Estrés comunitario frente a múltiples desastres durante la erupción volcánica y la pandemia covid-19: un estudio transversal / Community stress facing multiple disasters during the volcanic eruption and the covid-19 pandemic: a cross-sectional study

Objetivo: Este estudio tiene como objetivo determinar el estrés durante la pandemia de COVID-19 y afrontar las erupciones volcánicas y analizar los factores relacionados. Métodos: Esta investigación fue de tipo observacional analítica cuantitativa con un diseño transversal. El número de muestras fue de 352 pacientes mediante la técnica de muestreo accidental. El instrumento de investigación utiliza la escala de estrés percibido (PSS) -10 ítems y la escala de estrés COVID-19. Para el análisis de los datos se utilizaron las pruebas Kendal Tau y Chi-Cuadrado. Resultados: La mayoría de los encuestados experimentaron estrés leve durante la pandemia de COVID-19 (66,2%) y estrés moderado al lidiar con erupciones volcánicas (98,9%). Las variables relacionadas con el estrés durante una pandemia fueron género (p.017), educación (p.027), ingresos (p<.001) y distancia desde casa hasta la cima del volcán (p<0.036), mientras que las relacionadas con el estrés que enfrentan las erupciones volcánicas es sólo una experiencia de desastre de entrenamiento (p.033). Conclusiones: El estudio encontró que el nivel de estrés al enfrentar una erupción volcánica era mayor que durante la pandemia de COVID-19. El género, la educación, los ingresos y la distancia desde el hogar hasta la cima de un volcán están relacionados con el estrés durante una pandemia. Al mismo tiempo, la experiencia de la formación en desastres fue el único factor asociado con el estrés al afrontar las erupciones volcánicas. (AU)

Primary Goal: This study is to determine stress during the COVID-19 pandemic and dealing with volcanic eruptions and analyze the related factors. Methods: This research was an analytic observational quantitative with a cross-sectional design. The number of samples was 352 patients using the accidental sampling technique. The research instrument uses the Perceived stress scale (PSS)-10 items and the COVID-19 Stress Scale. Kendal Tau and Chi-Square tests were used for data analysis. Results: Most respondents experienced mild stress during the COVID-19 pandemic (66.2%) and moderate stress when dealing with volcanic eruptions (98.9%). Variables related to stress during a pandemic were gender (p.017), education (p.027), income (p<.001), and distance from home to the top of the volcano (p<0.036), while those related to the stress faced Volcanic eruptions are just a training disaster experience (p.033). Conclusions: The study found that the stress level of facing a volcanic eruption was higher than during the COVID-19 pandemic. Gender, education, income, and distance from home to the top of a volcano are related to stress during a pandemic. At the same time, the experience of disaster training is the only factor associated with stress in dealing with volcanic eruptions. (AU)

Integrated psychological intervention programme for frontline healthcare workers during the COVID-19 pandemic. A qualitative study / Programa integrado de intervenciones psicológicas de emergencia en sanitarios durante la pandemia de la COVID-19. Estudio cualitativo

Introduction: The outbreak of the COVID-19 pandemic put at risk the resilience of health-care professionals by exposing them to high levels of stress. Our aim was to identify key elements for implementing the STEP programme, a psychological support service for healthcare professionals.Methods: qualitative design. The study participants were hospital healthcare staff. Anon-ymous questionnaires and transcriptions of group interventions and focus groups were used to identify professionals’ preferences to receiving psychological support, needs, concerns, resilience (STEP1.0); constrained emotions and associated thoughts (STEP1.5); perception of self-efficacy on managing emotions (STEP2.0); and the professionals’ profile requiring individual therapy.Results: Three hundred professionals participated in the study, 100.0% in STEP 1.0 , 27.3% in STEP 1.5, 2.7% in STEP 2.0, and 10.0% in individual interventions. Two hundred and three (67.7%) participants reflected in the survey that they would prefer access to a face-to-face psychological service during working hours. Three consecutive phases with specific needs and concerns were identified: The “cognitive” phase, at the beginning of the pandemic, when infection and self-efficacy were major concerns, the “ventilation” phase, when constrained emotions associated with several factors were expressed; and the “recovery” phase, when the clinical overload decreased and professionals were able to focus on emotion manage-ment training. Several personal characteristics associated with referral to individual therapy were identified. Conclusions: The key characteristics of a psychological support service are proximity, face-to-face interaction during working shifts, and a chronological phase system adapted to dif-ferent emerging needs.(AU)

