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This longitudinal study aims to provide meaningful cutoff scores for total score of the teacher-rated Inventory of Callous-Unemotional Traits (ICU) from the preschool age until early adolescence, separately by age and sex. The ICU cutoff scores were determined by using low/high trajectories of oppositional defiant problems (ODP) and conduct problems in a Spanish community sample of 620 children that were followed up between the ages of 3 and 13. Receiver operating characteristic (ROC) curves with the two trajectories as criteria and ICU total score at each age as a predictor were estimated by sex separately, and the area under the ROC curve (AUC) was obtained. Average ICU cutoff scores of 26 for boys and 22 for girls were found to be of moderate utility for the prediction of high trajectories of each of ODP and conduct problems. They identified cases with an average sensitivity of 66% and specificity of 70% for boys and an average sensitivity of 69% and specificity of 72% for girls. The obtained cutoff scores might help clinical practitioners in their decision-making process when identifying low and high-risk groups of children. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background Four explanations for the concurrent and prospective associations between temperament and psychopathology in children have been suggested: predisposition, complication/scar, common cause/continuity, and pathoplasty/exacerbation. Because the confounding effects of common causes have not been ruled out in prior work, the support for the various explanations is uncertain. Methods Screen-stratified community samples of 4-year olds in Trondheim, Norway (n = 1,042), and 3-year olds in Barcelona, Spain (n = 622), were assessed biennially for symptoms of attention-deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct (CD), anxiety, and depressive disorders through interviewer-based psychiatric interviews across four waves of data collection. The parents completed child temperament ratings. The data were analyzed with random and fixed effects regression adjusted for all time-invariant unmeasured confounders (e.g., genetics, common methods bias, item overlap). Results In both Norway and Spain and across ages, negative affect predisposed children to symptoms of all disorders except CD, low effortful control predisposed children to ADHD and ODD-symptoms, and surgency predisposed children to increased ADHD-symptoms. Complication effects were observed in the Spanish children for ADHD-symptoms, which increased surgency and diminished effortful control, and for ODD-symptoms, which decreased surgency. The common cause and pathoplasty/exacerbation explanations were not supported. Conclusions The present results are consistent with the view that temperament plays a causal role in the development of symptoms of psychiatric disorders in children. Because temperament is malleable, interventions targeting the affective, attentional, and behavioral regulatory components of temperament may reduce psychopathology in children. © 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Maternal internalizing symptoms have been linked with child internalizing symptoms, but paternal internalizing difficulties have received little attention. Our aims were to prospectively analyse the simultaneous effect of maternal and paternal internalizing symptoms on child internalizing difficulties, examining gender differences, and to verify the mediating effect of parenting practices and child irritability. The sample included 470 families assessed at child ages 3, 6, 8, and 11. Multi-group structural equation modelling was performed with Mplus8.2. Complete equivalence was found between boys and girls for all paths. Maternal internalizing symptoms at age 3 had an indirect effect on child internalizing symptoms at age 11, via irritability at age 8. Paternal internalizing symptoms at age 3 were not associated with any of the variables under study. Maternal internalizing symptoms and child irritability are targets for intervention in order to prevent child internalizing difficulties.

Spanish children were locked down for 72 days due to COVID-19, causing severe disruption to their normal life. The threat posed by COVID-19 continues and clinicians, administrators, and families need to know the life conditions associated with more psychological problems to modify them and minimize their effect on mental health. The goal was to study the life conditions of adolescents during lockdown and their association with psychological problems. A total of 226 parents of 117 girls and 109 boys (mean age: 13.9, Standard deviation: 0.28) from the community that were participants in a longitudinal study answered an online questionnaire about life conditions during lockdown and the Strengths and Difficulties Questionnaire (SDQ). Stepwise regression analyses controlling by previous reports of SDQ were performed. Conduct, peer, prosocial, and total problems scores increased after lockdown. After adjusting for previous measures of psychopathology, worse adolescents&rsquo, mental health during COVID-19 lockdown was associated with unhealthy activities, worsening of the relationships with others, and dysfunctional parenting style. It seems important to mitigate psychological stress in a situation of isolation due to a state of emergency by keeping the adolescent active and maintaining their daily habits and routines in a non-conflictive atmosphere and give support to parents.

Background The Affective Reactivity Index (ARI) is a brief instrument originally designed as a self- and parent report. However, the view of teachers, who can observe social situations that may give rise to irritability, is relevant. The goal is to provide the measurement qualities of the ARI score as reported by teachers. Method Children formed part of a longitudinal study on behavior problems in Barcelona (Spain) and they were assessed when they were 7 (N = 471) and 11 years old (N = 454) with questionnaires about psychopathology, anger and aggressive behavior, and a diagnostic interview answered by the parents, youths and teachers. Confirmatory factor analysis, measurement invariance, reliability and validity were studied for the ARI answered by teachers. Results The 6-item, 1-factor model fitted well. Almost full metric invariance and partial scalar invariance was obtained across sex and over age. The ARI scores largely converged with other teacher-reported measures of anger and irritability, and with other measures of psychopathology, aggressive behavior, and callous-unemotional traits at a medium level. The associations with parent's measures were medium to low, and very low for child self-reported measures. The ARI scores significantly differentiated children with and without psychopathology and functional impairment, both cross-sectionally and longitudinally. Limitations Only one child self-report measure of irritability included. Limited internal consistency of some scale scores. Findings are mostly generalizable to Spanish children. Conclusions ARI could be a suitable instrument for measuring irritability as reported by teachers. The teacher's view can be useful when planning treatment by helping to identify treatment targets.

Irritability is a transdiagnostic symptom in oppositional defiant disorder, depression, and anxiety, all highly comorbid disorders but with unknown simultaneous evolution. The aim was to obtain the developmental trajectories of simultaneous irritability and oppositional, depression, and anxiety problems from preschool age to early adolescence. A sample of 493 community children was followed up annually from ages 3–11 years and assessed using categorical and dimensional measures answered by parents and teachers. Latent Class Growth Analysis for four parallel processes was used to identify distinct groups of individual trajectories for irritability and oppositional, depression, and anxiety problems. Outcomes at ages 11 and 12 were compared among trajectories using regression models and multiple comparisons. A 3-class model showed the highest entropy (0.961) and adequate posterior probabilities of class membership (≥0.969). Class 1 (n = 331, 67.1%) was made up of children with stable low scores in all the variables; class 2 (n = 55, 11.2%) of children with high depression, anxiety, and irritability and above the mean stable profiles for oppositional problems; and class 3 (n = 107, 21.7%) of children with medium-high increasing irritability and oppositional problems and on the mean depression and anxiety. The classes with symptomatology and irritability (2 and 3) clearly differed from class 1 (low) at baseline and in outcomes. The course of irritability and oppositional, depression, and anxiety problems from ages 3–11 years differed qualitatively and quantitatively across subgroups of children. The 3 classes identified may help to guide clinicians’ decision-making regarding treating irritability and its comorbid disorders.

