PROTOCOL: The efficacy of nutritional interventions in reducing childhood/youth aggressive and antisocial behavior: A systematic review and meta-analysis.

This is a protocol for a Campbell systematic review of intervention effectiveness. The goal of this systematic review is to answer the following questions based on the available empirical evidence: Are there nutritional interventions (dietary manipulation, fortification or supplementation) that can reduce excessive aggression towards others in children/youth? If yes, how strong is their effect and is there a difference among the three intervention types? Are there nutritional interventions that can reduce antisocial behaviors in children/youth? If yes, how strong is their effect and is there a difference among the intervention types? Are there nutritional interventions that can reduce violent offending in children/youth? If yes, how strong is their effect and is there a difference among the intervention types? Are there nutritional interventions that can reduce non-violent offending in children/youth? If yes, how strong is their effect and is there a difference among the intervention types? What implementation barriers and solutions to these exist in relation to the above nutritional interventions in children/youth?

Conduct problems, hyperactivity, and screen time among community youth: can mindfulness help? an exploratory study.

Background: The influence of mindfulness-based intervention (MBI) programs on behavioural problems among community youth is largely understudied. While technology continues to evolve and the prevalence of screen-based activities is rising, limited studies have accounted for screen time when examining the efficacy of an MBI. Accordingly, this study investigated the impact of MBI on conduct problems and hyperactivity among community youth, accounting for sociodemographic characteristics and four types of screen time. Method: Linear regression models were used to investigate 1) the association between four types of screen time and behavioural problems (i.e., conduct problems and hyperactivity) and 2) the efficacy of online mindfulness programs in reducing behavioural problems among community youth. The data were collected at baseline, intervention completion and 1-month follow-up (Spring 2021 to Spring 2022) in Ontario, Canada (n=117, mean age=16.82, male=22%, non-White=21%). Results: The average score for conduct problems was within the normal range, while the average score for hyperactivity was considered borderline at baseline. Accounting for other types of screen time, time spent playing video games was significantly associated with increased conduct problems (ß= 1.75, p=.03), albeit rendering non-significant after correcting for multiple comparisons. The online mindfulness program was significantly associated with reduced hyperactivity, controlling for baseline mental health, age, sex and screen time. Conclusion: The current findings suggest a 12-week online mindfulness program may play a positive role in reducing hyperactivity even when accounting for screen time. Our findings advocate the evidence base on the efficacy of MBI in managing hyperactivity.

Gender differences in the predictors of quality of life in patients with cancer: A cross sectional study.

PURPOSE: The aim of the present study was to explore potential differences in the sociodemographic (with a special focus on gender differences) and psychological predictors of quality of life in individuals diagnosed with cancer. METHODS: A cross-sectional, observational study was carried out involving individuals struggling with different forms of cancer (N = 430). Linear regression was used to investigate the concurrent predictive role of the independent variables, stratified by gender, for each of the five cancer-specific quality of life domains and overall quality of life. RESULTS: Sociodemographic characteristics had only a negligible to small role in predicting quality of life in both men and women. In contrast, the psychological variables explained a significantly larger portion of the variance in both genders. There were no statistically significant gender differences regarding the raw quality of life domain scores; however, their predictors were markedly different in the two groups. CONCLUSION: The results of the present study indicate that it is imperative to take gender differences into consideration when planning psychosocial interventions also focusing on strengths, resources, and coping strategies. Considering the consistently emerging importance of family support in patients' quality of life, offering psychological interventions to caregivers/family members seems warranted to empower them to provide support to patients throughout the illness trajectory.

Psychometric properties of the generalised version of the Screener for Substance and Behavioural Addictions (SSBA-G): A comprehensive screening tool for substance-related and behavioural addictions.

