48 research outputs found
Sensibilidad a la ansiedad como factor de vulnerabilidad transdiagnóstico para el consumo de tabaco: implicaciones clínicas y para el tratamiento
El tabaquismo es la principal causa evitable de morbilidad y muerte prematura a nivel mundial (López, Pérez-Ríos, Schiaffino y Fernández, 2016; Soriano et al., 2018; Organización Mundial de la Salud [OMS], 2019). En general, hay 1,3 mil millones de fumadores adultos en el mundo y se estima una prevalencia media de 42,5 % de intentos de dejar de fumar en el último año (Ahluwalia et al., 2018; Asma et al., 2015). En España, el porcentaje de fumadores diarios mostró una tendencia al alza en 2018, alcanzando el 34 % de la población. Sin embargo, casi dos tercios de ellos (65,85 %) han informado de al menos un intento de dejar de fumar en el último año (Plan Nacional sobre Drogas, 2019)
Concurrent validity of the alcohol purchase task in relation to alcohol involvement: protocol for a systematic review and meta-analysis
Introduction
Alcohol demand, as measured by an alcohol purchase task (APT), provides a multidimensional assessment of the relative reinforcing efficacy of alcohol. The objective of this meta-analysis is to critically appraise the existing literature on the concurrent validity of the APT by meta-analysing the cross-sectional relationships between indices of the APT (ie, breakpoint, Omax, Pmax, elasticity and intensity) and alcohol-related measures. It also aims to examine methodological procedures used to obtain APT indices and individual variables as potential moderators on the assessed estimations.
Methods and analysis
A comprehensive literature search conducted from inception to April 2020 will be conducted in the PubMed, PsycINFO, Web of Science and Scopus databases. Two authors will independently screen and extract data from articles using a predefined protocol search and extraction forms. Disagreements will be resolved through discussion with two additional reviewers. All results will be tabulated, and a random-effect meta-analysis will be conducted. Participants’ sex, number of prices and APT methodological procedures will be examined as potential moderators on the observed effect sizes.
Ethics and dissemination
Results of this meta-analysis will characterise the concurrent validity of the APT in the existing literature. Further, the results are anticipated to provide evidence on which index (or indices) is most robustly associated with alcohol use and severity. Ethics approval was not required for this study and the results will be published in a peer-reviewed journal
Episodic future thinking for the prevention and treatment of health risk behaviors
Non-communicable diseases (i.e., cardiovascular, oncological, respiratory, and endocrine diseases) represent the main cause of death and morbidity in the world, with tobacco and alcohol use, an unhealthy diet, and a sedentary lifestyle being the main risk factors. From reinforcer pathology theory, based on behavioral economics (BE), these health risk behaviors are understood as choice disorders, characterized by an excessive valuation of the reinforcer (e.g., the drug) and a preference for immediate reinforcers over delayed ones. Episodic future thinking (EFT) is a psychological intervention that consists of vividly visualizing future events and projecting oneself into them, in order to increase the valuation of the reinforcers associated with the execution of a healthy behavior. This technique shows promising results in reducing impulsive decision-making and increasing health-related behaviors (e.g.,
abstinence, diet, physical activity)
Does e-assessment always fit digital natives? A within-subject comparison between paper- and tablet-based gambling assessments in adolescents
Technological development has enabled the use of sophisticated methods for assessing multiple human behaviors. Despite the advantages of these new
technologies, concerns exist regarding their equivalence with paper-based measures in epidemiological and health-related surveys. To date, literature on this
topic in relation to adolescents is virtually nonexistent. This study compares respondents’ performance on the same survey using both paper- and electronic tablet-
based assessment methods. A final sample of 135 adolescents (mean age 17.30 years, SD = 0.59; 56.3% males) consecutively completed two versions of
the same survey on gambling behaviors and two questionnaires: The Gambling Motives Questionnaire (GMQ) and the South Oaks Gambling Screening-Revised
for Adolescents (SOGS-RA). An ad-hoc questionnaire assessing participants’ satisfaction levels with each method was also used. The digital survey
yielded a lifetime, past year, and past month gambling prevalence of 54.1%, 45.2%, and 27.4%, respectively. Paper-based prevalence rates were 3.7-5.2%
lower (all p >.092) and there were discrepancies in gambling activities. Although the reliability of the questionnaires was high in both formats, total scores were
consistently higher in the paper-based format. GMQ and SOGS-RA intraclass correlations between versions ranged from .856-.884. Unexpectedly, students
preferred the paper-based survey to the e-assessment (51.5% vs. 48.5%) and also enjoyed it more (31.3% vs 26.1%). Paper- and tablet-based surveys yield
different, albeit non-statistically significant, estimations of gambling behaviors even when the same participants were surveyed at one time. We recommend that
consistency be routinely checked across assessment formats when adapting paper-and-pencil measures to digital formats¿La evaluación electrónica siempre se adapta a los nativos digitales? Una comparación intra-sujeto de la evaluación del juego de azar entre papel y tabletas
electrónicas en adolescentes. El desarrollo tecnológico ha permitido el uso de métodos sofisticados de evaluación de múltiples comportamientos humanos.
