El procés d'avaluació i intervenció psicològica a pacients amb trastorns per abús d' alcohol i/o altres substàncies psicotròpiques

Aquest treball, realitzat al Centre d'Atenció i Seguiment de Drogodependències (CASD) de Nou Barris, ha tingut com a objectiu principal observar el rol del psicòleg clínic en el procés d'avaluació i intervenció psicoterapèutica en pacients que presenten un trastorn per dependència de substàncies psicotròpiques.

Percepción de las consecuencias del consumo de tabaco en fumadores adictos al juego

En una muestra de 34 adictos al juego en tratamiento, se examinan las características deconsumo de tabaco de los sujetos fumadores y la influencia de las consecuencias percibidas dela conducta de fumar en función de las etapas de cambio (Prochaska, DiClemente y Norcross,1992). Los resultados muestran que, aunque los porcentajes de fumadores doblan a los existentesen la población general, las personas fumadoras adictas al juego están representadas en lasdiferentes etapas de cambio con porcentajes parecidos a los de dicha población. Por otra parte,no se ha encontrado relación entre el nivel de dependencia medido con el Test de Fagerström yla etapa de cambio. En cuanto a la influencia de las consecuencias percibidas del consumo detabaco, en general los sujetos tienden a conceder mayor importancia a los perjuicios que a losbeneficios de fumar. En los análisis en función de las etapas de cambio, se encuentran diferenciassignificativas entre el grupo de los que piensan dejar de fumar en los próximos seis meses,(contempladores y preparados) y el grupo de los que no fuman (exfumadores y no fumadores) enel beneficio “fumar ayuda a relajarse” que es más valorado por los primeros. También seencuentran dichas diferencias entre los precontempladores y los que no fuman en dos perjuicios:“fumar produce a veces dolor de cabeza” y “fumar a veces provoca taquicardia” que son másvalorados por los segundos. Estos resultados sugieren la conveniencia de realizar las intervencionesmás adecuadas para cada etapa de cambio, a fin de que las personas adictas al juegopuedan también tener éxito en el abandono de la adicción al tabaco

Experimentation and Stages of Acquisition for Tobacco Consumption in Spanish Adolescents

One area which has been largely neglected when studying the acquisition of addiction to smoking with thetranstheoretical model is whether the individual had previously experimented with smoking. The importance of includingthe experimentation variable was supported by this research

Pràcticum II de Psicologia Clínica i de la Salut

L'autor exposa el treball de camp dut a terme durant més de cent hores de pràctiques en un centre de salut mental, CSAM de Manresa. S'inicia amb una visió general del centre, la seva història i els seus òrgans de funcionament. Es fa una petita exposició dels motius de l'elecció per part de l'alumne, l'orientació teòrica del centre, així com la metodologia utilitzada i la temporalització amb la qual s'ha dut a terme la tasca i, finalment, un seguiment i alguns resultats obtinguts de les sessions que s'han dut a terme en les àrees infanto-juvenil i d'addicció i control d'impulsos en adults. Acaba el treball amb una reflexió per als futurs estudiants de psicologia, en l'àrea clínica: Lluiteu, lluitem tots junts "por un prácticum clínico que no convierta a los estudiantes de psicología en pedigüeños de las prácticas y los coloquen en la zozobra inquieta que les lleve a un peregrinaje absurdo por diversos centros públicos o privados, a la búsqueda de algún paciente al que puedan simplemente observar" (De Josep Mª Farré, Psiquiatre de l'Institut Dexeus, en el llibre de María Dolores Avia (dir), "Cartas a un joven psicólogo", en la seva segonda edició).

Passive smoking in babies: The BIBE Study (Brief Intervention in babies. Effectiveness)

Background: There is evidence that exposure to passive smoking in general, and in babies in particular, is an important cause of morbimortality. Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome, acute respiratory diseases, worsening of asthma, acute-chronic middle ear disease and slowing of lung growth.The objective of this article is to describe the BIBE study protocol. The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care, directed to mothers and fathers that smoke, in order to reduce the exposure of babies to passive smoking (ETS).Methods/DesignCluster randomized field trial (control and intervention group), multicentric and open. Subject: Fathers and/or mothers who are smokers and their babies (under 18 months) that attend pediatric services in Primary Care in Catalonia.The measurements will be taken at three points in time, in each of the fathers and/or mothers who respond to a questionnaire regarding their baby's clinical background and characteristics of the baby's exposure, together with variables related to the parents' tobacco consumption. A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit (biological determination of nicotine). The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care.Discussion: Exposure to ETS is an avoidable factor related to infant morbimortality. Interventions to reduce exposure to ETS in babies are potentially beneficial for their health. The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits. Interventions in the form of advice, conducted by pediatric professionals, are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS.

