Comparative assessment of psychometric performance on the adjusting amounts versus the 21-item Monetary Choice Delay Discounting tasks among young adult substance users.

Delay discounting (DD) assessments offer a wide variety of procedures to suit specific clinical and research needs. This study compared the reliability and validity of two DD tasks: (a) an adjusting amounts task presented on a computer (AAC) and (b) the 21-item Monetary Choice Task, which was administered online (MCT). Participants were 1,573 Spanish young-adults reporting past-month substance use. Measures included quantity and severity of drug use (i.e., cigarette smoking, cannabis, alcohol) and two DD assessments (i.e., AAC, MCT). Reliability was assessed using both the classical test and item response theory. Correlations and linear regressions examined the validity of both DD tasks in relation to substance use. The MCT showed higher internal consistency than the AAC (α = .941 vs. α = .748). AAC precision was adequate for moderate levels of discounting (θ values between -2 and +2), but the MCT showed superior reliability at low, moderate, and high levels of discounting (θ values between -1 and +1.5). Both DD tasks showed more significant correlations for alcohol-related measures (|rs| ranged between .053 and .093) compared to cigarettes and cannabis. The incremental validity of DD tasks in relation to nicotine dependence (AUClogd: ß = -.664, 95% CI [-1.256, -.071]) and alcohol problems (AUClogd: ß = -3.098, 95% CI [-5.209, -.988]) was only supported for the AAC. The MCT was more reliable than the AAC for measuring impulsive choice in young adult substance users. Nevertheless, the AAC may serve as a valid marker of nicotine dependence and alcohol problems. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

New Validity Evidence of the Global Appraisal of Individual Needs-Short Screener for Evaluating Internalizing/Externalizing Behaviors in Spanish Adolescents.

OBJECTIVE: The Global Appraisal of Individual Needs (GAIN-SS) is a screening instrument evaluating internalizing/externalizing behaviors. This study examines the validity evidence of the GAIN-SS in Spanish adolescents and explores sex differences in its performance. METHOD: Participants were 1,547 Spanish adolescents from the community (females = 48.2%, mean [SD] age = 15.20 [0.74]). A cross-sectional online assessment was used to evaluate past-month substance use and gambling involvement. Problems associated to these behaviors were assessed using the GAIN-SS, the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), and the Rutgers Alcohol Problem Index (RAPI). Factor analyses were conducted to examine the internal structure of the GAIN-SS. RESULTS: Results revealed four subscales accounting for 47.03% of the variance related to externalizing (EDScr), internalizing (IDScr), substance use disorders (SDScr), and crime/violence problems (CVScr). Concurrent validity was supported through significant correlations between the GAIN-SS subscales, alcohol-related problems, and gambling behavior, with the exception of the IDScr. Past-month gamblers or substance users evidenced higher scores in the CVScr. Females reported more internalizing symptoms, whereas males reported higher scores in CVScr. CONCLUSIONS: The GAIN-SS is a valid screener for substance use and gambling in Spanish adolescents. Sensitivity of the GAIN-SS to sex differences suggests that it may be useful to design gender-sensitive interventions.

Validation of the Food Purchase Task (FPT) in a clinical sample of smokers with overweight and obesity.

Obesity is a major health problem associated with disease burden and mortality. In this context, analyzing food as a powerful reinforcer from a behavioral economics framework could be relevant for the treatment and prevention of obesity. The purposes of this study were to validate a food purchase task (FPT) in a clinical sample of Spanish smokers with overweight and obesity and to assess the internal structure of the FPT. We also analyzed the clinical utility of single-item breakpoint (i.e., commodity price that suppresses demand). A total of 120 smokers [% females: 54.2; Mage = 52.54; SD = 10.34] with overweight and obesity completed the FPT and weight/eating-related variables. Principal component analysis was used to examine the FPT structure, and a set of correlations were used to examine the relationship between the FPT, eating and weight-related variables. The FPT demonstrated robust convergent validity with other measures of eating. Higher food demand was related to higher food craving (r = .33), more binge eating problems (r = .39), more weight gain concerns (r = .35), higher frequency of both controlled (r = .37) and uncontrolled (r = .30) grazing, as well as to an eating style in response to emotions (r = .34) and external eating (r = .34). Of the demand indices, Intensity and Omax showed the highest magnitudes of effects. The FPT factors, persistence and amplitude, do not improve individual FPT indices; and the single-item breakpoint was not related to any eating or weight variable. The FPT is a valid measure of food reinforcement with potential clinical utility in smokers with obesity/overweight.

