Psychometric properties of the Smartphone Addiction Inventory - Short Form (SPAI-SF) in Brazilian adolescents.

The Smartphone Addiction Inventory - Short Form (SPAI-SF) is shorter version (10 items) of the original version of SPAI (26 items). In this study, we aimed to: (i) adapt and test the internal structure of the SPAI-SF, using confirmatory factor analysis (CFA), multigroup confirmatory factor analysis (MGCFA), and network analysis; (ii) analyze the internal consistency, temporal stability, criterion, predictive and construct validities of the SPAI-SF. A total of 392 adolescents (M = 12.76; SD = 1.00) completed the following measures: demographic questionnaire, SPAI-SF, Smartphone Addiction Scale - Short Version (SAS-SV), and the Internet Addiction Test (IAT). The CFA showed good fit indices with the original four factors, and MGCFA indicated measurement invariance for gender. Network analysis provided an understanding of the core symptoms of problematic smartphone use (PSU) for both boys and girls. The intraclass correlation coefficient (ICC) was 0.865 (95% CI: 0.841 - 0.887) and indicated a robust temporal stability. The instrument demonstrated acceptable overall reliability measured by Cronbach's alpha and McDonald's Omega criteria (α = 0.722; ω = 0.725) and did not show floor and ceiling effects. The scale's significant correlations demonstrated convergent and criterion validities of the SPAI-SF with SAS-SV, IAT, and Smartphone usage data. The SPAI-SF is a reliable instrument to detect PSU in adolescents.

Substance Use Disorder Among Bereaved Individuals: A Systematic Review / Transtorno por Uso de Substâncias entre Pessoas em Luto: Uma Revisão Sistemática / Trastorno por Uso de Sustancias entre Personas en Duelo: Una Revisión Sistemática

Abstract Substance use disorder (SUD) is related to several psychosocial factors, such as grief. This study aimed to find an association of SUD among bereaved individuals based on a systematic review. The research was registered in the PROSPERO platform and the following databases were used: MEDLINE, PsycNET, LILACS, PubMed, EMBASE, CINAHL, and SciELO. The Rayyan software tool was used and this study was performed under the guidelines of the PRISMA protocol. In total, 17 articles were eligible, of which more than 88% showed an association between SUD and the grieving process and almost 60% associated grief and drug use with depression and anxiety. Alcohol was the most used substance. These findings may contribute to future studies on grief and substance use and underlie the elaboration of preventive actions for drug use.

Resumo O Transtorno por Uso de Substâncias (TUS) relaciona-se a vários fatores psicossociais; como o luto. Este trabalho teve por objetivo identificar uma associação do TUS entre pessoas em processo de luto, a partir de uma revisão sistemática. A pesquisa foi registrada na plataforma PROSPERO e foram utilizadas as seguintes bases de dados: MEDLINE, PSYCNET, LILACS, PubMed, EMBASE, CINAHL e SciELO. Foi utilizado o software Rayyan e as etapas do protocolo PRISMA foram seguidas. Foram elegíveis 17 artigos, dos quais mais de 88% apresentaram uma associação entre o TUS e o processo de luto, e quase 60% associaram o luto e o consumo de drogas à depressão e à ansiedade. A substância mais consumida foi o álcool. Estes achados podem contribuir para futuras pesquisas na área de luto e uso de substâncias, bem como subsidiar a formulação de ações preventivas ao uso de drogas.

Resumen El Trastorno por Uso de Sustancias (TUS) está relacionado con varios factores psicosociales, como el duelo. A partir de una revisión sistemática, este trabajo se propuso identificar una asociación del TUS en personas en proceso de duelo. La investigación se registró en la plataforma PROSPERO, y se utilizaron las siguientes bases de datos: MEDLINE, PSYCNET, LILACS, PubMed, EMBASE, CINAHL y SciELO. Se utilizó el software Rayyan, y se siguieron los pasos del protocolo PRISMA. Diecisiete artículos fueron elegibles, de los cuales más del 88% mostraron una asociación entre el TUS y el proceso de duelo, y casi el 60% asociaron el duelo y el consumo de drogas con la depresión y la ansiedad. La sustancia más consumida fue el alcohol. Estos resultados pueden contribuir a futuras investigaciones sobre el duelo y el consumo de sustancias, además de subvencionar la formulación de acciones preventivas para el consumo de drogas.

