Abstract Throughout the years, university students showed a high prevalence of risky sexual behaviors. The beginning of sexual activity at an early age, having multiple sexual partners, alcohol consumption before having sexual relations and the inconsistent use of the condom are some of the most common characteristics and examples of risky sexual behaviors among students belonging to Higher Education. This study aimed to evaluate knowledge, attitudes and risky sexual behaviors among university students attending a University in Northern Portugal. For that purpose, we have used a transversal approach, applying a previously validated questionnaire, to a proportionately stratified sample, constituted by 840 university students. The analysis through questionnaire was divided between three different parts: knowledge about sexually transmissible diseases, attitudes towards sexually transmissible infections and attitudes towards the use of condom and risky sexual behaviors. Results have shown that the majority of university students were sexually active and that risky sexual behavior with higher prevalence refers to the inconsistent or incorrect usage of the condom. The level of knowledge about sexually transmissible infections and the attitudes towards those infections and the use of condom were moderate. We did not detect any correlation between knowledge and attitudes, however, the attitudes towards the use of condom accurately predict the risky sexual behaviors engaged upon by university students. This study has shown that understanding the factors that influence risky sexual behaviors in the context of higher education contributes for the development of educational programs about sexuality.

Resumo Os estudantes universitários ao longo dos anos revelaram uma elevada prevalência de comportamentos sexuais de risco. O início da atividade sexual em idade precoce, os múltiplos parceiros sexuais, o consumo de álcool antes da prática de relações sexuais e o uso inconsistente de preservativo são algumas das características comuns dos comportamentos sexuais de risco em estudantes do Ensino Superior. Este estudo pretendeu avaliar os conhecimentos, as atitudes e os comportamentos sexuais de risco entre estudantes universitários de uma Universidade do Norte de Portugal. Para tal, utilizamos uma abordagem transversal, aplicando um inquérito por questionário previamente validado, a uma amostra, estratificada proporcional, constituída por 840 estudantes universitários. O inquérito por questionário encontravam-se dividido em três partes: conhecimentos acerca das infeções sexualmente transmissíveis, atitudes face às infeções sexualmente transmissíveis e face ao uso de preservativo e comportamentos sexuais de risco. Os resultados evidenciaram que a maioria dos estudantes universitários eram sexualmente ativos e que o comportamento sexual de risco com maior prevalência refere-se ao uso inconsistente do preservativo. O nível de conhecimentos acerca das infeções sexualmente transmissíveis e as atitudes face a essas infeções e ao uso de preservativo foram moderadas. Não se verificou nenhuma correlação entre os conhecimentos e as atitudes, no entanto, as atitudes face ao uso do preservativo predizem os comportamentos sexuais de risco dos estudantes universitários. Este estudo mostrou que entender os fatores que influenciam os comportamentos sexuais de risco em estudantes do ensino superior contribui para o desenvolvimento de programas de educação em sexualidade.

ABSTRACT Introduction: Over the past sixty years, evidence for the adverse effects of chronic cannabis use has been demonstrated. Memory and concentration problems, the risk of schizophrenia in predisposed subjects, and amotivational syndrome have been referenced. There is not much doubt in relation to the first effect mentioned, but there is controversy around the last. Objective: To review the existing scientific evidence for the amotivational syndrome. Material and Methods: The review was conducted through academic database searching. The publications related to mental disorders associated with the chronic marijuana use, which referred to amotivational syndrome that fulfilled the criteria for articles attached to international standards, were taken into account. Results: A total of 31 articles were included. Of them, 16 presented the definition of amotivational syndrome. Once all the sources were integrated, the evidence found in 15 factors was organized. These factors included: apathy; disinterest; passivity; indifference; delay to perform tasks; sloth; presentism; reluctance to do prolonged activities that require attention or tenacity; abandonment of personal care; sexual disinterest; decreased reflexes; decreased self-efficacy; impairment in communication skills; social withdrawal, and unaltered affection. Conclusions: Based on these findings, we suggest that the amotivational syndrome is a constellation of symptoms and / or related signs which could constitute a typical morbidity caused by chronic cannabis use, so we expect that future research will be developed to demonstrate or discard their existence.

