Psychometric Properties of the Five-Item Francis Attitude Towards Christianity Scale in Colombian Psychiatric Outpatients.

This study aimed to know the psychometric properties of the five-item Francis scale of the attitude towards Christianity (Francis-5) by assessing psychiatric outpatients in Santa Marta, Colombia. A sample of 260 adult patients participated. The exploratory and confirmatory factor analyses revealed an excellent one-dimensional structure with high internal consistency. It was concluded that the Francis-5 exhibited good indicators of validity and reliability in Colombian psychiatric outpatients.

Prodromal questionnaire (PQ-16) dimensionality among Colombian adolescent school students.

AIMS: The study aimed to determine the dimensionality of the Spanish version of the PQ-16 among Colombian adolescent school students. METHODS: A validation study was designed with the participation of 334 Colombian adolescent students aged between 13 and 17 (M = 15.2, SD = 1.1); 171 (52.1%) were girls, and 163 (47.9%) were boys, 229 (68.6%) were ninth-grade students and 105 (31.4%) were tenth-grade students. Confirmatory factor analysis was performed, internal consistency was calculated with the Kuder-Richardson and McDonald's omega tests, and correlation with suicide ideation was computed with the Kendall correlation (r). RESULTS: The confirmatory factor analysis showed that the PQ-16 adequately fit a unidimensional structure: RMSEA = 0.05 (90%CI 0.04-0.06), CFI = 0.91, TLI = 0.90, SRMR = 0.05, chi-squared = 193.18 (df = 102, p < 0.001) and normalized chi-squared = 1.89. This factor presented high internal consistency: Kuder-Richardson test and McDonald's omega of 0.83. The correlation between the PQ-16 and suicide ideation was r = 0.45 (p < 0.001). CONCLUSION: The PQ-16 is a one-dimensional tool with high internal consistency and correlation with suicide ideation among schooled adolescents. Further research should explore the PQ-16 performance against a structured clinical interview.

Association Between Familiarity with Mental Disorders and Stigma Discrimination Related to Mental Disorders Among Colombian Students.

Children and adolescents with mental disorders are often discriminated against by their peers in the school context. However, knowing the variables associated with stigma discrimination related to mental disorders (SDRMD) in each school community is crucial. The study aimed to estimate the relationship of familiarity with mental disorders with SDRMD among students in Santa Marta, Colombia. A cross-sectional study was conducted. Familiarity with mental disorders and SDRMD were measured with the Reported and Intended Behavior Scale. Three hundred fifty students were aged between 10 and 17 years (13.34 ± 1.78), and 188 (53.71%) were girls. Having a close friend with a mental health problem (odds ratio = 0.17, 95% CI, 0.06-0.48) was a protective factor for SDRMD. Having a close friend with a mental health problem is protective against SDRMD among Colombian school students.

Performance of the Reported and Intended Behavior Scale Among Colombian Adolescents.

Background: Stigma discrimination against people who meet the criteria for mental disorders is frequent in Colombian adolescents; however, there is no valid and reliable instrument for measurement. The study aimed to establish the Reported and Intended Behavior Scale psychometric performance among Colombian adolescents. Methods: A validation study was carried out with 350 students aged between 10 and 17, 53.7% of whom were girls. The authors estimated frequencies for reported behaviors and measured internal consistency and confirmatory factor analysis for intended behaviors. The Reported and Intended Behavior Scale has 2 sub-scales-reported and intended behaviors, with 4 items each. Results: The reported behavior sub-scale ranged from 10.0% to 24.9%, whereas the intended behavior sub-scale presented a Cronbach's alpha of 0.88 (95% CI: 0.86-0.90) and a McDonald omega of 0.88. For the confirmatory factor analysis, Kaiser-Meyer-Olkin was 0.81, Bartlett chi-squared, was 771.1 (df = 6, P = .001), and Eigen value was 2.95 that explained 73.9% of the total variance. For the goodness-of-fit tests, chi-squared was 21.9 (df = 2, P = .001), root mean square error of approximation was 0.17 (90% CI: 0.11-0.24), Comparative Fit Index was 0.97, Tucker-Lewis Index was 0.92, and standardized root mean square residual was 0.03. Conclusions: The Reported and Intended Behavior Scale can measure reported behaviors, and the intended behavior sub-scale shows high internal consistency. However, the dimensionality of the intended behavior sub-scale presents modest goodness-of-fit indexes. These findings need replications.

Discrimination starts with adjectives.

Discrimination starts with adjectives.

Cultural psychiatry: beyond DSM-5.

