Person: Pina, David
Search Results
Prevalence Estimates of Symptom Feigning and Malingering in Spain
Symptom feigning and malingering should be evaluated in forensic contexts due to their important socio-economic consequences. Despite this, to date, there is little research in Spain that evaluates its prevalence. The aim of this study was to investigate this issue using the perception of the general population, students, and professionals of medicine and forensic psychology. Three adapted questionnaires were applied to a total of 1003 participants (61.5% women) from 5 different groups. Approximately two-thirds of participants reported knowing someone who feigned symptoms, and one-third disclosed feigning symptoms themselves in the past. Headache/migraine, neck pain, and anxious–depressive symptoms were the most commonly chosen. Experts in psychology and forensic medicine estimated a prevalence of 20 to 40% of non-credible symptom presentations in their work settings and reported not having sufficient means to assess the distorted presentation of symptoms with certainty. Professionals and laypersons alike acknowledge that non-credible symptom presentations (like feigning or malingering) are relevant in Spain and occur at a non-trivial rate, which compares with estimates in other parts of the world.
Effectiveness of multifamily therapy for adolescent disruptive behavior in a public institution: a randomized clinical trial
Introduction Behavioral problems in adolescents are one of the most common reasons for mental health care. Although some reviews support the effectiveness of group interventions, there is little work that demonstrates the efficacy and/or effectiveness of an integrative model similar to that of multifamily group therapy (MFT). Objective To compare the effectiveness of multifamily group therapy (MFT) with individual therapy as usual (TAU) in an outpatient medium. Method A randomized clinical trial was conducted on a sample of 75 adolescents aged 12–15 years of age from incident cases at a Mental Health Center in southeastern Spain. The Youth Self Report was used to measure problematic, externalizing and internalizing behaviors. Scores were recorded in baseline, at 6 months and one year, and differences were analyzed using multivariate analysis (MANOVA). Results The Group X Time analysis showed no significant differences between the two interventions at 6 months and one year of the intervention. However, the analysis of main factors appears to show greater TAU efficacy in Externalizing Behavior as a whole, as well as particularly in Verbal Aggression and Depression, whereas MFT shows greater efficacy in Internalizing Behavior. Conclusions Multifamily individual and group therapy are effective in reducing adolescent behavioral problems, albeit with certain differential aspects. Therefore, the two interventions are complementary, so receiving both treatments would be an added benefit for the adolescent compared to receiving a single form of treatment, as other works suggest.
Attitudes toward school violence against LGBTQIA+. A qualitative study
School climate is one of the main concerns in terms of research and intervention worldwide. Although it can be directed toward any student, some groups seem to be more vulnerable, as is the case of the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer and intersex +) students, among others. Attitudes toward violence are a construct of particular importance for action plans focused on improving school coexistence. The aim of this study is to examine attitudes toward school violence against LGBTQIA+ students and their relationship with violent behaviors. For this purpose, 96 Spanish students of Spanish elementary education (PE) and compulsory secondary education (CSE) participated in this qualitative study through focus groups for its subsequent thematic analysis. The results identify four types of attitudes toward violence, such as the use of violence as a form of fun, to feel better, when it is perceived as legitimate, and as a way of relating to the LGBTQIA+ community. In addition, a greater number of negative attitudes and violent behaviors toward homosexual boys and transgender minors are observed.
