Procedimientos psicológicos para el afrontamiento del dolor en niños con cáncer

Pain is one of the most common symptoms and more disabling in childhood cancer. Some medical treatments and diagnostic procedures are very intrusive and children with cancer consider them even more painful than the disease. The aim of this paper is to carry out a review on the pain in pediatric patients with cancer, stating the most common assessment procedures and techniques of psychological intervention. The characteristics and implementation procedure of breathing control, relaxation training, distraction, visualization, contingency management and hypnosis are reviewed. Therefore, several studies about the efficacy of each psychological technique for reducing pain in children with cancer are considered.El dolor es uno de los síntomas más frecuentes y a la vez más incapacitantes del cáncer infantil. Algunos procedimientos diagnósticos y tratamientos médicos son muy intrusivos y los niños los consideran incluso más dolorosos que la propia enfermedad. El objetivo de este trabajo es llevar a cabo una revisión sobre el dolor en el niño oncológico, exponiendo los procedimientos de evaluación y las técnicas de intervención psicológica más habituales. Se exponen las características y el procedimiento de aplicación de la respiración y relajación, distracción, visualización, manejo de contingencias e hipnosis. Asimismo, se revisan diversos estudios llevados a cabo que muestran la eficacia de las técnicas psicológicas de intervención en el dolor en cáncer infantil

Diseño placa de comunicación por buses industriales para ARDUINO

[ES] El trabajo trata del desarrollo de una pasarela de comunicaciones industriales, donde la trama de tres datos se recibe por un tipo de comunicación y se envía por otro completamente diferente, la cual se va a transmitir a una maqueta de un almacén automatizado que mueve los palets o bultos a diferentes posiciones dependiendo de la orden enviada. Para el envío de la trama se utilizará tanto el puerto serie del ordenador como una SCADA creado a partir de una pantalla LCD.Ante Espada, PJ. (2016). Diseño placa de comunicación por buses industriales para ARDUINO. Universitat Politècnica de València. http://hdl.handle.net/10251/73208TFG

Effectiveness of psychological treatments for depression in childhood and adolescence: A review of reviews

Depression in childhood and adolescence is a public health problem due to its high prevalence and the impact it has in the individual development. There is clear evidence of the efficacy of Interpersonal Therapy (IPT) and Cognitive-Behavioural Therapy (CBT) in the treatment of depression in children and adolescents; however, recent reviews and meta-analyses provide new perspectives for treatment. The purpose of this work is to synthesize the bibliography available through a systematic review of systematic reviews and meta-analysis that summarizes in a comprehensive way the evidence of the last two decades on the effectiveness of psychological interventions for infant-juvenile depression. A systematic review of systematic reviews and meta-analyses was performed. A search was conducted in the Web of Science and Scopus databases. Eight records met the inclusion criteria, 2 were analysed in their entirety and from the remaining 6 the information needed for independent analysis was extracted. Seven different psychotherapies were studied: CBT and IPT were the most studied (n=7; 87.5%), followed by family therapy (n=5; 62.5%), psychodynamic therapy (n=3; 37.5%), behavioural therapy (n=3; 37.5%), computerised CBT (n=2; 25%), problem-solving therapy (n=1; 12.5%) and supportive therapy (n=1; 12.5%). IPT and CBT were shown to be effective in the treatment of adolescent depression. Half of the reviews (n=4; 50%) had a low methodological quality and the other half (n=4; 50%) were classified as critically low. In general, psychological interventions for child and adolescent depression produce significant, but modest effects. Specifically, IPT and CBT can be considered the main treatment alternatives for adolescent depression. There is insufficient data of specific psychological treatment for children diagnosed with a depressive disorder. It is suggested that research should be increased to improve the methodological quality and increase the number of studies aimed at the children population.Eficacia de los tratamientos psicológicos para depresión en la infancia y la adolescencia: Una revisión de revisiones. La depresión infanto-juvenil es un problema de salud pública por su elevada prevalencia y el impacto que tiene en el desarrollo del individuo. Aunque existe una sólida evidencia sobre la eficacia de la psicoterapia interpersonal y la terapia cognitivo-conductual (TCC) en el tratamiento de la depresión en niños y adolescentes, recientes revisiones y meta-análisis aportan nuevas perspectivas de tratamiento. La finalidad de este trabajo es sintetizar la bibliografía disponible mediante una revisión sistemática de revisiones sistemáticas y meta-análisis que resuma de manera integral la evidencia de las últimas dos décadas sobre la eficacia de las intervenciones psicológicas para la depresión infanto-juvenil. Se realizó una revisión sistemática de revisiones sistemáticas y meta-análisis. Se llevó a cabo una búsqueda en las bases de datos Web of Science y Scopus. Ocho registros cumplieron los criterios de inclusión, 2 se analizaron en su totalidad y de los 6 restantes se extrajo la información necesaria para ser analizada independientemente. Se estudiaron siete psicoterapias distintas: la TCC y la terapia interpersonal fueron las más estudiadas (n=7; 87,5%), seguidas por la terapia familiar (n=5; 62,5%), la terapia psicodinámica (n=3; 37,5%), la terapia conductual (n=3; 37,5%), la TCC informatizada (n=2; 25%), la terapia de resolución de problemas (n=1; 12,5%) y la terapia de apoyo (n=1; 12,5%). La terapia interpersonal y la TCC demostraron ser efectivas en el tratamiento de la depresión adolescente. La mitad de las revisiones (n=4; 50%) presentaron una calidad metodológica baja y la otra mitad (n=4; 50%) se clasificó como críticamente baja. Las intervenciones psicológicas para la depresión infanto-juvenil, en general, producen efectos significativos, pero modestos. De forma específica, la terapia interpersonal y la TCC pueden considerarse las principales alternativas de tratamiento para la depresión adolescente. No se dispone de datos suficientes sobre el tratamiento psicológico específico para niños con un diagnóstico de un trastorno depresivo. Se sugiere un aumento de la investigación que mejore la calidad metodológica y aumenten los estudios dirigidos a la población infanti

