ABSTRACT
BACKGROUND: Bullying is a common form of violence among children and adolescents. Young people with neurodevelopmental or psychiatric conditions might have an increased risk of bullying victimisation and perpetration. We aimed to assess the odds of bullying involvement and its association with mental health measures in these populations. METHODS: In this systematic review and meta-analysis, we searched PubMed, ERIC, Psychology and Behavioural Sciences Collection, Web of Science Core Collection, PsycArticles, and PsycInfo databases from inception up to Aug 8, 2023, and included articles reporting data on bullying outcomes of current bullying (within the past year) among children and adolescents (aged 4-17 years) with a diagnosis of a neurodevelopmental or psychiatric condtion provided by a health professional. Bullying type was classified as traditional (physical, verbal, or relational) or as cyberbullying (intentional and repeated harm inflicted through electronic devices and social media), and bullying involvement was classified as victimisation, perpetration, and perpetration-victimisation. Mental health measures were collected and the associations with bullying involvement assessed. We used random-effects meta-analyses to estimate prevalence and odds ratios (ORs) for bullying involvement. Heterogeneity was assessed using the I2 statistic, and publication bias was tested with Egger's regression. This study is registered with PROSPERO, CRD42021235043. FINDINGS: We included 212 studies in the meta-analysis. The total sample comprised 126 717 cases (mean age 12·34 years [SD 1·82], 37·6% girls) and 504 806 controls (12·5 years [SD 1·86], 47·6% girls). For traditional bullying, the pooled prevalence was 42·2% (95% CI 39·6-44·9) for victimisation, 24·4% (22·6-26·3) for perpetration, and 14·0% (11·4-17·1) for perpetration-victimisation. For cyberbullying, the prevalence was 21·8% (16·0-28·9) for victimisation, 19·6% (13·4-27·7) for perpetration, and 20·7% (8·4-42·6) for perpetration-victimisation. Compared with controls, young people with neurodevelopmental or psychiatric conditions were more likely to be involved in traditional and cyberbullying as a victim (OR 2·85 [95% CI 2·62-3·09] and 2·07 [1·63-2·61]), perpetrator (2·42 [2·20-2·66] and 1·91 [1·60-2·28]), and perpetrator-victim (3·66 [2·83-4·74] and 1·85 [1·05-3·28]). Bullying involvement was associated with higher scores in mental health measures in young people with neurodevelopmental or psychiatric conditions, particularly internalising symptoms and externalising symptoms. INTERPRETATION: Our study underscores bullying involvement as a prevalent risk factor in young people with neurodevelopmental or psychiatric conditions that might add to their disease burden through its negative effects on mental health. Interventions targeting these vulnerable populations are warranted to improve their mental health and their future social integration. FUNDING: Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Consorcio Centro de Investigación Biomédica en Red.
Subject(s)
Bullying , Crime Victims , Cyberbullying , Mental Disorders , Female , Child , Humans , Adolescent , Male , Cyberbullying/psychology , Mental Disorders/epidemiology , Crime Victims/psychology , ViolenceABSTRACT
Los comportamientos autolesivos y suicidas en adolescentes, por su creciente prevalencia como por sus fatales consecuencias, son en nuestrosdías un problema de salud pública que requiere de intervenciones eficaces. Con el objetivo de dilucidar los tratamientos psicológicos que, hasta lafecha, mejor funcionan para reducir o eliminar estos comportamientos, se realizó una revisión de estudios de metaanálisis y revisiones sistemáticasen las bases de datos PsycArticles, PsycInfo y MEDLINE. Los criterios de elegibilidad establecidos permitieron la selección final de 10 registros.Los resultados mostraron una elevada heterogeneidad y un alcance limitado de los tratamientos psicológicos con tamaños del efecto de pequeñosa moderados tanto para las conductas autolesivas, como para la ideación suicida, la suicidabilidad y especialmente para la intención suicida. Estosefectos tendían a debilitarse o desaparecer en el medio y largo plazo. La Terapia Dialéctica Conductual (TDC) resultó ser comparativamente la quemejores resultados obtuvo de las intervenciones analizadas. El alcance restringido de los resultados y las importantes limitaciones metodológicashalladas alertan de la necesidad de más investigación, así como del futuro diseño de intervenciones específicas para este tipo de problemas. (AU)
