Overburden in Caregivers of Chronically Ill Adolescents: A Comparative Study between Pulmonological and Endocrinological Diseases.

Chronic pediatric disease has a major impact on the life of a child and his or her family. In this sense, the figure of the main caregiver is relevant, who may present adjustment difficulties before the disease, accompanied by high levels of stress and emotional discomfort, which interfere with the adolescent's adjustment before the new situation. The aim of this research was to carry out a comparative study among caregivers of adolescents with various diseases, analyzing the risk and protective factors for the stress presented by this population. For this purpose, a sample of 406 main caregivers of adolescents with an endocrinological or pneumological disease from different hospitals in Valencia was used, where characteristics related to the disease, attachment, type of family, and emotional distress of these caregivers were considered. In general, the results show higher levels of stress in caregivers of adolescents with an endocrinological disease, specifically DM1, and found significant predictors of anxiety-depressive symptomatology, the need for approval, and several variables related to the disease. These data reveal the importance of providing comprehensive care to the family system, offering health skills to overcome diseases, and reinforcing the protective factors offered by the family system.

How effective are psychological treatments for internet gaming disorder? An umbrella review / ¿Qué eficacia tienen los tratamientos psicológicos para el trastorno de juego por internet? Una revisión de revisiones

Behavioural addictions such as Internet addiction (IA) and, more specifically, Internet gaming disorder (IGD) or video game addiction, have increased their prevalence in recent years in the child and adolescent population. The aim of the present study was to review and synthesise the existingevidence on the effectiveness of psychological treatments for addressing this addiction, as well as to compare them with other types of treatment. Tothis end, an in-depth search for systematic reviews and meta-analyses was carried out across different databases (WOS, Scopus, PubmMed, Cochrane), inclusion and exclusion criteria were set, and guidelines for the search strategy were defined, as well as the study selection method. A totalof 14 reviews and meta-analyses were reviewed. The results showed that cognitive behavioural therapy (CBT) was the most studied psychologicaltreatment, consistently showing effectiveness in reducing the symptoms and severity of IA/IGD. Furthermore, CBT appeared to be more effectivewhen combined with other types of treatment such as pharmacological treatment. It is concluded that there is a need to investigate the effectivenessof psychological treatments for IA/IGD separately in order to provide appropriate interventions to reduce the severity of addiction and improve thequality of life and well-being of children and adolescents. (AU)

Las adicciones conductualescomo la adicción a internet (IA) y, concretamente, el trastorno de juego por internet (IGD) o adicción a videojuegos, han aumentado su prevalenciaen los últimos años en población infanto-juvenil. El objetivo del presente estudio fue realizar una revisión de revisiones para agrupar y sintetizar laevidencia existente acerca de la efectividad de los tratamientos psicológicos para abordar este tipo de adición, así como compararlos con otrostipos de tratamiento. Para ello, se realizó una búsqueda exhaustiva de revisiones sistemáticas y/o meta-análisis en diferentes bases de datos (WOS,Scopus, PubmMed, Cochrane), se establecieron los criterios de inclusión y exclusión, y se definió la estrategia de búsqueda, así como el método deselección de los estudios. En total se revisaron 14 revisiones y meta-análisis. Los resultaron evidenciaron que la terapia cognitivo-conductual (TCC)fue el tratamiento psicológico más estudiado, mostrando consistentemente efectividad para reducir los síntomas y la severidad de IA/IGD. Además,la TCC parece ser más efectiva cuando se combinaba con otros tipos de tratamiento como el farmacológico. Se concluye la necesidad de investigarla efectividad de los tratamientos psicológicos para IA/IGD de manera diferenciada con el objetivo de establecer intervenciones adecuadas quepermitan reducir la gravedad de la adicción y mejorar el bienestar y la calidad de vida de los niños y adolescentes. (AU)

Personal and family factors for emotional distress in adolescents with chronic disease.

