Search

RESUMEN Introducción: La psiquiatría cultural evalúa las manifestaciones, los síntomas de sufrimiento emocional o los trastornos mentales en los distintos contextos culturales; asimismo, aborda problemas sociales como la pobreza, la violencia y las desigualdades entre grupos o clases sociales. Objetivo: Presentar una revisión narrativa de los aspectos culturales más relevantes en el contexto de la práctica clínica en psiquiatría y proponer algunas alternativas para mejorar la competencia cultural de los profesionales de la salud. Métodos: Se llevó a cabo una revisión narrativa de los artículos más relevantes en el área. Resultados: Habitualmente se utiliza la perspectiva cultural para explicar diferencias en las prevalencias que se observan en algunos trastornos mentales según el sexo y la localización geográfica. Las diferencias culturales modifican la expresión de distress o sufrimiento emocional, y esto puede reducir la precisión y afectar a la confiabilidad de las clasificaciones y la validez de los diagnósticos actuales usados en psiquiatría. La Asociación Psiquiátrica Americana, en la clasificación más reciente, revisó los trastornos asociados con la cultura pero solo incluyó un reducido número de situaciones. La formación médica y la psiquiatría deben responder a las necesidades de comunidades diversas y proporcionar un cuidado de calidad mediante el desarrollo de competencias transculturales en los currículos. Conclusiones: Se debe considerar que las diferencias culturales modifican la expresión de distress y con ello se menoscaba la validez y la confiabilidad de los diagnósticos hegemónicos en distintos contextos culturales. En un mundo cada vez más globalizado, es posible que futuras clasificaciones diagnósticas omitan los «síndromes culturales». ABSTRACT Background: Cultural psychiatry evaluates manifestations, symptoms of emotional distress and mental disorders in diverse cultural contexts; it also addresses social problems such as poverty, violence, inequalities between groups or social classes. Objective: To present a narrative review of the most relevant cultural aspects in the context of clinical practice in psychiatry and to suggest some alternatives to improve the cultural competence of health care professionals. Method: A narrative review was carried out of the most relevant articles in the area. Results: Usually, the cultural argument is used to explain differences in observed prevalences in some mental disorders according to gender and geographical location. Cultural differences modify the expression of emotional distress and this can reduce the accuracy and affect the reliability and validity of the current diagnostic classification used in psychiatry. The American Psychiatric Association, in the most recent classification, revised cultural syndromes but only included a limited number of situations. Consequently, medical education and psychiatry must respond to diverse populations and provide quality care through the development of trans-cultural competence in the curriculum. Conclusions: It should be considered that cultural differences modify the expression of distress and thereby undermine the validity and reliability for diagnoses in distinct cultural contexts. In an increasingly globalised world, future classifications may completely omit 'cultural syndromes'.

RESUMEN Introducción: El conocimiento de la frecuencia de comportamientos zoofílicos en la población general es escaso. Objetivo: Revisar casos, series de casos y estudios de prevalencia de zoofilia en adultos de la población general. Métodos: Se realizó una revisión en las bases de datos de MEDLINE, a través de PubMed, Scopus y la Biblioteca Virtual en Salud de publicaciones desde enero de 2000 hasta diciembre de 2017. Resultados: Se revisaron 13 trabajos (10 informes de casos, 2 series de casos y 1 estudio transversal). Entre los casos se describió a 12 pacientes; las series de casos sumaron a 1.556 personas y el estudio transversal incluyó a 1.015 participantes e informó de una prevalencia de comportamientos zoofílicos del 2%. Conclusiones: Es escasa la información sobre la prevalencia de comportamientos zoofílicos en la población general. Es probable que internet permita investigar mejor estos comportamientos en los próximos años. ABSTRACT Background: Information about the frequency of zoophilic behaviour in the general population is scarce. Objective: To review cases, case series and prevalence studies of zoophilia in adults in the general population. Methods: A review of publications was carried out in MEDLINE via PubMed, Scopus and the Biblioteca Virtual en Salud [Virtual Health Library] ranging from January 2000 to December 2017. Results: Thirteen papers were reviewed (ten case reports, two case series and one cross-sectional study). Twelve patients were described, the case series totalled 1,556 people and the cross-sectional study included 1,015 participants and reported a prevalence of zoophilic behaviour of 2%. Conclusions: Information on the prevalence of zoophilic behaviour in the general population is limited. The Internet will probably be a valuable tool for further investigating these behaviours in coming years.