BACKGROUND: Cultural psychiatry evaluates manifestations, symptoms of emotional distress and mental disorders in diverse cultural contexts; it also addresses social problems such as poverty, violence, inequalities between groups or social classes. OBJECTIVE: To present a narrative review of the most relevant cultural aspects in the context of clinical practice in psychiatry and to suggest some alternatives to improve the cultural competence of health care professionals. METHOD: A narrative review was carried out of the most relevant articles in the area. RESULTS: Usually, the cultural argument is used to explain differences in observed prevalences in some mental disorders according to gender and geographical location. Cultural differences modify the expression of emotional distress and this can reduce the accuracy and affect the reliability and validity of the current diagnostic classification used in psychiatry. The American Psychiatric Association, in the most recent classification, revised cultural syndromes but only included a limited number of situations. Consequently, medical education and psychiatry must respond to diverse populations and provide quality care through the development of trans-cultural competence in the curriculum. CONCLUSIONS: It should be considered that cultural differences modify the expression of distress and thereby undermine the validity and reliability for diagnoses in distinct cultural contexts. In an increasingly globalised world, future classifications may completely omit 'cultural syndromes'.

Review of cases, case series and prevalence studies of zoophilia in the general population. / Revisión de casos, series de casos y estudios de prevalencia de zoofilia en la población general.

BACKGROUND: Information about the frequency of zoophilic behaviour in the general population is scarce. OBJECTIVE: To review cases, case series and prevalence studies of zoophilia in adults in the general population. METHODS: A review of publications was carried out in MEDLINE via PubMed, Scopus and the Biblioteca Virtual en Salud [Virtual Health Library] ranging from January 2000 to December 2017. RESULTS: Thirteen papers were reviewed (ten case reports, two case series and one cross-sectional study). Twelve patients were described, the case series totalled 1,556 people and the cross-sectional study included 1,015 participants and reported a prevalence of zoophilic behaviour of 2%. CONCLUSIONS: Information on the prevalence of zoophilic behaviour in the general population is limited. The Internet will probably be a valuable tool for further investigating these behaviours in coming years.

Stability of the Spanish version of the five-item Francis Scale of Attitude toward Christianity.

The aim of this study was to establish test-retest reliability of a Spanish version of the Francis Scale of Attitude toward Christianity (Campo-Arias, Oviedo, & Cogollo, 2009) among adolescent students in Cartagena, Colombia. A group of ninth grade students from two public schools in Colombia (N = 157) completed the five-item scale. Cronbach's alphas were .74 and .76 in the first and second administrations, respectively. Both Pearson's rho and intra-class correlation coefficient were .69. A Spanish translation of the 5-item scale had consistent stability over four weeks.

Prevalence of pattern of risky behaviors for reproductive and sexual health among middle- and high-school students.

This research aimed to establish the prevalence and factors associated with the pattern of risky behavior for reproductive and sexual health (PRBRSH) among secondary education students in Santa Marta, Colombia. A cross-sectional study was done. The PRBRSH was defined as having had two or more out of four possible risky sexual practices across the lifetime. Logistic regression was calculated to control for confounding variables. In total, 804 students reported lifetime sexual intercourse. PRBRSH was reported by 36.1% of the sample. Illegal substance use (OR=11.4), alcohol drinking (OR=2.5), being a middle-school student (OR=1.7) and middle or high socioeconomic status (1.4) were associated with PRBRSH. Around one out of three adolescent students is at high risk for HIV infection or unwanted pregnancy. Safe sex practices need to be promoted in this population.

[Homophobia among nursing students]. / Homofobia en estudiantes de enfermería.

Homophobia is defined as a general negative attitude towards homosexual persons, with implications on public health. This fact has been less investigated among nursing students. The objective of this review was to learn about the prevalence of homophobia and its associated variables among nursing students. A systematic review was performed on original articles published in EBSCO, Imbiomed, LILACS, MEDLINE, Ovid, and ProQuest, including articles published between 1998 and 2008 in English, Portuguese and Spanish. Keywords used were homophobia, homosexuality, and nursing students. Descriptive analysis was performed. Eight studies were analyzed. The incidence of homophobia in nursing students is between 7% and 16%. Homophobia is more common among males and religious conservatism people. Homophobia is quite frequent in nursing students. This negative attitude toward homosexuality may affect services and care giving by nursing professions and could have negative implications in nursing practice.

Barriers to access to mental health services among Colombia outpatients.