Introduction: Physical and psychological comorbidity is a challenge for public health, especially in the adolescent stage due to the difficulties of this age. The salutogenic perspective emphasizes general psychological resources such as self-esteem but also highlights the role of contextual factors such as family members in promoting health. From this perspective, the objective of this study was to analyze the joint influence of demographic factors (sex, age and type of chronic disease), personal factors (self-esteem and perception of threat of the disease) and family factors (affection and communication, psychological and behavioral control) of risk of emotional distress (anxiety-depressive symptoms) in chronically ill adolescents. Methods: The study is a cross-sectional design with 495 adolescents with chronic disease aged 12-16 years. In order to obtain the results, a linear methodology was used to compare means and perform regressions to predict belonging to the anxiety and depression typologies. Four typologies were constructed: typology I (high anxiety and depression scores); typology II (high anxiety and low depression scores); typology III (low anxiety and high depression scores) and typology IV (low anxiety and depression scores). Results: The results were consistent with the salutugenic theory. Potential mediating or moderating roles of age, sex, self-esteem, perceived threat and psychological and behavioral control marked the differences between the typologies. Discussion: This population could benefit from interventions focused on family flexibility.

Perceived Stress in the Primary Caregivers of Adolescents with Asthma: A Cross-Sectional Study.

This study aims to determine the impact of the disease on the perceived stress levels of caregivers of adolescents with asthma. A total of 140 primary caregivers, whose mean age was 45.43 years (SD = 5.03), of whom 85% were mothers, were assessed using the perceived stress questionnaire (PIP), and medical indicators related to asthma were recorded. Mean comparisons, correlations, and qualitative comparative analysis (QCA) models were used. The results indicated moderate levels of perceived stress in caregivers, no kinship differences were found, and age was negatively associated with perceived stress. QCA models suggested that perceived stress could be explained by a higher frequency of visits, poorer adherence, more frequent daily medication doses, and higher severity of asthma. In conclusion, the development of psychological interventions addressing the subjective overload of the family caregiver may benefit them, increasing their well-being, and in turn help to manage the emotional difficulties of adolescents.

Representaciones sociales del COVID-19 en adolescentes y progenitores / Adolescents' and parents' social representations of COVID-19

La pandemia de COVID-19 supuso el confinamiento de la población en numerosas partes del mundo, siendo España una de las más afectadas. Esta experiencia puede tener efectos psicológicos negativos dependiendo de la vivencia de amenaza, influida por lo que pensamos acerca del COVID-19. El objetivo de este estudio fue analizar las representaciones sociales del coronavirus en 61 adolescentes y sus familias (81 progenitores), utilizando un diseño mixto con datos transversales. Los resultados señalan seis categorías básicas que describen la representación social del COVID-19 de los participantes, destacando aspectos sanitarios y afectivos. Se concluye que la representación social del coronavirus de adolescentes y adultos es similar en el aspecto sanitario, pero es más amplia y anclada en el miedo en los adultos. Comprender las representaciones sociales de adolescentes y adultos en relación al coronavirus puede resultar útil para orientar futuras intervenciones psicológicas y emocionales durante la pandemia.(AU)

The COVID-19 pandemic caused the confinement of the population in many parts of the world, with Spain being one of the most affected countries. This particular situation may have negative psychological consequences, depending on the experience of threat. This experience is influenced by what we think about COVID-19. The aim of this study was to analyze the social representations of COVID-19 in 61 adolescents and their families (81 parents), using a mixed design with cross-sectional data. We identified six basic categories that describe participants' social representation of COVID-19, highlighting the health and emotional domains. In conclusion, the social representation of coronavirus in adolescents and adults is similar in the medical and health domain, but differs in the fact that it is broader and more fear-driven in adults. Understanding adolescents' and adult's social representation regarding the coronavirus can be useful in orienting future psychological and emotional interventions during the pandemic.(AU)

Psychological adjustment of Spanish adolescents and their parents during COVID-19 lockdown: A mixed method approach.