Human behaviours have different meanings according to the historical moment and context. In this article sexual behaviours are taken as a category in order to analyse how psychiatric nosology is structured, as manifested in texts such as the DSM-5. The development of these diagnostic manuals are tools that are far from being free of subjectivities and interference of elements of power, expressed in the way health, illness, mental health, and mental disorders, are assumed; in short, the normal and pathological. Each new diagnosis, or even its elimination, and the recomposing of the different diagnostic criteria, especially in the field of sexual behaviour, present visions of how individual and collective human life is conceived, as well as an expression of accurate attempts to control human sexualities through the medicalisation of behaviour, coupled with moral, religious, and even legal considerations. Categories such as gender dysphoria, paraphilia or paraphilic disorders are examples of how the limits intended to establish a biomedical perspective are also incomplete and imprecise. These violate individual and social construction of sexualities and the conception of mental health, showing persistent difficulties and controversies that are evident in the way psychiatric classifications are made.

Background: The process of evaluating measurement scales is an ongoing procedure that requires revisions and adaptations according to the characteristics of the participants. The Homophobia Scale of seven items (EHF-7) has showed acceptable performance in medical students attending to two universities in Colombia. However, performance of some items was poor and could be removed, with an improvement in the psychometric findings of items retained. Objective: To review the psychometric functioning and refine the content of EHF-7 among medical students from two Colombian universities. Methods: A group of 667 students from the first to tenth semester participated in the research. Theirs ages were between 18 and 34 (mean, 20.9 ±2.7) years-old, and 60.6% were females. Cronbach alpha (α) and omega of McDonald (Ω) were calculated as indicators of reliability and to refine the scale, an exploratory (EFA) and confirmatory factor analysis (CFA) was performed. Results: EHF-7 showed α = .793 and Ω = .796 and a main factor that explained 45.2% of the total variance. EFA and CFA suggested the suppression of three items. The four-item version (EHF-4) reached an α = .770 and Ω = .775, with a single factor that accounted for 59.7% of the total variance. CFA showed better indexes (x2 = 3.622; df = 1; p = 0.057; Root-mean-square error of approximation (RMSEA) = .063, 90% CI, .000-.130; Comparative Fit Indices (CFI) = .998; Tucker-Lewis Index (TLI) = .991). Conclusions: EHF-4 shows high internal consistency and a single dimension that explains more than 50% of the total variance. Further studies are needed to confirm these observa tions, that can be taken as preliminary. RESUMEN Introducción: La evaluación de escalas de medición es un proceso continuo que exige revisiones y adaptaciones según las características de los participantes. La Escala para Homofobia de siete ítems (EHF-7) ha mostrado aceptable desempeño general en estudiantes de Medicina de dos universidades en Colombia. No obstante, el desempeño de algunos ítems fue deficiente y se podría eliminar algunos con el mejoramiento en el comportamiento de los ítems conservados. Objetivo: Revisar el funcionamiento psicométrico y afinar el contenido de EHF-7 en estudiantes de Medicina de dos universidades colombianas. Métodos: Participaron 667 estudiantes de 18-34 (media, 20,9 ± 2,7) anos, de los que el 60,6% eran mujeres. Se calcularon el alfa de Cronbach (α) y el omega de McDonald (Ω) como indi cadores de confiabilidad, y para afinar la escala, se llevaron a cabo análisis de factores exploratorios (AFE) y confirmatorios (AFC). Resultados: EHF-7 mostró α = 0,793 y Ω = ,796, además de un factor principal que explicó el 45,2% de la varianza total. Los AFE y AFC indican eliminar tres ítems. La versión de cuatro ítems (EHF-4) alcanzó α = 0,770 y Ω = 0,775, con un único factor que dio cuenta del 59,7% de la varianza total, con AFC que mostró mejores indicadores (x2 = 3,622; gl = 1; p = 0,057; RMSEA = 0,063; IC90%, 0,000-0,130; CFI = 0,998; TLI = 0,991). Conclusiones: EHF-4 presenta alta consistencia interna y una dimensión que explica más del 50% de la varianza total. Es preciso realizar investigaciones que confirmen estas observa ciones aún preliminares.