Self-injurious and suicidal behaviors in adolescents are nowadays a public health problem that requires effective interventions. In order to elucidate the psychological treatments that, to date,work best to reduce or eliminate these behaviors, a review of meta-analysis and systematic reviews was carried out in the PsycArticles, PsycInfo andMEDLINE databases. The established eligibility criteria allowed the final selection of 10 records. The results showed high heterogeneity and poorresults for the psychological treatments with small to moderate effect sizes for self-injurious behaviors, suicidal ideation, suicidality and especiallyfor suicidal attempts. These effects tended to weaken or disappear in the medium to long term. Dialectical Behavior Therapy (DBT) proved to becomparatively the best performing of the interventions analyzed. The limited scope of the results and the important methodological limitations alertus to the need for further research and the future design of specific interventions for this type of problems. (AU)
Subject(s)
Humans , Adolescent , Psychotherapy/methods , Psychotherapy/trends , Self-Injurious Behavior/psychology , Self-Injurious Behavior/therapy , Suicide/psychology , Adolescent , Review Literature as Topic , Treatment OutcomeABSTRACT
Stress is a widespread problem in today's societies, having important consequences on brain function. Among the plethora of mechanisms involved in the stress response at the molecular level, the role of microRNAs (miRNAs) is beginning to be recognized. The control of gene expression by these noncoding RNAs makes them essential regulators of neuronal and synaptic physiology, and alterations in their levels have been associated with pathological conditions and mental disorders. In particular, the excitatory (i.e., glutamate-mediated) neurotransmission is importantly affected by stress. Here, we found that loss of miR-26a-5p (miR-26a henceforth) function in primary hippocampal neurons increased the frequency and amplitude of miniature excitatory currents, as well as the expression levels of the excitatory postsynaptic scaffolding protein PSD95. Incubation of primary hippocampal neurons with corticosterone downregulated miR-26a, an effect that mirrored our in vivo results, as miR-26a was downregulated in the hippocampus as well as in blood serum-derived small extracellular vesicles (sEVs) of rats exposed to two different stress paradigms by movement restriction (i.e., stress by restraint in cages or by complete immobilization in bags). Overall, these results suggest that miR-26a may be involved in the generalized stress response and that a stress-induced downregulation of miR-26a could have long-term effects on glutamate neurotransmission.
Subject(s)
Biomarkers/metabolism , Extracellular Vesicles/metabolism , MicroRNAs/metabolism , Stress, Psychological/genetics , Synaptic Transmission , Animals , Disease Models, Animal , Disks Large Homolog 4 Protein , Down-Regulation/genetics , MicroRNAs/blood , MicroRNAs/genetics , Miniature Postsynaptic Potentials , Rats, Sprague-Dawley , Synapses/metabolism , Synaptic Transmission/geneticsABSTRACT
Bacteria frequently cooperate by sharing secreted metabolites such as enzymes and siderophores. The expression of such 'public good' traits can be interdependent, and studies on laboratory systems have shown that trait linkage affects eco-evolutionary dynamics within bacterial communities. Here, we examine whether linkage among social traits occurs in natural habitats by examining investment levels and correlations between five public goods (biosurfactants, biofilm components, proteases, pyoverdines and toxic compounds) in 315 Pseudomonas isolates from soil and freshwater communities. Our phenotypic assays revealed that (i) social trait expression profiles varied dramatically; (ii) correlations between traits were frequent, exclusively positive and sometimes habitat-specific; and (iii) heterogeneous (specialised) trait repertoires were rarer than homogeneous (unspecialised) repertoires. Our results show that most isolates lie on a continuum between a 'social' type producing multiple public goods, and an 'asocial' type showing low investment into social traits. This segregation could reflect local adaptation to different microhabitats, or emerge from interactions between different social strategies. In the latter case, our findings suggest that the scope for competition among unspecialised isolates exceeds the scope for mutualistic exchange of different public goods between specialised isolates. Overall, our results indicate that complex interdependencies among social traits shape microbial lifestyles in nature.