Background: Physical restraint is often used during the hospitalization of elderly people. However, this procedure is associated with adverse outcomes; therefore, it is necessary to be aware of the circumstances that promote restraint use, such as the perceptions of professionals who use it. Objectives: The purpose of the research was to determine the situations in which nursing staff considered the use of physical restraint as most important and to evaluate the possible associations with the sociodemographic and professional variables. Methods: A descriptive cross-sectional multicenter study was carried out in 52 units of eight Spanish acute hospitals. A survey of registered nurses and nursing assistants was used to collect data related to sociodemographic characteristics, experience, training in restraint use, and the Perception of Restraint Use Questionnaire (PRUQ)—which assesses the perceived importance of reasons frequently given for the use of physical restraint. Results: The sample comprised 508 registered nurses and 347 nursing assistants. Almost all (98%) had used physical restraint, and 82% thought their training in the use of physical restraint was insufficient. Nursing assistants scored higher than registered nurses ( p < .005, d = .68) on PRUQ total score and individual item scores, suggesting they thought the factors were more important in restraint use. Both registered nurses and nursing assistants considered restraint as most important in the prevention of falls and in the removal of medical devices such as intravenous lines and urinary catheters. Associations between PRUQ total score and other variables (unit type, sociodemographic factors, hospital) were nonsignificant. Discussion: The professionals considered restraint as very important in preventing safety problems. In order to improve the quality of care, it is essential to identify the factors that can have an effect on the application of physical restraint. Educational programs are of fundamental importance, but to be more effective in reducing the use of physical restraint, they should address commonly held views on rationale for restraint use and be accompanied by institutional policies promoting a restraint-free environment.

Background and aims The main aim of this study was to analyze and describe the clinical characteristics and shared personality traits in different impulsivity–compulsivity spectrum disorders: substance use disorders (SUD), gambling disorder (GD), and bulimia nervosa (BN). The specific aims were to compare personality differences among individuals with pure SUD, BN with and without SUD, and GD with and without SUD. In addition, we assessed the differential predictive capacity of clinical and personality variables in relation to diagnostic subtype. Methods The sample comprised 998 subjects diagnosed according to DSM-IV-TR criteria: 101 patients were diagnosed with SUD, 482 with GD, 359 with BN, 11 with GD + SUD, and 45 patients with BN + SUD. Various assessment instruments were administered, as well as other clinical measures, to evaluate their predictive capacity. Results Marked differences in personality traits were observed between groups. Novelty seeking, harm avoidance, self-directedness, cooperation, and self-transcendence best differentiated the groups. Notably, novelty seeking was significantly higher in the two dual pathology subgroups. Patients with dual pathology showed the most dysfunctional personality profiles. Discussion and conclusion Our results indicate the existence of shared dysfunctional personality traits among the groups studied, especially in novelty seeking and self-directedness.

Background There is debate about whether the difficulties that children with different degrees of oppositionality (ODD) and callous–unemotional traits (CU) have in processing emotions are global or specific. The aim of this study is to identify difficulties in recognizing emotion (happiness, anger, sadness and fear) through a go/no-go task in children with different levels of ODD and CU traits. Method A total of 320 8-year-old children were assessed through questionnaires filled out by teachers about oppositional defiant symptoms and CU traits and were then distributed into four groups: LowCU–HighODD, HighCU–LowODD, HighCU–HighODD and a comparison group (LowCU–LowODD). Results The analyses of variance comparing the 4 groups showed that the two groups with high ODD were less accurate than the control group in recognizing the emotion when the stimuli expressed happiness, fear or neutral emotion. The HighCU–HighODD group differed in the quality of the response (correct/wrong responses) but not in the reaction time in relation to the comparison group. The LowCU–HighODD group was faster to respond to emotions than the comparison group. Implications The results show that the deficit in emotion processing is not restricted to specific distressing emotions such as fear or sadness, but they point to a global impairment in emotion processing in children scoring high in the constructs studied. The results also suggest that the difficulties that children with combined CU traits and oppositional conduct problems have in processing emotions are more of an emotional rather than an attentional nature.

Aims As eating disorders have severe consequences, they require prevention. We aimed to compare maladaptive beliefs related to eating disorders by following two programs based on media literacy in adolescents at post-test intervention, and after 6 and 12 month-follow-ups. The Male and Female Nutrition and Media Literacy Model preventive program (NUT + MEF + MEM + ML in Spanish) and the Theater Alive program are both based on the same contents, the former being presented in a multimedia and interactive format and the latter in a drama format. Both were compared to a control group without intervention, whose participants received usual classes before the assessments. Method Participants were 178 adolescents in the second year of compulsory secondary education from fours schools of Terrassa (Catalonia, Spain). All participants in each school were assigned to the same group, depending on school schedules. A mixed 3 (group: Theater Alive, NUT + MEF + MEM + ML, control) × 3 (time: post-test, 6-month-follow-up, 12-month-follow-up) factorial design was used to evaluate the effect on maladaptive beliefs measured using a CE-TCA tool. Results When compared to the control group, both Theater Alive ( d = 0.88) and NUT + MEM + MEF + ML ( d = 0.60) obtained lower scores over time, the latter being not statistically significant. Discussion The Theater Alive program may produce an effect of cognitive dissonance that might eliminate the discrepancy between the contents of the play and those that are internalized, thus modifying maladaptive beliefs. Participants in the Theater Alive program, as actors in front of an audience, had to defend certain content that was rehearsed over and over again to the point until it became internalized.

The objective was to obtain developmental trajectories combining callous-unemotional traits and the number of stressful life-events between ages 3 and 9 years and to ascertain their association with the polymorphism rs53576 at the Oxytocin Receptor gene (OXTR). A total of 377 children were assessed yearly from ages 3 to 9 years. Latent class growth analysis for parallel processes was used to identify distinct trajectories for callous-unemotional traits (assessed using the Inventory of Callous-Unemotional Traits, ICU) and number of stressful life-events, and then the influence of being an A allele carrier on class membership was included with OXTR genotypes as a binary time-invariant predictor, following a 3-step approach. A 3-class model showed the highest entropy (.859) and adequate posterior probabilities of class membership (≥.884). Class 1 (n = 226, 59.9%) included children with low and stable ICU scores and low and descending stressful life-events; class 2 (n = 127, 33.7%) included children with high and ascending ICU scores and low and slightly descending stressful life-events; and class 3 (n = 24, 6.4%) included children with persistently high profiles both for ICU scores and stressful life-events. Carrying an A allele (genotypes GA/AA) increased the odds of pertaining to class 3 (high and persistent ICU scores and stressful life-events) as opposed to class 2 (OR = 4.27, p = 0.034) or class 1 (OR = 3.81, p = 0.042). The results suggest the importance of considering callous-unemotional traits and stressful life-events in conjunction. In addition, the genetic variability of OXTR (rs53576) may help to understand individual differences in early development.

