Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance.

Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.

Organisations often seek to provide some form of psychosocial intervention after a traumatic event in the workplace.Previous reviews have contraindicated particular forms of 'debriefing', however, the evidence for post-incident psychosocial interventions in the workplace has not previously been systematically reviewed.Research evidence was generally of poor quality with limited evidence of effectiveness and clinical guidelines were inconsistent with the evidence. Nevertheless, research did not demonstrate harm from most established interventions and support was valued by workers.

[Prevention of mental health disorders in primary care: Pregnancy in adolescence]. / Prevención de los trastornos de la salud mental. Embarazo en la adolescencia.

Adolescent pregnancy is generally an unwanted pregnancy, a situation that involves significant biological, psychological and social overloads, with repercussions on the health of the mother and the child. But the psychosocially important fact is that an unwanted pregnancy in its entirety gives rise to the birth of an ambivalently wanted child, a high-risk child. Those born in Spain in 2020 to women under 20 years of age were 8,305, which corresponds to 1.97% of all births. This review presents measures and recommendations for the protection and prevention of the mental health of the mother and child when pregnancy takes place in adolescence.

[COVID-19 pandemic and mental health: Initial considerations from spanish primary health care]. / Pandemia de la COVID-19 y salud mental: reflexiones iniciales desde la atención primaria de salud española.

An approach is made to the psychological and psychosocial characteristics that the COVID-19 pandemic is acquiring in the countries of our socio-cultural environment. The scarcity of research in this regard and the necessary acceptance of uncertainty to face the situation, both socially, as well as health and psychological, are discussed. Consequently, a series of reflections and recommendations are proposed for the psychological care of the population, health workers and social organization based on: 1) The existence of psychological and psychosocial research into connected fields and 2) In the new neuroscientific perspectives on emotions and their elaboration in crisis situations.

O Pensamento de Fronteira de Carolina Maria de Jesus / Carolina Maria de Jesus' Border Thinking / El Pensamiento de frontera de Carolina Maria de Jesus

Este texto tem como objetivo refletir a respeito da pretensa universalidade do conhecimento, discutindo o modo como explicações eurocêntricas sobre o mundo acabam por orientar nossa produção acadêmica. Parte-se da ideia de que a colonialidade epistemológica, ao designar aquelas(es) que teriam direito de produzir teorias, acaba por criar uma série de não existências o que, em última instância, leva ao desperdício de experiências. A partir do conceito de pensamento de fronteira, desenvolvido pela perspectiva decolonial, trago a obra da escritora Carolina Maria de Jesus para discutir a possibilidade de se pensar a realidade a partir da ferida aberta pela diferença colonial. Com suas narrativas, Carolina permite que se compreenda que o conhecimento é gerado a partir de uma geopolítica que procura excluir algumas vozes e que, a despeito de incontáveis estratégias de subalternização, essas vozes teimam em resistir. Desejase aqui desempalidecer epistemes e produzir olhares "outros" para a produção de conhecimento em psicologia social....(AU)

: This text reflects on the alleged universality of knowledge, discussing the way Eurocentric explanations of the world end up guiding our academic production. It is assumed that epistemological coloniality, by designating those who have the right to produce theories, creates a series of nonexistences that ultimately lead to waste of experiences. Based on the concept of border thinking developed by the decolonial perspective, I discuss the work of the writer Carolina Maria de Jesus and the possibility of thinking about reality according to the wound opened by colonial difference. Through her narratives, Carolina allows us to comprehend that knowledge is generated from geopolitics that tries to exclude some voices and that, despite countless strategies for subalternation, those voices insist on resisting. This paper should thus serve to depart from epistemes and to produce "other" perspectives for the production of knowledge in social psychology....(AU)

Este texto tiene como objetivo reflexionar sobre la pretendida universalidad del conocimiento, discutiendo cómo explicaciones eurocéntricas sobre el mundo acaban por orientar nuestra producción académica. Se parte de la idea de que la colonialidad epistemológica, al designar aquellas que tendrían derecho a producir teorías, acaba por crear una serie de no-existencias, lo que, en última instancia, lleva al desperdicio de experiencias. A partir del concepto de pensamiento de frontera, desarrollado por la perspectiva decolonial, utilizo la obra de la escritora Carolina Maria de Jesus para discutir la posibilidad de pensar la realidad a partir de la herida abierta por la diferencia colonial. Las narrativas de Carolina permiten comprender que el conocimiento es generado a partir de una geopolítica que busca excluir algunas voces y que, a pesar de incontables estrategias de subalternización, esas voces resisten. Se busca aquí desempalidecer epistemes y producir "otras" miradas para la producción de conocimiento en psicología social....(AU)

[Mental health in epidemics: A perspective from the Spanish Primary Health Care]. / Salud mental en epidemias: una perspectiva desde la Atención Primaria de Salud española.

