Mireia Orgilés

Síntomas de trastornos de ansiedad en niños y adolescentes: Diferencias en función de la edad y el sexo en una muestra comunitaria

INTRODUCTION Anxiety symptoms in childhood and adolescence are an important risk factor for developing anxiety disorders in subsequent development stages. This study examines the frequency and characteristics of the symptoms of the principal anxiety disorders in children and adoloscents using a self-report questionnaire based on the diagnostic categories of the American Psychiatric Association (APA) manual. MATERIAL AND METHODS A cross-sectional, non-interventional study was conducted on 2522 children and adolescents form 8 to 17 years (49% males), enrolled from different schools in the Province of Alicante who completed the Spence Childrens Anxiety Scale. RESULTS The mean score obtained on the scale (range: 0-114) was 25.15 (standard deviation (SD)=13.54). More than one in four (26.41%) of the children and adolescents showed high scores in any anxiety disorder. The anxiety symptoms due to separation were the most frequent in the sample (5.5%), followed by physical fears (5.1%). Girls scored significantly higher in all disorders (P<.001), except in obsessive-compulsive disorder. Differences were found as regards age in all disorders, except physical fears, but the effect sizes were only in anxiety due to separation, which decreased with age, and generalised anxiety, which was higher in adolescents than in children. CONCLUSIONS From the mental health perspective, it is important to be able to detect anxiety symptoms in children from 8 years onwards, in order to intervene early and prevent the development of anxiety disorders in later life.

Component Analysis of a School-Based Substance Use Prevention Program in Spain: Contributions of Problem Solving and Social Skills Training Content

The objective of the present research was to examine the contribution of two intervention components, social skills training and problem solving training, to alcohol- and drug-related outcomes in a school-based substance use prevention program. Participants included 341 Spanish students from age 12 to 15 who received the prevention program Saluda in one of four experimental conditions: full program, social skills condition, problem solving condition, and a wait-list control group. Students completed self-report surveys at the pretest, posttest and 12-month follow-up assessments. Compared to the wait-list control group, the three intervention conditions produced reductions in alcohol use and intentions to use other substances. The intervention effect size for alcohol use was greatest in magnitude for the full program with all components. Problem-solving skills measured at the follow-up were strongest in the condition that received the full program with all components. We discuss the implications of these findings, including the advantages and disadvantages of implementing tailored interventions to students by selecting intervention components after a skills-based needs assessment.

A systematic review of the factor structure and reliability of the Spence Children's Anxiety Scale

BACKGROUND The Spence Childrens Anxiety Scale (SCAS) is a widely used instrument for assessing symptoms of anxiety disorders among children and adolescents. Previous studies have demonstrated its good reliability for children and adolescents from different backgrounds. However, remarkable variability in the reliability of the SCAS across studies and inconsistent results regarding its factor structure has been found. METHODS The present study aims to examine the SCAS factor structure by means of a systematic review with narrative synthesis, the mean reliability of the SCAS by means of a meta-analysis, and the influence of the moderators on the SCAS reliability. Databases employed to collect the studies included Scholar Google, PsycARTICLES, PsycINFO, Web of Science, and Scopus since 1997. RESULTS Twenty-nine and 32 studies, which examined the factor structure and the internal consistency of the SCAS, respectively, were included. The SCAS was found to have strong internal consistency, influenced by different moderators. The systematic review demonstrated that the original six-factor model was supported by most studies. LIMITATIONS Factorial invariance studies (across age, gender, country) and test-retest reliability of the SCAS were not examined in this study. CONCLUSIONS It is concluded that the SCAS is a reliable instrument for cross-cultural use, and it is suggested that the original six-factor model is appropriate for cross-cultural application.

Spanish version of the Sleep Self-Report (SSR): factorial structure and psychometric properties

BACKGROUND The Sleep Self-Report (SSR) is a questionnaire initially created for use with a sample from the USA to assess sleep patterns and problems in school-aged children. The objective of this study was to validate the SSR among a Spanish sample. METHODS Participants were 1228 Spanish children from 8 to 12 years of age who completed the questionnaires at school anonymously. RESULTS Internal consistency was good (ω = 0.85). Convergent validity with anxiety (r = 0.54) and perceived welfare (r = -0.53) measures, and divergent validity with a measure of academic performance and positive influence of peers (r = -0.22) were acceptable. Exploratory analysis suggested a factorial structure composed by four subscales: sleep quality, sleep anxiety, bedtime refusal and sleep routines. Confirmatory analysis indicated a good fit for the model (RMSEA = 0.04; GFI = 0.95; AGFI = 0.93; χ(2)/gl = 2.48). CONCLUSIONS The SSR has demonstrated to have good psychometric properties in the Spanish-speaking sample of children. The factorial structure supported by exploratory and confirmatory analysis examines the most relevant areas of sleep in children. The satisfactory psychometric properties support the use of the Spanish version of the SSR by researchers and clinicians.