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.

Is Activation the Active Ingredient of Transdiagnostic Therapies? A Randomized Clinical Trial of Behavioral Activation, Acceptance and Commitment Therapy, and Transdiagnostic Cognitive-Behavioral Therapy for Emotional Disorders.

Studying the usefulness of contextual and cognitive transdiagnostic therapies calls for an analysis of both their differential efficacy and their specificity when acting on the transdiagnostic conditions on which they focus. This controlled trial compares the post-treatment and 3- and 6-month follow-up effects of Behavioral Activation (BA), Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Transdiagnostic Therapy (TD-CBT) on emotional symptomatology, and analyses the role played by Experiential Avoidance, Cognitive Fusion, Activation and Emotion Regulation in the clinical change. One hundred twenty-eight patients who fulfilled diagnostic criteria for anxiety and/or depression (intention-to-treat sample) were randomly assigned to three experimental group-treatment conditions (BA, n = 34; ACT, n = 27; TD-CBT n = 33) and one control group (WL, n = 34). Ninety-nine (77.34%) completed the treatment (per-protocol sample). In the post-treatment, all therapies reduced anxiety and depression symptomatology. In the follow-ups, the reduction in emotional symptomatology was greater in the condition which produced greater and more prolonged effects on Activation. Activation appears to be the principal condition in modifying all the transdiagnostic patterns and BA was the most efficacious and specific treatment. The trial was registered at ClinicalTrials.gov NCT04117464. Raw data are available online http://dx.doi.org/10.17632/krj3w2hfsj.1.

Concurrent validity of the marijuana purchase task: a meta-analysis of trait-level cannabis demand and cannabis involvement.

BACKGROUND AND AIMS: The Marijuana Purchase Task (MPT) is increasingly used to measure cannabis reinforcing value and has potential use for cannabis etiological and regulatory research. This meta-analysis sought to evaluate for the first time the MPT's concurrent validity in relation to cannabis involvement. METHODS: Electronic databases and pre-print repositories were searched for MPT studies that examined the cross-sectional relationship between frequency and quantity of cannabis use, problems, dependence, and five MPT indicators: intensity (i.e. unrestricted consumption), Omax (i.e. maximum consumption), Pmax (i.e. price at which demand becomes elastic), breakpoint (i.e. first price at which consumption ceases), and elasticity (i.e. sensitivity to rising costs). Random effects meta-analyses of cross-sectional effect sizes were conducted, with Q tests for examining differences by cannabis variables, meta-regression to test quantitative moderators, and publication bias assessment. Moderators included sex, number of MPT prices, variable transformations, and year of publication. Populations included community and clinical samples. RESULTS: The searches yielded 14 studies (n = 4077, median % females: 44.8%: weighted average age = 29.08 [SD = 6.82]), published between 2015 and 2022. Intensity, Omax , and elasticity showed the most robust concurrent validity (|r's| = 0.147-325, ps < 0.014) with the largest significant effect sizes for quantity (|r| intensity = 0.325) and cannabis dependence (|r| Omax = 0.320, |r| intensity = 0.305, |r| elasticity = 0.303). Higher proportion of males was associated with increased estimates for elasticity-quantity and Pmax -problems. Higher number of MPT prices significantly altered magnitude of effects sizes for Pmax and problems, suggesting biased estimations if excessively low prices are considered. Methodological quality was generally good, and minimal evidence of publication bias was observed. CONCLUSIONS: The marijuana purchase task presents adequate concurrent validity to measure cannabis demand, most robustly for intensity, Omax , and elasticity. Moderating effects by sex suggest potentially meaningful sex differences in the reinforcing value of cannabis.

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)

Psychological Inflexibility, Anxiety and Depression: The Moderating Role of Cognitive Fusion, Experiential Avoidance and Activation.

