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ABSTRACT Objective. To report the risk from alcohol, cannabis, and their combined use for non-fatal road traffic injuries for drivers, passengers, and pedestrians. Methods. Risk was estimated using the case-crossover method. Participants (N= 306) were injured patients from an emergency department in Mar del Plata, Argentina. Results. Alcohol use (OR= 6.78, CI 95% 3.75-12.25) as well as combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.73) significantly increased the risk of a road traffic injuries. Alcohol use increased the risk in both, women (OR= 8.87, CI 95% 2.69-29.21) and men (OR= 6.16, CI 95% 3.10-12.23); in those >30 years old (OR= 6.01, CI 95% 2.09-17.24) and those <30 years old (OR= 7.15, CI 95% 3.49-14.65). This last group also had an increased risk after combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.75). Both drivers (OR= 6.40, CI 95% 3.23-12.69) and passengers (OR= 13.83, CI 95% 2.87-66.42) had an increased risk after alcohol consumption. Conclusions. To our knowledge, these are the first estimates of the risk of having a road traffic injury after alcohol and cannabis consumption in one of the countries of the Southern Cone (Argentina, Chile, and Uruguay). These results highlight the urgent need to implement and enforce comprehensive alcohol control measures. Furthermore, given the global trend towards legalizing cannabis for recreational use, our results could also inform policymakers to enact or amend impaired driving laws.
RESUMEN Objetivo. Informar sobre el riesgo lesiones por accidentes de tránsito debido al consumo de alcohol, cannabis o su combinación en conductores, pasajeros y peatones. Métodos. Se estimó el riesgo mediante el método de casos cruzados. Los participantes (N = 306) fueron pacientes que habían sufrido lesiones, provenientes de una sala de urgencias en Mar del Plata (Argentina). Resultados. El consumo de alcohol (OR = 6,78, IC95% 3,75-12,25), así como el consumo combinado de alcohol y cannabis (OR = 7,05, IC95% 1,16-42,73) aumentaron significativamente el riesgo de traumatismos por accidentes de tránsito. El consumo de alcohol aumentó el riesgo tanto en mujeres (OR = 8,87, IC95% 2,69-29,21) como en hombres (OR = 6,16, IC95% 3,10-12,23); así como en mayores de 30 años (OR = 6,01, IC95% 2,09-17,24) y en menores de 30 años (OR = 7,15, IC95% 3,49-14,65). Este último grupo también tuvo mayor riesgo tras un consumo combinado de alcohol y cannabis (OR = 7,05, IC95% 1,16-42,75). Tanto los conductores (OR = 6,40, IC95% 3,23-12,69) como los pasajeros (OR = 13,83, IC95% 2,87-66,42) presentaron mayor riesgo después del consumo de alcohol. Conclusiones. Hasta donde sabemos, estas son las primeras estimaciones del riesgo de sufrir lesiones por accidentes de tránsito tras el consumo de alcohol y cannabis en uno de los países del Cono Sur (Argentina, Chile y Uruguay). Estos resultados ponen de relieve la urgente necesidad de aplicar y hacer cumplir medidas integrales de control del alcohol. Además, dada la tendencia mundial hacia la legalización del cannabis para consumo recreativo, nuestros resultados también podrían orientar a los responsables de las políticas para que promulguen o enmienden las leyes sobre la conducción con capacidades alteradas debido al consumo de sustancias.
