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The relationship between mental disorders other than depression or anxiety, and low adherence to both antiretroviral treatment (ART) and linkage to HIV care are unclear. The aim of our study was to compare the prevalence of mental disorders in people living with HIV (PLHIV) in Spain who present low versus high adherence to ART. We performed a cross-sectional study comparing two groups of PLHIV: 20 PLHIV with low adherence and 80 PLHIV with high adherence to ART. PLHIV who met at least one of the following criteria were included in the low-adherence group: virological failure (HIV-VL > 50 copies/mL in two consecutive blood samples); low attendance to scheduled clinical visits (≥2 missed visits in last year); irregular administration of ART (≥10 forgotten doses in the last month); and interruption of ART for more than 1 week. Inclusion criteria for high adherence were: PLHIV who had been on stable ART for more than 1 year with an HIV-VL below 50 copies/mL and without missed visits over the previous 12 months. The Millon Clinical Multiaxial Inventory was administered to participants. PLHIV with low adherence showed higher scores for all mental disorders compared with those with high adherence. And, in the multivariate binary logistic regression analysis, drug dependence and post-traumatic stress disorder were independently associated with low adherence (Nagelkerke R2 = 0.0686). In conclusion, PLHIV with poorly controlled HIV infection presented important psychological vulnerabilities. Mental health should be checked at the beginning of ART and during follow-up, especially in PLHIV with low adherence or low linkage to the health care system.

Introduction: In recent years, the importance of training healthcare professionals in nontechnical skills using effective methodologies has been increasingly recognised as a means of preventing clinical errors in the practice of health care. The aim of this study was to evaluate the effectiveness of educational interventions on nontechnical skills in the emergency medical services and/or critical care unit settings., Methods: A systematic search was carried out in the PubMed, SCOPUS, CINAHL, and Web of Science databases according to predetermined inclusion and exclusion criteria. After the initial search, 7952 records were selected after duplicates removed. Finally, a selection of 38 studies was included for quantitative analysis. Separate meta-analyses of standardised mean changes were carried out for each outcome measure assuming a random-effects model. Cochran's Q-statistic and I 2 index were applied to verify study heterogeneity. Weighted analyses of variance and meta-regressions were conducted to test the influence of potential moderators and funnel plots using Duval and Tweedie's trim-and-fill method, and Egger's regression test were used to examine publication bias., Results: All the variables analysed had a significant effect size, with the exception of situational awareness (d +  = -0.448; 95% confidence interval [CI] = -1.034, 0.139). The highest mean effect size was found for knowledge (d +  = -0.925; 95% CI = -1.177, -0.673), followed by the mean effect sizes for global nontechnical skills (d +  = -0.642; 95% CI = -0.849, -0.434), team nontechnical skills (d +  = -0.606; 95% CI = -0.949, -0.262), and leadership nontechnical skills (d +  = -0.571; 95% CI = -0.877, -0.264). Similar mean effect sizes were found for attitude (d +  = -0.406; 95% CI = -0.769, -0.044), self-efficacy (d +  = -0.469; 95% CI = -0.874, -0.064), and communication nontechnical skills (d +  = -0.458; 95% CI = -0.818, -0.099). Large heterogeneity among the standardised mean changes was found in the meta-analyses (I 2  > 75% and p < .001), except for self-efficacy where I 2  = 58.17%, and there was a nonstatistical result for Cochran's Q. This great variability is also reflected in the forest plots., Discussion: The use of simulation interventions to train emergency and critical care healthcare professionals in nontechnical skills significantly improves levels of knowledge, attitude, self-efficacy, and nontechnical skills performance., (Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Suicide and homicide are considered important problems in public health. This study aims to identify the cognitive performance of suicidal and homicidal behaviors in people with schizophrenia spectrum disorders, as well as examining whether there are shared neuropsychological mechanisms. A systematic review of the recent literature was carried out from September 2012 to June 2022 using the Medline (via PubMed), Scopus, Embase, and Cochrane databases. Among the 870 studies initially identified, 23 were finally selected (15 related to suicidal behaviors and 8 to homicidal behaviors). The results evidenced a relationship between impairment of cognitive performance and homicidal behavior; meanwhile, for suicidal behaviors, no consistent results were found. High neuropsychological performance seems to act as a protective factor against violent behavior in people with schizophrenia spectrum disorders, but not against suicidal behavior; indeed, it can even act as a risk factor for suicidal behavior. To date, there is insufficient evidence that shared neurocognitive mechanisms exist. However, processing speed and visual memory seem to be affected in the presence of both behaviors.