Resumen Introduccion Se propone el concepto “complejo estigma-discriminacion asociado a trastorno mental” (CEDATM) para englobar los terminos usados en la teoria de la atribucion: estigma, estereotipo, prejuicio y discriminacion. El CEDATM (el internalizado y el percibido) es un fenomeno frecuente que puede explicar un porcentaje de los casos de suicidio. Objetivo Revisar los factores que pueden explicar la asociacion existente entre CEDATM y suicidio y postular posibles mecanismos implicados subyacentes. Resultados Se identificaron articulos en MEDLINE con los descriptores en ingles para “estigma”, “trastornos mentales” y “suicidio” o “tasa de suicidio”. Se incluyeron articulos publicados entre enero de 2000 y junio de 2014. No se consideraron revisiones del tema y estudios de casos. Los dos estudios incluidos mostraron que el estigma incrementa el riesgo de comportamientos suicidas. Se evidencio que las personas con estigma internalizado realizaron mas intentos de suicidio y que la tasa de suicidio en poblacion general es mas alta en los paises con mayor estigma percibido. Se considero que la relacion entre CEDATM y suicidio se establece por mecanismos interrelacionados: un mecanismo “directo” que incluye el CEDATM percibido y se configura como barreras de acceso a servicios y acciones en salud mental, y un mecanismo “indirecto” que involucra el CEDATM internalizado y que incrementa la vulnerabilidad a episodios depresivos y comportamientos autolesivos repetidos que pueden terminar en suicidio. Conclusiones El CEDATM impacta negativamente en la calidad de vida de las personas que reunen criterios de trastornos mentales y da cuenta de un numero importante de suicidios. Una primera via se relaciona con el estigma percibido, que se configura como barrera de acceso a servicios y acciones en salud mental, y una segunda ruta que incluye comportamientos autolesivos repetidos que reducen la autoestima e incrementan el estres percibido. Se necesitan investigaciones que profundicen en el conocimiento de esta asociacion.

Resumen Introduccion La desigualdad en los ingresos economicos se relaciona directamente con la salud mental de los ciudadanos. No obstante, a la fecha no se ha explorado la relacion entre la desigualdad en ingresos y la tasa de suicidio en Colombia. Objetivo Estimar la correlacion entre desigualdad y tasa de suicidio en Colombia entre 1994 y 2013. Metodos Se realizo un estudio ecologico en el que se estimo la correlacion de Spearman entre desigualdad (coeficiente de Gini) y tasa de suicidio entre 1994 y 2013, segun la informacion oficial disponible en el Departamento Administrativo Nacional de Estadistica (DANE) y el Instituto Nacional de Ciencias Forenses y Medicina Legal. Resultados Se observo un coeficiente de Gini entre 0,53 y 0,60 (mediana, 0,65 [intervalo intercuartilico, 0,54-0,57]) y las tasas de suicidio estuvieron entre 3,84 y 5,26 (mediana, 4,20 [4,08-4,86]). La correlacion entre desigualdad y tasa de suicidio fue positiva y estadisticamente significativa (r = 0,70; p Conclusiones Se observa una asociacion positiva entre desigualdad economica y tasa de suicidio en Colombia. Es importante lograr mayor equidad en la distribucion de los ingresos para reducir la tasa de suicidio en el pais.

Resumen Antecedentes En Colombia el conflicto armado interno es problema de salud publica, dado que genera distintas formas de violencia (desapariciones, desplazamientos, masacres, torturas y violencia sexual). La violencia es un estresor que menoscaba la salud mental de la poblacion colombiana; sin embargo, no hay precision sobre la prevalencia de sintomas, posibles casos y trastornos mentales en personas victimas de la violencia en situacion de desplazamiento. Objetivo Revisar la prevalencia de sintomas, posibles casos y trastornos mentales en victimas del conflicto armado en situacion de desplazamiento forzado en Colombia durante las ultimas dos decadas (1994-2013). Metodo Se llevo a cabo una revision sistematica de los estudios disponibles publicados durante los ultimos 20 anos. Se tomaron como palabras clave “conflicto armado”, “trastornos mentales”, “salud mental”, “prevalencia” y “Colombia”. Se observo la frecuencia de sintomas, posibles casos y trastornos mentales. Resultados Se incluyeron 13 estudios en los que participaron personas adultas. La prevalencia de sintomas se observo en un 9,9-63%; la de posibles casos, en un 21-97,3%, y la de trastornos mentales, en un 1,5-32,9%. Conclusiones La prevalencia de sintomas, posibles casos y trastornos mentales en este grupo poblacional es alta. Este hallazgo se debe interpretar con precaucion debido a la alta heterogeneidad y la baja calidad de los estudios. Se necesitan estudios en el area.