RESUMO Objetivo. Relatar o risco de lesões não fatais no trânsito atribuível ao álcool, à cannabis e a seu uso combinado para motoristas, passageiros e pedestres. Métodos. O risco foi estimado usando o método clínico cruzado (case-crossover). Os participantes (N=306) eram feridos atendidos em um pronto-socorro em Mar del Plata, Argentina. Resultados. O uso de álcool (OR = 6,78, IC95% 3,75; 12,25) e o uso combinado de álcool e cannabis (OR= 7,05, IC95% 1,16; 42,73) aumentaram significativamente o risco de lesões no trânsito. O uso de álcool aumentou o risco tanto em mulheres (OR = 8,87, IC95% 2,69; 29,21) quanto em homens (OR = 6,16, IC95% 3,10; 12,23); naqueles >30 anos de idade (OR = 6,01, IC95% 2,09; 17,24) e <30 anos de idade (OR = 7,15, IC95% 3,49; 14,65). Esse último grupo também apresentou um risco maior após o uso combinado de álcool e cannabis (OR = 7,05, IC95% 1,16; 42,75). Tanto motoristas (OR = 6,40, IC95% 3,23; 12,69) quanto passageiros (OR = 13,83, IC95% 2,87; 66,42) apresentaram risco maior após o consumo de álcool. Conclusões. Até onde sabemos, estas são as primeiras estimativas do risco de lesões de trânsito após o consumo de álcool e cannabis em um dos países do Cone Sul (Argentina, Chile e Uruguai). Os resultados destacam a necessidade urgente de implementar e aplicar medidas abrangentes de controle do álcool. Além disso, considerando a tendência global de legalização da cannabis para uso recreativo, nossos resultados também poderiam ajudar os formuladores de políticas a decretar ou alterar as leis sobre a condução sob efeito de substâncias psicoativas.
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Resumen La exposición prenatal al alcohol puede derivar en un espectro de trastornos congénitos, dentro de los cuales el Síndrome Alcohólico Fetal (SAF) es el más severo. Esto es 100 % prevenible si no se consume alcohol durante la gestación, por lo que conocer los factores que determinan que una mujer consuma alcohol estando embarazada es fundamental. El objetivo de este trabajo es evaluar si características del entorno (como son las normas sociales prescriptivas o NSP) se relacionan con el consumo de alcohol durante la gestación en mujeres de la ciudad de Mar del Plata, Argentina. Para ello, se realizó un muestro probabilístico de 852 mujeres gestantes durante el año 2016 en los principales centros de atención primaria a la salud de la ciudad. Se evaluó el consumo de alcohol antes y durante la gestación a través del Test de Identificación de Trastornos por Consumo de Alcohol y las NSP con preguntas construidas ad hoc. El 87 % consideró que las otras gestantes consumen alcohol; de ellas, 53 % cree que el consumo es igual, 10 % cree que es mayor y el resto menor. El 90 % reconoció que las personas importantes para ellas desaprobarían el consumo durante la gestación. Las mujeres con un entorno favorable hacia el consumo se correspondieron con ingesta de alcohol en el embarazo, mientras que se observó lo contrario en los casos en los que el entorno era desfavorable. Estos resultados indican que podría ser beneficioso diseñar estrategias preventivas que se focalicen no solo en la gestante, sino en el entorno cercano.
Abstract Prenatal alcohol exposure can lead to a spectrum of congenital disorders for the fetus with permanent consequences, known as fetal alcohol spectrum disorders (FASD), within which Fetal Alcohol Syndrome (SAF) is its most severe extreme. All FASD are 100 % preventable if no alcohol is consumed during pregnancy, so knowing the factors that determine that a woman decides to drink while pregnant is essential to develop effective prevention plans. Among these factors are the phenomena of social influence such as perceived social norms (PSN), both descriptive and prescriptive. The PSN are transmitted by social interaction and produced based on the perception of the beliefs or behaviors of others, beyond their real actions. It has been identified that PSN predict alcohol consumption in various populations, such as university students, but research is almost non-existent with pregnant women. The aim of this study is to assess whether environmental characteristics (such as PSN) are related to alcohol consumption during pregnancy in pregnant women in the city of Mar del Plata, Argentina. Method: a probabilistic sample of 852 pregnant women was carried out during 2016 in the main primary health care centers of the city of Mar del Plata. Alcohol consumption was assessed before and during pregnancy through the AUDIT and the PSN was assessed with five questions constructed ad hoc by specialists in the area of alcohol consumption. Descriptive analyses were performed to categorized social norms and the prescriptive ones were re-categorized into four groups: 1. It is bad for the health of the baby or the mother; 2. It is wrong for cultural or moral reasons; 3. consumption is accepted; 4. It does not know/does not matter. To describe them based on alcohol consumption, latent class analyses were performed. Models of two to four classes were estimated, reproduced 50 times to avoid local maximums, with the software R. Results: 87 % of pregnant women believed that others in their same condition consume alcohol. 