Adaptation and Validation of the Hooked on Nicotine Checklist (HONC) with Spanish Adolescents.

INTRODUCTION: The expansion of new tobacco consumption formats and electronic vapor products threatens to reverse the trend of declining smoking rates that had been observed among younger people in recent decades. Early detection in the health sector requires screening tools that have been adapted and validated in our context. This study aims to translate, culturally adapt, pilot and empirically validate the Hooked on Nicotine Checklist (HONC) with Spanish adolescents. METHODS: The process of translation and cultural adaptation included the following stages: direct translation, synthesis of translations, back translation, consolidation with a committee of experts and pre-test, along with a cognitive interview, which served as pilot testing. Empirical validation was conducted with a sample of 1027 adolescents aged between 12 and 18 (M=15.40; SD=1.638). RESULTS: The results obtained confirm that the HONC is a brief, clear and easy-to-understand tool, with appropriate psychometric properties. A Cronbach's alpha value of 0.90 was obtained. Sensitivity, specificity, PPV and NPV indices reached values of 0.56, 0.94, 0.79 and 0.83, respectively. Cut-off point 1 is the one reaching the best balance between the two values. CFA showed a model good overall fit. CONCLUSION: This study makes the Spanish version of the HONC available to researchers and clinicians, so that it can be used with sufficient psychometric guarantees.

Underage Problem Gambling: With Whom, Where and Why

BACKGROUND: Underage gambling is a widespread phenomenon with its own characteristics that differentiate it from adult gambling. In addition, problem gambling has shown a remarkable prevalence in previous studies. The present study examines underage gambling behaviour, studying its characteristics, as well as motivational and contextual aspects, and estimating the volume of problem gambling and possible moderating variables. METHOD: A sample of 9,681 students aged between 12 and 17 years old reported their involvement in gambling and filled in the Brief Adolescent Gambling Screen (BAGS), with 4,617 of them completing a questionnaire about gambling behaviours. RESULTS: Almost a quarter (23.5%) of the students reported having gambled in their lifetime (16.2% in-person, 1.4% online and 6% in both modalities), and 1.9% presented symptoms of problem gambling (BAGS ≥ 4). In-person gamblers preferred sport-betting machines, usually gambled in bars, and did not have their age checked. Online gamblers reported mainly sports betting, doing so on websites and paying with PayPal-like services and credit cards. Most gambled with friends and to win money. Problem gamblers were similar but gambled more frequently. CONCLUSIONS: These results present an image of the gambling situation among minors and, more importantly, of its context and related variables.

El uso de la cachimba entre los adolescentes. Posibles implicaciones y variables asociadas / Waterpipe use among adolescents. Possible implications and related variables

El consumo de sustancias en cachimba (generalmente tabaco o cannabis) constituye una práctica cada vez más popular, hasta el punto de convertirse ya en un problema de salud pública emergente, con serias consecuencias tanto a nivel pulmonar, como adictivo. A pesar de la creciente preocupación que suscita, son pocos los trabajos llevados a cabo en España que se hayan ocupado de analizar esta nueva práctica desde edades tempranas. El objetivo de este trabajo no sólo es disponer de nuevos datos acerca del uso de la cachimba entre los adolescentes, sino también analizar sus posibles implicaciones y variables asociadas. Para ello, se realizó una encuesta entre estudiantes de enseñanza secundaria de la comunidad gallega. Participaron 7.613 estudiantes de 12 a 18 años (M = 14,97; DT = 1,69). Se utilizó el CRAFFT, el AUDIT y el CAST para el cribado de consumos de riesgo. Las tasas de consumo de tabaco y de cannabis en cachimba se sitúan en niveles preocupantes (19,4% y 8,5%, respectivamente, para el último año), con tasas significativamente mayores de consumos de riesgo, de borracheras y binge drinking. Llama también la atención la baja percepción de riesgo existente. El uso de la cachimba constituye una práctica relativamente extendida en la adolescencia, que además de serias implicaciones para la salud, constituye un claro indicador de un patrón de consumo subyacente realmente problemático. La escasa percepción de riesgo, la práctica del botellón o la falta de normas familiares son elementos a tener en cuenta a nivel de prevención comunitaria. (AU)

Substance use in waterpipe (generally tobacco or cannabis) constitutes an increasingly popular practice. It has become an emerging public health problem, with serious consequences at both pulmonary and addiction levels. Despite the growing concern it raises, few studies have been carried out in Spain to analyze this new practice from an early age. The aim of this study is to have new data about waterpipe use among adolescents and to analyze its possible implications and related variables. A survey was conducted among secondary school students from the Galician community. A total of 7,613 students aged 12-18 years (M = 14.97; SD = 1.69) participated. The CRAFFT, the AUDIT and the CAST were used to screen the risky use of other substances. The rates of waterpipe tobacco and cannabis use are at worrying levels (19.4% and 8.5%, respectively, for the last year), with significantly higher rates of risky substance use, drunkenness and binge drinking. The low perception risk is striking. Waterpipe use is a widespread practice in adolescence. In addition to serious health implications, is a clear indicator of a problematic underlying consumption. The low perception of risk, the “botellón” or the lack of family control are elements to take into account in community prevention. (AU)

Underage Problem Gambling: With Whom, Where and Why / El Juego de Azar Problemático en Menores de Edad: Con Quién, Dónde y Por Qué