BACKGROUND: Evidence about how cognitive fusion (CF) and experiential avoidance (EA) interact with emotional distress underlines the importance of analyzing the interrelationships between the different processes of psychological inflexibility in order to improve ways of addressing emotional problems. This study analyzes the moderating effect of CF, EA and activation (A) in relation to four criteria of anxiety and depression. METHOD: A cross-sectional study of a clinical sample of adults was carried out by means of a questionnaire administered before (N = 172) and 6 months after (N = 114) participation in a clinical study. RESULTS: Regression analyses gave results which were consistent in the two evaluations. The EAxCF interaction modulated anxiety symptomatology, whereas A was not a significant predictor. Nevertheless, a reduction in A was the principal modulating condition in the symptomatology of depression; and although CF and EA did act as independent predictors, the EAxCF interaction was not significant. CONCLUSIONS: The presence and intensity of manifestations of emotional distress are explained and modulated by the progressive concurrence of CF, EA and reduction in A. The use of therapeutic approaches which increase activation could be a beneficial strategy with regard to decreasing cognitive fusion and experiential avoidance.

Is E-cigarette Use Associated With Persistence or Discontinuation of Combustible Cigarettes? A 24-Month Longitudinal Investigation in Young Adult Binge Drinkers.

INTRODUCTION: It remains unclear whether electronic cigarette (e-cigarette) use promotes persistent combustible tobacco use or smoking discontinuation over time. Alcohol use is associated with a greater risk of adverse health effects of tobacco, and higher likelihood of e-cigarette use, making drinkers a high-priority subpopulation. AIMS AND METHODS: This study examined longitudinal patterns of combustible tobacco and e-cigarette use over 24 months in young adult binge drinkers. A pooled dataset of 1002 (58.5% female; M age = 22.14) binge drinkers from the United States (60%) and Canada (40%) was used. The primary outcomes were past month combustible tobacco and e-cigarette use. Nicotine dependence was measured using the Fagerström Test of Cigarette Dependence. Alcohol severity was measured using the Young Adult Alcohol Consequences Questionnaire. Latent transition analysis (LTA) was used to identify patterns of cigarette smoking and e-cigarette use over 24 months. RESULTS: The LTA yielded a four-class solution: (1) e-cigarettes-only users (prevalence over time: 7.75%-10.10%), (2) dual-product users (2.61%-9.89%), (3) combustible-only smokers (8.12%-20.70%), and (4) nonusers (61.66%-80.06%). Dual-product users predominantly transitioned to complete abstinence or exclusively e-cigarette use. In combustible-only smokers, the most common transition was to abstinence, followed by persistence of combustible-only status. At 24 months, 63% of e-cigarettes-only users transitioned to abstinence, with 37% continuing e-cigarettes-only use and 0% transitioning to dual or combustible cigarette use. CONCLUSIONS: Dual-product use in young adult binge drinkers was associated with discontinuation of combustible tobacco over time, and e-cigarette-only use was not associated with subsequent combustible tobacco use. IMPLICATIONS: These findings suggest that concurrent or exclusive e-cigarette use is not a risk factor for the persistence or development of combustible tobacco use in this subpopulation, with dual-product use reflecting a transitional pattern away from combustible use, toward discontinuation.

Effects of Risk Perception and Accessibility on Cannabis Use among Young Population in Spain: Findings from the 2016 National Survey (ESTUDES).

BackgroundCannabis use in the young population has undergone a significant increase in Europe. Empirical assessments of individual and contextual mediating variables in relation to cannabis use are informative for prevention actions and have yet to be conducted in Spain. Objectives: This study used the 2016 National Survey on Drug Use in Secondary Education in Spain (ESTUDES) to inform on potentially relevant cannabis prevention targets. We examined individual variables (sex, age, and cannabis risk perception), past 30-day legal and illicit substance use, substance-free activities, and contextual factors (perceived accessibility to cannabis) associated to past 30-day cannabis use. Methods: Data were drawn from 35,369 adolescents (% females: 50.1). Structural equation modeling (SEM) was implemented to identify predictors of cannabis use, and indirect paths were tested via bootstrapping to examine the mediating effects of cannabis risk perception and accessibility. Results: Demographics (male sex, higher age), and past 30-day tobacco, alcohol, and illicit substance use were associated with past 30-day cannabis use. Frequency of past-year engagement in hobbies and reading did also predict past 30-day cannabis use. The mediators worked on most of the relationships examined, except for hobbies and illegal substance use in the case of accessibility and reading and hobbies in the case of risk perception. Conclusions/importance: Cannabis use is more likely to emerge in the event of low risk perception and high accessibility. Lower frequency of past year reading and higher engagement in some hobbies that are often carried out alone represent risk factors, which could potentially influence prevention programs.

