Personalidad en adolescentes en muestra general y clínica / Personality in adolescents in a general and clinical sample

El objetivo principal del estudio fue analizar las diferencias entre muestra general y clínica en los prototipos de personalidad (PRP) del “Inventario clínico para adolescentes de Millón” (MACI). La metodología incluyó un diseño observacional y analítico, utilizando un muestreo de participantes (13-17 años) aleatorio polietápico, estratificado y proporcional por conglomerados en muestra general (n= 461) y un muestreo consecutivo en muestra clínica (n= 219). Encontramos que los PRP introvertido, inhibido, pesimista, rudo, oposicionista, autopunitivo y límite presentan una media significativamente mayor en muestra clínica y los PRP histriónico y conformista en muestra general. Se observa ausencia de diferencias significativas en los PRP egocéntrico, sumiso y rebelde. En la variable sexo observamos más diferencias significativas de PRP en muestra clínica que en la general y en la variable edad encontramos una tendencia lineal significativa descendente en los PRP sumiso o conformista y ascendente en los PRP rebelde y rudo en muestra general. El clínico debe estar alerta ante la interpretación de los PRP del MACI que no diferencian entre muestra general y clínica. (AU)

The main objective of the study was to analyze the differences between samples from general and clinical sample in personality prototypes (PRP), derived from the Millon Adolescent Clinical Inventory (MACI). The methodology included an analytical and observational design with a random, multi-stage, stratified and proportional cluster sampling in general sample (n= 461) and consecutive sampling of clinical sample (n= 219), in adolescents between 13 and 17 years of age. We found introvert, inhibited, doleful, forceful, oppositional, self-demeaning and borderline PRP in the clinical sample and dramatizing and conforming PRP in the general sample present a significantly higher mean. There is a relevant absence of significant differences in egotistic, submissive and unruly PRP. By sex, more significant differences in PRP are observed in the clinical sample. By age, a significant downward linear trend in the submissive and conforming PRP is observed, as well as an upward trend in the unruly and forceful PRP in the general sample. The clinician must be alert in the interpretation of the MACI PRP that do not differentiate between general and clinical samples. (AU)

Prevalencia del trastorno negativista desafiante en España / Prevalence of oppositional defiant disorder in Spain

Introducción: El trastorno negativista desafiante (TND) se caracteriza por un patrón de comportamiento negativista, desafiante, desobediente y hostil, dirigido a las figuras de autoridad. El TND es uno de los motivos más frecuentes de consulta clínica en salud mental durante la infancia y adolescencia. Presenta gran morbilidad y disfuncionalidad, mostrando repercusiones futuras si no es tratado de forma temprana. Objetivo: Determinar la tasa de prevalencia de TND en escolares de 6-16 años de Castilla y León (España). Material y métodos: Estudio epidemiológico poblacional, con diseño muestral polietápico estratificado, proporcional y por conglomerados. Muestra analizada: 1.049 sujetos. Casos definidos según criterios DSM-IV. Resultados: La prevalencia de TND es 5,6% (IC 95%: 4,2-7%). Prevalencia género masculino = 6,8%; femenino = 4,3%. Prevalencia educación secundaria = 6,2%; educación primaria = 5,3%. No existen diferencias significativas en función del sexo, edad, tipo de centro, ni por zona sociodemográfica. La prevalencia de TND sin considerar deterioro funcional aumentaría al 7,4%. Los casos de TND presentan significativamente peores resultados académicos (resultados académicos globales, lectura, matemáticas y expresión escrita) y peor conducta en clase (relación con compañeros, respeto a las normas, destrezas de organización, realización de tareas académicas e interrupción de la clase). Conclusiones: Castilla y León presenta una tasa de prevalencia de TND levemente superior a la observada en publicaciones internacionales. En función de su distribución por edad, morbilidad y repercusión clínica disfuncional, parece necesaria una planificación sanitaria que incida en un diagnóstico temprano e intervención preventiva (AU)