ObjectiveTo examine the 1-year first incidence and prevalence of oppositional defiant disorder (ODD), the outcomes on psychopathology and functioning by age of onset and the risk factors of onset of ODD from ages 3 to 9 in children from the Spanish general population.DesignLongitudinal with seven follow-ups and double cohort (ODD and non-ODD children).SettingGeneral population of preschool and elementary school children in Barcelona (Spain).ParticipantsOn a first phase, the parent-rated Strengths and Difficulties Questionnaire conduct problems scale plus ODD Diagnostic and Statistical Manual of Mental Disorders, fourth version, symptoms were used to screen for behavioural problems. The second phase sample size contained 622 cases at age 3 and, at age 9, 418 remained in the study.ResultsThe probability of the onset of ODD showed increasing values at ages 4 (R=2.7%) and 5 years (R=4.4%). These values decreased until age 7 (R=1.9%) and increased again until age 9 (R=3.6%). Up to 9 years old, the cumulative risk of new cases of ODD was 21.9%. Early onset was associated with a higher risk of depression comorbidity and later onset with higher functional impairment and symptomatology. Subthreshold ODD, high scores in irritability and headstrong dimensions, attention deficit/hyperactivity disorder and other comorbidity, negative affectivity until age 7, difficulties in inhibit and emotional control, punitive parenting and maternal internalising problems were risk factors of a first episode of ODD during this 7-year period.ConclusionsThe risk of new cases of ODD in the general population at preschool age and during childhood is high. Preschool age is a target period for preventive interventions. Identified risk factors are objectives for targeted and indicated interventions.

To study the prevalence of subthreshold oppositional defiant disorder (ST ODD)—less than 4 symptoms, but nonetheless an impairing form of oppositional defiant disorder (ODD)—its coexistence with other homotypic externalizing and heterotypical internalizing problems in children and associated impairment, as well as the long-term effect of this condition. A population-based sample of 622 preschoolers (5.0% boys) was followed up from preschool to preadolescence. Parents were interviewed when the children were 3, 6 and 9 years old with the Diagnostic Interview for Preschoolers/Children and Adolescents versions following DSM-5 and the children’s functioning was assessed by trained clinicians. ST ODD diagnosis is highly prevalent (19.4–25.5%), highly comorbid [homo- (1.9–18.4%) and heterotypical (5.8–23.7%)], resulting in functional impairment across child development in a similar way for both genders. ST is also a risk factor condition that predicts the presence of psychological problems and impairment in childhood and preadolescence from preschool age. A broader clinical assessment and intervention similar to that provided full syndrome cases is needed for children presenting subthreshold forms of ODD.

IntroductionSchool victimization by peers is an important social problem with serious short- and long-term consequences poorly studied at preschool ages, which can lead to school bullying without timely intervention. Longitudinal data was used to determine the prevalence of warning signs of preschool peer victimization and its individual and family risk factors.MethodsData was obtained from 577 community preschoolers. School victimization was measured using the Strengths and Difficulties Questionnaire (SDQ) administered to parents and teachers of children at ages 4 and 5. Risk factors for the child (demographics, conduct and emotional problems, aggressiveness) and the family (maternal problems during pregnancy and early development, parenting styles, adaptive functioning and parents' problems) were previously recorded at 3 years old.ResultsCombined information from parents and teachers showed that 4.2% of preschoolers presented warning signs of victimization at ages 4 and 5. Low socioeconomic status, poor emotional control, early problems making friends and low level of parenting education in social norms at age 3 predicted later victimization at ages 4 and 5 (AUC = .78).ConclusionPeer victimization affects a considerable percentage of preschoolers. Early detection may help to reduce the risk of escalation.

Cultural differences in aggression are still poorly understood. The purpose of this article is to assess whether a tool for measuring aggression has the same meaning across cultures. Analyzing samples from Spain (n = 262), the United States (n = 344), and Hong Kong (n = 645), we used confirmatory factor analysis to investigate measurement invariance of the refined version of the Aggression Questionnaire (Bryant & Smith, 2001). The measurement of aggression was more equivalent between the Chinese and Spanish versions than between these two and the U.S. version. Aggression does not show invariance at the cultural level. Cultural variables such as affective autonomy or individualism could influence the meaning of aggression. Aggressive behavior models can be improved by incorporating cultural variables.

Hostile Attributional Bias (HAB) has been related to conduct problems. The common and unique associations between the different dimensions of Oppositional Defiant Disorder (ODD) symptoms, specific components of HAB, sex and types of aggression (overt and relational) in a community sample of 491 7-year-old children are investigated.Teachers rated the children's ODD symptoms and aggression and the children self-reported about HAB. Multiple linear regressions showed that ODD dimensions were directly associated with both types of aggression.Boys were more overtly aggressive and girls more relational. Emotional distress was directly associated with relational aggression. The relational component of HAB uniquely moderated the influence of the oppositional dimension on relational aggressive behaviour.The assessment of social cognition variables is necessary to approach specific interventions in the presence of ODD symptoms, as this may help to identify a subset of children prone to aggressive reactions.

ObjectiveThe present study aimed to assess the: (i) internal structure of the Spanish Child Food Security Survey Module (CFSSM-S) with exploratory and confirmatory factor analysis (EFA and CFA); (ii) measurement invariance by gender, grade, weight status, socio-economic status (SES) and family affluence; and (iii) relationships with these external variables.DesignA cross-sectional study was conducted. The CFSSM-S and other tools were employed to assess food insecurity, weight status, SES and family affluence, respectively.SettingA secondary school (grades 7–10) in the city of Terrassa in Catalonia, Spain.SubjectsParticipants included adolescent boys and girls (n426) aged 12–17 years.ResultsThe cross-validation design with EFA and CFA captured a single factor, ‘food insecurity’. The goodness-of-fit for the one-factor model with CFA (root-mean-square error of approximation=0·038, comparative fit index=0·984, Tucker–Lewis index=0·979) and internal consistency (ω=0·95) were excellent. The measurement invariance indicated that CFSSM-S could be used across genders, grades, weight status, SES and family affluence. Only mean differences for SES and family affluence were found which showed a linear trend, indicating higher CFSSM-S scores for participants with lower SES and family affluence. Of participants, 1·9 % experienced very low food security, 16·4 % low food security and 81·7 % were food secure.ConclusionsThe CFSSM-S is the first validated instrument to assess food insecurity with psychometric guarantees in Spanish adolescents. Researchers and health practitioners in Spain could use this self-reported questionnaire to gain more information about adolescent health in relation to food insecurity.