Background: Although some meta-analyses have identified potential moderators associated with treatment outcomes for pediatric obsessive-compulsive disorder (OCD), there is as yet no consensus regarding the influence of anxiety and depression symptoms on the recovery from pediatric OCD. A meta-analysis was conducted to investigate the effects of depression and anxiety symptoms and their comorbidities on the efficacy of CBT in pediatric OCD, as well as other potential moderators that may be associated with outcomes., Method: An exhaustive literature search from 1983 to March 2021 located 22 published articles that applied cognitive-behavioral therapy (CBT) to pediatric OCD, producing a total of 26 treatment groups. Some of the moderator variables analyzed included age, gender, comorbidity baseline in anxiety, depression and obsession, and methodological quality., Results: Results showed that the psychological treatment of OCD achieves clinically significant effectiveness, both for measures of obsessions and compulsions ( d + = 2.030), and for anxiety ( d + = 0.613) and depression ( d + = 0.451). An explanatory model for the CY-BOCS effect sizes showed that three moderator variables were statistically related: the mean of the CY-BOCS (Children´s Yale Brown Obsessive Compulsive Scale) in pretest, the effect size for anxiety, and the mean age of the sample., Conclusions: CBT reduced obsessive-compulsive symptoms and, to a lesser extent, anxiety and depression symptoms. Since anxiety symptoms are reduced with the same therapy, resources would be saved compared to other treatments.

Background: In the last years, overviews of systematic reviews, or umbrella reviews, have seen a dramatic increase in their use. An overview aims to provide a summary of the included reviews and will often examine research questions beyond those addressed in the systematic reviews being synthesised. The purpose of this article is to provide some recommendations on how overviews should be conducted and reported., Method: A literature review was performed to identify relevant papers on both methodological and applied overviews., Results: The current literature recommends carrying out overviews by following similar steps to those of systematic reviews: (a) Defining the overview research question; (b) inclusion and exclusion criteria; (c) literature search; (d) data extraction; (e) assessment of risk of bias and reporting quality; (f) overview results; and (g) reporting the overview. Of special interest is how to address dependencies between the systematic reviews., Conclusions: Overviews allow evidence to be efficiently combined from multiple systematic reviews. This offers the possibility of translating and summarizing large amounts of information. As in primary studies and systematic reviews, conducting and reporting of overviews must meet appropriate quality standards.

Previous studies have reported dysbiosis in the gut microbiota (GM) of children with autism spectrum disorders (ASD), which may be a determining factor on child development through the microbiota-gut-brain axis. However, it is not clear if there is a specific group of dysbiotic bacteria in ASD. The aim of this study was to carry out a meta-analysis on the studies that analyze GM in children with ASD. 18 studies fulfilled our selection criteria. Our results showed a lower relative abundance of Streptococcus (SMD +  = - 0.999; 95% CI - 1.549, - 0.449) and Bifidobacterium genera (SMD +  = - 0.513; 95% CI - 0.953, - 0.073) in children with ASD. Overall, the Bifidobacterium genera is involved. However, differences found between studies are attributed to factors such as reporting bias., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Meta-analysis is a powerful and important tool to synthesize the literature about a research topic. Like other kinds of research, meta-analyses must be reproducible to be compliant with the principles of the scientific method. Furthermore, reproducible meta-analyses can be easily updated with new data and reanalysed applying new and more refined analysis techniques. We attempted to empirically assess the prevalence of transparency and reproducibility-related reporting practices in published meta-analyses from clinical psychology by examining a random sample of 100 meta-analyses. Our purpose was to identify the key points that could be improved, with the aim of providing some recommendations for carrying out reproducible meta-analyses. We conducted a meta-review of meta-analyses of psychological interventions published between 2000 and 2020. We searched PubMed, PsycInfo and Web of Science databases. A structured coding form to assess transparency indicators was created based on previous studies and existing meta-analysis guidelines. We found major issues concerning: completely reproducible search procedures report, specification of the exact method to compute effect sizes, choice of weighting factors and estimators, lack of availability of the raw statistics used to compute the effect size and of interoperability of available data, and practically total absence of analysis script code sharing. Based on our findings, we conclude with recommendations intended to improve the transparency, openness, and reproducibility-related reporting practices of meta-analyses in clinical psychology and related areas., (© 2021. The Author(s).)