RESUMEN Introducción: Durante los últimos sesenta años se ha construido evidencia sobre los efectos adversos relacionados con el consumo crónico de cannabis. Los problemas de memoria y concentración, el riesgo de esquizofrenia en sujetos predispuestos y el síndrome amotivacional han sido referenciados. Con los primeros al parecer no hay muchas dudas, pero en relación con el último, existe controversia. Objetivo: revisar la evidencia científica existente sobre el síndrome amotivacional. Material y Métodos: La revisión se realizó mediante una búsqueda en bases de datos académicas, se tomaron en cuenta las publicaciones que estuvieran relacionadas con trastornos mentales relacionados con el consumo crónico de marihuana en los que se hacía referencia al síndrome amotivacional que cumplieran con criterios de calidad de los artículos apegados a estándares internacionales. Desarrollo: Se incluyó un total de 31 artículos, de los cuales 16 incluían la definición de síndrome amotivacional. Una vez integradas todas las fuentes, se determinó organizar la evidencia encontrada en 15 factores: apatía; desinterés; pasividad; indiferencia; demora en la realización de tareas; pereza; presentismo; desgano para actividades prolongadas que requieran atención o tenacidad; abandono del cuidado personal; desinterés sexual; disminución de los reflejos; autoeficacia disminuida; deterioro de las habilidades comunicativas; retraimiento social y afecto no alterado. Conclusiones: A partir de los hallazgos, se sugiere que el síndrome amotivacional es una constelación de síntomas y/o signos relacionados, lo que podría constituir una morbilidad propia del consumo crónico de cannabis, se espera que en el futuro se desarrollen investigaciones que prueben o rechacen su existencia.

Abstract It is common to find marijuana users with alterations in motivation, in clinical practice. Several studies have found evidence about a possible amotivational syndrome in marijuana users, both from the analysis of behavior and from the neurological examination. However, the existence of such a syndrome associated with the use of marijuana has not been firmly established, among other reasons, due to the concurrence of factors such as depression and the use of other drugs that may lead to inadequate generalization of the situation of some consumers of the substance and due to methodological difficulties in research aimed at establishing whether or not there is a decrease in the general motivation associated with the use of marijuana. Likewise, the decrease in motivation could be the result of the disorder by substances rather than by the consumption of marijuana. Due to the growing use of marijuana in the world, the study of its consequences is of the greatest importance, for the design of better treatments for people with substance use disorders. The aim of this study was to obtain evidence about the existence or not of deficiencies in the motivation of marijuana users. In addition, we sought to establish which are the characteristic behaviors that show this possible reduction of motivation. A battery of questions was constructed from a systematic literature review in PubMed, Lilacs, MedLine, Cochrane library, Embase, Science Direct and Bibliomed, using as terms “amotivational syndrome”, “amotivation cannabis”, “amotivation marijuana”, “comorbidity cannabis”, “comorbidity marijuaba”, “mental disorders and cannabis”, “cannabis and mental consequences”, “amotivation and drug use”. Likewise, an expert consultation was done about behaviors that were indicative of a reduction in the motivation of marijuana users. From the review and consultation of experts, a set of 70 possible behaviors expressed in questions about probable deficiencies in motivation was extracted. These questions, along with other instruments selected to exclude from the analysis participants with depression, prefrontal symptoms, alcohol use disorders, apathy and affective flattening, which could confuse the results, were presented to a sample of 1455 participants. The Rasch model was applied to establish whether it was possible to identify a measurable and consistent dimension that corresponded to a deficiency in motivation, and to discern which behaviors would be most characteristic of a possible motivational deficiency in habitual marijuana users. In addition, an exploratory factor analysis was carried out to identify possible groupings of the characteristic symptoms of a reduction in motivation. Our Results and conclusions show that it was estimated that 54.9 % of the participants would have a serious disorder due to the use of marijuana; 54.0 % presented symptoms of affective flattening, and 60.9 % would be marijuana users with high levels of tetrahydrocannabinol (THC). The average number of cigarettes consumed per month would be 44.5. Using the Rasch model it was established that, with the constructed set of questions, it was possible to identify a dimension or factor coinciding with a motivational deficiency. Using the exploratory factor analysis, it was found that the characteristic behaviors could be grouped into four possible subdimensions: emotional apathy; social withdrawal; neglect of personal image and motor slowdown.