The present study is centered in adapting and validating a Spanish version of the Irrational Procrastination Scale (IPS). The sample consists of 365 adults aged 18-77 years (M = 37.70, SD = 12.64). Participants were administered two measures of procrastination, the IPS and the Decisional Procrastination Questionnaire, as well as the Big Five Inventory, and the Satisfaction With Life Scale. First, the factor and replication analysis revealed that the internal structure of the scale is clearly one-dimensional, supporting the idea that IPS seems to measure general procrastination as a single trait. Second, the internal consistency is satisfactory as is the temporal stability of the IPS scores. Third, the correlations encountered between the IPS scores and other measures of procrastination, personality traits and satisfaction with life are all in the expected direction and magnitude. Finally, consistent with previous research, procrastination is related to age, with the youngest being the most procrastinating group. This study represents the first attempt in adapting and validating the IPS measure of procrastination into Spanish. Results suggest that the Spanish version of the IPS offers valid and reliable scores when applied to adult population.

Aims and objectives To study the internal structure and measurement invariance of the Physical Restraint Use Questionnaire and to compare perceptions, experience and training, regarding use of physical restraint on the older people between nursing staff working in hospitals and nursing homes. Background Physical restraint of patients is still common in many countries, and thus, it is important to study the attitudes of nursing staff. One of the most common tools used to assess perceptions regarding its use is the Physical Restraint Use Questionnaire. However, gaps exist in its internal structure and measurement invariance across different groups of respondents. Design Cross-sectional multicentre survey. Methods Data were collected from nurses working in eight Spanish hospitals and 19 nursing homes. All registered nurses and nurse assistants (N = 3,838) were contacted, of whom 1,635 agreed to participate. Confirmatory factor analysis was performed to determine internal structure and measurement invariance of Physical Restraint Use Questionnaire, after which scale scores and other measures of experience and training were compared between hospital-based (n = 855) and nursing homes-based (n = 780) nurses. Results The Physical Restraint Use Questionnaire showed three invariant factors across type of facility, and also professional category and sex. Nursing staff working in both types of facility scored similarly; prevention of therapy disruption and prevention of falls were rated more important. Nurses working in nursing homes reported using restraint "many times" more frequently (52.9% vs. 38.6%), less severe lack of training (18.2% vs. 58.7%) being perceived as more adequate (33.4% vs. 17.7%), than hospital-based nurses. Conclusions These findings support Physical Restraint Use Questionnaire as a valid and reliable tool for assessing the importance given to the use of physical restraint in the older people by nursing professionals, regardless of the setting being studied. Relevance to clinical practice The information would help design more specifically the physical restraint training of nursing staff and to plan institutional interventions aimed at reducing its use.

Qualitative studies examining gender differences of eating disorder prevention programmes are scarce. We aimed to evaluate gender differences in adolescents who participated in a larger study on effectiveness of a disordered eating prevention programme. Perceptions of eating, female and male aesthetic models, media influences, prevention programmes and emerging topics from 12 school-going boys who received a media-literacy programme ( n = 4), media-literacy plus nutrition-awareness programme ( n = 4) or neither ( n = 4) were explored using Interpretative Phenomenological Analysis and compared with previous results in girls. Findings suggest that the prevention programme is effective for both genders. Gender differences and consumer-culture influences may be considered in future interventions.

The aim of this study was to explore the differences in patterns of risk factors for body dissatisfaction and disordered eating attitudes in both female and male adolescents from Portugal and Spain. The sample included 455 adolescents aged 12–16 years (M = 13.28, SD = 0.65) from two urban areas of each country. Body mass index, self-reported self-esteem, perfectionism, internalisation of sociocultural ideals, body dissatisfaction and disordered eating attitudes were assessed. Path analyses provided partial support for a cross-cultural model of body dissatisfaction and disordered eating in Western countries due to the presence of certain differences in the patterns of relationships across sex and country. The findings suggest the importance not only of identifying cultural specificities, even in “neighbouring” countries, but also of developing a global and comprehensive preventive approach that focuses on the influence of the ideal of beauty transmitted by Western societies.

Objective Recently, the DSM-5 has developed a new diagnostic category named "Substance-related and Addictive Disorders". This category includes gambling disorder (GD) as the sole behavioral addiction, but does not include sex addiction (SA). The aim of this study is to investigate whether SA should be classified more closely to other behavioral addictions, via a comparison of the personality characteristics and comorbid psychopathology of individuals with SA with those of individuals with GD, which comes under the category of addiction and related disorders. Method The sample included 59 patients diagnosed with SA, who were compared to 2190 individuals diagnosed with GD and to 93 healthy controls. Assessment measures included the Diagnostic Questionnaire for Pathological Gambling, the South Oaks Gambling Screen, the Symptom CheckList-90 Items-Revised and the Temperament and Character Inventory-Revised. Results No statistically significant differences were found between the two clinical groups, except for socio-economic status. Although statistically significant differences were found between both clinical groups and controls for all scales on the SCL-90, no differences were found between the two clinical groups. The results were different for personality characteristics: logistic regression models showed that sex addictive behavior was predicted by a higher education level and by lower scores for TCI-R novelty-seeking, harm avoidance, persistence and self-transcendence. Being employed and lower scores in cooperativeness also tended to predict the presence of sex addiction. Conclusions While SA and GD share some psychopathological and personality traits that are not present in healthy controls, there are also some diagnostic-specific characteristics that differentiate between the two clinical groups. These findings may help to increase our knowledge of phenotypes existing in behavioral addictions.

Perinatal grief differs from other types of mourning. Two goals were set: to describe the progression of the process of grief and the symptoms of depression throughout the year following perinatal loss, and to study its association with socio-economic and obstetric factors.The study involved the participation of 70 women who had suffered a medical termination of pregnancy or a prenatal/postnatal death. Three assessments were made after the loss (after 1 month, 6 months and 1 year) with the Perinatal Grief Scale (PGS) to assess grief and the Beck Depression Inventory (BDI) for depressive symptomatology.Symptoms pertaining to grief and depression were observed in the first month after the loss, and a significant decrease in scores over the two follow-ups. No significant differences were observed in grief and depression depending on the type of loss, no significant associations were found with the age of the mother, her socioeconomic level, or obstetric factors (week of gestation of the loss, having a child or having suffered a previous miscarriage).Perinatal grief is a complex construct, with multiple variables involved, and one which involves significant emotional discomfort.