Absence of delta-9-tetrahydrocannabinol dysphoric effects in dynorphin-deficient mice

The involvement of dynorphin on Delta-9-tetrahydrocannabinol (THC) and morphine responses has been investigated by using mice with a targeted inactivation of the prodynorphin (Pdyn) gene. Dynorphin-deficient mice show specific changes in the behavioral effects of THC, including a reduction of spinal THC analgesia and the absence of THC-induced conditioned place aversion. In contrast, acute and chronic opioid effects were normal. The lack of negative motivational effects of THC in the absence of dynorphin demonstrates that this endogenous opioid peptide mediates the dysphoric effects of marijuana.

Cannabinoid withdrawal syndrome is reduced in pre-proenkephalin knock-out mice

The functional interactions between the endogenous cannabinoid and opioid systems were evaluated in pre-proenkephalin-deficient mice. Antinociception induced in the tail-immersion test by acute Delta9-tetrahydrocannabinol was reduced in mutant mice, whereas no difference between genotypes was observed in the effects induced on body temperature, locomotion, or ring catalepsy. During a chronic treatment with Delta9-tetrahydrocannabinol, the development of tolerance to the analgesic responses induced by this compound was slower in mice lacking enkephalin. In addition, cannabinoid withdrawal syndrome, precipitated in Delta9-tetrahydrocannabinol-dependent mice by the injection of SR141716A, was significantly attenuated in mutant mice. These results indicate that the endogenous enkephalinergic system is involved in the antinociceptive responses of Delta9-tetrahydrocannabinol and participates in the expression of cannabinoid abstinence.

Involvement of the extracellular signal-regulated kinase cascade for cocaine-rewarding properties

A central feature of drugs of abuse is to induce gene expression in discrete brain structures that are critically involved in behavioral responses related to addictive processes. Although extracellular signal-regulated kinase (ERK) has been implicated in several neurobiological processes, including neuronal plasticity, its role in drug addiction remains poorly understood. This study was designed to analyze the activation of ERK by cocaine, its involvement in cocaine-induced early and long-term behavioral effects, as well as in gene expression. We show, by immunocytochemistry, that acute cocaine administration activates ERK throughout the striatum, rapidly but transiently. This activation was blocked when SCH 23390 [a specific dopamine (DA)-D1 antagonist] but not raclopride (a DA-D2 antagonist) was injected before cocaine. Glutamate receptors of NMDA subtypes also participated in ERK activation, as shown after injection of the NMDA receptor antagonist MK 801. The systemic injection of SL327, a selective inhibitor of the ERK kinase MEK, before cocaine, abolished the cocaine-induced ERK activation and decreased cocaine-induced hyperlocomotion, indicating a role of this pathway in events underlying early behavioral responses. Moreover, the rewarding effects of cocaine were abolished by SL327 in the place-conditioning paradigm. Because SL327 antagonized cocaine-induced c-fos expression and Elk-1 hyperphosphorylation, we suggest that the ERK intracellular signaling cascade is also involved in the prime burst of gene expression underlying long-term behavioral changes induced by cocaine. Altogether, these results reveal a new mechanism to explain behavioral responses of cocaine related to its addictive properties.

A theory of reference-dependent behavior

Extensive field and experimental evidence in a variety of environments show that behavior depends on a reference point. This paper provides an axiomatic characterization of this dependence. We proceed by imposing gradually more structure on both choice correspondences and preference relations, requiring increasingly higher levels of rationality, and freeing the decision-maker from certain types of inconsistencies. The appropriate degree of behavioral structure will depend on the phenomenon that is to be modeled. Lastly, we provide two applications of our work: one to model the status-quo bias, and another to model addictive behavior.

Drogodependencias: aspectos terminológicos y taxonómicos

En este estudio se efectlia una revisión de los trabajos llevados a cabo previamente por la Organización Mundial de la Salud (OMS) sobre aspectos conceptuales y terminológicos de las Drogodependencias. Se pone especial énfasis en la definición y concepto de 'droga' y 'drogodependencia' a como en el término 'neuroadaptació' el cual es presentado como una alternativa al de 'dependencia flsica'. Se hace referencia también a las nuevas terminologías de 'abuso de drogas', o 'mal uso de drogas'. Por lo que respecta a cuestiones de clasificación, el estudio se centra en las aportaciones llevadas a cabo por el DSM-III-R de la Asociación Americana de Psiquiatria y el ICD-I0 de la OMS.

Etica y vida. El problema de las drogodependencias

El problema de las drogodependencias como tema ético puede abordarse, sin caer en la predicación moral, desde una Filosofia de la Vida. En realidad constituye, en última instancia, una importante cuestión filosófica donde se manifiesta la insuficiencia de la razón "pura" para entender esa realidad "imperfecta" que es la vida humana. Las consecuencias han sido no sdlo teóricas sino prácticas, lo que ha afectado gravemente a la moral contemporánea, que ha llegado a ser una realidad extraña a la vida. Esta tiene su propia estructura, progresivamente suplantada durante los últimos siglos por una cultura magnífica, pero sin raices, desactivadora de los estímulos naturales que la hacen posible.