Introducción: El estallido de la pandemia de la COVID-19 puso en riesgo la resiliencia de los profesionales sanitarios exponiéndolos a alto riesgo de estrés. Nuestro objetivo consistió en identificar elementos clave para implementar un servicio de apoyo psicológico para pro-fesionales.Método: Diseño cualitativo. Participaron profesionales a nivel hospitalario. Se utilizaron cuestionarios anónimos, transcripciones de intervenciones grupales y grupo focal. Se consideraron las variables asociadas a las herramientas de intervención psicológica im-plementadas: STEP 1.0, necesidades, preocupaciones y resiliencia; STEP 1.5, emociones contenidas y pensamientos asociados; STEP 2.0, percepción de autoeficacia en gestión de emociones. Características de profesionales asociadas a terapia individual; así como el método elegido para recibir apoyo psicológico. Resultados: Participaron 300 profesionales, 100.0% en STEP 1.0, 27.3% en STEP 1.5, 2.7% en STEP 2.0 y 10.0% en intervenciones individuales. En 203 cuestionarios los profesionales preferían un servicio psicológico presencial y durante las horas de trabajo. Se identificaron 3 fases consecutivas con necesidades y preocupaciones específicas: Fase “Cognitiva”, incial, cuando la infección y autoeficacia preocupaban más. Fase de “Ventilación” cuando se expresaron emociones contenidas asociadas a varios factores. Fase de “Recuperación”, cuando los profesionales afrontaron la gestión de emociones. Se identificaron característi-cas asociadas a la derivación a terapia individual. Conclusión: Las características clave de un servicio de apoyo psicológico son la proximi-dad, presencialidad, activarse en turnos laborales y seguir un sistema cronológico de fases adaptado a las distintas necesidades emergentes.(AU)

Mediators and Moderators of Active Music Engagement to Reduce Traumatic Stress Symptoms and Improve Well-being in Parents of Young Children With Cancer.

OBJECTIVE: This trial examined the effects of proximal/distal mediators and moderators of an Active Music Engagement (AME) intervention on young child/parent distress, quality of life, and family function outcomes. METHODS: Child/parent dyads (n = 125) were randomized to AME or Audio-storybooks attention control condition. Each group received 3 sessions with a credentialed music therapist for 3 consecutive days with data collection at baseline, post-intervention (T2), and 30-days later (T3). Potential proximal mediators included within session child and parent engagement. Potential distal mediators included changes in perceived family normalcy, parent self-efficacy, and independent use of play materials. Potential moderators included parent/child distress with prior hospitalizations, parent traumatic stress screener (PCL-6), and child age. Outcomes included child emotional distress and quality of life; parent emotion, traumatic stress symptoms (IES-R), well-being; and family function. Mediation effects were estimated using ANCOVA, with indirect effects estimated using the percentile bootstrap approach. Moderation effects were tested by including appropriate interaction terms in models. RESULTS: No significant mediation effects were observed. Child distress with prior hospitalizations moderated AME effects for IES-R intrusion subscale scores at T2 (P = .01) and avoidance subscale scores at T3 (P = .007). Traumatic stress screener scores (PCL-6) moderated intervention effects for IES-R hyperarousal subscale scores at T2 (P = .01). There were no moderation effects for child age. CONCLUSIONS: AME is a promising intervention for mitigating traumatic stress symptoms and supporting well-being in parents of children with cancer, particularly for parents who screen high for traumatic stress and whose children are more highly distressed with hospitalization.

Traumatic Stress-Induced Increases in Anxiety-like Behavior and Alcohol Self-Administration Are Mediated by Central Amygdala CRF1 Neurons That Project to the Lateral Hypothalamus.

Avoidance stress coping, defined as persistent internal and/or external avoidance of stress-related stimuli, is a key feature of anxiety- and stress-related disorders, and contributes to increases in alcohol misuse after stress exposure. Previous work using a rat model of predator odor stress avoidance identified corticotropin-releasing factor (CRF) signaling via CRF Type 1 receptors (CRF1) in the CeA, as well as CeA projections to the lateral hypothalamus (LH) as key mediators of conditioned avoidance of stress-paired contexts and/or increased alcohol drinking after stress. Here, we report that CRF1-expressing CeA cells that project to the LH are preferentially activated in male and female rats that show persistent avoidance of predator odor stress-paired contexts (termed Avoider rats), and that chemogenetic inhibition of these cells rescues stress-induced increases in anxiety-like behavior and alcohol self-administration in male and female Avoider rats. Using slice electrophysiology, we found that prior predator odor stress exposure blunts inhibitory synaptic transmission and increases synaptic drive in CRF1 CeA-LH cells. In addition, we found that CRF bath application reduces synaptic drive in CRF1 CeA-LH cells in Non-Avoiders only. Collectively, these data show that CRF1 CeA-LH cells contribute to stress-induced increases in anxiety-like behavior and alcohol self-administration in male and female Avoider rats.SIGNIFICANCE STATEMENT Stress may lead to a variety of behavioral and physiological negative consequences, and better understanding of the neurobiological mechanisms that contribute to negative stress effects may lead to improved prevention and treatment strategies. This study, performed in laboratory rats, shows that animals that exhibit avoidance stress coping go on to develop heightened anxiety-like behavior and alcohol self-administration, and that these behaviors can be rescued by inhibiting the activity of a specific population of neurons in the central amygdala. This study also describes stress-induced physiological changes in these neurons that may contribute to their role in promoting increased anxiety and alcohol self-administration.

The mediation role of resilience and postpartum traumatic stress disorder on parental attachment and the maternal-infant bonding.

