Resultados preliminares de una escala experimental para la evaluación del trastorno antisocial de la personalidad según los criterios diagnósticos DSM-III

El estudio que se presenta consiste en la aplicación de una escala ajustada a criterios para el diagnóstico del Trantorno Antisocial de la Personalidad (eje II, 301.70) a una población penitenciaria a efecto de comprovar su valor discriminativo resto al diagnóstico clínico. La escala propuesta se reveló altamente sensible (87,5%), específica (90%) y predictiva (valor predictivo positivo del 89% y valor predectivo negativo del 87%) frente a la evaluación clínica. La evaluación se llevó a cabo por dos clínicos especializados mediante la utilización de una entrevista semiestructurada extraida y adaptada del DIS (Robins, 1981), obteniéndose un índice concordancia intragrupo entre evaluadores de 8.82. Se hacen refencias a la posible explicación de los falsos positivos obtenidos en la escala TAP.

Escalas empíricas derivadas de la escala de Desviación Psicopática del MMPI, para la evaluación del trastorno antisocial de la personalidad del DSM-III en delincuentes y no delincuentes

Se realiza un análisis de los ítems de la escala de Desviación Psicopática (Pd;50 ítems) del MMPI que más discriminan entre delincuentes diagnosticados del trastorno antisocial de la personalidad (DSM-III), de delincuentes que no tienen el trastorno y estudiantes, del que se resulta dos escalas (Pd-P;24 ítems y Pd-N;33 ítems). Estas escalas obtienen mayor sensibilidad y especificidad que la propia escala Pd respecto al trastorno. Psicométricamente tienen mayor validez y fiabilidad, propiedades, que junto a su brevedad, hacen aconsejable su uso en el estudio de la personalidad antisocial.

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.

El organismo antisocial: aspectos teóricos, conductuales, biológicos y evaluación

En este artículo se revisan y comentan varios enfoques teóricos, que coexisten en la actualidad, sobre la personalidad antisocial. Se intenta buscar diferencias y similitudes del concepto desde la perspectiva de las teorías biológicas de la personalidad. Se pone énfasis en que la personaliad antisocial de naturaleza psicopática presenta déficits coductuales y biológicas propios y que no necesariamente se solapa con el Trastorno Antisocial de la Personalidad del DSM-III

Evaluación clínica y psicométrica del Trastorno Antisocial de la Personalidad

Este trabajo se diseñó para evaluar el Trastorno Antisocial de la Personalidad del DSM-III en presos, mediante una entrevista semiestructurada y una escala auto-informada, construida a partir de los criterios del trastorno. El elevado coeficiente de acuerdo interevaluadores (0,80) muestra que los criterios son muy fiables y operativos a efectos del diagnóstico. La escala auto-informada es aceptablemente sensible (88,23%) y específica (89,06%) respecto al trastorno antisocial de la personalidad. La consistencia interna alfa también se reveló muy elevada (0,92) y la escala tiene un alto valor discriminante frente a variables sociodemográficas y de índole penitenciaria.

Componentes psicológicos de la personalidad antisocial en delincuentes: búsqueda de sensaciones y susceptibilidad a las señales de premio y castigo

En este trabajo se plantea estudiar algunos componentes o variables de la personalidad que, según los modelos teóricos a que pertenecen, se asociarían a la personalida antisocial. Para ello se dispuso de una muestra de 67 reclusos penitenciarios clasificados en dos grupos en función de los criterios del diagnóstico de Trastorno Antisocial de la Personalidad del DSM-III. La escala Pd del MMPI, el Cuestionario Experimental de Psicopatía (CEP) y la Escala del Trastorno Antisocial de la Personalidad de Aluja (ETAPA), son las más predictivas del TAP. La escala de Susceptibilidad al Castigo (SC), escalas de Susceptibilidad a la Recompensa (SR) y escala de Búsqueda de Sensaciones (EBS), se relacionan menos con el trastorno, excepto cuando se les agregan las escalas CEP queda integrada dentro un factor de personalidad antisocial, pero también obtiene un peso importante en el factor de Búsqueda de Sensaciones, integrado también por SR. La escala SC no se relaciona con ninguno de los factores mencionados. Se hacen comentarios sobre las diferencias conceptuales y empíricas entre TAP y psicopatía.

