Psychometric adaptation of the Spanish version of the Brief Pittsburgh Sleep Quality Index in adolescents.

OBJECTIVE: Good sleep quality is essential for adolescent health, yet sleep difficulties persist in this age group. The 6-item Brief Pittsburgh Sleep Quality Index (B-PSQI) was recently developed to improve sleep quality assessment, however, its validity in adolescents remains unexplored. This study examined the B-PSQI's psychometric properties in Spanish adolescents and adapted the scoring method to age-specific sleep recommendations. METHODS: A cross-sectional study involving 1,065 adolescents (15-17 years; 56.8% female) was conducted in public high schools. Sleep quality was measured using the B-PSQI, the Insomnia Severity Index (ISI), the short Patient-Reported Outcomes Measurement Information System (PROMIS), and the Epworth Sleepiness Scale (ESS). Additionally, depression and anxiety were assessed using the Depression, Anxiety, and Stress Scales. Reliability, validity, and measurement invariance were analyzed. RESULTS: The B-PSQI global scores were 4.5 (SD = 1.9) for the original scoring method and 5.4 (SD = 2.8) for the age-adjusted. The age-adjusted B-PSQI showed satisfactory reliability (ω = 0.84) and concurrent, convergent, and discriminant validity (ISI rS = 0.67; PROMIS rS = 0.71; anxiety rS = 0.40; depression rS = 0.42; ESS rS = 0.29). Adequacy for one-factor structure (χ2(4) = 53.9; CFI = 0.97; TLI = 0.92; RMSEA = 0.108; SRMR = 0.05) and invariance across sexes were supported. Both B-PSQI scoring methods showed similar psychometric properties, but the original yielded a higher percentage of poor sleepers (43.1%; cutoff ≥5) than the age-adjusted version (41.9%; cutoff ≥6). CONCLUSIONS: Findings suggest that the B-PSQI is a valid and reliable measure to assess adolescent sleep quality. Its scoring can be adjusted to provide age-specific criteria for good sleep. The B-PSQI has potential utility for screening sleep problems and facilitating overall health promotion in adolescents.

Nighttime Texting on Social Media, Sleep Parameters, and Adolescent Sadness: A Mediation Analysis.

OBJECTIVES: The use of social media during bedtime has increased in the past years among adolescents, contributing to disturbed sleep quality, which could potentially be related to emotional problems. This study aimed to analyze the mediation effects of sleep parameters on the relationship between NightTime Texting (NTT) on social media and adolescent sadness. METHODS: We used a cross-sectional study and evaluated a total of 1464 Swedish students aged 15-17 (55.7% girls) to examine their frequency of NTT on social media, sleep parameters, and adolescent sadness. Bivariate and mediation analyses were performed. RESULTS: Approximately 60% (n = 882) of adolescents engaged in nighttime instant messaging, with 37% (n = 330) reporting texting every night. Higher frequency of NTT was significantly associated with later bedtimes (η2 > 0.12), extended weekend wake-up times (η2 = 0.07), increased social jetlag (η2 = 0.07), and reduced sleep duration on schooldays (η2 = 0.10). Multicategorical parallel mediation analyses revealed that sleep duration on schooldays had an indirect effect on the relationship between both Occasional NTT (a11b1 = 0.05, p < .05) and Daily NTT (a21b1 = 0.12, p < .05) with sadness. Mediation effects were not moderated by gender (p > .05), however, the association between Occasional NTT and higher sadness was significantly linked to boys (t = 2.72; p = .007). CONCLUSIONS: Findings showed a large percentage of adolescents engaging in nighttime social media use with worse quality of sleep, and underlined sleep duration on schooldays as a mediator associated with emotional problems in adolescents. These insights can aid in developing strategies for healthier habits to address the misuse of social media and prevent related health problems.

Effectiveness of the Brief Guided Self-Change Therapy Combined with Varenicline under "Real-Life" Conditions and Mediators for Smoking Cessation.

Background: Brief therapies have proven to reduce tobacco cost-effectively, however, unsuccessful quit attempts remain notable in real-life conditions, and the underlying mechanisms of treatment success are still unclear. Objectives: We aimed to analyze the effectiveness of the Guided Self-Change (GSC) therapy combined with varenicline (VAR+T) in public health services against varenicline alone (VAR), and to identify mediators of treatment outcomes. We conducted a two-arm quasi-experimental study with 126 treatment-seeking smokers (age=57.3±9.1 years; 59.5% women). Before treatment, and at weeks 12 and 24, we assessed tobacco use and five potential mediators: withdrawal, craving, motivation to quit, anxiety, and depression. Results: Only 25% of participants adhered to varenicline prescription, and 54% to GSC therapy. VAR+T group showed a greater proportion of abstainers compared to VAR group at week 12 (75% vs 57.4%; φc=0.21) and week 24 (62.9% vs 52.5%; φc=0.10). When controlling for weeks taking varenicline, motivation showed a significant indirect effect over abstinence rates in VAR+T compared with VAR (a1b1=1.34; 95%CI=0.04, 5.03). Conclusions: The GSC effectiveness seems to increase motivation which in turn contributes to reducing tobacco use. The implementation of GSC therapy in public health services could minimize treatment duration and increase smoking abstinence in 'real-life' conditions where varenicline adherence remains low.