Assessing addictive behaviours comprehensively and efficiently is a challenge in both research and clinical practice. Consequently, we tested the psychometric properties of the Generalized Screener for Substance and Behavioural Addictions (SSBA-G), a novel, brief screening tool measuring functional impairment resulting from both substance and behavioural addictions. The SSBA-G was developed from the Screener for Substance and Behavioural Addictions (Schluter et al., 2018) and tested in four samples including university students in Canada (n = 481) and the US (n = 164) as well as community adults in Canada (n = 301), and Hungary (n = 79). Confirmatory factor analysis supported the hypothesized bifactor model of the SSBA-G. Receiver-operation characteristic analyses revealed high differentiation accuracy (AUC=0.86-.95), as well as identical ideal cut points across the Substance Addiction (SSBA-G-S) and Behavioural Addiction (SSBA-G-B) Subscales. Results indicated good-to-excellent sensitivity and moderate-to-good specificity. The SSBA-G demonstrated excellent internal consistency and test-retest reliability as well as promising concurrent validity in relation to the original SSBA and additional questions regarding addiction-related impairment. The SSBA-G also showed good convergent and divergent validity with indicators of general mental health. These results indicate that the SSBA-G is a psychometrically sound and efficient measure of addiction-related impairment across substances and excessive behaviours.

Relationship satisfaction and self-esteem in patients with breast cancer and healthy women: the role of expected and actual personal projects support from the partner.

BACKGROUND: For breast cancer patients, the partner's support for personal projects can serve as a means of adaptation. We aimed to investigate the associations between the intimate partner's personal project support and women's well-being. METHODS: A sample of 274 Hungarian women (breast cancer patients n = 137, control n = 137) took part in the study. Expected and actually received autonomy-, directive- and emotional project support was assessed by the procedure of Personal Project Assessment. Well-being was measured by the Relationship Assessment Scale and the Rosenberg Self-Esteem Scale. For investigating the associations between project support and well-being in a multivariate way, structural equation modelling was used. RESULTS: Except for autonomy support, participants expected more support than they received. A path model indicated multiple associations between types of project support and relationship satisfaction and self-esteem. The partner's emotional project support was predictive of women's relationship satisfaction and self-esteem, while directive support was predictive of self-esteem only. The associations showed similar patterns in the subgroups of patients with breast cancer and control. CONCLUSIONS: Our results highlight the importance of involving women's subjective perspectives regarding the partner's project support while also have implications for praxis. Teaching women how to communicate their needs to their partner effectively (whether it is the need for autonomy or directive guidance) can help close the gap between expected and received support, which may in turn enhance relationship satisfaction and self-esteem.

Trans-diagnostic determinants of psychotherapeutic treatment response: The pressing need and new opportunities for a more systematic way of selecting psychotherapeutic treatment in the age of virtual service delivery.

Numerous forms of psychotherapy have demonstrated effectiveness for individuals with specific mental disorders. It is, therefore, the task of the clinician to choose the most appropriate therapeutic approach for any given client to maximize effectiveness. This can prove to be a difficult task due to at least three considerations: (1) there is no treatment approach, method or model that works well on all patients, even within a particular diagnostic class; (2) several treatments are equally efficacious (i.e., more likely to be effective than no treatment at all) when considered only in terms of the patient's diagnosis; and (3) effectiveness in the real-world therapeutic setting is determined by a host of non-diagnostic factors. Typically, consideration of these latter, trans-diagnostic factors is unmethodical or altogether excluded from treatment planning - often resulting in suboptimal patient care, inappropriate clinic resource utilization, patient dissatisfaction with care, patient demoralization/hopelessness, and treatment failure. In this perspective article, we argue that a more systematic research on and clinical consideration of trans-diagnostic factors determining psychotherapeutic treatment outcome (i.e., treatment moderators) would be beneficial and - with the seismic shift toward online service delivery - is more feasible than it used to be. Such a transition toward more client-centered care - systematically considering variables such as sociodemographic characteristics, patient motivation for change, self-efficacy, illness acuity, character pathology, trauma history when making treatment choices - would result in not only decreased symptom burden and improved quality of life but also better resource utilization in mental health care and improved staff morale reducing staff burnout and turnover.

The prevalence and mental health correlates of exposure to offensive behaviours at work in Hungary: results of a national representative survey.