Resumen Si bien es común ver en la práctica clínica deficiencias en la motivación en usuarios de marihuana, no ha sido firmemente establecida la existencia de un posible síndrome amotivacional asociado con el consumo de esta droga, entre otras razones por la concurrencia de factores como la depresión que pueden llevar a generalizar inadecuadamente la situación de algunos usuarios de la sustancia. Esta investigación se orientó a obtener evidencia acerca de la existencia de deficiencias en la motivación en consumidores de marihuana. Se construyó una batería de preguntas a partir de una revisión y una consulta a expertos, que fue aplicada a una muestra de 1455 participantes, junto con otros instrumentos seleccionados para excluir del análisis a los participantes con depresión, síntomas prefrontales, trastornos por uso de alcohol, apatía y aplanamiento afectivo, que pudieran confundir los resultados. Se aplicaron métodos estadísticos y psicométricos basados en el modelo de Rasch, para establecer qué comportamientos serían más característicos de una deficiencia motivacional en consumidores habituales de marihuana. Se estimó que un 54.9 % de los participantes tendría un trastorno grave por uso de marihuana, un 54.0 %, síntomas de aplanamiento afectivo y un 60.9 % serían usuarios de marihuana con altos niveles de tetrahidrocannabinol (THC). La media de cigarrillos de marihuana consumidos al mes sería de 44.5. Mediante el modelo de Rasch se estableció que con el conjunto de preguntas construido era posible identificar una dimensión o factor coincidente con una deficiencia motivacional. Se encontró evidencia que sugiere la existencia de apatía emocional; retraimiento social; descuido de la imagen personal y enlentecimiento motor.

A exposição de crianças ao fumo ambiental do tabaco é uma realidade mundial com consequências negativas graves na saúde infantil. Este estudo pretende avaliar a eficácia a curto-prazo do programa Domicílios 100% livres de fumo, na prevenção da exposição de crianças ao fumo ambiental do tabaco. Com essa finalidade foi realizado um estudo quase experimental que incluiu um grupo experimental constituído por alunos 466 do 4º ano de escolaridade de escolas de Braga e um grupo de controlo constituído por 273 alunos do 4º ano de escolaridade de escolas da Covilhã em Portugal. Aplicou-se um questionário de auto-preenchimento utilizado como pré/pós teste a ambos os grupos, tendo o programa sido implementado somente no grupo experimental. Observou-se uma redução significativa na prevalência de mães fumadoras do grupo experimental comparativamente ao grupo de controlo. Não se verificaram, contudo, alterações no consumo de tabaco no domicílio pelos pais dos alunos após a intervenção que possam ser atribuídas ao programa, confirmando a literatura existente. Intervenções futuras deverão actuar a um nível comunitário e focar-se directamente nos pais.

The exposure of children to secondhand smoke is a worldwide reality with serious negative consequences on children's health. This study aimed to evaluate the short-term efficacy of the intervention program Domicílios 100% livres de fumo, in the prevention of children's secondhand tobacco smoke exposure. The study included an experimental group of 466 4th graders students from Braga schools and a control group of 273 4th graders students from Covilhã schools in Portugal. A validated self-reported questionnaire was administered to both groups before and after the program implementation. The program was only administered to the experimental group. Results showed a significant lower prevalence of mothers who smoke in the experimental group than in the control group. However, no significant differences were found on the parents' tobacco consumption at home after the intervention, which confirms the results found in other studies. Future intervention programs should adopt a community approach and focus directly on parents.

Resumen Aunque contamos con tratamientos eficaces para la dependencia del tabaco, la recaída continúa siendo un fenómeno frecuente en aquellos que consiguen dejar de fumar. El objetivo del presente estudio fue analizar si existían diferencias en función del sexo en la curva de recaída en hombres y mujeres que participaron en un tratamiento psicológico cognitivo-conductual para dejar de fumar. La muestra estuvo formada por 266 personas (59.8 % mujeres) que dejaron de fumar al finalizar el tratamiento. Los resultados indicaron que a medida que se incrementaba el tiempo transcurrido tras la intervención, disminuía el porcentaje de participantes abstinentes. No obstante, no se encuentraron diferencias significativas entre hombres y mujeres en la curva de recaída, lo cual podría explicarse por la inclusión en el tratamiento de técnicas psicológicas eficaces para el afrontamiento de algunas de las principales causas de la recaída (e.g., estado de ánimo negativo). Dada la importancia que tiene la recaída en el proceso de dejar de fumar, es necesario profundizar en los distintos determinantes que la desencadenan.