Psychological Inflexibility, Anxiety and Depression: The Moderating Role of Cognitive Fusion, Experiential Avoidance and Activation / Inflexibilidad Psicológica, Ansiedad y Depresión: el Papel Moderador de la Fusión Cognitiva, la Evitación Experiencial y la Activación

Background: Evidence about how cognitive fusion (CF) and experientialavoidance (EA) interact with emotional distress underlines the importanceof analyzing the interrelationships between the different processesof psychological inflexibility in order to improve ways of address ingemotional problems. This study analyzes the moderating effect of CF, EAand activation (A) in relation to four criteria of anxiety and depression.Method: A cross-sectional study of a clinical sample of adults was carriedout by means of a questionnaire administered before (N = 172) and 6months after (N = 114) participation in a clinical study. Results: Regressionanalyses gave results which were consistent in the two evaluations. TheEAxCF interaction modulated anxiety symptomatology, whereas A wasnot a significant predictor. Nevertheless, a reduction in A was the principalmodulating condition in the symptomatology of depression; and althoughCF and EA did act as independent predictors, the EAxCF interaction wasnot significant. Conclusions: The presence and intensity of manifestationsof emotional distress are explained and modulated by the progressiveconcurrence of CF, EA and reduction in A. The use of therapeuticapproaches which increase activation could be a beneficial strategy withregard to decreasing cognitive fusion and experiential avoidance.

Antecedentes: las evidencias sobre la interacción entre la fusión cognitiva(FC) y la evitación experiencial (EE) con el distrés emocional señalan laimportancia de analizar las interrelaciones entre los diferentes procesos deinflexibilidad psicológica. Este estudio analiza el efecto moderador de laCF, EA y la activación (A) en relación con cuatro criterios de ansiedady depresión. Método: se evaluó transversalmente mediante cuestionariouna muestra clínica de adultos antes (N = 172) y 6 meses después (N =114) de participar en un estudio clínico. Resultados: análisis de regresión mostraron resultados consistentes entre medidas. La interacción EA ×CF moduló la sintomatología de ansiedad, pero la A no resultó predictor significativo. Sin embargo, la reducción de A fue la principal condición moduladora de la sintomatología depresiva; y aunque la CF y EA síactuaron como predictores independientes, la interacción EA × CF noresultó significativa. Conclusiones: se sugiere que la presencia e intensidad de las manifestaciones de malestar emocional se explica y modulada por laprogresiva concurrencia de CF, EA y pérdida de A. Podría ser beneficioso intervenir en la dirección de incrementar la activación como una estrategia adecuada para disminuir la fusión cognitiva y la evitación de experiencias.

Validity Evidence of the Multidimensional Emotional Disorders Inventory among Non-Clinical Spanish University Students.

The current diagnostic systems for mental health disorders are categorical, which, it has been argued, poorly reflect the reality of mental health problems. This is especially relevant in emotional disorders (EDs), especially due to the existing comorbidity between supposedly different disorders. To address this, Brown and Barlow developed a hybrid dimensional-categorical approach to EDs that can be evaluated with the Multidimensional Emotional Disorder Inventory (MEDI), a transdiagnostic self-report questionnaire. This study aims to adapt and explore the sources of validity evidence of the MEDI in a non-clinical sample of Spanish university students (n = 455). Two confirmatory analyses were performed: one with a four-dimensional structure obtained with an exploratory analysis and another with the original nine-dimensional structure of the MEDI. The latter obtained a better fit. The descriptive data, including percentiles, T-scores, and sex differences in total scores are also provided, together with sources of validity evidence. These revealed significant moderate interrelations between factors and with related measures (e.g., personality, depression, and anxiety). This study adapted the MEDI for use in Spanish, provides further support about its factor structure, and offers novel data about its validity sources. The MEDI makes the evaluation of dimensional and transdiagnostic models easier, which might be fundamental in present and future research and clinical practice.

Depression symptom profiles and long-term response to cognitive behavioral therapy plus contingency management for smoking cessation.