BACKGROUND: Within the last decades, a substantial number of reports have established bullying behaviours as a severe risk to the health and safety of workers. However, in Hungary, the severity of this issue remains largely unknown. Therefore, the current study aimed to 1) determine the prevalence of offensive workplace behaviours in the Hungarian working population and 2) examine the relationship between exposure to these offensive behaviours and certain mental health indicators. METHODS: The cross-sectional analyses of the present study are based on a sample of 13,104 active workers being representative of the Hungarian working population according to gender, age, educational level, and 18 occupational sectors. The mid-length version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) was used to measure workplace offensive behaviours (bullying, sexual harassment, threats of violence, and physical violence) in the 12 months preceding the survey. Examined mental health correlates included depressive symptomatology (Beck Depression Inventory), functional somatic symptoms (PHQ-15), perceived stress (Perceived Stress Scale), and general well-being (WHO Well-being Index). RESULTS: Almost half (48.7%) of the sample reported exposure to some form of offensive behaviour; 37.6% of participants reported occasional-, while 11.1% reported weekly or daily exposure. More women than men were exposed to offensive workplace behaviours, and those targeted the most were individuals aged 18-29 and in companies employing 20-49 employees. Top managers reported the lowest amount of bullying, while unskilled labourers reported the most frequent exposure. A moderately strong relationship was discovered between exposure to workplace offensive behaviours and all indicators of mental health. CONCLUSION: Workplace bullying was revealed to be a significant public health concern according to this large, representative data set from Hungary. Strategies to reduce the occurrence and impact of these behaviours on employee health should be a priority for occupational health and safety interventions.

Effectiveness of a complex psychosocial intervention to reduce metabolic syndrome in psychiatric outpatients with severe/persistent mental illness.

The prevalence of metabolic syndrome among individuals with severe mental illness is considerably higher than in the general population, contributing to the 15-20-year shorter life expectancy of this client population. The aim of this pilot study was to evaluate the effectiveness of a novel, complex psychosocial program to reduce metabolic syndrome. Members of both the intervention (n = 78) and control (n = 31) group were psychiatric outpatients with severe/persistent mental illness struggling with one or more symptoms of metabolic syndrome. Beyond the default elements of similar programs such as diet and exercise, the intervention covered medication use, sleep hygiene, stress management, as well as addressing spiritual needs, mindfulness, addictions, and self-care. Assessment of metabolic indicators were completed at baseline, at the end of the 11-week intervention, and 6 months post-intervention. The trajectory of change over time was significantly more favorable in the treatment than in the control group in terms of waist circumference (p = 0.013, η2 = 0.093) and a positive trend emerged in relation to blood glucose level (p = 0.082, η2 = 0.057). However, no statistically reliable difference was observed between the intervention and the control group regarding the other outcome variables (body mass index, systolic and diastolic blood pressure, serum triglyceride level, serum HDL cholesterol level, overall metabolic syndrome severity). These findings suggest that to produce more robust benefits, psychosocial interventions targeting the metabolic health of individuals with complex mental health needs should be either longer in duration if resources permit or narrower in focus (diet and exercise mainly) if resources are scarce. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-02269-3.

The Effectiveness of Family Constellation Therapy in Reducing Psychopathological Symptoms in a Naturalistic Setting.

BACKGROUND: The aim of this study (ClinicalTrials.gov identifier: NCT03233958) was to provide further evidence on the effectiveness and safety of family/systemic constellation therapy, a widely used but rarely investigated form of brief group psychotherapy. SUBJECTS AND METHODS: Altogether, 102 individuals from the general population were followed up 1- and 6 months after their participation in the 2-day intervention. Indicators of general and problem-area-specific psychopathology, interpersonal quality of life, meaning in life, and general wellbeing were assessed. Both statistical and clinical significance were considered, and active surveillance of potential iatrogenic effects was also conducted. RESULTS: The data showed significant improvement post-intervention in the case of the vast majority of the 17 outcome variables. At 1-month follow-up, the magnitude of improvements was typically in the moderate range. The patterns were very similar at the 6-month follow-up, suggesting that most intervention benefits were sustained in the middle term. Sensitivity analyses showed no therapist effects across the three intervention providers. Analyses into clinical significance showed that the most reliable improvements occurred in relation to interpersonal quality of life and non-diagnosis-specific psychopathology, with approximately half of the participants showing reliable improvement. Iatrogenic effects were comparable - both in terms of frequency and severity - to those reported for other forms of psychotherapy. CONCLUSIONS: Findings of the present study point toward the safety and effectiveness of family constellation therapy in reducing a variety of psychopathological symptoms (e.g., depression and anxiety) and increasing general well-being. This effectiveness is especially remarkable when considering the brevity and cost-effectiveness of the intervention.

Pain acceptance and illness intrusiveness in low-back pain: A longitudinal study.