De acordo com o último relatório do ESPAD (2012), 74% dos adolescentes portugueses reportaram ter consumido bebidas alcoólicas no último ano, 52% no último mês e 22% reportaram “binge drinking”. O consumo de álcool é um problema grave e prevalente entre os jovens, sendo indispensável identificar fatores associados a este consumo, por forma a desenvolver estratégias preventivas eficazes. Objetivos: Descrever as perceções sobre os fatores de risco e protetores associados à experimentação e ao consumo regular de álcool na adolescência, de acordo com o género. Metodologia: Recorreu-se à técnica de grupos focais, através da metodologia “World Café”. Organizaram-se nove grupos de estudantes (n=243): 2 grupos masculinos, 2 femininos, 4 mistos (de consumidores de álcool) e 1 grupo misto de jovens abstémicos. Os dados foram transcritos e analisados de acordo com a metodologia de análise de conteúdo. Resultados: Os participantes identificaram fatores de risco associados à experimentação (ex. atitudes da família face ao consumo) e ao consumo regular de bebidas alcoólicas (ex. gestão de emoções negativas). Foram encontradas diferenças de género na experimentação; as atitudes dos familiares face ao consumo surgem como mais relevantes para os rapazes, enquanto nas raparigas, a influência dos pares parece ter um papel mais preponderante. Conclusões: Os dados revelam diferentes fatores associados ao consumo de álcool na adolescência e identificam diferenças entre géneros. Os programas preventivos devem ter em conta estas diferenças e desenvolver ações suportadas pelas mesmas. Concomitantemente, revela-se importante que estes envolvam os pais, consciencializando-os para a influência dos seus comportamentos nos filhos.

According to the last ESPAD Report (2012), 74% of Portuguese adolescents reported to have used alcohol in the last year, with 52% using it in the last month and 22% reporting binge drinking. Alcohol consumption is a severe and prevalent problem among adolescents; therefore it is very important to identify factors associated with this consumption in order to develop effective preventive strategies. Objectives: To describe the perceptions about the risk and protective factors associated with experimentation and regular alcohol consumption in adolescence, by gender. Methods: A focus group technique was used trough a World Café methodology. Nine groups of students were organized (n=243): 2 male groups, 2 female groups, 4 mixed groups (boys and girls who used alcohol) and 1 group of abstinent students. Data was transcribed and analyzed through a content analysis methodology. Results: Participants identified risk factors associated with experimentation (e.g.: family attitudes towards alcohol consumption) and regular alcohol consumption (e.g.: way of dealing with negative emotions). Gender differences were also identified in experimentation; family attitude towards alcohol consumption seems to be more relevant to boys, while peer’s influence seems to play a predominant role to girls. Conclusions: Data reveals several factors associated with alcohol consumption in adolescents and identify gender differences. Preventive programs should take these differences into account and develop actions supported by those. At the same time, it is important that they involve parents, raising awareness to their influence in children’s behaviors.

Objectives: To assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. Methods: In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N = 3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Results: Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. Conclusions: Children's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Objetivos: Describir la prevalencia de la exposición de niños y niñas al humo ambiental del tabaco en el coche familiar; comparar la exposición de niños y niñas con padres fumadores y no fumadores. Métodos: En 2011, se aplicó un cuestionario auto-administrado a una muestra de niños y niñas portugueses de 4º curso (N = 3187, edad promedio 9,5 ± 0,7, 51,1% varones). Se calcularon ratios de prevalencia y pruebas de chi-cuadrado. Resultados: El 52,0% informaron tener al menos un padre/madre fumador. En la muestra total, la exposición fue del 28,9% (CI95%: 27,3-30,5). Esta exposición fue del 46,9% (CI95%:44,4-49,4) entre los niños y niñas con padres fumadores y del 8,6% (CI95%:7,1-10,1) entre los con padres no fumadores (p < 0,001), por lo tanto, fue más de cinco veces mayor entre los niños y niñas con padres fumadores. Conclusiones: La exposición es alta, especialmente si uno o ambos padres fuman. Esto indica la necesidad de medidas de control efectivo del consumo de tabaco para prevenir este severo riesgo para la salud.