The Effect of Psychosocial Interventions for Reducing Co-occurring Symptoms of Depression and Anxiety in Individuals with Problematic Internet Use: A Systematic Review and Meta-analysis.

The objective of this study is to conduct a systematic review and meta-analysis to assess the effect of psychosocial interventions in reducing problematic Internet use (PIU), anxiety, and depression symptoms in a sample of people. This review was registered on the PROSPERO database (CRD42020181912) and a total of 15 studies were included. Analyses of the effect of the interventions were conducted based on the standardized mean difference of the studied outcomes (PIU, anxiety, and depression). Most studies reported a positive effect of psychosocial interventions on reducing symptoms of PIU, depression, and anxiety among people with PIU. However, only one detected a robust effect in reducing symptoms of anxiety. For depression, this effect was more modest, and there was no difference between the different modalities of psychosocial interventions. The results suggest that psychosocial interventions are effective in reducing both symptoms of PIU and co-occurring symptoms of depression and anxiety in individuals with PIU. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-022-00846-6.

Association between quality of life and risk behaviors in Brazilian adolescents: An exploratory study.

We evaluated the association between risk behaviors and quality of life in 1,081 adolescents classified into the risk behavior (RB) or the non-risk behavior (nRB) group. The data were analyzed with logistic regression models, analysis of variance, and network analysis. The nRB group had higher quality-of-life scores, and having a religion (OR = .42) and better quality of life (OR = .95) significantly reduced the odds of risk behaviors. The network analysis identified that religion, gender, and type of school showed the best centrality and connectivity indices. These data showed a negative association between risk behaviors and lower quality-of-life levels.

The cultural adaptation and psychometric properties of the Selfitis Behavior Scale: cross-sectional study in Brazilian adolescents: Brazilian version of the Selfitis Behavior Scale / A adaptación cultural y propiedades psicométricas de la Escala de Comportamiento Selfitis: estudio transversal en adolescentes brasileños: Versión brasileña de la Escala de Comportamiento deSelfitis / A Adaptação cultural e propriedades psicométricas da Escala de Comportamento de Selfitis: estudo transversal em adolescentes brasileiros: Versão brasileira da Escala de comportamento de Selfitis

Objective: to translate, adapt, and identify the psychometric properties of the Selfitis Behavior Scale (SBS). Methods: online study conducted with 261 Brazilian adolescents. The translation and cross-cultural adaptation process followed international guidelines, resulting in an adequate scale with face, content and construct validity. Results: The five factors explained 78.2% of the total variance. Confirmatory factor analysis (structural equation model for latent variables) showed an adequate fit of the five-factor model with χ2= 2.42 p=0.001, GFI=0.92, AGFI= 0.89, NNFI= 0.92, TLI= 0.96, CFI= 0.93, RMSEA= 0.041. All factor loadings were statistically different from zero (0; t >1.96, p<0.05). The total internal consistency value by Cronbach's alpha and McDonald's omega was above 0.80 and the internal consistencies of each factor were above 0.79. Conclusion: This is the first Brazilian study to evaluate the psychometric properties of a selfie scale. The SBS proved to be a reliable and valid instrument to assess selfie behavior.

Objetivo: traducir, adaptar e identificar las propiedades psicométricas de la Escala de Comportamiento de Autolisis (SBS). Métodos: estudio online realizado con 261 adolescentes brasileños. El proceso de traducción y adaptación transcultural siguió las directrices internacionales, dando como resultado una escala adecuada con validez facial, de contenido y de constructo. Resultados: Los cinco factores explicaron el 78,2% de la varianza total. El análisis factorial confirmatorio (modelo de ecuaciones estructurales para las variables latentes) mostró un ajuste adecuado del modelo de cinco factores con χ2= 2,42 p=0,001, GFI=0,92, AGFI= 0,89, NNFI= 0,92, TLI= 0,96, CFI= 0,93, RMSEA= 0,041. Todas las cargas factoriales fueron estadísticamente diferentes de cero (0; t > 1,96, p<0,05). El valor total de la consistencia interna mediante el alfa de Cronbach y el omega de McDonald resultó ser superior a 0,80 y las consistencias internas de cada factor fueron superiores a 0,79. Conclusión: Este es el primer estudio brasileño que evalúa las propiedades psicométricas de una escala de selfie. El SBS demostró ser un instrumento fiable y válido para evaluar el comportamiento selfie.

