Epidemiología del juego patológico en España

El juego patológico constituye en la actualidad un grave problema que afecta a gran número de personas. El incremento del juego en España ha sido exponencial desde su legalización en 1977. La aparición de los primeros jugadores patológicos después de su legalización ha ido seguida de un sostenido incremento de jugadores patológicos año tras año. La revisión de los estudios realizados en España sobre la prevalencia del juego patológico indica que no menos de un 1.5% de la población mayor de 18 años son jugadores patológicos. En niños y adolescentes la cifra es aún mayor, al menos un 2%. A esto hay que añadir otro grupo en riesgo, el de los jugadores problema. La comparación de los resultados en España con otros países muestra unos niveles elevados de jugadores patológicos en tan poco tiempo, desde la legalización del juego. Los datos disponibles apuntan a la urgente necesidad de concienciar a la sociedad de este grave problema adictivo, para incrementar las acciones y programas de tratamiento para los jugadores, sus familias y prevenir el surgimiento de nuevos jugadores patológicosPathological gambling is a grave problem affecting a large number of people. Gambling has increased exponentially in Spain since it was legalized in 1977. The appearance of the first pathological gamblers after legalization has been followed by a constant annual increase in the number of pathological gamblers. A survey of the prevalence studies of pathological gambling carried out in Spain indicates that no less than 1.5% of the population over the age of 18 arc pathological gamblers. Among children and adolescents the rafe is even higher, between 1.6 and 2.4%. To this we have to add another high risk group: the problem gambler. A comparison of prevalence data in Spain with those from other countries shows that very high levels of pathological gamblers have appeared in the short time since legalization. The data underline the urgent need to make society aware of this serious addictive problem in order to ensure that more treatment programs and other activities are available for gamblers and their families and to prevent the appearance of new pathological gamblersS

¿Modelo de enfermedad cerebral o biopsicosocial en adicciones? Recordando el Estudio de Veteranos de Vietnam

Background: In recent years, we have repeatedly been told that addictions are a brain disease, leaving aside their classic biopsychosocial explanation. Objective: To describe both models and discusses the weakness and reductionism of the brain disease model following the consumption of heroin by North American soldiers in the Vietnam war in the 1970s. Method: A literature review of the Vietnam Veteran Study in relation to drug consumption. Results: The soldiers greatly increased their consumption of heroin in Vietnam, but almost all of them ceased using it upon returning home. The analysis of the environmental factors related to this self-healing is a critique of the brain disease model of addictions because it cannot explain this or other studies. Conclusion: The biopsychosocial model is still the best model to guide the fi eld of addiction due to its utility, coherence, and effi cacy in treatmentAntecedentes: en los últimos años se escucha cada vez más la afi rmación de que las adicciones son una enfermedad cerebral, dejando a un lado la clásica explicación biopsico-social en adicciones. Objetivo: describir ambos modelos y analizar la debilidad y reduccionismo del modelo de enfermedad cerebral siguiendo el Vietnan Veteram Study, sobre el consumo de heroína, en los soldados norteamericanos que participaron en la guerra del Vietnam. Método: revisión de la literatura del Vietnam Veteran Study en relación al consumo de drogas. Resultados: los soldados incrementaron de modo importante el consumo de heroína en Vietnam, pero casi todos dejaron de consumirla a su vuelta a casa. Analizando los factores ambientales relacionados con esta auto-cura se hace una crítica del modelo de enfermedad cerebral en adicciones ya que el mismo no puede explicar este ni otros estudios. Conclusión: el modelo biopsicosocial sigue siendo el mejor modelo para el campo de las adicciones debido a su utilidad, coherencia y efi cacia en su tratamientoS

La discrepancia entre la investigación y la práctica clínica de la terapia de conducta