Previous literature on the psychological impact of COVID-19 has shown a direct relationship between family conflicts and psychological distress among parents and their children during the domestic lockdown and social isolation; but there are also opportunities to enhance family bonding, encourage collective problem-solving and improve personal relationships. This study aimed to explore psychological adjustment processes of Spanish adolescents and their parents during the first month of lockdown by analyzing their narratives, perceived outcomes, protection and risk factors. A total of 142 people agreed to participate in this study. Of all participants, 61 were adolescents (M = 13.57; SD = 1.74; 57% women) and 81 were parents (M = 46.09; SD = 4.72; 91% mothers). All were Spanish residents and completed an online survey during the domestic lockdown in March 2020. From a qualitative design, methodology followed a mixed approach to analyze data. The results showed three different types of adaptation to lockdown and social isolation in both adolescents and their parents: 1) positive adjustment, 2) moderate adjustment, and 3) maladjustment. Most participants reported a good adjustment and only a 20% of parents and a 16% of adolescents stated that they had not been able to achieve a positive psychological adjustment. There are few significant quantitative differences between adolescents and their parents. The qualitative analysis of data showed that adolescents reported less psychological distress than their parents. The two most important protective factors were social support and keeping busy during lockdown. The most significant risk factors were loss of mobility and social isolation. The conclusions stressed that regarding psychological maladjustment, parents experienced feelings of uncertainty whereas adolescents experienced a kind of mourning process. These findings can be used to design and implement effective intervention measures for mental health and psychological well-being in such a difficult situation as domestic lockdown.

Influence of Social Support and Subjective Well-Being on the Perceived Overall Health of the Elderly.

Scientific interest in the positive aspects of aging and the development of healthy aging has increased, given the need to ensure older people well-being and quality of life. In this sense, social support and some sociodemographic variables may have a not yet entirely clear role. The main objective of this work was to analyze the predictive relationships of age, marital status, social support and subjective well-being on the general perception of the health of a group of elderly people. The participants were 137 people (77.4% women) between 61 and 91 years old (M = 73.11; SD = 6.22); 56.9% of them had a partner and 40.1% did not. The path analysis tested indicates that social support has an indirect predictive value on perceived overall health through its influence on subjective well-being. Age and life satisfaction are the most important direct predictors of perceived overall health. Conclusions highlight the need to delve into the study of explanatory factors of the general perception of the health of the elderly and promote interventions to facilitate the development of an appropriate social support network and increase the subjective well-being of this group.

EmoTIC: Impact of a game-based social-emotional programme on adolescents.

INTRODUCTION: Technologies provide a brilliant opportunity to promote social-emotional competences, well-being and adjustment in adolescence. Game-based programmes and serious games are digital tools that pursue an educational goal in an attractive environment for adolescents. The purpose of this study was therefore to determine the effectiveness of emoTIC, a game-based social-emotional programme designed according to Mayer, Caruso, and Salovey's model of emotional intelligence. MATERIALS AND METHODS: The participants were 119 adolescents between 11 and 15 years, randomly assigned to the experimental group and the control group. The adolescents completed questionnaires to assess their emotional intelligence, self-esteem, affect balance, difficulties, prosocial behaviour, depression, anxiety and stress. RESULTS: The MANCOVA results showed that adolescents who completed the game-based programme had improved self-esteem, affect balance, emotional symptoms, behavioural problems, and hyperactivity (Wilks' λ = .77; F = 2.10; p = .035). Hierarchical multiple regression indicated that adolescents in the experimental group had a greater change in self-esteem and affect balance (positive ß), while their emotional problems and hyperactivity decreased (negative ß). Anxiety moderated the influence of the intervention on self-esteem (b = .04; t = -2.55; p ≤ .05; LLCI = -0.43, ULCI = -0.05). Adolescents with low or medium anxiety improved their self-esteem with the intervention, while those with high anxiety did not develop it. CONCLUSIONS: The use of technology in social-emotional programmes could be the first step in increasing adolescents' interest in emotions and emoTIC could be considered a useful programme which influences their personal, emotional and social factors. TRIAL REGISTRATION: Clinical Trial identifier: NCT04414449.

Serious game to promote socioemotional learning and mental health (emoTIC): a study protocol for randomised controlled trial.