Subject(s)
Biological Factors/metabolism , Microbiota , Pseudomonas/physiology , Adaptation, Physiological , Biological Evolution , Ecosystem , Fresh Water/microbiology , Microbial Interactions , Phenotype , Pseudomonas/metabolism , Soil MicrobiologyABSTRACT
The differential contribution of maternal and paternal acceptance-rejection to children's psychological adjustment has been explained by differences in interpersonal power and prestige within families; however, there is not yet enough empirical support for this explanation. This study examines the moderating effects of interpersonal power and prestige on the relationship between perceived parental acceptance-rejection and psychological adjustment across children's sex and age. The sample was composed of 913 children ranging in age from 9 to 16 years. Multiple hierarchical regression analyses in the total sample showed a significant and independent contribution of parental acceptance-rejection and parental power and prestige. No moderating effects of interpersonal power and prestige were found for the total sample. However, when the regression analyses were conducted across different age groups, maternal acceptance had a higher contribution to psychological adjustment in children from nine to ten years old. Interestingly, the moderating effects of interpersonal prestige (not interpersonal power) were also significant in younger participants. Furthermore, the moderating effects of prestige on maternal acceptance-rejection were different in late childhood than in early adolescence. These results suggest how parental prestige may explain the higher contribution of maternal acceptance to younger children's psychological adjustment.
Subject(s)
Emotional Adjustment , Parent-Child Relations , Power, Psychological , Adaptation, Psychological , Adolescent , Age Factors , Child , Fathers/psychology , Female , Humans , Male , Models, Psychological , Mothers/psychology , Rejection, Psychology , Spain , Surveys and QuestionnairesABSTRACT
El presente estudio explora la dimensionalidad de la "Escala de depresión del Centro de Estudios Epidemiológicos para niños y adolescentes" (CES-DC; Radloff, 1977, 1991) en una muestra de 986 niños y adolescentes españoles (55% chicas) con edades entre los 9 y 18 anos. Se realizo un análisis factorial confirmatorio para un modelo de cuatro factores de primer orden basado en la estructura original (Afecto depresivo, Somatización, Afecto positivo y Problemas interpersonales), así como para otro modelo alternativo de segundo orden que agrega los factores previos. Se examinaron las propiedades psicométricas por items, por dimensiones y para la escala total. También se valoro la validez de criterio con diferentes variables que teóricamente se relacionan con la sintomatología depresiva. Los resultados muestran que los modelos explorados son adecuados para la población infantojuvenil española con pruebas de validez de criterio y propiedades psicométricas satisfactorias. Se discute el potencial discriminativo y las cualidades de la escala para la evaluación de la sintomatología depresiva en niños y adolescentes
The present study explores the dimensionality of the Center for Epidemiological Studies Depression Scale for Children and Adolescents (CES-DC; Radloff, 1977, 1991) in a sample of 986 Spanish children and adolescents (55% girls) between 9 and 18 years old. Confirmatory factor analysis was performed for a first order 4-factor model based on the original structure (Depressed affect, Somatic, Positive affect, and Interpersonal difficulties) and for another alternative model of second order which includes the previous factors. We examined the psychometric properties by items, by dimensions and for the total scale. The criterion validity was also evaluated with different variables which are theoretically related to the depressive symptomatology. The results show that the tested models are adequate for Spanish children and adolescents. Furthermore, evidence of criterion validity and psychometric properties were satisfactory. The potential discriminant validity and quality of the scale to assess the children's depressive symptoms are discussed
Subject(s)
Humans , Male , Female , Child , Adolescent , Adolescent Behavior/psychology , Stress, Psychological/psychology , Depression/epidemiology , Psychometrics/methods , Child Behavior/psychology , Psychology, Adolescent/statistics & numerical data , Factor Analysis, StatisticalABSTRACT
BACKGROUND: Tear of the anterior cruciate ligament (ACL) is a common ligamentous injury of the knee. Reconstruction of this ligament is often required to restore functional stability of the knee. Outcome of ACL reconstruction is significantly affected by how the graft is fixed to the bone. This study is to determine if there is a different clinical outcome after cortical versus cortical-cancellous suspension femoral fixation in hamstring based anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS: This is a retrospective comparative study conducted between 2006 and 2010. We enrolled patients who underwent arthroscopic ACL reconstruction. Sixty two patients met inclusion criteria and 41 agreed to come for followup assessment. Median age was of 28 years (range 18-39 years). Demographic baseline profile of both groups was similar. The femoral fixation devices were cortical (n = 16) and cortical-cancellous suspension techniques (n = 25). The average period of evolution at the time of assessment was 40 months (range 12-72 months). The patients were examined according to Lachman test (using Rolimeter knee tester), anterior drawer test, pivot shift test, International Knee Documentation Committee questionnaire, and Tegner-Lysholm knee scoring scale. RESULTS: The objective evaluation of the patients (Lachman test) showed better results in terms of stability in the group of patients who underwent the cortical-cancellous suspension method. These differences were not reflected in the assessment of activity level (Tegner-Lysholm), where both groups showed the same results. CONCLUSIONS: ACL reconstruction with both cortical and cortical-cancellous suspension femoral fixation techniques show the same clinical results at medium long followup. However, cortical-cancellous fixations seem to provide greater stability to the reconstruction.