AIMS: This study aimed to evaluate the correlation between parental attachment, resilience, postpartum traumatic stress disorder (PTSD), and maternal-infant bonding at 1 to 3 months postpartum. The mediation effect of resilience and PTSD on the postpartum parental attachment and maternal-infant bond was also evaluated. DESIGN: A cross-sectional research design was used. METHODS: A total of 400 postpartum women examined at a tertiary hospital in Wuhan from January 2021 to June 2021 were enrolled in the study. At about 1 to 3 months after giving birth, the women were asked to complete the Postpartum Bonding Questionnaire (PBQ), Connor-Davidson Resilience scale(CD-RISC), PTSD CheckList-Civilian version (PCL-C), and the Parental Bonding Instrument (PBI). The data were summarized using descriptive statistics. Mediation analyse and the Spearman correlation (r) were used to correlate the resilience and PTSD questionnaire scores. RESULTS: The care attachment dimension was significantly associated with resilience (r = 0.24, p < 0.01), PTSD (r = - 0.27, p < 0.01), and maternal-infant bonding (r = 0.10, p < 0.01), and the overprotection attachment dimension was significantly associated with resilience (r = - 0.11, p < 0.01), PTSD (r = 0.33, p < 0.01), and maternal-infant bonding (r = 0.16, p < 0.01). Resilience and PTSD can mediate the relationship between attachment and maternal-infant bonding. CONCLUSION: Parental attachment, resilience, and PTSD significantly affect maternal-infant bonding at 1 to 3 months postpartum. IMPACT: This study demonstrated that new interventions aimed at addressing PTSD symptoms and improving resilience might increase parental attachment and maternal-infant bonding after birth. However, further research is required to evaluate the success of these interventions.

Maternal steroids during pregnancy and their associations with exposure to lifetime stressful life events, prenatal stress appraisal and psychological functioning.

BACKGROUND: During pregnancy, steroids enable physiological adaptations in response to many factors, including maternal stress or psychological functioning. While stress and psychological dysfunction can have endocrine-disrupting effects beyond cortisol disruption, associations between prenatal maternal stress or related psychological dysfunction and the broader steroid milieu remain understudied. AIM: To assess associations between independent and joint maternal stress and psychological functioning measures and steroid profiles in pregnancy (22-40 gestational weeks) in the Programming of Intergenerational Stress Mechanisms (PRISM) birth cohort (n = 334). METHODS: Serum metabolomics detected 42 steroids and their metabolites, which were grouped into five classes (pregnenolone, androgens, estrogens, progestin, and corticosteroids). The Perceived Stress Scale, Life Stressor Checklist-Revised, and Edinburgh Postnatal Depression Scale indexed lifetime traumatic/non-traumatic stressors, global prenatal stress appraisal, and depressive symptoms during pregnancy, respectively. Exposures were categorized as high-low using the corresponding 3rd quartiles. We assessed associations between both individual and joint stress exposures with steroid classes using linear mixed effect models and with individual steroids using linear regressions. We also examined fetal sex-specific effects. RESULTS: High prenatal perceived stress was independently associated with lower levels of androgens and estrogens in the overall sample [ß (95%CI): androgens: -0.13 (-0.25;-0.01); estrogens: -0.16 (-0.31;-0.01)], particularly among women carrying males [androgens: -0.22 (-0.39;-0.05); estrogens: -0.28 (-0.50;-0.07)]. Results on estrogens were consistent when considering joint exposure to both greater lifetime stressors and higher prenatal perceived stress. We also found a single testosterone metabolite-5alpha-androstan-3alpha,17alpha-diol disulfate-negatively associated with both individual high perceived stress and joint exposure to high lifetime stressors and high perceived stress among women carrying males. CONCLUSIONS: Increased maternal perceived stress experienced in pregnancy was independently associated with lower maternal androgen and estrogen levels during pregnancy in the overall sample, particularly among women carrying males. Results on estrogens were consistent when we considered the joint exposure of increased lifetime stressors and higher prenatal perceived stress.

Effects of shear stress path and roughness on shear creep behavior of marine clay-concrete interface.

Floating piles have been widely employed as foundations in coastal regions abounding with marine clay. A growing concern for these floating piles is their long-term performance of bearing capacity. To better understand the time-dependent mechanisms behind the bearing capacity, in this paper a series of shear creep tests was conducted to study the effects of load paths/steps and roughness on shear strain of the marine clay-concrete interface. Four main empirical features were observed from the experimental results. First, the creep process of the marine clay-concrete interface can be largely decomposed into the instantaneous creep stage, the attenuation creep stage and the uniform creep stage. Second, the creep stability time and the shear creep displacement generally increase as the shear stress level increases. Third, the shear displacement rises as the number of loading steps drops under the same shear stress. The fourth feature is that under the shear stress condition, the rougher the interface is, the smaller the shear displacement is. Besides, the load-unloading shear creep tests suggest that: (a) shear creep displacement typically contains both viscoelastic and viscoplastic deformation; and (b) the proportion of unrecoverable plastic deformation increases with increasing shear stress. These tests confirm that the Nishihara model can provide a well-defined description of the shear creep behavior of marine clay-concrete interfaces.

Moving From Traumatic Events to Traumatic Experiences in the Study of Traumatic Psychopathology.