Introduction: Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. ODD is one of the most frequent reasons for clinical consultation on mental health during childhood and adolescence. ODD has a high morbidity and dysfunction, and has important implications for the future if not treated early. Objective: To determine the prevalence of ODD in schoolchildren aged 6-16 years in Castile and Leon (Spain). Material and methods: Population study with a stratified multistage sample, and a proportional cluster design. Sample analyzed: 1,049. Cases were defined according to DSM-IV criteria. Results: An overall prevalence rate of 5.6% was found (95% CI: 4.2%---7%). Male gender prevalence = 6.8%; female = 4.3%. Prevalence in secondary education = 6.2%; primary education = 5.3%. No significant differences by gender, age, grade, type of school, or demographic area were found. ODD prevalence without considering functional impairment, such as is performed in some research, would increase the prevalence to 7.4%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, maths and writing), and worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks, and disruption of the class). Conclusions: Castile and Leon has a prevalence rate of ODD slightly higher to that observed in international publications. Depending on the distribution by age, morbidity and clinical dysfunctional impact, an early diagnosis and a preventive intervention are required for health planning (AU)

Prevalence of oppositional defiant disorder in Spain.

INTRODUCTION: Oppositional defiant disorder (ODD) is characterized by a pattern of negative, defiant, disobedient and hostile behavior toward authority figures. ODD is one of the most frequent reasons for clinical consultation on mental health during childhood and adolescence. ODD has a high morbidity and dysfunction, and has important implications for the future if not treated early. OBJECTIVE: To determine the prevalence of ODD in schoolchildren aged 6-16 years in Castile and Leon (Spain). MATERIAL AND METHODS: Population study with a stratified multistage sample, and a proportional cluster design. Sample analyzed: 1,049. Cases were defined according to DSM-IV criteria. RESULTS: An overall prevalence rate of 5.6% was found (95% CI: 4.2%-7%). Male gender prevalence=6.8%; female=4.3%. Prevalence in secondary education=6.2%; primary education=5.3%. No significant differences by gender, age, grade, type of school, or demographic area were found. ODD prevalence without considering functional impairment, such as is performed in some research, would increase the prevalence to 7.4%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, maths and writing), and worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks, and disruption of the class). CONCLUSIONS: Castile and Leon has a prevalence rate of ODD slightly higher to that observed in international publications. Depending on the distribution by age, morbidity and clinical dysfunctional impact, an early diagnosis and a preventive intervention are required for health planning.

Utilidad de un modelo estadístico de estilos cognitivos en el trastorno por déficit de atención con hiperactividad / Utility of a statistical model of cognitive styles in attention deficit hyperactivity disorder

El objetivo de este estudio fue buscar el mejor modelo estadístico de estilos cognitivos, basado en las pruebas MFFT-20, CEFT y STROOP para predecir el trastorno por déficit de atención con hiperactividad (TDAH), analizando la validez del modelo para el diagnóstico del trastorno. Se estudió una muestra de 100 casos de TDAH (criterios DSM-IV) y 100 controles entre 7 y 11 años. Los controles fueron reclutados de forma aleatoria y emparejados según edad, sexo y zona sociodemográfica con los casos. Los casos presentaron en promedio mayor impulsividad (d: 1,28), menor flexibilidad cognitiva (d: ,91) y más dependencia de campo (d: 1,62) que los controles. El modelo de regresión logística que mejor predice TDAH está formado por las variables edad, CEFT, MFFT-20 y STROOP, y la fórmula derivada del modelo presenta una sensibilidad del 85% y especifidad del 85% para TDAH, tomando como prueba de referencia criterios DSM-IV. El modelo estadístico de estilos cognitivos presenta indicadores de adecuada validez diagnóstica en TDAH, contribuyendo a incrementar la objetividad en su análisis (AU)