We provide the first validation data on the Spanish version of the Brief Problem Monitor-Parent form (BPM-P), a recently developed abbreviated version of the 120-item Child Behavior Checklist for Ages 6 to 18 (CBCL/6-18) in young schoolchildren. Parents of a community sample of 521 children aged 6-8 answered the CBCL/6-18 yearly, and the 19 BPM-P items were examined; parents also provided different measures of psychopathology. Confirmatory factor analysis of the expected 3-factor model (attention, externalizing, and internalizing) showed adequate fit (root mean square error of approximation, RMSEA ≤ .057), and measurement invariance across sex and age was observed. Internal consistency for the derived scores was satisfactory (ω ≥ .83). Concurrent validity with the equivalent scale scores of the original full CBCL/6-18 (r ≥ .84) and convergent validity with parents' ratings of the Strengths and Difficulties Questionnaire scores (r ≥ .52) were good. BPM-P scores at age 7 showed good predictive accuracy for discriminating the use of mental health services (OR ≥ 1.12), functional impairment (B ≤ -1.25), and the presence of the corresponding disorders diagnosed with an independent clinical interview, both cross-sectionally at age 7 and longitudinally at age 8 (OR ≥ 1.24). The BPM-P provides reliable and valid scores as a very brief follow-up and screening tool for assessing behavioral and emotional problems in young schoolchildren. (PsycINFO Database Record

BackgroundCross-sectional studies show that neuroticism is strongly associated with affective disorders. We investigated whether neuroticism and affective disorders mutually reinforce each other over time, setting off a potential downward spiral.MethodA total of 2981 adults aged 18–65 years, consisting of healthy controls, persons with a prior history of affective disorders and persons with a current affective disorder were assessed at baseline (T1) and 2 (T2) and 4 years (T3) later. At each wave, affective disorders according to DSM-IV criteria were assessed with the Composite Interview Diagnostic Instrument (CIDI) version 2.1 and neuroticism with the Neuroticism–Extraversion–Openness Five Factor Inventory (NEO-FFI).ResultsUsing structural equation models the association of distress disorders (i.e. dysthymia, depressive disorder, generalized anxiety disorder) and fear disorders (i.e. social anxiety disorder, panic disorder, agoraphobia without panic) with neuroticism could be attributed to three components: (a) a strong correlation of the stable components of distress and fear disorders with the stable trait component of neuroticism; (b) a modest contemporaneous association of change in distress and fear disorders with change in neuroticism; (c) a small to modest delayed effect of change in distress and fear disorders on change in neuroticism. Moreover, neuroticism scores in participants newly affected at T2 but remitted at T3 did not differ from their pre-morbid scores at T1.ConclusionsOur results do not support a positive feedback cycle of changes in psychopathology and changes in neuroticism. In the context of a relative stability of neuroticism and affective disorders, only modest contemporaneous and small to modest delayed effects of psychopathology on neuroticism were observed.

Summary Objective This study aims to ev aluate the long-term outcome of new technology assisted guided self-help in adolescents with bulimia nervosa (BN). Methods O ne hundred and twenty-six patients with BN (29 adolescents and 97 adults) were randomly allocated to a cognitive behavioural therapy-based self-help program delivered by the Internet or bibliotherapy, both accompanied by e-mail guidance. Outcomes were assessed at baseline, month 4, 7 and 18 including remission rates and eating disorder associated psychopathology. Results I n all, 44 % of adolescents vs. 38.7 % of adults were in remission at month 7, and 55 % of adolescents vs. 62.5 % of adults were in remission at follow-up. Objective binge eating and compensatory behaviour improved significantly over time in both groups, with the highest decrease during the first 4 months. A significant decrease over time and no group differences have been found in almost all EDI-2 subscales. Conclusions E-m ail guided self-help (delivered via the Internet or bibliotherapy) is equally effective for adoles cents as for adults with BN, and can be recommended as an initial step of treatment for this younger age group.

We assessed changes in the body image of Spanish adolescents who participated in a programme aimed at preventing disordered eating, with a 30-month follow-up. 254 girls and 189 boys aged 12-14 were assigned to a control group (n=201) or one of two possible experimental conditions: media literacy programme (ML, n=143) and media literacy plus nutrition awareness programme (ML+NUT, n=99). Body image was assessed with the Body Image Questionnaire (Qüestionari d'Imatge Corporal; QÜIC). Pre-test, post-test, 7- and 30-month follow-up measurements were taken. Linear model analyses were carried out with a 2×3×3 ANOVA (sex×group×phase), adjusted by the baseline level. At 30-month follow-up, ML and ML+NUT participants showed fewer body problems and more body satisfaction than the control group. There is a need for prevention programmes addressing eating and body image disturbances that involve both boys and girls.

This study mainly compared the prevalence of internalizing symptoms of 834 Spanish and 159 Latin-American immigrant adolescents. Participants completed self-report measures about depression, anxiety and somatic symptoms and a socio-demographic questionnaire. The results indicated that being Latin-American was associated with higher levels of depressive symptoms and being female was related to higher depressive and anxiety symptoms. Gender differences were more prevalent in Spaniards than in Latinos, with girls showing more symptoms than boys. High socio-economic status was negatively related to depressive symptoms and anxiety. The results may alert clinicians of the importance of assessing depressive symptoms in Latino adolescents in order to treat this group of youths effectively.

BackgroundCognitive–behavioural therapy (CBT)-based guided self-help is recommended as a first step in the treatment of bulimia nervosa.AimsTo evaluate in a randomised controlled trial (Clinicaltrials.gov registration number: NCT00461071) the long-term effectiveness of internet-based guided self-help (INT-GSH) compared with conventional guided bibliotherapy (BIB-GSH) in females with bulimia nervosa.MethodA total of 155 participants were randomly assigned to INT-GSH or BIB-GSH for 7 months. Outcomes were assessed at baseline, month 4, month 7 and month 18.ResultsThe greatest improvement was reported after 4 months with a continued reduction in eating disorder symptomatology reported at month 7 and 18. After 18 months, 14.6% (n = 7/48) of the participants in the INT-GSH group and 25% (n = 7/28) in the BIB-GSH group were abstinent from binge eating and compensatory measures, 43.8% (n = 21/48) and 39.2% (n = 11/28) respectively were in remission. No differences regarding outcome between the two groups were found.ConclusionsInternet-based guided self-help for bulimia nervosa was not superior compared with bibliotherapy, the gold standard of self-help. Improvements remain stable in the long term.

