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Copyright of Salud Mental is the property of Instituto Nacional de Psiquiatria Ramon de la Fuente and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this article, the authors comment on the contribution of the Alcohol, Drugs and the Family research group to draw public and scientific attention to the suffering and needs of families coping with addiction problems. The article also describes the impact of the stress-strain-coping-support model and the 5-Step Method on the research, intervention and education domains in Mexico. Some of the limitations to positively influence public policy are underscored; these include the nature of the sociocultural context which favors the view of addictions as private problems that must be solved within the family. The experience of delivering the 5-Step Method to Mexican urban population and its adaptation to indigenous communities and web-based format are discussed as well. Overall, the development and implementation of the 5-Step Method in Mexico has been positive, as demonstrated particularly by a cost-effectiveness study carried out with indigenous communities. Based on this review, the scope and challenges for family intervention in Mexico are outlined considering: (1) the dissemination of the 5-Step Method in both the rural and urban contexts; (2) extensive training of family counsellors; and finally (3) policy making to fulfil the needs of families facing addictive problems. (Contains 1 note.)

OBJETIVO: Evaluar el riesgo para el uso excesivo de etanol en personas con historia familiar positiva de consumo de alcohol (HF+). MATERIAL Y MÉTODOS: Los datos corresponden a una muestra de población general (n= 8 890) y fueron recopilados a partir de una encuesta nacional de adicciones en población urbana de México, realizada en 1988. Se determinaron medidas epidemiológicas de frecuencia y asociación considerando los antecedentes de HF+ como factor de exposición. RESULTADOS: La prevalencia actual del consumo consuetudinario de alcohol fue de 13.7% para los hombres y 0.6% para las mujeres, las cifras para el síndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces más probabilidad de desarrollar el síndrome de dependencia que aquellos con HF-. La razón de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisión de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del síndrome de dependencia de los hijos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html

Copyright of Revista CienciaUAT is the property of Universidad Autonoma de Tamaulipas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud Mental is the property of Instituto Nacional de Psiquiatria Ramon de la Fuente and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Alcohol has been acknowledged as one of the psychotropic drugs consumed in nearly all cultures. The study of alcohol use among indigenous and rural communities from an anthropological perspective highlights the function of alcohol in the social cohesion, and tends to minimize the consequences of consumption. This research adopts a complementary paradigm more closely linked to the acknowledgement of the significant increase in alcohol availability, coupled with its excessive promotion and the lack of support services for other related social, economic and even religious problems. Two groups are affected by excessive drinking: consumers and their closest social nucleus, i.e. the family, both of which require assistance. The aim of this article is to describe the process followed to adapt to the indigenous context a brief intervention model to support the drinkers' families, which is based upon the stress-strain-coping-support model and has proved useful in helping to deal with the dilemmas faced by relatives concerned with a family member's excessive drinking. The adaptation process included four research phases involving different qualitative methods: 1. feasibility, which includes the initial ethnographic research, 2. the adaptation of instruments and psycho-educational materials, 3. the development of an intervention manual and finally, 4. the development of cost-benefit evaluation indicators. The data are drawn from two small indigenous communities located in the arid zone of Valle del Mezquital, in the state of Hidalgo, 300 km from Mexico City. Various strategies drawn from qualitative methods were used in the different phases, i.e. individual interviews with key informants and community members, focus groups, field notes, cognitive laboratories, and the application of semi-structured and structured questionnaires. Different factors were identified as potential challenges for intervention: The existence of a patriarchal organization, fear of gossip, the different perceptions of alcohol consumption, linguistic connotations, poverty, time constraints, and the right not to inform the participants exert. It is crucial to increase awareness in order to improve well-being through various means. Women must be offered alternative responses to a dominant patriarchal structure, by helping them overcome the fear of discussing their problems, taking care not to offend their traditions and encouraging mechanisms that will weaken the power of gossip. Likewise, men must be convinced of the harmfulness of alcohol consumption and its effects on the family. [ABSTRACT FROM AUTHOR]