Trauma is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as an event that includes "actual or threatened death, serious injury, or sexual violence" (p. 271). The list of traumatic events included in the DSM-5 represents a long history of psychiatry and psychology's attempts to define trauma and differentiate these events from less severe stressors. In this commentary, we suggest that this strict distinction between traumatic events and stressful events is not useful for public health. The current DSM-5 list of traumatic events may work well for identifying people with the most severe experiences and highest conditional probability of distress who need clinical care. However, the public health field has different priorities. If we think about posttraumatic psychological distress on a population scale, it is not only helping those with the most severe experiences that is needed; rather, public health requires paying attention to all people experiencing distressing stress and trauma reactions. We propose that context is crucial to the development of a population-relevant definition of trauma and provide examples of situations in which stressors have resulted in posttraumatic psychological distress and in which traumatic event reactions have been mitigated by the context in which they occur. We discuss trauma context from an epidemiologic perspective and conclude with recommendations for the field. This article is part of a Special Collection on Mental Health.

Crises in the Anthropocene.

2022 was a year of crises, not just one but multiple intersecting crises that caused traumatic stress in billions of people worldwide. COVID-19 is still not over. New wars have started, and the climate change impact is bigger than ever. Will the Anthropocene be an era of continued crises? This past year the European Journal of Psychotraumatology (EJPT) has again tried to contribute to how to prevent or treat the consequences of these major crises as well as other events and we will continue to do so the year to come. For instance, we will have special issues or collections addressing these big issues, such as climate change and traumatic stress, or early intervention after trauma or in times of conflict. In this editorial, we also present the past year's excellent journal metrics regarding reach, impact, and quality and the ESTSS EJPT award finalists for best paper of 2022 and look forward to 2023.

2022 was a year of multiple intersecting crises causing traumatic stress to billions of people around the world.European Journal of Psychotraumatology (EJPT) aims to contribute to how to understand, prevent or treat the consequences of these major crises.EJPT's editorial team again achieved excellent journal metrics regarding reach, impact, and quality in 2022.

History of the term 'appeasement': a response to Bailey et al. (2023).

This letter to the editor aims to address claims made by Bailey et al. [2023. Appeasement: Replacing Stockholm syndrome as a definition of a survival strategy. European Journal of Psychotraumatology, 14(1), 2161038] about the history of the concept of appeasement in relation to mammalian survival responses as well as the fawn response, by offering a brief overview and analysis of the literature.

Appeasement in political and foreign policy, social justice, ethology, psychology, and communication studies (multiple mammalian and avian species) feature elements of coregulation.The original conceptualisation of the fawn response may result in the misperception that it is unrelated to coregulation.Appeasement and coregulation can occur whether the vulnerable party initiating the appeasement is in a state that supports affiliative, distress, or shutdown behaviour.

Dos décadas de evidencia: hacia un enfoque integrador sobre los efectos de la adversidad y el maltrato infantil en la salud mental / Dues dècades d’evidència: cap a un enfocament integrador sobre els efectes de l’adversitat i del maltractament infantil a la salut mental / Two decades of evidence: towards an integrative approach to the effects of childhood adversity and mal- treatment on mental health

El objetivo de este artículo es recopilar la evidencia actual sobre el impacto del maltrato y laadversidad en la infancia sobre la salud mental, priorizando aquellos trastornos que no han ocupado tradicional-mente un lugar nuclear en la etiología. Se revisan las publicaciones aparecidas en las principales bases de datosen los últimos veinte años. Concluimos con la gran importancia de detectar de forma precoz los antecedentestraumáticos en la atención clínica y la necesidad de implementar intervenciones preventivas efectivas. Primamosla aproximación a los trastornos desde una óptica transdiagnóstica, como un acercamiento más eficiente a larealidad del neurodesarrollo y a la naturaleza, génesis y curso de la psicopatología.(AU)

The aim of this article is to compile the current evidence on the impact of childhoodadversity and maltreatment on mental health, prioritizing those disorders that have not traditionally occupieda central place in the etiology. We review the publications that have appeared in the main databases in the lasttwenty years. We conclude with the great importance of early detection of traumatic antecedents in clinical careand the need to implement effective preventive interventions. We prioritize the approach to disorders from atransdiagnostic perspective, as a more efficient approach to the reality of neurodevelopment and to the nature,genesis and course of psychopathology.(AU)

L’objectiu d’aquest article és recopilar l’evidència actual sobre l’impacte del maltracta-ment i l’adversitat a la infància sobre la salut mental, prioritzant aquells trastorns que no han ocupat tradicional-ment un lloc nuclear a l’etiologia. Es revisen les publicacions aparegudes a les principals bases de dades en elsdarrers vint anys. Concloem amb la gran importància de detectar de manera precoç els antecedents traumàticsa l’atenció clínica i la necessitat d’implementar intervencions preventives efectives. Prioritzem l’aproximació alstrastorns des d’una òptica transdiagnòstica, com un apropament més eficient a la realitat del neurodesenvolu-pament i a la natura, gènesi i curs de la psicopatologia.(AU)

Abuso sexual infantil y su retorno en la adultez: reflexiones desde un caso clínico / Abús sexual infantil i el retorn a l’adultesa: reflexions des d’un cas clínic / Childhood sexual abuse and its return in adulthood: reflections from a clinical case

