Síntomas psicopatológicos en adolescentes españoles: relación con los estilos parentales percibidos y la autoestima

The purpose of this research was to study the presence of psychopathologic symptoms in a community sample of 935 Spanish adolescents, and its relationship with perceived parental styles and the self-esteem. Numbers of males and females were 489 and 446, respectively. Age ranged from 12 to 18 years (M = 14.84, SD = 1.83). Fourteen High School centers in Murcia and Castilla-La Mancha agreed to participate in the current study. Five of them were randomly selected to collected data. The results showed age-related differences in all variables (the psychopathologic symptoms, self-esteem and perceived parental styles). On the other hand, females showed less psychopathologic symptoms and better perception of parental styles than males. Significant negative correlations were found between self-esteem, psychopathology and some positive dimensions of parental style. The main predictors of adolescent’s mental health were: self-esteem, age, gender, revelation and affect from father and psychological control of mother.El objetivo de esta investigación fue analizar la sintomatología psicopatológica evaluada con el SCL-90-R en una muestra comunitaria de 935 adolescentes españoles y su interacción con el estilo parental percibido y la autoestima. La muestra estuvo compuesta por 489 chicos y 446 chicas de edades comprendidas entre los 12 y 18 años (M = 14.84, DT = 1.83) que cursaban estudios de Educación Secundaria y Bachillerato. Catorce centros de la Región de Murcia y Castilla-La Mancha aceptaron participar en el estudio. De éstos, fueron seleccionados al azar siete teniendo en cuenta la titularidad (pública y concertada). Los resultados indicaron que la edad influía en todas las variables medidas, presentando los adolescentes de mayor edad medias más altas en síntomas psicopatológicos, menor autoestima y peor percepción de los estilos educativos parentales. Las mujeres presentaron menos niveles de sintomatología y mejor percepción de los estilos educativos. Los resultados de los análisis correlacionales confirmaron relaciones significativas inversas entre autoestima y síntomas psicopatológicos y entre algunas dimensiones positivas de los estilos educativos. Los predictores más relevantes y de mayor peso en la salud psicológica fueron: autoestima, edad, sexo, revelación y afecto del padre y control psicológico de la madre

Propiedades psicométricas del Inventario Obsesivo de Leyton para Niños Versión Corta en una muestra comunitaria de niños y adolescentes

The aim of the current study was to analyze psychometric properties of the Short LOI-CV in Spanish community sample. Participants were 914 children and adolescents with mean age of 13.01 years (51.3% males). An EFA yielded a three-factor model representing Obsessions, Compulsions, and Cleanliness dimensions. Both, total score and subscales showed an adequate internal consistency. The Spanish version also exhibited good test-retest reliability and moderate convergent and discriminant validity. The younger participants (from 8 to 10 years) obtained higher means for total score and subscales than older participants (groups 11-13 and 14-18 years). Significant differences related to gender were also observed since males obtained higher means in Compulsions subscale. Despite more research is required, the Spanish version of the Short LOI-CV exhibited promising psychometric results to assess obsessive-compulsive symptoms in community population.El objetivo de este estudio fueanalizar las propiedades psicométricas del ShortLOI-CVen unamuestra españolacomunitaria.Los participantes fueron 914 niñosyadolescentescon edad mediade13.01años (varones =51.3%).ElAFE mostróun modelo de tresfactores compuesto por los dominios Obsesiones, CompulsionesyLimpieza. Tanto lapuntuación total comolas subescalas mostraron una adecuadaconsistenciainterna.Laversión española mostróbuena fiabilidad test-retestymoderada validezconvergenteydiscriminante.Los participantes más jóvenes (8a10 años) obtuvieron medias más altasquela escala Totalydistintas subescalas quelos mayores (grupo de11-13yde 14-18años). Se encontraron también diferencias significativas respecto al sexo, siendo losvarones los que mayoresmedias mostraron en laescala de compulsiones.Pese aqueesnecesariamás investigación, estos resultados sugirieron que la versión en español del ShortLOI-CV mostróun buen rendimiento psicométricos para evaluar los síntomas obsesivo-compulsivosen niñosyadolescentesen población comunitari

High incidence of PTSD diagnosis and trauma-related symptoms in a trauma exposed bipolar I and II sample