Resumen Introduccion El prolongado fenomeno de violencia sociopolitica colombiana genero un alto numero de victimas, muchas de quienes sufrieron un continuo proceso de desplazamiento interno y del complejo estigma-discriminacion. Objetivo Postular por que en Colombia las victimas del conflicto armado interno en situacion de desplazamiento (VCAISD) fueron estigmatizadas-discriminadas. Resultados El estigma afecta a la salud mental no solo porque representa un estresor importante para las personas y los colectivos discriminados, sino tambien porque da cuenta de las desigualdades e inequidades que se observan en salud. Inicialmente, debido a que las VCAISD no se consideraron como tales, sino responsables de la situacion, las desigualdades sociales y economicas que debieron afrontar dieron cuenta parcialmente de la baja categorizacion o estatus que recibieron, posiblemente por la deficiente construccion de capital social en el pais. Asimismo, las VCAISD sufren de estigma y discriminacion intersectorial por otras caracteristicas como sexo, orientacion sexual y origen etnico-racial o por reunir criterios de trastorno mental. Conclusiones Se necesita un proceso de desarrollo social inclusivo para las VCAISD que reduzca los multiples complejos estigma-discriminacion y garantice el derecho a la salud mental.

Background: The perceived stigma represents a sociocultural barrier to access mental health services and prevents individuals who meet criteria for a mental disorder the possibility of receiving comprehensive and integred care.

Background The process of evaluating measurement scales is an ongoing procedure that requires revisions and adaptations according to the characteristics of the participants. The Homophobia Scale of seven items (EHF-7) has showed acceptable performance in medical students attending to two universities in Colombia. However, performance of some items was poor and could be removed, with an improvement in the psychometric findings of items retained. Objective To review the psychometric functioning and refine the content of EHF-7 among medical students from two Colombian universities. Methods A group of 667 students from the first to tenth semester participated in the research. Theirs ages were between 18 and 34 (mean, 20.9 ± 2.7) years-old, and 60.6% were females. Cronbach alpha ( α ) and omega of McDonald ( Ω ) were calculated as indicators of reliability and to refine the scale, an exploratory (EFA) and confirmatory factor analysis (CFA) was performed. Results EHF-7 showed α = .793 and Ω = .796 and a main factor that explained 45.2% of the total variance. EFA and CFA suggested the suppression of three items. The four-item version (EHF-4) reached an α = .770 and Ω = .775, with a single factor that accounted for 59.7% of the total variance. CFA showed better indexes ( χ 2 = 3.622; df = 1; p = 0.057; Root-mean-square error of approximation (RMSEA) = .063, 90% CI , .000–.130; Comparative Fit Indices (CFI) = .998; Tucker-Lewis Index (TLI) = .991). Conclusions EHF-4 shows high internal consistency and a single dimension that explains more than 50% of the total variance. Further studies are needed to confirm these observations, that can be taken as preliminary.

The validation of a measurement tool in mental health is a complex process that usually starts by estimating reliability, to later approach its validity. Factor analysis is a way to know the number of dimensions, domains or factors of a measuring tool, generally related to the construct validity of the scale. The analysis could be exploratory or confirmatory, and helps in the selection of the items with better performance. For an acceptable factor analysis, it is necessary to follow some steps and recommendations, conduct some statistical tests, and rely on a proper sample of participants.

Objective: To explore the prevalence of common mental disorders and their association with health-related behaviors in Colombian women. Method: A cross-sectional study was carried out with a multi-stage probability sample of women from the general population. Common mental disorders were explored with the General Health Questionnaire (GHQ-12) with a cut-off point of eleven or more. Non conditional logistic regression was computed to adjust associated variables. Results: A total of 1,740 women participated in this research. The mean age of participants was 38.3 years (SD=13.3), mean years of education were 8.8 years (SD=3.9), 59.5% were married, 37.0% were employed, 1.4% reported abusive alcohol consumption, 6.3% daily cigarette smoking, 44.5% daily coffee intake, 17.5% a medical condition, and 15.7% (95% CI 14.0-17.4) scored for a common mental disorder. Abusive alcohol consumption (OR=6.4, 95% CI 2.7-15.2), daily cigarette smoking (OR=3.3, 95% CI 2.1-5.0), medical condition (OR=2.0, 95% CI 1.4-2.8), and daily coffee intake (OR=1.3, 95% CI 1.0-1.8) were associated with common mental disorders, adjusted for age and education. Conclusions: Common mental disorders are frequent in Colombian women. Health risk behaviors and stressful events are strongly related to common mental disorders. It is necessary to identify and treat these mental disorders early on to reduce health risk behaviors in women.

