Ecological momentary assessment of contextual variables, satisfaction, and emotional and behavioral states of adolescents by level of victimization.

The harmful effects of victimization on mental health have been demonstrated in several age groups, cultures, and populations, but there is wide variability in the resulting psychopathology. Ecological momentary assessment (EMA) allows the expression of an emotional state to be recorded at any given time and linked to a situation or context. This study aimed to analyze the contextual variables (where, with whom, and what), momentary satisfaction, and perception of momentary emotional and behavioral symptoms in a cohort of adolescents by the level of victimization, using EMA. We explored the everyday symptom profiles and the contexts in which events took place among 100 adolescents over a one-week period. Sociodemographic data were collected and assessment was done using the EMA (as a smartphone application) and the Juvenile Victimization Questionnaire (to assess childhood and adolescent victimization). In this study, regarding contextual variables, the group with the highest level of victimization (top 10%) showed a significant relationship with being away from home and being with friends other than classmates, and not being with parents or relatives. There was also an unexpectedly higher frequency of sporting engagement in this group. A relationship existed between emotional and behavioral problems and higher levels of victimization. In conclusion, the different groups of victimized subjects present a relatively high level of satisfaction in relation to the daily contexts and show low levels of emotional and behavioral symptomatology.

Adaptación psicosocial en niños adoptados internacionalmente: percepción personal y parental / Internationally adopted children's psychosocial adjustment in internationally adopted children: personal and parental perceptions

Objetivo: Evaluar el nivel de adaptación psicosocial en la mediana infancia en niños adoptados internacionalmente en España. Material y métodos: Ciento un menores adoptados internacionalmente (67% niñas), de entre 8 y 12 años, y sus respectivos padres adoptivos (97 madres y 67 padres) completaron el Behavior Assessment System for Children (BASC). Se realizaron análisis descriptivos y de comparación de medias (t de Student y Anova) para examinar el efecto de las variables sexo, edad de adopción, edad actual y área de origen en las escalas y dimensiones globales del BASC para cada informante, y se efectuaron análisis de regresión lineal múltiple para conocer su valor predictivo. El acuerdo entre madres y padres se calculó mediante el coeficiente de correlación intraclase (CCI). Los porcentajes de menores en el rango normal y con sintomatología en las dimensiones globales se contrastaron con los teóricos mediante la prueba de la chi al cuadrado. Resultados: Se constata que los niños están en general bien adaptados, independientemente del informante. Existen diferencias adaptativas dentro de la normalidad según el área de origen, sexo y edad actual del los niños. El CCI presenta un intervalo entre 0,46 (satisfactorio) y 0,84 (excelente). En comparación con el grupo normativo, un mayor porcentaje de niños presenta desajuste escolar (24,8%; informado por los niños), problemas externalizados (el 27,8 y el 28,3%, informados por las madres y los padres, respectivamente) y dificultades comportamentales y adaptativas (el 28,4 y el 29,9%, respectivamente; informadas por los padres). Conclusiones: Entorno a un 25% de menores adoptados internacionalmente presenta dificultades en áreas adaptativas básicas, identificadas con claridad mediante el uso del BASC, que deben ser atendidas desde un enfoque psicológico y paidológico(AU)

Objective: To assess psychosocial adjustment in middle childhood in internationally adopted children in Spain. Material and methods: One hundred and one internationally adopted children (67% girls), aged 8 to 12, and their adoptive parents (97 mothers and 67 fathers) completed the Behaviour Assessment System for Children (BASC). Descriptive analyses and mean comparisons (Student's t test and ANOVA) were conducted to test for gender, age at adoption, current age and area of origin differences for each informant on the scales and composite-scales of the BASC. Multiple linear regression analyses were then performed. Agreement between mothers and fathers was calculated using intra-class correlation coefficients (ICC). Percentages of children in the normal and symptomatic range in composite-scales were compared to the theoretical ones using chi square tests. Results: The results showed that children were generally well-adjusted, regardless of the informant. Differences were found in children's adjustment by area of origin, gender and current age, although values remained within the normal range. The ICC ranged from 0.46 (satisfactory) to 0.84 (excellent). Compared to the normal-group, more children showed difficulties in adapting to school (24.8%; as reported by children), externalising problems, (27.8% and 28.3%; as reported by mothers and fathers, respectively), and behavioural and adaptive difficulties (28.4% and 29.9%, respectively; as reported by fathers). Conclusions: About 25% of the internationally adopted children showed adaptive difficulties in basic areas, clearly identified using the BASC, which need psychological and paedological support(AU)