Objetivo: traduzir, adaptar e identificar as propriedades psicométricas da Escala de Comportamento de Selfitis (SBS). Métodos: estudo on-line realizado com 261 adolescentes brasileiros. O processo de tradução e adaptação transcultural seguiu diretrizes internacionais, resultando em uma escala adequada com validade de face, conteúdo e validade construto. Resultados: Os cinco fatores explicaram 78,2% da variância total. A análise Fatorial confirmaria (modelo de equação estrutural para variáveis latentes) mostrou um ajuste adequado do modelo de cinco fatores com χ2= 2,42 p=0,001, GFI=0,92, AGFI= 0,89, NNFI= 0,92, TLI= 0,96, CFI= 0,93, RMSEA= 0,041. Todas as cargas de fatores foram estatisticamente diferentes de zero (0; t > 1,96, p<0,05). O valor total de consistência interna pelo alfa do Cronbach e ômega do McDonald's encontrou-se acima de 0,80 e as consistências internas de cada fator foram acima de 0,79. Conclusão: Este é o primeiro estudo brasileiro a avaliar as propriedades psicométricas de uma escala de selfie. O SBS provou ser um instrumento confiável e válido para avaliar o comportamento da selfie.  

Findings on the relationship between Internet addiction and psychological symptoms in Brazilian adults.

This study evaluated the prevalence of Internet addiction (IA) and its association with negative psychological symptoms in Brazilian adults. A network analysis was conducted to estimate specific variables and their expected influence on IA. In this cross-sectional study, 15,476 adults (Mage  = 37.5, SD = 9.59) completed an open web-based survey. Three questionnaires were used: the Internet Addiction Test (IAT), Depression Anxiety and Stress Scale (DASS-21) and Satisfaction With Life Scale (SWLS). Based on IAT scores, participants were classified as No-Risk user (NRU), Low-Risk user (LRU) or High-Risk user (HRU). We observed that 4.8% of the participants were classified in the HRU group. In addition, their risk for severe symptoms of depression was 10 times higher and, for anxiety, seven times higher than that in the NRU group (p < .001). Time spent using smartphones was also significantly higher in the HRU group (Mhours  = 5.1, p < .001). The main factors associated with IA were depression, gender and anxiety, but the variable "having children" was the most influential in the IA network. These findings suggest that psychiatric symptoms are the main factors associated with IA among the adult population.

Validity and reliability of the Brazilian version of the Smartphone Addiction Scale-Short Version for university students and adult population / Validade e confiabilidade da versão Brasileira da Smartphone Addiction Scale-Short Version para estudantes universitários e adultos

This study sought evidence of the validity of the Smartphone Addiction Scale-Short Version for a Brazilian sample of 718 individuals, amongst university students (n = 387, M age = 22.1 years) and adults (n = 331, M age = 35.2 years), who completed a sociodemographic questionnaire and the scale. The transcultural adaptation was carried out using specific protocols as recommended by expert's committees. The factorial structure was evaluated by three methods: Confirmatory Factor Analysis, Principal Component Analysis, and Network Analysis. The adjustment parameters were not adequate and Principal Component Analysis explained 39.2% of the variance. The scale showed good reliability (α = 0.81) and a 39.4% prevalence of problematic phone use. The Network Analysis indicated that the correlations between the items were similar in the two populations. This is an unpublished study evaluating the usage pattern of smartphones in a sample of the adult population from all Brazilian states.