Machine learning combining multi-omics data and network algorithms identifies adrenocortical carcinoma prognostic biomarkers.

Background: Rare endocrine cancers such as Adrenocortical Carcinoma (ACC) present a serious diagnostic and prognostication challenge. The knowledge about ACC pathogenesis is incomplete, and patients have limited therapeutic options. Identification of molecular drivers and effective biomarkers is required for timely diagnosis of the disease and stratify patients to offer the most beneficial treatments. In this study we demonstrate how machine learning methods integrating multi-omics data, in combination with system biology tools, can contribute to the identification of new prognostic biomarkers for ACC. Methods: ACC gene expression and DNA methylation datasets were downloaded from the Xena Browser (GDC TCGA Adrenocortical Carcinoma cohort). A highly correlated multi-omics signature discriminating groups of samples was identified with the data integration analysis for biomarker discovery using latent components (DIABLO) method. Additional regulators of the identified signature were discovered using Clarivate CBDD (Computational Biology for Drug Discovery) network propagation and hidden nodes algorithms on a curated network of molecular interactions (MetaBase™). The discriminative power of the multi-omics signature and their regulators was delineated by training a random forest classifier using 55 samples, by employing a 10-fold cross validation with five iterations. The prognostic value of the identified biomarkers was further assessed on an external ACC dataset obtained from GEO (GSE49280) using the Kaplan-Meier estimator method. An optimal prognostic signature was finally derived using the stepwise Akaike Information Criterion (AIC) that allowed categorization of samples into high and low-risk groups. Results: A multi-omics signature including genes, micro RNA's and methylation sites was generated. Systems biology tools identified additional genes regulating the features included in the multi-omics signature. RNA-seq, miRNA-seq and DNA methylation sets of features revealed a high power to classify patients from stages I-II and stages III-IV, outperforming previously identified prognostic biomarkers. Using an independent dataset, associations of the genes included in the signature with Overall Survival (OS) data demonstrated that patients with differential expression levels of 8 genes and 4 micro RNA's showed a statistically significant decrease in OS. We also found an independent prognostic signature for ACC with potential use in clinical practice, combining 9-gene/micro RNA features, that successfully predicted high-risk ACC cancer patients. Conclusion: Machine learning and integrative analysis of multi-omics data, in combination with Clarivate CBDD systems biology tools, identified a set of biomarkers with high prognostic value for ACC disease. Multi-omics data is a promising resource for the identification of drivers and new prognostic biomarkers in rare diseases that could be used in clinical practice.

Validation of the Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ) to Evaluate Nicotine Dependence in Spanish Clinical Settings.

An assessment of the different aspects of tobacco addiction is central to adapting interventions to the profiles and needs of smokers. The Glover−Nilsson Smoking Behavioral Questionnaire (GN-SBQ) is one of the few and most used scales to evaluate the behavioral aspects of tobacco addiction. However, few studies involve the validation of the GN-SBQ in clinical settings. Thus, this study aimed to analyze the psychometric properties of the GN-SBQ in a sample of Spanish smokers. A total of 341 smokers attending clinical services in Spain participated in this cross-sectional study. Measures included the psychological factors related to tobacco addiction, assessed with the GN-SBQ, the physical factors of nicotine addiction, withdrawal symptoms, smoking-related variables, and alcohol use. Data analysis included descriptive statistics, internal consistency coefficients, confirmatory factor analyses, Spearman correlations, and the Kruskal−Wallis test. The GN-SBQ showed adequate reliability (α = 0.76 and ω = 0.76) and a unidimensional structure. GN-SBQ scores also provided evidence of convergent and concurrent validity. GN-SBQ scores significantly correlated with the physical symptoms of addiction, age, number of cigarettes, and withdrawal symptoms. The results of discriminant validity were also adequate, as no correlation was observed between GN-SBQ scores and CO levels or alcohol use. Significant differences were found between all levels of psychological addiction based on the GN-SBQ scores regarding physical nicotine addiction, withdrawal symptoms, and age. Thus, this questionnaire is a reliable and valid instrument to assess the psychological aspects of tobacco addiction in smokers in clinical settings. The short length of the GN-SBQ proves advantageous for its use in time-limited assessments, which are common in public health services.

Psychometric Validity of the Minnesota Tobacco Withdrawal Scale in Smokers Attempting to Quit: Longitudinal Invariance across Smokers and Abstainers.