Background/Objective: The Padua Inventory-Revised (PI-R) is a widely applied instrument to measure obsessive-compulsive symptoms in clinical and nonclinical samples. We conducted a reliability generalization meta-analysis on the PI-R. Method: An exhaustive literature search yielded 118 empirical studies that had applied the PI-R, from which 30 studies (33 samples) reported an original reliability estimate. Results: Assuming a random-effects model, the average internal consistency reliability (Cronbach's alpha) was .92 (95% CI [.91, .93]) for the total scores, and ranged from .74 to .89 for the subscales. Assuming mixed-effects models, moderator analyses showed a positive statistically significant association between the standard deviation of the total scores and the reliability coefficients ( p  = .002; R 2  = .38). Conclusions: In terms of reliability, the PI-R scale was found to be adequate for both research and clinical purposes, although exhibiting large heterogeneity across studies. Future empirical studies using the PI-R should be required to provide at least one reliability estimate based on their own data., (© 2021 Asociación Española de Psicología Conductual. Published by Elsevier España, S.L.U.)

Background: The Dimensional Obsessive-Compulsive Scale (DOCS) is a well-established tool for assessing obsessive-compulsive symptomatology. A reliability generalization meta-analysis was conducted to estimate the average reliability of DOCS scores and how reliability estimates vary according to the composition and variability of samples, to identify study characteristics that can explain its variability, and to estimate the reliability induction rate., Method: A literature search produced 86 studies that met the inclusion criteria., Results: For the DOCS total scores, an average alpha coefficient of .925 was found (95% CI [.920,.931]), as well as mean alphas of .881, .905, .913, and .914 for Contamination, Responsibility, Unacceptable Thoughts, and Symmetry subscales, respectively. Moderator analysis showed that internal consistency fell significantly the more clinical and subclinical participants there were in the sample, and the larger the mean score in the sample for the total scores. The most important moderator variables for the subscales were the standard deviation and the mean of the scores., Conclusions: The DOCS scores exhibited excellent internal consistency reliability for both total score and subscale scores and DOCS is suitable both for research and clinical purposes.

Reliability generalization (RG) is a meta-analytic approach that aims to characterize how reliability estimates from the same test vary across different applications of the instrument. With this purpose RG meta-analyses typically focus on a particular test and intend to obtain an overall reliability of test scores and to investigate how the composition and variability of the samples affect reliability. Although several guidelines have been proposed in the meta-analytic literature to help authors improve the reporting quality of meta-analyses, none of them were devised for RG meta-analyses. The purpose of this investigation was to develop REGEMA (REliability GEneralization Meta-Analysis), a 30-item checklist (plus a flow chart) adapted to the specific issues that the reporting of an RG meta-analysis must take into account. Based on previous checklists and guidelines proposed in the meta-analytic arena, a first version was elaborated by applying the nominal group methodology. The resulting instrument was submitted to a list of independent meta-analysis experts and, after discussion, the final version of the REGEMA checklist was reached. In a pilot study, four pairs of coders applied REGEMA to a random sample of 40 RG meta-analyses in Psychology, and results showed satisfactory inter-coder reliability. REGEMA can be used by: (a) meta-analysts conducting or reporting an RG meta-analysis and aiming to improve its reporting quality; (b) consumers of RG meta-analyses who want to make informed critical appraisals of their reporting quality, and (c) reviewers and editors of journals who are considering submissions where an RG meta-analysis was reported for potential publication., (© 2021 John Wiley & Sons Ltd.)

Obtaining one or more low scores, or scores indicative of impairment, is common in neuropsychological batteries that include several measures even among cognitively normal individuals. However, the expected number of low scores in batteries with differing number of tests is unknown. Using 10 neuropsychological measures from the National Alzheimer's Coordinating Center database, 1,023 permutations were calculated from a sample of 5,046 cognitively normal individuals. The number of low scores (i.e., z score ≤-1.5) varied for the same number of measures and among different number of measures and did not increase linearly as the number of measures increased. According to the number of low scores shown by fewer than 10% of the sample, cognitive impairment should be suspected for 1 or more, 2 or more, and 3 or more in batteries with up to 2 measures, 3 to 9 measures, and 10 measures, respectively. These results may increase the identification of mild cognitive impairment.

