Missed first appointments: Prevalence and associated factors in first-time attendees at an outpatient psychiatric clinic in Nigeria

In Nigeria, outpatient care forms the bulk of the psychiatric service. While there are no published data, empirical observations indicate that default may be high and exerting a huge toll on the cost of care. The aims were to determine the first-appointment default rate among newly seen outpatients in a psychiatric clinic and to identify factors associated with it. The study was a survey of all newly seen patients from 1 January 2006 to 31 January 2006, and who were given a follow-up appointment. A total of 223 new patients were seen. Of these, 151 (67.7%) turned up for their appointment, 61 (27.4%) defaulted, and 11 (4.9%) were referred. Defaulters were more likely to be Christians, younger in age, and in employment. On using correlation statistics, respondents’ religion and occupational status demonstrated a linear relationship and a significant association with follow-up attendance/non-attendance. The rate of non-attendance at first follow-up is of clinical concern, and the possible contribution of religion to this may be enormous. Clinicians and health policy makers need to be sensitive to this. The introduction of community psychiatric services and collaboration between orthodox and traditional/religious practitioners may help reduce default rates.     

Potencial de aprendizaje: una presentación

Resumen

El «Potencial de Aprendizaje» (PA) es uno de los conceptos más prometedores como complemento y/o sustitución del estático constructo inteligencia y su medida. Basado en el concepto vygostkyano de «Zona de Desarrollo Próximo» así como en otros más recientes como «Modificabiliaad» o «Educabilidad», en los últimos años se han desarrollado una serie de investigaciones tratando tanto de profundizar en este concepto como de proceder a su medida. Con estos objetivos, en la última década un grupo de investigación en la Universidad Autónoma de Madrid han desarrollado un dispositivo de medida de PA. A modo de Introducción de este Dossier sobre «Potencial de Aprendizaje» se presenta una síntesis de las investigaciones realizadas.     

Entrevista con Julián de Ajuriaguerra

RESUMEN

En esta entrevista Julián de Ajuriaguerra describe su historia científica desde que era interno en hospitales psiquiátricos y alumno de Thomas y Lhermitte, comentando los trabajos que realizó con adultos, ancianos y dementes aunque su interés estuviese desde un principio en los niños. Responde, entre otras, a cuestiones tales como si lo biológico se complementa con lo social en el desarrollo, cómo son los vínculos de los padres con el niño, cuál es su posición respecto al psicoanálisis, si es necesaria la interdisciplinariedad para hacer psicología o qué opina del problema de los estadios. También realiza un balance del estado actual de la psicomotricidad, ejemplifica qué entiende por “diálogo tónico” y explica las diferencias entre los juegos de niños y niñas de siete, ocho y nueve años, admitiendo la distinta organización tónica de los sexos. Por último el autor se centra en el trabajo clínico, ofreciendo sugerencias para aquéllos que empiezan a llevarlo a cabo en España. Los comentarios que Ana María Pardo y Ángel Rivière realizan del autor y su obra introducen esta entrevista.     

Estudio y adaptación experimental del test discriminativo neurológico rápido «QNST»

RESUMEN

En este trabajo los autores presentan una primera adaptación al castellano del Test Discriminativo Neurológico Rápido (QNST), de Mutti, Sterling y Spalding (1974–1978). Para ello comienzan describiendo los catorce subtests que componen la prueba, cómo se corrige y los estudios de validez y fiabilidad realizados. Seguidamente presentan su propio estudio del test, teniendo en cuenta variables tales como edad, sexo, “status” y procedencia rural-urbana (esta última sólo para seleccionar la muestra) y realizan unos baremos referidos a una muestra de la población española. Los autores encuentran que los siete y ocho años son edades clave en las que se producen cambios significativos en la ejecución del QNST, que las diferencias encontradas según el sexo son mínimas y que el nivel cultural influye en la realización de algunas tareas.     

La adquisición del lenguaje: un análisis interaccional

Resumen

El principal objetivo de esta investigación fue analizar functionalmente las interacciones verbales niño-adulto, en seis sujetos, de edades comprendidas entre los 18 y los 30 meses, y sus familias, observados en ambiente natural. Un segundo objetivo fue definir y poner a prueba un sistema de Categorías funcionales para el análisis del lenguaje infantil. También se realizó un estudio del lenguaje adulto («input parental») en cuanto a una pluralidad de características, incluyendo las similitudes y diferencias entre el lenguaje de los padres y las madres.