Background: In chronic pain syndromes, acceptance of pain may be a better approach than pain control. So far, little data have been available on how pain and its acceptance affect illness intrusiveness among patients with low-back pain (LBP). Objective: The present longitudinal study evaluates the impact of pain acceptance on illness intrusiveness in patients with LBP. Methods: Study participants were asked to complete the following questionnaires during their visit (T1) at one of four diverse rheumatologic outpatient clinics, and then 2-3 months later (T2) via phone or online: Chronic Pain Acceptance Questionnaire (CPAQ), Illness Intrusiveness Rating Scale (IIRS), Roland-Morris Disability Questionnaire (RMDQ), Patient Health Questionnaire Depression subscale (PHQ9), and socioeconomic data. Results: One hundred and twenty-seven individuals completed the questionnaires at baseline (31 having acute, 15 subacute and 81 chronic low back pain) and 97 at follow-up. Illness intrusiveness was negatively correlated with chronic pain acceptance both at T1 (r = -0.39) and T2 (r = -0.44). Illness intrusiveness scores have not changed significantly from T1 (M = 28.59 SD = 13.08) to T2 (M = 28.24, SD = 15.76). In a multiple regression model-including pain intensity, functional status, pain acceptance, depression severity, age, sex and educational level-the independent predictors of follow-up illness intrusiveness scores were lower pain acceptance and higher depression scores. Conclusions: In our study, patients with acute, subacute and chronic low back pain reported similar levels of illness intrusiveness. In addition, illness intrusiveness scores have not changed significantly during the 2-month follow-up period and pain acceptance proved to be a significant independent predictor of illness intrusiveness among patients with chronic low-back pain.

Depression among predictors of intermittent claudication: A cross-sectional study.

PURPOSE: The aim of the present cross-sectional study was to investigate the relationship between depression and intermittent claudication (IC), independently of traditional risk factors. MAIN METHODS: The sample consisted of 300 individuals (M age = 65.3 ± 8.7 years, 61.0% female) recruited from the offices of 33 general practitioners. Participants' medical history and the presence of major cardiovascular risk factors were recorded. Participants completed the Edinburgh Claudication Questionnaire. The role of depression (assessed by a shortened version of the Beck Depression Inventory) in predicting IC was examined using a binary logistic regression analysis - controlled for sex, age, hypertonia, diabetes, smoking, hypercholesterinemia, hazardous drinking, and body mass index (BMI). RESULTS: The descriptive data indicated that the prevalence of depression was 57.9% in the IC subgroup and 16.1% in those free of IC. The bivariate analyses indicated that hypercholesterinemia, smoking, hazardous drinking, BMI, and depression were significantly associated with IC. Male sex and age showed a trend toward being a significant correlate of IC. Results of the multivariate analyses indicated that depressive symptomatology was significant in predicting IC (OR: 1.08 (1.05-1.11)), even after controlling for lifestyle and traditional risk factors such as smoking, hazardous drinking, and BMI. Among traditional risk factors, smoking (OR: 2.44 (1.26-4.74)), hazardous drinking (OR: 1.19 (1.02-1.40)), and hypercholesterinemia (OR: 2.17 (1.26-3.75)) showed a significant, positive relationship with IC. CONCLUSIONS: These results underscore the importance of a multidisciplinary approach that focuses on supporting health-related behavioral changes and managing mental health symptoms when providing care for patients with IC.

Validation of pandemic-specific version of the Perceived Stress Scale / Az Észlelt Stressz Kérdoív járványspecifikus verziójának validálása.

