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1.
PLoS One ; 16(8): e0255594, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34352012

RESUMO

INTRODUCTION: Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare. MATERIALS AND METHODS: Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status. RESULTS: 550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained. CONCLUSIONS: Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoólicos/psicologia , Depressão/terapia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/prevenção & controle , Intoxicação Alcoólica/psicologia , Alcoolismo/diagnóstico , Colômbia/epidemiologia , Comorbidade , Atenção à Saúde , Depressão/psicologia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , México/epidemiologia , Pessoa de Meia-Idade , Peru/epidemiologia , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Encaminhamento e Consulta , Detecção do Abuso de Substâncias/métodos
2.
Qual Health Res ; 26(5): 697-711, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25670665

RESUMO

In this study, we investigate the subjective experience of a group of individuals, diagnosed with schizophrenia, undergoing outpatient treatment in four psychiatric clinics in Mexico City. Our objective is to use the paradigm of intersectionality to explore the most common forms of stigma and discrimination faced by people with this illness, as well as the coping resources they employ. The major contribution of this study is its use of in-depth interviews and thematic analysis of the information obtained to identify the importance of sociocultural aspects of participants' experience of their illness. Schizophrenia, for them, was a problem of "nerves," whose origins were linked to magical or religious elements they attributed to their illness and which influenced their response to it. This resignification was useful to participants as a coping resource; it helped them find meaning and significance in their experience of the illness.


Assuntos
Adaptação Psicológica , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Estigma Social , Adulto , Relações Familiares , Feminino , Humanos , Relações Interpessoais , Masculino , México , Pessoa de Meia-Idade , Esquizofrenia/etnologia , Autoimagem , Estereotipagem
5.
Salud Publica Mex ; 55(1): 67-73, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23370260

RESUMO

This paper describes a plan for the attention of addictions from a public health perspective; it defines strengths of this perspective and its limitations to face the special challenges that the problem represents for social policies; adopts a wider perspective that includes the integration of health and social issues in measuring policy results having as a main aim the benefit of the person and of the communities with a perspective of the populations well being. It describes the challenge the country faces as producer, route of traffic and rates of consumption, analyzes briefly the evidence of public policies and makes a series of recommendations.


Assuntos
Saúde Pública , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Guias como Assunto , Humanos , Internacionalidade , México
6.
Salud pública Méx ; 55(1): 67-73, ene.-feb..
Artigo em Espanhol | LILACS | ID: lil-662976

RESUMO

El artículo presenta una propuesta para la atención del problema de las adicciones desde un enfoque de salud pública, define sus alcances y limitaciones frente a los retos del fenómeno, especialmente para la formulación de políticas; se suma a las propuestas que buscan integrar los temas sociales en la evaluación del resultado de las acciones y que proponen como meta última el bien de la persona y de las comunidades con una perspectiva de bienestar para la población. Describe el reto que enfrenta México en su papel como país productor, de tránsito y de consumo, analiza brevemente la evidencia sobre las políticas públicas y hace una serie de recomendaciones al respecto.


This paper describes a plan for the attention of addictions from a public health perspective; it defines strengths of this perspective and its limitations to face the special challenges that the problem represents for social policies; adopts a wider perspective that includes the integration of health and social issues in measuring policy results having as a main aim the benefit of the person and of the communities with a perspective of the populations well being. It describes the challenge the country faces as producer, route of traffic and rates of consumption, analyzes briefly the evidence of public policies and makes a series of recommendations.


Assuntos
Humanos , Saúde Pública , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Guias como Assunto , Internacionalidade , México
7.
Salud ment ; 36(1): 9-18, ene.-feb. 2013. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-685373

RESUMO

This article forms part of a collaborative study in which research teams from Canada and Mexico participated. The general objective is to describe the cultural adaptation and semantic validation of three instruments for measuring stigma and mental illness in Mexico City. The criteria of understanding, acceptance, relevance and semantic integrity were used to adapt the following instruments: The Internalized Stigma Inventory (ISMI), the Opinions on Mental Illness Survey (OMI) and the Devaluation and Discrimination Scale (DDS). Four Individual interviews and four group interviews were carried out with 37 informants from different groups (health personnel, persons with diagnostic of mental disorders, relatives and the general population). Lastly, an analysis was carried out on the contents of the information obtained. The instruments proved to be culturally appropriate for the population in Mexico in the various groups studied. The adapted versions would be useful for establishing comparative analyses with other countries. The scope and limitations of the process of semantic equivalence were analyzed in the transcultural research.