Background: Underage gambling is a widespread phenomenon with its own characteristics that differentiate it fromadult gambling. In addition, problem gambling has shown a remarkable prevalence in previous studies. The presentstudy examines underage gambling behaviour, studying its characteristics, as well as motivational and contextualaspects, and estimating the volume of problem gambling and possible moderating variables. Method: A sample of 9,681students aged between 12 and 17 years old reported their involvement in gambling and filled in the Brief AdolescentGambling Screen (BAGS), with 4,617 of them completing a questionnaire about gambling behaviours. Results:Almost a quarter (23.5%) of the students reported having gambled in their lifetime (16.2% in-person, 1.4% online and6% in both modalities), and 1.9% presented symptoms of problem gambling (BAGS ≥ 4). In-person gamblers preferredsport-betting machines, usually gambled in bars, and did not have their age checked. Online gamblers reported mainlysports betting, doing so on websites and paying with PayPal-like services and credit cards. Most gambled with friendsand to win money. Problem gamblers were similar but gambled more frequently. Conclusions: These results present animage of the gambling situation among minors and, more importantly, of its context and related variables.(AU)

Antecedentes: La participación de menores de edad en juegos de azar es un fenómeno extendido con característicasdiferenciales respecto a las personas adultas y muestra una elevada prevalencia. El presente estudio examina la conductade juego en menores, estudiando sus características, aspectos motivacionales y contextuales, el volumen de juegoproblemático y las posibles variables moderadoras. Método: La muestra está compuesta por 9.681 estudiantes de 12 a17 años que cumplimentaron el Brief Adolescent Gambling Screen (BAGS), 4.617 adolescentes completaron ademásun cuestionario sobre hábitos. Resultados: El 23,5% ha apostado alguna vez en su vida (presencial: 16,2%; online:1,4%; ambas: 6%) y el 1,9% presenta síntomas de juego problemático (BAGS≥4). Quienes juegan presencialmenteprefieren las máquinas de apuestas deportivas; suelen apostar en bares y generalmente sin acreditar su edad. Quienesjuegan online principalmente hacen apuestas deportivas, a través de páginas web y pagan con servicios tipo PayPal ytarjetas de crédito. Suelen apostar con amigos y para ganar dinero, aunque mayoritariamente reconocen que es pocoprobable que esto llegue a ocurrir. Los/as jugadores/as problemáticos muestran características similares, pero apuestancon mayor frecuencia. Conclusiones: Estos resultados muestran la situación del juego en menores y permite determinarsus variables contextuales relacionadas.(AU)

Hábitos de juego y síntomas de adicción a los videojuegos en adolescentes españoles / Gambling habits and symptoms of video game addiction in Spanish adolescents

El trastorno por uso de videojuegos ha recibido mayor atención desde su inclusión en la CIE-11. Sin embargo, apenas hay investigación en menores de edad en el contexto español. El presente trabajo tiene como objetivo de explorar los hábitos de uso de videojuegos y la sintomatología del trastorno por uso de videojuegos en esta población, así como analizar la relación entre ambos. Los hábitos fueron evaluados como la frecuencia y las horas semanales jugadas y la “Escala de adicción al juego para adolescentes” (GASA) fue aplicada a una muestra de 3748 estudiantes de entre 12 y 17 años. Los resultados mostraron que el 13,5% presentaba síntomas de juego problemático y el 3,3% una posible adicción a los videojuegos. También fue encontrada una relación entre los hábitos de juego y la presencia de síntomas de adicción. Estos resultados se comparan con los de otros estudios y se pone de manifiesto la heterogeneidad de datos disponibles en este ámbito. Además, se discuten las implicaciones de los resultados para posibles acciones preventivas llevadas a cabo por desarrolladores y familias. (AU)

Gaming disorder has been receiving increased attention since its inclusion in the ICD-11. However, there are still few studies on minors in the Spanish context. The present study aimed to explore the gaming habits and symptomatology of gaming disorder in this population, as well as analyzing the relationship between both. Gaming habits were assessed such as frequency and weekly hours played and the Game Addiction Scale for Adolescents was applied to a sample of 3748 students between 12 and 17 years old. It was found that 13.5% presented symptoms of problematic gaming and 3.3% a possible video game addiction. There was also a relationship between gambling habits and the presence of addiction symptoms. These results are compared to other studies and the heterogeneity of data available in the field is highlighted. Additionally, the implications of the results for preventive actions carried out by developers and families are discussed. (AU)

Waterpipe use among adolescents. Possible implications and related variables. / El uso de la cachimba entre los adolescentes. Posibles implicaciones y variables asociadas.

Substance use in waterpipe (generally tobacco or cannabis) constitutes an increasingly popular practice. It has become an emerging public health problem, with serious consequences at both pulmonary and addiction levels. Despite the growing concern it raises, few studies have been carried out in Spain to analyze this new practice from an early age. The aim of this study is to have new data about waterpipe use among adolescents and to analyze its possible implications and related variables. A survey was conducted among secondary school students from the Galician community. A total of 7,613 students aged 12-18 years (M = 14.97; SD = 1.69) participated. The CRAFFT, the AUDIT and the CAST were used to screen the risky use of other substances. The rates of waterpipe tobacco and cannabis use are at worrying levels (19.4% and 8.5%, respectively, for the last year), with significantly higher rates of risky substance use, drunkenness and binge drinking. The low perception risk is striking. Waterpipe use is a widespread practice in adolescence. In addition to serious health implications, is a clear indicator of a problematic underlying consumption. The low perception of risk, the "botellón" or the lack of family control are elements to take into account in community prevention.