ABSTRACT
Se presenta una revisión sistemática de estudios sobre prevalencia de la violencia en el noviazgo (física, psicológica y sexual) cometida y sufrida en adolescentes y jóvenes. De 1221 referencias iniciales, 113 cumplían con los criterios de calidad preestablecidos (evaluación de la violencia con instrumentos fiables y válidos, muestras superiores a 500 participantes u obtenidas mediante muestreo probabilístico). Se encontró una gran variabilidad en los datos de prevalencia, con rangos de variación entre el 3.8% y el 41.9% en violencia física cometida; entre el 0.4% y el 57.3% en violencia física sufrida; entre el 4.2% y el 97% en violencia psicológica cometida; entre el 8.5% y el 95.5% en violencia psicológica sufrida; entre el 1.2% y el 58.8% en violencia sexual cometida; y entre el 0.1% y el 64.6% en violencia sexual sufrida. Los resultados sugieren una mayor prevalencia en la perpetración de agresiones psicológicas por mujeres y sexuales por los hombres; una mayor victimización psicológica y sexual en mujeres; así como tasas ligeramente superiores de agresiones en los adolescentes que en los adultos jóvenes. Asimismo, en muchos de los trabajos revisados las agresiones tenían una naturaleza bidireccional (AU)
This article conducts a systematic review on the prevalence of dating violence in adolescents and young people. Primary studies about physical, psychological and sexual dating violence (perpetration and victimization) were analyzed. A total of 1,221 references were found and, out of those, 113 met the pre-established quality criteria (studies had to have used assessment tools with evidence of reliability and validity in samples of over 500 participants or obtained through probabilistic sampling). The results showed great variability in the figures on the prevalence of dating violence. Specifically, the percentages range from 3.8% to 41.9% for perpetrated physical violence; from 0.4% to 57.3% for victimized physical violence; from 4.2% to 97% for perpetrated psychological violence; from 8.5% to 95.5% for victimized psychological violence; from 1.2% to 58.8% for perpetrated sexual violence; and finally, from 0.1% to 64.6% for victimized sexual violence. The results suggest a higher prevalence in the perpetration of psychological aggression by women and sexual violence by men; greater psychological and sexual victimization in women; and slightly higher rates of aggression in adolescents than in young adults. Also, in many of the papers the aggression had a bidirectional nature (AU)
Subject(s)
Humans , Male , Female , Adolescent , Violence Against Women , Intimate Partner Violence/psychology , Adolescent Behavior/psychology , Sex Offenses , Sexual Partners/psychology , Crime Victims/psychology , Prevalence , Risk FactorsABSTRACT
This study analyzes how a child's clinical condition modifies the relationship of father involvement, parental (fathers and mothers) acceptance and the child´s psychological adjustment, including the internalizing and externalizing problems. The cohort studied was composed of 226 subjects (61.94% males) with a mean age of 14.08 years, of which 113 children were from an incidental clinical sample and 113 from the general population. Both groups were matched by sex, age and family status, and the data show that the same structure of parent-child relationships that predict the child´s psychological adjustment can be accepted for both the clinical and non-clinical groups of children. However, the intensity of the relationships between the variables father involvement, parental acceptance and the child´s outcomes differed in function of the child's clinical status. Specifically, in the clinically-referred sample compared to non-clinical sample father involvement had a stronger effect on the children´s internalizing (but not the externalizing) problems and on their global psychological adjustment via their perceived maternal acceptance. The role of father involvement in the family relationships of clinical children is discussed. This study provides important evidence to support the need for enhanced paternal participation in the intervention programs for families.
