Open Access
Prevalencia del juego patológico en el alcoholismo: un estudio exploratorio
(Asociación Española de Psicología Clínica y Psicopatología, 2005) Fernández-Montalvo, Javier; López-Goñi, José Javier; Landa González, Natalia; Psicología y Pedagogía; Psikologia eta Pedagogia
En este estudio se lleva a cabo un análisis de la prevalencia del juego patológico en 50 alcohólicos que acuden en busca de tratamiento. Para ello, se utilizaron los criterios diagnósticos del DSM-IV-TR para el juego patológico y el Cuestionario de Juego Patológico de South Oaks (SOGS). Los resultados obtenidos mostraron que el 20% de los alcohólicos de la muestra presentaba un diagnóstico comórbido de ludopatía. Además, un 12% adicional obtenía una puntuación en el SOGS indicadora de juego problemático. En suma, el 32% de la muestra presentaba síntomas de juego clínicamente significativos. La comparación entre los alcohólicos con y sin ludopatía asociada mostró diferencias significativas en las variables relacionadas con el consumo de alcohol, que eran más altas en la submuestra de alcohólicos ludópatas, pero no en la sintomatología psicopatológica evaluada con el SCL-90-R. Se comentan las implicaciones de este estudio para la práctica clínica y la investigación futura.
Open Access
Suicidal ideation and attempts among patients with lifetime physical and/or sexual abuse in treatment for substance use disorders
(Taylor & Francis, 2019) Fernández-Montalvo, Javier; López-Goñi, José Javier; Arteaga Olleta, Alfonso; Haro Escribano, Begoña; Ciencias de la Salud; Osasun Zientziak
Background: Several studies indicate that lifetime abuse is a relevant risk factor for suicidal ideation and/or attempts. However, little is known about this phenomenon in patients seeking treatment for substance use disorder. The prevalence rate of suicidal ideation and/or suicide attempts was explored among lifetime physically and/or sexually abused patients receiving treatment for drug addiction. The differential characteristics between these patients and those without suicidal behaviours were studied. Method: Three hundred and seventy-five patients were assessed. Socio-demographic characteristics, addiction severity, lifetime abuse, suicidal ideation and attempts, and psychopathological symptoms were explored. Results: Eighty-two patients (21.9%) presented with a history of lifetime abuse and were included in the study (37 men and 45 women). Sixty-two per cent of them presented with lifetime suicidal ideation (12.2% in the last month), and 30.5% with suicide attempts (1.2% in the last month). Patients with suicidal ideation or attempts showed a more severe addiction profile (assessed by the EuropASI) and more psychopathological symptoms (assessed by the SCL-90-R). Conclusion: This study highlights the relationship between previous traumatic experiences and suicidal behaviours. According to these results, systematic screening of suicidal risk in patients seeking treatment in addiction centres with histories of abuse is recommended.
Open Access
Addiction treatment dropout: exploring patients’ characteristics
(Wiley, 2012) López-Goñi, José Javier; Fernández-Montalvo, Javier; Arteaga Olleta, Alfonso; Psicología y Pedagogía; Psikologia eta Pedagogia; Gobierno de Navarra / Nafarroako Gobernua
This study explored the characteristics associated with treatment dropout in substance dependence patients. A sample of 122 addicted patients (84 treatment completers and 38 treatment dropouts) who sought outpatient treatment was assessed to collect information on socio-demographic, consumption (assessed by EuropAsi), psychopathological (assessed by SCL-90-R) and personality variables (assessed by MCMI-II). Completers and dropouts were compared on all studied variables. According to the results, dropouts scored significantly higher on the EuropAsi variables measuring employment/support, alcohol consumption and family/social problems, as well as on the schizotypal scale of MCMI-II. Because most of significant differences were found in EuropAsi variables, three clusters analyses (2, 3 and 4 groups) based on EuropAsi mean scores were carried out to determine clinically relevant information predicting dropout. The most relevant results were obtained when four groups were used. Comparisons between the four groups derived from cluster analysis showed statistically significant differences in the rate of dropout, with one group exhibiting the highest dropout rate. The distinctive characteristics of the group with highest dropout rate included the presence of an increased labour problem combined with high alcohol consumption. Furthermore, this group had the highest scores on three scales of the MCMI-II: phobic, dependent and schizotypal. The implications of these results for further research and clinical practice are discussed.