Este estudo buscou evidências de validade da Smartphone Addiction Scale-Short Version para uma amostra brasileira de 718 indivíduos, entre universitários (n = 387; Midade = 22,1 anos) e adultos (n = 331; Midade = 35,2 anos), que preencheram um questionário sociodemográfico e uma escala. Realizou-se a adaptação transcultural com protocolos específicos respondidos por juízes. A estrutura fatorial foi avaliada por três métodos: Análise Fatorial Confirmatória, Análise de Componentes Principais e Análise de Rede. Os parâmetros de ajustes não foram adequados e a Análise de Componentes Principais explicou 39,2% da variância. A escala mostrou boa confiabilidade (α = 0,81) e prevalência de 39,4% de uso problemático de smartphone. A Análise de Rede indicou que as correlações entre os itens foram parecidas nas duas populações. Este é um estudo inédito, avaliando o padrão de uso de smartphones em uma amostra da população adulta de todos os estados brasileiros.

O lazer e o uso de substâncias entre adolescentes: uma revisão integrativa / Leisure and substance use among adolescents: a systematic review / El ocio y uso de substancias entre los adolescentes: uma revisión sistemática

Com base em uma diversidade de definições, existe um consenso sobre o lazer enquanto um fenômeno extraordinário à vida cotidiana. Existem divergências em análises do lazer a partir de perspectivas do tempo, atividade e atitude, correlacionando-o muitas vezes com comportamentos de risco. Objetivamos verificar de forma sistemática se os componentes atitudinais relacionados à experiência do lazer de adolescentes e jovens estão relacionados à redução do uso de substâncias psicoativas. O Método utilizado foi a Revisão Integrativa a partir de consulta às principais bases de dados em saúde, seguida de apresentação dos artigos de acordo com o método PRISMA. Os critérios de revisão e inclusão foram apresentados pela estrutura PICOS. Nos resultados foram recuperados 555 artigos, porém somente 09 artigos preencheram os critérios para análise sistemática dos dados. A conclusão dos estudos sugerem associação da motivação intrínseca e tédio como fatores de risco no lazer para o abuso de substâncias. (AU)

Although there are diversity of concepts, there is a consensus on leisure as an extraordinary phenomenon to everyday life. Studies have divided itself between the prospects for leisure time as activity or attitude, it often correlating with risk behaviors. Objective: the aim of this review is to verify whether attitudinal components related to leisure experience of adolescents and young people are related to the reduction in the use of psychoactive substances. Method: integrative review from the main query databases in health, followed by presentation of the articles according to the PRISMA method. The criteria for review and inclusion were presented by the structure PICOS. Results: we retrieved 555 articles, but only 9 articles met the criteria for systematic analysis of the data. Conclusion: studies suggest intrinsic motivation and boredom as risk factors for substance abuse. (AU)

Basado en una variedad de definiciones, existe un consenso sobre el ocio mientras un fenómeno extraordinario de la vida cotidiana. Existen diferencias en las análisis de ocio de vez en perspectiva, la actividad y la actitud, lo correlaciona a menudo con un comportamiento de riesgo. Objetivo: Verificar sistemáticamente si los componentes actitudinales relacionados con el ocio de los jóvenes se relacionan con la reducción del uso de sustancias psicoactivas. Método: una revisión integrativa de las consultas a las bases de datos clave de la salud, seguida de la presentación de los artículos de acuerdo con el método PRISMA. Los criterios de inclusión para la revisión y fueron presentados por la estructura PICOS. Resultados: 555 artículos fueron recuperados, pero sólo 09 artículos cumplieron los criterios para el análisis sistemático de los datos. Conclusión: Los estudios han sugerido una asociación de la motivación intrínseca y el aburrimiento como factores de riesgo en el juego para el abuso de sustancias. (AU)

Avaliação de diferentes modalidades de ações preventivas na redução do consumo de substâncias psicotrópicas em estudantes no ambiente escolar: um estudo randomizado / Evaluation of different school-based preventive interventions for reducing the use of psychotropic substances among students: a randomized study

