Anna M. Pulpón Segura

Poly-victimization and psychopathology among Spanish adolescents in residential care.

The aim of this study was to analyze the effect of poly-victimization on symptom severity among adolescents being cared for by the child welfare system in a southwestern European country. The sample consisted of 127 youths (62 males and 65 females) aged 12-17 years (M=14.60, SD=1.61) who were recruited from short- and long-term residential centers. The Juvenile Victimization Questionnaire (Finkelhor, Hamby, Ormrod, & Turner, 2005) and the Youth Self-Report (Achenbach & Rescorla, 2001) were used to assess interpersonal victimization experiences and psychopathology, respectively. Victim (n=68), low poly-victim (n=48), and high poly-victim (n=18) groups had comparable rates of psychopathology severity, with the exception of rule-breaking behavior, which was more severe among those with more victimization experiences (Cramers V=.342). Poly-victimization was shown to be a significant predictor of clinically severe rule-breaking behavior, thought problems, and anxiety/depression symptoms. Among victimization types, sexual and electronic victimization significantly predicted withdrawn/depressed and aggressive behavior, and attention problems, respectively. The results of this study highlight the importance of assessing a wide range of victimization experiences among adolescents in care, since poly-victimization seems to underlie the serious psychological problems these youth present.

Prácticas de Enfermería Comunitaria: evaluación de una muestra de enfermeras tutoras (curso 2001-02)

Objective: To know nurses’ opinion related to knowledge, skills and attitudes of pregraduated nursing students who were in their clinical training in Primary Health Care (PHC) Centers. Participants and methods: A cross-sectional study was carried out at PHC Centers. The participants were nurses who have being training nursing students, for the last two years. The studied variables were theoretical knowledge (normal values of biological parameters, nursing care process, etc), skills (blood pressure measurement, ability interviewing patients, etc) and attitudes (attentive listening, patients respect, etc) from nursing students. Results: According to the nurses’ opinion: nursing students have difficulties in theoretical knowledge on: clinical protocols, paediatrics and chronic illnesses; they show insufficient skills in performing punctures and shots, treating wounds and in taking out blood samples; the weakest attitudes affect the taking decisions process. On the other hand, they have good knowledge on: biological parameters (63: 76,8%), nursing care process (62: 75,6%), health education (53: 64,6%). They scored very well in blood pressure measurement and in listening patients during clinical encounters. Conclusions: According to nurses’opinion knowledge and attitudes are the strengths and skills are the weaknesses that undergraduate nursing students bring to their clinical practice as nursing professionals.

Evaluación económica de un nuevo AINE COX-2 selectivo, rofecoxib, en un entorno de práctica real

Objetivo. Valorar las consecuencias economicas y sanitarias de la eventual utilizacion de un nuevo antiinflamatorio COX-2. Diseno. Analisis de coste-efectividad mediante modelizacion de tres alternativas de prescripcion de antiinflamatorios no esteroideos (AINE) en pacientes diagnosticados de artrosis y sometidos a tratamientos de larga duracion con AINE: a) alternativa 1: prescripcion de AINE sin gastroproteccion a los pacientes de bajo riesgo y de AINE con gastroproteccion a los expuestos a un riesgo medio y alto de presentar complicaciones (procedimiento actual); alternativa 2: prescripcion exclusiva de rofecoxib (25 mg/dia) a todos los pacientes (alto y bajo riesgo), y c) alternativa 3: prescripcion en monoterapia de rofecoxib (25 mg/dia) a los pacientes susceptibles de recibir tratamiento combinado (AINE + gastroproteccion) debido al riesgo de complicaciones. Se contabilizan, en cada caso, los recursos y los beneficios clinicos esperados mediante el calculo del coste por cada efecto secundario gastrointestinal (ESGI) de gravedad moderada o alta (ulcus sintomaticos y complicaciones) evitado. Se cuantifica el impacto economico directo que supondria para el centro pasar de la primera alternativa a cualquiera de las otras dos. Emplazamiento y participantes. El estudio se ha realizado en el Centro de Atencion primaria de la Barceloneta y ha incluido para la modelizacion a los 124 pacientes diagnosticados de artrosis que durante el ano 2000 recibieron AINE de forma continuada. Resultados. La alternativa 2 supondria evitar 1,5 casos de ESGI (0,5 ulcus sintomaticos y 0,9 complicaciones graves), con un coste adicional de 336.566,78 euros. Cada caso evitado costaria 24.641,50 euros y cada caso grave evitado 38.464,77 euros. La alternativa 3 evitaria 0,25 casos de complicacion grave, a un coste adicional de 9.015,18 euros. Evitar un caso costaria 37.262,75 euros. Conclusiones. Los eventuales beneficios sanitarios derivados de la incorporacion universal o parcial de un AINE inhibidor selectivo de la COX-2 comportan un coste por unidad de beneficio de 24.000 o 36.000 euros, segun la alternativa. El impacto sobre el presupuesto de farmacia del centro se incrementaria en un 1,3% con la alternativa 2 y un 0,35% con la 3.