Los resultados ponen de relieve que el lenguaje de los niños, a pesar de las limitaciones formales de estas primeras etapas, es altamente funcional e interaccional. También se ha puesto de manifiesto que el lenguaje que el adulto dirige al niño reviste unas características (en cuanto a claridad, corrección, simplicidad, etc.) en sí mismo facilitadoras de los procesos de transmisión-adquisición del lenguaje. Al mismo tiempo se ha evidenciado la existencia de estrategias educativas no intencionales en las interacciones verbales niño-adulto. Estas estrategias poseen cierto valor explicativo respecto a los procesos de desarrollo del lenguaje.

Los niños del estudio y sus familias eran catalano-parlantes, por tanto este trabajo es asimismo un estudio longitudinal sobre la adquisición del catalán como primera lengua.     

Preschool Children’s Beliefs about Gender Differences in Academic Skills

Evidence from different Latin American countries shows a gap in the academic achievement of girls and boys. Chilean children’s achievement is a case in point, with the gender gap being especially large for mathematics achievement. These differences can be explained partly from the viewpoint of beliefs and implicit theories. Research in this field has focused mainly on elementary and secondary students, and there is no relevant data on preschool children. This study examines Chilean kindergarten children’s beliefs about differences in the academicals skills of girls and boys. Eighty-one preschool children (34 girls, mean age 5 years and 11 months) were recruited from schools serving a middle SES population from downtown Santiago. An instrument to test children’s implicit beliefs about gender differences in academic ability was adapted from previous research. Results support the hypothesis that boys and girls at the age of 5 already hold stereotypical expectations about boys’ and girls’ academic achievement. When asked about which school subject a character liked more, was better at, and found easier, participants showed no preference between math and language when reasoning about a male character, but they indicated that a female character would find math harder, perform worse at it, and like it less than language. These responses did not differ according to the gender of the participating children. Implications of these findings are addressed and limitations and future research are discussed.     

Reading strategies and prior knowledge in learning from hypertext

In two experiments, we identified two main strategies followed by hypertext readers in selecting their reading orders. The first consisted in selecting the text semantically related to the previously read section (coherence strategy), and the second in choosing the most interesting text, delaying reading of less interesting sections (interest strategy). Comprehension data revealed that these strategies affected learning differently as a function of the reader's prior knowledge. For low-knowledge readers, the coherence strategy supported better learning of the content. This effect seems to rely on the improvement of reading order coherence induced by this strategy. By contrast, for intermediate-knowledge readers the coherence and the interest strategies benefited comprehension equally. In both cases, learning was supported through the active processing induced by these strategies. Discussion focuses on resolving inconsistencies in the literature concerning whether or not hypertext supports better comprehension than does traditional linear texts.     

Spanish adaptation of the Psychological Well-Being Scales (PWBS)

The aim of this paper is to adapt to Spanish the D. van Direndonck version of Carol Ryff's Psychological Well-Being Scales, and to analyse its consistency and factorial validity. All the scales exhibited good internal reliabilities, with Cronbach alpha's ranging from 0.83 (Self-acceptance) to 0.68 (Personal growth). However, confirmatory factor analyses didn't corroborate the six-factor model (Self-acceptance, Positive relations, Autonomy, Environmental mastery, Purpose in life, and Personal growth) with a second order factor called Psychological Well-Being . To improve the psychometric properties, a new reduced version was proposed that indeed will facilitate the application. The scales of the new version maintain and raise its internal consistency (Cronbach alpha's 0.84 to 0.70). Furthermore, the scales shown an excellent fit to the theoretical model proposed by D. van Dierendonck.     

Effects of increasing cognitive load on sustained attention tasks in schizophrenic disorders and schizotypy

In this study we analyze the attentional performance using different cognitive load attentional tasks: low-load cognition (0-CPT) and high-load cognition (DS-CPT). Participants were a group of schizophrenic patients and two groups of normal population psychometrically classified as low schizotypy and high schizotypy according to the SPQ. Our results show that schizophrenic patients were more sensitive to increments on cognitive load, being their attentional performace worse than the rest of the groups. The lack of significant findings in vigilance on the schizotypal traits group is discussed in terms of conceptual and methodological issues about the utility of psychometric strategies to identify vulnerable populations within the spectrum of the schizophrenic disorders.     

A comparison between elemental and compound training of cues in retrospective revaluation

Associative learning theories assume that cue interaction and, specifically, retrospective revaluation occur only when the target cue is previously trained in compound with the to-be-revalued cue. However, there are recent demonstrations of retrospective revaluation in the absence of compound training (e.g., Matute & Pine?o, 1998a, 1998b). Nevertheless, it seems reasonable to assume that cue interaction should be stronger when the cues are trained together than when they are trained apart. In two experiments with humans, we directly compared compound and elemental training of cues. The results showed that retrospective revaluation in the elemental condition can be as strong as and, sometimes, stronger than that in the compound condition. This suggests that within-compound associations are not necessary for retrospective revaluation to occur and that these effects can possibly be best understood in the framework of general interference theory.