Este trabajo forma parte de un estudio colaborativo en el que participan equipos de investigación en Canadá y México. El objetivo general consiste en describir el proceso de adaptación cultural y validación semántica de tres instrumentos de medición sobre el estigma y la enfermedad mental en la Ciudad de México. A partir de los criterios de comprensión, aceptación, relevancia e integridad semántica se adaptaron los siguientes instrumentos: el Inventario de Estigma Internalizado (ISMI), el Cuestionario de Opiniones hacia la Enfermedad Mental (OMI) y la Escala de Percepción de la Devaluación y Discriminación hacia la Enfermedad Mental (DDS). Para ello se llevaron a cabo cuatro entrevistas individuales y cuatro grupales con 37 informantes de diversos sectores (personal de salud, personas con diagnóstico de trastorno mental grave, familiares y población general). Finalmente se efectuó un análisis de contenido de la información obtenida. Los instrumentos adaptados fueron culturalmente apropiados para la población de los diferentes grupos estudiados en México. Las versiones adaptadas serán de utilidad para establecer análisis comparativos con otras regiones. Se analizan los alcances y limitaciones del proceso de equivalencia semántica en la investigación transcultural.

8.
Soc Sci Med ; 78: 70-7, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23268776

RESUMO

This paper offers a conceptual overview of a neglected field. Evidence is presented to suggest that, globally, addiction is sufficiently stressful to cause pain and suffering to a large but uncounted number of adult affected family members (AFMs), possibly in the region of 100 million worldwide. A non-pathological stress-strain-coping-support model of the experience of AFMs is presented. The model is based on research in a number of different sociocultural groups in Mexico, England, Australia and Italy and aims to be sensitive to the circumstances of AFMs in low and middle income countries and in minority ethnic and indigenous groups as well to those of majorities in wealthier nations. It highlights the social and economic stressors of many kinds which AFMs face, their lack of information and social support, dilemmas about how to cope, and resulting high risk for ill-health. The public sector and personal costs are likely to be high. Attention is drawn to the relative lack of forms of help designed for AFMs in their own right. A 5-Step form of help aiming to fill that gap is briefly described. Family members affected by addiction have for too long been a group without a collective voice; research and action using the model and method described can make a contribution to changing that state of affairs.


Assuntos
Comportamento Aditivo/psicologia , Efeitos Psicossociais da Doença , Família/psicologia , Saúde Global , Estresse Psicológico/etiologia , Adaptação Psicológica , Adulto , Austrália , Comportamento Aditivo/economia , Inglaterra , Humanos , Itália , México , Modelos Psicológicos , Determinação de Necessidades de Cuidados de Saúde , Apoio Social , Estresse Psicológico/psicologia
10.
Salud ment ; 32(3): 223-230, may.-jun. 2009. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-632646