Relación entre la edad de debut sexual y el sexo bajo los efectos de las drogas en la adolescencia

El debut sexual temprano y la práctica de sexo asociada al consumo de drogas incrementan el riesgo de contraer infecciones de transmisión sexual y embarazos no deseados. No existen datos hasta el momento sobre cómo se relacionan entre sí ambos factores de riesgo. El objetivo de este estudio es analizar la relación entre el uso de drogas asociado a la actividad sexual y la edad de debut sexual en jóvenes. Participaron 351 estudiantes españoles sexualmente activos con una edad media de 15,9 años (DT = 0,75; rango: 14-18), de los que el 55% eran chicas y el 45% eran chicos. Se evaluó la actividad sexual (activo o no activo) y la práctica de relaciones sexuales bajo los efectos de las drogas. Se establecieron tres grupos empleando como criterio la edad media de debut sexual: debut sexual temprano (anterior a los 15 años), promedio (15 años) y tardío (posterior a los 15 años). Los jóvenes que debutaron sexualmente antes de los 15 años habían combinado en mayor proporción sexo y alcohol respecto al resto. No hubo diferencias en el uso de otras drogas combinado con sexo entre los tres grupos. Los análisis de regresión mostraron que la edad de la primera experiencia sexual es un factor predictor de las prácticas sexuales bajo los efectos de las drogas. Debutar sexualmente antes de los 15 se asoció con una mayor probabilidad de mantener relaciones sexuales bajo los efectos de las drogas. Se recomienda un abordaje conjunto de ambas problemáticas a edades tempranas.An early sexual debut and practice of sex associated with drug use have been shown to increase the risk of sexual transmitted infections and unwanted pregnancies. So far there has been no data on how both risk factors are related with each other. The aim of this study is to analyze the relationship between drug use associated with sexual activity and age of sexual debut among young people. Participants were 351 Spanish students who reported being sexually active. The mean age was 15.9 years (SD = 0.75, range: 14-18), 55% girls and 45% boys. We assessed sexual activity (active or non-active) and having had sex under the infl uence of drugs. Three groups were established using as criteria the average age of fi rst sexual relations: early sexual debut (earlier than 15), average (15) and late (later than 15). A higher proportion of young people who began having sex before age 15 had combined sex and alcohol in comparison to the rest. There were no differences in the use of other drugs combined with sex among the three groups. Regression analyzes showed that age of fi rst sexual experience is a predictor of unsafe sex under the infl uence of drugs. Sexual debut earlier than 15 was associated with increased likelihood of having sex under the infl uence of drugs. We recommend a combined approach to both problems at an early age