Els usos d'internet, les xarxes socials i els jocs online, concretament els MMORPG

L’objectiu d’aquest treball és descriure els riscos i les possibilitats d’Internet i les Web 2.0 i la importància de com utilitzem Internet, les xarxes socials i els jocs de rol massius en línia (MMORPG). A la recerca han participat 34 estudiants universitaris, els quals han respost un qüestionari per determinar els usos, abusos, les conductes de risc i la possible addicció a Internet o a alguna aplicació 2.0. Per últim, hi ha una proposta de disseny d’un projecte per a la sensibilització d’educadors/es socials entorn d’aquestes eines.

Impact of the Spanish smoking law on exponsure to secondhand smoke in offices and hospitality venues: before-and-after study

BACKGROUND/OBJECTIVES: A smoking law was passed by the Spanish Parliament in December 2005 and was enforced by 1 January 2006. The law bans smoking in all indoor workplaces but only in some hospitality venues, because owners are allowed to establish a smoking zone (venues>100 m2) or to allow smoking without restrictions (venues<100 m2). The objective of the study is to assess the impact of the Spanish smoking law on exposure to secondhand smoke (SHS) in enclosed workplaces, including hospitality venues. MATERIALS AND METHODS: The study design is a before-and-after evaluation. We studied workplaces and hospitality venues from eight different regions of Spain. We took repeated samples of vapor-phase nicotine concentration in 398 premises, including private offices (162), public administration offices (90), university premises (43), bars and restaurants (79), and discotheques and pubs (24). RESULTS: In the follow-up period, SHS levels were markedly reduced in indoor offices. The median decrease in nicotine concentration ranged from 60.0% in public premises to 97.4% in private areas. Nicotine concentrations were also markedly reduced in bars and restaurants that became smoke-free (96.7%) and in the no-smoking zones of venues with separate spaces for smokers (88.9%). We found no significant changes in smoking zones or in premises allowing smoking, including discotheques and pubs. CONCLUSIONS: Overall, this study shows the positive impact of the law on reducing SHS in indoor workplaces. However, SHS was substantially reduced only in bars and restaurants that became smoke-free. Most hospitality workers continue to be exposed to very high levels of SHS. Therefore, a 100% smoke-free policy for all hospitality venues is required.

Protracted treatment with MDMA induces heteromeric nicotinic receptor up-regulation in rat brain: an autoradiography study.

Previous studies indicate that 3,4-methylenedioxy-methamphetamine (MDMA, ecstasy) can induce heteromeric nicotinic acetylcholine receptor (nAChR, mainly of α4β2 subtype) up-regulation. In this study we treated Sprague-Dawley rats twice-daily for 10 days with either saline or MDMA (7 mg/kg) and killed them on day 11 to perform [125I]epibatidine binding autoradiograms on serial coronal slices. Results showed significant increases in nAChR density in the substantia nigra, ventral tegmental area, nucleus accumbens, olfactory tubercle, anterior caudate-putamen, somatosensory cortex, motor cortex, auditory cortex, retrosplenial cortex, laterodorsal thalamus nuclei, amygdala, postsubiculum and pontine nuclei. These increases ranged from 3% (retrosplenial cortex) to 30 and 33% (amygdala and substantia nigra). No increased α4 subunit immunoreactivity was found in up-regulated areas compared with saline-treated rats, suggesting a post-translational mechanism as occurs with nicotine. The percentage of up-regulation correlated positively with the density of serotonin transporters, according to the serotonergic profile of MDMA. The heteromeric nAChR increase in concrete areas could account, at least in part, for the reinforcing, sensitizing and psychiatric disorders observed after long-term treatment with MDMA.

Protracted treatment with MDMA induces heteromeric nicotinic receptor up-regulation in rat brain: an autoradiography study.

Previous studies indicate that 3,4-methylenedioxy-methamphetamine (MDMA, ecstasy) can induce heteromeric nicotinic acetylcholine receptor (nAChR, mainly of α4β2 subtype) up-regulation. In this study we treated Sprague-Dawley rats twice-daily for 10 days with either saline or MDMA (7 mg/kg) and killed them on day 11 to perform [125I]epibatidine binding autoradiograms on serial coronal slices. Results showed significant increases in nAChR density in the substantia nigra, ventral tegmental area, nucleus accumbens, olfactory tubercle, anterior caudate-putamen, somatosensory cortex, motor cortex, auditory cortex, retrosplenial cortex, laterodorsal thalamus nuclei, amygdala, postsubiculum and pontine nuclei. These increases ranged from 3% (retrosplenial cortex) to 30 and 33% (amygdala and substantia nigra). No increased α4 subunit immunoreactivity was found in up-regulated areas compared with saline-treated rats, suggesting a post-translational mechanism as occurs with nicotine. The percentage of up-regulation correlated positively with the density of serotonin transporters, according to the serotonergic profile of MDMA. The heteromeric nAChR increase in concrete areas could account, at least in part, for the reinforcing, sensitizing and psychiatric disorders observed after long-term treatment with MDMA.