[Internationally adopted children's psychosocial adjustment in internationally adopted children: personal and parental perceptions]. / Adaptación psicosocial en niños adoptados internacionalmente: percepción personal y parental.

OBJECTIVE: To assess psychosocial adjustment in middle childhood in internationally adopted children in Spain. MATERIAL AND METHODS: One hundred and one internationally adopted children (67% girls), aged 8 to 12, and their adoptive parents (97 mothers and 67 fathers) completed the Behaviour Assessment System for Children (BASC). Descriptive analyses and mean comparisons (Student's t test and ANOVA) were conducted to test for gender, age at adoption, current age and area of origin differences for each informant on the scales and composite-scales of the BASC. Multiple linear regression analyses were then performed. Agreement between mothers and fathers was calculated using intra-class correlation coefficients (ICC). Percentages of children in the normal and symptomatic range in composite-scales were compared to the theoretical ones using chi square tests. RESULTS: The results showed that children were generally well-adjusted, regardless of the informant. Differences were found in children's adjustment by area of origin, gender and current age, although values remained within the normal range. The ICC ranged from 0.46 (satisfactory) to 0.84 (excellent). Compared to the normal-group, more children showed difficulties in adapting to school (24.8%; as reported by children), externalising problems, (27.8% and 28.3%; as reported by mothers and fathers, respectively), and behavioural and adaptive difficulties (28.4% and 29.9%, respectively; as reported by fathers). CONCLUSIONS: About 25% of the internationally adopted children showed adaptive difficulties in basic areas, clearly identified using the BASC, which need psychological and paedological support.

Identifying by means of coping typologies and primary appraisal the likelihood of positive ß-hCG test results in women undergoing IVF treatment: a preliminary study.

BACKGROUND: At a psychological level, having to undergo IVF in order to be a mother may be appraised differently by women who start this treatment. These different forms of assessment can affect the pregnancy rates. The objective of this study was to determine whether psychological variables such as primary appraisal and coping typologies were associated with positive results in ß-hCG pregnancy test after IVF. METHODS: We performed a cross-sectional clinical study in a private infertility centre. We recruited women undergoing IVF treatment in the Assisted Reproduction Unit of the Hospital Clinic prior to treatment commencement. Women were asked to complete the Spanish adaptation of the Coping Responses Inventory-Adult Form, and coping typologies analysed in relation to pregnancy outcome of that round of treatment. RESULTS: Women who face infertility and IVF with optimistic appraisal had a considerably increased likelihood of pregnancy compared with those with a pessimistic appraisal (odds ratio = 4.37; 95% confidence interval = 1.76-10.83). On the other hand, the pregnancy rate was significantly higher than the non-pregnancy rate among women who have a coping typology characterized by high use of approach strategies and with low use of avoidance strategies (Z-test = 4.34, P < 0.001). CONCLUSIONS: Psychological variables such as positive appraisal and coping typologies were associated with increased pregnancy rates after IVF. The main limitations of this study were the size of the sample and in particular its cross-sectional design which only allows predictive associations to be made.

Attention behavior and hyperactivity and concurrent neurocognitive and social competence functioning in 4-year-olds from two population-based birth cohorts.