The purpose of this study was to determine the best statistical model of cognitive styles, based on the MFFT-20, CEFT and Stroop tests to predict attention deficit hyperactivity disorder (ADHD), analyzing the validity of the model for the diagnosis of the disease. We studied 100 ADHD cases (DSM-IV criteria) and 100 controls, age ranging between 7 and 11 years. Controls were randomly recruited and matched in age, gender and sociodemographic area with ADHD cases. On average, ADHD cases showed more impulsiveness (d: 1.28), less cognitive flexibility (d: 0.91) and more field dependence (d: 1.62) than controls. The logistic regression model that predicts ADHD best is made up of age, CEFT, MFFT-20 and Stroop tests and the formula derived from the model shows 85% sensitivity and 85% specificity for ADHD, regarding the DSM-IV criteria as the standard. The statistical model of cognitive styles presents valid indicators to diagnose ADHD, contributing to an increase in the objectivity of its analysis (AU)

[Utility of a statistical model of cognitive styles in attention deficit hyperactivity disorder]. / Utilidad de un modelo estadístico de estilos cognitivos en el trastorno por déficit de atención con hiperactividad.

The purpose of this study was to determine the best statistical model of cognitive styles, based on the MFFT-20, CEFT and Stroop tests to predict attention deficit hyperactivity disorder (ADHD), analyzing the validity of the model for the diagnosis of the disease. We studied 100 ADHD cases (DSM-IV criteria) and 100 controls, age ranging between 7 and 11 years. Controls were randomly recruited and matched in age, gender and sociodemographic area with ADHD cases. On average, ADHD cases showed more impulsiveness (d: 1.28), less cognitive flexibility (d: 0.91) and more field dependence (d: 1.62) than controls. The logistic regression model that predicts ADHD best is made up of age, CEFT, MFFT-20 and Stroop tests and the formula derived from the model shows 85% sensitivity and 85% specificity for ADHD, regarding the DSM-IV criteria as the standard. The statistical model of cognitive styles presents valid indicators to diagnose ADHD, contributing to an increase in the objectivity of its analysis.

[Usefulness of the Stroop test in attention deficit hyperactivity disorder]. / Utilidad del test de Stroop en el trastorno por déficit de atencion/hiperactividad.

AIMS: The aim of this study is to analyse the differences in the Stroop effect between cases with attention deficit hyper-activity disorder (ADHD) and controls. It also seeks to find the best model based on the third task of the colours and words test (Stroop-CW) for predicting ADHD and to analyse the validity of the Stroop-CW test for diagnosing the disorder. SUBJECTS AND METHODS: The sample studied consisted of 100 cases of ADHD -according to Diagnostic and statistical manual of mental disorders (DSM-IV) criteria- and 100 controls, between 7 and 11 years of age, who were evaluated using the Stroop test. The controls were recruited at random and paired by age, sex and sociodemographic area with the cases. RESULTS: The cases present a mean cognitive style that is significantly less flexible (d = -1.06) and they also display a lower capacity to inhibit or control automatic responses than the controls at all ages (7 years: d = 1.67; 8 years: d = 1.02; 9 years: d = 1.32; 10 years: d = 2.04; 11 years: d = 0.89). The model of logistic regression analysis that best predicts ADHD is made up of age and Stroop-CW. The formulation derived from the model offers a sensitivity of 81% and a specificity of 72%, taking the criteria of the DSM-IV for ADHD as the reference test. CONCLUSIONS: The Stroop-CW test presents usefulness and complementary criteria validity for the diagnosis of ADHD.

Utilidad del test de Stroop en el trastorno por déficit de atención/hiperactividad / Usefulness of the Stroop test in attention deficit hyperactivity disorder