Predicting condom use in adolescents: a test of three socio-cognitive models using a structural equation modeling approach

BackgroundThe theory of planned behavior (TPB), socio-cognitive model (SCM), and information-motivation-behavioral skills (IMB) model are effective in predicting condom use. However, the adequacy of these three theoretical models in predicting the frequency of condom use (FCU) among young people has not been compared. This cross-sectional study tested the applicability and suitability of these three models in predicting the FCU, and analyzed the relationships among the postulated constructs.MethodsSexually experienced adolescents (n = 410) aged 13–18 completed a survey assessing the TPB, SCM, and IMB model constructs. Participants were students recruited from 18 high schools, randomly selected from the north, south, east, and southeast of Spain. A structural equation modelling (SEM) analysis was applied to test TPB, SCM and IBM and constructs relationships of each model using R.ResultsThe results of SEM demonstrated that behavioral skills predict behavior via motivation as hypothesized by the IMB model, but not directly via knowledge about condom use and sexually transmitted infections (STIs). Cognitive factors, such knowledge about condom use and STIs as well as condom use self-efficacy, directly predicted the FCU when modeled as per the SCM. According to the TPB, condom use intention was the best predictor of the FCU, and condom use intention was predicted by attitudes toward condom use and subjective norms related to condom use, but perceived control was not directly or indirectly related to the FCU. Based on the data, the TPB becomes the best-fit model for predicting the FCU among young people compared to the SCM and IMB model.ConclusionsFrom a statistical perspective, the TPB seems to be the most suitable model for predicting the FCU among young people compared to the other models. Overall, key direct predictors of the FCU in adolescents included condom use intention, behavioral skills and cognitive factors, such as STIs knowledge and condom use self-efficacy. The next step should be to test integrative models that include personal, contextual, environmental, and social factors.

Sexual behaviour under the influence of alcohol among Spanish adolescents

Este trabajo tiene como objetivo comparar el comportamiento sexual y los factores protectores y de riesgo entre adolescentes que mantienen relaciones sexuales bajo la influencia del alcohol y los que no lo hacen, y determinar los factores predictores de la combinacion sexo y drogas. Se analizaron las diferencias entre estos dos grupos en comportamiento sexual, actitud hacia el VIH, norma subjetiva y conocimientos sobre el VIH. Mediante medidas de autoinforme fueron evaluados 1216 adolescentes espanoles entre 14 y 18 anos (M = 15.92, DT = .76), fueron seleccionados 297 por ser sexualmente activos. De estos, 117 informaron haber mantenido relaciones sexuales bajo la influencia del alcohol en los ultimos seis meses (51% fueron chicas). Los adolescentes que combinaron sexo y alcohol se implicaron en mayor medida en sexo vaginal, sexo oral y sexo anal respecto a los que no lo hicieron. Haber mantenido relaciones sexuales bajo la influencia del alcohol en los ultimos seis meses se relaciono con una actitud negativa hacia el uso del condon cuando existen obstaculos para su uso y menor uso consistente del preservativo. No hubo diferencias en el conocimiento sobre el VIH entre ambos grupos. Los adolescentes que combinaron sexo y alcohol presentaron en mayor medida caracteristicas asociadas con el riesgo sexual. Las medidas preventivas deben atender a las caracteristicas particulares de este grupo de riesgo. Se requiere mayor evidencia de los efectos del alcohol sobre el comportamiento sexual.

Validación de una escala de conocimiento sobre el VIH y otras infecciones de transmisión sexual en población adolescente

Resumen Objetivo El objetivo de esta investigación es analizar la fiabilidad y validez de un cuestionario que evalúe de forma específica el conocimiento sobre el VIH y otras infecciones de transmisión sexual en una muestra de adolescentes españoles. Diseño Estudio descriptivo transversal para la validación de un cuestionario. Emplazamiento 17 centros escolares de cinco provincias españolas. Participantes 1.570 adolescentes entre los 13 y los 17 años escolarizados en institutos. Intervenciones Se estableció un banco de 40 ítems relativos a conocimiento sobre VIH y otras infecciones de transmisión sexual. Este banco fue sometido a un juicio de expertos, para detectar posibles errores. Seguidamente, se administró a un grupo piloto, con las mismas características sociodemográficas de la muestra, para garantizar la comprensión. Mediciones principales Análisis de ítems, consistencia interna, test-retest y análisis factorial exploratorio Resultados Cinco factores explicaban el 46% de la varianza total: conocimiento general sobre el VIH, del preservativo como método protector, de las vías de transmisión del VIH, de las medidas de prevención del VIH y sobre otras infecciones de transmisión sexual. La fiabilidad oscila desde 0,66 hasta 0,88. La correlación test-retest fue de 0,59. Existen diferencias de conocimientos en función del sexo. Conclusiones Estos factores tienen una adecuada consistencia interna y una correlación test-retest aceptable. A nivel teórico encajan adecuadamente respecto al contenido de los ítems. Entre los factores se observa una relación moderada, lo que indica que el tener un elevado grado de conocimiento respecto a un aspecto, no garantiza el tener conocimiento general elevado. El disponer de un cuestionario para evaluar el conocimiento de las infecciones de transmisión sexual es de gran ayuda para evaluar programas preventivos.OBJECTIVE The objective of this research is to determine the validity and reliability of a questionnaire designed to specifically assess the knowledge of HIV and other sexually transmitted infections in a Spanish adolescent population. DESIGN Cross-sectional study for the validation of a questionnaire. LOCATION A total of 17 schools in five Spanish provinces. PARTICIPANTS A total of 1,570 adolescent schoolchildren between 13 and 17 years old. INTERVENTION A pool of 40 items relating to knowledge about HIV and other sexually transmitted infections was established. This pool was analyzed by an expert panel. It was then administered to a pilot group with the same demographic characteristics of the sample, to ensure comprehension. MAIN MEASUREMENT Item analysis, internal consistency, test/retest and exploratory factorial analysis. RESULTS A factor analysis was performed, in which five factors that explained 46% of the total variance were retained: general knowledge about HIV, condom as a protective method, routes of HIV transmission, the prevention of HIV, and other sexually transmitted infections. Reliability measures ranged from 0.66 to 0.88. The test-retest correlation was 0.59. There were gender differences in the knowledge of infections. CONCLUSIONS These factors have adequate internal consistency and acceptable test-retest correlation. Theoretically, these factors fit properly with the content of the items. The factors have a moderate relationship, indicating that a high degree of knowledge about an aspect, but not a guarantee of general knowledge. The availability of a questionnaire to assess knowledge of sexually transmitted infections is helpful to evaluate prevention programs.