Background: Post-traumatic stress disorder (PTSD) is an established comorbidity in Bipolar Disorder (BD), but little is known about the characteristics of psychological trauma beyond a PTSD diagnosis and differences in trauma symptoms between BD-I and BD-II. Objective: (1) To present characteristics of a trauma-exposed BD sample; (2) to investigate prevalence and trauma symptom profile across BD-I and BD-II; (3) to assess the impact of a lifetime PTSD diagnosis vs. a history of trauma on BD course; and (4) to research the impacts of sexual and physical abuse. Methods: This multi-center study comprised 79 adult participants with BD with a history of psychological trauma and reports baseline data from a trial registered in Clinical Trials (https://clinicaltrials.gov; ref: NCT02634372). Clinical variables were gathered through clinical interview, validated scales and a review of case notes. Results: The majority (80.8%) of our sample had experienced a relevant stressful life event prior to onset of BD, over half of our sample 51.9% had a lifetime diagnosis of PTSD according to the Clinician Administered PTSD scale. The mean Impact of Event Scale-Revised scores indicated high levels of trauma-related distress across the sample, including clinical symptoms in the PTSD group and subsyndromal symptoms in the non-PTSD group. Levels of dissociation were not higher than normative values for BD. A PTSD diagnosis (vs. a history of trauma) was associated with psychotic symptoms [2(1) = 5.404, p = 0.02] but not with other indicators of BD clinical severity. There was no significant difference between BD-I and BD-II in terms of lifetime PTSD diagnosis or trauma symptom profile. Sexual abuse significantly predicted rapid cycling [2(1) = 4.15, p = 0.042], while physical abuse was not significantly associated with any clinical indicator of severity. Conclusion: Trauma load in BD is marked with a lack of difference in trauma profile between BD-I and BD-II. Although PTSD and sexual abuse may have a negative impact on BD course, in many indicators of BD severity there is no significant difference between PTSD and subsyndromal trauma symptoms. Our results support further research to clarify the role of subsyndromic PTSD symptoms, and highlight the importance of screening for trauma in BD patients

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Executive Functioning and Clinical Variables in Patients with Obsessive-Compulsive Disorder

Background: Cognitive flexibility, response inhibition, and working memory are considered the main mechanisms responsible for executive control. This study examined differences in cognitive flexibility, inhibition, and working memory in patients with obsessive–compulsive disorder (OCD) relative to a control group. Method: A total of 62 obsessive-compulsive participants (OCD = 32; healthy control = 32) aged between 17 and 56 years old (M = 33.16, SD = 9.23) were administered the computerized Wisconsin Card Sorting Test, Stroop Color–Word Test, Go/No-Go Task, Digit Test, and Corsi Block Test. Clinician-rated and self-reported obsessive–compulsive symptom severity, and anxiety, depression, and obsessive beliefs were evaluated. Results: The control group performed better than the OCD group in tasks involving cognitive flexibility, inhibition, and visuospatial working memory. Anxiety and obsessive beliefs influenced the participants’ performance on inhibition and working memory tasks. Similarly, comorbidity also influenced inhibition and working memory. In addition, the use of pharmacotherapy and the degree of OCD symptom severity influenced verbal working memory. Conclusions: Cognitive flexibility, inhibition, and visuospatial working memory deficits may be endophenotypes of OCD but require further examination for specificity. OCD severity, comorbidity patterns, anxiety, and obsessive beliefs may influence performance

Coping Strategies, Anxiety and Depression in OCD and Schizophrenia: Changes during COVID-19

Background: The main aim was to examine changes in coping strategies, anxiety and depression in obsessive–compulsive and schizophrenia patients during COVID-19, in addition to controlling the influence of intolerance to uncertainty and experiential avoidance. Method: The first time, the study comprised (15–30 April 2020) 293 patients, 113 of whom were diagnosed with obsessive–compulsive disorder, 61 with schizophrenia and 119 healthy controls, aged 13–77 years (M = 37.89, SD = 12.65). The second time (15–30 November), the study comprised 195 participants (85 obsessive–compulsive patients, 42 schizophrenic patiens and 77 healthy controls participants). The evaluation was carried out through an online survey. Results: The clinical groups worsened over time in cognitive coping, anxiety and depression, while the control group only worsened in depression. Intergroup differences in anxiety, depression and coping strategies were maintained, highlighting the use of some maladaptive strategies (avoidance, spiritual) in clinical groups. Experiential avoidance and tolerance for uncertainty mainly affected coping. Conclusions: The duration of COVID-19 not only produced changes in anxiety and depression in clinical groups but also in coping strategies to face this pandemic and its consequences