INTRODUCTION: The development of emotional competences may be a protective factor for mental health problems, promoting well-being at such a complex age as adolescence. Technologies may be used to carry out this empowerment because adolescents are attracted to them. The purpose of the study is to design a serious game based on the Mayer et al's emotional intelligence ability model and analyse the effectiveness of the emoTIC programme to develop emotional competences, well-being, mental health, and personal strengths immediately after completion and at 12 months. METHODS AND ANALYSIS: The new version of emoTIC will be designed following the suggestions of the adolescents who participated in the pilot study and the results obtained from the statistical analysis. The participants will be 385 adolescents aged 11-16 years who will be randomly assigned to the control group and the experimental group. The experimental group will complete the emoTIC programme. The primary outcomes include emotional competences and subjective well-being. The secondary outcomes are self-esteem; general self-efficacy; personality; social and personal responsibility; school social climate; somatic complaints; depression, anxiety and stress symptoms; emotional and behavioural difficulties; suicidal behaviour; and subjective happiness. Data will be collected at three moments: baseline (T1), immediately post-intervention (T2) and 12-month follow-up (T3). The effectiveness of the programme will be analysed using different statistical packages. ETHICS AND DISSEMINATION: The study has been approved by the Ethics Commission of the University of Valencia (H152865096049), and the standards of the Declaration of Helsinki to collect the data will be followed. Results will be disseminated across the scientific community. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04414449). TRIAL SPONSOR: University of Valencia. Principal investigator: Inmaculada Montoya-Castilla.

Ajuste familiar durante la pandemia de la COVID-19: un estudio de díadas / Family adjustment during the COVID-19 pandemic: a dyad study

La pandemia mundial del COVID-19 ha traído una gran cantidad de cambios vitales para la sociedad. Ante esta situación, las familias y sus hijos han tenido que adaptarse a nuevas rutinas y situaciones, lo que puede haber aumentado o agravado el padecimiento de sintomatología emocional. No obstante, la presencia de resiliencia y de estrategias de regulación emocional positivas, puede amortiguar este impacto en las familias con hijos pequeños. El objetivo del presente trabajo es conocer las variables que explicaban los problemas de ajuste emocional familiar ante la pandemia del COVID-19, teniendo en cuenta las díadas de progenitores y sus hijos adolescentes. Participaron 31 díadas de adolescentes entre 11 y 19 años (M =13.90; DT=1.85) y sus cuidadores principales, siendo el 93,50% madres. Tras aceptar participar en el estudio se evaluó la regulación emocional (Cuestionario de Regulación Emocional; ERQ), la resiliencia (Escala de Resiliencia de Connor-Davidson; CD-RISC) y la sintomatología ansiosa, depresiva y el estrés (Escala de Depresión, Ansiedad y Estrés; DASS). Se realizaron modelos de análisis comparativo cualitativo de conjuntos difusos (fsQCA). En la explicación del desajuste emocional de los cuidadores, el clima familiar negativo y las estrategias de regulación emocional deficientes en sus hijos fueron las variables más relevantes. En la explicación del malestar emocional de los adolescentes, lo fueron la baja resiliencia de estos y las estrategias deficientes de regulación emocional de sus padres. Nuestro estudio señala la relevancia de atender a los miembros de las familias en su conjunto ante crisis vitales de este tipo, mediante programas de intervención que mejoren los vínculos familiares y las estrategias de regulación emocional

The global pandemic of COVID-19 has brought a host of vital changes to society. Families and their children have had to adapt to new routines and situations, which may have increased or aggravated the suffering of emotional symptoms. However, the presence of resilience and positive emotional regulation strategies can cushion this impact on families with young children. The aim of the present study is to know the variables that explained the problems of family emotional adjustment to the COVID-19 pandemic, considering the dyads of parents and their adolescent children. Thirty-one dyads of adolescents between 11 and 19 years old (M = 13.90; SD = 1.85) and their main caregivers participated, 93.50% of whom were mothers. After accepting to participate in the study, emotional regulation (Emotional Regulation Questionnaire; ERQ), resilience (Connor-Davidson Resilience Scale; CD-RISC) and anxious, depressive and stress symptoms (Depression, Anxiety and Stress Scale; DASS) were evaluated. Qualitative comparative fuzzy set analysis (fsQCA) models were performed. In the explanation of the emotional maladjustment of the caregivers, the negative family climate and the deficient emotional regulation strategies in their children were the most relevant variables. In the explanation of the emotional discomfort of the adolescents, the low resilience of these and the deficient strategies of emotional regulation of their parents were the most relevant variables. Our study points out the relevance of caring for family members when facing this kind of life crisis, through intervention programs that improve family bonds and emotional regulation strategies

¿Qué dicen los adolescentes sobre el acoso escolar? / What do adolescents say about bullying?