OBJECTIVE: We studied the associations between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and the neurobehavioral status in two population-based birth cohorts. METHODS: Children (n=467) were assessed by psychologists and teachers for neuropsychological functioning (McCarthy Scales, MCSA), inattention-hyperactivity symptoms (ADHD-DSM-IV form list) and social behavior (California Preschool Social Competence Scale, CPSCS). Regression models were used with covariate adjustment. RESULTS: Sixteen percent of children had ADHD-DSM-IV symptoms. MCSA scores were linearly associated with ADHD symptom scores (general cognitive Beta=-0.6 [-1.0; -0.3] per symptom), specifically inattention scores (general cognitive Beta=-1.8 [-2.3; -1.2]). CPSCS scores were associated with ADHD symptoms (Beta=-2.19 [-2.5; -1.9]). MCSA scores of executive function, perceptive-performance and quantitative sub-areas had stronger associations with ADHD symptoms. CONCLUSIONS: Preschooler ADHD symptoms are associated with concurrent decrements in neurocognitive and social competence functioning. The association patterns are similar to those found in older children with ADHD symptomology (Marks et al., 2005 [36], Seidman, 2006 [46], Sonuga-Barke et al., 2003 [48], Yochman et al., 2006 [53]).

[Implication of the anxiety and depression in eating disorders of young obese]. / Implicación de la ansiedad y la depresión en los trastornos de alimentación de jóvenes con obesidad.

OBJECTIVES: the goals of the present study were: 1) to compare the levels of anxiety, depression, and eating disorders in young patients assisted at a children's hospital for obesity; 2) to determine whether anxiety and depression explain the symptoms of the eating disorders; and 3) to know which of these symptoms better discriminate the young people with different degrees of obesity. MATERIALS AND METHOD: Descriptive, cross-sectional study with a sample comprised by 281 youngsters (56% girls) aged 11-17 years. The BMI percentiles were calculated by using the WHO growth tables. Two study groups were created: severe obesity and overweight/light-moderate obesity. The following questionnaires were used: Eating Disorders Inventory-2 (EDI-2), depression questionnaire (DQ), and Status-Trait Anxiety Questionnaire (STAI). RESULTS: The youngsters with obesity showed more psychological problems than youngsters with overweight/light-moderate obesity, 12% had anxiety, and 11% depression. In both groups, the behaviours related with eating disorders were partially explained by the presence of symptoms of anxiety and depression. Dissatisfaction with the body and high anxiety trait increased the risk for perpetuating the obesity and were the two symptoms that better discriminated the patients with or without severe obesity. CONCLUSION: Obesity prevention programmes should include body dissatisfaction and the anxiety trait into the assessment and management protocols, and prevent anxiety getting fixed as a personality trait.

Implicación de la ansiedad y la depresión en los trastornos de alimentación de jóvenes con obesidad / Implication of the anxiety and depression in eating disorders of young obese

Objetivos: Los objetivos del presente estudio eran: 1) comparar los niveles de ansiedad, depresión y trastornos de alimentación en jóvenes atendidos en un hospital pediátrico por obesidad; 2) determinar si la ansiedad y la depresión explican los síntomas de trastornos de alimentación, y 3) conocer cuáles de esos síntomas discriminan mejor entre jóvenes con distintos grados de obesidad. Material y métodos: Estudio descriptivo, transversal con una muestra de 281 jóvenes (56% mujeres) de entre 11 y 17 años. Los percentiles de IMC se calcularon utilizando las tablas de crecimiento de la OMS. Se crearon dos grupos de estudio: obesidad severa y sobrepeso-obesidad leve-moderada. Se utilizaron los siguiente cuestionarios: Eating Disorders Inventory-2 (EDI-2), cuestionario de depresión(CDI) y cuestionario de ansiedad estado-rasgo (STAI). Resultados: Los jóvenes con obesidad severa mostraron más problemas psicológicos que los jóvenes con sobrepeso-obesidad leve-moderada, un 12% presentaban ansiedad y un 11% depresión. En ambos grupos, las conductas relacionadas con los trastornos de alimentación eran, en parte, explicadas por la mayor presencia de síntomas de ansiedad y de depresión. La insatisfacción corporal junto con una elevada ansiedad rasgo incrementaban el riesgo de perpetuar la obesidad y eran los dos síntomas que mejor discriminaban a los pacientes con o sin obesidad severa. Conclusión: Los programas de prevención de la obesidad deberían incluir la insatisfacción corporal y la ansiedad rasgo en los protocolos de evaluación y tratamiento, y prevenir que la ansiedad se instaure como rasgo de personalidad (AU)