Predictions of the MCMI-III personality disorders from NEO-PI-R domains and facets: Comparison between American and Spanish samples

Este estudio ex post facto analiza las relaciones entre las dimensiones y facetas del NEO-PI-R y los 14 trastornos de personalidad del MCMI-III en una muestra no clínica española (N = 674). Se exploran las diferencias y similitudes con los resul- tados de Dyce y O’Connor en una muestra americana con los mismos instrumentos. Como se esperaba, los análisis factoriales de facetas reteniendo cinco factores mostraron un modelo de relaciones muy similar entre ambas muestras, con un coeficiente de la congruencia total de 0,92, y coeficientes de congruencia de factor aceptables, salvo para el factor Apertura (0,68). En consonancia con las predicciones de Widiger y Widiger et al. los porcentajes de correlaciones significativas estaban alrededor de 60% en ambas muestras, y la mayoría coincidían. El análisis de regresión múltiple con dimensiones también reveló un gran parecido entre los resultados americanos y españoles, Neuroticismo fue el predictor más relacionado con los trastornos de personalidad. Se encontraron diferencias en las regresiones por facetas, aunque la varianza explicada fue prácticamente la misma que en las dimensiones. Se discute la validez transcultural y el valor predictivo del NEO-PI-R sobre los trastornos de personalidad del MCMI-III, junto con las ventajas relativas de las facetas sobre las dimensiones.

Allele variants in functional MicroRNA target sites of the neurotrophin-3 receptor gene (NTRK3) as susceptibility factors for anxiety disorders

Genetic and functional data indicate that variation in the expression of the neurotrophin-3 receptor gene (NTRK3) may have an impact on neuronal plasticity, suggesting a role for NTRK3 in the pathophysiology of anxiety disorders. MicroRNA (miRNA) posttranscriptional gene regulators act by base-pairing to specific sequence sites, usually at the 3'UTR of the target mRNA. Variants at these sites might result in gene expression changes contributing to disease susceptibility. We investigated genetic variation in two different isoforms of NTRK3 as candidate susceptibility factors for anxiety by resequencing their 3'UTRs in patients with panic disorder (PD), obsessive-compulsive disorder (OCD), and in controls. We have found the C allele of rs28521337, located in a functional target site for miR-485-3p in the truncated isoform of NTRK3, to be significantly associated with the hoarding phenotype of OCD. We have also identified two new rare variants in the 3'UTR of NTRK3, ss102661458 and ss102661460, each present only in one chromosome of a patient with PD. The ss102661458 variant is located in a functional target site for miR-765, and the ss102661460 in functional target sites for two miRNAs, miR-509 and miR-128, the latter being a brain-enriched miRNA involved in neuronal differentiation and synaptic processing. Interestingly, these two variants significantly alter the miRNA-mediated regulation of NTRK3, resulting in recovery of gene expression. These data implicate miRNAs as key posttranscriptional regulators of NTRK3 and provide a framework for allele-specific miRNA regulation of NTRK3 in anxiety disorders.

Confirmatory factor analysis of an integrated model of psycopathology assessed with MMPI-2-RF and the MCMI-III

We presented an integrated hierarchical model of psychopathology that more accurately captures empirical patterns of comorbidity between clinical syndromes and personality disorders.In order to verify the structural validity of the model proposed, this study aimed to analyze the convergence between the Restructured Clinical (RC) scales and Personality scales (PSY-5) of the MMPI-2-RF and the Clinical Syndrome and Personality Disorder scales of the MCMI-III.The MMPI-2-RF and MCMI-III were administered to a clinical sample of 377 outpatients (167 men and 210 women).The structural hypothesiswas assessed by using a Confirmatory Factor Analytic design with four common superordinate factors. An independent-cluster-basis solution was proposed based on maximum likelihood estimation and the application of several fit indices.The fit of the proposed model can be considered as good and more so if we take into account its complexity.