To examine the differences between Prevalence Ratio (PR) and Odds Ratio (OR) in a cross-sectional study and to provide tools to calculate PR using two statistical packages widely used in substance use research (STATA and R).We used cross-sectional data from 41,263 participants of 16 European countries participating in the Survey on Health, Ageing and Retirement in Europe (SHARE). The dependent variable, hazardous drinking, was calculated using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C). The main independent variable was gender. Other variables used were: age, educational level and country of residence. PR of hazardous drinking in men with relation to women was estimated using Mantel-Haenszel method, log-binomial regression models and poisson regression models with robust variance. These estimations were compared to the OR calculated using logistic regression models.Prevalence of hazardous drinkers varied among countries. Generally, men have higher prevalence of hazardous drinking than women [PR=1.43 (1.38-1.47)]. Estimated PR was identical independently of the method and the statistical package used. However, OR overestimated PR, depending on the prevalence of hazardous drinking in the country.In cross-sectional studies, where comparisons between countries with differences in the prevalence of the disease or condition are made, it is advisable to use PR instead of OR.Objetivo: Examinar las diferencias entre la Razón de Prevalencia (RP) y la Odds Ratio (OR) en un estudio transversal y proporcionar herramientas para calcular la RP usando dos paquetes estadísticos ampliamente utilizados en la investigación de adicciones (STATA y R). Métodos: Se utilizaron los datos de un estudio transversal de 41.263 participantes de 16 países de Europa que participaron en la Encuesta sobre Salud y Envejecimiento en Europa (SHARE). La variable dependiente, consumo de riesgo de alcohol, se calculó a partir del Alcohol Use Disorders Identification Test – Consumption (AUDIT-C). Como principal variable independiente se utilizó el género. Otras variables fueron la edad, el nivel de estudios y el país de residencia. Las RP de consumo de riesgo de alcohol entre hombres y mujeres se estimaron a partir del método de Mantel Haenzel, de modelos de regresión log-binomial y de modelos de regresión de Poisson con varianza robusta. Estas estimaciones fueron comparadas con las OR obtenidas a partir de modelos de regresión logística. Resultados: La prevalencia de consumidores de riesgo de alcohol varía según país. En general los hombres tienen un mayor consumo de riesgo que las mujeres [RP=1.43 (1.38-1.47)]. La RP estimada no varía, independientemente del método o paquete estadístico utilizado. Sin embargo, dependiendo de la prevalencia del consumo de riesgo del país, la OR entre los consumidores de riesgo y el género sobrestima la RP. Conclusiones: En estudios transversales en los que se comparan distintos países con diferente prevalencia de una determinada enfermedad o condición es recomendable utilizar la RP en lugar de la OR.

To identify the frequency of completion of informed consent and medical prescription in the clinical records of older patients subject to physical restraint, and to analyse the association between patient characteristics and the absence of such documentation.A cross-sectional and descriptive multicentre study with direct observation and review of clinical records was conducted in nine public nursing homes, comprising 1,058 beds.274 residents were physically restrained. Informed consent was not included in 82.5% of cases and was incomplete in a further 13.9%. There was no medical prescription in 68.3% of cases and it was incomplete in a further 12.0%. The only statistical association found was between the lack of prescription and the patients' advanced age (PR=1.03; p0.005).Failure to produce this documentation contravenes the law. Organisational characteristics, ignorance of the legal requirements or the fact that some professionals may consider physical restraint to be a risk-free procedure may explain these results.

The assessment of eating disorder prevention-programmes has mainly been addressed quantitatively excluding complexity that may improve prevention. We compared perceptions of eating, female and male aesthetic-models, media influences, prevention-programmes and emerging topics among 12 young females who received a media literacy programme ( N = 4), media literacy plus nutrition awareness programme ( N = 4) or were assigned to a control condition ( N = 4). Interpretative Phenomenological Analysis highlighted ego-syntonic eating-patterns and signs of internalization of the thin ideal. Findings provide invaluable and rich information to improve future iterations of the programme.

The objective of this article was to examine lifestyle behaviours in eating disorder (ED) patients and healthy controls. A total of 801 ED patients and 727 healthy controls from five European countries completed the questions related to lifestyle behaviours of the Cross-Cultural Questionnaire (CCQ). For children, the ED sample exhibited more solitary activities (rigorously doing homework [p

The study compared clinical, psychopathological, and personality profiles between immigrants and Spanish native-born pathological gambling patients. A total of 1,601 native-born and 133 immigrant patients attending treatment at a specialized hospital unit were administered a battery of questionnaires during clinical assessment. Outcome measures were compared between both groups and the incremental predictive accuracy of the area of origin was examined using a regression model. Native-born Spaniards showed a mean 2.6 yr. greater duration of the disorder, while immigrants scored higher on South Oaks Gambling Screen, frequency of going to casinos, and total money spent (in a single day and / or to recover losses). General psychopathology and personality scores did not differ between the cohorts. However, immigration from Asia had a statistically significantly incremental validity for pathological gambling in South Oaks Gambling Screen scores. Both cohorts shared more similarities than differences in their gambling profiles.

Objectives The aim of this study was to evaluate the psychometric properties of the Spanish version of the short Egna Minnen Betraffande Uppfostran–Adolescent version (S-EMBU-A) in a clinical context. Methods The S-EMBU-A is a 22-item self-report questionnaire, based on the original 64-item EMBU-A, that assesses perceived parental rearing style in adolescents, comprising 3 subscales (Rejection, Emotional Warmth, and Overprotection). The questionnaire was administered to a clinical sample of 281 Spanish psychiatric outpatients aged 13 to 18 years. Confirmatory factor analysis was performed, analyzing the adolescents' reports about their parents' rearing style. Results Confirmatory factor analysis yielded an acceptable fit to data of the 3-factor model (comparative fit index=0.90; root mean squared error of approximation=0.054) and parameters were equivalent for the ratings assigned to fathers and mothers. Satisfactory internal consistency reliability was obtained for the 3 scales (Cronbach α ≥ .74). The influence of gender (of adolescents and parents) and age on scale scores was inappreciable. High scores for Rejection and low scores for Emotional Warmth were related to bad relationships with parents, absence of family support, presence of rejection, harsh discipline, and lack of parental supervision. Conclusions The Spanish version of S-EMBU-A can be used with psychometric guarantees to identify rearing style in psychiatric outpatients, because evidence of quality in clinical setting matches that obtained in community samples.

To conduct a latent profile analysis (LPA) in eating disorder (ED) patients using temperament and character (TCI-R) measures as indicators. 1312 ED patients including those with anorexia nervosa (AN), bulimia nervosa (BN) and EDNOS were assessed. The final LPA solution was validated using demographics, clinical variables, ED symptomatology (EDI-2) and impulsive behaviors. The best-fitting model consisted of a six-profile solution using the seven subscales of the TCI-R. These profiles were labeled: "self-focused", "inhibited", "average", "impulsive", "adaptive" and "maladaptive". Validation analyses indicated that the "inhibited" and "maladaptive" profiles generally presented with the highest values for ED symptomatology and impulsive behaviors. Whereas high levels of Harm Avoidance and low levels of Novelty Seeking and Persistence characterized the "inhibited" profile, the "maladaptive" profile presented with low levels of Reward Dependence, Self-Directedness and Cooperativeness. The most favorable results on the other hand were exhibited by the "adaptive" profile, characterized by high scores on Reward Dependence, Self-Directedness, Cooperativeness and low levels on Novelty Seeking. Finally, when our six-profile solution was compared with the DSM-IV ED diagnoses, significant differences among profiles and ED diagnoses were observed. Our study shows that ED patients can be meaningfully grouped according to temperament and character.