The pandemic of the disease known as COVID-19 (acronym for coronavirus disease-2019), which was first detected in the Chinese city of Wuhan in December 2019, has led to an international public health emergency. This due to several reasons (threat to the lives of many people, unprecedented health and socioeconomic crisis, cessation of school and work activities, or the need to adopt extraordinary measures, including quarantining entire cities or countries). The PAPPS Mental Health Group has considered it important to observe, reflect and investigate the phenomena that are occurring, and will occur, in what has possibly been one of the most extensive and radical public health interventions in recent history. This work makes an approach to the psychological and psychosocial characteristics that the COVID-19 pandemic is acquiring in the countries of our socio-cultural environment, and proposes a series of reflections and recommendations for the psychological care of the population, health workers, and social organisation.

Ações das equipes volantes de CRAS no interior do Rio Grande do Norte / CRAS mobile team's performance in the countryside of Rio Grande do Norte / Acciones de los equipos móviles de CRAS dentro del Rio Grande do Norte

As equipes volantes de CRAS surgiram para viabilizar o acesso das famílias que vivem em regiões de difícil acesso ou grande espalhamento territorial aos serviços socioassistenciais. Investigou-se como as ações dessas equipes respondem às demandas de seus territórios no Rio Grande do Norte. Foram realizadas oito entrevistas semiestruturadas com equipes de sete municípios. Devido à falta de infraestrutura e quantidade de comunidades rurais espalhadas pelos territórios, a presença das equipes nas áreas rurais se torna esporádica, fragilizando a continuidade das ações. O conhecimento das profissionais sobre a realidade dos territórios é precário, pois a busca pelas demandas é assistemática. Entretanto, algumas equipes realizam ações que buscam romper com os limites e práticas assistencialistas, promovendo articulações com equipamentos e movimentos sociais que estão mais próximos às famílias.

The CRAS mobile teams were created to enable the access of families who live in areas which are difficult to access or have an extensive territory to the social services. We investigated how the performance of these mobile teams meets the demands of their territories in Rio Grande do Norte by making eight semi-structured interviews with teams that work in seven small towns. Given the lack of infrastructure and the number of rural communities scattered throughout the territory, the presence of the teams in rural areas becomes sporadic and ultimately the continuity of actions is undermined. The knowledge of the professionals about the reality of the territories is precarious, as the search for demands is asystematic. Nevertheless, some teams perform strategies and actions that seek to overcome the limits and the traditional assistencialism, working in partnership with social movements and equipments that are closer to the families.

Los equipos móviles del CRAS han surgido para facilitar el acceso de las familias que viven en zonas de difícil acceso o gran dispersión territorial para los servicios de asistencia social. Se investigó como las acciones de estos equipos responden a las demandas de sus territorios en el Rio Grande do Norte. Se realizaron ocho entrevistas semi-estructuradas con equipos de siete municipios. Debido a la falta de infraestructura y cantidad de comunidades rurales dispersadas por los territorios, la presencia de los equipos en las zonas rurales se vuelve esporádica, lo que debilita la continuidad de las acciones. El conocimiento de los profesionales sobre la realidad de los territorios es precaria, ya que la búsqueda de las demandas es poco sistemática. Sin embargo, algunos equipos realizan acciones que buscan romper con los límites y prácticas tradicionales, promoviendo las conexiones con los materiales y movimientos sociales que están más cerca de las familias.

Salud mental en desastres naturales: estrategias interventivas con adultos mayores en sectores rurales de Chile.

En el presente artículo se da a conocer una estrategia de intervención llevada a cabo con adultos mayores en la comuna de Paredones, sexta región de Chile, con posterioridad al terremoto y tsunami del 27 de febrero 2010 en Chile, en el contexto de una investigación sobre fortalezas y vulnerabilidades desplegadas por este grupo etario, con posterioridad a un desastre natural. Se presenta una descripción del desarrollo metodológico de la intervención y de los sustentos teóricos y conceptuales en los que se basa. Como resultado de este proceso, se propone una estrategia que trabaje a través de la identificación de las propias experiencias y fortalezas de los sujetos. De tal forma se minimizan los efectos negativos de los determinantes sociales de la salud (como la edad y el lugar de residencia) en contexto de crisis; permitiendo a los adultos mayores fortalecer sus recursos individuales y colectivos, en pro de su bienestar psicosocial.