BACKGROUND: Access barriers are all situations or conditions that limit seeking, receiving or enjoying benefits offered by the health system. This set of situations translates into underutilization of the services offered. In Colombia, there is little information about barriers to accessing medical care in general, and even less in the specific field of mental health. AIM: To determine the barriers to accessing psychiatric care in outpatients in Santa Marta, Colombia. METHODS: The authors designed a cross-sectional study with a non-probability sample of adult patients who consulted between August and December 2018. The barriers to access were measured with a 20-item version of the Barriers to Access to Care Evaluation (BACE) scale. RESULTS: A total of 247 patients participated; they were between 18 and 82 years (mean (M) = 47.5, standard deviation (SD) = 13.9). A total of 69 (27.9%) patients classified as having major attitudinal barriers; 62 (25.1%) patients, major barriers related to stigma-discrimination; and 41 (16.6%) patients, major instrumental barriers. Concerning the associated variables, age less than 45 years was related to major attitudinal barriers (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.6-5.5), major barriers related to stigma-discrimination (OR = 3.8, 95% CI 2.0-7.2) and major instrumental barriers (OR = 2.7, 95% CI 1.3-5.3). Men reported major instrumental barriers more frequently than women (OR = 2.8, 95% CI 1.3-5.8). CONCLUSION: The major attitudinal, related to stigma-discrimination and instrumental barriers to access frequently delay a consultation with mental health services. Actions are necessary to reduce barriers to accessing mental health care.

Innovations, Reviews and Proposals on the DSM-5: the Case of Sexual Dysfunctions, Gender Dysphoria and Paraphilic Disorders. / Novedades, críticas y propuestas al DSM-5: el caso de las disfunciones sexuales, la disforia de género y los trastornos parafílicos.

Human behaviours have different meanings according to the historical moment and context. In this article sexual behaviours are taken as a category in order to analyse how psychiatric nosology is structured, as manifested in texts such as the DSM-5. The development of these diagnostic manuals are tools that are far from being free of subjectivities and interference of elements of power, expressed in the way health, illness, mental health, and mental disorders, are assumed; in short, the normal and pathological. Each new diagnosis, or even its elimination, and the recomposing of the different diagnostic criteria, especially in the field of sexual behaviour, present visions of how individual and collective human life is conceived, as well as an expression of accurate attempts to control human sexualities through the medicalisation of behaviour, coupled with moral, religious, and even legal considerations. Categories such as gender dysphoria, paraphilia or paraphilic disorders are examples of how the limits intended to establish a biomedical perspective are also incomplete and imprecise. These violate individual and social construction of sexualities and the conception of mental health, showing persistent difficulties and controversies that are evident in the way psychiatric classifications are made.

[A Brief Homophobia Scale in Medical Students From Two Universities: Results of A Refinement Process]. / Escala breve para homofobia en estudiantes de Medicina de dos universidades colombianas: resultados de un proceso de refinamiento.

BACKGROUND: The process of evaluating measurement scales is an ongoing procedure that requires revisions and adaptations according to the characteristics of the participants. The Homophobia Scale of seven items (EHF-7) has showed acceptable performance in medical students attending to two universities in Colombia. However, performance of some items was poor and could be removed, with an improvement in the psychometric findings of items retained. OBJECTIVE: To review the psychometric functioning and refine the content of EHF-7 among medical students from two Colombian universities. METHODS: A group of 667 students from the first to tenth semester participated in the research. Theirs ages were between 18 and 34 (mean, 20.9±2.7) years-old, and 60.6% were females. Cronbach alpha (α) and omega of McDonald (Ω) were calculated as indicators of reliability and to refine the scale, an exploratory (EFA) and confirmatory factor analysis (CFA) was performed. RESULTS: EHF-7 showed α=.793 and Ω=.796 and a main factor that explained 45.2% of the total variance. EFA and CFA suggested the suppression of three items. The four-item version (EHF-4) reached an α=.770 and Ω=.775, with a single factor that accounted for 59.7% of the total variance. CFA showed better indexes (χ2=3.622; df=1; P=.057; Root-mean-square error of approximation (RMSEA)=.063, 90% CI, .000-.130; Comparative Fit Indices (CFI)=.998; Tucker-Lewis Index (TLI)=.991). CONCLUSIONS: EHF-4 shows high internal consistency and a single dimension that explains more than 50% of the total variance. Further studies are needed to confirm these observations, that can be taken as preliminary.

[Frequency and variables associated with perceived devaluation-discrimination in victims of the armed conflict in Colombia]. / Frecuencia y variables asociadas a estigma-discriminación percibido en víctimas del conflicto armado colombiano.