La clínica con adultosabusados sexualmente en la infancia es una línea de investigación muy abordada en estudios sobre el abusosexual infantil. El presente trabajo es un estudio descriptivo de caso único con el objetivo de analizar el materialclínico de una paciente de veinticinco años que sufrió abuso intrafamiliar en la infancia. Este material se extraede entrevistas de un proceso psicoterapéutico. En primer lugar, se realiza la descripción del caso clínico y lue-go se articula con análisis teórico psicoanalítico. Se profundiza en: desubjetivación, traumatismo, mecanismosdefensivos y desamparo, acomodación, síntomas, elaboración terapéutica y contexto patriarcal. Por último, sereflexiona sobre el ideal de familia como dadora incondicional de cuidado y se plantea al abuso sexual infantilcomo síntoma social, siendo una compleja problemática que requiere de abordajes interdisciplinarios.(AU)

The clinic with sexually abu-sed adults in childhood is a line of research that has been widely addressed in studies on child sexual abuse. Thepresent work is a descriptive single case study with the aim of analyzing the clinical material of a twenty-five yearold patient who suffered intrafamilial abuse in childhood. This material is extracted from interviews of a psychothe-rapeutic process. First, a description of the clinical case is made and then it is articulated with psychoanalytictheoretical analysis. It is deepened in: desubjectivation, traumatism, defensive mechanisms and helplessness, ac-commodation, symptoms, therapeutic elaboration and patriarchal context. Finally, we reflect on the ideal of thefamily as an unconditional giver of care and consider child sexual abuse as a social symptom, a complex problemthat requires interdisciplinary approaches.(AU)

La clínica amb adults abusats sexual-ment a la infància és una línia de recerca molt abordada en estudis sobre l'abús sexual infantil. Aquest treball ésun estudi descriptiu de cas únic amb l'objectiu d'analitzar el material clínic d'una pacient de vint-i-cinc anys queva patir abús intrafamiliar a la infància. Aquest material s’extreu d’entrevistes d’un procés psicoterapèutic. Enprimer lloc, es fa la descripció del cas clínic i després s’articula amb anàlisi teòrica psicoanalítica. S'aprofundeixen: desubjectivació, traumatisme, mecanismes defensius i desemparament, acomodació, símptomes, elaboracióterapèutica i context patriarcal. Finalment, es reflexiona sobre l’ideal de família com a donadora incondicionalde cura i es planteja l’abús sexual infantil com a símptoma social, cosa que és una problemàtica complexa querequereix abordatges interdisciplinaris.(AU)

Posttraumatic Stress and Perceived Interpersonal Provocation in Adolescents.

Objective: To examine the impact of posttraumatic stress on the choice of responses to and attribution of intentionality in peer provocation in adolescent boys and girls. Methods: A sample of 2678 adolescents from Northern Russia, aged 13-17 years (59.3% female; 95.7% ethnic Russian) completed self-reports on posttraumatic stress and rated hypothetical peer provocation scenarios that teenagers can encounter in their daily lives. Results: Adolescents with clinically significant levels of posttraumatic stress symptoms (n=184 (6.8%)) reported a different pattern of reactions to peer provocation as compared to all other adolescents. Boys and girls with high levels of posttraumatic symptoms reported that they would be less likely to discuss conflict situations and more likely to react with physical aggression. Compared to their male counterparts, girls with high levels of posttraumatic stress symptoms were more likely to endorse hostile intentions, avoid provocations, and were less likely to endorse verbally aggressive responses. In provocation scenarios that involved physical aggression, girls with high levels of posttraumatic stress symptoms were less likely to endorse verbal aggressive responses and more likely to endorse physically aggressive responses than girls without clinically significant levels of posttraumatic symptoms. Girls with high levels of posttraumatic stress symptoms were also more likely to avoid socially aggressive situations than non-traumatized girls, whereas boys had an opposite pattern. Conclusions: High levels of posttraumatic stress symptoms may play a significant role in the endorsement of aggressive reactions in conflicts with peers and patterns of reactions may be gender-specific. A history of posttraumatic stress should be carefully evaluated in children and adolescents seeking treatment for aggressive behavior.

The position statement of the Working Group on the diagnosis of the post-traumatic stress disorders in adults. / Stanowisko grupy roboczej dotyczace diagnozy zaburzen zwiazanych ze stresem pourazowym u osób doroslych.

Experiencing a situation of extreme danger can lead to serious stress disorders (such as PTSD) that can affect both the victims and the professional helpers. Military operations in Ukraine in the first half of 2022 started an ongoing migration crisis, resulting in the displacement of approximately 3.5 million people to Poland. It is indicated that post-traumatic stress disorders may affect up to one third of adult refugees. Exposure to traumatic stress related to assault, limitation of basic resources, fear, insecurity, death, and a sense of injustice affected the entire population of the country. As a result, refugees, healthcare professionals, uniformed services, volunteers, and NGO workers constitute a group at risk of developing stress-related disorders, including post-traumatic stress disorder (PTSD). The presented recommendations were developed by an interdisciplinary team of experts in the field of psychiatry, clinical psychology, psychotherapy, and family medicine to present systematic guidelines for diagnostic procedures in medical and psychological practice.

