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BACKGROUND: Mental health problems and suicide ideation are common in adolescents. Early detection of these issues could prevent the escalation of mental health-related symptoms in the long term. Moreover, characterizing different profiles of prevalent symptoms in conjunction with emotional regulation strategies could guide the design of specific interventions. The use of web-based screening (WBS) tools has been regarded as a suitable strategy to timely detect symptomatology while improving the appeal, cost, timeliness, and reach of detection in young populations. However, the evidence regarding the accuracy of these approaches is not fully conclusive. OBJECTIVE: The study aims (1) to examine the capability of a WBS to identify adolescents with psychiatric symptoms and suicidality and (2) to characterize the mental health profiles of a large sample of adolescents using WBS. METHODS: A total of 1599 Latin American Spanish-speaking adolescents (mean age 15.56, SD 1.34 years), consisting of 47.3% (n=753) female, 98.5% Chilean (n=1570), and 1.5% Venezuelan (n=24) participants, responded to a mental health WBS. A randomized subsample of participants also responded to the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). McNemar χ2 and receiver-operating characteristic curves tested the detection accuracy of WBS contrasted with the MINI-KID. Latent profile analyses explored the symptomatic and emotional regulation profiles of participants. RESULTS: Both measures showed an adequate level of agreement (area under the curve per symptom domain ranging from 0.70 to 0.89); however, WBS yielded a higher prevalence than MINI-KID for all psychiatric symptoms, except suicide ideation and depression. Latent profile analyses yielded 4 profiles-one of them presented elevated psychopathological symptoms, constituting 11% of the sample (n=175). Rumination (odds ratio [OR] 130.15, 95% CI 51.75-439.89; P<.001), entrapment (OR 96.35, 95% CI 29.21-317.79; P<.001), and defeat (OR 156.79, 95% CI 50.45-487.23; P<.001) contributed significantly to the prediction of latent profile memberships, while cognitive reappraisal did not contribute to the prediction of any latent profile memberships, and expressive suppression was only associated to profile-2 membership. CONCLUSIONS: WBS is acceptable for the timely detection of adolescents at risk of mental health conditions. Findings from the symptomatic and emotional regulation profiles highlight the need for comprehensive assessments and differential interventions.
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INTRODUCTION: Psychosocial functioning is closely associated with psychopathology and wellbeing in different populations, particularly adolescents. Despite its relevance, measures assessing psychosocial functioning in healthy adolescents are scant as most focus on adults or clinical populations. We evaluated the psychometric properties of the Multidimensional Adolescent Functioning Scale (MAFS), a self-report questionnaire created to assess three dimensions of psychosocial functioning ('general functioning', 'family-related functioning', and 'peer-related functioning') in adolescents from the general population. METHODS: After translation and cultural adaptation, we administered the Spanish MAFS to 619 adolescents aged 14 to 19. We assessed the factor structure, internal consistency, and associations with depressive symptoms, suicidal ideation, cognitive-behavioral skills, cognitive reappraisal (CR), and expressive suppression (ES). We additionally tested for measurement invariance based on biological sex. RESULTS: The original three-factor structure showed the best fit. Internal consistency was good for the total scale (ω = 0.874; α = 0.869; GLB = 0.939, rM=0.216) and for all subscales (ω = 0.806-0.839; α = 0.769 to 0.812; GLB = 0.861-0.873). Correlations between all three MAFS subscales were significant, ranging between 0.291 and 0.554. All MAFS subscales correlated positively and significantly with cognitive-behavioral skills and adaptive regulatory strategies and negatively with depressive symptoms and suicidal ideation. CONCLUSION: The Spanish MAFS translation is a valid and reliable self-report measure to assess three domains of psychosocial functioning in adolescents aged 14-19 from the general population.
Assuntos
Relações Interpessoais , Qualidade de Vida , Adulto , Humanos , Adolescente , Chile , Instituições Acadêmicas , EstudantesRESUMO
Suicidal ideation is prevalent in adolescents and is a marker for subsequent psychiatric vulnerability and symptom severity. Literature shows that blended care (integrating online and offline components in a treatment process) could improve the effectiveness and adherence of interventions targeting suicidal ideation in adolescents, but the evidence is inconclusive. Thus, we will test the effectiveness of a blended intervention to reduce suicidal ideation (primary outcome) in school settings using a single-blind two-armed cluster randomized controlled trial (cRCT). The internet-based component corresponds to the Reframe-IT, a program encompassing eight online sessions based on cognitive-behavioral therapy (CBT) principles. The face-to-face intervention will be delivered through four CBT sessions. Additionally, we will assess the effect of the intervention on the following secondary outcomes: suicidal attempts, depressive symptoms, hopelessness, emotional regulation, and problem-solving skills. Primary and secondary outcomes will be assessed at post-intervention, 3-month, 6-month, and 12-month follow-up. Finally, we will explore the mediation role of cognitive, emotional, and behavioral correlates of suicide on the effect of the intervention. Results will inform whether the intervention can reduce suicide among school adolescents and be implemented on a large scale in Chile.