RESUMO

In Mexico, excess drinking constitutes one of the main public health challenges nationwide. The 2002 National Addictions Survey documented the existence of 11 035 262 heavy drinkers, 3 226 490 habitual drinkers, 2 841 303 persons with alcohol dependence and 2 343 71 0 persons who started arguing with their spouse or partner when drunk. Illnesses that are directly or indirectly associated with drinking are among the ten leading causes of death in Mexico among the general population: specifically, men die from attacks or homicide, self-inflicted wounds, alcoholic liver disease and other chronic diseases of the liver and alcohol dependence syndrome. Although there are various intervention strategies that attempt to influence this problem, it is not known whether these interventions are a causal factor in the change produced by the consumer and the way in which this change is produced after treatment; one way of determining this is by evaluating their results. Although Solution-Focused Therapy constitutes a different alternative to those that have traditionally been used for treating alcohol consumption, most research conducted in Mexico and other countries is carried out using a social learning model. Although the results of the Solution-Focused Therapy have been documented in various countries in America and the European Community, the findings are insufficient for it to be regarded as an optimal treatment for modifying excess alcohol consumption among the Mexican population. Objective To evaluate the results of the Solution-Focused Therapy in ethanol-dependent persons and to determine the differences between those that seek to modify problems associated with alcohol consumption and those that seek to change their drinking styles. Method A comparative O1-X-O2 longitudinal design was used, with a 12-month follow-up. The sample comprised 60 intentionally selected alcohol consumers, ages 18 to 50, who attended the Center of Assistance for Alcoholics and Their Relatives (CAAF) at the Ramón de la Fuente National Institute of Psychiatry. They had consumed alcohol in the past year, met the Alcohol Dependence Criteria according to the DSM-IV and gave their written consent. The sample was divided into 30 ethanol-dependent persons who attended the CAAF in an attempt to modify their drinking levels and 30 ethanol-dependent persons who sought to modify problems associated with their consumption. In this study, the results of the intervention were defined on the basis of the time elapsed between an ethanol-dependent person's last therapy session and the time when he or she experiences a relapse and continues with the problems associated with alcohol consumption. The subjects' history of alcohol consumption was characterized by their pattern of consumption, level of dependence, number of DSM-IV criteria, history of treatment, problems of alcohol consumption in the previous two generations of their families of origin, and alcohol-related problems. The number of additional sessions, services and treatments were regarded as mediators of the results of the intervention. The information was obtained through various instruments, such as the pre-consultation and initial consultation cards, the Scale of Ethanol-Dependence and a version of the Index of the Severity of Addiction drawn up by the Center of Assistance for Alcoholics and their Relatives. The procedure was carried out in three stages: the baseline, the application of Solution-Focused Therapy and a follow-up beginning twelve months after the last therapy session. The field operation began in April 2002 and ended in August 2004, with the last phase being carried out on both the subjects that had completed their treatment and on those that had interrupted it and requested assistance again at any of the services offered by the CAAF. Results Seventy-eight per cent of the sample were married; 38% had completed elementary school; the average age was 35.5, and most had a low socio-economic level. A total of 39% were heavy drinkers; 43% displayed a substantial level of dependence, and 70% had a record of treatment. The highest need for treatment was recorded in family problems associated with alcohol consumption, totaling 48%. Sixty-three per cent of the sample attended one to three sessions, while the remainder attended over three. A follow-up study of 83% of the sample showed that most sought assistance at two of the Center's treatment services, while 55% of the dependents received treatment at the CAAF alone. Thirty per cent cut short their treatment because they did not want to stop drinking or did not need help or were annexed; 28% stopped for work or financial reasons, while only 2% reported that the treatment failed to cover their expectations. Fifty-six per cent of the sample did not relapse, and successfully modified the problems associated with alcohol consumption; 32% relapsed and failed to modify their alcohol-related problems, while the remainder relapsed yet managed to modify the problems associated with alcohol consumption (12%) with a value of χ² = 29.94 and p equivalent to 0.00. The heterogeneity tests did not display statistically significant differences between the subjects that relapsed and continued with their alcohol-related problems (44%) and those that did not relapse and modified their alcohol-related problems (56%) by either alcohol consumption characteristics or the factors mediated by the results of the intervention. The study showed that the first four months after the last therapy session are those during which subjects experience the highest risk of relapsing and continuing with problems associated with alcohol consumption. Just 47% of the patients that cited modifying their drinking levels as the reason for seeking treatment proved not to have relapsed and to have successfully modified the problems associated with their drinking at the 1 2-month follow-up as opposed to 83% of those that sought to modify the problems associated with their drinking, with a statistical significance of less than 0.01 in the log-rank test. The intervention was observed to achieve better results among alcohol-dependent persons that sought to modify problems associated with alcohol consumption, had a lower socio-economic level, a record of treatment for their alcohol consumption, high levels of dependence, a medium-high need for treatment in psychological, work problems, and did not receive any form of treatment outside the CAAF. The article discusses the role of the demand for treatment as a predictor not only of the search for services, as supported by international literature, but also of the results of the intervention. It confirms the importance of conceiving alcoholism as a symptom resulting from relational systems the drinker maintains with his/her surroundings, rather than as a problem that can be solved by ensuring that the drinker remains sober. The article suggests including a control group with another type of therapeutic intervention in order to compare the results of the Solution-Focused Therapy and have more elements for making evidence-based decisions.