Introduction: Mental capacity is understood as a multidimensional construct that alludes to the capacity of individuals of making autonomous decisions. Mental competency is the ability to perform a task and the ability of a person to act or behave appropriately in certain circumstances, with a clear reference to legal aspects. However, there is a tendency to assimilate both concepts. Objective: To show how mental capacity can be evaluated in a structured way avoiding inadequate assessments, violations of patients’ human rights, and the generation of a bioethical dilemma when the principle of beneficence is given more relevance than the principle of autonomy. Method: Various instruments that allow a valid and trustworthy evaluation of mental capacity are reviewed. It is convenient that physicians train in their application and interpretation of results. Conclusion: More studies on the subject are required in Latin America.

Introduction: Intra- and inter-rater concordance studies are important in order to measure the reliability or the reproducibility of evaluations (interviews or scales applied by a rater) in psychiatry. Objective: To present some principles regarding the validation process of diagnostic interviews or scales applied by a rater, and regarding the handling and comprehension of more useful statistical tests. Method: Review of literature. Results: Concordance is understood as the grade of agreement or disagreement among evaluations made to the same subject successively by an evaluator or among two or more interviewers. This process is part of the

The concept stigma-discrimination complex associated with mental disorder (SDCAMD) is proposed to encompass the terms used in the attribution theory: stigma, stereotype, prejudice and discrimination. SDCAMD is one of the most frequent disorders worldwide. Internalized and perceived SDCAMD may explain a number of suicide cases.To update the factors that may explain the association between SDCAMD and suicide, and postulate possible underlying mechanisms.Articles were identified in MEDLINE using the descriptors for "stigma", "mental disorders" and "suicide" or "suicide rate". Articles published between January 2000 and June 2014 were included. Reviews and case studies were not considered. The two included studies showed that stigma increased the risk of suicidal behaviors. It was evident that people who meet criteria for mental disorder and reported high self-stigma made a greater number of suicide attempts, and countries with high stigma in the general population have a higher suicide rate. It was considered that the relationship between SDCAMD and suicide is established by a set of interrelated mechanisms. A "direct" mechanism involving perceived stigma and is configured as a barrier to access mental health services, and an "indirect" mechanism involving the self-stigma, which increases the vulnerability to depressive episodes and repeated self-injurious behaviors that ultimately end in suicide.The SDCAMD impacts negatively on the quality of life of people who meet criteria for mental disorders, and accounts for a significant number of suicides. One way is related to the perceived stigma that is configured as a barrier to access mental health services and, the second one includes repeated self-injurious behaviors that reduce self-esteem and increases perceived stress. Further research is required to increase the knowledge of this association.

The prolonged sociopolitical phenomenon of Colombian violence generated a high number of victims, many of whom suffered a continual process of internal displacement and stigma-discrimination complex.To postulate possible mechanisms by which victims of Colombia's internal armed conflict in a situation of forced displacement were stigmatized and discriminated.Stigma affects mental health, not only because it represents a major stressor for discriminated individuals and groups, but also because it accounts for inequalities and inequities in health. Initially, as the victims of the internal armed conflict in situation of forced displacement were not considered as such, but as responsible for the situation. Thus, they had to cope with the social and economic inequalities, explained partially by low categorization or status that they received, possibly due to poor construction of social capital in the country. Also, victims of the internal armed conflict suffer from intersectional stigma and discrimination due to other characteristics such as gender, sexual orientation, ethnic-racial origin, or meeting criteria for a mental disorder.An active process of inclusive social development is required for the displaced victims of the armed conflict,in order to reduce multiple stigma and ensure their mental health.