Objetivos. Analizar las diferencias entre casos de trastorno por déficit de atención/hiperactividad (TDAH) y controles en el efecto Stroop, y buscar el mejor modelo basado en la tercera prueba del test de colores y palabras (Stroop-PC) que permita predecir el TDAH y analizar la validez del Stroop-PC para el diagnóstico del trastorno. Sujetos y métodos. Se estudia una muestra de 100 casos de TDAH –criterios del Manual diagnóstico y estadístico de los trastornos mentales, 4 ed. (DSM-IV)– y 100 controles, entre 7 y 11 años, evaluados mediante el test de Stroop. Los controles fueron reclutados de forma aleatoria y emparejados según la edad, el sexo y la zona sociodemográfica con los casos. Resultados. Los casos presentan un estilo cognitivo medio significativamente menos flexible (d = –1,06) y reflejan menor capacidad para inhibir o controlar respuestas automáticas que los controles en todas las edades (7 años: d = –1,67; 8 años: d = –1,02; 9 años: d = –1,32; 10 años: d = –2,04; 11 años: d = –0,89). El modelo de regresión logística que mejor predice el TDAH está formado por edad y Stroop-PC. La formulación derivada del modelo presenta una sensibilidad del 81% y una especificidad del 72%, tomando como prueba de referencia los criterios del DSM-IV para el TDAH. Conclusiones. El Stroop-PC presenta utilidad y validez de criterio complementaria para el diagnóstico de TDAH (AU)

Aims. The aim of this study is to analyse the differences in the Stroop effect between cases with attention deficit hyperactivity disorder (ADHD) and controls. It also seeks to find the best model based on the third task of the colours and words test (Stroop-CW) for predicting ADHD and to analyse the validity of the Stroop-CW test for diagnosing the disorder. Subjects and methods. The sample studied consisted of 100 cases of ADHD –according to Diagnostic and statistical manual of mental disorders (DSM-IV) criteria– and 100 controls, between 7 and 11 years of age, who were evaluated using the Stroop test. The controls were recruited at random and paired by age, sex and sociodemographic area with the cases. Results. The cases present a mean cognitive style that is significantly less flexible (d = –1.06) and they also display a lower capacity to inhibit or control automatic responses than the controls at all ages (7 years: d = 1.67; 8 years: d = 1.02; 9 years: d = 1.32; 10 years: d = 2.04; 11 years: d = 0.89). The model of logistic regression analysis that best predicts ADHD is made up of age and Stroop-CW. The formulation derived from the model offers a sensitivity of 81% and a specificity of 72%, taking the criteria of the DSM-IV for ADHD as the reference test. Conclusions. The Stroop-CW test presents usefulness and complementary criteria validity for the diagnosis of ADHD(AU)

Trastorno por deficit de atencion con hiperactividad: evolucion en dimensiones clinicas, cognitivas, académicas y relacionales / Attention deficit hyperactivity disorder: development of clinical, cognitive, academic and social dimensions

El estudio analiza el desarrollo a través de la edad de dimensiones clínicas, cognitivas, académicas y relacionales en casos clínicos de Trastorno por Déficit de Atención con Hiperactividad (TDAH). Metodología de investigación: Se analiza una muestra de 90 casos con TDAH (6-16 años), con un diseño seccional, comparaciones transversales y criterios de investigación diferencial en función de la edad. El caso de TDAH se valoró según criterios DSM-IV y se consideraron las variables perfil intelectual, resultados académicos, dimensión relacional y comorbilidad. Se utilizaron estadísticos descriptivos y exploratorios, implementando un procedimiento de regresión lineal. Resultados: Los casos de TDAH analizados presentan importante alteración en dimensiones clínicas, académicas y relacionales. Solo los resultados académicos se deterioran progresivamente con la edad (p<0.05) (AU)

The study analyses the development through the age of clinical, cognitive, academic and social dimensions, in clinical cases of attention deficit hyperactivity disorder (ADHD). Investigation methodology: A sample of 90 cases of ADHD is analysed (6-16 years). The design is sectional, transverse comparisons and with criterion of differential investigation in function of the age. The case of ADHD was valued according to DSM-IV criterion. There was considered the following variables: intellectual profile, academic results, relational factor and comorbidity. Descriptive and exploratory statistic was used and a procedure of lineal regression was implemented. Results: The cases of ADHD present important alteration in clinical, academic and social dimensions. Only the academic results deteriorate progressively with the age (p <0.05) (AU)