En México, el consumo excesivo de alcohol representa uno de los principales retos de salud pública a escala nacional. Aunque existen diversas estrategias de intervención que pretenden incidir en este problema también hay un gran vacío con respecto a si dichas intervenciones son un factor causal en el cambio producido por el consumidor y la manera en que dicho cambio se produce después del tratamiento. Una vía para conocerlo es evaluar sus resultados. La Terapia Centrada en Soluciones (TCS) constituye una alternativa a las que tradicionalmente se utilizan para tratar el consumo de alcohol. Sus resultados se han documentado en diferentes países de América y de la Comunidad Europea, pero no en población hispana. Objetivo Evaluar los resultados de la Terapia Centrada en Soluciones en dependientes al etanol y determinar las diferencias entre quienes buscaban modificar los problemas asociados al consumo de alcohol y los que pretendían cambiar su manera de beber. Método Se trabajó con un diseño longitudinal de tipo O1-X-O2, comparativo, con un seguimiento a doce meses. La muestra se integró con 60 consumidores de alcohol de 18 a 50 años de edad que acudieron al Centro de Ayuda al Alcohólico y sus Familiares (CAAF) del Instituto Nacional de Psiquiatría Ramón de la Fuente. Todos fueron seleccionados de manera intencional, consumieron alcohol en el último año, cubrieron los criterios de dependencia al alcohol según el DSM-IV y brindaron por escrito su consentimiento informado. La muestra se dividió en 30 dependientes al etanol que acudieron al CAAF en busca de modificar su nivel de consumo y 30 dependientes que pretendían modificar los problemas asociados a su consumo. En la presente investigación, los resultados de la intervención se definieron a partir del tiempo transcurrido desde que un dependiente asistía a la última sesión de terapia hasta que presentaba una recaída y continuaba con los problemas asociados al consumo de alcohol. La historia de consumo de alcohol de los sujetos se caracterizó por medio del patrón de consumo, nivel de dependencia, número de criterios del DSM-IV, antecedentes de tratamiento, problemas de consumo de alcohol en la familia de origen en dos generaciones previas y problemas asociados al consumo de alcohol. El número de sesiones, servicios y tratamientos adicionales se consideró como mediador de los resultados de la intervención. Resultados Del total de la muestra, 78% era casado; 38% tenía instrucción básica; la edad promedio fue de 35.5 años; la mayoría pertenecía a un nivel socioeconómico bajo; 39% era consumidor de alto nivel; 43% se ubicó en un nivel de dependencia sustancial y 70% contaba con antecedentes de tratamiento. La necesidad de tratamiento más alta se registró en los problemas familiares asociados al consumo de alcohol con 48%. Del total de la muestra, 63% asistió de una a dos sesiones y los restantes asistieron a más de dos, con un seguimiento de 83% de la muestra. En el análisis de sobrevida, los primeros cuatro meses después de tratamiento se identificaron como los meses de mayor riesgo para recaer. Se observó que la TCS tuvo mejores resultados en dependientes que buscaban modificar los problemas asociados al consumo de alcohol. Éstos se ubicaron en los niveles socioeconómicos más bajos y presentaron un nivel de deterioro importante por el consumo de alcohol.

11.
Qual Health Res ; 18(6): 830-42, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18503024

RESUMO

The population's conceptions about health are crucial to the development of any intervention strategy in the field of public health. We are interested in describing the sense adult inhabitants confer on emotional ailments in daily life. We used the Theory of Social Representations as a framework of reference and a multimethod perspective, which will enable us to recover the subjective experience of participants in the study, not only regarding emotional suffering, but also as a means of incorporating their perceptions of pleasurable states into their everyday lives. Finally, we discuss our findings, taking into account the implications of using various methodological strategies to obtain a more integral health approach that proved extremely useful for identifying the felt needs of the population and proposing their inclusion in mental health care programs.


Assuntos
Sintomas Afetivos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Áreas de Pobreza , Adaptação Psicológica , Adulto , Feminino , Acesso aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Masculino , Saúde Mental , México , Pessoa de Meia-Idade
12.
Salud ment ; 29(6): 73-80, nov.-dic. 2006.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-985988