Resumo Embora algumas escolas realizem ações preventivas do uso de drogas, pouco se sabe sobre o seu processo de implementação e os resultados. Assim, o presente estudo buscou avaliar, no contexto escolar, o impacto de três diferentes modalidades preventivas na redução do consumo de substâncias entre os estudantes. Fizeram parte deste estudo 1316 estudantes entre o 9° ano do ensino fundamental e 3° ano do ensino médio de 8 escolas da rede pública estadual do Município de Guarulhos-SP. Os estudantes foram aleatoriamente alocados nos grupos de intervenções e controle, e avaliados em dois momentos quanto ao consumo de sustâncias. Os resultados indicaram a efetividade das intervenções feitas pelos educadores, tanto na redução do consumo como na intensidade de problemas. As intervenções feitas por especialistas apresentaram efetividade parcial, pois reduziram o consumo apenas dos usuários experimentais. O resultado da modalidade ‘Palestra única’ indicaram-na contraproducente. Em suma, ações preventivas contextualizadas à realidade do estudante e do ambiente escolar, e que incluam o envolvimento ativo do educador e do aluno, apresentam melhor impacto na redução da prevalência de uso de substâncias e intensidade de problemas.

Abstract Although many schools perform preventive interventions for reducing drug use, little is known about their implementation processes and results. Accordingly, this study aimed to evaluate the effectiveness of three different types of preventive intervention performed in the school setting for reducing substance use among students. The study comprised 1316 students from the 9th year of elementary school to the 3rd year of secondary school in 8 public schools in the city of Guarulhos, São Paulo state, Brazil. Students were randomly assigned to the intervention groups or a control group and were evaluated at two different time-points regarding substance use. The results indicated that interventions performed by teachers were most effective in reducing both substance use and the severity of substance-associated problems. Interventions performed by experts were partially effective, although they only reduced use among experimental users. The results of “Single lecture” interventions revealed that such approaches are counterproductive. In summary, preventive actions that were contextualized to the student's reality and the school environment and that included the active involvement of both teacher and student were most effective at reducing the prevalence of substance use and the severity of associated problems in students.

Evaluation of different school-based preventive interventions for reducing the use of psychotropic substances among students: a randomized study.

Although many schools perform preventive interventions for reducing drug use, little is known about their implementation processes and results. Accordingly, this study aimed to evaluate the effectiveness of three different types of preventive intervention performed in the school setting for reducing substance use among students. The study comprised 1316 students from the 9th year of elementary school to the 3rd year of secondary school in 8 public schools in the city of Guarulhos, São Paulo state, Brazil. Students were randomly assigned to the intervention groups or a control group and were evaluated at two different time-points regarding substance use. The results indicated that interventions performed by teachers were most effective in reducing both substance use and the severity of substance-associated problems. Interventions performed by experts were partially effective, although they only reduced use among experimental users. The results of "Single lecture" interventions revealed that such approaches are counterproductive. In summary, preventive actions that were contextualized to the student's reality and the school environment and that included the active involvement of both teacher and student were most effective at reducing the prevalence of substance use and the severity of associated problems in students.

Relationship between stress symptoms and drug use among secondary students.

The aim of this study was to evaluate the relationship between drug use and four kinds of stress symptoms in 954 Brazilian students from the 6th to the 11th grades, in 4 public and 5 private schools in the city of Sao Paulo. Based on their answers to the Drug Use Screening Inventory (DUSI-R) and to the Stress Scale for Adolescents (SSA), we compared regular drug users with non/occasional drug users regarding the frequency of four kinds of stress symptoms (psychological, cognitive, physiological, interpersonal), and the period in which it happened. When compared to non/occasional drug users, regular drug users presented higher levels of psychological, cognitive and physiological symptoms of stress and these symptoms were in the most severe spectrum of severity (near to exhaustion and exhaustion). The association between drug use and stress was even stronger in the youngest age group (11 to 13 years old). Most of the regular drug users were 16 years old and over, from upper-middle class families, had poor family relationships and more academic problems. These results confirm the association between drug use and stress in adolescents and highlight the need for early screening and intervention in both drug use and stressful situations.

Psychometric and discriminative properties of the Teen Addiction Severity Index (Brazilian Portuguese version).