Suicide is one of the main premature causes of death in patients with schizophrenia. However, little is known about the relationship between neurocognitive functioning and suicidality in violent offenders with schizophrenia who have been sentenced to psychiatric treatment after committing violent crimes. We examined the neurocognitive functioning of a sample of 61 violent offenders, most of them murderers with schizophrenia who were classified as suicide attempters ( n = 26) and non-attempters ( n = 35). We compared the neurocognitive functioning of both groups using a neuropsychological battery. Suicide attempters showed similar performance to non-attempters in a neuropsychological test across all domains of cognitive functioning, memory, attention, verbal fluency, and executive functioning. However, after controlling for demographic and clinical variables, suicide attempters performed better than non-attempters in two planning-related tasks: the Tower of London ( p < 0.01) and the Zoo Map ( p < 0.01). Suicide attempters were also characterized as having more family histories of suicidality and as displaying more depressive symptoms and negative symptoms of psychopathology on the Positive and Negative Syndrome Scale (PANSS) scale. These results suggest that suicide attempters have a greater ability to formulate plans and initiate goals directed at making a suicide attempt.

The Medical Outcome Study-HIV Health Survey (MOS-HIV) is one of the most used questionnaires for the evaluation of the health-related quality of life (HRQoL) in people living with HIV (PLWHIV) in both medical settings and research studies. This study aimed to estimate the average reliability of the MOS-HIV scores and to evaluate the characteristics of the studies that could explain the variability between reliability estimates. Furthermore, the study aimed to estimate the induction rate of the reliability of the MOS-HIV. A systematic review of the previous literature, including studies that reported α and/or test-retest coefficients with the data at hand for the total score of the MOS-HIV and the subscales, was conducted. Fifty studies (52 samples; N = 14,132) were included in the reliability generalization meta-analysis. The average α coefficient for the total score of MOS-HIV was .91 and above .80 for all of the subscales, except for role functioning, which had an average coefficient of .76. Different study dimensions were related to the heterogeneity of reliability between studies. Reliability induction was found to be 76.1%. The results obtained in the present study indicate that the MOS-HIV is a reliable instrument for HRQoL evaluation in PLWHIV, for clinical and research purposes. In the clinical practice of health services, nurses could employ this gold standard for reliable evaluations of HRQoL in PLWHIV., (© 2020 Wiley Periodicals LLC.)

Introduction: To analyse the possible relationship between dementia in the elderly and the subsequent development of suicide ideation, attempts and / or completed suicides., Methods: Systematic review and meta-analysis., Selection Criteria: studies that analysed the relationship between dementia and suicide., Search Strategy: i) in PubMed, EMBASE, CINAHL, IME and Lilacs until December 2018; ii) manual search of the bibliography of selected articles; iii) contact with leading authors. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. The effect size index was calculated using Odds Ratio (OR) and its 95% confidence interval (random-effects model). Heterogeneity was evaluated with forest plots, Cochran's Q and I 2 index. Assessment of publication bias using funnel plots ("trim-and-fill" method) and the Egger test. The analysis of moderating variables was performed using a multiple meta-regression under a mixed-effects model., Results: 37 studies and 47 basic units of study were identified. Effect size of the association of dementia with: Suicidal Ideation OR = 1.37 (95% CI: .78-2.39); Suicide Attempt: OR = 2.24 (95% CI: 1.01-4.97); and Completed Suicide: OR = 1.28 (95% CI: .77-2.14). Possible publication bias was ruled out., Conclusions: A trend towards suicidal events is identified, especially suicide attempts in people with dementia. Greater attention and care are recommended after a recent diagnosis of dementia, especially with adequate assessment of comorbidities, which could influence the occurrence and outcome of suicidal events., (Copyright © 2020 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.)

The aim was to determine the survival of tooth-coloured restorative materials in proximal restorations of primary teeth at 24 months of follow-up and the influence of the following variables: use of coating, use of cavity conditioner, use of rubber dam isolation, the cavity form, the dentist's experience and the methodological characteristics of the studies. We conducted a search until May 2019, obtaining 16 articles from which 30 independent studies were extracted, which were considered as units of analysis. Four outcome measures were extracted from each study: retention, marginal integrity, anatomic form, and absence of recurrent caries. Separate meta-analyses were carried for each outcome and multiple meta-regression model was applied. The outcomes with the highest mean success rates were absence of recurrent caries and anatomic form. The type of material significantly influenced success rates. The best materials were resin-based material plus total-etching adhesion and resin-modified glass ionomer cement (RMGIC), and the worst high viscosity glass ionomer cement (HVGIC). Atraumatic restorative treatment (ART) had a lower success rate than the conventional cavity form. RMGIC had the best clinical performance and HVGIC the worst. The form of the cavity, blinding and the experience of the operator were the variables that influenced success rates. Proximal primary molar restorations should be performed with RMGIC as it combines good mechanical performance of the resins together with the prevention of secondary caries of glass ionomers.