RESUMO

Abstract: The purpose of this study was to test the factorial validity of the Symptom Rating Test (SRT) on women (mothers and wives of alcohol and drug users) coping with alcohol and drug use in a close relative (n=155). The purpose was to develop a common model of symptoms that would serve as the basis for establishing comparative analyses based on variables such as type of relationship with the drug user and country. This article is part of a broader transcultural study on family and addictions, carried out simultaneously in Mexico City and Southeast England. The overall sample in the two countries con-sisted of 200 families from both countries. The original methodology has been broadly described in previous studies. Half the sample came from specialized drug treatment centers, while the other half was drawn from the community population. The criteria for inclusion were as follows: a) Alcohol and/or drug use of a son, daughter or spouse during the six months prior to the interviews; b) Display of concern over active alcohol and/ or drug consumption of close relative (of either sex). Evidence was found of the validity and consistence of the symptom rating test, which included thirteen items (alpha = .93) and consists of two subscales of physical and psychological symptoms (X2 = 64.6 64 gl, p= 0.053). Variance analysis showed one main effect for the subscale of physical symptoms: Mexican women were more likely to somatize an addiction problem than English women (F=4.930. gl1/155, p <.05) and the interaction between the type of relationship and the country was also signifi-cant (F=6.327, gl1/155, p <.05). On the basis of the above, the implications of this study for future research are to increase the evidence of the factorial structure on the 13-item symptom scale in which different socio-cultural groups are considered, for instance, to explore how the male relatives of drug users express their symptoms. On the other hand, it is very important to consider the differences about type of drug and trajectory of use, between the rural and urban popu-lation, in order to identify the communalities and differences regarding symptoms and their meanings. This can be achieved by using complementary qualitative methodologies, in order to have more sensitive measurements and to establish standards of transcultural comparison that will enable to promote comparative studies.


Resumen: El objetivo de este trabajo fue comprobar la validez factorial de la Escala de Síntomas (Symptom Rating Test, SRT), en mujeres (madres y esposas de usuarios de alcohol y drogas) que hacen frente al consumo de alcohol y de drogas en un familiar cercano (n=155). El propósito fue desarrollar un modelo común de síntomas que sirviera como base para establecer análisis comparativos a partir de ciertas variables tales como tipo de relación con el usuario de drogas y país. Este trabajo forma parte de un estudio trascultural más amplio sobre familia y adicciones, que se llevó a cabo simultáneamente en la Ciudad de México y en el Suroeste de Inglaterra. La muestra global en ambos países fue de 200 familias. La metodología original se ha descrito en trabajos previos. De la muestra, 50% provenía de centros especializados de atención en drogas y el restante 50% de población comunitaria. Los criterios de inclusión fueron los siguientes: a) Consumo de alcohol y/o drogas en un hijo(a) o cónyuge durante los seis meses previos a la realización de la entrevista; b) Mostrar preocupación por el consumo activo de alcohol y/o drogas de un familiar cercano (de uno u otro sexo). Je encontraron pruebas de la validez y consistencia de la escala de síntomas que incluye trece reactivos (alpha=.93) y que consta de dos subescalas de síntomas físicos y psicológicos (X2=64.6 64gl, p=0.053). El análisis de varianza mostró un efecto principal para la subescala de síntomas físicos. Las mujeres mexicanas tendían más a somatizar un problema de adicciones que las inglesas (F=4.930. gl1/155, p <.05) y la interacción entre el tipo de relación y el país también fue significativa (F=6.327, gl1/155, p <.05). Las implicaciones de este trabajo en investigaciones futuras son poder comprobar más ampliamente la validez de la estructura factorial de la escala de síntomas con trece reactivos en la que se consideren diferentes grupos socioculturales, por ejemplo, cómo se expresan los síntomas en el caso de los familiares varones de usuarios de drogas. Por otra parte, es importante contrastar a la población rural y urbana, por tipo de droga y por trayectorias de consumo, a fin de poder identificar las comunalidades y diferencias respecto a los síntomas y sus significados. Lo anterior puede lograrse utilizando estrategias metodológicas complementarias de carácter cualitativo, para poder establecer estándares de comparación transcultural y contar con mediciones más sensibles que permitan impulsar los estudios comparativos.