Objectives: the goals of the present study were: 1) to compare the levels of anxiety, depression, and eating disorders in young patients assisted at a children's hospital for obesity; 2) to determine whether anxiety and depression explain the symptoms of the eating disorders; and 3) to know which of these symptoms better discriminate the young people with different degrees of obesity. Materials and method: Descriptive, cross-sectional study with a sample comprised by 281 youngsters (56% girls) aged 11-17 years. The BMI percentiles were calculated by using the WHO growth tables. Two study groups were created: severe obesity and overweight/light-moderate obesity. The following questionnaires were used: Eating Disorders Inventory-2 (EDI-2), depression questionnaire (DQ), and Status-Trait Anxiety Questionnaire (STAI). Results: The youngsters with obesity showed more psychological problems than youngsters with overweight/light-moderate obesity, 12% had anxiety, and 11% depression. In both groups, the behaviours related with eating disorders were partially explained by the presence of symptoms of anxiety and depression. Dissatisfaction with the body and high anxiety trait increased the risk for perpetuating the obesity and were the two symptoms that better discriminated the patients with or without severe obesity. Conclusion: Obesity prevention programmes should include body dissatisfaction and the anxiety trait into the assessment and management protocols, and prevent anxiety getting fixed as a personality trait (AU)

Obesidad infantil: ansiedad y síntomas cognitivos y conductuales propios de los trastornos de alimentación / Adolescent obesity: Anxiety, cognitive and behavioural symptoms characteristic of eating disorders

Objetivo: Evaluar la presencia de síntomas de ansiedad y síntomas cognitivos y conductuales característicos de los trastornos de alimentación en adolescentes con exceso de peso. Material y método: Muestra de 297 adolescentes (55,2% de mujeres y 44,8% de hombres) de entre 11 y 17 años, divididos en 4 grupos según su índice de masa corporal (IMC) percentilado: normopeso, sobrepeso, obesidad y obesidad grave. Los cuestionarios utilizados fueron el Eating Disorders Inventory-2 (EDI-2) y el cuestionario de ansiedad estado-rasgo (STAI). Resultados: Los resultados indican que los adolescentes con obesidad grave muestran más preocupación por su aspecto físico, por su entorno social, mayor sensibilidad corporal y más tensión subjetiva que los adolescentes con sobrepeso u obesidad. En nuestra muestra clínica, los adolescentes normopeso presentan factores específicos para desarrollar en un futuro trastornos de alimentación. Conclusiones: A medida que incrementa el IMC aumentan los síntomas de ansiedad y los síntomas asociados a los trastornos de alimentación (AU)

Objective: To assess the presence of symptoms of anxiety, cognitive and behavioural symptoms characteristic of eating disorders in overweight adolescents. Material and Methods: The sample consisted of 297 adolescents (55.2% female and 44.8% male) aged from 11 to 17 years, divided into four groups according to their BMI percentile: normal weight, overweight, obesity and severe obesity. The questionnaires used were the Eating Disorders Inventory-2 (EDI-2) and the state-trait anxiety questionnaire (STAI). Results: The results showed that the adolescents with severe obesity were more concerned about their physical appearance (body dissatisfaction and obsession with being thin), by their social environment (interpersonal distrust), and showed more anxiety state and anxiety trait than adolescent overweight or obese. In the clinical sample, the adolescents with normal weight showed specific factors for developing eating disorders in the future. Conclusions: As the BMI increased, symptoms of anxiety and symptoms associated with eating disorders were also increased. The findings of this study are discussed in order to improve therapeutic interventions (AU)

[Adolescent obesity: anxiety, cognitive and behavioural symptoms characteristic of eating disorders]. / Obesidad infantil: ansiedad y síntomas cognitivos y conductuales propios de los trastornos de alimentación.

