Posttraumatic stress disorder: Efficacy of a treatment program using virtual reality for victims of criminal violence in Mexican population

En el presente estudio se muestran resultados de eficacia del tratamiento del Trastorno por Estrés Postraumático (TEPT) por violencia criminal mediante realidad virtual. La muestra clínica estuvo conformada por 20 participantes de Cd. Juárez, México, que voluntariamente aceptaron integrarse a la investigación, con edades entre 18 y 65 años. Todos los participantes cumplían los criterios del DSM-IV-TR para TEPT y fueron distribuidos aleatoriamente a dos condiciones de tratamiento: (a) tratamiento de exposición prolongada mediante realidad virtual (TERV; n=10) y (b) tratamiento de exposición prolongada mediante imaginación (TEI; n=10). La intervención se realizó en 12 sesiones (Rothbaum, Difede y Rizzo, 2008), dos sesiones semanales, en modalidad presencial e individual, de 90 min. Se emplearon dos escenarios virtuales para la exposición en el tratamiento del TEPT. Se apreció mejoría en las medidas de TEPT, ansiedad y depresión para los dos grupos que recibieron el tratamiento. No obstante, solo se alcanzaron diferencias estadísticamente significativas entre los grupos de tratamiento en las medidas de diagnóstico y la subescala de evitación, obteniendo ganancias terapéuticas superiores en el TERV. Los resultados apoyan a la propagación de los tratamientos empíricamente validados y eficaces en el área de alud mental para población mexicana.The present study shows results of efficacy or virtual reality treatment for Posttraumatic Stress Disorder (PTSD) for criminal violence. The clinical sample was conformed for 20 participants from city of Juarez, Mexico, who voluntarily agreed to join the study, aged between 18 and 65. All participants met the DSM-IV-TR criteria for PTSD and were randomized to two treatment conditions: (a) prolonged virtual reality exposure (n=10) and (b) prolonged imaginal exposure (n=10). Treatment 5was delivered in 12, 90 min individual sessions conducted twice a week. Therapist used a treatment manual (Rothbaum, Difede & Rizzo, 2008). Two virtual scenarios for PTSD exposure treatment were used. Improvement was seen in measures of PTSD, anxiety and depression in both treatment groups. However, only reached statistically significant differences between treatment groups on measures of diagnosis and avoidance subscale, obtaining higher therapeutic gains in prolonged virtual reality exposure. The results support the dissemination of empirically validated treatments in Mexican mental health field

Efficacy of an Early Cognitive-Behavioral Intervention for Acute Stress Disorder in Mexican Earthquake Victims

Acute stress disorder (ASD) refers to the symptoms associated with posttraumatic stress disorder (PTSD) within the first four weeks following the traumatic event. Recent theoretical models suggest that early detection of ASD provides an opportunity to implement early interventions to prevent the development of PTSD or ameliorate its symptomatology. The aim of the present study was the evaluation of the efficacy of an ASD treatment for earthquake victims, which would serve as an early intervention for PTSD. A single-case (n = 1) quasi-experimental design was used, with pre and post-assessments, as well as one, three and six-month follow-ups, with direct treatment replications. Fourteen participants completed the treatment and the follow-up measurements. The results obtained using a single-case analysis showed significant clinical improvement and clinically significant change when employing a clinical significance analysis and the reliable index of change. Statistical analyses of the dataset displayed statistically significant differences between the pre and post-assessments and the follow-up measures, as well as large effect sizes in all clinical measures. These results suggest that the treatment was an efficacious early intervention for PTSD during the months following the traumatic event, although some relevant study limitations are discussed in the text

Desarrollo y evaluación de simuladores virtuales para la enseñanza de competencias en el campo de la salud