13.
Salud ment ; 28(2): 82-90, mar.-abr. 2005.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-985888

RESUMO

resumen está disponible en el texto completo


Abstract: In México, addictions among the middle- and high-school student population have been widely studied, which has shed light on certain risks associated with alcohol abuse, including a higher probability of expriencing with other drugs -particularly in the case of males-, engaging in risky sexual practices and attempting suicide, a situation that is twice as common among those who drink and drive. Nevertheless, research on alcohol abuse among the university population has been less explored, particularly as regards the identification of the variables that predict excessive alcohol consumption. A review of the international literature on factors associated with alcohol abuse in this type of population indicates that it is among university students that high or explosive consumption tends to be largest, even among young people who do not attend school, and that the period of higher consumption is between 17 and 21 years of age. Other factors that have been identified include exposure to negative life events, inappropriate coping styles, personality variables, resorting to alcohol to reduce tension, and environmental and socio-cognitive variables, foremost among which are expectations of the positive effects of alcohol. These expectations not only predict alcohol consumption but also differentiate between problem and non-problem drinking. For example, while social drinkers tend to harbor more social expectations when drinking alcohol, excessive drinkers expect alcohol to increase their aggressive and social behavior, while reducing stress or tension. This paper seeks to evaluate the impact of expectations regarding alcohol, in predicting alcohol abuse among students at public and private universities in Mexico City. Indicators of alcohol abuse include consumption of five or more drinks on each occasion, drunkenness during the past month and year as well as associated problems. The study also seeks to determine the way in which sub-scales of expectations interact with each other. An ex post facto transversal study was carried out on a sample of 678 university male and female students aged 17 to 25, with an average age of 20 (s.d. = 1.80). Participants were asked to complete a self-report which included the following areas: a) Sociodemographic data, b) Questionnaire on Expectations regarding Alcohol (AEQ), in a version adapted to this population and c) Alcohol consumption habits over the past month and year. As regards drinking habits, a comparative analysis was carried out by sex and age. Consumption of 5 or more drinks per occasions tends to be more common among men, while the consumption of 5 drinks or less is more frequent in women. At the same time, a higher proportion of heavy drinkers was concentrated in the 20 to 22 age range. Consumers of over 5 glasses of alcohol began drinking at an average age of 14 (s.d. = 2.55) whereas consumers of fewer than 5 drinks began drinking at the age of 15 (t= 4.79 , p < .001). In both cases, the means obtained from the indicators of abuse were highest among consumers of five or more drinks. Males take more drinks than women when they get drunk, consuming an average of 9 glasses (s.d. = 4.7) whereas women get drunk after an average of 5 glasses (s.d. = 3.2) (t= -10.80, p < .001). Out of a total of 26% of young people who mentioned having problems associated with their drinking, most were men (17.9%) as opposed to women (8.2%). The multiple regression analysis carried out to determine the impact of the sub-scales of AEQ expectations on alcohol abuse found that expectations regarding alcohol as a "facilitator of group interaction" and the sub-scale of "reduction of psychological tension" were the main predictors of abuse. This model explained 20% of the variance (F=19.35, p < .001). A logistic regression analysis found that the sub-scale of expectations regarding "increase of power and aggression" as well as alcohol abuse predicted problems associated with drinking. A model was subsequently designed to integrate the expectations that predicted alcohol abu se and associated problems. A structural equations model was used which found that expectations regarding "reduction of psychological tension" and alcohol as a jacilitator of group interaction predicted 30% and 24% of abuse, respectively (X2sb = 33.52, p >0.00, CFI = 0.99 and RMSEA = 0.01). The rest of the sub-scales concerning expectations were regarded as mediating varia bles to see how they interacted with each other. As one can see, although the sub-scales of expectations are inter-related, group expectations were specifically associated with the sub-scales of "increase in sexuality," "physical tension" and "increase in power and aggression." At the same time, expectations regarding "reduction of psychological tension" are closely linked to the social sphere, specifically the expectations regarding "verbal expressiveness" and "lack of inhibition." Along these same lines, alcohol abuse and the expectations regarding alcohol as an agent that increases feelings of power and aggression predicted 26% and 28% of alcohol-related problems. One of the contributions of this research is that it considered the inter-relationship of sub-scales of expectations to explain alcohol abuse. Psychological tension, for example, appears to be linked to social aspects, specifically to verbal expressiveness and lack of inhibition, while group expectations refer to sexuality, the reduction of psychological tension and the increase of aggressiveness and feelings of power. Likewise, it is interesting to note that in addition to alcohol abuse, expectations regarding an increase in power and feelings of aggression are the best predictors of problems associated with alcohol use. The results have implications at the intervention level for developing programs specifically aimed at this population. The fact that expectations regarding alcohol as a "facilitator of social interaction" is one of the main predictors of abuse indicates the importance of considering environmental factors in the development of prevention programs. This involves including not only young people but also parents, schools, and other adults in order to question the cultural norms that promote beliefs regarding alcohol consumption, as a way of enjoying social interaction with positive, pleasurable states, and as a socially appropriate response for coping with negative events that arise in everyday life, such as drinking to relieve tension, handle crises and as an escape from chronic stress, by providing information on the negative consequences of use and promoting healthier lifestyles. At the intervention level, it is essential to target university students through programs specially designed for young people who engage in high-risk drinking. As regards expectations, actions must be carried out to resignify the positive beliefs surrounding alcohol, by providing information on the high health costs of heavy drinking and offering alternative resources oriented towards other means of responding to stress that do not involve excessive alcohol consumption.

