Burden and anticipatory grief in caregivers of family members with Alzheimer's disease and other dementias.

OBJECTIVES: This study aimed to analyze the different factors that intervene in the task of caring for relatives of people with Alzheimer's and other dementias. A first objective focused on assessing the relation between burden and anticipatory grief, considering the possibility of social support and the risk of psychopathology. A second objective aimed to examine whether caregiver burden modulates the relationships between anticipatory grief and psychopathology. A cross-sectional design was employed. METHODS: The sample consists of 129 participants who care for a family member with Alzheimer's and other dementias. A protocol based on a battery of tests has been applied and a mediation analysis was carried out. RESULTS: The results show a positive relationship between burden and anticipatory grief. Social support could have an indirect relationship with anticipatory grief, based on its effect on the level of psychopathology and caregiver burden. Finally, a modulation model reflects that the relationship between anticipatory grief and psychopathology is strong, the latter having a greater effect as a result variable than as a risk variable. However, it seems that the relationship between grief and psychopathology is better explained directly than not through the modulating effect of the caregiver burden. SIGNIFICANCE OF RESULTS: The results obtained encourage us to think that an approach focused on intervening in the anticipatory grief may be an opportunity to reduce or buffer other caregiving outcomes, especially those related to the perception of caregiver burden and psychopathology.

Hacia un cambio de paradigma en la atención psicológica en grandes emergencias: de incidentes con múltiples víctimas a incidentes con múltiples afectados / Towards a paradigm shift in psychological care in major emergencies: from incidents with multiple victims to incidents with multiple victims

Las grandes emergencias o desastres plantean grandes retos a la sociedad y en especial a todos los servicios de emergencia. En las últimas décadas, se ha incorporado la perspectiva de la salud mental como una parte importante de la atención sanitaria integral a los afectados. Así, el cambio conceptual de «incidente de múltiples víctimas» (IMV) a «incidente de múltiples afectados» (IMA) se centra en la atención y bienestar de todas las personas afectadas por un incidente, no solo en aquellos que han sufrido lesiones físicas. El objetivo del presente artículo se centra en conocer las posibilidades de intervención con afectados etiquetados en un triaje como verdes psicológicos (sin afectación y/o lesiones físicas), a partir de la intervención psicológica avanzada en emergencias (IPA). La IPA, más allá de alejar a los afectados del peligro, persigue aumentar su sensación de control y eficacia, tanto para afrontar la situación como para aumentar su sentido de competencia en la vivencia de trauma posterior respecto a esa experiencia. En este sentido, las posibilidades recientes de evaluación, así como los enfoques de primeros auxilios psicológicos, permiten nuevas aplicaciones de intervención en emergencias como las que posibilitan los soportes aéreos remotos (drones). Se discute su aplicación y posibilidades como opciones de futuro. (AU)

Major emergencies or disasters pose great challenges to society and especially to all emergency services. In the last decades, the Mental Health perspective has been incorporated as an important part of comprehensive health care for those affected. Thus, the conceptual change from “multiple casualty incident” (MCI) to “multiple affected incident” (MAI) focuses on the care and well-being of all people affected by an incident, not only those who have suffered physical injuries. The objective of this article is focused on finding out the possibilities of intervention with patients labeled in triage as psychological green (without affectation and/or physical injuries), based on advanced psychological intervention in emergencies (IPA). The IPA, beyond removing those affected from danger, seeks to increase their sense of control and efficacy, both to face the situation and to increase their sense of competence in the experience of subsequent trauma with respect to that experience. In this sense, recent assessment possibilities, as well as psychological first aid approaches, allow new intervention applications in emergencies such as those made possible by remote air support (drones). Its application and possibilities as future options are discussed. (AU)

Characterization and Evolution of Mental Health Problems Attended to in a Telephone Helpline During the Lockdown and De-Escalation by COVID-19.