Behavior therapy and modification, with 40 years of history, it is today consolidated as the more relevant and efficient of the psychological treatments. However it becomes evident the emergence of discrepancies among the investigation that sustain their treatment techniques and the practice of the same one on the part of the clinical psychologist. Different discrepancies are analyzed that are come crawling for years (e.g., the role of psychiatric diagnosis; behavioral assessment vs. traditional psychological assessment; single cases vs. complex cases; fixed treatment vs. changing treatment; therapist in the research and in the clinical practice; the designs of N=1; the clinical significance vs. the statistical significance; analogue samples vs. clinical samples; duration of therapy; successes and failures; and follow-ups) as well as the current situation. We analyzed the state of the previous one as well as the little incidence of the research in the clinical practice, the step of the formal training to the clinical practice, the time dedicated to the reading on the part of the clinical and researchers, the primacy of several problems clinically representatives, the effectiveness in the research and in the clinical practice, and its strong and weaks points. We conclude that an important part of the above is related with the step from the theory to the practice and of the practice to the technology and this is usual in all the applied sciences. To know this can help it to solve some of the discrepancies that have been analyzed. La terapia y modificación de conducta se ha consolidado como la terapia psicológica de mayor relevancia y eficacia en sus 40 años de existencia. Sin embargo cada vez más se hace evidente el surgimiento de discrepancias entre la investigación que sustenta sus técnicas de tratamiento y la práctica de la misma por parte de los psicólogos clínicos. Se analizan distintas discrepancias que se vienen arrastrando desde hace años (p. ej., el diagnóstico psiquiátrico; evaluación conductual vs. psicodiagnóstico clásico; casos simples vs. complejos; tratamientos simples vs. complejos; tratamiento fijo vs. cambiante; terapeutas en la investigación y en la práctica clínica; los diseños de caso único; criterio clínico vs. estadístico; poblaciones análogas vs. clínicas; duración de la terapia; éxitos y fracasos; y, seguimientos) así como la situación actual. Dentro de ésta se analiza el estado de las anteriores así como la escasa incidencia de la investigación en la práctica clínica, el paso del entrenamiento formal a la práctica clínica, el tiempo dedicado a la lectura (actualización) por parte de los clínicos e investigadores, la primacía de varios problemas clínicamente representativos, la eficacia en la investigación y práctica clínica y sus puntos fuertes y débiles. Se concluye que una parte importante de lo expuesto se relaciona con el paso de la teoría a la práctica y de la práctica a la tecnología y que ello es habitual en todas las ciencias aplicadas. El ser conscientes de ello puede ayudar a solventar algunas de las discrepancias que se han analizado

Psychological bases of the prevention of drug abuse

El consumo de drogas se ha convertido en un importante problema social en los últimos años en todos los países desarrollados. Un modo de contener o atajar este problema es a través de la prevención del consumo de drogas. La psicología siempre ha tenido un papel destacado en la prevención del consumo de drogas, tanto para comprender y explicar esta conducta desde los procesos que estudia la psicología, a la realización de estudios para explicar por qué unas personas consumen drogas y otras no, como elaborar teorías y modelos para explicar e intervenir en los consumidores y, de modo especial, en el desarrollo de programas preventivos eficaces, como de tratamiento. Esta conducta, la del consumo de drogas, tiene una gran relevancia para la psicología por su alta prevalencia y los graves problemas que acarrea a muchos individuos (físicos, psicológicos y sociales). Los resultados obtenidos con los programas de prevención del consumo de drogas son buenos aunque no siempre su implantación llega al nivel deseableThe drug consumption has become an important social problem in the last years in all the developed countries. It's possible to cut this problem through the prevention of the drug consumption. The psychology has always had a paper highlighted in the prevention of drug consumption, to understand and to explain this behavior from the psychological processes, the realization of studies to explain why some people consume drugs and other not, elaborate theories and models to explain the consumption and to treat the abusers and, in a special way, in the development of effective preventive and treatment programs. This behavior, drug consumption, has a great relevance for the psychology by their high prevalence and the serious problems it produce at many individuals (physical, psychological and social). The results obtained with the preventive programs of drug consumption are goods although their implementation not always reach the desirable levelS

Resiliencia : definición, características y utilidad del concepto

Resilience, or the capacity to overcome adverse events, and to be able to develop oneself success-fully despite very adverse circumstances (parents' death, wars, serious traumas, etc.), has become a concept of great interest during the last years and is becoming a popular term. In this paper we review the existing information about resilience, and clarify some of its central aspects such as its definition, characteristics, differentiation from other related concepts (competence, vulnerability, locus of control and attributional style, hardiness, recovery, risk and protective factors, positive psychology), and the types of studies that have been carried out on this topic (centred in the variable or in the person, as a trait or a behavioural pattern, as the process or the result). We conclude that resilience is a useful term that needs, however, more conceptual clarification as well as further studies to verify the utility of the explanatory power of the construct as regards the prevention and treatment of different psychopatho-logical disorders.La resiliencia, o capacidad de superar los eventos adversos, y ser capaz de tener un desarrollo exitoso a pesar de circunstancias muy adversas (muerte de los padres, guerras, graves traumas, etc.), ha cobrado un gran interés en los últimos años y poco a poco se va convirtiendo en un término muy popular. En este artículo se revisa la información que existe sobre la resiliencia clarificando aspectos centrales como son su definición, características, delimitarlo de otros conceptos relacionados (competencia, vulnerabilidad, locus de control y estilo atribucional, dureza, recuperación, factores de riesgo y protección, psicología positiva) y los tipos de investigación que se han hecho bajo este término (centrada en la variable o en la persona, como rasgo de personalidad o patrón conductual, como proceso o como resultado). Se concluye que la resiliencia es un término útil pero que precisa tanto una mayor clarificación conceptual como la realización de estudios para comprobar la utilidad del constructo a nivel explicativo, para la prevención y para el tratamiento de los distintos trastornos psicopatológicos