Open Access
Relapse precipitants in addictions: results in a therapeutic community
(Taylor & Francis, 2007) Fernández-Montalvo, Javier; López-Goñi, José Javier; Illescas, Cristina; Landa González, Natalia; Lorea Conde, Iñaki; Psicología y Pedagogía; Psikologia eta Pedagogia; Gobierno de Navarra / Nafarroako Gobernua, 35/2001
In this paper, a study examining high-risk situations for relapse is presented. The sample consisted of 72 participants (51 male and 21 female) who had relapsed after having received a residential psychological treatment for drug addition in a therapeutic community in Spain. In order to analyze what personal, environmental or social factors were the most immediate triggers of relapse, a personal interview, using the Relapse Interview, was administered to each one of the relapsed patients. Results showed that most of the relapses took place during the first year after completing the treatment program. Likewise, the factors most frequently cited for relapse were the following: to cope with negative emotional states (49.5%), to be unable to resist temptations or impulses to consume (17.5%), to test personal control (10.3%) and to cope with interpersonal conflicts (9.3%). As can been observed, most factors were of an intrapersonal nature. Implications of these results for further research and clinical practice are commented upon.
Open Access
What differentiates batterer men with and without histories of childhood family violence?
(SAGE, 2020) Fernández-Montalvo, Javier; Echauri, José Antonio; Azcárate, Juana M.; Martínez, María; Siria Mendaza, Sandra; López-Goñi, José Javier; Ciencias de la Salud; Osasun Zientziak
Aims: The goals of this study were to explore the prevalence of childhood family violence (CFV) (both suffered and witnessed) among male batterers in treatment, and to analyse the specific psychological profile of these perpetrators with CFV. Method: A sample of 1421 men recruited from a specialized batterer treatment programme was assessed. A description of the sociodemographic, violence and psychopathological characteristics of the sample was carried out. Moreover, a comparison of all the variables studied between batterer men with and those without CFV was conducted. Findings: The results showed that 35.2% (n = 500) of the sample reported having been victims of CFV (67.2% of them directly suffered abuse, and 32.8% witnessed violence between their parents, mainly from father to mother). Batterers with CFV presented with more irrational beliefs both about women and about violence as a strategy to cope with everyday difficulties. Moreover, they had significantly higher scores than batterers without CFV on all psychopathological symptoms as assessed by the SCL-90-R, as well as on most of the STAXI-2 subscales. In the logistic regression analysis, the main variables related to having a history of CFV were low education level, voluntary access to the programme, having a previous psychiatric history, being an immigrant, having children, and presenting a greater number of psychopathological symptoms. Major implications: According to these results, batterers with CFV showed a higher severity in most of the variables studied than those without CFV. Consequently, these findings highlight the importance of tailoring batterer treatment programmes to their specific characteristics, particularly those regarding childhood victimization.
Open Access
Evaluation of a therapeutic community treatment of addictions: a long-term follow-up study in Spain
(Taylor & Francis, 2008) Fernández-Montalvo, Javier; López-Goñi, José Javier; Illescas, Cristina; Landa González, Natalia; Lorea Conde, Iñaki; Psicología y Pedagogía; Psikologia eta Pedagogia; Gobierno de Navarra / Nafarroako Gobernua, 35/2001
The aims of this paper were to carry out a long-term follow-up evaluation of a well-established therapeutic community treatment for addictions in Navarre (Spain) and to make a comparison between the program completers and dropouts, as well as between relapsing and non-relapsing patients, on a wide set of variables. A long-term follow-up design (mean of 6 years after leaving treatment) was used to analyze the outcomes of the therapeutic program. The sample consisted of 155 subjects (113 completers and 42 dropouts). A personal interview was carried out with each one of the located subjects. The interviews took place between September 2000 and September 2004. Treatment "dropouts" manifested a higher and earlier rate both of relapses, and of new treatments for their drug addiction than the completion group. The program was also effective in reducing criminal behavior and improving the state of health. Significant differences were found across outcome variables when comparison was made between treatment completers and "dropouts". All subjects improved on outcome variables after receiving the treatment. When patients with and without relapse were compared, significant outcome differences were also found between groups. The study's limitations are noted and future needed research is suggested.
Open Access
Adicción a la cocaína y trastornos de personalidad: un estudio con el MCMI-II
(Sociedad Científica Española de Estudios sobre el Alcohol, el Alcoholismo y las otras Toxicomanías, 2009) Lorea Conde, Iñaki; Fernández-Montalvo, Javier; López-Goñi, José Javier; Landa González, Natalia; Psicología y Pedagogía; Psikologia eta Pedagogia; Gobierno de Navarra / Nafarroako Gobernua, 2/2006
En este artículo se lleva a cabo un estudio de los trastornos de personalidad asociados a la adicción a la cocaína. Para ello se contó con una muestra de 60 pacientes cocainómanos, que cumplimentaron el MCMI-II antes del tratamiento, y de 50 sujetos de la población normal con las mismas características demográficas (edad, sexo y nivel socioeconómico). El 36,7% de la muestra clínica (frente al 16% de la muestra normativa) presentaba, al menos, un trastorno de personalidad. Los trastornos de mayor prevalencia entre los cocainómanos fueron el trastorno pasivo-agresivo de la personalidad y el trastorno dependiente de la personalidad (10% cada uno de ellos), seguidos del trastorno obsesivo-compulsivo y el histriónico (6,7% cada uno). Asimismo, el 15% de la muestra clínica presentaba simultáneamente dos o más trastornos. Por último, se comentan las implicaciones de este estudio para la práctica clínica y para las investigaciones futuras.