Stressful Life Events in Children Aged 3 to 15 Years During the COVID-19 Pandemic: A Latent Class Analysis / Eventos Vitales Estresantes en Niños de 3 a 15 Años Durante la Pandemia deCOVID-19: Un Análisis de Clases Latentes

Background: Although several studies have reported an increase in psychological problems during the COVID-19 pandemic, the impact of stressful life events on Spanish children and adolescents using a person-oriented statistical approach and the relationships between the profiles and emotional and behavioral symptoms have not yet been examined. The present study aims to identify profiles of Spanish children and adolescents, considering life-threatening stressful events during the COVID-19 pandemic. Method: Participants were 252 parents of children aged 3 to 15 years old who completed an online structured questionnaire that collected information about stressful life events related to the pandemic and its impact on their children’s welfare. Results: Through Latent Class Analysis (LCA), four profiles of children and adolescents were found according to the stressful events experienced: “COVID infection, social confinement,” “economic loss,” “reduced social contact“ and “parental stress,” with no significant age or gender differences. Reduction in social contact was the most prevalent stressor. Comparisons of psychological symptoms across latent classes were analyzed. Conclusions: The findings increase our understanding of how stressful life events during the COVID-19 situation impacted young people’s psychological welfare and highlight the need to promote strategies to prevent emotional problems during a pandemic considering the identified profiles.(AU)

Antecedentes: Aunque diversos estudios han informado sobre el aumento de problemas psicológicos durante la pandemia de COVID-19, hasta el momento no se ha examinado el impacto de los eventos vitales estresantes en niños y adolescentes mediante un enfoque estadístico orientado a la persona, y la relación entre los perfiles y los síntomas emocionales y conductuales. El presente estudio tiene como objetivo determinar perfiles identificativos de niños y adolescentes españoles, ante eventos estresantes de riesgo durante la pandemia. Método: Participaron 252 padres de niños de 3 a 15 años, quienes completaron un cuestionario estructurado online que recopiló información sobre eventos estresantes relacionados con la pandemia y sobre su impacto en el bienestar de sus hijos. Resultados: Mediante Análisis de Clases Latentes (LCA), se encontraron cuatro perfiles, según los eventos estresantes experimentados: “Infección por COVID, encierro social,” “pérdida económica,” “contacto social reducido” y “estrés de los padres,” sin diferencias significativas en las variables edad y género. La reducción del contacto social fue el estresor más prevalente. Se analizaron las comparaciones de síntomas psicológicos entre clases latentes. Conclusiones: Los hallazgos resaltan la necesidad de promover estrategias para prevenir problemas emocionales durante la pandemia.(AU)

O florir da violeta: um estudo de caso em avaliação terapêutica / The flowering of violet: a case study in therapeutic assessment / La flor de la violeta: un estudio de caso en evaluación terapéutica

A Avaliação Terapêutica (AT) é um processo avaliativo e interventivo proposto para ser semiestruturado e colaborativo com o objetivo de promover mudanças positivas no cliente, que é convidado a ter uma participação ativa durante o processo. Na AT, os resultados dos testes psicológicos padronizados ganham destaque como facilitadores do processo de autoconhecimento do cliente. Desse modo, usualmente, integram-se os achados de testes psicológicos de autorrelato com os métodos projetivos para gerar informações que possam ampliar a visão que o cliente tem de si. Neste artigo, buscou-se compreender o potencial de uso dos testes psicológicos e da relação colaborativa a partir de um caso atendido na perspectiva da AT. A participante, Violeta (nome fictício), foi atendida em 10 sessões com duração entre 60 e 115 minutos. Foram utilizados os testes psicológicos Escala de Bem-Estar Psicológico (Ebep), Escala de Vulnerabilidade e Estresse no Trabalho (Event), Bateria Fatorial de Personalidade (BFP), Método de Rorschach e Inventários de Habilidades Sociais 2 (IHS-2). Observou-se que, durante o processo, Violeta ampliou sua autopercepção, o que possibilitou mudanças no modo de agir em seus relacionamentos amorosos e na reflexão sobre como sua postura era vista por si e por seus colegas de trabalho. Acredita-se que a AT cumpriu com o objetivo de estabelecer uma experiência terapêutica que possibilitasse mudanças positivas para a cliente. Este estudo de caso contribuiu para ampliar a compreensão sobre a importância e o uso dos testes psicológicos neste modelo de avaliação psicológica.(AU)

The Therapeutic Assessment (TA) is an evaluative and interventional process proposed to be semi-structured and collaborative with the objective of promoting positive changes in the client, who is invited to have an active participation during the process. At the TA, the results of standardized psychological tests are highlighted as facilitators of the client's self-knowledge process. In this way, the findings of psychological self-report tests are usually integrated with projective methods to generate information that can broaden the client's view of themselves. In this article, understanding the potential use of psychological tests and of the collaborative relationship from a case treated from the TA perspective was sought. The participant, Violet (fictitious name), was assisted in 10 sessions lasting between 60 and 115 minutes. The psychological tests Psychological Well-Being Scale (EBEP), Vulnerability and Stress at Work Scale (EVENT), Personality Factorial Battery (BFP), Rorschach Method and Social Skills Inventories 2 (IHS-2) were used. It was observed that, during the process, Violet increased her self-perception, which allowed changes in her way of acting in her love life and in her reflection on how her posture was seen by herself and herco-workers. It is believed that TA fulfilled the objective of establishing a therapeutic experience that would enable positive changes for the client. This case study contributed to broaden the understanding about the importance and use of psychological testing in this psychological assessment model.(AU)