Objectives: To assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. Methods: In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N = 3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Results: Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. Conclusions: Children's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Objetivos: Describir la prevalencia de la exposición de niños y niñas al humo ambiental del tabaco en el coche familiar; comparar la exposición de niños y niñas con padres fumadores y no fumadores. Métodos: En 2011, se aplicó un cuestionario auto-administrado a una muestra de niños y niñas portugueses de 4º curso (N = 3187, edad promedio 9,5 ± 0,7, 51,1% varones). Se calcularon ratios de prevalencia y pruebas de chi-cuadrado. Resultados: El 52,0% informaron tener al menos un padre/madre fumador. En la muestra total, la exposición fue del 28,9% (CI95%: 27,3-30,5). Esta exposición fue del 46,9% (CI95%:44,4-49,4) entre los niños y niñas con padres fumadores y del 8,6% (CI95%:7,1-10,1) entre los con padres no fumadores (p < 0,001), por lo tanto, fue más de cinco veces mayor entre los niños y niñas con padres fumadores. Conclusiones: La exposición es alta, especialmente si uno o ambos padres fuman. Esto indica la necesidad de medidas de control efectivo del consumo de tabaco para prevenir este severo riesgo para la salud.

Objectivos: Esta investigação pretende avaliar o impacto da lei antitabágica Portuguesa - Lei n.º 37/2007, de 14 de agosto - na exposição das crianças ao Fumo Ambiental do Tabaco em casa Tipo de estudo: Realizaram-se três estudos observacionais, transversais e analíticos Local: Escolas do 1.º ciclo de Braga População: Alunos do 4.º ano, do 1.º ciclo das escolas de Braga Métodos: Foram utilizados questionários de autopreenchimento, aplicados em contexto de sala de aula. Na análise de dados foi utilizado o qui-quadrado por se tratar de variáveis de categoria. Utilizou-se a mesma metodologia em momentos diferentes, o primeiro em 2007 (antes da entrada em vigor da lei), o segundo em 2010 e o terceiro em 2011 (ambos após a entrada em vigor da lei). Resultados: Em 2007, a amostra era constituída por 793 alunos do 4.º ano e no segundo e terceiro estudos participaram, respetivamente, 513 e 509 alunos do mesmo ano de escolaridade de escolas de Braga - Portugal. FA prevalência de crianças expostas diária ou ocasionalmente ao FAT, pelo facto de pelo menos um dos conviventes fumar em casa, desceu de 43,2% em 2007 para 19,9% em 2011 (p<0,001). Conclusões: A entrada em vigor da lei antitabágica Portuguesa poderá estar associada a uma diminuição do consumo de tabaco no domicílio.

Aims: This study aims to assess the impact of the new Portuguese anti-smoking law of 2007 on the exposure to tobacco smoke at home. Study type: Three observational and cross-sectional studies Setting: Elementary schools in Braga, Portugal Population: 4th grade students in Braga Methods: Self-report questionnaires were distributed in the classrooms. Chi-square tests were used to compare categorical variables. Three observational studies were performed on similar samples at three different times. The first was conducted on 793 students in 2007 before passage of the law. The second was conducted on 513 students in 2010 and the third on 509 students in 2011, after passage of the law. Results: The proportion of children exposed to daily or occasional environmental tobacco smoke by at least one person who smokes at home decreased from 43.2% in 2007 to 19.9% in 2011 (p<0.001). Conclusions: Passage of the Portuguese anti-smoking law may be associated with a reduction in tobacco use in the home.

Several studies show that when using motivational interviewing (MI) added to standard treatment, in order to increase motivation, treatment outcomes improve. The aim of this study was to examine whether smokers who receive an intervention with MI before a cognitive-behavioral psychological treatment to quit smoking they improve adherence and treatment effectiveness, and they reduce the risk of relapse at follow up compared with smokers who only receive cognitive-behavioral psychological treatment for smoking cessation. We compared the effectiveness of adding or not MI to a psychological treatment to quit smoking in a sample of 58 smokers (46.6% men and 53.4% women). The experimental group received 2 sessions of MI before the beginning of the 6 sessions of the psychological treatment, while the control group received only 6 sessions of treatment. The results showed no statistically significant differences between the two groups in adherence to treatment, and treatment outcomes at the end of treatment and at 6 and 12-month follow-ups. We conclude that intervention with MI does not produce better results compared to the application of cognitive-behavioral psychological treatment alone.