Psychotherapeutic and psychosocial interventions for managing stress in multiple sclerosis: the contribution of mindfulness-based interventions.

Depression or anxiety in multiple sclerosis (MS) has been linked to a more severe course of the disease and higher numbers of relapses, in addition to poorer treatment adherence and exacerbated immune system dysregulation. Recent investigations indicate that psychotherapeutic interventions for stress management, such as mindfulness-based interventions (MBIs), could improve quality of life, depression, anxiety, and fatigue in MS patients. Mindfulness fosters the ability to slow down and observe experiences as they truly are, which improves affect regulation. Mindfulness is acquired through training; its advantage over other psychotherapeutic interventions is that effects may remain over time, since cultivating mindfulness depends on regular practising of abilities learned during training. The objective of this article is to review the current evidence of psychotherapeutic and psychosocial interventions, including MBIs for stress management, and their beneficial effects on MS patients.

Cognitive intervention therapy as treatment for behaviour disorders in Alzheimer disease: evidence on efficacy and neurobiological correlations.

INTRODUCTION: The prevalence of behavioural and psychological symptoms (BPS) is very high among patients with Alzheimer disease (AD); more than 90% of AD patients will present such symptoms during the course of the disease. These symptoms result in poorer quality of life for both patients and caregivers and increased healthcare costs. BPS are the main factors involved in increases to the caregiver burden, and they often precipitate the admission of patients to residential care centres. DEVELOPMENT: Current consensus holds that intervention models combining pharmacological and non-pharmacological treatments are the most effective for AD patients. Several studies have shown cholinesterase inhibitors and memantine combined with cognitive intervention therapy (CIT) to be effective for improving patients' cognitive function and functional capacity for undertaking daily life activities. However, the efficacy of CIT as a treatment for BPS has not yet been clearly established, which limits its use for this purpose in clinical practice. The objective of this review is to gather available evidence on the efficacy of cognitive intervention therapy (CIT) on BPS in patients with AD. CONCLUSIONS: The results of this review suggest that CIT may have a beneficial effect on BPS in patients with AD and should therefore be considered a treatment option for patients with AD and BPS.

Efecto del Programa Psicoeducativo ProFamille en el grado de sobrecarga y síntomas psíquicos en familiares cuidadores de personas enfermas de esquizofrenia / Effect of the ProFamille Psychoeducational Program on the degree of burden of care and psychological symptoms in family caregivers of people with schizophrenia

Most people with schizophrenia continue their treatment within their families. This can lead to a deterioration of the life quality of their caregivers, by compromising economic and social aspects, as well as their physical and mental health. Evidence shows that psychosocial interventions can alleviate this burden of care. In Chile, the Ministry of Health recommends the inclusion of psychosocial interventions in the treatment of schizophrenia patients but does not propose any specific programs. The purpose of this research is to examine the effect of the program Profamille on the severity of burden of care and psychological symptoms of caregivers of patients with schizophrenia. Subjects and Methods: Open, non-controlled clinical trial. The program was carried out in rehabilitation centers in three Chilean cities for a period of five months. Participants included 51 caregivers of people with schizophrenia with at least one year of evolution and ambulatory treatment. The program consisted of 10 biweekly, 2.5 hours long sessions led by a clinical psychologist and a psychiatric resident. Self-evaluation scales were used to assess the results. Results: The program dropout rate was 31 percent. Mean scores showed significant differences in the scales of depression and anxiety, pre and post program, with a moderate effect size. There were no differences in the scale of burden of care. Discussion: The Profamille program shows ease of implementation, cost-effectiveness, and a potential favorable effect. Further examination of this program with medium and long term follow-up is suggested...