Contribución De La Competencia Del Terapeuta En El Tratamiento De Adolescentes Con Fobia Social Generalizada

Background: The purpose of this study was to explore which of the outcomes attained by the application of the psychological program Intervención en Adolescentes con Fobia Social (Intervention in Adolescents with Social Phobia) can be attributed to the therapist’s competence. Method: The experimental study consists of three conditions: Waiting list control, Group treated by expert psychologists, and Group treated by inexperienced psychologists, with a sample of 110 Spanish adolescents whose mean age was 15.42 years (SD = 0.97, range: 14-18). All participants met the criteria for diagnosis of Generalized Social Phobia) and most of them were female (65.45%). Results: (i) The effect size attributable to the therapist was low compared to the effect size associated with the manual-based treatment program in the dependent variables measured, and (ii) Expert therapists attained a much greater remission of the criteria for the diagnosis of Generalized Social Phobia among participants than did the inexperienced therapists. Conclusions: The IAFS Program was responsible for most of the change measured in participants

El Inventario De Fobia Social Y Ansiedadprimeros Resultados De Confiabilidad Y Validez Estructural En Adolescentes Chilenos

In this report we examined the reliability and structural validity of the Chilean version of the Social Phobia and Anxiety Inventory, SPAI, (Turner, Beidel, Dancu & Stanley, 1989), using a sample of 1040 non clinical Chilean adolescents (range of age between 13 and 18 years). The structural validity analysis indicated the existence of two, clearly differentiated, subscales (Social Phobia and Agoraphobia) that explained 43.4% of the variance. The alpha reliability coefficients were very high in each one of the subscales. In spite of finding significant differences, for sex in both scales, the effect size was small. On the other hand, the age variable was significant in the social phobia scale but not in the agoraphobia one, but again the effect size was small. In general the results offer empirical evidence in support of the reliability and validity of the Chilean version of the Social Phobia and Anxiety Inventory

The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth

Objective: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well-established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure of these dimensions in unselected schoolchildren and in children with OCD. Method: We estimated the network structure of OCD symptom dimensions in 6,991 schoolchildren and 704 children diagnosed with OCD from 18 sites across 6 countries. All participants completed the Obsessive-Compulsive Inventory−Child Version. Results: In both the school-based and clinic-based samples, the OCD dimensions formed an interconnected network with doubting/checking emerging as a highly central node, that is, having strong connections to other symptom dimensions in the network. The centrality of the doubting/checking dimension was consistent across countries, sexes, age groups, clinical status, and tic disorder comorbidity. Network differences were observed for age and sex in the school-based but not the clinic-based samples. Conclusion: The centrality of doubting/checking in the network structure of childhood OCD adds to classic and recent conceptualizations of the disorder in which the important role of doubt in disorder severity and maintenance is highlighted. The present results suggest that doubting/checking is a potentially important target for further research into the etiology and treatment of childhood OCD.Mr. Cervin has received funding from L.J. Boëthius Foundation, Lindhaga Foundation, Jerring Foundation, and Region Skåne that made possible the preparation of the present manuscript. Original data was collected in part by support from grants from the National Institute of Mental Health (NIMH) to Drs. Storch (1R01MH093381) and Geller (5R01MH093402)

Traumatic events in dual disorders: prevalence and clinical characteristics

Psychological trauma has been identified in substance use disorders (SUD) as a major etiological risk factor. However, detailed and systematic data about the prevalence and types of psychological trauma in dual disorders have been scarce to date. In this study, 150 inpatients were recruited and cross-sectionally screened on their substance use severity, psychological trauma symptoms, comorbidities, and clinical severity. One hundred patients fulfilled criteria for a dual disorder, while 50 patients were diagnosed with only SUD. Ninety-four percent of the whole sample suffered from at least one lifetime traumatic event. The prevalence rates of Posttraumatic Stress Disorder diagnosis for dual disorder and only SUD was around 20% in both groups; however, patients with dual disorder presented more adverse events, more childhood trauma, more dissociative symptoms, and a more severe clinical profile than patients with only SUD. Childhood maltreatment can also serve as a predictor for developing a dual disorder diagnosis and as a risk factor for developing a more complex and severe clinical profile. These data challenge our current clinical practice in the treatment of patients suffering from dual disorder or only SUD diagnosis and favor the incorporation of an additional trauma-focused therapy in this population. This may improve the prognosis and the course of the illness in these patients