Twin studies have shown that a substantial proportion of the variance for sleep variables is due to genetic factors. However, there is still considerable heterogeneity among research reports. Our main objectives were to: 1) Review the twin literature regarding sleep quality and duration, as well as their behavioural correlates; 2) Estimate the mean heritability of subjective sleep quality and sleep duration; 3) Assess heterogeneity among studies on these topics; and 4) Search for moderator variables. Two parallel meta-analyses were carried out for sleep quality and sleep duration. Seventeen articles were included in the meta-analysis. Mean MZ correlations were consistently higher than DZ correlations. A mean heritability of 0.31 (95% CI: 0.20, 0.41) was found for subjective sleep quality (range: 0-0.43) and 0.38 (95% CI: 0.16, 0.56) for sleep duration (range: 0-1). Heterogeneity indexes were significant for both sleep quality (I 2 = 98.77, p < .001) and sleep duration (I 2 = 99.73, p < .001). The high heterogeneity warrants further research considering possible moderators that may affect heritability., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The Padua Inventory-Washington State University Revision (PI-WSUR) is a frequently used test to assess obsessive-compulsive symptoms in screening and clinical contexts. A reliability generalization meta-analysis was carried out to estimate the average reliability of the PI-WSUR scores and its subscales and to search for characteristics of the studies that can explain the heterogeneity among reliability coefficients. A total of 124 independent samples reported some coefficient alpha or test-retest correlation with the data at hand for the PI-WSUR scores. The average internal consistency reliability of the PI-WSUR total scores was .929 (95% CI [.922, .936]), and for the subscales, the means ranged from .792 to .900. The test-retest reliability for PI-WSUR total scores was .767 (95% CI [.700, .820]), with the subscales ranging from .540 to .790. Moderator analyses revealed a positive relationship between the standard deviation of PI-WSUR total scores and alpha coefficients, as well as higher reliability estimates for the original version of the test and for studies from North America. The reliability induction rate for the PI-WSUR was 53.7%. Regarding reliability, the PI-WSUR ranks among the best scales for assessing obsessive-compulsive symptoms. Internal consistency reliability was excellent for the PI-WSUR total score and good for the subscales.

Background: The present protocol was designed for a systematic review and meta-analysis aimed at determining the association of telomere length with substance use disorders with the exclusion of nicotine addiction, and to identify potential moderators of the effect of telomere length. Such methodological information may provide guidance to improve the quality of future research on this important topic., Methods: Potential studies will be identified through electronic databases (PubMed/MEDLINE, EMBASE, PsycINFO, and Web of Science) up from inception onwards. The inclusion criteria will include published or unpublished observational studies (cohort, case-control, and cross-sectional studies) reporting telomere length in adult patients with substance use disorder compared with a control group. Non-human studies or other study designs such as reviews, case-only, family-based, and/or population studies with only healthy participants will be excluded, as well as those focused solely on nicotine addiction. The main outcome will be telomere length in adults with substance use disorder (primary) and, specifically, in those with alcohol use disorder (secondary). Two investigators will independently evaluate the preselected studies for possible inclusion and will extract data following a standardized protocol. Disagreements will be resolved by consensus. The risk of bias of all included studies will be assessed using the Newcastle-Ottawa Quality Assessment Scale for non-randomized studies. Data will be converted into standardized mean differences as effect size index, and random-effects models will be used for the meta-analysis. Cochran's Q statistic, I 2 index, and visual inspection of the forest plot will be used to verify study heterogeneity. Subgroup analyses and meta-regressions will be conducted to ascertain heterogeneity. Several sensitivity analyses will be conducted to address the influence of potential confounding factors. Publication bias will be examined using the "funnel plot" method with Duval and Tweedie's trim-and-fill method and Egger test., Discussion: This systematic review will assess the association of telomere length with substance use disorders aside from nicotine addiction., Systematic Review Registration: PROSPERO registration number CRD42019119785.