A disadvantage faced by students during their professional training is the lack of spaces and opportunities in which to put their knowledge into practice. Teaching clinical skills, at the beginning of training, usually involves the use of textbooks and clinical formats in class. One possible solution to this problem is to conduct training in real clinical settings, however due to time constraints, cost of supervision, ineffective access to real scenarios and potential error; The training of graduates to acquire professional clinical skills is negatively impacted. To respond to this lack of practice with which to reduce the error rates of students and new professionals in the field of mental health, the Laboratory of Virtual Teaching and Cyberpsychology of the Faculty of Psychology of the UNAM, designed, developed and evaluated a Series of four low fidelity virtual simulators for the teaching of technical skills and professional skills, which replicate the situations that occur in a professional setting, but with the advantage that it is possible to control the events that occur in the virtual environment of the simulator and receive Immediate feedback. The present work describes first the results of the usability evaluation of the Beta version of four simulators for teaching clinical competences in Psychology students of the National Autonomous University of Mexico: (1) Cognitive behavioral interview, (2) motivational interview, (3) behavioral interview, and (4) interviewing coping resources. Likewise, the evaluation of learning strategies such as modeling, shaping and backward chaining for the development of simulated learning strategies is reported. The results obtained indicate that simulators with virtual patients provide students with the opportunity to improve knowledge, facilitate the acquisition of skills and competences, as well as their usefulness in reducing anxiety and promoting clinical judgment in a safe environment. Simulation is a powerful teaching tool to help professionals reach the highest levels of competence and therefore important to continue to develop and evaluate future developments.Una desventaja a la que se enfrentan los estudiantes, durante su formación profesional, es la carencia de espacios y oportunidades en las cuales ponga en práctica sus conocimientos. La enseñanza de habilidades clínicas, al principio de la formación, por lo general implica el uso de libros de texto y de formatos clínicos en clase. Una posible solución a este problema, es llevar a cabo la formación en entornos clínicos reales, sin embargo, debido a las restricciones de tiempo, el costo de la supervisión, el acceso ineficaz a los escenarios reales y el error potencial; la formación del egresado para adquirir competencias clínicas profesionales se ve impactada de manera negativa. Para responder a esta carencia de práctica con la cual reducir las tasas de error de estudiantes y profesionales novatos en el campo de la salud mental, el Laboratorio de Enseñanza virtual y Ciberpsicología de la Facultad de Psicología de la UNAM, diseñó, desarrolló y evaluó una serie de cuatro simuladores virtuales de baja fidelidad para la enseñanza de habilidades técnicas y competencias profesionales, que replican las situaciones que ocurren en un escenario profesional, pero con la ventaja de que es posible controlar los eventos que ocurren en el ambiente virtual del simulador y recibir retroalimentación inmediata. El presente trabajo describe primeramente los resultados de la evaluación de usabilidad de la versión Beta de cuatro simuladores para la enseñanza de competencias clínicas en estudiantes de Psicología de la Universidad Nacional Autónoma de México: (1) entrevista Cognitivo Conductual, (2) entrevista motivacional, (3) entrevista conductual y (4) entrevista de recursos de afrontamiento. Así mismo, se informa de la evaluación de las estrategias de aprendizaje como son el modelamiento, moldeamiento y encadenamiento hacia atrás para el desarrollo de estrategias de aprendizaje simuladas. Los resultados obtenidos señalan que los simuladores con pacientes virtuales proporcionan a los estudiantes la oportunidad de mejorar los conocimientos, facilitar la adquisición de habilidades y competencias, así como su utilidad para disminuir la ansiedad y promover el juicio clínico en un ambiente seguro. La simulación resulta un instrumento de enseñanza poderoso para ayudar a los profesionistas a alcanzar los niveles más altos de competencia y por ende importante continuar desarrollando y evaluando desarrollos futuros

Evaluación ecológica mediante Realidad Virtual de las necesidades psicológicas básicas

Pese a que las técnicas de evaluación psicológica comúnmente utilizadas en lápiz y papel son una estrategia elegida por su adecuada validez, se presentan algunas limitaciones importantes que pueden superarse por los avances recientes en Realidad Virtual (RV), al permitir la evaluación de constructos psicológicos en entornos inmersivos, como una forma de evaluación ecológica. Es así que el propósito de la presente investigación fue determinar la eficacia de una herramienta de realidad virtual en la evaluación de cuatro necesidades psicológicas básicas: apego, autoestima, autoeficacia, maximización del placer/minimización del dolor. La muestra la conformaron 61 participantes, quienes fueron expuestos a entornos virtuales centrados en la evaluación conductual de cada uno de estos constructos. Los resultados mostraron una adecuada precisión de los entornos de RV en cuanto al reconocimiento de las necesidades evaluadas. En conclusión, los hallazgos permitieron contar con mayor evidencia en cuanto al uso de la RV como una alternativa válida para la medición de los constructos, se reconocen limitaciones importantes referentes al número limitado de participantes y a la ausencia de población clínica.

