective for public healthcare settings.

Antecedentes/Objetivo: La Terapia Cognitivo-Conductual para la psicosis (TCCp) es un tratamiento eficaz mediado por el afrontamiento del estrés. Las Intervenciones Basadas en Mindfulness (IBM) han demostrado efectos positivos en psicosis por lo que combinarlas con TCCp podría mejorar el afrontamiento. El estudio compara el efecto de la TCCp con TCCp+IBM sobre el afrontamiento en psicosis. Método: Cincuenta y seis participantes con psicosis fueron reclutados y asignados aleatoriamente a TCCp o TCCp+IBM. Los protocolos fueron sincronizados con las rutinas de los participantes. Las medidas incluyeron la entrevista PANSS y el inventario COPE. Los datos se analizaron con ANOVA de medidas repetidas y se calculó el RCI. Resultados: No hubo diferencias estadísticamente significativas entre grupos en el pre-tratamiento, sí las hubo en la interacción Tratamiento x Tiempo en desconexión mental (F = 5,65, p = 0,021, η2 = 0,102), Aceptación (F = 7,69, p = 0,008, η2 = 0,133), y Supresión de distractores (F = 4,62, p = 0,037, η2 = 0,085). Conclusiones: La IBM fomenta estilos de afrontamiento en psicosis que la TCCp en solitario no. TCCp+IBM mejoró la aceptación del estresor y redujo la desconexión mental. La intervención es eficaz y viable en un contexto asistencial.

Risk and Protective Factors in Adolescent Suicidal Behaviour: A Network Analysis.

Given that death by suicide continues to rank among the top three causes of death during adolescence, new psychological models may contribute critical insight towards understanding the complex interactions between risk and protective factors in suicidal behaviour. The main objective of this study was to analyse the psychological network structure of suicidal behaviour and putative risk and protective factors in school-aged adolescents. METHODS: Stratified random cluster sampling was performed. The final sample comprised 1790 students (53.7% female, M = 15.7 years, SD = 1.26). Instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, prosocial behaviour, subjective well-being, self-esteem, depressive symptomatology, academic performance, socio-economic status, school engagement, bullying, and cyberbullying. RESULTS: In the estimated psychological network, the node with the highest strength was depressive symptomatology, and that with the highest expected influence value was bullying. Suicidal behaviour was positively connected to symptoms of depression and behavioural problems. In addition, suicidal behaviour was negatively connected to self-esteem and personal well-being. The results of the stability analysis indicated that the network was accurately estimated. CONCLUSIONS: Suicidal behaviour can be conceptualised as a dynamic, complex system of cognitive, emotional, and affective characteristics. New psychological models allow us to analyse and understand human behaviour from a new perspective, suggesting new forms of conceptualisation, evaluation, intervention, and prevention.

Mindfulness improves theory of mind in people experiencing psychosis: A pilot randomized clinical trial.

Impaired Theory of Mind (ToM) ability is a core feature of psychotic disorders that challenges psychosis treatment. We aimed to explore the effect of a Mindfulness-Based Intervention (MBI) on ToM ability in a randomized clinical trial (RCT). A sample of 36 participants diagnosed with psychotic disorder were recruited from a community center and randomly allocated to Integrated Rehabilitation Treatment (IRT) or IRT+MBI. ToM skills were assessed through the Hinting Test and the Reading the Mind in the Eyes Test (RMET). IRT+MBI scored higher in RMET than IRT at posttreatment. MBI is a promising tool for improving ToM ability in psychosis.