La mayoría de las personas enfermas de esquizofrenia, continúan su tratamiento a cargo de sus familias. Esto lleva al deterioro en la calidad de vida de sus cuidadores, comprometiendo aspectos económicos, sociales y de salud física y mental. La evidencia muestra que las intervenciones psicosociales, pueden aliviar esta sobrecarga. En Chile, el Ministerio de Salud, recomienda incluirlas en el tratamiento de la esquizofrenia, sin proponer programas específicos. El propósito de esta investigación, es conocer el efecto del programa Profamille, en el grado de sobrecarga y sintomatologia depresiva y ansiosa de familiares de personas con esquizofrenia. Sujetos y Método: Ensayo clínico abierto, no controlado, de tipo pre-post. El Programa consistió en 10 sesiones bisemanales, de 2 horas y media de duración, dirigidas por un psicólogo clínico y un residente de psiquiatría, en centros de rehabilitación de la quinta región. Participaron 51 cuidadores de personas con diagnóstico de esquizofrenia, con al menos, un año de evolución y en tratamiento ambulatorio. El efecto del Programa fue medido con las Escalas de Sobrecarga de Zarit, Depresión de Zungy Conde y Ansiedad de Zung. Resultados: El porcentaje de abandono del programa fue un 31 por ciento. Las medias de los puntajes pre y post programa, muestran diferencias significativas en las escalas de depresión y ansiedad, con un tamaño de efecto moderado, no así en la escala de sobrecarga. Discusión: Por su costo-efectividad, facilidad de implementación y potencial efecto favorable, se recomiendan más ensayos con este programa con seguimientos de mediano y largo plazo...

Autistic spectrum disorders: Diagnostic and therapeutic challenges in Mexico / Trastornos del espectro autista: retos diagnósticos y terapéuticos en el contexto de México

Autistic Spectrum Disorders (ASD) are developmental disorders with impairments in three broad domains: social interaction, communication and stereotypic movements and repetitive behavior. Their symptoms are complex, bizarre and most of them persistent, causing maladaptive and poor psychosocial adjustment. Early detection and diagnosis is a priority in ASD, parents are the first to notice early autism symptoms: 50% observe signs in the first 12 months of age. Despite initial observations of atypical development, there are significant delays in seeking proper medical attention and correct diagnosis; less than 38% of families receive their diagnosis through health services. Educational and health primary care providers need training in developmental milestones with focus on language and socio-communicative domains. Health policy planners should facilitate rationale referral when key symptoms such as language alterations are detected. The use of valid instruments and surveillance approaches versus awareness through red flag symptoms is discussed. Psychosocial interventions are the most important treatment, with ABA and TEACHH techniques recommended; pharmacological treatment (atypical antipsychotics, antidepressants, drugs for hyperactivity, sleep problems and anxiety) must be directed to treat comorbid conditions and combined with behavioral interventions.

Los trastornos del espectro autista (TEA) son trastornos del desarrollo con alteración en tres dominios: interacción social, comunicación y conductas repetitivas o movimientos estereotipados. Los síntomas son complejos, bizarros y la mayoría persistentes y causan un pobre ajuste psicosocial. La detección y diagnóstico tempranos son prioridad en los TEA; los padres son los primeros en advertir los síntomas tempranos del autismo: 50% observan manifestaciones en los primeros doce meses de edad. A pesar de las observaciones tempranas del desarrollo atípico, existen atrasos en la búsqueda de atención médica apropiada. Los proveedores de servicios educativos y cuidados primarios en salud necesitan adiestramiento en los hitos del desarrollo enfocados en el lenguaje y dominios sociocomunicativos. Se discute el uso de instrumentos y protocolos de abordaje frente a programas sobre advertencia de los síntomas de alarma. Las intervenciones médicas y psicosociales se describen de acuerdo con un abordaje de manejo integral. Las intervenciones psicosociales son las más importantes, en particular el empleo de los programas conocidos como ABA y TEACHH. El tratamiento farmacológico debe combinarse con intervenciones conductuales y utilizarse para el manejo de la comorbilidad.

Dolor abdominal recurrente (dar) o crónico en niños y adolescentes / Recurrent or chronic abdominal pain in childrens and adolescents

El dolor abdominal crónico es muy frecuente en la edad pediátrica. Los criterios de Roma III permiten hacer el diagnóstico de las diferentes entidades con dolor abdominal funcional, en base a la sintomatología, y no como de exclusión. Actualmente se propone una etiología biopsicosocial, que obliga a una aproximación integrada para ofrecer tratamiento centrado en la sintomatología de cada paciente pudiendo combinarse cambios en la alimentación, fármacos e intervenciones psicosociales. Aunque la mayoría de los pacientes mejora al tranquilizarlos y con el tiempo, una proporción significativa sigue con sintomatología intensa y discapacitante en la adultez.

Chronic abdominal pain is common in childhood. Rome III criteria allows the diagnosis of different entities with functional abdominal pain, based on by symptoms, rather than exclusion. The biopsychosocial etiology proposed currently, requires an integrated approach to provide focused treatment to each patient's symptoms and may combine changes in food, drugs and psychosocial interventions. Although most patients will improve with reassurance and time, a significant number of patients continue to have intense and disabling symptoms in adulthood.