In this study we evaluated the internal consistency of the Brazilian Portuguese version of Teen Addiction Severity Index (T-ASI) and validated its "substance use" area. Evaluating 100 psychoactive substance abusers/dependent adolescents (SUD) and 108 adolescents without such diagnosis (NON-SUD), we found good correlations between the classification by the Composite International Diagnostic Interview (CIDI, used as "gold standard") and the severity (r = 0.73) and composite (r = 0.72) scores of the T-ASI. The area under the ROC curve was 0.88, showing a satisfactory correct classification rate. The internal consistency, evaluated by Cronbach's alpha coefficients, was considered good regarding the substance use (0.89), legal (0.81), and psychiatric (0.80) areas of the T-ASI. The Brazilian Portuguese version of T-ASI presented good internal consistency and a valid substance use area. A comparison between the groups regarding the answers to each question in all the areas was conducted in order to identify which questions in the T-ASI discriminate SUD from NON-SUD adolescents, to have a basis for the proposal of a shorter version of the instrument.

[Study on the effectiveness of brief intervention for alcohol and other drug use directed to adolescents in a primary health care unit]. / Estudo da efetividade da intervenção breve para o uso de álcool e outras drogas em adolescentes atendidos num serviço de assistência primária à saúde.

OBJECTIVE: The main purpose of this study was to evaluate the effectiveness of a brief intervention and a preventive orientation on the use of alcohol and other drugs directed towards adolescents. METHODS: Ninety nine youths who sought medical assistance in an out patient service specialized in adolescents were classified, according to their level of consumption of substances, into users during the last month (UM) or non users during the last month (NUM). Each of these was divided into four groups: a control group of users in the last month (COUM), a control group of non users in the last month (CONUM), a Brief Intervention group (BI--in case they were regular users) and a Preventive Orientation group (PO--in case they were non users in the last month). The preventive orientation lasted 2-3 minutes and the brief intervention took about 20 minutes, both followed a structured schedule. All participants were followed-up and evaluated for a 6 months period. RESULTS: In the 6-month follow-up, a significant increase in cannabis, alcohol and tobacco consumption, as well as in the intensity of related-problems, was observed in the CONUM group. The increase of alcohol and tobacco consumption observed in the PO group had a significantly lesser frequency and lower intensity than in the CONUM group. Moreover, no increase in cannabis consumption was observed in this group. The BI group showed a significant reduction in the number of users during the last month with respect to most substances, as well as in relation to substance-related problems. CONCLUSION: Our results confirm that a single brief intervention session is effective in reducing consumption of psychoactive substances in adolescents. Although influence of other factors could not be discarded, preventive orientation reduced the increase of cannabis consumption but increased use of tobacco and alcohol. Further and more in depth studies are required to evaluate the usefulness of preventive programs on alcohol and other drug consumption, in order to bring to light more effective and comprehensive approaches.

Estudo da efetividade da intervenção breve para o uso de álcool e outras drogas em adolescentes atendidos num serviço de assistência primária à saúde / Study on the effectiveness of brief intervention for alcohol and other drug use directed to adolescents in a primary health care unit

OBJETIVOS: O principal objetivo deste estudo foi avaliar a efetividade de uma intervenção breve e de uma orientação preventiva do uso de álcool e/ou outras drogas, dirigidas a adolescentes. MÉTODOS: Noventa e nove adolescentes que buscaram atendimento médico em um serviço ambulatorial especializado no atendimento de adolescentes foram divididos de acordo com seus níveis de consumo de substâncias em usuários no último mês (UM) e não usuários no último mês (NUM). Cada um destes grupos foi dividido em dois: um grupo controle de usuários no último mês (COUM), um grupo controle de não usuários no último mês (CONUM), um grupo que receberia Intervenção Breve no caso de serem usuários no mês (UM-IB) e um grupo que receberia Orientação Preventiva no caso de serem não usuários no mês (NUM-OP), totalizando quatro grupos. A orientação preventiva teve duração de 2 a 3 minutos e intervenção breve de 20 minutos, sendo realizada segundo roteiro pré-estruturado. Todos os participantes foram novamente avaliados após seis meses. RESULTADOS: No seguimento realizado ao final de seis meses, observou-se um aumento significativo na prevalência de consumo de maconha, álcool e tabaco bem como na intensidade de problemas e comportamentos de risco no grupo CONUM. No grupo NUM-OP, embora também tenha sido observado aumento na prevalência de consumo de drogas lícitas (álcool e tabaco), este foi significativamente menor em freqüência e intensidade do que o observado no grupo CONUM. Além disso, neste grupo não ocorreu aumento no uso de maconha. No grupo de adolescentes usuários no último mês que receberam Intervenção Breve (UM-IB), observou-se redução significativa na proporção de usuários em relação à maioria das substâncias avaliadas, bem como redução na intensidade dos problemas e comportamentos de risco. CONCLUSAO: Nossos resultados confirmam a efetividade de uma sessão única de intervenção breve dirigida a adolescentes usuários de substâncias psicoativas na redução do consumo de substâncias. Embora outros fatores possam ter também contribuído para isto, a orientação preventiva parece ter reduzido o aumento no consumo de maconha, mas aumentado o de álcool e tabaco. São necessários estudos mais aprofundados sobre a efetividade de programas de prevenção do uso de álcool e outras drogas, a fim de que se desenvolvam abordagens mais abrangentes e eficazes.