Összefoglaló. Bevezetés: Egyre több adat bizonyítja, hogy a COVID-19-járvány hatással van a pszichés egészségre, beleértve a megnövekedett észlelt stresszt is. Célkituzés: Az Észlelt Stressz Kérdoív 10 tételes, járványspecifikus verziójának (PSS-PAN) megalkotása, validitásának és megbízhatóságának tesztelése. Módszer: A skála faktorstruktúráját, konvergens és divergens validitását teszteltük egy internetes vizsgálat során (n = 1164; átlagéletkor: 38,57 év; szórás: 6,27 év; 84,2% no). Eredmények: Igazoltuk a PSS-PAN egykomponensu szerkezetét. A kérdoív továbbá szignifikánsan korrelált a rövidített Beck Depresszió Kérdoív (r = 0,41; n = 1164; p<0,001), a 4 tételes Észlelt Stressz Kérdoív (r = 0,46; n = 1164; p<0,001) és az Élettel Való Elégedettség Skála pontszámaival (r = -0,29; n = 1164; p<0,001). A nok esetében a PSS-PAN átlaga szignifikánsan magasabb volt, mint a férfiaknál (t(1162) = -7,135; p<0,001), de ez a hatásnagyság nagyon csekély volt (Cohen-féle d = 0,06). A PSS-PAN átlagpontszáma szignifikánsan nem különbözött a legmagasabb iskolai végzettség kategóriái mentén (F(6;1157) = 2,035; p = 0,06; η2 = 0,01). Az alsó középosztályba tartozó résztvevok átlagpontszáma szignifikánsan magasabb volt, mint a középosztályba tartozó kitöltoké a post hoc elemzés alapján (F(4;1159) = 3,461; p = 0,01; η2 = 0,01). A skála pontszáma nem korrelált szignifikánsan az életkorral (r = -0,04; n = 1164; p = 0,13). A Cronbach-alfa 0,89 volt, vagyis a kérdoív belso megbízhatósága kiváló. Megbeszélés: A skála egykomponensu struktúrát mutatott. A többi skálával való közepesen eros és gyenge korrelációja a skála validitását igazolta, és azt, hogy a járványhoz kapcsolódó észlelt stressz külön indikátora. Pontszámát nem vagy nem erosen befolyásolta a nem, a kor, az iskolázottság vagy a szocioökonómiai státusz. Következtetés: A PSS-PAN a járványokhoz kötodo stressz mérésének megfelelo eszköze. Orv Hetil. 2021; 162(35): 1391-1396. INTRODUCTION: A growing amount of evidence indicates that the COVID-19 pandemic influences mental health, including an increased level of perceived stress. OBJECTIVE: To develop and psychometrically investigate a pandemic-specific version of the Perceived Stress Scale (PSS-PAN) that measures stress related to the pandemic. METHOD: Factor structure as well as convergent and divergent validity of the 10-item PSS-PAN were examined on the data set of an online survey (n = 1164; mean age: 38.57 years; standard deviation: 6.27 years; 84.2% women). RESULTS: A one-factor structure for the PSS-PAN was confirmed. The scale correlated significantly with scores on the Shortened Beck Depression Inventory (r = 0.41; n = 1164; p<0.001), the 4-item Perceived Stress Scale (r = 0.46; n = 1164; p<0.001), and the Satisfaction with Life Scale (r = -0.29; n = 1164; p<0.001). Women's PSS-PAN scores were significantly higher than men's (t(1162) = -7.135; p<0.001) but this difference was trivial (Cohen's d = 0.06). Further, scale scores did not differ significantly across educational attainment (F(6;1157) = 2.035; p = 0.06; η2 = 0.01). Lower middle class participants' mean scores were significantly higher than those of middle-class respondents according to the post hoc test (F(4;1159) = 3.461; p = 0.01; η2 = 0.01). PSS-PAN scores did not correlate significantly with age (r = -0.04; n = 1164; p = 0.13). Cronbach's alpha was 0.89 indicating excellent internal consistency. DISCUSSION: The PSS-PAN has a single-component structure. Moderately strong and weak correlations with other scales support its convergent and divergent validity and indicate that it is a distinct indicator of pandemic-related perceived stress. Its total score was not or not strongly associated with gender, age, education level, or socioeconomic status. CONCLUSION: The PSS-PAN is a proper instrument to measure pandemic-specific perceived stress. Orv Hetil. 2021; 162(35): 1391-1396.

ADHD symptomatology of children with congenital heart disease 10 years after cardiac surgery: the role of age at operation.

BACKGROUND: The aim of the present study was to investigate the differences in ADHD symptomatology between healthy controls and children who underwent cardiac surgery at different ages. METHODS: Altogether, 133 children (54 patients with congenital heart disease undergoing first cardiac surgery under 3 years of age, 26 operated at the age of 3 or later, and 53 healthy controls) were examined. Patients completed the Youth Self Report (YSR), while their parents completed the Child Behaviour Checklist (CBCL) and the ADHD Rating Scale-IV. RESULTS: Children receiving surgery for the first time under the age of 3 years were more likely diagnosed with cyanotic type malformation and have undergone to a greater number of operations. However, ADHD symptoms of those treated surgically at or above 3 years of age were more severe than that of the control group or those who were treated surgically at a younger age. The control group and those treated surgically below the age of three did not differ across any of the ADHD symptom severity indicators. CONCLUSIONS: The age at the time of cardiac surgery might be associated with later ADHD symptom severity - with lower age at operation associated with better outcomes. Further, adequately powered studies are needed to confirm these exploratory findings and investigate the moderators of this relationship.

