Risk factors for suicide reattempt: a systematic review and meta-analysis.

BACKGROUND: Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor. METHODS: This systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury). RESULTS: The initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt. CONCLUSION: Most of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.

Short-term effects and adherence to the practice of different meditation modalities in mindfulness-based interventions / Efectos a corto plazo y adherencia en la práctica de diferentes modalidades de meditación en intervenciones basadas en mindfulness

Antecedents: Previous research has distinguished between mindfulness practices, specifically focused-attention meditation and open-monitoring meditation, noting that the different modalities appear to impact medium- and long-term benefits. However, understanding their distinct effects in the very short term is also crucial, as it may elucidate some of the adherence issues. Objectives: This study aims to examine the short-term effects of various meditation practices that differ in attentional focus and stimuli among novices. The focus is on immediate affect, perceived difficulty, and adherence. Method: A randomized controlled within-subject design with pretest and posttest measures was employed in a workshop consisting of four sessions (four weekly sessions of 1 hour each). Four experimental conditions were established: Internal and Focused (I-FA, Internal Focused-attention), External and Focused (E-FA, External Focused-attention), Internal and Open (IOM, Internal Open monitoring), and External and Open (E-OM, External Open monitoring). Results: The E-OM modality demonstrated a more significant reduction in discomfort compared to the I-OM modality. Participants reported higher difficulty in meditating on external stimuli compared to internal stimuli, irrespective of whether the meditation was focused or open. However, at least in this study, the modality type did not seem to influence adherence to the meditation practice. Conclusions: The findings suggest the importance of further investigating E-OM meditation as an alternative to I-OM at the beginning of mindfulness training.(AU)

Antecedentes: Investigaciones previas han diferenciado entre prácticas de mindfulness, específicamente la meditación de atención focalizada y la meditación de monitoreo abierto, señalando que las diferentes modalidades parecen tener impactos en beneficios a medio y largo plazo. Sin embargo, comprender sus efectos diferenciales a nivel anímico también es crucial, ya que puede arrojar luz sobre algunos problemas de adherencia. Objetivos: Este estudio tiene como objetivo examinar los efectos a corto plazo de diversas prácticas de meditación que difieren en el enfoque de la atención y los estímulos entre los principiantes. El enfoque se centra en el afecto inmediato, la dificultad percibida y la adherencia. Método: Se empleó un diseño controlado aleatorio dentro de sujetos con medidas pre y post en un taller que constaba de cuatro sesiones (cuatro sesiones semanales de 1 hora cada una). Se establecieron cuatro condiciones experimentales: Interna y Focalizada (I-FA, Atención focalizada interna), Externa y Focalizada (E-FA, Atención focalizada externa), Interna y Abierta (I-OM, Monitoreo abierto interno), y Externa y Abierta (E-OM, Monitoreo abierto externo). Resultados: La modalidad E-OM demostró una reducción más significativa en la incomodidad en comparación con la modalidad I-OM. Los participantes informaron mayor dificultad al meditar con estímulos externos en comparación con estímulos internos, independientemente de si la meditación era focalizada o abierta. Sin embargo, al menos en este estudio, el tipo de modalidad no pareció influir en la adherencia a la práctica de meditación. Conclusiones: Los hallazgos sugieren la importancia de investigar las potenciales ventajas de incluir la meditación E-OM como alternativa a I-OM en el comienzo del entrenamiento en mindfulness.(AU)

Exploring Pathways and Obstacles to Well-Being in Victims of Terrorism: A Qualitative Approach.

On March 11, 2004, Madrid suffered one of the worst terrorist attacks in the history of Spain, leaving more than 190 dead and 2,000 injured. For years, the psychological consequences of the attacks have been studied; however, its long-term effects on symptomatology and especially on well-being remains unknown. This study aims to explore, through a qualitative approach, pathways and obstacles to the well-being of those affected directly or indirectly by the attacks of March 11 in Madrid. Two focus groups were held, one for indirect victims and one for direct victims. Subsequently, a thematic analysis of the materials obtained was carried out. More than 10 years after the attacks, most of the participants reported great difficulty in achieving well-being. Acceptance and victims' associations seemed to act as key facilitators, while symptoms, political institutions and the media were the main obstacles. Direct and indirect victims presented similar data although aspects such as guilt and family relationships played a different role in their well-being.