Smoking Cessation in a Woman With Breast Cancer, Cardiovascular Problems, and Depressive Symptomatology: Case Study

Smoking is the leading preventable cause of morbidity and mortality and has been linked with diseases such as cancer and cardiovascular diseases. The case of a 50-year-old woman with breast cancer, who suffered a stroke the previous month and is in treatment for depression and wants to quit smoking, is analyzed. She smoked 10 cigarettes a day and had never quit smoking. She received six sessions of a cognitive-behavioral psychological intervention to quit smoking. She stopped smoking and remained abstinent through the 1-year follow-up, showing a clear physical improvement and a significant reduction of depressive symptomatology (from 24 on the Beck Depression Inventory–II [BDI-II] before treatment to 1 at the 12-month follow-up). This indicates that, in many cases, smoking cessation produces an improvement not only in physical health but also in moodThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The present investigation was funded by the Ministry of Economy and Competitiveness of Spain (Project No. PSI2015-66755-R) and the European Fund for Regional Development (FEDER), 2014-2020S

The pathological gambling in spanish children

El juego patológico en niños y adolescentes está cobrando un gran interés en los últimos años después de la aparición de varios estudios epidemiológicos que indican una tasa de prevalencia superior a la de los adultos. En el presente estudio analizamos en una muestra representativa de niños de segundo ciclo de E.G.B. (edades de 12 a 14 años, fundamentalmente) de la ciudad de La Coruña (N = 1.200) la prevalencia del juego patológico utilizando el cuestionario DSM-IVJ de Fisher (1993b). Los resultados indican que un 2.23% de la muestra serían probables jugadores patológicos, con una mayor incidencia en hombres que mujeres (85% vs. 15%), incremento según la edad y relación con el juego paterno. En función de los resultados se presentan aquellas acciones que sería necesario llevar a cabo de cara a la reducción de la prevalencia del juego patológico en niños y adolescentes para conseguir que no se incremente en el futuro la actual tasa existente de jugadores patológicos adultosPathological gambling in children and adolescents has reached a great relevance in the last years after several epidemiologic studies which indicated a prevalence rate in adolescents greater than in adults. In the present study we analyzed in a representative sample of scholars (12 to 14 years old predominatly) of the city of La Coruña (N = 1.200) the prevalence of pathological gambling utilizing the Fishers´s (1993b) Questionnaire for Pathological Gambling “DSM-IVJ”. The results showed a 2.23% of probable pathological gamblers, with a greater rate of men that women (85% vs. 15%), increase with years and related with the gambler of fathers. Since these results we present the actions that are necessary to carry out to the reduction of the prevalence of pathological gambling in children and adolescents in order to no increase the current prevalence rate of adult pathological gambling in the futureS

Knowledge, attitudes and practice of self-medication among university students in Portugal: A cross-sectional study

Aims: To describe the knowledge, attitudes and practices of self-medication in college students and to analyse the predicting factors for the engagement in that behaviour. Design: This is a cross-sectional study involving students (n = 840) from a Portuguese university, selected through stratified and proportional sampling. Data were collected using a self-administered questionnaire containing, in addition to sociodemographic issues, a scale measuring knowledge about self-medication (α = .488), a scale measuring attitudes towards self-medication (α = .708) and questions about the patterns of self-medication practices (α = .445). Differences between outcomes and sociodemographics were analysed through independent t-tests and ANOVA. A generalised linear model was calculated to determine the predictive variables of self-medication. Results: Over half of the respondents ( 54.3%, n = 434) had used some form of self-medication during the preceding year. Students revealed poor knowledge about the referred practice, correctly answering 1.60 (SD = 0.936) questions in a total of 3, and favourable attitudes towards self-medication (M = 2.17, SD = 0.950, range 1–5). Attending engineering sciences (β = .718, 95% CI: 1.373–3.069, p < .001), being female (β = .866, 95% CI: 1.700–3.327, p < .001) and having negative attitudes towards self-medication (β = .367, 95% CI: 1.227–1.698, p < .001) predict the adoption of those practices. Conclusions: Self-medication is a common practice among university students, the level of self-medication knowledge is low and the low score of the level of attitudes revealed that students tended to have a correct positioning towards self-medication. Therefore, the recommendation to develop campaigns or educational programmes becomes obvious, in order to inform about the adverse effects of the use of non-prescribed medicineThe authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Foundation for Science and Technology – FCT (Portuguese Ministry of Education and Science) (SFRH/BD/120758/2016)S