Poly-Victimization and Peer Harassment Involvement in a Technological World:

This article explores the ways poly-victimized youth (those experiencing multiple different types of victimization over the course of 1 year) use technology to interact with peers. Particular attention is given to the peer harassment victimization and perpetration experiences of poly-victimized youth compared with less victimized and non-victimized youth—both overall and through technology. Data were collected as part of the Technology Harassment Victimization (THV) study; a national survey of 791 youth, ages 10 to 20 across the United States. Study results document the heightened risks that poly-victimized youth experience when interacting with peers. Low and high poly-victimized youth were both at significantly greater risk of being dual victims and perpetrators of peer harassment when compared with non-victimized youth even after taking into account other potentially explanatory factors. This was not found to be the case for less victimized youth. This was true for high poly-victims and technology-involved harassment risk as well. There were indications that poly-victimized youth were interacting with peers in more intense and risky ways in general using new technology. The increase in attention to poly-victimization in recent years has importantly identified the detrimental role that experiencing different forms of victimization have on youth. This study not only adds to that literature but suggests that there is an opportunity to interrupt additional victimization by understanding how poly-victimized youth interact with peers before and during adolescence. Although preliminary, the differences in technology use by poly-victimized youth versus others suggest that more information is needed to understand how they are relating to peers in both positive and risky ways in this environment.

Facing Interpersonal Violence: Identifying the Coping Profile of Poly-Victimized Resilient Adolescents

Coping strategies are factors that mediate the relationship between interpersonal victimizations and psychological maladjustment. The objectives are as follows: (a) to establish the coping profile of adolescents according to the number of reported interpersonal victimizations; (b) to identify the most victimized adolescents (poly-victims), detecting those with psychological symptoms (nonresilient poly-victims) and those without psychological symptoms (resilient poly-victims), and then to examine any differences in coping strategies between the two groups; (c) to determine the accumulative effect of victimizations on mental health; and (d) to test the mediating role of both approach and avoidance coping between lifetime interpersonal victimizations and symptoms. Participants were 918 community Spanish adolescents (62.7% girls) aged between 14 and 18 years. Measures used were Youth Self-Report, Juvenile Victimization Questionnaire, and Adolescent Coping Orientation for Problem Experiences. The following results were reported: (a) The most victimized adolescents used to a greater degree avoidance coping strategies than nonvictimized adolescents. (b) Resilient poly-victimized adolescents were more likely to seek family support and tended to use more positive reappraisal than nonresilient poly-victimized adolescents. (c) A clear cumulative effect of victimizations on mental health was observed: 45% of the most victimized adolescents (poly-victims) reached clinical range on Youth Self-Report in front of 2% of nonvictimized adolescents. (d) Avoidance coping and more specifically Escaping and Venting feelings strategies played a mediating role between interpersonal victimizations and psychological symptoms. Approach coping had no mediating role, except for Positive reappraisal in girls. In conclusion, the possibility of identifying the coping profile of victimized adolescents may have clinical implications in terms of both prevention and intervention.