El consumo de sustancias en cachimba (generalmente tabaco o cannabis) constituye una práctica cada vez más popular, hasta el punto de convertirse ya en un problema de salud pública emergente, con serias consecuencias tanto a nivel pulmonar, como adictivo. A pesar de la creciente preocupación que suscita, son pocos los trabajos llevados a cabo en España que se hayan ocupado de analizar esta nueva práctica desde edades tempranas. El objetivo de este trabajo no sólo es disponer de nuevos datos acerca del uso de la cachimba entre los adolescentes, sino también analizar sus posibles implicaciones y variables asociadas. Para ello, se realizó una encuesta entre estudiantes de enseñanza secundaria de la comunidad gallega. Participaron 7.613 estudiantes de 12 a 18 años (M = 14,97; DT = 1,69). Se utilizó el CRAFFT, el AUDIT y el CAST para el cribado de consumos de riesgo. Las tasas de consumo de tabaco y de cannabis en cachimba se sitúan en niveles preocupantes (19,4% y 8,5%, respectivamente, para el último año), con tasas significativamente mayores de consumos de riesgo, de borracheras y binge drinking. Llama también la atención la baja percepción de riesgo existente. El uso de la cachimba constituye una práctica relativamente extendida en la adolescencia, que además de serias implicaciones para la salud, constituye un claro indicador de un patrón de consumo subyacente realmente problemático. La escasa percepción de riesgo, la práctica del botellón o la falta de normas familiares son elementos a tener en cuenta a nivel de prevención comunitaria.

Psychometric properties of CAST for early detection of problematic cannabis use in Spanish adolescents.

The high prevalence rates of cannabis use in adolescents and its early onset constitutes a major public health problem, raising the need for its early detection. The availability of validated tools to analyze early cannabis use is essential to detect problematic use at an early age. The Cannabis Abuse Screening Test (CAST) (Legleye et al., 2007) is widely applied in Europe; however, the CAST cut-off scores vary according to the setting, the screening objective, and the correction version (CAST-f or CAST-b), creating therefore confusion in its application. Moreover, the psychometric properties of the CAST as a tool for detecting problematic cannabis use are understudied. To fill this gap, such psychometric properties have been analyzed in a sample of Spanish adolescents while using different cut-off scores for CAST-f and CAST-b. Based on our findings, the optimal cut-off scores are 2 points for CAST-b and 4 points for CAST-f. The internal reliability of CAST-f (α = 0.83) and CAST-b (KR-20 = 0.80) are satisfactory. Factorial analysis suggested the assumption of a one-dimension model. The CAST seems to be a valid and reliable tool for early screening of problematic cannabis use in Spanish adolescents.

Menores y consumo de cannabis: un análisis por género y edad / Minors and cannabis use: an analysis by gender and age

El consumo de cannabis sigue constituyendo a día de hoy uno de los principales problemas de salud pública en la población juvenil tanto española como europea. A las elevadas prevalencias de consumo actuales se unen nuevos formatos y nuevos rituales de consumo, niveles de THC significativamente mayores y edades de inicio especialmente tempranas, lo cual suscita una creciente preocupación social, especialmente cuando nos referimos a adolescentes. El presente trabajo, llevado a cabo con una muestra de casi 4.000 estudiantes de 12 a 17 años de la comunidad gallega, no sólo permite constatar los elevados niveles de consumo existentes a edades tempranas y tasas de consumo problemático alarmantes, sino que evidencia la interesante interacción entre las variables género y edad, que se da en las fases iniciales del consumo. Asumir que en términos generales puede haber o no diferencias de género en el consumo de cannabis implica ignorar el papel de las normas y roles de género en los procesos de socialización de las y los adolescentes. De forma más concreta, se ha constatado niveles de consumo y consumo problemático (evaluado a través del CAST) significativamente mayores entre las chicas a los 14-15 años, produciéndose una progresiva masculinización del consumo de cannabis a partir de dicha edad. Estos resultados poseen interesantes implicaciones a la hora de diseñar nuevas estrategias y políticas de prevención. (AU)

Cannabis use continues to be one of the main public health problems in the Spanish and European youth population. The current high prevalence of consumption is compounded by new formats and new consumption rituals, significantly higher THC levels and particularly early age of onset, which is of growing social concern, especially when referring to adolescents. The present study, carried out with a sample of almost 4,000 students aged 12 to 17 years in the Galician community, not only allows us to confirm the high levels of consumption at early ages and alarming rates of problematic consumption, but also shows the interesting interaction between gender and age variables, which occurs in the initial phases of consumption. Assuming that in general terms there may or may not be gender differences in cannabis use implies ignoring the role of gender norms and roles in the socialization processes of adolescents. More specifically, significantly higher levels of consumption and problematic use (assessed through the CAST) have been found among girls at 14-15 years of age, with a progressive masculinization of cannabis use from that age onwards. These results have interesting implications for the design of new prevention strategies and policies. (AU)

Sex Differences in Adolescent Bullying Behaviours / Las diferencias de sexo en las conductas de acoso de los adolescentes

