RESUMO
INTRODUCTION: Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries. AIM: The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers. METHOD: This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated. EXPECTED RESULTS: Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731).
INTRODUCCIÓN: La sensibilidad y la mentalización materna constituyen competencias fundamentales para el desarrollo de la salud mental infantil. A su vez, dichas habilidades han sido negativamente asociadas con la presencia de sintomatología depresiva postparto, la cual aumenta su prevalencia en contextos de bajo nivel socioeconómico y riesgo psicosocial, en donde el acceso a tratamiento escasea. Paralelamente, si bien internacionalmente el video-retroalimentación constituye una herramienta efectiva en intervenciones basadas en el apego, el costo, idioma y necesidad de adaptación cultural dificultan su implementación en países latinoamericanos. OBJETIVO: Evaluar la factibilidad y aceptabilidad de una video-intervención informada por la mentalización, dirigida a díadas madre-bebé con sintomatología depresiva, atendidas en centros públicos de atención en salud mental en Chile. MÉTODOS: Ensayo clínico aleatorio piloto con dos grupos de 60 díadas madre-bebé de entre 4 y 12 meses de edad, quienes serán asignados aleatoriamente a grupos control y experimental en una proporción de 1:1. Si bien ambos grupos recibirán el tratamiento habitual, el grupo experimental recibirá también la video-intervención. Al término del estudio se evaluará la factibilidad a partir de grupos focales dirigidos a interventores e indicadores de resultados cuantitativos tales como tasa de reclutamiento, de completación de cuestionarios y finalización de la intervención. La aceptabilidad se evaluará a partir de entrevistas en profundidad a las participantes. Adicionalmente se calculará tamaño del efecto de indicadores de resultados primarios y secundarios. RESULTADOS ESPERADOS: Se espera que los resultados del estudio generen parámetros para diseñar un ensayo clínico de mayor escala y evaluar preliminarmente el efecto de la intervención informada en la mentalización en la sensibilidad materna. Se busca además contribuir con una intervención en salud mental basada en la teoría del apego dirigida a díadas madre-bebé de bajos ingresos, que pueda ser implementada de manera remota, a bajo costo y apta para ser escalada a los sistemas de atención en salud mental.
Assuntos
Humanos , Feminino , Lactente , Depressão/terapia , Mães/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos de Viabilidade , Saúde Mental , RetroalimentaçãoRESUMO
Resumen Antecedentes Las mujeres universitarias socioeconómicamente vulnerables son un grupo de riesgo para desarrollar problemas de salud mental durante la pandemia por COVID-19, encontrándose que la regulación emocional y factores de apoyo docente pueden moderar este efecto. Objetivo Evaluar un modelo de moderación moderada del apoyo docente sobre las estrategias de regulación emocional (ERE) en la relación entre estresores académicos y sintomatología depresiva en universitarias socioeconómicamente vulnerables. Método 371 mujeres entre 18 y 29 años que cursaban estudios superiores completaron una encuesta donde se evaluó la sintomatología depresiva a través del PHQ-9 y las ERE mediante el CERQ. Para evaluar los estresores académicos y percepción del apoyo docente, se diseñaron preguntas específicas. Resultados Se identificaron dos modelos de efectos indirectos que mostraron que un bajo apoyo docente moderó la moderación de niveles bajos y medios de la estrategia de regulación de planificación en la relación entre los estresores académicos "calidad de aprendizaje online" y "preocupación por el rendimiento académico" con la sintomatología depresiva. Conclusiones Se discute sobre el rol de estrategias de regulación emocional que apuntan a aspectos metacognitivos y apoyo docente como factores protectores para este grupo específico frente a los estresores académicos, principalmente ligados al rendimiento académico.
Abstract Background female university students from socioeconomically vulnerable groups is a high-risk group for the development of mental health problems in the covid-19 pandemic. Objective To evaluate the moderating role of teacher support on emotional regulation strategies (ERS) in the relationship between academic stressors (AS) and depressive symptoms in female university students from socioeconomically vulnerable groups. Method 371 women between 18 and 29 years old who were in higher education completed a survey where depressive symptoms were evaluated through the PHQ-9 and the ERD through CERQ. To assess academic stressors and perception of teacher support, specific questions were designed. Results Two indirect effect models were identified that showed that low teacher support moderated the moderation of low and medium levels of ERS planning in the relationship of "quality of online learning" and "concern for academic performance" with depressive symptoms. Conclusions The role of ERS that points to metacognitive aspects and teaching support as protective factors for this specific group against AS, mainly linked to academic performance is discussed at the end.
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Humanos , Feminino , Adolescente , Adulto , COVID-19 , Inquéritos e QuestionáriosRESUMO
Background: Chilean higher education students have faced highly stressful events in 2020, including confinement and remote education. This population is particularly susceptible to mental health problems, such as high levels of stress, anxiety, and depression. Aim: To evaluate possible negative impacts of confinement by COVID-19 on Chilean higher education students' mental health. Material and Methods: The Center for Epidemiologic Studies Depression Scale (CES-D) Scale and the Profile of Mood States (POMS) were applied to 315 students during 2016 and to 301 students during 2020. Results: In 2020, depression mean scores for men (24.1) and women (29.7) exceeded the cutoff point, therefore suggesting the presence of depressive disorder. Women had higher depressive and anxious symptoms in both years, however, in 2020 a significant increase was observed for depression, indicating interaction between the year of assessment andgender (0 = 6.74; p <.001). In both samples, first-year students hadsignificantly higherdepressionscores (fl = −1,909;p = 0.05). Conclusions: An increase in depression was observed in 2020. Confinement by COVID-19 had a high impact on mental health in female students. Women and first-year students appear to be high risk groups for developing depressive symptoms.