Marcela Larraguibel

Adolescentes con trastorno por consumo de sustancias: Una caracterización de personalidad a través de las normas chilenas del MACI

Background: Adolescence is the most vulnerable development stage to start drug abuse in our country. Moreover, adolescent personality may be an individual risk factor for drug abuse. Aim: To characterize the personality of adolescent drug abusers using the Millon Adolescent Clinical Inventory (MACI) and its Chilean norms. Patients and methods: Adolescents consulting in a mental health facility were studied. MACI was applied to 46 subjects, aged 16 ± 1 years (30 males) with a history of drug abuse and compared with 58 peers aged 15 ± 2 years (34 males) without such history. Results: Male and female drug abuser adolescents had a transgressor type of personality. Males had a high degree of sociability and unrestrained sexuality while females present signs of sexual abuse, suicide risk, and a more severe personality disorder. Conclusions: The personality traits detected in this group of drug abuser adolescents using Chilean norms is similar to those detected abroad and should help to plan rehabilitation (Rev Med Chile 2009; 137: 466-74). (Key words: Adolescent; Personality disorders; Substance-related disorders)

Construct validity and parent–child agreement of the six new or modified disorders included in the Spanish version of the kiddie Schedule for Affective Disorders and Schizophrenia present and Lifetime Version DSM-5 (K-SADS-PL-5)

Changes to the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) incorporate the inclusion or modification of six disorders: Autism Spectrum Disorder, Social Anxiety Disorder, Intermittent Explosive Disorder, Disruptive Mood Dysregulation Disorder, Avoidant/Restrictive Food Intake Disorder and Binge Eating Disorder. The objectives of this study were to assess the construct validity and parent-child agreement of these six disorders in the Spanish language Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL-5) in a clinical population of children and adolescents from Latin America. The Spanish version of the K-SADS-PL was modified to integrate changes made to the DSM-5. Clinicians received training in the K-SADS-PL-5 and 90% agreement between raters was obtained. A total of 80 patients were recruited in four different countries in Latin America. All items from each of the six disorders were included in a factor analysis. Parent-child agreement was calculated for every item of the six disorders, including the effect of sex and age. The factor analysis revealed 6 factors separately grouping the items defining each of the new or modified disorders, with Eigenvalues greater than 2. Very good parent-child agreements (r>0.8) were found for the large majority of the items (93%), even when considering the sex or age of the patient. This independent grouping of disorders suggests that the manner in which the disorders were included into the K-SADS-PL-5 reflects robustly the DSM-5 constructs and displayed a significant inter-informant reliability. These findings support the use of K-SADS-PL-5 as a clinical and research tool to evaluate these new or modified diagnoses.

Validity and reliability of the kiddie schedule for affective disorders and schizophrenia present and lifetime version DSM-5 (K-SADS-PL-5) Spanish version

BackgroundThere are various language adaptations of the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL). In order to comply with the changes in DSM classification, the Spanish edition of the interview was in need of update and evaluation.MethodsK-SADS-PL was adapted to correspond to DSM-5 categories. All clinicians received training, and a 90% agreement was reached. Patients and their parents or guardians were interviewed and videotaped, and the videos were exchanged between raters. Factor analysis was performed and inter-rater reliability was calculated only in the case of diagnoses in which there were more than five patients.ResultsA total of 74 subjects were included. The Factor Analysis yielded six factors (Depressive, Stress Hyperarousal, Disruptive Behavioral, Irritable Explosive, Obsessive Repetitive and Encopresis), representing 72% of the variance. Kappa values for inter-rater agreement were larger than 0.7 for over half of the disorders.ConclusionsThe factor structure of diagnoses, made with the instrument was found to correspond to the DSM-5 disorder organization. The instrument showed good construct validity and inter-rater reliability, which makes it a useful tool for clinical research studies in children and adolescents.

Anxiety and hostility in written verbal samples of male and female subjects : A content analytic study

Nonclinical populations of male and female subjects of middle socioeconomic level and different age ranges were assessed by means of the content analysis method developed by Gottschalk and associates. Verbal samples consisted of written productions in response to a standard ambiguous instruction to narrate a dramatic or interesting life experience and were scored for anxiety and hostility. Results show that the method shows no influence of gender under the conditions of this study and can be employed for diagnostic purposes, assuming that personality factors and psychopathological influences might have a more pronounced impact on affect scores.