There is no information on frequency of perceived devaluation-discrimination in victims of the armed conflict in Colombia. The aim of this study was thus to determine the frequency of perceived devaluation-discrimination and associated variables among victims of the armed conflict in municipalities in the Department of Magdalena, Colombia. A cross-sectional study was conducted among victims enrolled in the Program for Psychosocial Care and Comprehensive Healthcare for Victims. Depressive symptoms were quantified with four dichotomous items (three or more were classified as high level of depressive symptoms), and perceived devaluation-discrimination was quantified with six dichotomous items (two or more were classified as high perceived devaluation-discrimination). A total of 943 adults participated (M = 47.9; SD = 14.2); 67.4%, women; 109 (11.6%) reported high level of depressive symptoms and 217 (23%) showed high perceived devaluation-discrimination. High perceived devaluation-discrimination was associated with high level of depressive symptoms (OR = 6.47; 95%CI: 4.23-9.88). In conclusion, one-fourth of the victims of the armed conflict in Magdalena reported high perceived devaluation-discrimination, which was significantly associated with high level of depressive symptoms.

Se desconoce la frecuencia de complejo estigma-discriminación percibido en víctimas del conflicto armado colombiano. El objetivo del estudio fue establecer la frecuencia y variables asociadas al estigma-discriminación percibido en víctimas del conflicto armado, en municipios del Departamento del Magdalena, Colombia. Se realizó un estudio transversal con víctimas registradas en el Programa de Atención Psicosocial y Salud Integral a Víctimas. Los síntomas depresivos se cuantificaron con cuatro ítems dicotómicos (tres o más se clasificaron como alto nivel de síntomas depresivos) y el estigma-discriminación percibido se cuantificó con seis incisos dicotómicos (dos o más afirmaciones se categorizó como alto estigma-discriminación percibido). Participaron 943 adultos (M = 47,9; DE = 14,2); 67,4%, mujeres; 109 (11,6%) informaron alto nivel de síntomas depresivos y 217 (23%) presentaron alto estigma-discriminación percibido. El alto estigma-discriminación percibido se asoció a alto nivel de síntomas depresivos (OR = 6,47; IC95%: 4,23-9,88). Se concluye que un cuarto de las víctimas del conflicto armado en Magdalena informa alto estigma-discriminación percibido; éste se asocia significativamente a alto nivel de síntomas depresivos.

É desconhecida a frequência do complexo estigma-discriminação percebido em vítimas do conflito armado colombiano. O objetivo do estudo foi estabelecer a frequência e variáveis associadas ao estigma-discriminação percebido em vítimas do conflito armado, em municípios do Departamento de Magdalena, Colômbia. Foi realizado um estudo transversal com vítimas registradas no Programa de Atenção Psicossocial e Saúde Integral às Vítimas. Os sintomas depressivos foram quantificados com quatro itens dicotômicos (três ou mais foram classificados como alto nível de sintomas depressivos), e o estigma-discriminação percebido foi quantificado com seis subsecções dicotômicas (com duas ou mais afirmações foi categorizado como alto estigma-discriminação percebido). Participaram 943 adultos (M = 47,9; DP = 14,2); 67,4%, mulheres; 109 (11,6%) informaram alto nível de sintomas depressivos e 217 (23%) presentaram um alto estigma-discriminação percebido. O alto estigma-discriminação percebido foi associado à alto nível de sintomas depressivos (OR = 6,47; IC95%: 4,23-9,88). Concluiu-se que um quarto das vítimas do conflito armado em Magdalena informa alto estigma-discriminação percebido, que foi associado significativamente à alto nível de sintomas depressivos.

[Psychometric assessment of a brief Modern Racism Scale]. / Valoración psicométrica de la Escala Breve para Racismo Moderno.

Objective To find the internal consistency of the Modern Racism Scale (MRS) among medical students in Bucaramanga, Colombia. Methods A total of 352 medical students, mean age=20.0 years (SD=1.9) reported their attitudes towards Afro-Colombians; 59.4 % were women. Students completed the 10-item version of MRS. Cronbach alpha and McDonald omega were calculated. Exploratory factor analyses were done to propose a brief version of the MRS. Results The 10-item version showed a Cronbach alpha of 0.48 and a McDonald omega of 0.15. The short version, the Brief Modern Racism Scale (BMRS) (items 1, 4, 5, 7 and 8) presented a Cronbach alpha of 0.64 and McDonald omega of 0.65. The BMRS showed one salient factor responsible of 41.6 % of the total variance. Conclusions A Spanish-language short version of the MRS shows better psychometric performance than the original version. Further study is needed to corroborate these findings or make adjustments for Colombian cultural regions.