Nutritional supplementation in the treatment of violent and aggressive behavior: A systematic review.

Aggression in correctional and psychiatric settings is relatively common and has a negative effect on physical and mental health both among inmates/clients and staff, as well as organizational-level functioning. The aim of the present study was to critically review the evidence on the effectiveness of nutritional supplements in reducing aggression and violence to contribute to a better understanding of options available for managing aggressive behaviors in adults. The EMBASE, MEDLINE, PsycINFO, Cochrane Library, and PubMed databases were searched for effectiveness studies published in English anytime up until March 2020. Study quality was assessed using the Mixed Methods Appraisal Tool. Altogether, 14 studies met inclusion criteria; 2 investigated micronutrients, 10 examined macronutrients, while further 2 examined a combination of micro and macronutrients. Out of the 14 studies, 5 reported a beneficial effect of nutritional supplementation (omega-3 fatty acids, vitamins/minerals, S-adenosyl-l-methionine, or tryptophan). Five studies did not report a significant beneficial effect of nutritional supplementation (omega-3 fatty acids, folic acid, tryptophan, broad range supplement containing vitamins and fatty acids, and fatty acids in augmentation with valproic acid), while four studies reported mixed effects (on l-tryptophan, broad-range micronutrient formula, folic acid, and omega-3 fatty acids). The results overall indicated that research in this area is in its infancy: very few studies examined the same composition of nutritional supplementation and when they did so the results were contradictory. The methodological shortcoming of existing studies and directions for future research are discussed to facilitate high-quality research in this evolving area of nutritional psychiatry.

The Effectiveness of Family Constellation Therapy in Improving Mental Health: A Systematic Review.

Family/systemic constellation therapy is a short-term group intervention aiming to help clients better understand and then change their conflictive experiences within a social system (e.g., family). The aim of the present systematic review was to synthetize the empirical evidence on the tolerability and effectiveness of this intervention in improving mental health. The PsycINFO, Embase, MEDLINE, ISI Web of Science, Psyndex, PsycEXTRA, ProQuest Dissertations & Theses, The Cochrane Library, Google Scholar, and an intervention-specific organization's databases were searched for quantitative, prospective studies published in English, German, Spanish, French, Dutch or Hungarian up until April 2020. Out of 4,197 identified records, 67 were assessed for eligibility, with 12 studies fulfilling inclusion criteria (10 independent samples; altogether 568 participants). Outcome variables were diverse ranging from positive self-image through psychopathology to perceived quality of family relationships. Out of the 12 studies, nine showed statistically significant improvement postintervention. The studies showing no significant treatment benefit were of lower methodological quality. The random-effect meta-analysis-conducted on five studies in relation to general psychopathology-indicated a moderate effect (Hedges' g of 0.531, CI: 0.387-0.676). Authors of seven studies also investigated potential iatrogenic effects and four studies reported minor or moderate negative effects in a small proportion (5-8%) of participants that potentially could have been linked to the intervention. The data accumulated to date point into the direction that family constellation therapy is an effective intervention with significant mental health benefits in the general population; however, the quantity and overall quality of the evidence is low.

