ABSTRACT
BACKGROUND: Early adverse stress is a risk factor for the appearance of mental health ailments during adulthood. AIM: To systematically review treatment outcomes on mental health symptoms and functional domains, and of interventions aimed at treating adults with depressive disorders and early adverse stress (EAS). MATERIAL AND METHODS: Systematic review and meta-analysis including experimental and quasi-experimental published studies indexed in the CINAHL, EMBASE, PubMed, and Web of Science databases, which explored the effectiveness of treatment interventions for depressive disorders in adults exposed to EAS. Data on outcomes was extracted from the included studies. A narrative, qualitative approach or a quality-effects model for meta-analysis were used for synthesizing these data. RESULTS: Thirteen studies were included. Psychological or combined treatment interventions for depression in adults exposed to EAS may be effective in reducing trauma-related symptoms and social dysfunction in the short-and mid-term, with small effect size and without substantive heterogeneity. The assessment of anxiety symptoms and health-related quality of life yielded mixed results. CONCLUSIONS: Despite the ubiquity of EAS and its adverse and long-lasting consequences for well-being and health, treatment alternatives are scant. This review suggests that there are treatment interventions for depression in adults exposed to EAS that may achieve integral mental health benefits, alleviating its impact on various symptoms and functional domains, when EAS is explicitly considered in the treatment intervention.
Subject(s)
Humans , Adult , Quality of Life , Mental Disorders/psychology , Anxiety , Mental Health , Treatment OutcomeABSTRACT
OBJECTIVE: We assessed the prevalence of bullying and cyberbullying in 12-16-year-olds and the association with student self-reports after a police informative talk. DESIGN: We used a survey to assess the impact of the intervention: 1458 high school students received a police informative talk during the 2018-2019 school year and completed the self-administered EBIP-Q and ECI-Q questionnaires. Perceptions of conduct and bystanders' attitudes were assessed. Correspondence indexes were calculated using Cohen's kappa and gender differences studied using logistic regression. RESULTS: 81.34% (95% CI: 79.33-83.34) of students were involved in bullying and 54.75% (95% CI: 52.19-56.76) in cyberbullying. Almost 90% of participants did not perceive their real bullying correctly. Girls were more frequently victims of bullying and cyberbullying (OR = 1.67 and OR = 1.22, p = .004), but more frequently self-reported being bullies or victim/bully (OR = 0.57 and 0.39, p < .05). Male bystanders reported 7.33% (p < .001) more feelings of inadequacy than girls when witnessing bullying. CONCLUSION: Poor self-reporting reflects poor understanding of bullying and cyber-bullying. Police information sessions might produce the opposite reactions in adolescents, as they reduce bullying to visible, harmful violence. Educators should focus on adolescent relationships rather than violence prevention. A friendly, male-targeted approach is needed.
Subject(s)
Bullying , Crime Victims , Adolescent , Female , Humans , Male , Police , Prevalence , Self Report , Surveys and QuestionnairesABSTRACT
Introduction: A significant proportion of adults with depressive or bipolar disorders exposed to early adverse stressors do not adequately respond to standard treatments. This review aimed at synthesizing the evidence on the effectiveness of treatment interventions for depressive or bipolar disorders in adult individuals (aged 18 years or more) exposed to adverse stress early in life. Methods: Systematic review and meta-analysis including experimental and quasi-experimental published studies indexed in CINAHL, EMBASE, PubMed, and Web of Science databases and/or in reference lists. Data management and critical appraisal (with the Study Quality Assessment Tools) was conducted independently by multiple researchers. A quality-effects model for meta-analysis was used for data synthesis and publication bias was assessed using the Doi plot and LFK index. The main outcome was short-term reductions in depressive symptoms. Results: Eight randomized controlled trials, three controlled before-and-after (pre-post) studies, and three uncontrolled before-and-after studies were included. Studies lacked bipolar disorder patients. Unclear randomization procedures and reporting of blinded outcome assessor, and limited use of intention-to-treat analysis, were relevant potential sources of bias. Meta-analyses indicated that psychological, pharmacological, and combined interventions were effective in reducing depressive symptoms in the short- (Cohen's d = -0.55, 95% CI -0.75 to -0.36, I 2 = 0%) and mid-term (Cohen's d = -0.66, 95% CI -1.07 to -0.25, I 2 = 65.0%). However, a high risk of publication bias was detected for these outcomes. A small number of studies, with mixed results, reported interventions with long-term improvements in depressive symptomatology, and short- and mid-term response to treatment and remission. Conclusion: Despite the well-documented long-lasting, negative, and costly impact of early adverse stressors on adult psychopathology, evidence on treatment alternatives remains scant. Trauma-focused treatment interventions-whether psychological interventions alone or in combination with pharmacotherapy-may have the potential to reduce the severity of depressive symptom in adults who were exposed to early adverse stress. Findings must be interpreted with considerable caution, as important study and outcome-level limitations were observed and gray literature was not considered in this systematic review and meta-analysis.