Tobacco withdrawal symptoms vary during smoking cessation increasing relapse risk; therefore, a longitudinal invariant measure seems necessary to validly assess withdrawal changes. This study aimed to examine the psychometric properties of the 7-item Minnesota Tobacco Withdrawal Scale (MTWS) during cessation, and to analyze longitudinal invariance across smokers and abstainers. We conducted a longitudinal study with 309 Spanish smokers (56.2 ± 9.9 years; 52.4% women). We assessed withdrawal at three occasions: pre-treatment (T1), week-12 (T2), and week-24 (T3). Reliability, validity, and invariance analyses were performed. MTWS reliability remained adequate over time (ωT1 = 0.78; ωT2 = 0.68; ωT3 = 0.80) in both smokers and abstainers, with satisfactory temporal stability (ICC = 0.73). MTWS correlations with anxiety, depression, and nicotine dependence (rs > 0.3) supported convergent and concurrent validity. MTWS showed no correlation with craving at T2 (rs < 0.24), suggesting discriminant validity. Unifactorial structure proved partial scalar invariance across time (χ2 = 246.009; CFI = 0.91; IFI = 0.91; SRMR = 0.09), yet longitudinal invariance between abstainers and smokers was not supported. Across groups, partial scalar invariance was only achieved at T2. Noninvariance at T3 was mainly due to item irritability (dMACS = 0.93). The MTWS is reliable and valid measure to assess withdrawal changes during cessation. Long-term MTWS comparisons between smokers and abstainers should be taken with caution since different withdrawal patterns may exist.

Brief version of the Pittsburgh Sleep Quality Index (B-PSQI) and measurement invariance across gender and age in a population-based sample.

The Pittsburgh Sleep Quality Index (PSQI) is the most widely used questionnaire in research and clinical practice to assess sleep quality. However, a brief version of this measure would improve its efficiency and applicability. This study aimed to develop a brief form of the PSQI and to study measurement invariance across gender and age in a nonclinical population. In total, 609 participants with a mean age of 37.3 years (standard deviation [SD] = 11.9) were recruited, of whom 71.8% (n = 437) were women. Participants completed online versions of the PSQI and the Insomnia Severity Index (ISI). Reliability analyses were performed to reduce the number of items, followed by validity and measurement invariance analyses for the new Brief Version of the PSQI (B-PSQI). Six questions were included in the B-PSQI out of the initial 18; the brief form had adequate internal consistency (α = .79 and ω = 0.91). Confirmatory factor analysis showed optimal fit of the B-PSQI (χ2(4) = 22.428; p < .01; comparative fit index (CFI) = 0.99; normed fit index (NFI) = 0.99; Tucker-Lewis index (TLI) = 0.98; root mean squared error of approximation (RMSEA) = 0.06; standardized root mean square residual (SRMR) = 0.04), achieving partial scalar invariance across gender-same factorial structure, loadings, and thresholds in the majority of the items. Invariance across age was only achieved for model structure. Additionally, the B-PSQI yielded favorable sensitivity (75.82%) and specificity (76.99%) for classifying poor sleepers, similar to values for the full PSQI. In conclusion, the B-PSQI is a brief, reliable, and valid measure that can be used as a screening tool, allowing valid score comparisons between men and women of similar age. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cambios en las actitudes vocacionales hacia la psiquiatría de los estudiantes de Medicina durante la carrera / Changes in vocational tendencies towards psychiatry among students during medical degree

Introducción: El objetivo de este estudio es observar los cambios en las actitudes, opiniones y tendencias vocacionales hacia la psiquiatría de los estudiantes de medicina durante la carrera. Material y métodos: La muestra del estudio consiste en un total de 207 estudiantes; 117 de primer curso de la facultad de Medicina de la Universidad Autónoma de Barcelona (UAB) y 90 de quinto curso de las distintas unidades docentes que componen dicha facultad. El instrumento seleccionado para la obtención de los datos fue una adaptación con dos variantes del cuestionario de Balon. Resultados: Se han observado cambios significativos en algunos aspectos sobre la eficacia y lugar de la psiquiatría entre las demás especialidades médicas, sobre algunas funciones y posibles abusos de los psiquiatras y, finalmente, sobre algunas características de la carrera profesional. Sin embargo, los estudiantes siguen manteniendo una elevada presión social al elegir la especialidad y restan peso a la función del psiquiatra dentro del sistema de salud mental. Ni la sensación de haber adquirido una buena preparación práctica ni la convivencia con pacientes psiquiátricos parece influir en la decisión de escoger psiquiatría. Conclusiones: La elevada tendencia vocacional entre los alumnos de quinto (14%), no observada en otros países, puede responder, en parte, por una propensión a percibir la elección de la especialidad como un reto (AU)

Introduction: The aim of this study is to observe changes in the attitudes, opnions, and vocational tendencies towards psychiatry among students during medical studies. Material and methods: Sample included a total of 207 students; 117 in their first year at medical school of the Universidad Autonoma de Barcelona (UAB), and 90 in their fifth year. Data was collected by means of the selected Balon questionnaire adapted with two variants. Results: We have observed significant changes in some aspects regarding: efficacy and role of psychiatry among other medical specialities; some psychiatrists' functions and possible abuses; and finally, features about the professional career. Students still feel high social criticism if they choose psychiatry and diminish the psychiatrists' function within the mental health system. The decision to choose psychiatry does not seem to be influenced neither by the feeling of welllearned psychiatric training nor by cohabitation with psychiatric patients. Conclusions: Perception of psychiatry as a challenge could partially explain the high vocational tendencies among fifth-year medical students (14%) not observed in other countries (AU)