BACKGROUND: Depression is heterogeneous in nature and using diagnostic categories limits insight into understanding psychopathology and its impact on treatment efficacy. This secondary analysis sought to: 1) identify distinct subpopulations of cigarette users with depression, and 2) examine their response to cognitive-behavioral treatment (CBT) + contingency management (CM) for smoking cessation at one year. METHOD: The sample comprised 238 (74 % females) adults who smoke receiving CBT only or CBT + CM. A latent class analysis was conducted on baseline depressive symptoms measured using the Beck Depression Inventory-II. Generalized estimating equations assessed the main and interactive effects of class, time, treatment, and sex on smoking abstinence. RESULTS: Three distinct classes were identified: C1 (n= 76/238), characterized by mild depression, loss of energy, pessimism, and criticism, C2 (n= 100/238) presenting moderate severity and decreased appetite, and C3 (n= 62/238) showing severe depression, increased appetite, and feelings of punishment. There was a significant cluster × treatment interaction, which indicated additive effects of CM over CBT alone for Class 1 and 2. Persons in Class 1 and 2 were 3.60 [95 % CI: 1.62, 7.97] and 2.65 [95 % CI: 1.19, 5.91] times more likely to be abstinent if CBT + CM was delivered rather than CBT only. No differential sex effects were observed on treatment response according to cluster. CONCLUSIONS: Profiling depression symptom subtypes of cigarette users may be more informative to improve CM treatment response than merely focusing on total scores.

Does e-assessment always fit digital natives? A within-subject comparison between paperand tablet-based gambling assessments in adolescents / ¿La evaluación electrónica siempre se adapta a los nativos digitales? Una comparación intra-sujeto de la evaluación del juego de azar entre papel y tabletas electrónicas en adolescentes

Technological development has enabled the use of sophisticated methods for assessing multiple human behaviors. Despite the advantages of these newtechnologies, concerns exist regarding their equivalence with paper-based measures in epidemiological and health-related surveys. To date, literature on thistopic in relation to adolescents is virtually nonexistent. This study compares respondents’ performance on the same survey using both paper- and electronic tab-let-based assessment methods. A final sample of 135 adolescents (mean age 17.30 years, SD = 0.59; 56.3% males) consecutively completed two versions ofthe same survey on gambling behaviors and two questionnaires: The Gambling Motives Questionnaire (GMQ) and the South Oaks Gambling Screening-Re-vised for Adolescents (SOGS-RA). An ad-hoc questionnaire assessing participants’ satisfaction levels with each method was also used. The digital surveyyielded a lifetime, past year, and past month gambling prevalence of 54.1%, 45.2%, and 27.4%, respectively. Paper-based prevalence rates were 3.7-5.2%lower (all p < .092) and there were discrepancies in gambling activities. Although the reliability of the questionnaires was high in both formats, total scores wereconsistently higher in the paper-based format. GMQ and SOGS-RA intraclass correlations between versions ranged from .856-.884. Unexpectedly, studentspreferred the paper-based survey to the e-assessment (51.5% vs. 48.5%) and also enjoyed it more (31.3% vs 26.1%). Paper- and tablet-based surveys yielddifferent, albeit non-statistically significant, estimations of gambling behaviors even when the same participants were surveyed at one time. We recommend thatconsistency be routinely checked across assessment formats when adapting paper-and-pencil measures to digital formats.(AU)

El desarrollo tecnológico ha permitido el uso de métodos sofisticados de evaluación de múltiples comportamientos humanos.A pesar de los avances de estas nuevas tecnologías, existen preocupaciones sobre su equivalencia con las medidas de papel y lápiz en encuestas epidemio-lógicas y de salud. Hasta la fecha, la literatura en el tema en relación con los adolescentes es prácticamente inexistente. Este estudio compara el desempeñode los participantes sobre la misma encuesta utilizando métodos de evaluación de papel y lápiz y electrónicos. Una muestra de 135 adolescentes (edad media17.30 años, DT = 0.59; 56.3% hombres) completaron consecutivamente os versiones de la misma encuesta sobre conductas de juego y dos cuestionarios: elCuestionario de Motivos de Juego (GMQ) y el Cribado de Juego de South Oaks en su versión revisada para adolescentes (SOGS-RA). También se utilizó uncuestionario ad-hoc para evaluar el nivel de satisfacción de los participantes en cada método. La encuesta digital arrojó una prevalencia de juego vida, año y mesde 54,1%, 45,2%, y 27,4%, respectivamente. Las prevalencias en papel fueron 3,7-5,2% menores (todas p < ,092) y se mostraron discrepancias en las activi-dades de apuestas. A pesar de que la fiabilidad de los cuestionarios fue alta en ambos formatos, las puntuaciones totales fueron consistentemente más altas enel formato en papel. Las correlaciones intraclase en el GMQ y SOGS-RA oscilaban entre ,856 - ,884. Inesperadamente, los estudiantes preferían la encuestaen papel sobre el formato digital (51,5% vs. 48,5%) y también lo disfrutaron más (31,3% vs 26,1%). La encuesta en papel y en tableta electrónica mostraronestimaciones diferentes, aunque no estadísticamente significativas, en las conductas de juego...(AU)