Subject(s)
Adaptation, Psychological , Adolescent Behavior/psychology , Child Behavior/psychology , Emotional Adjustment , Father-Child Relations , Fathers/psychology , Adaptation, Psychological/physiology , Adolescent , Child , Cohort Studies , Emotional Adjustment/physiology , Female , Humans , Male , Mothers/psychology , Parents/psychology , Self Report , Young AdultABSTRACT
BACKGROUND: Biomaterials are widely used to regenerate or substitute bone tissue. In order to evaluate their potential use for clinical applications, these need to be tested and evaluated in vitro with cell culture models. Frequently, immortalized osteoblastic cell lines are used in these studies. However, their uncontrolled proliferation rate, phenotypic changes or aberrations in mitotic processes limits their use in long-term investigations. Recently, we described a new pluripotent-like subpopulation of dental pulp stem cells derived from the third molars (DPPSC) that shows genetic stability and shares some pluripotent characteristics with embryonic stem cells. In this study we aim to describe the use of DPPSC to test biomaterials, since we believe that the biomaterial cues will be more critical in order to enhance the differentiation of pluripotent stem cells. METHODS: The capacity of DPPSC to differentiate into osteogenic lineage was compared with human sarcoma osteogenic cell line (SAOS-2). Collagen and titanium were used to assess the cell behavior in commonly used biomaterials. The analyses were performed by flow cytometry, alkaline phosphatase and mineralization stains, RT-PCR, immunohistochemistry, scanning electron microscopy, Western blot and enzymatic activity. Moreover, the genetic stability was evaluated and compared before and after differentiation by short-comparative genomic hybridization (sCGH). RESULTS: DPPSC showed excellent differentiation into osteogenic lineages expressing bone-related markers similar to SAOS-2. When cells were cultured on biomaterials, DPPSC showed higher initial adhesion levels. Nevertheless, their osteogenic differentiation showed similar trend among both cell types. Interestingly, only DPPSC maintained a normal chromosomal dosage before and after differentiation on 2D monolayer and on biomaterials. CONCLUSIONS: Taken together, these results promote the use of DPPSC as a new pluripotent-like cell model to evaluate the biocompatibility and the differentiation capacity of biomaterials used in bone regeneration.
Subject(s)
Cell Culture Techniques/methods , Chromosomal Instability/physiology , Dental Pulp/cytology , Materials Testing/methods , Molar, Third/cytology , Osteogenesis/physiology , Pluripotent Stem Cells/cytology , Adolescent , Biocompatible Materials , Cell Differentiation , Cell Line, Tumor , Cells, Cultured , Comparative Genomic Hybridization , Female , Humans , Male , Molar, Third/metabolism , Pluripotent Stem Cells/metabolism , Pluripotent Stem Cells/physiology , Tissue Engineering , Young AdultABSTRACT
OBJECTIVES: The aims of this randomized clinical trial were to compare the dimensional changes and the histological composition after using deproteinized bovine bone mineral (DBBM) or deproteinized bovine bone mineral with 10% collagen (DBBM-C) and a collagen membrane in ridge preservation procedures. MATERIAL AND METHODS: Patients who required an extraction and a subsequent implant-supported rehabilitation at a non-molar site were recruited. After extraction, a cone beam computed tomography (CBCT) was performed and sites were randomly treated either with DBBM or DBBM-C plus a collagen membrane. At 5 months, before implant placement, a second CBCT was performed and a biopsy of the area was obtained. A blinded investigator superimposed the CBCTs and performed measurements to determine bone volume changes between the two time points. Additionally, a histomorphometric analysis of the biopsies was performed in a blinded manner. RESULTS: Eleven sites belonged to the DBBM group and eleven to the DBBM-C group. All together, a significant reduction in height and width was observed at 5 months of healing, but no statistically significant differences were observed between the DBBM and the DBBM-C group. The histomorphometric analysis revealed a similar composition in terms of newly formed bone, connective tissue and residual graft particles in both groups. CONCLUSIONS: Deproteinized bovine bone mineral with 10% collagen showed a similar behaviour as DBBM not only in its capacity to minimize ridge contraction but also from a histological point of view. Thus, both graft materials seem to be suitable for ridge preservation procedures.