In recent decades there has been a progressive increase in concern and research into the problems of peer aggression, both in the educational setting and more recently, online. The present study sought to explore sex differences in traditional bullying and cyberbullying, since current literature has not reached a consensus in how bullying involvement could be moderated by sex. The sample consisted of 3,174 adolescents aged 12-17 years old who completed a paper survey which included the European Bullying Intervention Project Questionnaire and the European Cyberbullying Intervention Project Questionnaire. The main results found no differences in cyberbullying rates for boys and girls. In the case of bullying, there were more bully-victims among the boys, but no differences were found in the pure victims or pure perpetrators. When analysing the specific bullying behaviours suffered or perpetrated, several differences were found. However, said differences were discrete and it seems that there are not distinctly differentiated bullying patterns, which discourages the use of clearly differentiated preventive strategies for boys and girls. (AU)

En las últimas décadas ha ido creciendo la preocupación por las agresiones entre iguales y su investigación, tanto en el propio entorno escolar como, más recientemente, a través de la red. El presente estudio se planteó con el objetivo de explorar las diferencias de sexo tanto en el acoso tradicional como en el ciberacoso, pues la bibliografía existente no llega a un consenso sobre la forma en que la implicación en el acoso puede estar siendo moderada por el sexo o el género. La muestra constó de 3,174 adolescentes de 12 a 17 años que cumplimentaron por escrito una encuesta que incluía el European Bullying Intervention Project Questionnaire y el European Cyberbullying Intervention Project Questionnaire. Los principales resultados no mostraron diferencias en las tasas de ciberacoso de chicas y chicos. Respecto al acoso tradicional, aunque se han hallado más víctimas-agresoras en los chicos, no se han encontrado diferencias en la tasa de víctimas y agresores puros. Al analizar las conductas específicas sufridas o perpetradas, se encontraron varias diferencias entre chicas y chicos. Sin embargo, esas diferencias eran pequeñas y no parece que haya un patrón de acoso claramente diferenciado, lo que desaconseja emplear estrategias preventivas claramente diferenciadas para chicas y para chicos. (AU)

Cyberbullies, the Cyberbullied, and Problematic Internet Use: Some Reasonable Similarities.

BACKGROUND: The spread of the internet and Information and Communications Technologies (ICT) have completely changed society in the last few decades. The transfer of traditional face-to-face bullying to the virtual environment is one of the risks adolescents face in this new reality. The present study sought to explore the relationship between involvement in cyberbullying and behaviours such as internet and mobile usage and other risky online behaviours. METHOD: The sample consisted of 3,188 adolescents aged 12-17 years old (Mean= 14.44; SD= 1.67). RESULTS: The application of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) found that 5.2% were victims, 4.5% perpetrators and 4.3% bully-victims. CONCLUSIONS: Results also showed that cyberbullying seems to be associated with both Problematic Internet Use and behaviours such as sexting, gambling and contacting strangers, which suggests a need for a comprehensive approach for preventing all these issues. Moreover, parental monitoring could serve as a modulating factor, which should also be taken into account in the development of appropriate prevention strategies.

Bullying and Cyberbullying among Students with Cochlear Implants.

Bullying is a significant problem for young people nowadays, regardless of their identity, culture, or background. Although the scientific evidence warns of a greater impact of bullying on vulnerable groups such as cochlear implant (CI) users, few specific studies have been carried out in this regard. As such, the fundamental objective of this study was to estimate the prevalence of both traditional bullying and cyberbullying among Spanish adolescents and young people with CI. Parents with children CI users were also invited to participate to explore their perspective concerning the victimization of their children. The information was collected using one survey for students aged 11-23 year (n = 102) and another for parents (n = 127). Beyond the frequency and types of bullying suffered or the methods used for coping with victimization, results also show lower rates of bullying when students were asked specifically with a single-item question than when applying multi-item questionnaires. The results are discussed in terms of the broader international bullying and victimization literature.

Cyberbullies, the Cyberbullied, and Problematic Internet Use: Some Reasonable Similarities / Ciberacosados, Ciberacosadores y Uso Problemático de Internet: Algunos Parecidos Razonables

Background: The spread of the internet and Information and Communications Technologies (ICT) have completely changed society inthe last few decades. The transfer of traditional face-to-face bullying to the virtual environment is one of the risks adolescents face in this new reality. The present study sought to explore the relationship between involvement in cyberbullying and behaviours such as internet and mobile usage and other risky online behaviours. Method: The sample consisted of 3,188 adolescents aged 12-17 years old (Mean= 14.44; SD= 1.67). Results: The application of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) found that 5.2% were victims, 4.5% perpetrators and 4.3% bully-victims. Conclusions: Results also showed that cyberbullying seems to be associated with both Problematic Internet Use and behaviours such as sexting, gambling and contacting strangers, which suggests a need for a comprehensive approach for preventing all these issues. Moreover, parental monitoring could serve as a modulating factor, which should also be taken into account in the development of appropriate prevention strategies. (AU)