La hora de la evaluación ambulatoria / The time of ambulatory assessment

La evaluación ambulatoria aglutina un conjunto de métodos que permiten evaluar mediante dispositivos móviles, y en múltiples momentos temporales, el comportamiento de las personas en su entorno natural y contexto diario. Permite una evaluación más precisa, dinámica, contextual e ideográfica que los métodos clásicos, abriendo nuevos horizontes con claras implicaciones para el diagnóstico y la intervención psicológica. El objetivo de este trabajo es realizar una introducción a la evaluación ambulatoria. En primer lugar, se realiza una delimitación conceptual y se comentan las cuestiones que viene a solucionar y sus posibles beneficios. En segundo lugar, se exponen aspectos relacionados con la metodología, abordando los diseños, los tipos de datos y un protocolo general de evaluación. En tercer lugar, se comentan algunas de las principales limitaciones, y se exponen las aplicaciones más relevantes. Finalmente, se comentan algunas recomendaciones para la aplicación de este tipo de metodología, y se analizan los retos y perspectivas futuras.(AU)

Ambulatory assessment brings together a set of methods that make it possible to evaluate, through mobile devices, and at multiple moments in time, the behavior of people in their natural environment and daily context. It allows a more precise, dynamic, contextual, and ideographic evaluation than the classical approaches, opening new horizons with clear implications for psychological intervention. The main goal of this paper is to provide an introduction to ambulatory assessment. First, a conceptual delimitation is made and the issues to be solved are discussed, as well as their possible benefits. Second, aspects related to the methodology are exposed, addressing the designs, data types, and a general evaluation protocol. Third, some of the main limitations are discussed, and the most relevant applications are presented. Finally, some recommendations for the application of this type of methodology are discussed, and some challenges and future perspectives are analyzed.(AU)

The Multi-Component Smoking Cessation Support Programme (McSCSP) is effective in patients with severe mental disorder without gender differences. / El programa multicomponente de apoyo para el cese del tabaquismo (McSCSP) es efectivo en pacientes con trastorno mental grave sin diferencias de género.

High prevalence of smoking in people with severe mental disorders (SMD) contributes to their medical morbidity and reduced life expectancy. Despite the evidence of gender differences in smoking cessation, few studies have tested those differences among people with SMD. This is a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to examine gender differences in the efficacy, safety and tolerability of a Multi-Component Smoking Cessation Support Programme (McSCSP). The results showed that there were no significant differences in short- (males 44.9% vs females 57.7%, chi-square = 1.112, p = 0.292) or long-term efficacy (week 24: males 40.8%, females 42.3%, chi-square = 0.016, p = 0.901; week 36: males 36.7%, females 38.5%, chi-square = 0.022, p = 0.883) between gender, neither controlled by diagnosis or treatment. Regarding safety and tolerability, there was significant increase in abdominal perimeter in males [from 105.98 (SD 13.28) to 108.52 (SD 14.01), t = -3.436, p = 0.002)], but not in females. However, there were no significant gender differences in adverse events (constipation, abnormal/vivid dreams, nausea/vomiting or skin rash/redness around patch site). In conclusion, we have demonstrated that is effective and safe to help either male or female patients with stabilized SMD to quit smoking. However, it might be a tendency in females to respond better to varenicline treatment in the short-term. Future research with larger samples is required to more clearly determine whether or not the there are differences, in addition to their reliability and robustness.

La elevada prevalencia del tabaquismo en personas con trastorno mental grave (TMG) contribuye a su morbilidad médica y reduce su esperanza de vida. A pesar de la existencia de diferencias de género en el cese del tabaquismo, pocos estudios han evaluado esas diferencias en personas con TMG. Este es un ensayo multicéntrico de seguimiento prospectivo, no aleatorizado, abierto de 9 meses para examinar las diferencias de género en la eficacia, seguridad y tolerabilidad de un programa multicomponente de apoyo para el cese del tabaquismo (McSCSP). Los resultados mostraron que no hubo diferencias de género significativas en la eficacia a corto (hombres 44,9% vs mujeres 57,7%, chi cuadrado = 1,112, p = ,292) ni a largo plazo (semana 24: hombres 40,8%, mujeres 42,0.3%, chi cuadrado = 0.016, p = ,901; semana 36: hombres 36,7%, mujeres 38,5%, chi cuadrado = 0,022, p = ,883), incluso controlando por diagnóstico o tratamiento.  Con respecto a la seguridad y la tolerabilidad, hubo un aumento significativo en el perímetro abdominal en los hombres [de 105,98 (DT 13,28) a 108,52 (DT 14,01), t = -3,436, p = ,002)], pero no en las mujeres. Sin embargo, no hubo diferencias de género significativas en los eventos adversos (estreñimiento, sueños anormales/vívidos, náuseas/vómitos o erupción cutánea/enrojecimiento alrededor de la zona del parche). En conclusión, hemos demostrado que es efectivo y seguro ayudar a los hombres y mujeres con TMG estabilizados a dejar de fumar.  Sin embargo, podría haber una tendencia en las mujeres a responder mejor al tratamiento con vareniclina a corto plazo. Se requiere investigación futura con muestras más amplias para determinar con más claridad la existencia de diferencias, además de la fiabilidad y robustez.