A pesar de los avances de estas nuevas tecnologías, existen preocupaciones sobre su equivalencia con las medidas de papel y lápiz en encuestas epidemiológicas
y de salud. Hasta la fecha, la literatura en el tema en relación con los adolescentes es prácticamente inexistente. Este estudio compara el desempeño
de los participantes sobre la misma encuesta utilizando métodos de evaluación de papel y lápiz y electrónicos. Una muestra de 135 adolescentes (edad media
17.30 años, DT = 0.59; 56.3% hombres) completaron consecutivamente os versiones de la misma encuesta sobre conductas de juego y dos cuestionarios: el
Cuestionario de Motivos de Juego (GMQ) y el Cribado de Juego de South Oaks en su versión revisada para adolescentes (SOGS-RA). También se utilizó un
cuestionario ad-hoc para evaluar el nivel de satisfacción de los participantes en cada método. La encuesta digital arrojó una prevalencia de juego vida, año y mes
de 54,1%, 45,2%, y 27,4%, respectivamente. Las prevalencias en papel fueron 3,7-5,2% menores (todas p >,092) y se mostraron discrepancias en las actividades
de apuestas. A pesar de que la fiabilidad de los cuestionarios fue alta en ambos formatos, las puntuaciones totales fueron consistentemente más altas en
el formato en papel. Las correlaciones intraclase en el GMQ y SOGS-RA oscilaban entre ,856 - ,884. Inesperadamente, los estudiantes preferían la encuesta
en papel sobre el formato digital (51,5% vs. 48,5%) y también lo disfrutaron más (31,3% vs 26,1%). La encuesta en papel y en tableta electrónica mostraron
estimaciones diferentes, aunque no estadísticamente significativas, en las conductas de juego, incluso a pesar de haber sido encuestados en el mismo momento.
Recomendamos comprobar de manera rutinaria la consistencia entre formatos de evaluación cuando se adapten medidas de papel y lápiz a formato digita
Validation of the Food Purchase Task (FPT) in a clinical sample of smokers with overweight and obesity
[EN] Obesity is a major health problem associated with disease burden and mortality. In this context, analyzing food as a powerful reinforcer from a behavioral economics framework could be relevant for the treatment and prevention of obesity. The purposes of this study were to validate a food purchase task (FPT) in a clinical sample of Spanish smokers with overweight and obesity and to assess the internal structure of the FPT. We also analyzed the clinical utility of single-item breakpoint (i.e., commodity price that suppresses demand). A total of 120 smokers [% females: 54.2; Mage = 52.54; SD = 10.34] with overweight and obesity completed the FPT and weight/eating-related variables. Principal component analysis was used to examine the FPT structure, and a set of correlations were used to examine the relationship between the FPT, eating and weight-related variables. The FPT demonstrated robust convergent validity with other measures of eating. Higher food demand was related to higher food craving (r = .33), more binge eating problems (r = .39), more weight gain concerns (r = .35), higher frequency of both controlled (r = .37) and uncontrolled (r = .30) grazing, as well as to an eating style in response to emotions (r = .34) and external eating (r = .34). Of the demand indices, Intensity and Omax showed the highest magnitudes of effects. The FPT factors, persistence and amplitude, do not improve individual FPT indices; and the single-item breakpoint was not related to any eating or weight variable. The FPT is a valid measure of food reinforcement with potential clinical utility in smokers with obesity/overweight.S
Insights from behavioral economics to characterize substance use involvement in adolescents: a cluster analysis
Reinforcement pathology (RP), a framework rooted in behavioral economics, has contributed to advances in the etiology and treatment of substance
use. Drug demand and delay discounting (DD) have gained considerable interest, as they inform on the risk for escalation to substance use as well as
treatment-specific targets. No prior study conducted in Spain has explored the interplay of demand and DD in adolescents. This study was aimed to: 1)
identify whether DD and alcohol demand can yield empirically driven subgroups, and 2) examine differences in substance use involvement. The sample
comprised 107 (% females = 54.2) adolescents (M=15.46, SD=1.25) from a high school in Asturias (Spain). Participants filled out an ad-hoc survey
on substance use over the prior 30 days and one year. A 20-item alcohol purchase task (APT) was used to assess the reinforcing value of alcohol. The
21-item Monetary Choice Questionnaire evaluated impulsive choice. Two subgroups emerged: Cluster 1 (n = 72) and Cluster 2 (n = 35). Participants in
C2 consistently showed higher impulsivity and demand for alcohol, signifying lower responsiveness to alcohol pricing. As compared to C1, those in C2
had a higher prevalence of past-month substance use [C1: 26/72 (36.1%) vs. C2: 33/35 (94.3%), p <.001], and a greater frequency of drunkenness
[p <.001] and binge drinking episodes [p <.001]. RP differentiate between subgroups of adolescent substance users with patterns of more versus less
substance use involvement. The existence of specific drug use subpopulations should be considered when designing environmental preventive policiesLa economía conductual para caracterizar el uso de drogas en adolescentes: análisis de cluster. La patología del refuerzo (PR), basada en la economía
conductual, ha contribuido al avance de la etiología y el tratamiento de drogas. La demanda y el descuento por demora (DD) informan sobre el incremento
en el consumo y los objetivos de tratamiento. Ningún estudio realizado en España ha examinado la interacción entre ambas variables en adolescentes.