Subject(s)
Alveolar Bone Loss/diagnostic imaging , Alveolar Bone Loss/prevention & control , Alveolar Ridge Augmentation/methods , Collagen/therapeutic use , Cone-Beam Computed Tomography , Minerals/therapeutic use , Animals , Biopsy , Cattle , Dental Implantation, Endosseous , Dental Implants , Dental Prosthesis, Implant-Supported , Double-Blind Method , Female , Humans , Male , Mandible/surgery , Middle Aged , Spain , Surgical Flaps , Swine , Tooth Extraction , Tooth Socket/surgeryABSTRACT
BACKGROUND: Clinical research stresses the importance of cognitive variables for predisposition, onset, and especially, perpetuation of perceived fatigue. The aim was to analyze the mediating effects of emotional symptomatology (somatic, depressive and anxiety) between anticipatory fatigue and perception of physical and cognitive fatigue. METHODS: The sample was composed of 317 participants (29% from a clinical population) aged 18 to 76. Anticipatory fatigue and perception of fatigue were measured by fatigue scales. Emotional symptoms were assessed by the General Health Questionnaire, GHQ-28. RESULTS: Depressive symptomatology mediated the relationship between anticipatory fatigue and cognitive fatigue in both groups, and also somatic symptoms/somatization in patients. The indirect effect of physical fatigue was observed only in the clinical group, with depressive symptoms partially mediating the anticipatory fatigue and cognitive fatigue relationship. CONCLUSIONS: Anticipatory fatigue has a partial indirect effect on total physical fatigue, and full indirect effect on cognitive fatigue, mediated by depressive and somatic symptoms. Anticipatory fatigue is a relevant cognitive factor in the design of psychological intervention for improvement of cognitive and physical fatigue
ANTECEDENTES: la investigación clínica resalta la importancia de variables cognitivas en la predisposición, inicio y mantenimiento de la fatiga percibida. Se analizan los efectos de mediación de la sintomatología emocional entre la fatiga anticipatoria y la percepción de la fatiga física y cognitiva. MÉTODOS: la muestra se compone de 317 participantes (29% de población clínica) de 18 a 76 años. La fatiga anticipatoria y la percepción de la fatiga se midieron a través de escalas de fatiga y los síntomas emocionales a través del Cuestionario GHQ-28. RESULTADOS: la sintomatología depresiva media la relación entre fatiga anticipatoria y la fatiga cognitiva en ambos grupos, y también para el grupo de pacientes cuando además los síntomas son somáticos. En el caso de la fatiga física, el efecto indirecto se da solo para el grupo clínico, siendo la sintomatología depresiva la variable que media parcialmente la relación. CONCLUSIONES: la fatiga anticipatoria tiene un efecto indirecto parcial sobre la fatiga física e indirecto total sobre la fatiga cognitiva, mediado por los síntomas depresivos y somáticos. Este factor cognitivo es relevante en el diseño de la intervención psicológica para la disminución de la fatiga cognitiva y física
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Fatigue/prevention & control , Fatigue/psychology , Fatigue/therapy , Anxiety/prevention & control , Anxiety/psychology , Anxiety/therapy , Depression/prevention & control , Depression/psychology , Affect/physiology , Motivation/physiology , Symptom Assessment/instrumentation , Symptom Assessment/methods , Symptom Assessment , Mental Health , Mental Disorders/pathology , Mental Disorders/prevention & control , Mental Disorders/psychology , Reproducibility of Results/instrumentation , Reproducibility of Results/methods , Surveys and QuestionnairesABSTRACT
La comorbilidad entre depresión y agresión infanto-adolescente ha sido contrastada básicamente a un nivel estadístico. Sin embargo, pocos estudios han comprobado de manera longitudinal otra de las premisas fundamentales que permite establecer la comorbilidad: la sinergia, es decir, la acción conjunta de dos o más trastornos que se traduce en una severidad y cronicidad superior a las generadas por la suma de los efectos individuales. Mediante un diseño longitudinal a lo largo de 3 años se examinó la severidad y cronicidad de un grupo de sujetos comórbidos depresivos - agresivos. Se analizaron los niveles de depresión y agresión, así como el papel del sexo en estas relaciones. La evaluación se realizó a través de autoinformes en una muestra de 525 sujetos de edades comprendidas entre los 11 y 13 años. La muestra fue aleatoriamente seleccionada de diferentes colegios de la Comunidad de Madrid (España). Los resultados muestran que la depresión y agresión se relacionan de manera estadísticamente significativa. Los sujetos comórbidos exhiben una cronicidad de mayor duración en las respuestas agresivas que en las depresivas. La severidad en los sujetos comórbidos es mayor en las respuestas agresivas de tipo total y verbal, así como en las depresivas. El sexo no ejerce ningún efecto significativo. Se concluye que los datos indican la importancia de explorar la comorbilidad con diferentes tipos de agresión, especialmente la verbal, y en diferentes grupos de edad. Se discute la necesidad de atender a los síntomas subyacentes al trastorno principal en afectados de larga duración, ya que a la expresión de uno de los trastornos puede subyacer la cronicidad asociada a la comorbilidad con importantes repercusiones para su diagnóstico y tratamiento.