Open Access
Rendimiento neuropsicológico en la adicción a la cocaína: una revisión crítica
(Viguera Editores, 2010) Lorea Conde, Iñaki; Fernández-Montalvo, Javier; Tirapu Ustárroz, Javier; Landa González, Natalia; López-Goñi, José Javier; Psicología y Pedagogía; Psikologia eta Pedagogia
Introducción. El uso crónico de cocaína se ha asociado con un amplio rango de déficits neuropsicológicos que afectan a la atención, la memoria, el aprendizaje o las funciones ejecutivas, aunque no se ha encontrado un perfil único de afectación asociado a la adicción a esta sustancia. Objetivo. Revisar los principales estudios de rendimiento neurocognitivo en adictos a la cocaína, con especial atención al método de investigación empleado. Desarrollo. Existe una gran diversidad metodológica en la investigación del déficit cognitivo asociado a la adicción a la cocaína. Estas diferencias dificultan la comparación de resultados y la obtención de un perfil claro de alteraciones neurocognitivas. Aun así, la mayoría de investigaciones encuentran déficit neuropsicológico, casi siempre de tamaño medio, asociado a la adicción a la cocaína. Este déficit afecta a la atención, memoria verbal y visual, y funciones ejecutivas (memoria de trabajo, flexibilidad mental, fluidez verbal, inhibición y toma de decisiones). Algunos estudios arrojan resultados con un perfil de ejecución cognitiva disociado. Conclusiones. El uso crónico de cocaína se asocia con un peor rendimiento cognitivo. Por lo tanto, la valoración cognitiva de adictos a la cocaína puede mejorar la comprensión de la naturaleza de las dificultades que estos pacientes exhiben en su vida cotidiana y, además, puede servir de referencia para orientar su tratamiento. Es posible que sutiles alteraciones cognitivas conlleven importantes consecuencias en la conducta de estos pacientes. Sin embargo, la evaluación neuropsicológica no forma parte aún de los protocolos habituales de evaluación de este trastorno. Por lo tanto, se propone incluir una evaluación neuropsicológica en los protocolos de evaluación inicial de estos pacientes y adaptar el tratamiento al déficit encontrado.
Open Access
Comorbilidad psicopatológica en el alcoholismo: un estudio descriptivo
(Asociacion Española de Psicología Conductual, 2006) Landa González, Natalia; Fernández-Montalvo, Javier; López-Goñi, José Javier; Lorea Conde, Iñaki; Psicología y Pedagogía; Psikologia eta Pedagogia
En este estudio se lleva a cabo un análisis del perfil de bebida y de la comorbilidad psicopatológica en 50 pacientes alcohólicos que acuden en busca de tratamiento a un programa ambulatorio de Proyecto Hombre de Navarra. Para ello, se lleva a cabo un estudio ex post facto, de carácter retrospectivo y con un grupo cuasi control. Se utilizan los criterios diagnósticos del DSM-IV-TR para la dependencia alcohólica, el Müncher Alkoholismus Test (MALT), para valorar la gravedad del alcoholismo, y el SCL-90-R, como medida de la sintomatología asociada. Los resultados obtenidos muestran la presencia de numerosa sintomatología psicopatológica, con elevaciones significativas en la mayoría de las dimensiones del SCL-90-R, tanto en los hombres como en las mujeres de la muestra. La comparación con las muestras normativas refleja que los alcohólicos de la muestra presentan más síntomas psicopatológicos que la población normal, pero menos que la población psiquiátrica. Asimismo, la gravedad del alcoholismo se relaciona de forma significativa con la mayor presencia e intensidad de comorbilidad. Por último, se comentan las implicaciones de este estudio para la práctica clínica y para la investigación futura.
Open Access
Employment integration after therapeutic community treatment: a case study from Spain
(Wiley, 2011) López-Goñi, José Javier; Fernández-Montalvo, Javier; Menéndez, Juan Carlos; Yudego, Fausto; Rico García, Ángel; Esarte Eseverri, Sonia; Psicología y Pedagogía; Psikologia eta Pedagogia
This article describes the employment evolution from pre- to post-treatment of 112 patients in two therapeutic communities of Proyecto Hombre (Spain). Moreover, an analysis was made using the composite scores of the EuropASI in order to evaluate the secondary outcomes in work status, beyond drug consumption. The results show that nearly half of the patients (46% of the sample) changed their employment status after treatment. Specifically, 78.6 per cent of the men (N=77) and 64.3 per cent of the women (N=9) were working after treatment; there were no statistically significant differences between them. Although the unemployment figures after treatment remained high, the residents were satisfied with their work integration. No statistically significant differences were observed between those who completed the treatment and those who did not. Implications of these results for further research and clinical practice are discussed.