La Evaluación Terapéutica (ET) es un proceso de evaluación e intervención que se propone ser semiestructurado y colaborativo, con el objetivo de lograr cambios positivos en el cliente, quien es invitado a tener participación activa durante el proceso. En la ET se destacan los resultados de las pruebas psicológicas estandarizadas como facilitadoras del proceso de autoconocimiento del cliente. Los hallazgos de las pruebas psicológicas de autoinforme suelen integrarse con métodos proyectivos para generar información que pueda ampliar la visión que el cliente tiene de sí mismo. En este artículo se buscó comprender el uso potencial de las pruebas psicológicas y de la relación colaborativa a partir de un estudio de caso tratado desde la perspectiva de la ET. Atendieron a la participante Violeta (nombre ficticio), en 10 sesiones que duraron entre 60 y 115 minutos. Se utilizaron las pruebas psicológicas Escala de Bienestar Psicológico (EBEP), Escala de Vulnerabilidad y Estrés en el Trabajo (EVENT), Batería de Factorial de la Personalidad (BFP), Método de Rorschach e Inventario de Habilidades Sociales 2 (IHS-dos). Se observó que, durante el proceso, Violeta amplió su autopercepción, lo que permitió cambios en la forma de actuar en sus relaciones amorosas y en el reflejo de como ella y sus compañeros de trabajo veían su postura. Así, se cree que ET ha cumplido el objetivo de establecer una experiencia terapéutica que permitió cambios positivos a la cliente. Este estudio contribuyó a ampliar la comprensión sobre la importancia y el uso de las pruebas psicológicas en este modelo de evaluación psicológica.(AU)

Implicações da prática profissional no acolhimento institucional de crianças: perspectiva de cuidadoras / Implications of professional practice in children's institutional sheltering: caregivers' perspective / Implicaciones de la práctica profesional en el alojamiento institucional de niños: perspectiva de cuidadoras

Este estudo qualitativo teve como objetivo compreender, a partir da teoria de bioecológica de desenvolvimento, as implicações da prática profissional no processo de acolhimento de crianças em uma casa-abrigo, na perspectiva de cuidadoras. As participantes foram 10 profissionais de uma casa-abrigo localizada na região sul do Brasil. Utilizou-se a entrevista semiestruturada e a organização e análise dos dados sustentou-se na Grounded Theory, com auxílio do software Atlas.ti 8.4.14. Os resultados evidenciaram uma centralização das ações de acolhimento e atenção em torno dos cuidados físicos das crianças. As ações para promover suporte e cuidados emocionais dentro da casa-abrigo eram delegadas às profissionais da equipe técnica da instituição. Observou-se que as dificuldades encontradas pelas cuidadoras diziam respeito à falta de segurança e preparação para responder e acolher as demandas emocionais das crianças, as quais estão presentes em diversos momentos do processo de acolhimento. Percebeu-se que as práticas institucionais afetaram decisivamente tanto as ações de acolhimento das participantes e o suporte emocional oferecido às crianças na passagem pela casa-abrigo quanto as cuidadoras, no sentido de vivenciarem no trabalho sentimentos de insegurança. Os resultados tensionam ecologicamente a interação nos processos proximais presentes no desenvolvimento humano. Advoga-se pela reflexão sobre as implicações das práticas institucionais de uma casa-abrigo e o desenvolvimento infantil, visando o cuidado integral dos acolhidos.(AU)

Based on the developmental bioecological theory, this study analyzes the implications of professional practice in children's user embracement at a shelter from the caregivers' perspective. Semi-structured interviews were conducted with 10 professionals from a shelter located in southern Brazil. Data organization and analysis was performed based on Grounded Theory using the Atlas.ti 8.4.14 software. Results showed that embracement and attention focus on the physical care of children. Support and emotional care activities were delegated to the institution's technical team. Caregivers faced difficulties regarding the lack of security and preparation to respond to and accept the children's emotional demands, which arise at different moments in the embracement process. The institutional practices decisively affected both user embracement actions and the emotional support offered to the children, as well as the caregivers, in the sense of experiencing feelings of insecurity. These findings ecologically tension the interaction in the proximal processes present in human development. Further reflections on the implications of institutional shelter-based practices for child development are needed to provide comprehensive care.(AU)

Este estudio cualitativo tuvo como objetivo comprender, desde la perspectiva de la teoría bioecológica del desarrollo, las implicaciones de la práctica profesional en el proceso de acogida de niños en una institución infantil desde la perspectiva de las cuidadoras. Las participantes fueron 10 profesionales de una institución de acogida infantil ubicada en la región Sur de Brasil. Se utilizó la entrevista semiestructurada, y para la organización y análisis de datos se aplicó Grounded Theory, con el uso del software Atlas.ti 8.4.14. Los resultados mostraron que las acciones de recepción y atención se centran en el cuidado físico de los niños. Las acciones de promoción de apoyo y cuidado emocional dentro del alojamiento se asignaron a los profesionales del equipo técnico de la institución. Se observó que las dificultades encontradas por las cuidadoras estaban relacionadas con la falta de seguridad y preparación para responder y aceptar las demandas emocionales de los niños, las cuales se encuentran presentes en diferentes momentos del proceso de acogida. Se notó que las prácticas institucionales afectaron decisivamente tanto las acciones de acogida de las participantes como el apoyo emocional que la institución brinda a los niños durante su paso, así como a las cuidadoras en el sentido de experimentar sentimientos de inseguridad en el trabajo. Estos resultados tensan ecológicamente la interacción en los procesos proximales presentes en el desarrollo humano. Se aboga por reflexionar sobre las implicaciones de las prácticas institucionales en los alojamientos institucionales y el desarrollo infantil, apuntando a la atención integral de los acogidos.(AU)