Distintos estudios muestran que cuando se utiliza la entrevista motivacional (EM) añadida a un tratamiento estándar, con el objetivo de aumentar la motivación, mejoran los resultados del tratamiento. El objetivo del presente estudio fue analizar si los fumadores que reciben una intervención con EM antes de un tratamiento psicológico cognitivo conductual para dejar de fumar mejoran la adherencia y la eficacia del tratamiento y reducen la recaída en los seguimientos, en comparación con fumadores que únicamente reciben un tratamiento psicológico cognitivo conductual para dejar de fumar. Se comparó en 58 fumadores (46.6% hombres y 53.4% mujeres) la eficacia de añadir o no EM a un tratamiento psicológico para dejar de fumar. El grupo experimental recibió 2 sesiones de EM antes del comienzo de las 6 sesiones del tratamiento psicológico, mientras que el grupo de control recibió únicamente las 6 sesiones del tratamiento. Los resultados no mostraron diferencias estadísticamente significativas entre los 2 grupos en la adherencia al tratamiento, resultados al final del tratamiento y en los seguimientos a los 6 y 12 meses. Concluimos que la intervención con EM no produce mejores resultados en comparación con la aplicación de un tratamiento psicológico cognitivo conductual solo.

The objective of this paper is to develop and validate an instrument to assess the problematic use of new technologies (NT) in youth and adolescents. After the pilot study, an initial questionnaire of 35 items was developed. The questionnaire was applied to a sample of 2747 students from 5th grade to 5th university degree. Results from the analysis of reliability (Cronbach Alpha) point in all cases (full scale and subscales) values higher than .70. The appropriate analyses were conducted to establish convergent, clinical and construct validity. The final results point to the convenience to reducing the questionnaire to 26 items. The factorial structure point to seven factors, one for each considered NT (Internet, video games, mobile and television), plus other three, which grouped similar behaviour in the various NT. The suitability of the questionnaire is discusses.

El objetivo del presente trabajo es desarrollar y validar un instrumento para evaluar el uso problemático de Nuevas Tecnologías (NT) en jóvenes y adolescentes. Tras el estudio piloto se desarrolló un cuestionario inicial de 35 items. Se aplicó a una muestra de 2747 estudiantes, desde 5º de primaria a 5º de licenciatura. Los resultados obtenidos en los análisis de fiabilidad (alfa de Cronbach) señalan en todos los casos (escala total y subescalas) valores superiores a .70. Se realizaron los análisis pertinentes para establecer la validez convergente, clínica y de constructo. Los resultados finales señalan la conveniencia de reducir el cuestionario a 26 ítems. La estructura factorial apunta 7 factores, uno por cada NT considerada (Internet, Video-juegos, Móvil y Televisión), más otros tres que agrupan conductas similares en las distintas NT. Se discute la idoneidad del instrumento para la identificación de conductas problemáticas en el uso de NT.

The aim of this study was to analyze some variables of great relevance in the treatment of personality disorders such as quality of life, the severity level of psychological adjustment, the concomitant Axis I psychopathology and perception of family dynamics of tríese patients. The sample is composed of 68 patients with a personality disorder of which 57.4% are drug addicts undergoing treatment in an outpatient drug addiction center and 42.6% are users of a mental health clinic has not addictive disorders. The results showed no significant differences in life quality or severity of psychological adjustment among patients on the basis of drug addiction. The differences appear to be linked to the concomitance of psychopathology on Axis I, because for those who do not have a quality of life higher and better psychological adjustment. This indicates that the presence of Axis I psychopathology, in patients with personality disorders, increases the difficulty associated with treating these patients. In terms of family dynamics has been shown that while the attachment has a negative impact on quality of life of these patients, family resources the better. It seems that the perceived quality of life in patients with personality disorders, drug or mental health consumers, is determined by the concomitant presence of other psychopathology on Axis I. This concomitant should be targeted for therapeutic intervention.