Resilience and psychopathology among victimized youth in residential care

This study examines the role of several resilience resources in the relationship between lifetime victimization and mental health problems among adolescents in care. The sample comprised 127 adolescents (53.% females, aged 12-17 years) from residential care facilities in Catalonia, Spain. The Juvenile Victimization Questionnaire, the Youth Self-Report, and the Adolescent Resilience Questionnaire were used to assess victimization, psychological symptoms, and resilience respectively. Results indicated that poly-victimization was associated with fewer resources, and with an increased risk of mental health problems. Self-resources mediated the relationship between victimization and internalizing and externalizing symptoms; community support mediated the relationship between victimization and internalizing symptoms. Self, school and peer support moderated the relationship between victimization and externalizing symptoms. Adolescents with fewer self-resources and less school support reported more externalizing symptoms, as did those with more peer support. However, poly-victimized youths reported symptoms within the clinical range, regardless of their level of resources. The findings stress the importance of preventing poly-victimization and of empowering poly-victimized adolescents, who appear to present low levels of resources. Researchers and clinicians should continue to study the poly-victimization/psychopathology relationship, and also design interventions and prevention programs which incorporate the most relevant resilience resources.

Poly-victimization and Mental Health Problems Among Adolescents in Residential Facilities in Spain

In the past, children and adolescents who suffered child abuse and neglect in Spain were mostly attended to by private charities. Today, each region in Spain has its own structured child welfare system, which protects vulnerable children by applying measures such as foster or residential care. Previous studies have shown that children and adolescents cared for by the child welfare system are among the most likely to suffer multiple types of victimization or poly-victimization. This chapter presents an original report that analyzes the relationship between poly-victimization and symptom severity among youth cared for in residential facilities. The sample consisted of 95 adolescents (51.6% males and 48.4% females), aged between 12 and 17 (M = 14.49, SD = 1.64) recruited from short- and long-term residential centers. The Juvenile Victimization Questionnaire and the Youth Self-Report were used to assess interpersonal victimization experiences and psychopathology, respectively. Poly-victimization was found to be a significant predictor of clinically severe internalizing and externalizing symptoms. Our findings highlight the importance of regular assessment of the ability of residential care facilities to protect children and adolescents against re-victimization, since the accumulation of multiple types of victimization places adolescent poly-victims at a high risk of developing serious mental health problems.

Polyvictimization and Its Effects On Mental Health Problems Among Immigrant and Native Adolescents in Catalonia

Introduction Several studies have reported that immigrant adolescents suffer high rates of victimization. Polyvictimization was established as a well predictor of mental health problems. Many authors have highlighted the need to study immigrant adolescents’ community as they were immersed in a stressful process. Objective The aim is to assess multiple types of victimization (polyvictimization) and mental health problems among immigrants (first and second generation) in comparison to native adolescents. Method The sample was composed of 296 adolescents (62.2% girls) aged 13-18 (M = 15.63; SD = 1.19) in Catalonia. Participants were distributed in three groups: native (50%), first (34%) and second (16%) generation immigrants. The Juvenile Victimization Questionnaire and the Youth Self Report were used to assess victimization experiences during the last year and psychological distress, respectively. Results Immigrant and native adolescents were comparable in average of total victimizations and in different types of victimization. Nevertheless, significant differences were shown among first immigrant generation and natives in relation to child maltreatment (p = .005). Significant associations were found between multiple kinds of victimization and mental health problems. However, for first immigrant generation who had experienced multiple victimizations were more associated with internalizing symptoms, while victimized native adolescents were more associated with externalizing symptoms. Conclusions Results emphasized the importance to assess victimization experiences which were suffered by adolescents, and also suggested that polyvictimization will be associated differently depend on the migration status group of the adolescents with mental health problems.