Exploring Pathways and Obstacles to Well-Being in Victims of Terrorism: A Qualitative Approach

On March 11, 2004, Madrid suffered one of the worst terrorist attacks in the history of Spain, leaving more than 190 dead and 2,000 injured. For years, the psychological consequences of the attacks have been studied; however, its long-term effects on symptomatology and especially on well-being remains unknown. This study aims to explore, through a qualitative approach, pathways and obstacles to the well-being of those affected directly or indirectly by the attacks of March 11 in Madrid. Two focus groups were held, one for indirect victims and one for direct victims. Subsequently, a thematic analysis of the materials obtained was carried out. More than 10 years after the attacks, most of the participants reported great difficulty in achieving well-being. Acceptance and victims’ associations seemed to act as key facilitators, while symptoms, political institutions and the media were the main obstacles. Direct and indirect victims presented similar data although aspects such as guilt and family relationships played a different role in their well-being. (AU)

Short mindfulness meditation training: does it really reduce perceived stress?

To study whether an 8-week mindfulness meditation training program truly reduces perceived stress without designing a stress reduction program. An experimental study was performed in which we studied the effects of 8 weeks of MM training on attention and awareness, as measured by the MAAS (mindfulness attention awareness scale) and perceived stress, as measured by the PSQ (perceived stress questionnaire), in 80 volunteers from the general public recruited by email from university centers. An increase in the individual's dispositional capacity to be attentive and aware of the experience of the present moment in everyday life was observed in the experimental group versus the control group; F (2, 156) = 14.30, p = .000, η2 partial = .155. Perceived stress showed no significant differences between groups in: social acceptance; F (2, 156) = 2.30, p = .103, overload; F (2, 156) = 2.32, p = .101, irritability, tension and fatigue; F (2, 156) = 2.27, p = .106, energy and joy; F (2, 156) = 2.79, p = .065. MM practice for 8 weeks of training increases the individual's dispositional capacity to be attentive and aware of the experience of the present moment in everyday life but may not reduce perceived stress.

A comparative study of climacteric symptoms among two populations of mid-aged women.

The purpose of this study was to compare climacteric symptoms associated with health-related quality of life (HRQOL) among women from Madrid (Spain) and Belgrade (Serbia). A cross-sectional study included 461 women from Madrid and 513 women from Belgrade aged 40-65 years. Climacteric symptoms and HRQOL were examined using the Menopause Rating Scale (MRS). There were no differences in MRS total score (p = 0.873), somato-vegetative and urogenital domain scores regarding country groups. However, women from Belgrade had poorer psychological domain score than women from Madrid (p = 0.027). Madrilenian women were more likely to have worse MRS score if they were coupled, had gynaecological complaints and longer duration of amenorrhoea. In Belgradian women, having higher level of education and using hormone-replacement therapy was associated with worse MRS score. Midlife women from Madrid and Belgrade had similar perception of intensity of urogenital and somato-vegetative climacteric symptoms. Belgradian women, however, perceived psychological symptoms as more severe.IMPACT STATEMENTWhat is already known on this subject? Social and cultural meanings of menopause vary across countries. It is quite delicate to strike a balance between two or more populations of women that can be compared, but also have specific features that are unique to their area. Similarities such as position of women in the society, access to education, contraception and safe induced abortion can facilitate this comparison.What do the results of this study add? Spanish and Serbian women rated similarly somato-vegetative and urogenital complaints, but Serbian women had worse psychological symptoms compared to Spanish women. Spanish women were more likely to endure climacteric symptoms until they withdraw spontaneously. Serbian women of higher education were more likely to use hormone-replacement therapy to manage climacteric complaints.What are the implications of these findings for clinical practice and/or further research? This study is the first to compare climacteric symptoms between women in Spain and Serbia. Despite the universality of menopause, culture seems to play a major role in differences in the perception of specific climacteric symptoms. Examination of quality of life in menopausal transition is an important measure of health status and should become a part of the routine health care in midlife.

Women in a situation of homelessness and violence: a single-case study using the photo-elicitation technique.

BACKGROUND: Violence against women places them in a vulnerable position with regard to homelessness. Although sometimes invisible, women's homelessness is a complex reality shrouded in dramatic biographies that should be sensitively addressed to avoid revictimization. METHODS: With the aim of understanding the chaotic discourse of homeless women's experiences of violence, a qualitative single-case study was conducted using the photo-elicitation technique. Data were analyzed in accordance with grounded theory. RESULTS: The participant's discourse could be summarized in the following categories: "Living in a spiral of violence", "Confronting vulnerability and violence", "Being a strong woman", "New family networks", "Re-building mother-child relationships", and "Nurturing spiritual wellbeing". CONCLUSIONS: Supporting homelessness women requires an approach that focuses on the prevention of re-victimization and the consequences of violence in terms of physical and mental health. Shelters are spaces of care for recovery and represent referential elements for the re-construction of self.