La vuelta al colegio tras la pandemia : Adaptación de los niños y adolescentes españoles

Aiming to mitigate the COVID-19 spread, the government of Spain applied restrictive measures, like schools’ closure. Although the effects of the pandemic on children's emotional well-being have been studied, there is a lack of studies examining school adjustment following the pandemic and the role that the infection has played in the adjustment process. The objective is to analyze the relationship between stressful events related to school experienced by children and their adjustment to school after the home confinement, including anxiety as a mediator variable. Participants were the parentsof 219 Spanish children and adolescents aged 3 and 18 years who completed a survey about their children’s anxiety (Spanish Brief Child Version of the Spence Children’s Anxiety Scale), the stressful events experienced related to school (Stressful Events related to Pandemic Inventory), and the adjustment to school (Adjustment of Children after Pandemic School Closure Scale). Results showed that social distance was the most reported stressful event (87%). Having COVID-19 and expe-riencing bullying were directly related to a high level of anxiety. Children ́s who decreased social contact and experienced bullying showed a worse adjustment to school. Anxiety was an indirect mediator of this relationship. Findings highlight the importance of supervising school adaptation and promoting strategies to prevent emotional problems when the youths are exposed to stressful situations.Para frenar la propagación del COVID-19, el gobierno español aplicó medidas restrictivas, como el cierre escolar. Aunque los efectos de la pandemia en el bienestar emocional de los niños han sido estudiados, faltan estudios que examinen la adaptación escolar tras la pandemia y el papel que la infección ha tenido en el proceso de adaptación. El objetivo es analizar la relación entre los eventos estresantes relacionados con la escuela y la adaptación escolar después del confinamiento, incluyendo la ansiedad como mediadora. Los participantes fueron 219 padres de niños y adolescentes españoles de entre 3 y 18 años que completaron encuestas sobre la ansiedad de sus hijos (Spanish Brief Child Version of the Spence Children's Anxiety Scale), los eventos estresantes vividos relacionados con la escuela (Stressful Eventos relacionados con el Inventario de Pandemia), y la adaptación escolar (Escala de Ajuste de los Niños después del Cierre Escolar de la Pandemia). Los resultados mostraron mayor prevalencia en el evento estresante distancia social (87%). Tener COVID-19 y sufrir acoso escolar se relacionó directamente con una mayor ansiedad. Los niños que disminuye-ron el contacto social y sufrieron acoso escolar mostraron peor adaptación escolar, siendo la ansiedad un mediador indirecto. Los hallazgos destacan la importancia de supervisar la adaptación escolar y promover estrategias para prevenir problemas emocionales en jóvenes expuestos a situaciones estresantes