Introduction: The Berg Balance Scale is the most widely used clinical scale used to assess balance performance in neurological conditions. Reliability is not an unalterable value of a scale across different applications, but is a property referring to the results obtained with the scale, not the instrument in itself. The results of a scale can vary depending on the context where it is applied and the characteristics of the participants, therefore the reliability coefficient should be reported in each study. A systematic review and meta-analysis of the reliability coefficients obtained in different applications of the test with the data at hand is the best method to examine how the reliability of a test scores varies. The objectives of this systematic revision are: To determine the mean of internal consistency, intra and interrater reliability of the Berg balance scale in the clinical, nonclinical and mixed populations, to determine the methodological and substantive characteristics and to propose a predictive model enabling researchers and clinicians to use it in the future to estimate the expected reliability based on the characteristics of the most relevant studies., Evidence Acquisition: The MEDLINE (Pubmed), EMBASE and CINAHL databases were searched from 1989 to 2015. Two reviewers independently selected empirical studies published in English or in Spanish that applied the Berg Balance Scale and reported any reliability coefficient., Evidence Synthesis: The 80 samples in the 65 studies reported any the Berg Balance Scale reliability estimate. Coefficient alpha ranged from 0.62 to .98, with a mean of 0.92. For intra-rater agreement, the mean intraclass correlation was ICC+=0.957, and for inter-rater agreement ICC+=0.97. The SD of the Berg Balance Scale scores presented statistically significant relationships with the coefficient alpha and with ICC (intra-rater). In addition, the clinical population and the institutionalized population presented statistically significant relationships with the coefficient alpha. The sample size and mean scale results were also statistically related to ICCs (intra-rater)., Conclusions: The alpha coefficient and intra- and inter-rater agreement for Berg Balance Scale scores was very satisfactory. Several characteristics of the studies were statistically associated to the alpha coefficient and with intra-rater reliability.

The Best Possible Self (BPS) exercise promotes a positive view of oneself in the best possible future, after working hard towards it. Since the first work that attempted to examine the benefits of this intervention in 2001, studies on the BPS have grown exponentially and, currently, this is one of the most widely used Positive Psychology Interventions. However, little is yet known about its overall effectiveness in increasing wellbeing outcomes. Thus, the aim of this meta-analysis is to shed light on this question. A systematic literature search was conducted, and 29 studies (in 26 articles) met the inclusion criteria of empirically testing the intervention and comparing it to a control condition. In addition, BPS was compared to gratitude interventions in some of the included studies. A total of 2,909 participants were involved in the analyses. The outcome measures were wellbeing, optimism, depressive symptoms, and positive and negative affect. Results showed that the BPS is an effective intervention to improve wellbeing (d+ = .325), optimism (d+ = .334) and positive affect (d+ = .511) comparing to controls. Small effect sizes were obtained for negative affect and depressive symptoms. Moderator analyses did not show statistically significant results for wellbeing, except for a trend towards significance in the age of the participants (years) and the magnitude of the intervention (total minutes of practice). In addition, the BPS was found to be more beneficial for positive and negative affect than gratitude interventions (d+ = .326 and d+ = .485, respectively). These results indicate that the BPS can be considered a valuable Positive Psychology Intervention to improve clients' wellbeing, and it seems that it might be more effective for older participants and with shorter practices (measured as total minutes of practice)., Competing Interests: The authors have declared that no competing interests exist.

Background and Aims: Research shows inconsistent findings about the link between muscle dysmorphia (MD) and eating disorder (ED) symptomatology. The aim of this study is to synthesize the scientific evidence available on this topic, the researchers conducted a systematic review and meta-analysis., Methods: The literature search enabled us to identify 39 published articles, which provided 36 independent estimations of the correlation between the two variables., Results: Our analysis found a positive association between MD and ED symptoms ( r +  = .36; 95% CI = 0.30, 0.41). Moderator analyses showed that the type of sample and the tools for assessing MD and ED were statistically associated with the MD-ED effect sizes. The methodological quality of the studies exhibited a positive, statistically significant association with the MD-ED effect sizes., Conclusions: Higher levels of MD were related to greater ED symptomatology, but several study characteristics may moderate the association between the two variables. In this study, we discuss limitations and implications for clinical practice and future research.

