A Systematic Review of the Quality of Perpetrator Programs' Outcome Studies: Toward A New Model of Outcome Measurement.

This systematic review assessed whether studies on the outcomes of perpetrator programs comply with the model recommendations for outcome evaluation. Three databases (PsycINFO, Medline, and Scopus) were used to identify perpetrator program outcome studies from 1988 to 2021. The inclusion criteria were as follows: empirical studies with no time restriction; published in English or Spanish; evaluated interventions aimed at male perpetrators of any type of abuse toward women; evaluated the effectiveness of the intervention in a follow-up post-intervention; and provided an indicator of recidivism. The search and selection process resulted in 46 original studies. The results showed that studies did not include a thorough description of the study sample. Many approaches to psychological intervention are used, with cognitive behavioral therapy being the most widely used. Most studies did not describe the program content. Dropout rates varied greatly from one study to another (from 0% to 64%) and only eight studies provided dropout rates specified by each type of perpetrator. The follow-up period ranged from 3 months to 9 years. The recidivism rates (ranging from 5% to 72.5%), and their assessments were also very different. Only 12 of the 46 studies (26.1%) used more than one source to obtain recidivism rates. In terms of outcomes, few studies considered (ex-) partner accounts. Some studies had other measures of outcome, whereas a few included a pretest-posttest. In summary, these studies do not follow the recommendations of the model.

Stress and coping in times of pandemic: Longitudinal follow-up of a group of medical patients / Estrés y afrontamiento en tiempos de pandemia: Seguimiento longitudinal de un grupo de pacientes médico

The Covid-19 pandemic has impacted the mental health and medical care of patients with pre-existing conditions. We longitudinally evaluated perceived stress, psychological distress, and coping strategies in 50 patients with medical diseases, finding that, 6 months after baseline evaluation, perceived stress and psychological distress were increased, and that less use was made of active coping strategies. Age (younger patients), previous psychological problems, and altered medical treatments emerge as risk factors. Proactive detection of psychopathological suffering is essential to prevent a parallel mental health pandemic from unfolding. Covid-19 has had an impact on patients with medical diseases, expressed in increased psychological vulnerability that may interfere in their disease course. While telematic monitoring is an important factor in reducing impact, early detection of psychopathological symptoms is crucial to ensuring adherence to treatments and to developing effective biopsychosocial approaches.

La pandemia de Covid-19 ha afectado la salud mental y la atención médica de pacientes con afecciones preexistentes. Se evaluó longitudinalmente la percepción de estrés, malestar psicológico y estrategias de afrontamiento en 50 pacientes con patologías médicas, encontrándose que, 6 meses después de la evaluación inicial, el estrés percibido y el malestar psicológico se incrementaron, mientras que se redujo el uso de estrategias de afrontamiento activas. La edad (pacientes más jóvenes), los problemas psicológicos previos y la alteración del tratamiento médico emergen como factores de riesgo. La detección proactiva del sufrimiento psicopatológico es esencial para evitar que se desarrolle una pandemia paralela de salud mental. La Covid-19 ha tenido un impacto en pacientes con enfermedades médicas, expresado en una mayor vulnerabilidad psicológica que puede interferir en el curso de su enfermedad. Si bien el monitoreo telemático es un factor importante para reducir el impacto, la detección temprana de los síntomas psicopatológicos es crucial para garantizar la adherencia a los tratamientos y para desarrollar enfoques biopsicosociales efectivos.

Psychological Distress in Erectile Dysfunction: The Moderating Role of Attachment.

INTRODUCTION: In clinical consultations, men with erectile dysfunction do not always express personal, sexual, and interpersonal concerns. AIM: We explore whether the attenuated impact of erectile dysfunction may be explained by a regulation of negative affect that causes activation of the attachment system. METHODS: The study sample consisted of 69 men diagnosed with erectile dysfunction, mean (SD) age 56 (10.83) years. Participants completed self-reported questionnaires to assess erectile dysfunction severity, attachment style, sexual satisfaction, relationship satisfaction, and psychological symptoms. MAIN OUTCOME MEASURE: The moderating role of attachment between erectile dysfunction and sexual satisfaction, relationship satisfaction, and psychological distress was evaluated using multiple linear regression and moderation analysis. RESULTS: All men in the sample had high attachment avoidance, distributed between the dismissive-avoidant (69.6%) and fearful-avoidant (30.4%) substyles, but low levels of psychological symptoms. Despite their erectile dysfunction, 27 patients (39.1%) rated their sexual life as satisfactory, and 46 (66.7%) rated their relationship with their partner as satisfactory. Men with fearful-avoidant attachment reported feeling more sexual desire and less sexual satisfaction than men with dismissive-avoidant attachment. Multiple linear regression analysis showed that sexual satisfaction variance was explained by erectile dysfunction severity, attachment anxiety, and relationship satisfaction scores. Moderation analysis showed that attachment anxiety, but not relationship satisfaction, moderated the impact of erectile dysfunction on sexual satisfaction. CONCLUSION: The avoidance dimension of attachment, which tends to be high in patients with erectile dysfunction, involves deactivation of the sexual system in an effort to minimize the emotional distress associated with erectile dysfunction, which damages sexual and relationship intimacy and delays the decision to obtain professional help. The presence of high attachment avoidance and the moderating value of attachment anxiety allow us to propose specific treatments for these men. Maestre-Lorén F, Castillo-Garayoa JA, López-i-Martín X, et al. Psychological Distress in Erectile Dysfunction: The Moderating Role of Attachment. Sex Med 2021;9:100436.