The comorbidity between depression and aggression in children and adolescents is an issue that has sparked controversy as its existence has important implications for the validity of the classification systems, for the establishment of explanatory models, the design of new treatments as well as in the final outcome which the comorbid person presents in these in comparison with conventional treatments. In addition, the prevalence rates in depressive-aggressive comorbidity are significant, oscillating between 7.97 and 10.91%. Therefore, the study of comorbidity becomes necessary and the lack of studies focusing on the subject comes as a surprise. Perhaps one of the main problems concerning the research of comorbidity lies in the fact that most of the studies do not validate the clinical criteria that focuses on the principle of synergy, as Clark and Watson had established in Tripartite model, since doing so would require longitudinal studies measuring the effects of a commorbid disorder in contrast to those where there is no comorbidity to be found. In addition to clinical judgment, the Tripartite model demands a further statistic indicating the existence of a significant correlation between those synergistic disorders, which is the one on which most studies have been focusing. This type of results, based solely on clinical judgment, mainly through cross-sectional studies, has not allowed to implement another type of results, as suggested by the Tripartite model, that would have helped to establish clinical and diagnostic criteria through dimensional self-assessment tools which are closer to a reality in child and adolescent assessment where comorbidity is rather the rule than the exception. Therefore, that kind of study, using a longitudinal design over a period of three years, will help expand those cross-sectional ones, which will allow for examining whether there is a significant association, as well as a synergy that attests to the existence of an aggressive-depressive comorbidity on both, statistical and clinical level. In order to do so this study examined the severity and chronicity of a group of comorbid depressive-aggressive persons. In addition, the levels of depression and aggression and the role of sex within these relationships were analyzed. The sample, randomly selected from different schools in the Community of Madrid (Spain), comprised 525 individuals ranging from 11 to 13 years old, 58.9% female, the family structure was mostly biparental (92%) and the vast majority belonged to a middle class environment (85%). Depression and aggression were assessed through specific types of self-report questionnaires for children and adolescents, both in their Spanish version. The results support the statistical basis, since depression and aggression exhibit a significant positive and moderate association ranging between .11 and .24, in which the fact that the found association was higher within verbal aggression than in the physical one among all ages with the exception of the group of subjects to testing aged 12 needs to be stressed. With regards to the clinical criteria, the results provide partial support, as comorbid subjects exhibit a longer duration in chronic aggressive symptoms than those other groups affected only by depression or aggression, while they are similar to those of merely depressive subjects in the symptoms indicating a depression. Regarding severity, comorbid subjects show a higher level within the field of totally and verbally aggressive symptoms, as well as in the depressive ones which makes their physical aggression comparable to the one found in the test group of total aggression, hence, the data partially support the clinical standard. The tested person's sex, however, is of no significant meaning for the outcome. In conclusion, the data indicates the importance of exploring the comorbidity of different types of aggression, particularly the verbal one, and within different age groups. The need for addressing the underlying primary disorder symptoms in long-term affected patients is discussed, since chronic comorbidity may underlie the expression of one of the disorders and entail important implications for diagnosis and treatment.