OBJECTIVE: To assess the presence of symptoms of anxiety, cognitive and behavioural symptoms characteristic of eating disorders in overweight adolescents. MATERIAL AND METHODS: The sample consisted of 297 adolescents (55.2% female and 44.8% male) aged from 11 to 17 years, divided into four groups according to their BMI percentile: normal weight, overweight, obesity and severe obesity. The questionnaires used were the Eating Disorders Inventory-2 (EDI-2) and the state-trait anxiety questionnaire (STAI). RESULTS: The results showed that the adolescents with severe obesity were more concerned about their physical appearance (body dissatisfaction and obsession with being thin), by their social environment (interpersonal distrust), and showed more anxiety state and anxiety trait than adolescent overweight or obese. In the clinical sample, the adolescents with normal weight showed specific factors for developing eating disorders in the future. CONCLUSIONS: As the BMI increased, symptoms of anxiety and symptoms associated with eating disorders were also increased. The findings of this study are discussed in order to improve therapeutic interventions.

Use of the Kidcope to identify socio-economically diverse Spanish school-age children's stressors and coping strategies.

BACKGROUND: The process by which children cope with stressful events is a very relevant topic. However, few systematic efforts have been made to design age-specific measures. METHODS: This study examined problems commonly experienced by children, ages between 7 and 12 years, from two different sources: a primary school mainly enrolling families of medium socio-economic status, and an after-school social care centre from a socially and economically deprived neighbourhood. Data were obtained using the younger version of the Kidcope. RESULTS: Almost 55% of the sample reported a problem related to others with no differences observed in age, gender or school group. The strategies that children considered the most effective were 'social support' (35%), 'emotional regulation' (33%) and 'wishful thinking' (32%). The children from disadvantaged backgrounds reported different problems mainly related with 'victimization and violence', 'moving house' and conflicts with 'norms and rules' and tended to use avoidant strategies to face them, which could be related to the perception of uncontrollability of these stressors. CONCLUSIONS: This study reported the first descriptive results in the type of problems and coping strategies of two different social groups of Spanish children using the Kidcope. The Kidcope can be useful to screen children for coping abilities at an early age living under stressful conditions in underprivileged sectors of society.

Langerhans cell sarcoma in a patient who underwent transplantation.

Langerhans cell sarcoma is a rare, aggressive tumour that may metastasize to many organs, likely leading to death of the patient within 1 year. We present the first case described in the literature in a patient who underwent transplantation.

Clinical comparison of dexketoprofen trometamol and dipyrone in postoperative dental pain.

A total of 125 outpatients with moderate to severe pain after surgical removal of one impacted third molar were randomly assigned to receive dexketoprofen trometamol 12.5 or 25 mg or dipyrone 575 mg. For first-dose assessments, patients rated their pain intensity and its relief at regular intervals. From 60 min post dose to the end of the 6-h observation period, both doses of dexketoprofen trometamol had higher pain relief scores than dipyrone: Between 3 and 6 h the differences were statistically significant. In addition, peak measures (PIDmax and PARmax) were statistically superior after both doses of dexketoprofen trometamol compared to dipyrone. The overall efficacy assessed at the end of the first-dose phase was rated as good or excellent by 90%, 83.3%, and 70% of patients receiving dexketoprofen trometamol 25 mg, dexketoprofen trometamol 12.5 mg, and dipyrone, respectively. The number of patients who required remedication during the 6-h period was significantly lower in both dexketoprofen groups. Repeated-dose data were also obtained. No significant differences were found in the efficacy after repeated doses, the number of doses taken, or the mean time elapsed between doses. The overall efficacy at the end of the repeated-dose phase was rated as good or excellent by 84.2%, 66.7%, and 70% of patients receiving dexketoprofen trometamol 25 mg, dexketoprofen trometamol 12.5 mg, and dipyrone, respectively. The frequency of adverse events was similar for all treatments and no serious adverse events were reported during the study.