La terapia de constelación sistémica/familiar es una intervención grupal a corto plazo orientada a ayudar a los pacientes a comprender mejor y a cambiar sus experiencias conflictivas dentro de un sistema social (p. ej.: la familia). El objetivo del presente análisis sistemático fue sintetizar las pruebas empíricas sobre la tolerabilidad y la eficacia de esta intervención en la mejora de la salud mental. Se buscó en PsycINFO, Embase, MEDLINE, ISI Web of Science, Psyndex, PsycEXTRA, ProQuest Dissertations & Theses, The Cochrane Library, Google Scholar y en bases de datos de una organización dedicada a las intervenciones para obtener estudios cuantitativos y prospectivos publicados en inglés, alemán, español, francés, holandés o húngaro hasta abril de 2020. Se identificaron 4197 documentos y se evaluó la elegibilidad de 67. Finalmente se determinó que 12 cumplían con los criterios de inclusión (10 muestras independientes; en total, 568 participantes). Los criterios de valoración fueron diversos y abarcaron desde una autoimagen positiva hasta la psicopatología y la calidad percibida de las relaciones familiares. De los 12 estudios, 9 demostraron mejoras estadísticamente significativas después de la intervención. Los estudios que no demostraron ningún beneficio significativo del tratamiento fueron de menor calidad metodológica. El metaanálisis de efectos aleatorios -realizado en 5 estudios en relación con la psicopatología general- indicaron un efecto moderado (g de Hedges de 0.531, CI: 0.387-0.676). Los autores de 7 estudios también investigaron los posibles efectos iatrogénicos, y en 4 estudios se informaron efectos negativos moderados o leves en una pequeña proporción (5-8%) de participantes que podrían haber estado ligados a la intervención. Los datos acumulados hasta la fecha señalan que la terapia de constelación familiar es una intervención eficaz con beneficios considerables para la salud mental en la población en general; sin embargo, la cantidad y la calidad general de las pruebas es baja.

Preferred ways of giving birth in non-pregnant and pregnant nulliparous women: the role of control beliefs.

PURPOSE: To explore the association between delivery-specific, health-related control beliefs and preferred ways of delivery in nulliparous Hungarian women. Moreover, since data about the delivery-specific control beliefs and delivery-related preferences of non-pregnant nulliparous women are lacking, the present study also seeks to provide descriptive information in this regard. METHODS: A total of 984 Hungarian nulliparous women (26.45 ± 5.42 years; 660/77.2% non-pregnant and 224/22.8% pregnant) were included in the present study. The online assessment included measures of delivery-specific (internal-, healthcare professional-, and chance-related) health control beliefs, fears of childbirth, self-esteem, as well as preferences regarding delivery setting (i.e. spontaneous vaginal birth in hospital, planned cesarean birth and home birth). RESULTS: Healthcare professional-related control beliefs were associated with a stronger preference for spontaneous vaginal birth in hospital (OR = 1.87, 95% CI: 1.56-2.23) and planned cesarean birth (OR = 1.96, 95% CI: 1.60-2.40), alongside a weaker preference for home birth (OR = 0.31, 95% CI: 0.25-0.39). In contrast, internal delivery-specific control beliefs predicted a weaker preference for planned cesarean (OR = 0.66, 95% CI: 0.55-0.78) and a stronger preference for home birth (OR = 1.63, 95% CI: 1.33-2.00). A general preference index for medicalized ways of delivery was negatively associated with internal - and positively with healthcare professional - and chance-related control beliefs (ßs = -.173, .074 and .445, respectively). CONCLUSIONS: Delivery-related control beliefs are important psychological characteristics in the prediction of preferences for ways of delivery. Understanding delivery-specific control beliefs may be an important component of supporting women to give birth in a mentally and physically healthy way.

Predictive utility of the brief Screener for Substance and Behavioral Addictions for identifying self-attributed problems.

BACKGROUND AND AIMS: The Brief Screener for Substance and Behavioral Addictions (SSBAs) was developed to assess a common addiction construct across four substances (alcohol, tobacco, cannabis, and cocaine), and six behaviors (gambling, shopping, videogaming, eating, sexual activity, and working) using a lay epidemiology perspective. This paper extends our previous work by examining the predictive utility of the SSBA to identify self-attributed addiction problems. METHOD: Participants (N = 6,000) were recruited in Canada using quota sampling methods. Receiver Operating Characteristics (ROCs) analyses were conducted, and thresholds established for each target behavior's subscale to predict self-attributed problems with these substances and behaviors. For each substance and behavior, regression models compared overall classification accuracy and model fit when lay epidemiologic indicators assessed using the SSBA were compared with validated screening measures to predict selfattributed problems. RESULTS: ROC analyses indicted moderate to high diagnostic accuracy (Area under the curves (AUCs) 0.73-0.94) across SSBA subscales. Thresholds for identifying self-attributed problems were 3 for six of the subscales (alcohol, tobacco, cannabis, cocaine, shopping, and gaming), and 2 for the remaining four behaviors (gambling, eating, sexual activity, and working). Compared to other instruments assessing addiction problems, models using the SSBA provided equivalent or better model fit, and overall had higher classification accuracy in the prediction of self-attributed problems. DISCUSSION AND CONCLUSIONS: The SSBA is a viable screening tool for problematic engagement across ten potentially addictive behaviors. Where longer screening tools are not appropriate, the SSBA may be used to identify individuals who would benefit from further assessment.