Antecedentes: el uso generalizado de Internet y de las Tecnologías de la Información y las Comunicaciones (TIC) ha cambiado completamente la sociedad en las últimas décadas. La transferencia del tradicional acoso escolar al entorno virtual es uno de los riesgos a los que se enfrentan los adolescentes en esta nueva realidad. El presente estudio se planteó como objetivo explorar la relación entre ciberacoso y uso de Internet y teléfono móvil y otras conductas de riesgo en línea. Método: la muestra estuvo compuesta por 3.188 adolescentes de entre 12 y 17 años (Media= 14,44; DT= 1,67). Resultados: tras aplicar el European Cyberbullying Intervention Project Questionnaire (ECIPQ) se encontró que el 5,2% eran víctimas, 4,5% agresores y el 4,3% víctimasagresoras. Conclusiones: el ciberacoso parece estar asociado tanto al uso problemático de Internet como a comportamientos como el sexting, el juego online o el contacto con desconocidos a través de la Red, lo que sugiere la necesidad de un enfoque integral a nivel de prevención. Además, la supervisión parental constituiría un importante elemento modulador, lo cual debe ser tenido en cuenta para la elaboración de estrategias preventivas efi caces. (AU)

The age of onset for alcohol consumption among adolescents: Implications and related variables. / La edad de inicio en el consumo de alcohol en adolescentes: implicaciones y variables asociadas.

Adolescence is a critical period in the development of addictive behaviors. In particular, the age at which adolescents start drinking is not a trivial matter, given the important consequences that it has. However, relatively little is known about what it is that causes them to start drinking at an ever earlier age. The aim of this paper is to collect new empirical data about the implications of an early age of onset and, at the same time, to identify possible associated variables. Furthermore, the mean age of onset of the different substances is updated by expanding the sample frame of the ESTUDES (14-18 years) to incorporate adolescents aged 12 and 13. The results obtained with a sample of 3,419 adolescents from the Autonomous Community of Galicia (M = 14.57 and SD = 1.76) reveal that at 13.4 years of age, the age at which adolescents tend to start drinking is lower than suggested by ESTUDES 2016-2017. In addition, those who start drinking earlier are more likely to use other substances, their rates of high-risk consumption are 3 times higher and they are more involved in potentially dangerous practices. Finally, variables such as risk perception and expectations of use yield very limited explanatory capacity, especially if they are compared with those related to drinking within the family or peer group. The results reinforce the need to delay the age of alcohol onset as one of the strategic objectives of prevention policies.

La adolescencia constituye un período crítico en el desarrollo de conductas adictivas. En particular, la edad a la que los jóvenes se inician en el consumo de alcohol no es una cuestión banal, habida cuenta de las importantes repercusiones que posee a diferentes niveles. Sin embargo se sabe relativamente poco de por qué cada vez se empieza a consumir de manera más precoz. El objetivo del presente trabajo ha sido recabar nuevos datos empíricos sobre las implicaciones de una edad de inicio temprana e identificar, al mismo tiempo, posibles variables asociadas. Se han actualizado además las edades medias de inicio de consumo de distintas sustancias, ampliando el marco muestral habitual del ESTUDES (14-18 años), incorporando a los adolescentes de 12 y 13 años. Los resultados obtenidos con una muestra de 3419 adolescentes de la comunidad gallega (M = 14,57 y DT = 1,76) permiten constatar que la edad a la que los adolescentes suelen iniciarse en el consumo de alcohol es menor de lo que sugiere el ESTUDES 2016-2017, situándose en 13,4 años. Además quienes se inician antes en su consumo presentan una mayor probabilidad de consumir otras sustancias, tasas de consumo de riesgo 3 veces superiores y se implican más en prácticas potencialmente peligrosas. Por último, variables como la percepción de riesgo o las expectativas presentan una capacidad explicativa escasa, sobre todo si se compara con otras relacionadas con el consumo del entorno familiar o entre iguales. Los resultados refuerzan la necesidad de retrasar la edad de inicio del consumo de alcohol como uno de los objetivos estratégicos de las políticas de prevención.

Minors and Online Gambling: Prevalence and Related Variables.

Substantial access to the Internet by minors has brought about consequences that are not always positive. The increase of online gambling or betting is one of those. Although in most cases online gambling by minors does not result in a disorder, it does imply a higher probability of developing a gambling disorder in adulthood, and it can cause economic, family, school and social problems. The aim of this study, carried out in the Galician region of Spain with a sample of 3772 students aged between 12 and 17 years, was to estimate the prevalence of online gambling in minors; to characterize the profile of online gamblers; to explore the differences in Internet and smartphone usage habits, online risky practices, problematic Internet use and parental involvement between online gamblers and non-online gamblers; and to analyse the relation between online gambling and academic performance. The results revealed that 6.5% of Galician adolescents are online gamblers, a figure that has more than tripled over seven years. 9 out of 10 online gamblers are male, and their mean age is 15. Online gamblers had significantly higher rates of problematic Internet use, active sexting, cyberbullying, or contacting strangers through the Internet. Furthermore, online gamblers had higher scores on impulsiveness, lower scores on assertiveness, and were lacking parental control. These data show that online gambling is not an isolated problem, so prevention should be understood in a comprehensive manner.

Effectiveness of an educational intervention to improve the safety culture in primary care: a randomized trial.