Quality of Life and the International Convention on the Rights of Persons With Disabilities: Consensus Indicators for Assessment / Calidad de Vida y la Convención Internacional Sobre los Derechos delas Personas con Discapacidad: Indicadores Consensuados Para laEvaluación

Background: The quality of life construct provides an ideal conceptualframework for translating such abstract concepts as self-determination,equity, accessibility, and inclusion. Through consultation with expertraters, we sought to develop and validate a bank of indicators and items,based on the quality of life conceptual framework, to be used as a means ofevaluating and implementing the Articles of the Convention on the Rightsof Persons with Disabilities (CRPD). Method: Thirty-two experts in thefield of intellectual and developmental disabilities participated, ratingthe suitability, importance, and clarity of a bank of 296 items, as well asthe relevance of controlling for 70 sociodemographic variables. Results:After qualitative and quantitative analysis of the data, the final selectioncomprised 60 sociodemographic variables and 153 items that scored highlyon all criteria and produced an excellent level of agreement between theexperts. Conclusions: This bank of items and set of sociodemographicvariables constitute the pilot version of a CRPD assessment and monitoringinstrument with sufficient evidence of content validity, which may be usefulin developing evidence-based practices and in detecting rights violations.

Antecedentes: el constructo de calidad de vida proporcionaun marco conceptual ideal para traducir conceptos abstractos comoautodeterminación, equidad, accesibilidad o inclusión. Mediante una consultaa expertos se pretende desarrollar y validar un banco de indicadores e ítemsbasados en el marco conceptual de la calidad de vida que pueda ser utilizadopara evaluar e implementar los derechos recogidos en la Convención sobre losDerechos de las Personas con Discapacidad (CDPD). Método: participaron32 expertos en el campo de las discapacidades intelectuales y del desarrollocalificando la idoneidad, importancia y claridad de un banco de 296ítems, así como la relevancia de controlar 70 variables sociodemográficas.Resultados: tras el análisis cualitativo y cuantitativo de los datos, se llegóa una solución consensuada de 60 variables sociodemográficas y 153 ítemsque puntuaron alto en todos los criterios y obtuvieron un excelente grado deacuerdo entre los expertos. Conclusiones: este banco de ítems y conjunto devariables sociodemográficas constituye la versión piloto de un instrumentode evaluación y seguimiento de la CDPD con suficientes evidencias devalidez basadas en el contenido, que puede ser útil para desarrollar prácticasbasadas en la evidencia y para detectar violaciones de derechos.

El programa multicomponente de apoyo para el cese del tabaquismo (McSCSP) es efectivo en pacientes con trastorno mental grave sin diferencias de género / The Multi-Component Smoking Cessation Support Programme (McSCSP) is effective in patients with severe mental disorder without gender differences