ABSTRACT
BACKGROUND: Early adverse stress is a risk factor for the appearance of mental health ailments during adulthood. AIM: To systematically review treatment outcomes on mental health symptoms and functional domains, and of interventions aimed at treating adults with depressive disorders and early adverse stress (EAS). MATERIAL AND METHODS: Systematic review and meta-analysis including experimental and quasi-experimental published studies indexed in the CINAHL, EMBASE, PubMed, and Web of Science databases, which explored the effectiveness of treatment interventions for depressive disorders in adults exposed to EAS. Data on outcomes was extracted from the included studies. A narrative, qualitative approach or a quality-effects model for meta-analysis were used for synthesizing these data. RESULTS: Thirteen studies were included. Psychological or combined treatment interventions for depression in adults exposed to EAS may be effective in reducing trauma-related symptoms and social dysfunction in the short-and mid-term, with small effect size and without substantive heterogeneity. The assessment of anxiety symptoms and health-related quality of life yielded mixed results. CONCLUSIONS: Despite the ubiquity of EAS and its adverse and long-lasting consequences for well-being and health, treatment alternatives are scant. This review suggests that there are treatment interventions for depression in adults exposed to EAS that may achieve integral mental health benefits, alleviating its impact on various symptoms and functional domains, when EAS is explicitly considered in the treatment intervention.
Subject(s)
Mental Disorders , Quality of Life , Adult , Anxiety , Humans , Mental Disorders/psychology , Mental Health , Treatment OutcomeABSTRACT
BACKGROUND: Childhood Trauma Questionnaire-Short Form (CTQ-SF) is an instrument to assess child abuse and neglect Aim: to adapt and confirm the psychometric properties of the Spanish version of the CTQ-SF in Chile. MATERIAL AND METHODS: The CTQ-SF was applied to 89 clinically depressed subjects (77.5% women) who consulted at an outpatient mental health clinic. Confirmatory factor analysis (CFA), reliability (Cronbach's α) tests, and convergent validity analyses with clinical markers of complex depression were carried out. RESULTS: The Chilean version of the CTQ-SF demonstrated an acceptable fit to a five-factor model, with adequate psychometric properties. The CFA revealed that a better fit to a five-factor model would be achieved after elimination of two items from the physical neglect scale, the less reliable scale of the questionnaire. The physical abuse scale discriminated between patients with a complex depression versus non-complex depression, and all the CTQ-SF's scales discriminated between patients with high suicide risk and/or history of psychiatric admissions versus those patients without this background. CONCLUSIONS: the Chilean version of the CTQ-SF shows evidence of structural and discriminant validity, and reliability, in a clinical sample. Better alternatives to specifically assess the physical neglect construct should be developed.
Subject(s)
Surveys and Questionnaires , Child , Chile , Factor Analysis, Statistical , Female , Humans , Male , Psychometrics , Reproducibility of ResultsABSTRACT
Background: Childhood Trauma Questionnaire-Short Form (CTQ-SF) is an instrument to assess child abuse and neglect Aim: to adapt and confirm the psychometric properties of the Spanish version of the CTQ-SF in Chile. Material and Methods: The CTQ-SF was applied to 89 clinically depressed subjects (77.5% women) who consulted at an outpatient mental health clinic. Confirmatory factor analysis (CFA), reliability (Cronbach's α) tests, and convergent validity analyses with clinical markers of complex depression were carried out. Results: The Chilean version of the CTQ-SF demonstrated an acceptable fit to a five-factor model, with adequate psychometric properties. The CFA revealed that a better fit to a five-factor model would be achieved after elimination of two items from the physical neglect scale, the less reliable scale of the questionnaire. The physical abuse scale discriminated between patients with a complex depression versus non-complex depression, and all the CTQ-SF's scales discriminated between patients with high suicide risk and/or history of psychiatric admissions versus those patients without this background. Conclusions: the Chilean version of the CTQ-SF shows evidence of structural and discriminant validity, and reliability, in a clinical sample. Better alternatives to specifically assess the physical neglect construct should be developed.
Subject(s)
Humans , Male , Female , Child , Surveys and Questionnaires , Psychometrics , Chile , Reproducibility of Results , Factor Analysis, StatisticalABSTRACT
La actual tendencia de modelos asistenciales es de proporcionar atención personalizada y de calidad a través de constante colaboración interprofesional de la cual rsultan beneficiados el usuario como la Institución que oferta el servicio. El presente trabajo de investigación tiene como objetivoconocer la situación actual del fisoterapeuta en ámbito laboral. Para dicho fin el universo son todos los fisoterapeutas egresados de la carrera de Terpaia Física de la Facultad de Medicna de la universidad Mayor de San Andrés, que radican en la ciudades de La Paz y El Alto en el area urbana. La investigación abarca a 115 profesionales de los 461 que se encuentran registrados en la carrera de Terapia Física, gestión 1981 a 1998. Para dicho estudio se tomó encuenta año de egreso, edad, sexo, estado civil, condición bajo la cual trabaja, carga horaria, costo por servicios profesionales, salario básico percibido, estudios superiores obtenidos, especialidades a las que se dedican y su criterio sobre la demanda laboral...