Two-year follow-op of cognitive functions in Schizophrenia spectrum disorders of adolescent patients treated with electroconvulsive therapy

Objective: The aim of the current study was to investigate the long-term cognitive effects of electroconvulsive therapy (ECT) in a sample of adolescent patients in whom schizophrenia spectrum disorders were diagnosed. Methods: The sample was composed of nine adolescent subjects in whom schizophrenia or schizoaffective disorder was diagnosed according to DSM-IV-TR criteria on whom ECT was conducted (ECT group) and nine adolescent subjects matched by age, socioeconomic status, and diagnostic and Positive and Negative Syndrome Scale (PANSS) total score at baseline on whom ECT was not conducted (NECT group). Clinical and neuropsychological assessments were carried out at baseline before ECT treatment and at 2-year follow-up. Results: Significant differences were found between groups in the number of unsuccessful medication trials. No statistically significant differences were found between the ECT group and theNECT group in either severity as assessed by the PANSS, or in any cognitive variables at baseline.At follow-up, both groups showed significant improvement in clinical variables (subscales of positive, general, and total scores of PANSS and Clinical Global Impressions-Improvement). In the cognitive assessment at follow-up, significant improvement was found in both groups in the semantic category of verbal fluency task and digits forward. However, no significant differences were found between groups in any clinical or cognitive variable at follow-up. Repeated measures analysis found no significant interaction of time · group in any clinical or neuropsychological measures. Conclusions: The current study showed no significant differences in change over time in clinical or neuropsychological variables between the ECT group and the NECT group at 2-year follow-up. Thus, ECT did not show any negative influence on long-term neuropsychological variables in our sample.

Mood and anxiety disorders across the adult lifespan: a European perspective

BACKGROUND: The World Mental Health Survey Initiative (WMHSI) has advanced our understanding of mental disorders by providing data suitable for analysis across many countries. However, these data have not yet been fully explored from a cross-national lifespan perspective. In particular, there is a shortage of research on the relationship between mood and anxiety disorders and age across countries. In this study we used multigroup methods to model the distribution of 12-month DSM-IV/CIDI mood and anxiety disorders across the adult lifespan in relation to determinants of mental health in 10 European Union (EU) countries. METHOD: Logistic regression was used to model the odds of any mood or any anxiety disorder as a function of age, gender, marital status, urbanicity and employment using a multigroup approach (n = 35500). This allowed for the testing of specific lifespan hypotheses across participating countries. RESULTS: No simple geographical pattern exists with which to describe the relationship between 12-month prevalence of mood and anxiety disorders and age. Of the adults sampled, very few aged ≥ 80 years met DSM-IV diagnostic criteria for these disorders. The associations between these disorders and key sociodemographic variables were relatively homogeneous across countries after adjusting for age. CONCLUSIONS: Further research is required to confirm that there are indeed stages in the lifespan where the reported prevalence of mental disorders is low, such as among younger adults in the East and older adults in the West. This project illustrates the difficulties in conducting research among different age groups simultaneously.

The factorial structure of the 41-item version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Spanish population of 8 to 12 years-old

On this instrumental study we intend to analyse the factorial structure of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Spanish sample using exploratory and confirmatory factorial analysis. As a second objective we intend to develop a short form of it for rapid screening and, finally, to analyze the reliabilities of both questionnaires. The SCARED was administered to a community sample of 1,508 children aged between 8 and 12 years. The sample was randomly split using half for the exploratory analysis and the other half for the confirmatory study. Furthermore a reduced version of the SCARED was developed using the SchmidLeiman procedure. Exploratory Factor Analysis yielded a four factor structure comprised of Somatic/panic, Generalized anxiety, Separation anxiety and Social phobia factors This structure was confirmed using Confirmatory Factor Analysis. The four factors, the full scale and the short scale showed good reliabilities. The results obtained seem to indicate that the Spanish version of the SCARED has good internal consistency, and along with other recent results, has a structure of four related factors that replicates the dimensions proposed for anxiety disorders by the DSM-IV-TR