53 % of them believed they consume the same as before pregnancy, 10 % believed they consume more and the rest that they reduced their consumption. The belief about the average amount that other pregnant women would consume is more than three drinks, the equivalent of one bottle of beer per occasion of consumption. 90 % recognized that people important to them would disapprove consumption during pregnancy because doing so would cause harm to the baby, the mother, pregnancy in general or because alcohol is considered harmful to health. 6 % considered that people important to them would approve consumption because few amounts are tolerated or because alcohol is good for breastfeeding. The latent class analysis indicated a better fit for the two-class model. Class 1 was made up of women who claimed that for their people, alcohol consumption during pregnancy was acceptable and they themselves consumed alcohol during pregnancy. Class 2 conglomerated women who thought that others would see their consumption as bad at this stage and there was a low probability that they themselves consumed during pregnancy. Conclusions: These results indicate that it could be beneficial to design preventive strategies that focus not only on the future mother, but on the nearby environment (couple, family, friends), and even throughout the community, where social norms are established and reproduced.
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Las razones para reducir el consumo de alcohol pueden ser definidas como motivos que llevan a una persona a disminuir el consumo de alcohol o mantener la sobriedad. Este tema suele ser poco estudiado, particularmente en países latinoamericanos y en poblaciones en riesgo. El objetivo de esta investigación de diseño secuencial exploratorio fue explorar las razones para cambiar el consumo de alcohol en universitarios que lo hayan modificado (N = 100), de la ciudad de Mar del Plata, Argentina, con una pregunta abierta. A su vez, la descripción se realizó sobre la base de la experiencia previa de consumo excesivo episódico del alcohol, trastornos por uso de alcohol, y el sexo de los participantes. Los resultados indican que el motivo más frecuente es el disgusto o indiferencia por la sustancia en casi todos los grupos considerados. Sin embargo, cuando el trastorno por uso de alcohol fue grave o moderado, se observaron diferencias. Se discuten los aportes teóricos de la investigación, entre ellos, comprender qué lleva a cada grupo a cambiar su consumo alcohol, y las implicancias para el desarrollo de intervenciones específicas basadas en esta información.
The reasons to reduce alcohol consumption may be defined as the causes leading a person to decrease alcohol consumption or to stay sober. This topic is not often widely studied, particularly in Latin American countries and at-risk populations. The aim of this sequential exploratory research was to explore, through an open question, the reasons why university students (N = 100) of the city of Mar del Plata, Argentina, changed their alcohol consumption. Additionally, the description was based on previous heavy episodic alcohol consumption, disorders caused by alcohol use, and participants' gender. The results indicate that almost all studied groups reduced alcohol consumption due to their distaste or indifference for the substance. However, when disorders caused by alcohol use were severe or moderate, differences were observed. The theoretical contributions of this research are discussed, including the understanding of what leads each group to change its alcohol consumption, and the implications for the development of specific interventions based on this information.
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Abstract The aim of this article was to analyze the psychometric properties of an adapted version of the Alcohol Expectancy Questionnaire Adolescent (AEQ-A) in university students from Mar del Plata city, Argentina. Expectancies about the effects of alcohol refer to the beliefs that people hold about the consequences of alcohol consumption on behavior. Expectancies have been related to drinking initiation and maintenance, and to habitual drinking patterns. Although several questionnaires have been developed to measure expectancies, the AEQ-A has been one of the most frequently used. Studies in different cultural that, given expectancies' cultural variability, the questionnaire must be adapted to each particular context. A version of the AEQ-A previously validated in Mar del Plata, Argentina, was used, consisting of 40 items measured on a (true / false) dichotomous scale. The sample consisted of 1076 psychology students from the National University of Mar del Plata, Argentina. Exploratory and confirmatory factor analyzes were performed. The factorial analysis resulted in six factors containing 37 items. Internal consistency of each subscale was adequate. Concurrent validity was satisfactory inasmuch as scores on the subscales about beliefs associated with positive effects of consumption in social situations relate to heavy episodic drinking. Instruments like this one to evaluate expectancies, will allow the study of psychosocial factors associated with consumption and provide useful information to develop prevention strategies.