Insights from behavioral economics to characterize substance use involvement in adolescents: a cluster analysis / La economía conductual para caracterizar el uso de drogas en adolescentes: análisis de cluster

Reinforcement pathology (RP), a framework rooted in behavioral economics, has contributed to advances in the etiology and treatment of substanceuse. Drug demand and delay discounting (DD) have gained considerable interest, as they inform on the risk for escalation to substance use as well astreatment-specific targets. No prior study conducted in Spain has explored the interplay of demand and DD in adolescents. This study was aimed to: 1)identify whether DD and alcohol demand can yield empirically driven subgroups, and 2) examine differences in substance use involvement. The samplecomprised 107 (% females = 54.2) adolescents (M=15.46, SD=1.25) from a high school in Asturias (Spain). Participants filled out an ad-hoc surveyon substance use over the prior 30 days and one year. A 20-item alcohol purchase task (APT) was used to assess the reinforcing value of alcohol. The21-item Monetary Choice Questionnaire evaluated impulsive choice. Two subgroups emerged: Cluster 1 (n = 72) and Cluster 2 (n = 35). Participants inC2 consistently showed higher impulsivity and demand for alcohol, signifying lower responsiveness to alcohol pricing. As compared to C1, those in C2had a higher prevalence of past-month substance use [C1: 26/72 (36.1%) vs. C2: 33/35 (94.3%), p <.001], and a greater frequency of drunkenness[p <.001] and binge drinking episodes [p <.001]. RP differentiate between subgroups of adolescent substance users with patterns of more versus lesssubstance use involvement. The existence of specific drug use subpopulations should be considered when designing environmental preventive policies.(AU)

La patología del refuerzo (PR), basada en la economíaconductual, ha contribuido al avance de la etiología y el tratamiento de drogas. La demanda y el descuento por demora (DD) informan sobre el incrementoen el consumo y los objetivos de tratamiento. Ningún estudio realizado en España ha examinado la interacción entre ambas variables en adolescentes.Los objetivos fueron: 1) identificar si el DD y la demanda de alcohol pueden identificar distintos subgrupos y, 2) examinar sus diferencias en el consumode sustancias. La muestra incluyó 107 (% mujeres = 54,2) adolescentes (M =15,46, DT =1,25) de enseñanza obligatoria en Asturias (España). Se evaluóel consumo de drogas en los últimos 30 días y el último año. El poder reforzante del alcohol se evaluó mediante una tarea de compra de 20 ítems (APT).La toma de decisiones impulsiva se evaluó mediante el Cuestionario de Elección Monetaria. Se identificaron dos subgrupos: Grupo 1 (n = 72) y Grupo2 (n = 35). El Grupo 2 mostró una demanda e impulsividad más elevada, indicando menor sensibilidad a incrementos en el precio. Comparado con elGrupo 1, el 2 obtuvo una prevalencia más elevada de consumo en el último mes [G1: 26/72 (36,1%) vs. G2: 33/35 (94,3%), p <,001], mayor frecuenciade borracheras (p <,001) y episodios de consumo intensivo de alcohol (p <,001). La PR permite caracterizar e identificar grupos con distintos patronesde consumo de sustancias. La existencia de distintos perfiles debería ser considerada a la hora de desarrollar políticas preventivas.(AU)

Episodic future thinking for smoking cessation in individuals with substance use disorder: Treatment feasibility and acceptability.