El objetivo de este estudio ha sido analizar algunas variables de gran relevancia en el tratamiento de los trastornos de la personalidad como son la calidad de vida, el nivel de gravedad de ajuste psicológico, la concomitancia con psicopatología del Eje I y la percepción de dinámica familiar de estos pacientes. La muestra la componen 68 pacientes que presentan un trastorno de la personalidad de los que el 57.4 % son drogodependientes en tratamiento en un centro ambulatorio de atención a las drogodependencias y el 42.6 % son usuarios de un centro ambulatorio de salud mental que no presenta trastornos adictivos. Los resultados muestran que no existen diferencias significativas en calidad de vida ni gravedad de ajuste psicológico entre los pacientes en función de la drogadicción. Las diferencias parecen estar vinculadas a la concomitancia de psicopatología en el Eje I, porque los que no la presentan cuentan con un nivel de calidad de vida más elevado y mejor ajuste psicológico. Esto indica que la presencia de psicopatología en el Eje I, en pacientes con trastornos de la personalidad, incrementa la dificultad asociada al tratamiento de estos pacientes. En relación a la dinámica familiar se ha podido constatar que mientras el apego influye negativamente en la calidad de vida de estos pacientes, los recursos familiares la mejoran. Todo parece indicar que la calidad de vida autopercibida en pacientes con trastornos de la personalidad, drogodependientes o usuarios de salud mental, está determinada por la presencia concomitante de otra psicopatología en el Eje I. Esta concomitancia debe convertirse en objetivo de intervención terapéutica.

The percentage of women smokers is still on the rise in Spain. If the current smoking patterns among women continue, the number of deaths will continue rising sharply over the next hundred years. There may be more female smokers than male smokers in the adult population in Spain in the near future. This review provides an update of current knowledge as to the impact cigarette smoking has on women’s health, the current patterns of use among them, the special factors which have a baring on their smoking and the difficulties they have when they are considering the possibility of or trying to quit smoking. We also suggest ways in which a minimum degree of counseling, behavior therapy and nicotine substitute can be incorporated as treatment strategies suited to the special needs of women smokers.

El porcentaje de mujeres fumadoras está todavía aumentando en España. Si persisten los patrones actuales de fumar entre las mujeres, el número de muertes continuará creciendo de modo acusado en el próximo siglo. Es posible que en un futuro cercano fumen más mujeres que hombres entre la población adulta española. En esta revisión se actualiza lo que se conoce sobre el impacto que tiene fumar cigarrillos en la salud de las mujeres, los patrones de consumo actuales entre las mismas, los factores especiales que influyen en que fumen y las dificultades que tienen cuando consideran e intentan dejar de fumar. También sugerimos formas en las cuales el consejo mínimo, la terapia de conducta y los productos sustitutivos de la nicotina se pueden incorporar como estrategias de tratamiento adaptadas a las necesidades especiales de las mujeres que fuman.

The percentage of women smokers is still on the rise in Spain. If the current smoking patterns among women continue, the number of deaths will continue rising sharply over the next hundred years. There may be more female smokers than male smokers in the adult population in Spain in the near future. This review provides an update of current knowledge as to the impact cigarette smoking has on women’s health, the current patterns of use among them, the special factors which have a baring on their smoking and the difficulties they have when they are considering the possibility of or trying to quit smoking. We also suggest ways in which a minimum degree of counseling, behavior therapy and nicotine substitute can be incorporated as treatment strategies suited to the special needs of women smokers.

El porcentaje de mujeres fumadoras está todavía aumentando en España. Si persisten los patrones actuales de fumar entre las mujeres, el número de muertes continuará creciendo de modo acusado en el próximo siglo. Es posible que en un futuro cercano fumen más mujeres que hombres entre la población adulta española. En esta revisión se actualiza lo que se conoce sobre el impacto que tiene fumar cigarrillos en la salud de las mujeres, los patrones de consumo actuales entre las mismas, los factores especiales que influyen en que fumen y las dificultades que tienen cuando consideran e intentan dejar de fumar. También sugerimos formas en las cuales el consejo mínimo, la terapia de conducta y los productos sustitutivos de la nicotina se pueden incorporar como estrategias de tratamiento adaptadas a las necesidades especiales de las mujeres que fuman.