14.
Salud ment ; 24(4): 3-19, jul.-ago. 2001. ilus, mapas, tab, graf, CD-ROM
Artigo em Espanhol | LILACS | ID: lil-309636

RESUMO

Los cambios sociales de las últimas décadas -derivados de variaciones en la dinámica y composición de la estructura demográfica de la población, en que hay, en números absolutos, mayor cantidad de adolescentes y de personas de la tercera edad; crisis económicas recurrentes a las que se suman problemas de pobreza agravados por el incremento en el uso de drogas, y una acelerada apertura social y cultural frente al proceso de modernización y globalización- han afectado las vidas de las personas en los ámbitos individual, familiar y social en que interviene el abuso de sustancias. Al tradicional problema del abuso de bebidas alcohólicas entre los varones de edad media, ahora se han sumado las mujeres y los adolescentes que copian los modelos adultos asociados con frecuencia al consumo y la embriaguez. Aunque ha habido un cambio en la percepción social del tabaco como producto adictivo y dañino para la salud, los adolescentes, principalmente mujeres, lo consumen cada vez más. Asimismo, al tradicional problema del uso de inhalables entre los menores y de mariguana entre los jóvenes y algunos grupos de la población adulta, se agrega ahora un consumo cada vez mayor de cocaína, que ha llegado incluso a los niños y a los sectores pobres de la población; en los adultos, este consumo se ha incrementado por vía intravenosa. Por otra parte, se ha detectado un brote epidémico de consumo de heroína en algunas regiones de la frontera norte y también han aparecido nuevas drogas como las meta-anfetaminas. En el artículo se describe el panorama del uso de drogas, sus tendencias a partir de 1970 y el pronóstico, a la luz de las condiciones sociales que prevalecen en México. Se discute la relación entre el uso de droga y la conducta sexual de riesgo y la conducta delictiva, se describe su asociación con los accidentes y con diferentes formas de violencia incluyendo la violencia intrafamiliar y el suicidio. Se hace por último una revisión de los principales determinantes macrosociales del problema (globalización, desarrollo económico y desigualdades sociales, migración, cambios en los roles de género y en la composición familiar) y su relación con el consumo de sustancias, y se concluye con los retos para el futuro y las necesidades de investigación.


Assuntos
Alcoolismo , Mudança Social , Transtornos Relacionados ao Uso de Substâncias , Acidentes , México , Comportamento Sexual , Violência Doméstica/psicologia
17.
Salud ment ; 21(1): 1-13, ene.-feb. 1998. tab
Artigo em Inglês | LILACS | ID: lil-243136

RESUMO

Este trabajo es la primera aproximáción cualitativa al estudio de la salud, las emociones y los estresores relacionados con el uso de drogas en la familia. La comprensión de los aspectos centrales de las experiencias de los familiares que viven con un usuario de alcohol o drogas, y la manera como responden a ello, puede contribuir no sólo con el conocimiento acerca de las estrategias de enfrentamiento, sino también con el papel de la familia en los procesos de cambio. En este sentido, se consideran los aspectos transculturales al explorar y descubrir las variaciones psicológicas de cada cultura que no están presentes en otras. La información proviene de 12 entrevistas inglesas y 12 mexicanas a familiares con características semejantes, y se enfoca en las descripciones de los estresores que han experimentado, sus reacciones emocionales y los signos de estrés físico o mental. El objetivo de este trabajo es proporcionar una descripción detallada, por medio de testimonios, de los estresores y tensiones así como de los posibles vínculos que hay entre ellos. El método principal de recolección de la información que se utilizó en el proyecto fue una entrevista semiestructurada, y la principal estrategia de análisis es cualitativa (Strauss y Corbin, 1990). La hipótesis que surgierón de este trabajo se basan en el hecho de que ciertas experiencias de los familiares son universales en esas circunstancias. Estas experiencias consisten en las repercusiones negativas de vivir con el usuario; el interés por la salud y el desempeño del usuario; las dificultades económicas; los efectos dañinos del consumo en la familia y el hogar; los sentimientos de ansiedad, preocupación, desesperanza, desesperación y depresión; la manera como afecta la salud mental y los síntomas específicos que el familiar atribuye, en parte, al estrés por vivir bajo los efectos de la problemática del consumo de alcohol o drogas. Hay un gran contraste entre la ciudad de México y las áreas del sur de Inglaterra, de donde proceden los participantes ingleses. La cultura de los participantes mexicanos tiende a ser más colectivista, mientras que la cultura inglesa es más individualista. También hubo divergencias en las dimensiones urbano-rural, religioso-secular y católico-protestante