Depressive symptomatology and personality traits in patients with symptomatic and asymptomatic peripheral arterial disease.

BACKGROUND: The aim of this study was to examine the relationship of depressive symptomatology and personality traits with peripheral arterial disease (PAD). METHODS: The sample of this cross-sectional study comprised of 300 individuals (Mage = 65.3 ± 8.7 years, 61.0% female) recruited from the offices of 33 general practitioners. Based on at-rest ankle-brachial index (ABI) values and claudication symptoms, four subsamples were formed: clear PAD-positive, clear PAD-negative, ABI-negative but symptomatic, and a non-compressible-artery group. The concurrent role of depression (assessed by a shortened version of the Beck Depression Inventory) and personality traits (measured by the Big Five Inventory) in predicting PAD status was examined using multinomial logistic regression - controlled for sex, age, hypertonia, diabetes, smoking, hazardous drinking, and body mass index. RESULTS: Depressive symptomatology was significant in predicting peripheral arterial disease status even after controlling for both traditional risk factors and personality traits. Among the Big Five personality traits, neuroticism showed a significant, positive relationship with PAD - independently of depression. CONCLUSIONS: Patients with PAD - even those with asymptomatic forms of the disease - are at higher risk for suffering from depression compared to individuals without PAD, independently of neuroticism, other Big Five personality dimensions or traditional risk factors for cardiovascular diseases.

The role of vital exhaustion in predicting the recurrence of vascular events: A longitudinal study.

BACKGROUND/OBJECTIVE: The aim of this study was to examine the role of vital exhaustion in predicting the recurrence of vascular events. METHOD: The sample comprised of 816 individuals (65.3% female, M age  = 43.2 years, SD = 14.7 years), 395 (48.4%) of whom reported treatment for the reoccurrence of a vascular event during the four-year follow-up period. Concurrent effects of baseline vital exhaustion (measured by a shortened version of the Maastricht Questionnaire), depression (assessed by a shortened version of the BDI), anxiety (assessed by the HADS), and hostility (assessed by a shortened version of the Cook-Medley Hostility Scale) in predicting the recurrence of T2 vascular events were examined. The analyses were also controlled for traditional risk factors, such as age, education, body mass index, smoking, alcohol use, and lack of physical activity. RESULTS: The regression analyses showed that vital exhaustion scores significantly predicted the reoccurrence of vascular events even after controlling for all covariates. None of the other psychological predictors (depression, anxiety, and hostility) was significant in the final model. CONCLUSIONS: These results suggest that despite the partial conceptual overlap with several similar constructs, vital exhaustion is a distinct phenomenon that deserves consideration when planning and implementing interventions to reduce the risk of vascular diseases.

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue examinar el papel del agotamiento vital en la predicción de la recurrencia de eventos vasculares. MÉTODO: La muestra estaba compuesta por 816 sujetos (65,3% mujeres, M edad = 43,20 años; DT = 14,70 años), 395 (48,40%) de los cuales tuvieron tratamiento para la reincidencia de evento vascular durante los cuatro años de seguimiento. Se examinaron los efectos concurrentes del agotamiento vital inicial (medido por una versión abreviada del Maastricht Questionnaire), depresión (evaluada por una versión abreviada del BDI), ansiedad (evaluada por el HADS) y hostilidad (evaluada por una versión reducida de la Cook-Medley Hostility Scale) en la predicción de la recurrencia de eventos vasculares T2. Los análisis también fueron controlados por factores de riesgo (edad, educación, índice de masa corporal, tabaquismo, consumo de alcohol y falta de actividad física). RESULTADOS: Las puntuaciones de agotamiento vital predijeron la recurrencia de eventos vasculares, incluso después de controlar todas las covariables. Ninguno de los otros predictores psicológicos fue significativo en el modelo final. CONCLUSIONES: A pesar de la superposición conceptual parcial con varios constructos similares, el agotamiento vital es un fenómeno distinto que merece ser considerado al planificar e implementar intervenciones para reducir el riesgo de enfermedades vasculares.