Objective The risk for suicide attempts is elevated in anorexia nervosa (AN), yet we know little about the relation between suicide and personality in this group. We explored the prevalence of lifetime suicide attempts in women with AN and compared those who had and had not attempted suicide on eating disorder symptoms, general psychopathology, and personality both relative to a healthy control group and then across AN subtypes. Method One hundred four outpatients with restricting AN, 68 outpatients with purging AN, and 146 comparison individuals participated in the study. Results The prevalence of suicide attempts differed significantly across the 3 groups (P = .003), with 0% in the controls, 8.65% in the restricting AN group, and 25.0% in the purging AN group. Depression measures were elevated in those with suicide attempts. Within the restricting AN group, those who attempted suicide scored significantly higher on Phobic Anxiety, measured by means of the Symptom Checklist–Revised, than those who did not (P = .001). Conclusion The presence of purging and depressive symptoms in individuals with AN should increase vigilance for suicidality; and among restrictors, greater anxiety may index greater suicide risk.

Objective To assess the relationship between childhood sexual and physical abuse, and key attitudinal and behavioural aspects of eating disorders (ED). Method Participants included 708 female undergraduates in a Spanish public university, aged from 18 to 30. Abuse was measured by the Traumatic Life Events Questionnaire, and ED by the Eating Disorders Examination Questionnaire (EDE-Q). Results 14.3% of the sample had suffered childhood sexual abuse (CSA) and 3.8% childhood physical abuse (CPA). With respect to ED attitudinal features, we observed an increased Weight Concern score among CSA survivors. No association was found between this kind of abuse and disordered eating behaviours, after adjusting for depression, anxiety, self-esteem, body mass index, age and socioeconomic status. An inverse relationship was found between CPA and ED attitudes measured by EDE-Q (Restraint, Weight Concern, Shape Concern and the Overall Score), whereas no association was found with the behavioural aspects of eating disturbances. Discussion After controlling for different risk factors, CSA appears to be related to an increased Weight Concern, whilst other ED attitudinal features and behaviours do not seem to be related to childhood abuse. The inverse relationship found is discussed. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

Objective: To explore the psychometric properties of the Cross-Cultural Questionnaire (CCQ), a new self-report tool for assessing factors of risk and maintenance for eating disorders (ED). Method: Data was collected during a multi-centre case-control study. The sample included 854 ED patients and 784 healthy participants from the UK, Spain, Austria, Slovenia and Italy. Exploratory factor analyses examined the factor structure of each section of the CCQ, and Cronbach's alpha coefficients valued the internal consistency of each derived scale score. Logistic regression and receiver operating characteristic (ROC) curve procedure assessed the screening accuracy and predictive validity of the empirical factors. Results: Based on a total of 127 items, nine dimensions emerged, with satisfactory internal consistency and high congruence between countries. CCQ scores demonstrated satisfactory accuracy for discriminating between ED cases and controls (area under the ROC curve = 0.88). Most of the items achieved discriminative accuracy. Conclusions: This study offers preliminary evidence that the CCQ, available in five languages, is a useful and valid tool to assess factors of risk and maintenance for EDs. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • The CCQ is a new self-report questionnaire for assessing factors of risk and maintenance for eating disorders. • The CCQ is available in five languages (Spanish, English, German, Italian and Slovenian) and is free of charge for research purposes. • CCQ scores demonstrated satisfactory accuracy for discriminating between ED cases and controls.

Background: We provide the first validation data of the Spanish version of the Egna Minnen Beträffande Uppfostran—Child Version (EMBU-C) in a clinical context. The EMBU-C is a 41-item self-report questionnaire that assesses perceived parental rearing style in children, comprising 4 subscales (rejection, emotional warmth, control attempts/overprotection, and favoring subjects). Methods: The test was administered to a clinical sample of 174 Spanish psychiatric outpatients aged 8 to 12. Confirmatory factor analyses were performed, analyzing the children's reports about their parents' rearing style. Results: The results were almost equivalent for father's and mother's ratings. Confirmatory factor analysis yielded an acceptable fit to data of the 3-factor model when removing the items of the favoring subjects scale (root mean squared error of approximation .73), whereas control attempts scale showed lower values, as in previous studies. The influence of sex (of children and parents) on scale scores was inappreciable and children tended to perceive their parents as progressively less warm as they grew older. As predicted, the scores for rejection and emotional warmth were related to bad relationships with parents, absence of family support, harsh discipline, and lack of parental supervision. Conclusions: The Spanish version of EMBU-C can be used with psychometric guarantees to identify rearing style in psychiatric outpatients because evidences of quality in this setting match those obtained in community samples.

Objective The purpose of this study is to explore the effect of sex as a moderator variable for gambling and clinical profiles in a large sample of Spanish treatment-seeking patients for pathologic gambling (PG). Method Clinical and personality profiles were compared between 143 male and 143 female pathologic gamblers who sought consultation at a specialized hospital unit. Multiple regressions explored the incremental predictive accuracy of sex on PG severity in consideration of sociodemographic and psychologic characteristics. Results Men gambled most frequently using slot machines and lotteries, spent more money, and had most arguments with family and friends. Although the age of onset of PG was 7.1 years higher for females, the severity was equal for both sexes. Women evidenced more general psychopathology, with higher mean scores in all the Symptom ChekList-90 items scales (except for hostility and psychoticism), and had significantly higher scores for harm avoidance and lower scores for self-directedness than the male group. However, sex alone did not obtain a significant incremental validity for PG severity. Conclusions These results may provide guidance for obtaining accurate diagnostic information about PG, properly identifying patients with specific needs and planning sex-specific targets.

Objectives To assess the differences in comorbid lifetime and current substance use (tobacco, alcohol and drug use) between eating disorder (ED) patients and healthy controls in five different European countries. Method A total of 1664 participants took part in the present study. ED cases ( n = 879) were referred to specialized ED units in five European countries. The ED cases were compared to a balanced control group of 785 healthy individuals. Assessment Participants completed the Substance Use Subscale of the Cross Cultural (Environmental) Questionnaire (CCQ), a measure of lifetime tobacco, alcohol and drug use. In the control group, also the GHQ-28, the SCID-I interview and the EAT-26 were used. Results ED patients had higher lifetime and current tobacco and general drug use. The only non-significant result was obtained for lifetime and current alcohol use. Significant differences across ED subdiagnoses and controls also emerged, with BN and AN-BP generally presenting the highest and AN-R and controls the lowest rates. The only exception was detected for alcohol use where EDNOS demonstrated the highest values. Only a few cultural differences between countries emerged. Conclusions With the exception of alcohol consumption, tobacco and drug use appear to be more prevalent in ED patients than healthy controls. The differential risk observed in patients with bulimic features might be related to differences in temperament or might be the result of increased sensitivity to reward.