BACKGROUND: Smokers with substance use disorders (SUD) smoke approximately four times more than the general population. Current efforts are focused on improving smoking cessation treatments for this population. Episodic future thinking (EFT), a novel intervention aimed at decreasing impulsive choice, has shown promising results for reducing cigarette demand in experimental settings. This feasibility study sought to examine the feasibility and preliminary EFT effects on delay discounting (DD) and nicotine intake reductions throughout treatment. METHOD: Smokers in substance use treatment (N = 29; 75.9% males) received an 8-week cognitive-behavioral treatment (CBT) + EFT for smoking cessation. The study assessed feasibility through successful recruitment rates, retention, and adherence to treatment. Participants' satisfaction acted as our acceptability measure. We computed nonparametric range tests to analyze changes in continuous variables. RESULTS: Among interested individuals, 42 (43.75%) met the inclusion criteria, and 29 entered the treatment program. Rate of treatment completion was 65.5% (19/29). Mean (SD) sessions attended were 7(1.11), and mean patient satisfaction rating with treatment was 8.83/10. The study observed low compliance with EFT, with 15.8% (3/19) of patients practicing at least 50% of the requested times. CONCLUSIONS: CBT + EFT is acceptable for the SUD population. However, future studies should implement some adjustments to improve the adherence and feasibility of EFT, such as reducing the number of practices and temporal intervals in EFT events. Given the small sample size, and the absence of a control group, future larger scale trials are needed to elucidate EFT effects on DD and smoking cessation.

Sex differences in comorbidity between substance use and mental health in adolescents two sides of the same coin / Diferencias de Sexo en Comorbilidad entre Consumo de Sustancias y Salud Mental en Adolescentes: Dos Caras de la Misma Moneda

BACKGROUND: This study aims to evaluate sex differences in alcohol and cannabis use and mental health disorders (MHD) in adolescents, and to evaluate the predictive role of mental health disorders for alcohol and cannabis use disorders (AUD and CUD respectively). METHOD: A sample of 863 adolescents from the general population (53.7% girls, Mage = 16.62, SD = 0.85) completed a computerized battery including questions on substance use frequency, the Brief Symptom Inventory, the Cannabis Problems Questionnaire for Adolescents - Short version, the Rutgers Alcohol Problem Index and the DSM-IV-TR criteria for AUD and CUD. Bivariate analyses and binary logistic regressions were performed. RESULTS: Girls presented significantly more mental health problems and a higher prevalence of comorbidity between SUD and MHD. Obsessive-compulsive symptoms and phobic anxiety indicated a higher risk of AUD, whereas depression and interaction between hostility and obsessive-compulsive disorder indicated a higher risk of CUD. CONCLUSIONS: Comorbidity between SUD and MHD is high among adolescents, and significantly higher among girls

ANTECEDENTES: el objetivo de esta investigación es evaluar las diferencias de sexo en el uso de cannabis y alcohol y en trastornos de salud mental TSM en adolescentes, y el rol predictivo de los TSM sobre los trastornos por uso de alcohol y cannabis (TUA y TUC, respectivamente). MÉTODO: una muestra de 863 adolescentes de la población general (53,7% chicas, edad media = 16.62, DT = 0,85) completaron una batería informatizada sobre la frecuencia de uso de sustancias, el Inventario Breve de Síntomas, el Cuestionario de Problemas por Consumo de Cannabis - versión breve, el Índice de Rutgers de Problemas con el Alcohol y los criterios DSM-IV-TR para el TUA y TUC. Se realizaron análisis bivariados y de regresión logística binaria. RESULTADOS: las chicas presentaron significativamente más problemas de salud mental y mayor prevalencia de comorbilidad entre TUS y TSM. El trastorno obsesivo-compulsivo (TOC) y la ansiedad fóbica indicaron un mayor riesgo de TUA, mientras que la depresión y la interacción entre hostilidad y TOC indicaron mayor riesgo de TUC. CONCLUSIONES: la comorbilidad entre TUS y TSM es alta entre los adolescentes, y significativamente mayor entre las chicas

Sex Differences in Comorbidity Between Substance Use and Mental Health in Adolescents: Two Sides of the Same Coin.