Terapia de conducta para la fobia escolar: estudio de un caso

School phobia is defined as maladapted patterns of anxiety behaviours related to school situations. It is considered one of the most disabling anxiety disorders during childhood and adolescence. In this article a case study of a 15 years-old adolescent, diagnosed with school phobia is presented. The identified antecedent stimuli were aversive social situations, as being the target of jokes and threats by her peers during school situations such as recess, and anticipatory behaviours like gearing up for school, getting out of home, and/or taking the bus. Deficits in social skills and self-esteem were also found as mediating factors. Problembehaviours were high anxiety, passive and active avoiding behaviours, and negative thoughts. The treatment focused on enhancing coping skills involved in school situations, and improving the repertory of social behaviours. The techniques used were therapeutic contract, social skill training, in-vivo exposure, self-instructions and contingency management. When the treatment ended, the patient was attending her classes and her social competence level had improved. Treatment gains were maintained at follow-up session.ResumenLa fobia escolar se define como un patrón desadaptativo de respuestas de ansiedad ante situaciones escolares, y está considerado como uno de los trastornos infanto-juveniles más incapacitantes. En este trabajo se presenta el caso clínico de una adolescente de 15 años diagnosticada de fobia escolar. Fueron identificados como estímulos antecedentes situaciones sociales aversivas, como ser objeto de burlas y amenazas, situaciones escolares como el recreo, y situaciones anticipatorias como vestirse, salir de casa y coger el autobús. Además, se detectó un déficit en habilidades sociales y autoestima, que actuaban como variables mediadoras. Las conductas problema eran una elevada ansiedad, conductas de evitación activa y pasiva, y pensamientos negativos. El tratamiento se centró en potenciar las habilidades para afrontar la ansiedad en situaciones escolares, y mejorar el repertorio de conductas sociales. Las técnicas empleadas fueron el contrato terapéutico, entrenamiento en habilidades sociales, exposición en vivo, autoinstrucciones y manejo de contingencias. La incorporación a clase se hizo efectiva al término del tratamiento y se mantenía en los seguimientos, habiéndose mejorado también el nivel de competencia social.AbstractSchool phobia is defined as maladapted patterns of anxiety behaviours related to school situations. It is considered one of the most disabling anxiety disorders during childhood and adolescence. In this article a case study of a 15 years-old adolescent, diagnosed with school phobia is presented. The identified antecedent stimuli were aversive social situations, as being the target of jokes and threats by her peers during school situations such as recess, and anticipatory behaviours like gearing up for school, getting out of home, and/or taking the bus. Deficits in social skills and self-esteem were also found as mediating factors. Problembehaviours were high anxiety, passive and active avoiding behaviours, and negative thoughts. The treatment focused on enhancing coping skills involved in school situations, and improving the repertory of social behaviours. The techniques used were therapeutic contract, social skill training, in-vivo exposure, self-instructions and contingency management. When the treatment ended, the patient was attending her classes and her social competence level had improved. Treatment gains were maintained at follow-up session.

Validation of the Children’s Separation Anxiety Scale – Parent Version (CSAS-P)

The main objective of this research was to validate the parents’ version of the Children’s Separation Anxiety Scale (CSAS-P), which assesses separation anxiety symptoms in pre-adolescence, the stage with the highest incidence of anxiety disorder due to separation. In Study 1, 1,089 parents, those children aged between 8 and 11 (M = 9.59, SD = 1.11), 51.7% girls, were selected by random cluster sampling, who completed the CSAS-P to obtain the factorial structure. Exploratory factor analysis identified four related factors: Worry, Opposition, Calm, and Distress, which explained 42.93% of the variance. In Study 2, 3,801 parents, those children aged between 8 and 11 (M = 9.50, SD = 1.10), 50.2% girls, completed the CSAS-P, and their children completed the Children’s Separation Anxiety Scale (CSAS). The four related-factor model from Study 1 was validated by confirmatory factor analysis. The CSAS-P had adequate internal consistency (α = 0.84), temporal stability (r = 0.72), and invariance across children’s age and gender and the parent who completed the scale. Age and gender differences were small: older children scored higher on Worry and younger children on Distress; the girls scored higher on all factors. Small differences were also found depending on the parent who completed the scale without finding a clear pattern. Parents scored significantly lower than the child on all four factors of the scale. The results support the reliability and validity of the CSAS-P, an instrument that complements the child’s self-report in the framework of the multi-source assessment.This research was supported by the Spanish National Plan for Research, Development and Technological Innovation Grant (EDU2008-05060) awarded to XM

Psychological symptoms and behavioral changes in children and adolescents during the early phase of COVID-19 quarantine in three European countries