Income inequality is directly related to the mental health of the population. However, the relationship between income inequality and suicide rates in Colombia has still not been explored.To estimate the relationship between inequality and suicide rates in Colombia from 1994 to 2013.An ecological study was conducted, in which the correlation was estimated (Spearman) between inequality (Gini coefficient) and suicide rate between 1994 and 2013, according to official information available from the National Administrative Department of Statistics (DANE), and the National Institute of Forensic Science and Forensic Medicine.A Gini coefficient between 0.53 and 0.60 (median, 0.65 [interquartile range, 0.54-0.57]) was observed, and suicide rates were between 3.84 and 5.26 (median, 4.20 [4.08-4.86]). The correlation between inequality and suicide rates was positive and statistically significant (r=.70; p.001).There is a positive association between economic inequality and suicide rate in Colombia. It is important to achieve greater equity in the distribution of income to reduce suicide rate in the country.

The perceived stigma represents a sociocultural barrier to access mental health services and prevents individuals who meet criteria for a mental disorder the possibility of receiving comprehensive and integred care.To update institutional mechanisms by which stigma related to mental disorders, perceived and perpetrated, acts as a barrier to mental health access.Stigma as a barrier to access to mental health services is due to a reduction in service requests, the allocation of limited resources to mental health, the systematic process of impoverishment of the people who suffer a mental disorder, increased risk of crime, and implications in contact with the legal system, and the invisibility of the vulnerability of these people.Structured awareness and education programs are needed to promote awareness about mental disorders, promote community-based psychosocial rehabilitation, and reintegration into productive life process. In Colombia, the frequency and variables associated with the stigma of mental disorders needs to be studied. This knowledge will enable the implementation of measures to promote the social and labor inclusion of people who meet the criteria for mental disorders.

In Colombia, the internal armed conflict is a public health problem that generates various forms of violence (forced disappearances, forced displacement, massacres, torture and sexual violence). Violence is a major psychosocial stressor that impairs the mental health of the Colombian population. However, there are no real estimates on the prevalence of mental symptoms, possible cases and disorders in victims of violence in displacement situations.To determine the prevalence of mental symptoms, possible cases and disorders due to the forced displacement of victims of the armed conflict in Colombia during the past two decades (1994-2013).A systematic review was carried out on all available studies published over the last twenty years. The keywords used were "armed conflict", "mental disorders", "mental health", "prevalence" and "Colombia". Authors observed the frequency of symptoms, possible cases, and mental disorders.Thirteen studies involving adults were included. The prevalence of symptoms was observed as between 9.9% and 63%; possible cases, between 21% and 97.3%; and mental disorders, between 1.5% and 32.9%.The prevalence of symptoms, possible cases and mental disorders is high in this Colombian population. This finding should be interpreted with caution due to the high heterogeneity and low quality of the studies. More research is needed.

En Colombia la discusion acerca del reconocimiento de los derechos a personas no heterosexuales (lesbianas, gais, bisexuales, transexuales e intersexuales [LGBTI]) y parejas del mismo sexo ha tenido espacio creciente en los medios de comunicacion durante la ultima decada. La adopcion por parejas del mismo sexo ha sido un punto polemico en este debate1–4. La opinion desfavorable frente a la adopcion por parejas del mismo sexo es frecuente tanto en la comunidad general como en algunos grupos de cientificos en ciencias de la salud5,6. Por ejemplo, en el contexto colombiano, se pregunto a una muestra de 199 estudiantes de medicina sobre la aceptacion de adopcion por parte de parejas de hombres, y el 64,8% de los participantes manifesto estar en desacuerdo con la legalizacion7. Asimismo, en el contexto mundial se ha acumulado en los anos mas recientes alguna evidencia relacionada con los efectos en ninos, ninas y adolescentes criados en hogares con padres del mismo sexo. Las investigaciones adecuadamente disenadas observaron que el crecimiento y el desarrollo positivos de ninos, ninas y adolescentes guarda una asociacion directa con las caracteristicas de las relaciones y el ambiente en el contexto familiar y que la orientacion sexual de los padres ejerce un efecto minimo e insignificante estadisticamente en la calidad de vida de los hijos8–12. Ninos, ninas y adolescentes educados por padres del mismo sexo presentan logros academicos y psicosociales similares a los de los criados

The validation of a measurement tool in mental health is a complex process that usually starts by estimating reliability, to later approach its validity. Factor analysis is a way to know the number of dimensions, domains or factors of a measuring tool, generally related to the construct validity of the scale. The analysis could be exploratory or confirmatory, and helps in the selection of the items with better performance. For an acceptable factor analysis, it is necessary to follow some steps and recommendations, conduct some statistical tests, and rely on a proper sample of participants.