Objective: This meta-analytical study examined the effects of psychological treatments applied to family members of children and adolescents with cancer, as well as the characteristics of the studies that can be associated with their effects., Methods: Four databases were searched between January 1980 and January 2017; the references of the located studies were reviewed, and emails were sent to experts in this topic. Forty articles fulfilled the selection criteria. The standardized mean pretest-posttest (or pretest-follow-up) change was used as the effect-size index for the treatment and control groups., Results: The 40 articles included 40 treatment groups and 21 control groups. When treatment and control pretest-posttest mean effects were compared, psychological interventions revealed positive, statistically significant results for anxiety (d adj  = 0.339) and problem-solving skills (d adj  = 0.385) and, to a lesser extent, for posttraumatic stress (d adj  = 0.224). No statistically significant differences were found for mood (d adj  = 0.147), acute stress (d adj  = -0.010), coping skills (d adj  = 0.123), social support (d adj  = 0.245), or quality of life (d adj  = 0.538)., Conclusions: Positive effects of mild to moderate magnitude were found in the posttests for some outcome measures. Behavioral interventions seem to be the most promising. Interventions achieved the best results when they were long in duration and low in intensity and when they were applied to family members with young children who were undergoing medical treatment. At follow-up, the intervention benefits were diminished. The application of psychological interventions is recommended to mitigate the negative psychological repercussions in this population., (© 2019 John Wiley & Sons, Ltd.)

Background: Perfectionism is a prevalent disposition of personality involved in the development and maintenance of a wide range of psychological disorders. The Child and Adolescent Perfectionism Scale (CAPS) is the most usually applied test to assess perfectionism in children and adolescents. This study aimed: (a) to conduct a reliability generalization meta-analysis to estimate the average reliability of the CAPS scores and to search for characteristics of the studies that may explain the variability among reliability estimates, and (b) to estimate the reliability induction rate of the CAPS., Method: An exhaustive search allowed to select 56 studies that reported alpha coefficients with the data at hand for the CAPS., Results: The average alpha coefficients were 0.87, 0.84 and 0.83, respectively for the CAPS total score and its two subscales, Socially Prescribed Perfectionism (SPP) and Self-Oriented Perfectionism (SOP). Regarding O'Connor's version, the average reliability coefficients were 0.82, 0.74 and 0.73, respectively, for SPP, SOP-Critical and SOP-Strivings. Some study characteristics (ethnicity, language, mean age and standard deviation of the scores, psychometric vs applied) showed a statistical association with the reliability coefficients of SPP and SOP. The reliability induction rate was 29.8%., Limitations: Due to the scarcity of studies, we could not examine the reliability scores of other versions of the CAPS and test-retest reliability., Conclusions: In terms of reliability, the original version of the CAPS present better results than O'Connor's version. The original version of the CAPS is a reliable instrument to be employed with general research purposes, but not for clinical practice., (Copyright © 2018. Published by Elsevier B.V.)

Loneliness perception during adolescence has been increased dramatically in recent years. Changes in lifestyle and difficulties in social interaction could explain this increased phenomenon. As described in previous research, this fact has been associated with the development of high stress levels and dysfunctional lifestyles, in which eating habits play a main role. In this regard, loneliness has been classically associated with poor eating habits, fundamentally the consumption of processed food with little nutritional value. However, the relationship between loneliness and healthy eating patterns, such as the Mediterranean Diet (MD), has not been previously analyzed. The main aim of the present study was to identify the relationship between perceived loneliness, stress, dietary habits, and adherence to the MD in a sample of 527 Spanish adolescents. The obtained results show a significant association between high perceived loneliness and high stress levels with lower MD adherence. Hence, adolescents with high perceived loneliness exhibit poor dietary habits in comparison to those counterparts with low perceived loneliness. Mediation analyses demonstrated an indirect effect of the loneliness on adherence to the MD through the mediation effect of stress. These findings point out a possible mechanism that underlies the classic association between loneliness and health deterioration, based on a poor adherence to a healthy dietary pattern, such as the MD.

This article presents a methodological review of 54 meta-analyses of the effectiveness of clinical psychological treatments, using standardized mean differences as the effect size index. We statistically analyzed the distribution of the number of studies of the meta-analyses, the distribution of the sample sizes in the studies of each meta-analysis, the distribution of the effect sizes in each of the meta-analyses, the distribution of the between-studies variance values, and the Pearson correlations between effect size and sample size in each meta-analysis. The results are presented as a function of the type of standardized mean difference: posttest standardized mean difference, standardized mean change from pretest to posttest, and standardized mean change difference between groups. These findings will help researchers design future Monte Carlo and theoretical studies on the performance of meta-analytic procedures, based on the manipulation of realistic model assumptions and parameters of the meta-analyses. Furthermore, the analysis of the distribution of the mean effect sizes through the meta-analyses provides a specific guide for the interpretation of the clinical significance of the different types of standardized mean differences within the field of the evaluation of clinical psychological interventions.