The coronavirus disease (COVID-19) pandemic forced the home confinement of the majority of population around the world, including a significant number of children and adolescents, for several weeks in 2020. Negative psychological effects have been identified in adults, but research about the impact of this type of social distancing measure on children and adolescents is scarce. The present study aimed to describe and compare the immediate psychological and behavioral symptoms associated with COVID-19 quarantine in children and adolescents from three southern European countries with different levels of restrictions (Italy, Spain, and Portugal). Parents of 1,480 children and adolescents (52.8% boys) between 3 and 18 years old (M = 9.15, SD = 4.27) participated in the study. An online survey using snowball sampling techniques was conducted during 15 days between March and April 2020, representing the early phase of the quarantine associated with COVID-19 outbreak. Parents answered questionnaires about sociodemographic data, housing conditions, immediate psychological responses during quarantine (e.g., anxiety, mood, sleep, and behavioral alterations), patterns of use of screens, daily physical activity, and sleep hours before and during the quarantine. The results revealed an increase in children's psychological and behavioral symptoms, increased screen-time, reduced physical activity, and more sleep hours/night. Italian children presented less psychological and behavioral symptoms compared with Portuguese and Spanish children. In general, hierarchical multiple regressions revealed that having an outdoor exit in the house (e.g., garden, terrace) contributed to lower levels of psychological and behavioral symptomatology. Future studies are needed to identify family and individual variables that can better predict children and adolescents' well-being during and after quarantine. Recommendations for families and implications for practice are discussed.info:eu-repo/semantics/publishedVersio

Coping behaviors and psychological disturbances in youth affected by the COVID-19 health crisis

The COVID-19 pandemic and the quarantine undergone by children in many countries is a stressful situation about which little is known to date.Children and adolescents’ behaviors to cope with home confinement may be associated with their emotional welfare. The objectives of this study were: (1) to examine the coping strategies used out by children and adolescents during the COVID-19 health crisis, (2) to analyze the differences in these behaviors in three countries, and (3) to examine the relationship between different coping modalities and adaptation. Participants were 1,480 parents of children aged 3–18 years from three European countries (nSpain=431,nItaly=712, and nPortugal=355). The children’s mean age was 9.15 years (SD=4.27). Parents completed an online survey providing information on symptoms and coping behaviors observed in their children. The most frequent coping strategies were accepting what is happening(58.9%), collaborating with quarantine social activities(e.g., drawings on the windows,supportive applauses) (35.9%), acting as if nothing is happening (35.5%), highlighting the advantages of being at home (35.1%), and not appearing to be worried about what is happening (30.1%). Compared to Italian and Spanish children, Portuguese children used a sense of humor more frequently when their parents talked about the situation. Acting as if nothing was happening, collaborating with social activities, and seeking comfort from others were more likely in Spanish children than in children from the other countries.Compared to Portuguese and Spanish children, Italian children did not seem worried about what was happening. Overall, an emotional-oriented coping style was directly correlated with a greater presence of anxious symptoms, as well as to mood, sleep,behavioral, and cognitive alterations. Task-oriented and avoidance-oriented styles were related to better psychological adaptation (considered a low presence of psychological symptoms). Results also show that unaffected children or children with a lower level of impact were more likely to use strategies based on a positive focus on the situation. This study provides interesting data on the strategies to be promoted by parents to cope with the COVID-19 health crisis in children.info:eu-repo/semantics/publishedVersio

Anxiety and depressive symptoms in children and adolescents during COVID-19 pandemic: a transcultural approach

Background: Despite being necessary to delay the spread of COVID- 19, home confinement could have affected the emotional well-being of children and adolescents. Knowing which variables are involved in anxiety and depressive symptoms could help to prevent young people’s psychological problems related to lockdown as early as possible. This crosssectional study aims to examine anxiety and depressive symptomatology in Italian, Spanish, and Portuguese children and adolescents in order to determine which variables are related to poorer well-being during the pandemic. Method: The parents of 515 children, aged 3-18 years old, completed an online survey. Children’s anxiety symptoms were assessed using the Spence Children’s Anxiety Scale-Parent Version, and depressive symptoms were measured with the Short Mood and Feelings Questionnaire-Parent Version. Results: We found differences in anxiety and depression between countries, with higher anxiety scores in Spanish children, and higher depression scores in Spanish and Italian children compared to the Portuguese. Anxiety and depressive symptoms were more likely in children whose parents reported higher levels of stress. Conclusions: These findings are discussed in the light of detecting and supporting affected children as early as possible.info:eu-repo/semantics/publishedVersio