The present paper is a part of a broader research project aimed at adapting a brief intervention model to help families cope with substance abuse for its application to an indigenous population. Due to cultural differences between urban and indigenous contexts, the adaptation of psychological instruments to assess the intervention outcomes is a major need. Poortinga and Van de Vijver point out that transferring an instrument from the cultural group where it has been designed to another group is a common and economic practice; however, it can lead to invalid conclusions. For this reason, the adaptation must be pursued according to a thorough systematic process in order to develop reliable, understandable, and culture-sensitive instruments. Cognitive laboratories are among the different methods to evaluate instruments previous to its final application. Its main utility is to generate information about the quality of an instrument and about the way a single question is interpreted, accepted or rejected in different cultural groups. The objective of this article is to adapt the Coping Questionnaire (CQ), the Symptom Rating Test (SRT) and the Center for Epidemiologic Studies Depression Scale (CES-D) for its use in indigenous population through the cognitive laboratories method. The main interest is to develop instruments to assess psychological distress and how people cope with excessive drinking in the Mezquital Valley. To accomplish this objective, a two-phase study was carried out. Language adaptation for all three instruments was completed in phase 1, while the validation and identification of the psychometric properties of the new version took place during phase 2. The study was carried out in a community located in Municipio del Cardonal, Hidalgo, where around 60% of the population aged 5 or older speak an indigenous language, mainly Otomi also known as Ñahñu. The participants in phase 1 were 43 bilingual (Spanish-Ñahñu) women aged between 16 and 60 years, whose main activity was housekeeping. Women were contacted at community meetings, and they agreed to participate voluntarily once the objectives of the study were explained. They were also asked to authorize the recording of the interviews. The language adaptation was performed through the concurrent probing method of cognitive laboratory in its individual modality. Each one of the original items and answer options were read aloud as many times as needed. Immediately following the response, every participant was asked: What does this question mean?, Could you rephrase it?, How would you explain this question to another person in your community?. All comments were taken into account to rewrite each item. The instructions of all three questionnaires were also simplified to facilitate understanding. As a result of this procedure, the phrasing of 26 out of the 30 items of the CQ changed. The way the SRT questions were written was adjusted so that they could be used in an interview, which is why nearly all the items were modified. As for the CES-D, 9 items were modified, while 11 remained as in the original. Through this method, versions that were easier to understand were achieved, since commonly used terms among the population being studied were incorporated, which in turn reduced the time required to apply the three questionnaires. During the second phase, the researchers proceeded to validate the final version of the three instruments with a non-probabilistic study of 191 women who were contacted in the health center of the municipal head town; these were inhabitants of 30 of the 92 communities comprising the Municipio del Cardonal. All of them spoke Spanish, 65.8% were aged between 26 and 45 (X=35.2, SD=10.05), 29.5% had completed their primary school studies, while 26% had finished junior high school.… [ABSTRACT FROM AUTHOR]

Copyright of Salud Mental is the property of Instituto Nacional de Psiquiatria Ramon de la Fuente and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article focuses on a study on determination of dropout in self-guided web-based interventions for depression by different variables. It states that self-guided interventions show inferior results and higher dropout rates due than guided web-based interventions, and mentions that factors associated with increased risks of dropping out before treatment such as being man with lower education and being older with comorbid anxiety symptoms.

Objective. Estimate the cost-effectiveness ratio of a five-step brief intervention aimed at reducing the stress and symptoms of depression caused by living with an alcohol abuser. Methods. The cost-effectiveness analysis was carried out with a decision tree, based on symptoms of depression measured on the CES-D scale. The effectiveness of the brief intervention was evaluated by comparing a group of indigenous women who received the intervention (n = 43) with a similar group who did not (n = 30). The groups were evaluated before, immediately after, and 12 months after the intervention, in the state of Hidalgo (Mexico). Pharmacological treatment was selected for comparison, using different estimates. Cost-effectiveness and incremental cost-effectiveness ratios were used to calculate the value of the remission of depressive symptoms. Sensitivity analyses were also conducted. Results. The brief intervention turned out to be more effective than the pharmacological one in terms of the remission of depressive symptoms. Its cost was also lower ($US 31.24 versus $US 107.60). The brief intervention would cease to be cost-effective only if its cost increased by 338% or more, or if its effectiveness were 22.8% or less. Conclusions. The five-step brief intervention is a cost-effective option that results in significant reductions in depressive symptoms in indigenous women caused by living with alcohol abusers. It is also an affordable option for primary mental health care. [ABSTRACT FROM AUTHOR]