Comparison of dexketoprofen trometamol and ketoprofen in the treatment of osteoarthritis of the knee.

Dexketoprofen, the active enantiomer of the racemic compound ketoprofen, is a new nonsteroidal antiinflammatory drug (NSAID) of the arylpropionate family. The efficacy and safety of dexketoprofen trometamol were compared with the equivalent enantiomeric dose of ketoprofen in a multicenter, randomized, double-blind 3-week trial of adult outpatients with pain due to osteoarthritis of the knee. After a washout period of 7-15 days, patients were randomly assigned to receive either dexketoprofen trometamol 25 mg tid (N = 89) or ketoprofen 50 mg tid (N = 94). Of the 183 patients enrolled, two were lost to follow-up. At the end of treatment (3 weeks), the main efficacy outcome measures were significantly better in the dexketoprofen trometamol group than in the ketoprofen group. In addition, overall physician assessment indicated that 75% of the dexketoprofen group had improved compared with 50% of the ketoprofen patients. There were fewer adverse events in the dexketoprofen treatment group, but the difference did not reach statistical significance. These results demonstrate that dexketoprofen trometamol 25 mg tid is more effective than ketoprofen 50 mg tid in short-term symptomatic treatment of knee osteoarthritis and suggest that the tolerability of dexketoprofen trometamol is more favorable than ketoprofen. Therefore, the substitution of dexketoprofen for racemic ketoprofen may be advantageous in clinical practice.

Leu-M1 immunoreactivity and phaeochromocytoma.

The aim was to evaluate Leu-M1 immunoreactivity as a prognostic factor in phaeochromocytoma. Anti-Leu-M1 monoclonal antibodies were used to determine the Leu-M1 immunoreactivity in 17 histologically confirmed phaeochromocytomas from 15 patients, using an avidin-biotin technique. Ten patients had a sporadic phaeochromocytoma, and five had multiple endocrine neoplasia type 2A (MEN 2A). Malignancy was diagnosed in three patients by the presence of metastases. Leu-M1 immunoreactivity was shown in 12 (70.5%) phaeochromocytomas. Three patterns of arrangement were observed: isolated (scattered positive cells) (n = 3); focal (aggregates of positive cells) (n = 5), and diffuse patterns (dispersed positive cells) (n = 4). Two cases of malignant phaeochromocytoma were positive (one focal and one isolated pattern). All cases of MEN 2A showed immunoreactivity, although no characteristic pattern was prevalent. A diffuse pattern was observed in all phaeochromocytomas longer than 7 cm. In conclusion, Leu-M1 expression is frequent in phaeochromocytoma. However, Leu-M1 immunoreactivity seems to be useless in predicting malignant behaviour and to be influenced mainly by tumour size.

[Disseminated aspergillosis in patients with acquired immunodeficiency syndrome]. / Aspergilosis diseminada en pacientes con síndrome de inmunodeficiencia adquirida.

Disseminated aspergillosis is very infrequent in patients infected by the human immunodeficiency virus and diagnosis is made usually upon necropsy. The case of a 28 year old male who presented multiple abscesses by Aspergillus sp. in the lung, thyroid glands, spleen, myocardium, pancreas, kidney and in both cerebral hemispheres is presented. The patient also concommitantly showed M. avium in the spleen, liver and central nervous system. The literature was reviewed to evaluate the clinical characteristics and predisposing factors which may contribute to diagnosis and treatment.