[Validation of the Brazilian version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)]. / Validação da versão brasileira do teste de triagem do envolvimento com álcool, cigarro e outras substâncias (ASSIST).

BACKGROUND: Considering the increasing levels of psychoactive substance use in Brazil and around the world, it is necessary the development of an instrument to early detection, that could be considered valid, reliable and useful at primary health care settings. In order to do that, an international team of researchers, supported by the World Health Organization (WHO) developed the Alcohol Smoking and Substance Screening Test (ASSIST). The objective of the present study was to evaluate the psychometric properties of the Brazilian version of ASSIST, as well as its reliability and concurrent validity in the detection of psychoactive substance use and related problems. METHODS: The ASSIST and three validated diagnostic instruments (Mini-Plus, AUDIT, RTQ) were applied to 99 patients of primary/secondary health care services and to 48 patients in treatment for alcohol and drug dependence in specialized services, at São Paulo and Curitiba cities. RESULTS: The ASSIST' scores to alcohol showed good correlation with AUDIT' scores. The ASSIST presented high sensitivity and specificity in the detection of alcohol, cannabis and cocaine abuse/dependence, considering the MINI-Plus diagnostic the "gold-standard". The reliability of the instrument was good (Cronbach's alpha of 0.80 to alcohol, 0.79 to cannabis and 0.81 to cocaine). CONCLUSIONS: The psychometric properties of the Brazilian version of the ASSIST seem to be satisfactory, recommending its use in patients of primary/secondary health care services.

Validação da versão brasileira do teste de triagem do envolvimento com álcool, cigarro e outras substâncias (ASSIST) / Validation of the Brazilian version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

OBJETIVO: Considerando-se os índices cada vez maiores do uso de substâncias psicoativas no Brasil, faz-se necessário um instrumento para a sua detecção precoce que seja válido, confiável e passível de ser utilizado em serviços de atenção primária à saúde. Para tal finalidade, foi desenvolvido um instrumento denominado teste de triagem do envolvimento com álcool, tabaco e outras substâncias (ASSIST), em um projeto multicêntrico coordenado pela Organização Mundial de Saúde (OMS). O presente estudo teve como objetivo avaliar as propriedades psicométricas da versão brasileira deste instrumento, sua validade concorrente e confiabilidade na detecção do uso de substâncias psicoativas e problemas associados. MÉTODOS: O ASSIST e três instrumentos diagnósticos validados (MINI-Plus, AUDIT e RTQ) foram aplicados a 99 pacientes que procuraram serviços de assistência primária/secundária à saúde e a 48 pacientes em tratamento especializado para dependência de álcool ou outras substâncias. RESULTADOS: Os escores do ASSIST para álcool apresentaram boa correlação com os escores do AUDIT. O ASSIST apresentou boa sensibilidade e especificidade na detecção de uso abusivo/dependência de álcool, maconha e cocaína, considerando como padrão-ouro o diagnóstico do MINI-Plus. A confiabilidade do instrumento foi boa (alfa de Cronbach de 0,80 para álcool, 0,79 para maconha e 0,81 para cocaína). CONCLUSÃO: As propriedades psicométricas da versão brasileira do ASSIST se mostraram satisfatórias, o que recomenda a sua aplicação a pacientes de serviços de atenção primária/secundária à saúde.

Drug use by Brazilian students: associations with family, psychosocial, health, demographic and behavioral characteristics.