Association between attitudes toward violence and violent behavior in the school context: a systematic review and correlational meta-analysis
Background/Objective: Both theoretical proposals and empirical work point to a common concurrence between attitudes toward school violence and violent behavior. Studies often address this issue superficially or within intervention programs. Our objective is to describe the results of a systematic review and to conduct a meta-analysis exploring these associations. Method: A systematic review was conducted in the main databases. Effect sizes were calculated and synthesized using random-effects meta-analysis to estimate the relationship between attitudes toward violence and school violence. A meta-regression was performed for the moderator analysis of sex and age. Results: The literature search strategy produced 12,293 articles. The review process produced a final result of 23 studies. Our results estimate a significant positive relationship (r = .368 p < .001; 95% CI [.323, .412]) between attitudes toward violence and school violence in children and adolescents. Conclusions: This study allows us to quantify with an adequate degree of specificity the attitude-behavior relationship in the school context. These results may facilitate future researchers to design programs that address this specificity in order to improve school climate. More research is needed using validated instruments to further specify the type of attitudes that have the greatest influence on the manifestation of school violence. -------------------
Users' perception of violence and conflicts with professionals in Primary Care centers before and during COVID-19. A qualitative study
Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users' point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide enough information on the health status of users. Another professional group widely addressed in the focus groups was the administrative staff, being described as lacking in communication skills, assertiveness, or empathy. Users recognize the existence of a demanding/aggressive profile among users, who makes instrumental use of violence to achieve privileges over users in general. We have also identified the profile of the user who makes use of Primary Care as a way of socializing or managing conflicts of a socioemotional nature. As proposals for this thematic block, users suggest group therapies, the use of audiovisual material complementary to the information provided by professionals or community interventions in psychoeducation. Conclusion: This study allows to explore conflicts between users and professionals from the Primary Care patients' perspective. Our results are complementary to the available evidence that has used the professional's approach to study the phenomenon of workplace violence. The identification of sources of conflict and the assessment and contribution of users on possible ways of improvement can serve as a basis for the design of prevention and intervention plans to improve the work environment in Primary Care centers.
Rating criteria of the causal nexus in Whiplash Associated Disorders: a study of interrater reliability
Introduction The diagnosis of Whiplash Associated Disorders is subject to various criteria, some of a subjective nature, which impedes a high percentage of agreement among raters of the causal nexus. It is necessary to develop an evidence-based methodology to maximize the uniformity of this diagnosis. Our objective is to assess the interrater reliability of four experts in legal medicine who establish the causal nexus of traffic accident patients. Material and method 300 traffic accident patients evaluated by 4 legal medicine experts. They conducted two ratings, one without and one with a study of the biomechanics of the accident. The degree of concordance of the ratings was studied by the intraclass correlation coefficient (ICC) and the concordance index (CI). Results The results of both the intraclass correlation coefficient and the concordance index of the rating prior to the biomechanical study of the injury yield moderate-high values (ICC=.70; CI=.60). Likewise, the values observed in the rating with the study of biomechanics also indicate moderate-high agreement (ICC=.78, CI=.67). Conclusions The study of biomechanics slightly improves concordance. However, the aforementioned study does not help to reduce the proportion of doubtful cases and the levels of improvement are not acceptable. There are significant differences between the classifications, suggesting that the proposed valuation methodology is not uniform enough to reach a consensus. -------------
Attitudes Towards Suicide: A Systematic Review of Evaluation Instruments in Different Settings
Background/Aim: Suicide is a complex and multidimensional phenomenon that involves multiple variables, among which attitudes stand out. Given its usefulness for suicide prevention and the heteronomy found in the assessment of these attitudes, the aim of this study is to provide an updated synthesis of the instruments available for their evaluation. Method: A systematic review was conducted following PRISMA guidelines. The search included articles published up to December 2023 in the databases Scopus, PubMed, Web of Science, ProQuest, Cochrane, and the meta-search engine EBSCOHOST. Results: A total of 105,151 papers were obtained, of which 316 were subjected to a full-text screening that identified 41 studies that met the inclusion criteria. We found 14 original instruments, 11 validations in other samples, 13 psychometric studies and 3 papers that developed modified versions of previous questionnaires. Conclusions: This review can serve as a guide for the choice of tools for the assessment of attitudes towards suicide and, in addition, as a complement for studies on the prevention of suicidal behavior. In this way, the results facilitate responsible decision making based on the available evidence and adjusted to the needs of the professional.