Integrating Virtual Realities and Psychotherapy: SWOT Analysis on VR and MR Based Treatments of Anxiety and Stress-related Disorders

The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments

CONSUMO DE ALIMENTO Y ENDULZANTES BAJO CONDICIONES DE ESTRÉS CRÓNICO EN RATA S

Diversos estudios han reportado un aumento en el consumo de alimento bajocondiciones de estrés. El objetivo de este estudio fue evaluar los efectos delestrés crónico sobre el consumo de comida y agua con glucosa o sucralosaen ratas albinas. Se utilizaron 12 ratas Wistar de tres meses de edad (6 hembrasy 6 machos) divididas en tres grupos. El grupo 1 recibió una soluciónde 200 ml de agua con 5 g de glucosa, el grupo 2 una solución de 200 ml deagua con 2 g de sucralosa y el grupo 3 recibió 200 ml de agua. Además de lasoluciones, todos los sujetos recibieron 50 g de alimento disponibles durantedos horas. El experimento se dividió en 5 fases, las fases 1, 3 y 5 fueron de línea base (10 días). Las fases 2 y 4 fueron los periodos experimentales (3días), en los cuales se aplicó el estímulo estresor mediante una pinza depresión durante las dos horas en las que las soluciones y el alimento estuvierondisponibles. Los resultados indicaron que el estrés modificó el patrónde consumo de agua en el grupo de glucosa y el consumo de alimento en lostres grupos

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS)

© 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).INTRODUCTION: Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. AIMS: The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. METHODS: Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; M age: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. RESULTS: A two-factor model with factors describing 'alcohol use' (items 1-3) and 'alcohol problems' (items 4-10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. CONCLUSIONS: In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations.Peer reviewe

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) across cross-cultural subgroups, genders, and sexual orientations: Findings from the International Sex Survey (ISS)

Introduction. Despite being a widely used screening questionnaire, there is no consensus on the most appropriate measurement model for the Alcohol Use Disorders Identification Test (AUDIT). Furthermore, there have been limited studies on its measurement invariance across cross-cultural subgroups, genders, and sexual orientations. Aims. The present study aimed to examine the fit of different measurement models for the AUDIT and its measurement invariance across a wide range of subgroups by country, language, gender, and sexual orientation. Methods. Responses concerning past-year alcohol use from the participants of the cross-sectional International Sex Survey were considered (N = 62,943; Mage: 32.73; SD = 12.59). Confirmatory factor analysis, as well as measurement invariance tests were performed for 21 countries, 14 languages, three genders, and four sexual-orientation subgroups that met the minimum sample size requirement for inclusion in these analyses. Results. A two-factor model with factors describing ‘alcohol use’ (items 1–3) and ‘alcohol problems’ (items 4–10) showed the best model fit across countries, languages, genders, and sexual orientations. For the former two, scalar and latent mean levels of invariance were reached considering different criteria. For gender and sexual orientation, a latent mean level of invariance was reached. Conclusions. In line with the two-factor model, the calculation of separate alcohol-use and alcohol-problem scores is recommended when using the AUDIT. The high levels of measurement invariance achieved for the AUDIT support its use in cross-cultural research, capable also of meaningful comparisons among genders and sexual orientations

The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations

© 2024 The Author(s). Published by Elsevier B.V. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (CC BY-NC), https://creativecommons.org/licenses/by-nc/4.0/Background The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups. Methods We used global survey data from 82,243 individuals (Mean age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation. Results Confirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001). Conclusion The SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.Peer reviewe

Compulsive Sexual Behavior Disorder in 42 Countries: Insights from the International Sex Survey and Introduction of Standardized Assessment Tools

Background and aims: Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide stan- dardized, state-of-the-art screening tools for research and clinical practice. Method: Using data from the International Sex Survey (N 5 82,243; Mage 5 32.39 years, SD 5 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. Results: A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were pre- sent in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. Discus- sion and conclusions: This study contributes to a better under- standing of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive pre- vention and intervention strategies for CSBD that are currently missing from the literature