Sexual risk behaviors increasing among adolescents over time: comparison of two cohorts in Spain

Despite advances in treatment and prevention, HIV/AIDS remains a serious health and social problem. This studys objective is to examine sexual behavior, levels of knowledge, and attitudes toward HIV/AIDS between two cohorts in Spanish adolescents, and to analyze gender differences in these cohorts. Participants were 2132 adolescents between 15 and 18 years of age: 1222 in 2006 (43.2% boys) and 910 in 2012 (54.1% boys). The results indicate lower HIV knowledge and less favorable attitudes about HIV/AIDS in the 2012 cohort. In addition, adolescents from the 2012 cohort had their first sexual intercourse at an earlier age and have more sexual partners than those from the 2006 cohort. Compared to boys, girls engage in fewer risky behaviors, although they did not use condoms with their stable partner; girls tended to use condom less when they were in a stable relationship than boys. This study confirms the insufficiency of prevention campaigns as well as the need to improve the impact from programs that promote healthy sexual habits. Assuming comparability of cohorts, this study suggests increased risk of HIV/AIDS over time.

Pilot clinic study of Project EX for smoking cessation with Spanish adolescents

INTRODUCTION Despite efforts to prevent smoking, the prevalence of smoking in Spanish adolescents remains high. So far, there are no evidence-based smoking cessation programs for adolescents in Spain. METHODS This study describes the evaluation of Project EX, an eight-session school-based clinic smoking cessation program, with Spanish cigarette smokers 13-19 years of age, from 9 schools (four program condition schools and five control condition schools). A group-randomized controlled trial was used. There were 211 smokers at baseline (112 program group, and 99 control group). Evaluation involved an immediate pretest and posttest survey (administered five-weeks later) and six-month follow-up (after the immediate posttest). RESULTS At immediate posttest, Project EX significantly reduced future nicotine dependence scores (mFTQ; p<.001), and increased intention to quit smoking (p<.001), and led to a higher previous day (prior to assessment) quit rate (p<.03). At the six-month follow-up, the percentage of quitters in the program group was 14.28%, whereas no smokers quit smoking in the control group (p<.04), and Project EX had a significant influence on future smoking expectation (p=.006) and overall level of 30-day smoking. CONCLUSIONS Results for the Project EX school-based clinic are promising for adolescent smokers in Spain, although difficulties in recruitment and high attrition are of concern. Findings and limitations are discussed and suggestions for future research are suggested.

Factor structure and psychometric properties of the Spanish version of the Alabama Parenting Questionnaire (APQ) for children

BACKGROUND The Alabama Child Parenting Questionnaire (APQ) is a multi-source and multi-method instrument created to assess the most relevant parenting practices from a bidirectional perspective. Despite its advantages, the APQ has not been validated with a Spanish population. The objective of this study was to analyse the psychometric properties and factor structure of the APQ, child self-report version, in a community sample of Spanish children. METHOD The participants were 423 Spanish children (58.9% boys) aged between 8 and 12 years. RESULTS Exploratory factor analysis suggested a version of the questionnaire that consists of 16 items with a four-factor structure: Parental Involvement, Positive Parenting, Inconsistent Discipline, and Poor Supervision. The internal consistency of the subscales was moderate, except for the fathers Parental Involvement factor, which reached acceptable reliability. Convergent validity with a measure of quality of life was adequate. Gender differences were only found in Poor Supervision, with higher scores in boys than in girls. CONCLUSIONS Overall, these findings provide support for the use of the APQ to measure parenting practices perceived by Spanish children.