AIMS: In the last few years, epidemiological studies in Brazil have detected significant increases in the use and abuse of psychoactive drugs by adolescents; however, there is a paucity of data on the factors associated with this use. OBJECTIVES: To assess the prevalence of drug use by students from public schools in a Brazilian city and to evaluate the influence of age, school achievement, family, psychosocial, health, demographic and behavioural characteristics on regular drug use. DESIGN: This cross-sectional study was conducted using a representative sample of 6417 students attending public schools in the city of Barueri, Brazil and included adolescents from the 5th grade of elementary school to the 3rd year of high school. The Brazilian version of the Drug Use Screening Inventory (DUSI-R) was administered in the classroom by trained educational advisers without teachers being present. FINDINGS: Prevalence rates for the previous month were: alcohol: 48%, tobacco: 22.5%, cannabis: 14%, inhalants/solvents: 5%, cocaine: 3%, tranquillizers: 0.5%, amphetamines: 0.9%, anabolic steroids: 0.1% and ecstasy: 0.9%. With the exceptions of tranquillizers and amphetamines, the older students reported significantly higher frequencies and amounts of drug use than the younger ones. Boys reported a significantly higher consumption of alcohol, cannabis, cocaine and ecstasy than girls, as well as higher percentages of frequent/heavy use. Logistic regression analysis detected that poor school achievement, a poor or bad relationship with those with whom they live, studying in the evening period, presence of antisocial behaviour, family problems and friends who use drugs were factors significantly associated with drug use. CONCLUSIONS: The findings suggest that preventive programmes should be more comprehensive in scope, rather than focusing only on information about the negative consequences of drug use.

Effects of identification and usefulness of the Lie Scale of the Drug Use Screening Inventory (DUSI-R) in the assessment of adolescent drug use.

OBJECTIVES: The main objectives of this study were to evaluate the effects of subject identification versus anonymity on adolescents' drug use assessment using the Drug Use Screening Inventory-R and to assess the usefulness of the "Lie Scale" of that instrument. METHODS: Six hundred and fifty-five Brazilian students (5th to 11th graders) from a public school of São Paulo participated in the study. One third of them were instructed to put their names on the questionnaire, one third answered it anonymously and the remaining ones were partially identified according to a code list that was kept by one student who represented his classmates. The answers of the identified groups of students were compared with those from the anonymous group. According to their scores in the Lie Scale, the students were divided into two groups: low and high score groups. RESULTS AND CONCLUSIONS: No significant differences were found among anonymous, identified and partially identified groups regarding alcohol or drug consumption report, or in the density of problems in all drug use screening inventory (DUSI) areas. Regarding the Lie Scale, the high score group reported lower alcohol or drug consumption and fewer alcohol or drug related problems in all DUSI areas when compared to the low score group. The results suggest that identification or anonymity does not affect the students' answers to the DUSI and point out the usefulness of the Lie Scale of DUSI-R.

Psychometric properties of the Brazilian version of the drug use screening inventory.

BACKGROUND: Adolescent involvement with alcohol and other drugs is rising in Brazil, and there is an increasing need for psychometrically sound assessment tools to detect early drug involvement. METHODS: The psychometric properties of the Brazilian version of the Drug Use Screening Inventory (DUSI) were examined in a sample composed of 71 non-drug-dependent adolescents and 142 adolescents who met DSM-III-R criteria for drug dependence. RESULTS: With a cutoff score of 13% or lower for the absolute density index of the substance use area, DUSI correctly classified 80% of the drug-dependent adolescents and 90% of the non-drug-dependent adolescents, thus correctly classifying 83.6% of the sample. Factor analysis applied to each of the 10 DUSI areas indicated their unidimensionality, with substantial percentages of variance on the first factor. The Brazilian version of DUSI presented strong internal consistency reliability for the whole sample (drug-dependents and non-drug-dependent adolescents) with an average across all 10 scales for Cronbach's alpha reliability coefficient of 0.96 (standard deviation = 0.02) and for the split-half reliability coefficient of 0.88 (standard deviation = 0.08). CONCLUSIONS: These results suggest that the Brazilian version of DUSI preserves its original psychometric properties and is a sensitive and useful screening instrument for drug use.