Aplicación individual del tratamiento transdiagnóstico a un caso de ansiedad generalizada / Individual application of the transdiagnostic treatment to a case of generalized anxiety disorder

OBJETIVO: Se describe el caso clínico de una mujer, C.G, de 22 años con trastorno de ansiedad generalizada, con el propósito de evaluar el efecto del Protocolo Unificado para el Tratamiento Transdiagnóstico de los trastornos emocionales para reducir la ansiedad. MÉTODO: Se trata de un diseño de caso único, pre- postramiento. Los instrumentos de evaluación utilizados para el diagnóstico y posterior establecimiento del tratamiento fueron el Inventario de Ansiedad Estado-Rasgo (Spielberger, Gorusch, y Lushene), la Escala de Valoración de la Ansiedad de Hamilton (Hamilton, 1959; Lobo et al., 2002), el Cuestionario de Preocupaciones del Estado de Pensilvania (Comeche, Díaz, y Vallejo, 1995; Meyer, Miller, Metzger y Borkovec, 1990), y el Inventario de Depresión de Beck (Beck, Steer, y Brown, 2011). La intervención fue la aplicación del Protocolo Unificado para el Tratamiento Transdiagnóstico de los trastornos emocionales (Barlow et al., 2015) en 23 sesiones de 50 minutos. Finalmente se volvió a evaluar con los mismos instrumentos previos al tratamiento. RESULTADOS: Conforme a las pruebas postratamiento, en concreto Cuestionario de Preocupaciones del Estado de Pensilvania (Comeche, Díaz, y Vallejo, 1995; Meyer, Miller, Metzger y Borkovec, 1990), C.G. ya no reúne los criterios ni alcanza la puntuación (de 77 a 40) para el diagnóstico de trastorno de ansiedad generalizada. CONCLUSIONES: Tras el tratamiento, se observa una clara mejoría con una reducción significativa en el número de anticipaciones, lo que confirma la eficacia del tratamiento transdiagnóstico para este caso

OBJECTIVE: The clinical case of a 22-year-old woman, C.G, with generalized anxiety disorder is described, with the purpose of evaluating the effect of the Unified Protocol for the Transdiagnostic Treatment of emotional disorders to reduce anxiety. METHOD: This is a single case design, pre-post treatment. The evaluation instruments used for the diagnosis and subsequent establishment of the treatment were the State-Trait Anxiety Inventory (Spielberger, Gorusch, and Lushene), the Hamilton Anxiety Assessment Scale (Hamilton, 1959; Lobo et al., 2002), the Pennsylvania State Concerns Questionnaire (Comeche, Díaz, and Vallejo, 1995; Meyer, Miller, Metzger and Borkovec, 1990), and the Beck Depression Inventory (Beck, Steer, and Brown, 2011). RESULTS: According to post-treatment tests, specifically Pennsylvania State Concerns Questionnaire (Comeche, Díaz, and Vallejo, 1995; Meyer, Miller, Metzger and Borkovec, 1990), C.G. It no longer meets the criteria or reaches the score (from 77 to 40) for the diagnosis of generalized anxiety disorder. CONCLUSIONS: After the treatment, a clear improvement is observed with a significant reduction in the number of anticipations, which confirms the effectiveness of the transdiagnosis treatment for this case

La Adherencia al Entrenamiento en Meditación Mindfulness con Registro en Papel y en Aplicación Móvil / The influence of different monitoring means on the adherence to mindfulness meditation practice

Los efectos beneficiosos de la meditación mindfulness (MM) se han observado en numerosos estudios, pudiendo ser la atención y conciencia en el momento presente una variable esencial. Sin embargo, la adherencia al entrenamiento de la práctica meditativa es en ocasiones baja. Se investigaron los efectos del entrenamiento en MM sobre la atención y conciencia y si el formato de registro de la práctica de MM, formato papel (PP) (n = 27) o aplicación móvil (APP) (n = 21), produce diferencias en la adherencia al entrenamiento y en la atención y conciencia. Los resultados mostraron un aumento de la atención y conciencia tras el entrenamiento, independientemente del formato de registro de la práctica. La APP redujo el abandono al entrenamiento y aumentó el tiempo de práctica de MM cada día que se practicó

Beneficial effects of mindfulness meditation (MM) have been observed in many studies, with attention to and awareness of the present moment possibly representing an essential variable. However, adhering to the meditation regimes is poor at times. As such, the effects of MM training on attention and awareness were examined here, and whether the means of recording the practice of MM - using paper (PP, n = 27) or through a mobile phone application (APP, n = 21) - produced any differences in terms of adherence to the training, or in attention and awareness. The results demonstrate that training enhances attention and awareness, irrespective of the format with which it was recorded. The APP reduced the rate of withdrawal from the training and it increased the time dedicated to the practice of MM each day