Objectives: To picture the psychological impact on the general population consulting the Emergency Medical System (EMS) of Catalonia for psychological assistance due to the COVID-19. Methods: Calls received to the 061 emergency phone number between the months of March and June 2020 (period of lockdown and de-escalation) were analyzed. The reason, most prevalent psychological symptoms, presence of psychological antecedents, and type of intervention that was carried out were analyzed. Results: A total of 2,516 calls were analyzed. Weeks 6, 7, 8 and 9 of lockdown saw the highest volume of calls (298, 314, 282 and 290 daily calls, respectively). The main profile of the affected person was women, under the age of 50 who are responsible for others. Psychologically, they present symptoms of depression (7.33%) and anxiety (39.44%). The greatest impacts on mental health throughout lockdown seem to be related to an increase of interpersonal conflict (8.8% < 11.2%), work-related problems (1.7% < 4.6%), and problems of psychological distress (6.5% < 17.0%). Conclusion: The information obtained enables us to better understand the possible evolution of the impacts on mental health derived from the lockdown.

Counselling toward reducing alcohol use, knowledge about its morbidity and personal consumption among students of medical and dental courses in north-western Spain

Background: Alcohol use disorder (AUD) is directly linked to high-risk consumption. Healthcare students have a crucial role to play in its prevention and management. The aim of this study is to analyse alcohol consumption, as well as to consider the knowledge and attitudes regarding morbidity, and the stage of change when providing assistance to quit AUD. Material and Methods: A cross-sectional study was conducted among Dentistry and Medical students using specific and validated questionnaires in an anonymous and voluntary way. Initially, 925 students were invited to participate, of them 500 were reached. Results: Among them 85.9% suffered from AUD of whom 75% were women (p<0.001), and it was considered that the female gender constituted an independent risk factor (OR=2.63, CI 95% 1.55-4.45, p<0.001). The majority of the participants did not achieve the pass mark, nonetheless, the results showed improved levels of knowledge among participants in the latter years of their studies (p<0.001). Dental students demonstrated greater shortcomings in terms of their knowledge of general pathology, whereas the medical students’ knowledge of oral pathologies proved worse (p<0.001). Most of students believed that identifying cases of AUD-affected patients falls within their competence, nonetheless, they believed that they do not have the necessary competencies. Among participants 58.2% were in a stage of change regarding AUD attitudes. Conclusions: The majority of respondents presented AUD. In general, the participants’ knowledge about alcohol was low. Reviewing the syllabuses and evaluating the implementation of gender-differentiated training programmes in both degrees would be considered necessary.(AU)

Association between xerostomia, oral and general health, and obesity in adults. A cross-sectional pilot study / Asociación entre xerostomía, salud bucal y general, y obesidad en adultos. Un estudio piloto transversal

Background: The objective of this study was to analyse the association between oral and general health variablesand obesity indicators with the sensation of dry mouth or xerostomia as evaluated on the Xerostomia Inventory(XI).Material and Methods: A total of 354 randomly selected subjects participated in this cross-sectional pilot studyand completed an anonymous questionnaire. Anthropometric, clinical, and xerostomic variables were evaluated.Kruskal-Wallis, ANOVA and Bonferroni test were used for multiple comparisons. ROC curves and multinomiallogistic regression were used to determine the (OR) risk of xerostomia.Results: A total of 30.7 % of respondents reported xerostomia based on XI. The dry mouth question, the XItaken as a “gold standard”, showed a diagnostic sensitivity of 70.37 %, and a specificity of 83.27 % (AUC=0.768,p<0.001). Logistical regression showed the highest xerostomia OR was associated to patients with bad self-per-ceived health, 6.31 (CI 95% 2.89-13.80, p<0.001). In the model adjusted for tooth mobility, bone or respiratorydiseases, and the consumption of anxiolytics and antidepressants, the OR was 3.46 (CI 95% 1.47-8.18, p=0.005).Conclusions: a high prevalence of xerostomia was found in this cross-sectional pilot study, which was significantlymore frequent in women, and increased with age. Xerostomia was associated to several systemic diseases, psycho-logical conditions, and oral functional disorders such as tooth mobility.These preliminary results can serve as the basis for developing guidelines for the application of innovative mea-sures designed to improve the quality of life of individuals with xerostomia.(AU)

Alzheimer's Disease Caregiver Characteristics and Their Relationship with Anticipatory Grief.

In Alzheimer's disease, two fundamental aspects become important for caregivers: ambiguity and ambivalence. Thus, anticipatory grief is considered an active psychological process that is very different from the mere anticipation of death. The present study aims to determine which characteristics of family caregivers of people with dementia, such as age, gender, educational level, relationship with the person with dementia, years with dementia or years as a caregiver, are related to the presence of anticipatory grief. A cross-sectional design was employed. The sample consisted of a total of 129 subjects who cared for a family member with dementia. A sociodemographic data sheet and a battery of tests measure the presence of anticipatory grief, caregiver burden and/or psychopathology. The results obtained allowed us to confirm some of the hypotheses regarding the anticipatory grief construct, the importance of the care time factor, in years and per day, as well as the relevance of the previous demographic and psychopathological profile (being female, spouse function and possible depressive symptomatology). Likewise, from the prediction analyzes performed, it seems that these variables can predict anticipatory grief. These results propose interesting opportunities to formulate care proposals to professionals and family caregivers in relation to care tasks and caregiver skills.

Protective factors promoting resilience in the relation between child sexual victimization and internalizing and externalizing symptoms.

Sexual victimization has been one of the most frequently studied forms of child victimization. Its effects are common and diverse; however, not all children and youth exposed to sexual victimization eventually develop adjustment problems. A total of 1105 children and youth (590 male and 515 female) aged between 12 and 17 from northeastern Spain were assessed regarding their experiences of sexual victimization, symptoms of psychopathology, and protective factors. The results showed that all forms of sexual victimization were associated with higher levels of emotional and behavioral problems. However, the presence of a low Negative Cognition, high Social Skills and high Confidence seem to act buffering internalizing problems. Additionally, a significant interaction between Sexual Victimization and low Negative Cognition was observed (p<0.5), so that, low Negative Cognition was related to a lower risk of being in the clinical range for internalizing problems. Likewise, high scores on Empathy/Tolerance, Connectedness to School, Connectedness to Family and low Negative Cognition acted as promotive factors in relation to externalizing symptoms, in this case without any interaction effect. The strong relationship found with emotional and behavioral problems highlights the importance of continuing the research on the protective factors underlying resilience in the relationship between sexual victimization and psychopathological symptoms. The findings also support the multi-dimensional and specific nature of resilience and identify some of the protective factors that should be regarded as key intervention targets in adolescents with a history of sexual victimization.

Revisión sistemática de la prevalencia de ideación y conducta suicida en menores víctimas de abuso sexual / Systematic review of the prevalence of suicidal ideation and behavior in minors who have been sexually abused

La experiencia de abuso sexual en la infancia constituye un grave problema de salud pública, que se asocia con el comportamiento suicida en un elevado número de casos. Conocer la relación entre la experiencia de abuso sexual infantil y la ideación y conducta suicida en el adolescente es relevante, a nivel académico y profesional. Método. El presente trabajo pretende llevar a cabo una revisión sistemática de los estudios publicados sobre la prevalencia del suicidio en menores víctimas de abuso sexual pertenecientes a la población comunitaria. Se han seleccionado aquellos trabajos publicados en las bases de datos Psycinfo, Scopus y Medline de la Web of Science utilizando los términos: «sexual abuse» AND «child» AND «suicide» AND «prevalence» OR «incidence». Resultados. Los resultados obtenidos de los 16 estudios revisados muestran la elevada frecuencia de ideación y conducta suicida en estas víctimas y alertan de una grave consecuencia del abuso sexual que parece afectar a un número importante de menores. Las víctimas de abuso sexual infantil tienen entre 2 y 3 veces más riesgo de presentar ideación suicida y entre 3 y 4 veces más riesgo de cometer algún intento de suicidio que las no víctimas. Conclusiones. Desde el ámbito de la salud, es necesario un mayor conocimiento de los efectos concretos, a corto y largo plazo, del abuso sexual infantil, lo que permitirá una intervención más adecuada para sus víctimas y un tratamiento más eficaz de aquellas que presentan un mayor riesgo de suicidio

The experience of sexual abuse in childhood is a serious public health problem that is associated with suicidal behavior in numerous cases. Awareness of the relation between the experience of sexual abuse in childhood with suicidal ideation and behavior in adolescence is relevant in academic and professional terms. Method. A systematic review was made of published studies on the prevalence of suicide among childhood victims of sexual abuse in the European Union. Studies cited in the PsycINFO, Scopus and MEDLINE Web of Science databases were retrieved using the terms: «sexual abuse» AND «child» AND «suicide» AND «prevalence» OR «incidence». Results. The results obtained from the 16 studies reviewed show a high frequency of suicidal ideation and behavior in these victims and highlight a serious consequence of sexual abuse that seems to affect a significant number of minors. The victims of childhood sexual abuse have a 2- to 3-fold higher risk of suicidal ideation and 3- to 4-fold higher risk of attempted suicide than nonvictims. Conclusions. In the health care field, it is important to understand the specific short-term and long-term effects of childhood sexual abuse, which could improve the effectiveness of intervention in victims and treatment for those at increased risk of suicide

Systematic review of the prevalence of suicidal ideation and behavior in minors who have been sexually abused.

UNLABELLED: The experience of sexual abuse in childhood is a serious public health problem that is associated with suicidal behavior in numerous cases. Awareness of the relation between the experience of sexual abuse in childhood with suicidal ideation and behavior in adolescence is relevant in academic and professional terms. METHOD: A systematic review was made of published studies on the prevalence of suicide among childhood victims of sexual abuse in the European Union. Studies cited in the PsycINFO, Scopus and MEDLINE Web of Science databases were retrieved using the terms: “sexual abuse” AND “child” AND “suicide” AND “prevalence” OR “incidence”. RESULTS: The results obtained from the 16 studies reviewed show a high frequency of suicidal ideation and behavior in these victims and highlight a serious consequence of sexual abuse that seems to affect a significant number of minors. The victims of childhood sexual abuse have a 2- to 3-fold higher risk of suicidal ideation and 3- to 4-fold higher risk of attempted suicide than nonvictims. CONCLUSIONS: In the health care field, it is important to understand the specific short-term and long-term effects of childhood sexual abuse, which could improve the effectiveness of intervention in victims and treatment for those at increased risk of suicide.

Especialidades y acreditaciones en psicología / No disponible

Este trabajo parte de la base de que la Psicología Profesional ha alcanzado en el estado español la madurez suficiente para tener una estructura permanente de especialidades y subespecialidades (bajo la denominación de Expertos). Se analiza el estado de la cuestión en España y en las organizaciones profesionales de psicólogos de otras partes del mundo, con especial hincapié en las cultural y sociológicamente próximas y de nuestro entorno. Se diferencia entre los títulos de especialidades oficiales y los avalados por organizaciones profesionales, en nuestro caso Colegios de Psicólogos y la conexión entre ellas. Se realiza, para su discusión por la comunidad de Psicólogos, una propuesta que incluye un número limitado de especialidades, ilimitado de títulos de expertos y los procedimientos de acreditación con las condiciones mínimas para su obtención (AU)

This paper assumes that the Professional Psychology has achieved in Spain mature enough to have a permanent structure of specialties and subspecialties (under the name of Experts). We analyze the state of this topic in Spain and professional organizations of psychologists from around the world, with special emphasis on cultural and sociological future and our environment. It differs from the official specialty titles and endorsed by professional organizations, in our case Associations of Psychologists and the connection between them. We generate for discussion by the community of psychologists, a proposal that includes a limited number of specialties, unlimited expert qualifications and accreditation procedures with the minimum conditions for obtaining it (AU)