ABSTRACT
La comorbilidad entre depresión y agresión infanto-adolescente ha sido contrastada básicamente a un nivel estadístico. Sin embargo, pocos estudios han comprobado de manera longitudinal otra de las premisas fundamentales que permite establecer la comorbilidad: la sinergia, es decir, la acción conjunta de dos o más trastornos que se traduce en una severidad y cronicidad superior a las generadas por la suma de los efectos individuales. Mediante un diseño longitudinal a lo largo de 3 años se examinó la severidad y cronicidad de un grupo de sujetos comórbidos depresivos - agresivos. Se analizaron los niveles de depresión y agresión, así como el papel del sexo en estas relaciones. La evaluación se realizó a través de autoinformes en una muestra de 525 sujetos de edades comprendidas entre los 11 y 13 años. La muestra fue aleatoriamente seleccionada de diferentes colegios de la Comunidad de Madrid (España). Los resultados muestran que la depresión y agresión se relacionan de manera estadísticamente significativa. Los sujetos comórbidos exhiben una cronicidad de mayor duración en las respuestas agresivas que en las depresivas. La severidad en los sujetos comórbidos es mayor en las respuestas agresivas de tipo total y verbal, así como en las depresivas. El sexo no ejerce ningún efecto significativo. Se concluye que los datos indican la importancia de explorar la comorbilidad con diferentes tipos de agresión, especialmente la verbal, y en diferentes grupos de edad. Se discute la necesidad de atender a los síntomas subyacentes al trastorno principal en afectados de larga duración, ya que a la expresión de uno de los trastornos puede subyacer la cronicidad asociada a la comorbilidad con importantes repercusiones para su diagnóstico y tratamiento.(AU)
The comorbidity between depression and aggression in children and adolescents is an issue that has sparked controversy as its existence has important implications for the validity of the classification systems, for the establishment of explanatory models, the design of new treatments as well as in the final outcome which the comorbid person presents in these in comparison with conventional treatments. In addition, the prevalence rates in depressive-aggressive comorbidity are significant, oscillating between 7.97 and 10.91%. Therefore, the study of comorbidity becomes necessary and the lack of studies focusing on the subject comes as a surprise. Perhaps one of the main problems concerning the research of comorbidity lies in the fact that most of the studies do not validate the clinical criteria that focuses on the principle of synergy, as Clark and Watson had established in Tripartite model, since doing so would require longitudinal studies measuring the effects of a commorbid disorder in contrast to those where there is no comorbidity to be found. In addition to clinical judgment, the Tripartite model demands a further statistic indicating the existence of a significant correlation between those synergistic disorders, which is the one on which most studies have been focusing. This type of results, based solely on clinical judgment, mainly through cross-sectional studies, has not allowed to implement another type of results, as suggested by the Tripartite model, that would have helped to establish clinical and diagnostic criteria through dimensional self-assessment tools which are closer to a reality in child and adolescent assessment where comorbidity is rather the rule than the exception. Therefore, that kind of study, using a longitudinal design over a period of three years, will help expand those cross-sectional ones, which will allow for examining whether there is a significant association, as well as a synergy that attests to the existence of an aggressive-depressive comorbidity on both, statistical and clinical level. In order to do so this study examined the severity and chronicity of a group of comorbid depressive-aggressive persons. In addition, the levels of depression and aggression and the role of sex within these relationships were analyzed. The sample, randomly selected from different schools in the Community of Madrid (Spain), comprised 525 individuals ranging from 11 to 13 years old, 58.9% female, the family structure was mostly biparental (92%) and the vast majority belonged to a middle class environment (85%). Depression and aggression were assessed through specific types of self-report questionnaires for children and adolescents, both in their Spanish version. The results support the statistical basis, since depression and aggression exhibit a significant positive and moderate association ranging between .11 and .24, in which the fact that the found association was higher within verbal aggression than in the physical one among all ages with the exception of the group of subjects to testing aged 12 needs to be stressed. With regards to the clinical criteria, the results provide partial support, as comorbid subjects exhibit a longer duration in chronic aggressive symptoms than those other groups affected only by depression or aggression, while they are similar to those of merely depressive subjects in the symptoms indicating a depression. Regarding severity, comorbid subjects show a higher level within the field of totally and verbally aggressive symptoms, as well as in the depressive ones which makes their physical aggression comparable to the one found in the test group of total aggression, hence, the data partially support the clinical standard. The tested persons sex, however, is of no significant meaning for the outcome. In conclusion, the data indicates the importance of exploring the comorbidity of different types of aggression, particularly the verbal one, and within different age groups. The need for addressing the underlying primary disorder symptoms in long-term affected patients is discussed, since chronic comorbidity may underlie the expression of one of the disorders and entail important implications for diagnosis and treatment.(AU)
ABSTRACT
En el presente trabajo se realizo un analisis de los elementos sometidos a flexion. Para efectos de torsion y corte no se vio necesario un analisis particular para el Hormigon Parcialmente Pretensado, pudiendose usar los mismos conceptos y formulas desarrolladas para el Hormigon Totalmente Pretensado. El trabajo se divide en dos partes a) Analisis teorico a la flexion para vigas I, que puede ser aplicado en secciones cajon. En el analisis teorico se estudiaron el estado limite ultimo, y el estado bajo cargas de servicio, en este se incluye un analisis de la fisuracion y las de flexiones. Se propone un metodo para diseno de Hormigon Parcialmente Pretensado. b) Programas en computadora que realizan un calculo automatico y permiten optimizar la estructura. Los programas incluyen: un programa para el analisis de cargas en puentes continuos (Envolvente de momentos), un programa para el diseno de vigas en general y un programa que verifica las condiciones de servicio.