The random-effects model, applied in most meta-analyses nowadays, typically assumes normality of the distribution of the effect parameters. The purpose of this study was to examine the performance of various random-effects methods (standard method, Hartung's method, profile likelihood method, and bootstrapping) for computing an average effect size estimate and a confidence interval (CI) around it, when the normality assumption is not met. For comparison purposes, we also included the fixed-effect model. We manipulated a wide range of conditions, including conditions with some degree of departure from the normality assumption, using Monte Carlo simulation. To simulate realistic scenarios, we chose the manipulated conditions from a systematic review of meta-analyses on the effectiveness of psychological treatments. We compared the performance of the different methods in terms of bias and mean squared error of the average effect estimators, empirical coverage probability and width of the CIs, and variability of the standard errors. Our results suggest that random-effects methods are largely robust to departures from normality, with Hartung's profile likelihood methods yielding the best performance under suboptimal conditions., (© 2018 John Wiley & Sons, Ltd.)

Background: There are conflicting results on the relationship between neuroticism and suicidal ideation in community population. The objectives of this study were to estimate the magnitude and direction of the association between neuroticism and suicide ideation, and to analyze the influence of moderator variables on the effect size., Methods: A systematic review and a meta-analysis were carried out. The search for studies was conducted in PubMed/MEDLINE, IME, Lilacs, CINAHL, and EMBASE, until January 2015. A manual search was also carried out and main researchers were contacted. The inclusion criteria were: (a) studies of the association between neuroticism and suicidal ideation; (b) observational and descriptive studies; (c) studies carried out with community population over 18 years; (d) in any geographic region; and (e) written in English, Spanish, French, Portuguese or Italian. The random-effects model was applied to obtain the mean effect size and to explore moderators., Results: Thirteen articles focused on the association between neuroticism and suicide ideation were included in the meta-analysis. The mean effect size was r+ = 0.446 (IC 95%: 0.266-0.595). Publication bias was discarded as a threat against the validity of the results. A predictive model was stablished with two moderator variables: gender and type of self-report to measure neuroticism., Conclusions: Neuroticism can be considered as a risk factor for suicide ideation. This result is important to prevent both suicidal ideation and suicide behavior.

The Padua Inventory (PI) of obsessions and compulsions is one of the most usually applied tests to assess obsessive-compulsive symptomatology in research contexts as well as for clinical and screening purposes. A reliability generalization meta-analysis was accomplished to estimate the average reliability of the PI scores and to search for characteristics of the samples and studies that can explain the variability among reliability estimates. An exhaustive literature search enabled us to select 39 studies (53 independent samples) that reported alpha and/or test-retest coefficients with the data at hand for the PI total score and subscales. An excellent average coefficient alpha was found for the PI total score (M = .935; 95%CI = .922-.949) and for Impaired Mental Control subscale (M = .911; 95%CI = .897-.924), being good for Contamination (M = .861; 95%CI = .841-.882) and Checking (M = .880; 95%CI = .856-.903), and fair for Urges and Worries (M = .783; 95%CI = .745-.822). The average test-retest reliability for PI total score was also satisfactory (M = .835; 95%CI = .782-.877). Moderator analyses showed larger coefficients alpha for larger standard deviation of the PI total scores (p = .0005; R 2 = .46), for adapted versions of the test (p = .002; R 2 = .32), and for samples composed of clinical participants (p = .066; R 2 = .10). The practical implications of these results are discussed as well as the need for researchers to report reliability estimates with the data at hand.

Subgroup analyses allow us to examine the influence of a categorical moderator on the effect size in meta-analysis. We conducted a simulation study using a dichotomous moderator, and compared the impact of pooled versus separate estimates of the residual between-studies variance on the statistical performance of the Q B (P) and Q B (S) tests for subgroup analyses assuming a mixed-effects model. Our results suggested that similar performance can be expected as long as there are at least 20 studies and these are approximately balanced across categories. Conversely, when subgroups were unbalanced, the practical consequences of having heterogeneous residual between-studies variances were more evident, with both tests leading to the wrong statistical conclusion more often than in the conditions with balanced subgroups. A pooled estimate should be preferred for most scenarios, unless the residual between-studies variances are clearly different and there are enough studies in each category to obtain precise separate estimates., (© 2017 The British Psychological Society.)