Passion has been shown to be involved in psychological processes that emerge in diverse human activities like physical activity and sports, work, leisure, videogaming, pathological gambling, and interpersonal relationships. We aimed to present evidence of validity and internal consistency of the Passion Scale in Spanish based on the Dualistic Model of Passion, comprising harmonious and obsessive dimensions.The sample comprised 1,007 participants (350 females and 657 males), aged 16-65 (Md= 30.0 years). Exploratory Structural Equation Modeling (ESEM), measurement invariance and Multiple-Cause-Multiple-Indicator models (MIMIC) were used.Fit for the ESEM 2-factor solution was acceptable. Near full or partial measurement invariance across sex, type of activity, and age was supported. Relationships between both harmonious and obsessive dimensions and the external variables considered (age, sex, and criterion items) reasonably replicated those found in previous studies. Both scale scores showed adequate internal consistency (alpha; = .81).Empirical evidence for the validity and internal consistency of the Spanish version of the Passion Scale is satisfactory and reveals that the scale is comparable to the English and French versions. Therefore, the Passion Scale can be used in research conducted in Spanish.

Objectives. (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity.Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits.Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence.Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits.

The objective of the study was to analyse shared commonalities and differences between bulimia nervosa (BN) and certain impulse-related disorders, namely compulsive buying (CB) and gambling disorder (GD), with respect to general psychopathology and personality traits.A total of 188 female patients [50 BN without comorbid CB (BN-CB), 49 BN with comorbid CB (BN+CB), 53 GD and 36 CB] and 50 comparison non-psychiatric women participated in the current study. All patients were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth revised edition, the Temperament and Character Inventory-Revised, and other clinical indices.A positive-growing trend was observed in psychopathology and personality traits across the four clinical groups. Comorbid BN with CB was associated with highest eating psychopathology and social anxiety. On Novelty Seeking, the CB, GD and BN+CB were similar to each other, whereas BN-CB presented a distinct profile. Moreover, the BN+CB group displayed more dysfunctional personality traits and higher general psychopathology. The clinical groups demonstrated overall higher levels of psychopathology compared with the control group.The results of this study demonstrate that disorders with impulsive traits (CB, GD, BN+CB and BN-CB) follow a linear trend in general psychopathology and specific personality traits, but differ along specific personality and psychopathological dimensions.

Technology assisted guided self-help has been proven to be effective in the treatment of bulimia nervosa (BN). The aim of this study was to determine predictors of good long-term outcome as well as drop-out, in order to identify patients for whom these interventions are most suitable.One hundred and fifty six patients with BN were assigned to either 7 months internet-based guided self-help (INT-GSH) or to conventional guided bibliotherapy (BIB-GSH), both guided by e-mail support. Evaluations were taken at baseline, after 4, 7, and 18 months. As potential predictors, psychiatric comorbidity, personality features, and eating disorder psychopathology were considered.Higher motivation, lower frequency of binge eating, and lower body dissatisfaction at baseline predicted good outcome after the end of treatment. Lower frequency of binge eating predicted good outcome at long-term follow-up. Factors prediciting drop-out were higher depression and lower self-directedness at baseline.Technology assisted self-help can be recommended for patients with a high motivation to change, lower binge-eating frequency and lower depression scores.

Aims. To evaluate the long-term effects of two school-based prevention programs administered to a universal mixed-sex sample of school-going adolescents on disturbed eating attitudes, aesthetic ideal internalization, and other eating disorder risk factors, when compared to a control group.Methods. Participants were 200 adolescents aged 12–15 selected by means of incidental sampling from second-year compulsory secondary education at schools. An interactive multimedia media literacy program (ML + NUT,Media LiteracyandNutrition) and a program focused on the same topics using dramatic arts (Theatre Alive) were applied and compared with a control group. Pretest, posttest (1 month later), and 5- and 13-month follow-up measurements were taken. Analyses were conducted with two-way mixed3×3ANCOVA (group × phase) adjusted by baseline levels, body mass index, and sex.Results. Participants in both experimental groups showed significantly higher self-esteem scores than the control group over time. The ML + NUT group also presented lower aesthetic ideal internalization scores than the control group.Discussion. Both programs can benefit students’ self-esteem. Moreover, ML + NUT program was useful in reducing thin-ideal internalization. However, differences in body dissatisfaction and disordered eating attitudes were not found. The programs may be protective on the core psychological variables, which are essential to adaptive adolescent development.

Emotion dysregulation is a unifying dimension of several psychopathological symptoms such as prolonged dysphoria, labile mood, high anger, persistent fear and excessive worry. Deficits in emotion regulation (ER), or emotion dysregulation, appear to be relevant to the development, maintenance, and promising treatment target in a broad range of mental disorders. The Difficulties in Emotion Regulation Scale (DERS) is the most comprehensive measure of emotion dysregulation to date, but the Spanish version has not been validated in adolescents.A community sample of 642 Spanish adolescents aged 12-18 responded to the DERS.Factor analysis suggested a six-factor solution, and strict measurement invariance across sex was achieved. Internal consistency for the subscales was moderate to satisfactory (.71-.88), except for Awareness (alpha; = .62). We found some sex differences on subscale scores, with small effect sizes.The results obtained for the Spanish version of the DERS are promising for investigating emotion dysregulation in Spanish adolescents.

The aim of this study was to explore the association between pathological gambling (PG) and anger by assessing whether psychopathology and personality are related to PG and to evaluate gender differences. The sample comprised 71 PGs and 37 healthy controls. Anger, psychopathology and personality were assessed with the STAXI-2, SCL-90-R and TCI-R respectively. Gender did not affect anger expression after stratifying by diagnostic condition (p > .05). Among PG patients, anger, psychopathology and personality measures were correlated with good effect-size (r > .30). Scores in the Anger Temperament (B = 0.21, p = .038) and Anger External-Expression (B = 0.27, p = .029) scales were positively associated with PG severity scores. Anger expression in PG should be considered in future treatment programs.

The purposes of this study were to examine the specific contribution of illegal acts to the diagnostic criteria of pathological gambling, to assess the possibility of differential item functioning across patients' sex and age, and to explore the existence of different clinical phenotypes based on the presence of illegal acts. The sample consisted of 2,155 patients seeking treatment for pathological gambling at the University Hospital of Bellvitge in Barcelona, Spain. The illegal acts item did not show different item functioning, and younger patients presented higher latent means than middle-aged and older patients, whereas no differences were found across sex. This item also showed the lowest discrimination coefficient; its exclusion would maintain satisfactory internal consistency for the remaining 9 symptoms and was poorly related to psychopathology and the severity of the gambling behavior. The relevance of the illegal acts as a diagnostic criterion appears to be limited, and its elimination from the Diagnostic and Statistical Manual for Mental Disorders, 5th edition, seems justified. However, illegal acts have implications for both the clinical and legal domains and contribute to increase the patients' impairment.