Attitudes towards school violence: a qualitative study with Spanish children
School violence is a social issue of particular interest both for intervention and research. Attitudes towards violence have been reported in the literature as relevant variables for evaluation, prevention, and intervention in this field. This study aims to examine in-depth attitudes toward school violence. The sample consists of 96 participants from Spanish Elementary Education and Compulsory Secondary Education schools. A qualitative study was conducted through focus groups and thematic analysis of the data. The results identify a habitual set of attitudes towards violence in children. These are related to violence as a way to feel better or increase self-esteem, as leisure or fun, perceived as legitimate, when violence is exercised against those who are different, when it has no consequences, to resolve conflicts, to socialize, and to attract the attention of peers. These results could serve as a basis for the creation of evaluation tools, as well as the design of prevention and intervention plans based on attitude modification.
Differences in workplace violence and health variables among professionals in a hospital emergency department: A descriptivecomparative study
Introduction Workplace violence is a relevant social problem due to its high prevalence and serious consequences. A quarter of workplace violence occurs in the healthcare sector. Evidence shows differences among professionals, with emergency department workers being especially vulnerable, presenting a higher risk of suffering mental and physical health problems, as well as threats to their professional and social integrity. Objective To explore the frequency with which emergency department professionals are exposed to user violence and violence by their own coworkers; as well as to analyze the differences between different professionals in exposure to violence in the workplace and some of its most studied consequences such as burnout, job satisfaction, engagement, and general health. Methods A descriptive comparative study was carried out with a sample of 120 emergency department workers from three hospitals in Alicante. The majority were healthcare professionals (84.2%), women (61.7%), obtaining a mean age of 41.8 years (SD = 10.8). Sociodemographic and occupational variables, user violence, violence among colleagues and superiors, general health, burnout, engagement, and job satisfaction were evaluated. Results A high prevalence of both physical and non-physical user violence in the healthcare setting was observed, especially affecting nursing and administrative assistants. In addition, significant differences were identified between professionals in terms of non-physical user violence, burnout, engagement, and job satisfaction. Administrative staff suffer greater nonphysical user violence, while nursing assistants show higher levels of engagement. Regarding job satisfaction, nurses report higher intrinsic satisfaction. Medical staff, nurses and nursing assistants show higher levels of extrinsic satisfaction compared to administrative staff. Discussion Our results are consistent with other studies in which a relationship between exposure to violence and job satisfaction is observed. In addition, administrative staff appear to be the professionals most exposed to violence from both patients and coworkers. These results provide evidence for future research focused on improving the work environment and health of emergency department professionals.
Prevalence of Symptom Overreporting in the Structured Inventory of Malingered Symptomatology (SIMS) in Clinical Patients: A Meta- Analysis
Antecedentes: Los fallos en las pruebas de validez de síntomas (puntuar por encima del punto de corte establecido) pueden producirse en diversos contextos y situaciones, incluidos los entornos clínicos rutinarios. Hasta la fecha, ningún metaanálisis se ha centrado en la tasa de fallos del Inventario Estructurado de Simulación de Síntomas (SIMS) en evaluaciones clínicas. Método: Se realizó un meta-análisis de efectos aleatorios binomial-normal para estimar la tasa de fallos combinada del SIMS entre pacientes con un diagnóstico clínico que fueron evaluados en un entorno no forense. Resultados: Se incluyeron 34 estudios y 40 muestras (n = 8844). La puntuación media total del SIMS fue de 15.9 (DE = 5.2). La tasa global estimada de fallo de la SIMS fue del 36% (IC del 95%: 30%-43%; I2 = 96.6%, p < .001). Conclusiones: Existe una elevada tasa de fallo en el SIMS en poblaciones de pacientes clínicos; sin embargo, estos resultados positivos no son necesariamente falsos positivos. El reto metodológico de diferenciar los verdaderos de los falsos positivos es vital y debería dictar tanto la planificación cuidadosa de futuros estudios como la circunspección en la interpretación de las tasas de fallo de las pruebas de validez en las evaluaciones clínicas
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