BACKGROUND: Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in the family and community medicine teaching units in an Atlantic European Region. METHODS: Randomized study conducted in family and community medicine teaching units in Galicia (Spain). Participants were all fourth-year residents and their tutors (N = 138). Those who agreed to participate were randomized into one of two groups (27 tutors/26 residents in the intervention group, 23 tutors/ 23 residents in the control one).All were sent the Survey on Patient Safety Culture. After that, the intervention group received specific training in safety; they also recorded incidents over 15 days, documented them following a structured approach, and had feedback on their performance. The control group did not receive any action. All participants completed the same survey four months later. Outcome measures were the changes in safety culture as quantified by the results variables of the Survey: Patient Safety Grade and Number of events reported. We conducted bivariate and adjusted analyses for the outcome measures. To explore the influence of participants' demographic characteristics and their evaluation of the 12 dimensions of the safety culture, we fitted a multivariate model for each outcome. RESULTS: Trial followed published protocol. There were 19 drop outs. The groups were comparable in outcome and independent variables at start. The experiment did not have any effect on Patient safety grade (- 0.040) in bivariate analysis. The odds of reporting one to two events increased by 1.14 (0.39-3.35), and by 13.75 (2.41-354.37) the odds of reporting 3 or more events. Different dimensions had significant independent effects on each outcome variable. CONCLUSION: A educational intervention in family and community medicine teaching units may improve the incidents reported. The associations observed among organizational dimensions and outcomes evidence the complexity of patient safety culture measurement and, also, show the paths for improvement. In the future, it would be worthwhile to replicate this study in teaching units from different settings and with different health professionals engaged. TRIAL REGISTRATION: It was retrospectively registered with ( ISRCTN41911128 , 31/12/2010).

Cannabis use among adolescents: Risk pattern, implications and possible explanatory variables. / Consumo de cannabis entre adolescentes: patrón de riesgo, implicaciones y posibles variables explicativas.

In contrast to the achievements with other substances, it has not yet been possible to reduce the levels of cannabis use, the most used illegal substance among Spanish adolescents. The objective of this paper consists of updating levels of use (incorporating ages 12 and 13), estimating high-risk use and analyzing possible associated variables. For this purpose, a correlational method was used consisting of the administration of a survey to compulsory secondary school and high school students from the autonomous community of Galicia (Spain) in 2016. Results obtained from a sample of 3,882 Galician adolescents aged 12 to 18 (M = 14.52; SD = 1.72) reveal that the percentage of adolescents currently using tobacco and cannabis is higher than that of those using tobacco alone (12.7% vs 10.5%). This implies not only a higher probability of using other illegal substances, but also of developing rather high-risk use pattern, binge drinking or even experiencing problematic Internet use or cyberbullying. From a preventive perspective, the results reveal that personal variables such as self-esteem, assertiveness, social skills or impulsiveness have really weak explanatory power compared with other variables related to the setting of rules and limits by parents. One of the main conclusions of this paper is the need to adopt a comprehensive prevention approach.

Contrariamente a lo que ocurre con el resto de sustancias todavía no se han logrado disminuir los niveles de consumo de cannabis, que sigue siendo la droga ilegal más consumida entre los adolescentes españoles. El objetivo de este estudio consiste en actualizar los niveles de consumo (incorporando la franja de edad de 12-13 años), estimar los consumos propiamente de riesgo y analizar las posibles variables asociadas. Para ello se ha utilizado una metodología correlacional consistente en la realización de una encuesta a estudiantes de ESO y Bachillerato de la comunidad autónoma de Galicia (España) en el año 2016. La muestra final estuvo compuesta por 3.882 adolescentes gallegos de entre 12 y 18 años (M = 14,52 y DT = 1,72). Los resultados obtenidos revelan que a día de hoy es ya mayor el porcentaje de adolescentes que consumen tabaco y cannabis que únicamente tabaco (12,7% vs 10,5%) y que ello no sólo implica una mayor probabilidad de consumir otras sustancias ilegales, sino también de desarrollar un patrón consumo de alcohol de riesgo, de Binge Drinking o incluso de experimentar un Uso Problemático de Internet o de ciberacoso. Las variables personales como la autoestima, la asertividad, las habilidades sociales o la impulsividad tienen una capacidad explicativa realmente débil, en comparación con otras variables vinculadas al establecimiento de normas y límites por parte de los padres. Una de las principales conclusiones de este trabajo es la necesidad de adoptar un enfoque de prevención integral.

Empirical validation of the CRAFFT Abuse Screening Test in a Spanish sample. / Validación empírica del CRAFFT Abuse Screening Test en una muestra de adolescentes españoles.

The CRAFFT Substance Abuse Screening Instrument, developed by the Center for Adolescents Substance Abuse Research (CeASAR) (Knight et al., 1999), is a screening tool for high-risk alcohol and drug risk consumption designed for use with adolescents. Since its publication it has been the subject of translations and validations in different countries, populations and contexts that have demonstrated its enormous potential. However, there is still no empirical validation study that would ensure its good psychometric performance in Spain. The aim of this paper is to develop an adapted version of the CRAFFT in Spanish and to analyze its psychometric properties in a sample of Spanish adolescents. For this purpose an individual interview was conducted on 312 adolescents aged between 12 and 18 years of age (M = 15.01; SD = 1.83) from the Galician community. The interview included a part of the Adolescent Diagnostic Interview (ADI) and the Problem Oriented Screening Instrument for Teenagers (POSIT). The results obtained, similar to those found in other countries, allow us to report that the Spanish version of the CRAFFT has a good psychometric behaviorproperties. It was found to have a satisfactory internal consistency with a Cronbach’s alpha value of .74. In terms of sensitivity and specificity, values of 74.4% and 96.4% respectively, were obtained and the area under the ROC curve was .946. The Spanish version of the CRAFFT is made available to researchers and professionals in the field of addictive behaviors, so that it can be used with the necessary psychometric guarantees.