La elevada prevalencia del tabaquismo en personas con trastorno mentalgrave (TMG) contribuye a su morbilidad médica y reduce su esperanzade vida. A pesar de la existencia de diferencias de género en el cese deltabaquismo, pocos estudios han evaluado esas diferencias en personascon TMG. Este es un ensayo multicéntrico de seguimiento prospectivo,no aleatorizado, abierto de 9 meses para examinar las diferencias de género en la eficacia, seguridad y tolerabilidad de un programa multicomponente de apoyo para el cese del tabaquismo (McSCSP). Los resultadosmostraron que no hubo diferencias de género significativas en la eficaciaa corto (hombres 44,9% vs mujeres 57,7%, chi cuadrado = 1,112, p =,292) ni a largo plazo (semana 24: hombres 40,8%, mujeres 42,0.3%, chicuadrado = 0.016, p = ,901; semana 36: hombres 36,7%, mujeres 38,5%, chi cuadrado = 0,022, p = ,883), incluso controlando por diagnóstico otratamiento. Con respecto a la seguridad y la tolerabilidad, hubo unaumento significativo en el perímetro abdominal en los hombres [de105,98 (DT 13,28) a 108,52 (DT 14,01), t = -3,436, p = ,002)], pero no enlas mujeres. Sin embargo, no hubo diferencias de género significativasen los eventos adversos (estreñimiento, sueños anormales/vívidos, náuseas/vómitos o erupción cutánea/enrojecimiento alrededor de la zonadel parche). En conclusión, hemos demostrado que es efectivo y seguroayudar a los hombres y mujeres con TMG estabilizados a dejar de fumar.Sin embargo, podría haber una tendencia en las mujeres a respondermejor al tratamiento con vareniclina a corto plazo. Se requiere investigación futura con muestras más amplias para determinar con más claridadla existencia de diferencias, además de la fiabilidad y robustez. (AU)

High prevalence of smoking in people with severe mental disorders(SMD) contributes to their medical morbidity and reduced lifeexpectancy. Despite the evidence of gender differences in smokingcessation, few studies have tested those differences among peoplewith SMD. This is a non-randomized, open-label, prospective,9-month follow-up multicentre trial to examine gender differencesin the efficacy, safety and tolerability of a Multi-Component SmokingCessation Support Programme (McSCSP). The results showed thatthere were no significant differences in short- (males 44.9% vs females57.7%, chi-square = 1.112, p = 0.292) or long-term efficacy (week 24:males 40.8%, females 42.3%, chi-square = 0.016, p = 0.901; week 36:males 36.7%, females 38.5%, chi-square = 0.022, p = 0.883) between gender, neither controlled by diagnosis or treatment. Regarding safetyand tolerability, there was significant increase in abdominal perimeterin males [from 105.98 (SD 13.28) to 108.52 (SD 14.01), t = -3.436,p = 0.002)], but not in females. However, there were no significantgender differences in adverse events (constipation, abnormal/vividdreams, nausea/vomiting or skin rash/redness around patch site). Inconclusion, we have demonstrated that is effective and safe to helpeither male or female patients with stabilized SMD to quit smoking.However, it might be a tendency in females to respond better tovarenicline treatment in the short-term. Future research with largersamples is required to more clearly determine whether or not thethere are differences, in addition to their reliability and robustness. (AU)

Conducta suicida y periodo perinatal: entre el tabú y la incomprensión / Suicidal behavior and the perinatal period: taboo and is understanding

El suicidio es la primera causa de muerte de las mujeres durante el periodo perinatal, que comprende desde el embarazo hasta un año después del parto. Hay apoyo empírico suficiente para afirmar que las mujeres embarazadas tienen mayor ideación suicida que su correspondiente grupo de comparación en la población general. A pesar de estos datos, este tipo de problemas no suelen ni prevenirse ni reconocerse adecuadamente. Sin embargo, si las disonancias y dilemas asociados a la maternidad, así como los problemas de salud mental, no se previenen o se abordan adecuadamente, éstos pueden afectar al bienestar de las mujeres, al de sus hijos y al de otros miembros de la familia. Se exponen los factores implicados en la conducta suicida de este grupo de mujeres, así como algunas directrices generales de actuación. Se reclama la necesaria puesta en marcha de estrategias de prevención. (AU)

Suicide is the leading cause of death for women during the perinatal period, which commences in pregnancy and finishes one year after delivery. Empirical evidence from previous studies shows that pregnant women have greater suicidal ideation than their comparison group in the general population. However, there is a tendency for these problems to be neither prevented nor adequately recognized. Nevertheless, if the dissonancesand dilemmas associated with motherhood, as well as mental health problems, are not prevented or adequately addressed, they can affect thewell-being of women, their children, and other family members. Risk and protective factors for suicidal behavior in this group of women are discussed, as well as general principles of action. The need for the implementation of prevention strategies is highlighted. (AU)

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.