Resumo O objetivo do presente trabalho foi analisar as propriedades psicométricas (estrutura fatorial, consistência interna e validade concorrente) de uma versão adaptada do Alcohol Expectancy Questionnaire Adolescents (AEQ-A) em estudantes universitários da cidade de Mar del Plata, Argentina. As expectativas para os efeitos do álcool referem-se às crenças que as pessoas têm sobre os efeitos que produz o consumo de álcool no comportamento, e têm sido relacionadas com o início, a manutenção e os padrões de consumo. Embora tenham sido desenvolvidos vários instrumentos para sua medida, o AEQ-A tem sido um dos mais utilizados; no entanto devido à variabilidade cultural das expectativas, é recomendável realizar adaptações deste aos contextos particulares em estudo. Para este trabalho, utilizou-se uma versão do AEQ-A previamente validada em Mar del Plata, Argentina, que consta de 40 itens medidos numa escala dicotômica (verdadeiro/falso). A amostra esteve composta por 1076 estudantes de Psicologia da Universidad Nacional de Mar del Plata. Realizaram-se análises fatoriais exploratórias e confirmatórias, nas quais se encontrou uma estrutura de seis fatores que reuniram 37 itens. A consistência interna de cada subescala foi adequada e a validade concorrente foi satisfatóriajá que as pontuações nas subescalas de crenças sobre os efeitos positivos do consumo em situações sociais relacionaram-se com o consumo excessivo episódico. Concluiu-se que contar com instrumentos de avaliação das expectativas permitirá estudar os fatores psicossociais associados ao consumo e dar informação útil para a elaboração de intervenções.
Resumen El objetivo del presente trabajo fue analizar las propiedades psicométricas (estructura factorial, consistencia interna y validez concurrente) de una versión adaptada del Alcohol Expectancy Questionnaire Adolescents (AEQ-A) en estudiantes universitarios de la ciudad de Mar del Plata, Argentina. Las expectativas hacia los efectos del alcohol se refieren a las creencias que las personas tienen sobre los efectos que produce el consumo de alcohol en el comportamiento, y han sido relacionadas con el inicio, el mantenimiento y los patrones de consumo. Si bien se han desarrollado varios instrumentos para su medición, el AEQ-A ha sido uno de los más utilizados; sin embargo debido a la variabilidad cultural de las expectativas, es recomendable realizar adaptaciones del mismo a los contextos particulares en estudio. Para este trabajo se utilizó una versión del AEQ-A previamente validada en Mar del Plata, Argentina, que consta de 40 ítems medidos en una escala dicotómica (verdadero/falso). La muestra estuvo compuesta por 1076 estudiantes de Psicología de la Universidad Nacional de Mar del Plata. Se realizaron análisis factoriales exploratorios y confirmatorios, en los cuales se encontró una estructura de seis factores que reunieron 37 ítems. La consistencia interna de cada subescala fue adecuada y la validez concurrente fue satisfactoria ya que los puntajes en las subescalas de creencias sobre los efectos positivos del consumo en situaciones sociales se relacionaron con el consumo excesivo episódico. Se concluyó que contar con instrumentos de evaluación de las expectativas permitirá estudiar los factores psicosociales asociados al consumo y brindar información útil para el diseño de intervenciones.
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Humanos , Adulto Joven , Estudiantes , AlcoholismoRESUMEN
Introducción: las expectativas hacia el consumo de alcohol se definen como creencias de los efectos del alcohol sobre el comportamiento y podrían predecir su consumo. El objetivo de este trabajo es resumir la información disponible sobre los cuestionarios que las miden y su validez. Métodos: se realizaron búsquedas en las bases de datos Pubmed, Scopus, PsycINFO, Lilacs y Scielo, seleccionando estudios sobre la validez de los cuestionarios. La calidad del material se evaluó con la guía CASP y la síntesis de datos fue cualitativa. Resultados: de las 133 referencias resultantes, 56 se eliminaron por repetirse, 52 por no ser de la temática/objetivo, y se agregaron 7 de otras fuentes. Se hallaron 16 instrumentos con buenos índices de fiabilidad y validez, algunos de ellos utilizados eficazmente para predecir el consumo de alcohol. Conclusión: los cuestionarios de expectativas hacia el consumo de alcohol podrían constituir una herramienta útil para la investigación, evaluación clínica y tamizaje.