Assuntos
Humanos , Masculino , Feminino , Alcoolismo/psicologia , Coleta de Dados , Inglaterra , Núcleo Familiar/psicologia , Estresse Psicológico , Transtornos Relacionados ao Uso de Substâncias/psicologia , México , Transtornos Relacionados ao Uso de Substâncias
18.
Salud ment ; 17(3): 15-23, sept. 1994. tab
Artigo em Espanhol | LILACS | ID: lil-143251

RESUMO

La validación de la Escala de Síntomas Symptom Rating Test (SRT)(Kellner y Sheffield, 1973) se llevó a cabo en México en estudiantes de enseñanza media-superior. Se entrevistaron 338 sujetos, de los cuales 54 por ciento eran mujeres y 46 por ciento hombres, considerados unos u otros como población sin problemas psiquiátricos. Se hicieron las rutinas de discrimación de reactivos y un análisis factorial a fin de probar la validez conceptual de las cuatro subáreas que evalúa el cuestionario, tales como inadecuación social, ansiedad, somatización y depresión. Aunque el SRT es una escala confiable (alpha = .93), la estructura factorial no se mantuvo estable con respecto a la escala original. La escala de síntomas se puede trabajar en este tipo de población por medio del empleo de dos subescalas que evalúan los síntomas físicos y los psicológicos; o bien por medio de las cuatro subescalas originales modificadas. En estas últimas, las mujeres obtuvieron mayores puntajes en sintomatología que los hombres, en las áreas de depresión, somatización, ansiedad e inadecuación


Assuntos
Adulto , Kit de Reagentes para Diagnóstico , Entrevista Psiquiátrica Padronizada/estatística & dados numéricos , Valor Preditivo dos Testes , Estudantes/psicologia , Sintomas em Homeopatia
19.
In. México. Secretaría de Salud. Consejo Nacional Contra las Adicciones. Las adicciones en México: hacia un enfoque multidisciplinario. México D.F, Secretaría de Salud, 1992. p.79-86.
Monografia em Espanhol | LILACS | ID: lil-147886

RESUMO

Ante el problema del alcoholismo y el de las drogas, en el seno familiar surgen y se desarrollan diversas formas y actitudes para enfrentarlos. Las formas observadas al enfrentar esta problemática son, en lo general: emocionales, tolerantes, controladoras, evitadoras, confrontativas, de apoyo al adicto, indiferentes. Por este motivo, el interés fundamental del presente trabajo es ofrecer una "reflexión" sobre las emociones y su "aplicabilidad" en el estudio del abuso de alcohol y drogas, con objeto de proporcionar una explicación sobre los mecanismos conducentes para enfrentar este problema


Assuntos
Alcoolismo/complicações , Alcoolismo/prevenção & controle , Alcoolismo/psicologia , Saúde da Família , México , Preparações Farmacêuticas , Transtornos Relacionados ao Uso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/psicologia
20.
Salud ment ; 13(3): 20-6, sept. 1990. tab
Artigo em Espanhol | LILACS | ID: lil-99051

RESUMO

En este artículo se hizo un esfuerzo para encontrar la forma de enfocar el problema del alcohol y la familia desde una perspectiva cultural comparativa. A fin de comprender el comportamiento de una familia individual, debemos conocer los patrones culturales que determinan el contexto de cualquier conducta individual. Se presenta una breve descripción de las características socioculturales de la familia en México y en Finlandia, así como algunos de los resultados obtenidos en estudios realizados sobre la familia y el alcohol en estos países. El artículo muestra que las familias mexicanas y las finlandesas difieren entre sí de manera por demás dramática. No obstante, algunos patrones de consumo de alcohol y de su control informal, se asemejan más de lo que cabría esperar considerando las divergencias en los estilos de vida familiar, en general. Nuestra exploración preliminar destaca la idea de que el uso de alcohol y su control están relacionados con las estructuras básicas fundamentales de la cultura, en que se refiere a los roles sexuales.


Assuntos
Humanos , Adulto , Masculino , Feminino , Consumo de Bebidas Alcoólicas/etnologia , Família/etnologia , Religião e Sexo , Fatores Socioeconômicos
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