All antisocial acts, including violence and bullying behavior, are such thing within the community where they occur; they are a reflection of that community. This study aims to analyze the spontaneous discourse about bullying at school of 406 adolescents aged between 15 and 21 years. Qualitative analysis of the data permitted to derive four discursive principles: denial of the existence of violence ("it doesn’t happen"), denial of one’s own responsibility ("if it happens, it isn’t me, everybody does it"), denial of seriousness ("if it is a joke, it doesn’t hurt"), and attribution to the victim (bullying behavior happens to the victim for a reason). The analysis of adolescent’s spontaneous discourse contributes to the definition of interpretive context regarding peer violence. This knowledge should be included in the scientific model in order to help developing effective intervention programs

Todos los actos antisociales, incluidos la violencia y el acoso escolar, lo son dentro de la colectividad en la que se producen y son un reflejo de esa colectividad. Este estudio se centra en el discurso espontáneo de 406 adolescentes entre 15 y 21 años sobre el acoso escolar. El análisis cualitativo de los datos permite inferir cuatro principios discursivos que se articulan desde la inicial negación de la violencia ("eso no pasa"), a la negación de la responsabilidad ("si pasa, no soy yo, somos todos"), la negación de la gravedad ("si es broma, no hace daño"), y la atribución a la víctima (el acoso tiene más que ver con la víctima que con el agresor). El análisis del discurso espontáneo adolescente contribuye a definir su contexto interpretativo respecto a la violencia entre iguales. Incluir este conocimiento en el modelo científico es necesario para dar lugar a programas de intervención eficaces

Diferencias conductuales según género en convivencia escolar / Behavioral gender differences in school relationships

Los adolescentes asumen diferentes roles sociales mediados por el género que influyen el desarrollo de su identidad y cómo se manifiesta la violencia escolar. El objetivo de este trabajo es estudiar las diferencias conductuales en el acoso escolar según el género. La muestra (N= 641) tiene una edad entre12 y 16 años. Se estudiaron variables personales mediante autoinformes, y variables relacionales con medidas sociométricas. Los resultados indican mayor incidencia de acoso, rechazo entre iguales e inadaptación escolar entre los chicos. Ellas refieren más agresiones relacionales, aceptación y habilidades sociales, pero también mayor inadaptación personal. Las víctimas femeninas son las más rechazadas. Las diferencias de género parecen más relevantes en las variables relacionales, sugiriendo la importancia del contexto relacional en el acoso (AU)

Adolescents take on different social roles mediated by gender, which affect the development of their identity and the expression of school violence. The purpose of this work is to study the behavioral differences in bullying depending on gender. The sample (N= 641) is aged between 12 and 16 years old. Personal variables are assessed byself-reports, and relational variables by sociometric measures. Results indicate a large incidence of bullying, peer rejection, and school maladjustment among boys. Girls report more relational aggressions, acceptance and social skills, but also higher personal maladjustment. Female victims are rejected the most. Gender differences seem more relevant in relational variables, suggesting the special importance of the relational context in bullying (AU)

[Behavioral gender differences in school relationships]. / Diferencias conductuales según género en convivencia escolar.

Adolescents take on different social roles mediated by gender, which affect the development of their identity and the expression of school violence. The purpose of this work is to study the behavioral differences in bullying depending on gender. The sample (N=641) is aged between 12 and 16 years old. Personal variables are assessed by self-reports, and relational variables by sociometric measures. Results indicate a large incidence of bullying, peer rejection, and school maladjustment among boys. Girls report more relational aggressions, acceptance and social skills, but also higher personal maladjustment. Female victims are rejected the most. Gender differences seem more relevant in relational variables, suggesting the special importance of the relational context in bullying.