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Humanos , Alcoholismo , Cribado de LíquidosRESUMEN
El consumo intensivo episódico (CIEA) constituye un problema de salud pública que afecta a los más jóvenes. El estudio de los determinantes cognitivo motivacionales de este patrón de consumo es un área reciente y en creciente desarrollo. Una de las teorías que se ha mostrado adecuada para la explicación de esta conducta es la Teoría del Comportamiento Planeado (TCP). Este trabajo tiene como objetivo estudiar la relación entre la intención de CIEA, la actitud, la norma subjetiva y la percepción de control conductual en estudiantes secundarios diferenciándolos por género. Método: La muestra fue intencional, de estudiantes secundarios (n = 185) de la ciudad de Mar del Plata (Argentina) de 12-18 años. Se utilizó un cuestionario que indagaba sobre: patrones de consumo, variables de la TCP, edad y sexo. Se realizaron análisis de regresión jerárquica para varones y mujeres por separado, considerando la intención como variable dependiente. Resultados: La principal variable que predice la intención de CIEA, tanto para varones como mujeres es la actitud. La norma subjetiva resultó predictora únicamente en mujeres. Conclusiones: las creencias y evaluaciones respecto al CIEA juegan un importante papel en la disposición para realizar el comportamiento. En el caso de las mujeres también incide la norma subjetiva. Si bien este estudio posee algunas limitaciones, sus resultados permiten aproximarse al estudio de los factores cognitivos motivacionales relacionados con el CIEA en adolescentes, de acuerdo al género.
Binge drinking (BD) is a public health problem that affects younger people. The study of cognitive motivational determinants of this consumption pattern is a growing and recently developed area. One theory that has proved to be adequate for the explanation of this behavior is the Theory of Planned Behavior (TPB). This paper aims to study the relationship between BD intention, attitude, subjective norm and perceived behavioral control in high school students, by gender. Method: The sampling was intentional, comprising high school students (n = 185) of the city of Mar del Plata (Argentina) from 12 -18 years old. A questionnaire was developed inquiring about: habitual consumption pattern, TPB variables, age and gender. Hierarchical regression analyses were conducted for men and women separately, considering intention as the dependent variable. Results: The main variable that predicted intention of BD, for both, males and females, was the attitude. The subjective norm was a predictor only in females. Conclusions: Beliefs and evaluations regarding the BD play a significant role in the disposition for the behavior. For females, subjective norms also affected intention of BD. While this study had some limitations, results highlight the importance of the study of cognitive motivational factors related to BD in adolescents by gender.
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Humanos , Adolescente , Alcoholismo , Asunción de Riesgos , Consumo de Bebidas AlcohólicasAsunto(s)
Niño , Conducta , Conducta Infantil , Factores de Riesgo , Conducta de Reducción del Riesgo , Asunción de RiesgosRESUMEN
Este trabalho oferece uma visão geral da literatura científica publicada no âmbito da Psicologia do Trânsito. A revisão se baseia no estudo extensivo de referências, se analiza a evolução da produção no período, se identificam as publicações mais representativas da área e os paises mais produtivos. Assim, analizam-se as palavras-chave dos artigos com a finalidade de identificar e descrever os principais temas e áreas de investigação. Esta análise completa-se com a revisão dos resumos e artigos completos publicados na revista Transportation Research Part F: Traffic Psychology & Behaviour, que pode ser considerado o principal âmbito de publicação na área. Espera-se que este trabalho contribua para um maior conhecimento e difusão da Psicología do Trânsito e permita o desenvolvimento de áreas de investigação na América Latina.
