Evaluación de la impulsividad en adolescentes consumidores de sustancias

Tesis con mención internacional. Tesis doctoral por el sistema de compendio de publicacionesLa impulsividad se define como una mayor probabilidad a reaccionar de manera rápida y no planificada ante estímulos internos y externos sin tener en cuenta las consecuencias negativas potencialmente derivadas. Debido a su multidimensionalidad, se han desarrollado diversos autoinformes y pruebas de laboratorio para evaluar distintos aspectos de la misma. A pesar de la evidencia sobre el papel de la impulsividad en el inicio, uso frecuente y dependencia del alcohol, tabaco y cannabis, aún no se comprende adecuadamente esta relación. La presente tesis doctoral tiene como objetivo superar carencias y limitaciones de la investigación previa mediante cuatro objetivos específicos: 1) adaptar a población adolescente española la Escala de Impulsividad de Barratt y la Escala de Búsqueda de Sensaciones Impulsiva de Zuckerman-Kuhlman, 2) comparar los niveles de impulsividad en adolescentes con distintos patrones de consumo, 3) identificar patrones longitudinales de consumo y analizar las diferencias en impulsividad entre ellos e 4) identificar trayectorias de desarrollo de impulsividad y analizar su valor predictivo sobre el consumo de alcohol, tabaco y cánnabis. Los resultados muestran que las adaptaciones españolas del BIS-11-A y del ImpSS son instrumentos fiables, válidos y útiles para evaluar distintas facetas de impulsividad y para predecir conductas de riesgo. Se han hallado altos niveles de impulsividad en adolescentes tempranos consumidores de distintas sustancias, evidenciando la sensibilidad diferencial de las distintas medidas utilizadas. Por otro lado, se encontraron tres trayectorias de policonsumo (consumidores tempranos, consumidores experimentales y escaladores) y dos facetas de impulsividad (falta de premeditación y búsqueda de sensaciones) especialmente relevantes. Finalmente, se encontraron dos trayectorias de desarrollo de la impulsividad en adolescentes varones y cinco en adolescentes mujeres, siendo la falta de premeditación y el descuento por demora las dos facetas más importantes para explicar la asociación entre las distintas trayectorias y el consumo de sustancias. A pesar de la existencia de limitaciones, la presente tesis doctoral contribuye significativamente al avance en la comprensión entre el binomio impulsividad-uso de sustancias, aportando hallazgos de interés de cara al desarrollo de intervenciones psicológicas en el campo de las adicciones

Patients´ and Therapists´ Reports of Psychotherapy Outcomes: Similarities and Differences

Background: Discrepancies between therapists’ and patients’ measures regarding therapeutic results indicate the need to analyze which symptoms and processes are being taken into consideration when reporting clinical change. This study analyzes the concordance between patient and therapist, at pre- and post-treatment, when reporting about anxiety, depression, Experiential Avoidance (EA), Cognitive Fusion (CF) and Activation (A). Method: Convergence was examined between information obtained by means of standardized measures and visual analogical scales (VAS) in 94 patients with anxiety and/or depression who participated in a controlled clinical study (TRANSACTIVA study). Results: Statistically significant correlation (p < .05) was found between all the measures of anxiety and depression, regardless of the source, timepoint, and measures procedure at 95% confidence. In the VAS, patient and therapist agreed (p < .05) in their evaluation of specific symptoms. For EA, CF and A, the therapists’ measures demonstrated stronger correlations than those of the patients, although, in each condition, all the patients’ measures correlated with each other (p < .05). Conclusions: Suitable agreement was found between therapist and patient when reporting clinical change. One-item VAS appeared to b suitable for identifying anxiety, depression and the transdiagnostic patterns of EA, CF and A

Sex differences in comorbidity between substance use and mental health in adolescents: Two sides of the same coin

Background: This study aims to evaluate sex differences in alcohol and cannabis use and mental health disorders (MHD) in adolescents, and to evaluate the predictive role of mental health disorders for alcohol and cannabis use disorders (AUD and CUD respectively). Method: A sample of 863 adolescents from the general population (53.7% girls, Mage = 16.62, SD = 0.85) completed a computerized battery including questions on substance use frequency, the Brief Symptom Inventory, the Cannabis Problems Questionnaire for Adolescents - Short version, the Rutgers Alcohol Problem Index and the DSM-IV-TR criteria for AUD and CUD. Bivariate analyses and binary logistic regressions were performed. Results: Girls presented significantly more mental health problems and a higher prevalence of comorbidity between SUD and MHD. Obsessivecompulsive symptoms and phobic anxiety indicated a higher risk of AUD, whereas depression and interaction between hostility and obsessivecompulsive disorder indicated a higher risk of CUD. Conclusions: Comorbidity between SUD and MHD is high among adolescents, and significantly higher among girls. Antecedentes: el objetivo de esta investigación es evaluar las diferencias de sexo en el uso de cannabis y alcohol y en trastornos de salud mental TSM en adolescentes, y el rol predictivo de los TSM sobre los trastornos por uso de alcohol y cannabis (TUA y TUC, respectivamente). Método: una muestra de 863 adolescentes de la población general (53, 7% chicas, edad media = 16.62, DT = 0, 85) completaron una batería informatizada sobre la frecuencia de uso de sustancias, el Inventario Breve de Síntomas, el Cuestionario de Problemas por Consumo de Cannabis - versión breve, el Índice de Rutgers de Problemas con el Alcohol y los criterios DSM-IV-TR para el TUA y TUC. Se realizaron análisis bivariados y de regresión logística binaria. Resultados: las chicas presentaron significativamente más problemas de salud mental y mayor prevalencia de comorbilidad entre TUS y TSM. El trastorno obsesivo-compulsivo (TOC) y la ansiedad fóbica indicaron un mayor riesgo de TUA, mientras que la depresión y la interacción entre hostilidad y TOC indicaron mayor riesgo de TUC. Conclusiones: la comorbilidad entre TUS y TSM es alta entre los adolescentes, y significativamente mayor entre las chicas