Avaliação da relação entre eventos traumáticos infantis e comportamentos autolesivos em adolescentes / Evaluation of the relationship between childhood traumatic events and self-injurious behavior in adolescents / Evaluación de la relación entre eventos traumáticos infantiles y comportamiento autolesivo en adolescentes

Esta pesquisa teve como objetivo verificar a relação entre eventos traumáticos (ET) na infância e a ocorrência de comportamentos autolesivos em adolescentes. Os instrumentos utilizados foram o Questionário sobre Traumas na Infância (QUESI) e o Inventário de Autolesão Deliberada - reduzido (IAD-r). Participaram 494 estudantes do ensino médio de ambos os sexos e idade entre 15 e 18 anos (M = 16,4). Destes, 58,5% afirmaram ter sofrido abuso emocional de forma recorrente e 19,0% e 59,5% assumiram já ter sofrido abuso sexual e físico, respectivamente. Quanto à prática de autolesão, 65,0% revelaram já ter se engajado em comportamentos autolesivos. De acordo com a análise de Regressão Logística Binomial, todos os tipos de ET exibiram associação significativa com a prática de comportamentos autolesivos. A análise de moderação a respeito da interação entre a ocorrência de ET infantis e a prática de autolesão revelou ausência de moderação pelo sexo e pela idade. Porém, quanto ao abuso físico, o efeito de moderação da idade apresentou significância estatística limítrofe e indicou que os adolescentes mais novos, de 15 e 16 anos, que sofreram este tipo de abuso na infância, foram mais susceptíveis à prática autolesiva. Portanto, as altas taxas de ET e de autolesão encontradas nesta pesquisa revelam a gravidade do problema. Espera-se que esta investigação possa contribuir para a elaboração de intervenções para prevenção e controle dos fatores de risco que acometem a população infanto-juvenil.(AU)

This research aimed to verify the relationship between traumatic events (TE) in childhood and the occurrence of self-injurious behavior in adolescents. The instruments used were the Childhood Trauma Questionnaire (QUESI) and the Deliberate Self-Injury Inventory - reduced (IAD-r). The sample was composed of 494 high school students of both genders and aged between 15 and 18 years old (M = 16.4). Of those, 58.5% declared to have suffered recurring emotional abuse and 19.0% declared to have suffered sexual abuse and 59.5% physical abuse. Regarding the practice of self-harm, 65.0% reported having already engaged in self-injurious behaviors. According to the Binomial Logistic Regression analysis, all types of TE were associated with the practice of self-injurious behaviors. The moderation analysis between the occurrence of childhood TE and self-injury showed no moderation by sex or age. However, regarding physical abuse, the moderating effect of age showed borderline statistical significance and indicated that younger adolescents, 15 and 16 years old, who suffered this type of abuse in childhood, were more susceptible to self-injurious behavior. Therefore, the high rates of TE and self-injury found in this research reveal the seriousness of the problem. It is hoped for this investigation to contribute to the development of interventions to prevent and control risk factors that affect children and adolescents.(AU)

Esta investigación tuvo como objetivo verificar la relación entre eventos traumáticos (ET) en la infancia y la ocurrencia de conductas autolesivas en adolescentes. Los instrumentos utilizados fueron el Cuestionario de Trauma Infantil (QUESI) y el Inventario de Autolesiones Deliberadas -reducido (IAD-r). Participaron 494 estudiantes de la secundaria, de ambos sexos y con edades entre 15 y 18 años (M = 16,4). De estos, el 58,5% afirmaron haber sufrido maltrato emocional de forma recurrente, el 19,0% dijeron haber sufrido maltrato sexual y el 59,5%, maltrato físico. En cuanto a la práctica de la autolesión, el 65,0% informaron haber realizado conductas autolesivas. El análisis de Regresión Logística Binomial mostró que todos los tipos de ET tuvieron una asociación significativa con la práctica de conductas autolesivas. El análisis de la moderación respecto a la interacción entre la ocurrencia de ET infantil y la práctica de la autolesión reveló una ausencia de moderación por sexo o edad. En cuanto al maltrato físico, el efecto moderador de la edad mostró una significación estadística marginal e indicó que los adolescentes más jóvenes, de 15 y 16 años, que sufrieron este tipo de maltrato en la infancia, son más susceptibles a la práctica de autolesiones. Por lo tanto, las altas tasas de ET y autolesiones encontradas en esta investigación revelan la gravedad del problema. Se espera que esta investigación contribuya con el desarrollo de intervenciones para la prevención y control de los factores de riesgo que afectan a niños y adolescentes.(AU)