This paper offers a general overview of the scientific literature published in the area of Traffic Psychology. The review is based on a study of bibliographic references gathered from the PsycINFO, data base from 2000 to 2006. The evolution of the production in the period is analyzed, and the most representative publications of the area and the most productive countries are identified. Also, the key words of the papers are analyzed in order to identifying the main research topics. This analysis is complemented with a review of the abstracts and the full text papers published in 'Transportation Research Part F: Traffic Psychology & Behaviour', which is the most representative journal in the area. The intention is to contribute to a greater knowledge of the Traffic Psychology and stimulate the Latin American researchers to initiate research projects in the area.
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Conducta , Publicación Periódica , Psicología Aplicada , Indicadores de Producción CientíficaRESUMEN
The objective of the study was to assess the use of helmets in a community where helmet use is mandatory but low as there is no police enforcement. A sample comprising 451 motorcyclists in the city of Mar del Plata, Argentina, was studied in 2006. The following variables were studied: gender, type of motorcycle, weather conditions, time of the day, city area and type of road where motorcyclists traveled. Data were analyzed through a multiple logistic regression model. An overall 40 percent prevalence (95 percent CI: 35.5;44.5) of helmet use was found. Higher rates of helmet use were seen among women, and under unfavorable weather conditions, lower rates were found in the city outskirts, and variable use was seen according to the type of motorcycle. There is a need to improve law enforcement and to promote education of motorcyclists.
O estudo teve por objetivo analisar o uso de capacetes em uma comunidade onde, embora o uso seja obrigatório, não há policiamento e o uso é baixo. A amostra foi composta por 451 motociclistas observados na cidade de Mar del Plata, Argentina, em 2006. As variáveis estudadas foram: sexo do motociclista, tipo de motocicleta, condições climáticas, hora do dia, região da cidade e tipo de via em que circulavam as motocicletas.Os dados foram analisados em modelo de regressão logística múltipla. A prevalência do uso do capacete foi de 40 por cento (IC 95 por cento: 35,5;44,5), com maior uso pelas mulheres e em condições climáticas desfavoráveis, menor uso na periferia da cidade e variações segundo o tipo de motocicleta. Os resultados mostram a necessidade de haver maior controle e melhor educação dos condutores motociclistas.
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Accidentes de Tránsito/prevención & control , Dispositivos de Protección de la Cabeza , Motocicletas , ArgentinaRESUMEN
Este trabajo analiza la relaciones entre el rasgo Búsqueda Impulsiva Sensaciones (ImpSS) y los comportamientos de riesgo durante la conducción. Se trabaja con una muestra no-probabilística por cuotas de edad y sexo, compuesta por 204 conductores de la ciudad de Mar del Plata (Argentina). Los datos se obtienen mediante la escala de ImpSS del cuestionario de personalidad de Zuckerman-Kuhlman y una escala tipo Likert compuesta por un conjunto de ítems que indagan conductas de riesgo en la conducción. La relación entre ambos constructos se analiza para la muestra total y para los subgrupos definidos por género y edad. Los resultados indican la existencia de una correlación positiva entre las variables para la muestra total. Esta correlación resulta más pronunciada en los grupos de menor edad, especialmente los hombres jóvenes. Los hallazgos van en el sentido de lo que indica la literatura previa proveniente de otros países y culturas. Se discuten las consecuencias prácticas de estos resultados.
This paper analyzes the relationship between Impulsive Sensation Seeking (ImpSS) and risky driving behaviour. Participants are 204 Argentinean drivers from a non-probabilistic sample stratified by gender and age. Impulsive Sensation Seeking is measured by the ImpSS scale from the ZKPQ personality questionnaire. Risky driving is assessed by a Likert type scale containing items that are indicators of several risky driving behaviours. The correlation between both constructs is analyzed for the total sample and for sub-samples of age and gender. The results indicate a positive correlation between the variables for the total sample. The correlation is stronger for the group of young people; especially, for the young men sub-sample. Our findings are according to the previous research from others countries and cultures. The practical implications of these results are discussed.