BACKGROUND: This study aims to evaluate sex differences in alcohol and cannabis use and mental health disorders (MHD) in adolescents, and to evaluate the predictive role of mental health disorders for alcohol and cannabis use disorders (AUD and CUD respectively). METHOD: A sample of 863 adolescents from the general population (53.7% girls, Mage = 16.62, SD = 0.85) completed a computerized battery including questions on substance use frequency, the Brief Symptom Inventory, the Cannabis Problems Questionnaire for Adolescents - Short version, the Rutgers Alcohol Problem Index and the DSM-IV-TR criteria for AUD and CUD. Bivariate analyses and binary logistic regressions were performed. RESULTS: Girls presented significantly more mental health problems and a higher prevalence of comorbidity between SUD and MHD. Obsessive-compulsive symptoms and phobic anxiety indicated a higher risk of AUD, whereas depression and interaction between hostility and obsessive-compulsive disorder indicated a higher risk of CUD. CONCLUSIONS: Comorbidity between SUD and MHD is high among adolescents, and significantly higher among girls.

One-Year Efficacy and Incremental Cost-effectiveness of Contingency Management for Cigarette Smokers With Depression.

INTRODUCTION: Contingency management (CM) is efficacious for smoking cessation. To date, the number of cost-effectiveness evaluations of behavioral and pharmacological smoking cessation treatments far outnumbers the ones on CM. This study estimated 1-year efficacy and incremental cost-effectiveness of adding CM in relation to abstinence outcomes for a cognitive-behavioral therapy (CBT)+behavioral activation (BA) treatment. METHODS: The study sample comprised 120 smokers with depression (% females: 70.8%; mean age: 51.67 [SD = 9.59]) enrolled in an 8-week randomized controlled clinical trial. Clinical effectiveness variables were point-prevalence abstinence, continuous abstinence, longest duration of abstinence (LDA), and Beck-Depression Inventory-II (BDI-II) scores at 1-year follow-up. Cost-effectiveness analyses were based on resource utilization, unit costs per patient, and incremental cost per additional LDA week at 1 year. RESULTS: There was a significant effect of time by treatment group interaction, which indicated superior effects of CBT+BA+CM across time. Point-prevalence abstinence (53.3% [32/60]) was superior in participants receiving CBT+BA+CM compared with those in CBT+BA (23.3% [14/60]), but both groups were equally likely to present sustained reductions in depression. The average cost per patient was €208.85 (US$236.57) for CBT+BA and €410.64 (US$465.14) for CBT+BA+CM, p < .001. The incremental cost of using CM to enhance 1-year abstinence by one extra LDA week was €18 (US$20.39) (95% confidence interval: 17.75-18.25). CONCLUSIONS: Behavioral treatments addressing both smoking and depression are efficacious for sustaining high quit rates at 1 year. Adding CM to CBT+BA for smoking cessation is highly cost-effective, with an estimated net benefit of €4704 (US$5344.80). IMPLICATIONS: Informing on the cost-effectiveness of CM might expedite the translation of research findings into clinical practice. Findings suggested that CM is feasible and highly cost-effective, confirming that its implementation is worthwhile. At a CM cost per patient of €410.64 (US$465.14), the net benefit equals €4704 (US$5344.80), although even starting from a minimum investment of €20 (US$22.72) was cost-effective. CLINICALTRIALS-GOV IDENTIFIER: NCT03163056.

Spanish Adaptation of the Overall Anxiety and Depression Severity and Impairment Scales in University Students.

The lifetime prevalence of emotional disorders in Spain is 4.1% for anxiety and 5.2% for depression, increasing among university students. Considering the scarcity of screenings with adequate psychometric properties, this study aims to explore the validity evidence of the Overall Anxiety/Depression Severity and Impairment Scales (OASIS and ODSIS). A total of 382 university students from the general population were assessed on anxiety and depressive symptoms, as well as quality of life. The one-dimensional structure of both the OASIS and ODSIS explained 87.53% and 90.60% of variance, with excellent internal consistency (α = 0.94 and 0.95, respectively) and optimal cut-offs of 4 and 5, respectively. Both scales show a significant moderate association with other measures of anxiety, depression and quality of life. The OASIS and ODSIS have shown good reliability and sound validity evidence that recommend their use for the assessment and early detection of anxiety and depressive symptoms, and associated quality of life impairment in Spanish youth.