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

Propuesta de Unidad Didáctica para el alumnado TEA en un aula de Educación Primaria

Este Trabajo de Fin de Grado de Magisterio en Educación Primaria trata sobre la inclusión plena del alumnado con Trastorno del Espectro Autista en un aula ordinaria, mediante una Unidad Didáctica que se puede adaptar y amoldar a todo el alumnado, tanto a los alumnos ordinales como al alumnado TEA.En este trabajo se expondrán las diversas dificultades que pueden experimentar los alumnos con autismo, con la finalidad de que se visibilice y normalice a este alumnado. La inclusión plena significa ofrecer apoyo y diversas adaptaciones a ciertos alumnos, utilizando las metodologías y recursos materiales adecuados.La Unidad Didáctica que se propone tiene en cuenta las necesidades de este alumnado, adaptando y amoldando los diferentes materiales sin dejar de lado al alumnado que no tiene dificultades.<br /

La necesidad de integrar la asignatura de “Salud” en sexto de Primaria

Este trabajo propone una intervención educativa en la cual se integre en la educación la asignatura de "Salud" en sexto de Primaria.En este se tratarán varios temas relacionados con la salud, como son la higiene personal, la alimentación y la salud mental y física. Es necesario concienciar al alumnado para que comprenda la importancia de esta en todos sus aspectos, para así lograr mejorar la calidad de vida.<br /

The relationship between impulsivity and problem gambling in adolescence

Gambling has become one of the most frequently reported addictive behaviors among young people. Understanding risk factors associated with the onset or maintenance of gambling problems in adolescence has implications for its prevention and treatment. The main aim of the present study was to examine the potential relationships between impulsivity and problem gambling in adolescence. Participants were 874 high school students (average age: 15 years old) who were surveyed to provide data on gambling and impulsivity. Selfreported gambling behavior was assessed using the South Oaks Gambling Screen – Revised for Adolescents (SOGS-RA) and impulsivity was measured using the Impulsive Sensation Seeking Questionnaire (ZKPQ), the Barrat Impulsiveness Scale (BIS-11-A), and a delay discounting task. The data were analyzed using both a prospective-longitudinal and a cross-sectional design. In the longitudinal analyses, results showed that the impulsivity subscale of the ZKPQ increased the risk of problem gambling (p = 0.003). In the crosssectional analyses, all the impulsivity measures were higher in at-risk/problem gamblers than in non-problem gamblers (p = 0.04; 0.03; and 0.01, respectively). These findings further support the relationship between impulsivity and gambling in adolescence. Moreover, our findings suggest a bidirectional relationship between impulsivity and problem gambling in adolescence. These results have consequences for the development of prevention and treatment programs for adolescents with gambling problems

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

Multifactor implicit measures to assess enterprising personality dimensions

Background: Several implicit measures have been proposed to overcome limitations of self-reports. The present study aimed to develop a new implicit association test (MFT-IAT) to assess enterprising-related traits, exploring its reliability and validity evidence. Method: A total of 1,142 individuals (Mean age 42.36 years, SD = 13.17) from the general population were assessed. Participants were asked about sociodemographic data, employment status, and personality traits using the Battery for the Assessment of the Enterprising Personality (BEPE). They completed an MFT-IAT designed to assess the BEPE’s traits (achievement motivation, autonomy, innovativeness, self-effi cacy, locus of control, optimism, stress tolerance and risk taking). Reliability was estimated using Cronbach’s alpha. Exploratory Factor Analyses (EFAs) were performed to assess the internal structure of the MFT-IAT. Correlations and a Multiple Analysis of Variance were used to estimate validity evidence based on the relationship towith participants’ employment status. Results: EFAs provided validity evidence for all dimensions with high internal consistency (a = .92-.93). Correlations between implicit and explicit measures were non-signifi cant. Non- implicit measures yielded signifi cant differences between employment statuses. Discussion: This is a pioneering study in this fi eld and more research is needed to improve the feasibility and practicality of implicit measures in applied assessment settings.The present study was funded by the Ministry of Economy and Competitiveness (Refs: PSI2014-56114-P and PSI2017-85724-P) and a predoctoral grant (Ref: BES- 2015-073327). Both funding sources played no role in the study design, data collection, analysis or interpretation of the result

Validity evidence of the multidimensional emotional disorders inventory among non-clinical spanish university students

The current diagnostic systems for mental health disorders are categorical, which, it has been argued, poorly reflect the reality of mental health problems. This is especially relevant in emotional disorders (EDs), especially due to the existing comorbidity between supposedly different disorders. To address this, Brown and Barlow developed a hybrid dimensional−categorical approach to EDs that can be evaluated with the Multidimensional Emotional Disorder Inventory (MEDI), a transdiagnostic self-report questionnaire. This study aims to adapt and explore the sources of validity evidence of the MEDI in a non-clinical sample of Spanish university students (n = 455). Two confirmatory analyses were performed: one with a four-dimensional structure obtained with an exploratory analysis and another with the original nine-dimensional structure of the MEDI. The latter obtained a better fit. The descriptive data, including percentiles, T-scores, and sex differences in total scores are also provided, together with sources of validity evidence. These revealed significant moderate interrelations between factors and with related measures (e.g., personality, depression, and anxiety). This study adapted the MEDI for use in Spanish, provides further support about its factor structure, and offers novel data about its validity sources. The MEDI makes the evaluation of dimensional and transdiagnostic models easier, which might be fundamental in present and future research and clinical practice