El CRAFFT Abuse Screening Test, desarrollado por el Center for Adolescents Substance Abuse Research (CeASAR) (Knight et al., 1999), es una herramienta de cribado del consumo de riesgo de alcohol y otras sustancias diseñada para su uso con adolescentes. Desde su publicación ha sido objeto de numerosas traducciones y validaciones en diferentes países, poblaciones y contextos que han dado cuenta de su enorme potencial. No obstante, seguimos sin disponer de estudios de validación empírica que garanticen su adecuado comportamiento psicométrico en España. El objetivo del presente trabajo consiste en desarrollar una versión adaptada del CRAFFT en castellano y analizar sus propiedades psicométricas en una muestra de adolescentes españoles. Para ello, se realizó una entrevista individual a 312 adolescentes de entre 12 y 18 años (M = 15,01; DT = 1,83) de la comunidad gallega, que incluyó una parte de la Adolescent Diagnostic Interview (ADI) y del Problem Oriented Screening Instrument for Teenagers (POSIT). Los resultados obtenidos, similares a los encontrados en otros países, permiten informar que la versión española del CRAFFT presenta un buen comportamiento psicométrico. A nivel de consistencia interna se obtuvo un a de Cronbach satisfactorio de ,74. En cuanto a la sensibilidad y especificidad se obtuvieron unos valores del 74,4% y el 96,4% respectivamente, con un área bajo la curva COR de ,946. Por lo tanto, queda a disposición de investigadores y profesionales del ámbito de las conductas adictivas la versión española del CRAFFT, para que pueda ser utilizada en adelante con las garantías psicométricas necesarias.

Consumo de cannabis entre adolescentes: patrón de riesgo, implicaciones y posibles variables explicativas / Cannabis use among adolescents: Risk pattern, implications and possible explanatory variables

Contrariamente a lo que ocurre con el resto de sustancias todavía no se han logrado disminuir los niveles de consumo de cannabis, que sigue siendo la droga ilegal más consumida entre los adolescentes españoles. El objetivo de este estudio consiste en actualizar los niveles de consumo (incorporando la franja de edad de 12-13 años), estimar los consumos propiamente de riesgo y analizar las posibles variables asociadas. Para ello se ha utilizado una metodología correlacional consistente en la realización de una encuesta a estudiantes de ESO y Bachillerato de la comunidad autónoma de Galicia (España) en el año 2016. La muestra final estuvo compuesta por 3.882 adolescentes gallegos de entre 12 y 18 años (M = 14,52 y DT = 1,72). Los resultados obtenidos revelan que a día de hoy es ya mayor el porcentaje de adolescentes que consumen tabaco y cannabis que únicamente tabaco (12,7% vs 10,5%) y que ello no sólo implica una mayor probabilidad de consumir otras sustancias ilegales, sino también de desarrollar un patrón consumo de alcohol de riesgo, de Binge Drinking o incluso de experimentar un Uso Problemático de Internet o de ciberacoso. Las variables personales como la autoestima, la asertividad, las habilidades sociales o la impulsividad tienen una capacidad explicativa realmente débil, en comparación con otras variables vinculadas al establecimiento de normas y límites por parte de los padres. Una de las principales conclusiones de este trabajo es la necesidad de adoptar un enfoque de prevención integral

In contrast to the achievements with other substances, it has not yet been possible to reduce the levels of cannabis use, the most used illegal substance among Spanish adolescents. The objective of this paper consists of updating levels of use (incorporating ages 12 and 13), estimating high-risk use and analyzing possible associated variables. For this purpose, a correlational method was used consisting of the administration of a survey to compulsory secondary school and high school students from the autonomous community of Galicia (Spain) in 2016. Results obtained from a sample of 3,882 Galician adolescents aged 12 to 18 (M = 14.52; SD = 1.72) reveal that the percentage of adolescents currently using tobacco and cannabis is higher than that of those using tobacco alone (12.7% vs 10.5%). This implies not only a higher probability of using other illegal substances, but also of developing rather high-risk use pattern, binge drinking or even experiencing problematic Internet use or cyberbullying. From a preventive perspective, the results reveal that personal variables such as self-esteem, assertiveness, social skills or impulsiveness have really weak explanatory power compared with other variables related to the setting of rules and limits by parents. One of the main conclusions of this paper is the need to adopt a comprehensive prevention approach

Validación empírica del CRAFFT Abuse Screening Test en una muestra de adolescentes españoles / Empirical validation of the CRAFFT Abuse Screening Test in a Spanish simple

El CRAFFT Abuse Screening Test, desarrollado por el Center for Adolescents Substance Abuse Research (CeASAR) (Knight et al., 1999), es una herramienta de cribado del consumo de riesgo de alcohol y otras sustancias diseñada para su uso con adolescentes. Desde su publicación ha sido objeto de numerosas traducciones y validaciones en diferentes países, poblaciones y contextos que han dado cuenta de su enorme potencial. No obstante, seguimos sin disponer de estudios de validación empírica que garanticen su adecuado comportamiento psicométrico en España. El objetivo del presente trabajo consiste en desarrollar una versión adaptada del CRAFFT en castellano y analizar sus propiedades psicométricas en una muestra de adolescentes españoles. Para ello, se realizó una entrevista individual a 312 adolescentes de entre 12 y 18 años (M = 15,01; DT = 1,83) de la comunidad gallega, que incluyó una parte de la Adolescent Diagnostic Interview (ADI) y del Problem Oriented Screening Instrument for Teenagers (POSIT). Los resultados obtenidos, similares a los encontrados en otros países, permiten informar que la versión española del CRAFFT presenta un buen comportamiento psicométrico. A nivel de consistencia interna se obtuvo un a de Cronbach satisfactorio de ,74. En cuanto a la sensibilidad y especificidad se obtuvieron unos valores del 74,4% y el 96,4% respectivamente, con un área bajo la curva COR de ,946. Por lo tanto, queda a disposición de investigadores y profesionales del ámbito de las conductas adictivas la versión española del CRAFFT, para que pueda ser utilizada en adelante con las garantías psicométricas necesarias

The CRAFFT Substance Abuse Screening Instrument, developed by the Center for Adolescents Substance Abuse Research (CeASAR) (Knight et al., 1999), is a screening tool for high-risk alcohol and drug risk consumption designed for use with adolescents. Since its publication it has been the subject of translations and validations in different countries, populations and contexts that have demonstrated its enormous potential. However, there is still no empirical validation study that would ensure its good psychometric performance in Spain. The aim of this paper is to develop an adapted version of the CRAFFT in Spanish and to analyze its psychometric properties in a sample of Spanish adolescents. For this purpose an individual interview was conducted on 312 adolescents aged between 12 and 18 years of age (M = 15.01; SD = 1.83) from the Galician community. The interview included a part of the Adolescent Diagnostic Interview (ADI) and the Problem Oriented Screening Instrument for Teenagers (POSIT). The results obtained, similar to those found in other countries, allow us to report that the Spanish version of the CRAFFT has a good psychometric behaviorproperties. It was found to have a satisfactory internal consistency with a Cronbach’s alpha value of .74. In terms of sensitivity and specificity, values of 74.4% and 96.4% respectively, were obtained and the area under the ROC curve was .946. The Spanish version of the CRAFFT is made available to researchers and professionals in the field of addictive behaviors, so that it can be used with the necessary psychometric guarantees

Psychometric validation of the POSIT for screening alcohol and other drugs risk consumption among adolescents. / Validación psicométrica del POSIT para el cribado del consumo de riesgo de alcohol y otras drogas entre adolescentes.

Early detection of alcohol and drug abuse among adolescents is decisive not only for rapid referral and intervention in cases of risk, but also as an indicator for use in the evaluation of prevention programs and public policies to reduce consumption. One of the most widely-used screening instruments in the world is the Problem Oriented Screening Instrument for Teenagers (POSIT) (Rahdert, 1991), whose substance use and abuse subscale (POSITUAS) is a brief tool of enormous applied potential. However, there is still no empirical validation study that would ensure its good psychometric performance in Spain. The aim of this paper is to analyse the psychometric properties of POSITUAS among Spanish adolescents. For this purpose, 569 students aged between 12 and 18 years (M = 14.71; SD = 1.79) were personally interviewed. The study sample was selected through two-stage sampling. The results obtained, using the Adolescent Diagnostic Interview (Winters & Henly, 1993) as the gold criterion, allow us to inform that the Spanish version of the POSITUAS has excellent psychometric behaviour, both at the level of internal consistency (a  = .82) as well as regards sensitivity (94.3%) and specificity (83.9%), with an area under the ROC curve of .953. Also, the realisation of a Confirmatory Factor Analysis allows for verifying the one-dimensional character of the scale. As a result, POSITUAS is made available to researchers and professionals in the field of addictive behaviours for use with a minimum of psychometric guarantees.

La detección precoz del consumo abusivo de alcohol y otras drogas en adolescentes resulta decisiva no sólo para una derivación e intervención rápida en los casos de riesgo, sino también como un indicador a utilizar en la evaluación de los programas de prevención y en las políticas públicas de reducción del consumo. Uno de los instrumentos de screening más utilizados a nivel internacional es el Problem Oriented Screening Instrument for Teenagers (POSIT) (Rahdert, 1991), cuya subescala de Uso y Abuso de Sustancias (POSITUAS) constituye una herramienta breve de enorme potencial aplicado. Sin embargo, en España no existe todavía ningún estudio de validación empírica que permita garantizar su adecuado funcionamiento psicométrico. El objetivo del presente trabajo consiste precisamente en analizar las propiedades psicométricas del POSITUAS en adolescentes españoles. Para ello fueron entrevistados de forma personal 569 estudiantes de entre 12 y 18 años (M = 14,71; DT = 1,79), seleccionados a partir de un muestreo bietápico. Los resultados obtenidos, utilizando la Adolescent Diagnostic Interview (Winters & Henly, 1993) como criterio, permiten informar que la versión española del POSITUAS posee un excelente comportamiento psicométrico, tanto a nivel de consistencia interna (a=,82), como de sensibilidad (94,3%) y especificidad (83,9%), con un área bajo la curva ROC de ,953. Asimismo, la realización de un Análisis Factorial Confirmatorio permite constatar el carácter unidimensional de la escala. Como consecuencia se pone a disposición de investigadores y profesionales del ámbito de las conductas adictivas el POSITUAS, que puede ser utilizado en adelante con las garantías psicométricas requeridas.