Los objetivos fueron: 1) identificar si el DD y la demanda de alcohol pueden identificar distintos subgrupos y, 2) examinar sus diferencias en el consumo
de sustancias. La muestra incluyó 107 (% mujeres = 54,2) adolescentes (M =15,46, DT =1,25) de enseñanza obligatoria en Asturias (España). Se evaluó
el consumo de drogas en los últimos 30 días y el último año. El poder reforzante del alcohol se evaluó mediante una tarea de compra de 20 ítems (APT).
La toma de decisiones impulsiva se evaluó mediante el Cuestionario de Elección Monetaria. Se identificaron dos subgrupos: Grupo 1 (n = 72) y Grupo
2 (n = 35). El Grupo 2 mostró una demanda e impulsividad más elevada, indicando menor sensibilidad a incrementos en el precio. Comparado con el
Grupo 1, el 2 obtuvo una prevalencia más elevada de consumo en el último mes [G1: 26/72 (36,1%) vs. G2: 33/35 (94,3%), p <,001], mayor frecuencia
de borracheras (p <,001) y episodios de consumo intensivo de alcohol (p <,001). La PR permite caracterizar e identificar grupos con distintos patrones
de consumo de sustancias. La existencia de distintos perfiles debería ser considerada a la hora de desarrollar políticas preventiva
Evaluación de los niveles de dependencia de la nicotina en usuarios de cigarrillos electrónicos
Contingency management effects on delay discounting among patients receiving smoking cessation treatment
Antecedentes: la evidencia sugiere que el descuento por demora puede cambiar tras recibir intervenciones eficaces. No obstante, estudios previos que evaluaron el efecto del manejo de contingencias (MC) sobre el descuento por demora son escasos y presentan resultados mixtos. Se evaluó si el MC combinado con tratamiento cognitivo-conductual (TCC) para dejar de fumar se asoció con cambios en el descuento por demora al final del tratamiento y a los seis de seguimiento comparado con TCC. Método: Ciento dieciséis fumadores fueron asignados aleatoriamente a MC+TCC (n = 69) o a TCC solo (n = 47). Completaron la tarea de descuento por demora en la línea base, al final del tratamiento y a los seis meses de seguimiento. Evaluamos el efecto del MC en el descuento por demora con métodos paramétricos y no paramétricos. Resultados: Los análisis entre-grupos mostraron que ninguno de los tratamientos modificó el descuento por demora al final del tratamiento y a los seis meses de seguimiento. No obstante, algunos análisis intra-grupos mostraron que la condición de MC + TCC evidenció cierta reducción. Conclusiones: una intervención de MC no se asocia robustamente con cambios en el descuento por demora. Futuros estudios han de abordar qué tratamientos pueden modificarlo
Tratamientos psicológicos empíricamente apoyados para adultos: Una revisión selectiva
Antecedentes: los tratamientos psicológicos han mostrado su eficacia, efectividad y eficiencia para el abordaje de los trastornos mentales; no obstante, considerando el conocimiento científico generado en los últimos años, no se dispone de trabajos de actualización en español sobre cuáles son los tratamientos psicológicos con respaldo empírico. El objetivo fue realizar una revisión selectiva de los principales tratamientos psicológicos empíricamente apoyados para el abordaje de trastornos mentales en personas adultas. Método: se recogen niveles de evidencia y grados de recomendación en función de los criterios propuestos por el Sistema Nacional de Salud de España (en las Guías de Práctica Clínica) para diferentes trastornos psicológicos. Resultados: los resultados sugieren que los tratamientos psicológicos disponen de apoyo empírico para el abordaje de un amplio elenco de trastornos psicológicos. El grado de apoyo empírico oscila de bajo a alto en función del trastorno psicológico analizado. La revisión sugiere que ciertos campos de intervención necesitan una mayor investigación. Conclusiones: a partir de esta revisión selectiva, los profesionales de la psicología podrán disponer de información rigurosa y actualizada que les permita tomar decisiones informadas a la hora de implementar aquellos procedimientos psicoterapéuticos empíricamente fundamentados en función de las características de las personas que demandan ayuda.
Background: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. Method: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. Results: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. Conclusions: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help
Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.
BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden