DINÁMICA FAMILIAR EN LA ADOLESCENTE EMBARAZADA DE LA COMUNIDAD DE LASSO-ECUADOR.

Introducción: el embarazo en la adolescencia es un problema de salud pública, que genera graves consecuencias personales, sociales y económicas. Objetivo: Determinar la dinámica familiar en la adolescente embarazada de la Comunidad de Lasso-Ecuador. Métodos: Estudio cuantitativo-cualitativo, transversal y descriptivo en una muestra no pirobalística por conveniencia de 12 adolescentes embarazadas, con sus respectivos padres, pertenecientes a la Comunidad de Lasso, de la Parroquia Tan cuchi, Cantón Latacunga, Provincia de Cotopaxi, Ecuador. Los datos se recolectaron mediante una entrevista semiestructurada y la aplicación de un test FF-SIL diseñado para evaluar la funcionalidad familiar en los adolescentes. Resultados Las adolescentes embarazadas no pertenecen a una familia funcional debido a la falta de afectividad y cohesión entre sus miembros, el (58.33%) de las adolescentes viven con sus padres forjando así vínculos afectivos de tal manera que conciernen a una familia moderadamente funcional, seguido del (33.33%) perteneciente a una familia disfuncional y en un (8.33%) no reflejan ningún vínculo familiar, por lo que se considera que su núcleo familiar es severamente disfuncional. De esta manera la falta de cohesión y comunicación de los padres se asocia a una conducta de riesgo alta en el desarrollo de las adolescentes. Conclusiones: Se evidenció que las adolescentes no cuentan con el suficiente apoyo familiar, desencadenando así una serie de conflictos, desconfianza y separación con los miembros de la familia. Por lo cual es muy importante mencionar que durante la adolescencia la comunicación y atención por parte de los padres adquiere relevancia en la dinámica familiar. Palabras Clave: Sexualidad; embarazo en adolescentes; dinámica familiar, padres. ABSTRACT Introduction: teenage pregnancy is a public health problem, which generates serious personal, social and economic consequences. Objective: To determine the family dynamics in the pregnant adolescent of the Community of Lasso-Ecuador. Methods: Quantitative-qualitative, cross-sectional and descriptive study in a non-pyro-ballistic convenience sample of 12 pregnant adolescents, with their respective parents, belonging to the Lasso Community, Tan Cuchi Parish, Latacunga Canton, Cotopaxi Province, Ecuador. Data were collected through a semi-structured interview and the application of an FF-SIL test designed to assess family functionality in adolescents. Results: The pregnant adolescents do not belong to a functional family due to the lack of affectivity and cohesion among its members, (58.33%) of the adolescents live with their parents, thus forging affective bonds in such a way that they concern a moderately functional family, followed of the (33.33%) belonging to a dysfunctional family and in a (8.33%) they do not reflect any family bond, for which it is considered that their family nucleus is severely dysfunctional. In this way, the lack of cohesion and communication of the parents is associated with a high risk behavior in the development of adolescents. Conclusions: It was evidenced that adolescents do not have sufficient family support, thus triggering a series of conflicts, distrust and separation with family members. Therefore, it is very important to mention that during adolescence, communication and attention by parents acquires relevance in family dynamics. Keywords: Sexuality; pregnancy in adolescence; family dinamics, parents.

Family and Community Support, Brain-Derived Neurotrophic Factor, and Cognitive Performance in Older Adults: Findings From the Health, Wellbeing and Aging Study Population-Based Cohort

Background: Social networks can modulate physiological responses, protects against the detrimental consequences of prolonged stress, and enhance health outcomes. Family ties represent an essential source of social networks among older adults. However, the impact of family support on cognitive performance and the biological factors influencing that relationship is still unclear. We aimed to determine the relationship between family support, cognitive performance and BDNF levels.Methods: Cross-sectional data from three-hundred, eight-six individuals aged on average 60 years enrolled in the Health, Wellbeing and Aging Study (SABE), a population-cohort study, were assessed for family support, community support and cognitive performance. Structural and functional family support was evaluated based on family size and interactions allied to scores in the Family APGAR questionnaire. Community assistance (received or provided) assessed the community support. Cognitive performance was determined using the Mini-Mental State Examination (MMSE), verbal fluency (animals per minute) and backward digital span. Blood samples were obtained to determine BDNF levels.Results: Multivariate analysis showed that functional family support, but not structural, was associated with higher MMSE, verbal fluency and digit span scores, even controlling for potential cofounders (p < 0.001). Providing support to the community, rather than receiving support from others, was associated with better cognitive performance (p < 0.001). BDNF concentration was not associated with community support, family function, or cognitive performance.Conclusion: These findings suggest that emotional components of functional family and community support (e.g., loving and empathic relationship) may be more significant to cognitive health than size and frequency of social interactions.

Evaluating a Functional Family Therapy Intervention: Challenges and Lessons Learned

Purpose: This case study is the introspective account of the evaluation process of Functional Family Therapy (FFT) as implemented in Middlesex County in New Jersey between 2005 and 2011. The study presents challenges and issues in evaluation falling into three main categories. Methods: The case study is based on the recollections and documented experiences of the author who was responsible for all major aspects of the evaluation including designing the study, collecting the data, and handling daily evaluation activities. Results: The author differentiated among three main categories of challenges. In respect to research design, the relative merits of experimental versus nonexperimental designs and quantitative versus qualitative research methods are discussed. The second set of issues involves developing and exercising the social competence skills necessary to form working partnerships with service providers. The third set encompasses logistical barriers encountered during daily evaluation activities. Conclusions: The challenges and lessons learned from conducting the outcome evaluation of FFT are situated within scholarly debates on evaluation research, with the goal of providing further insights into the on-the-ground implementation and process of program evaluations. The experiences, recollections and processes illustrate challenges and solutions applicable to evaluations of other family-based violence prevention interventions.

Callous-Unemotional Traits Do Not Predict Functional Family Therapy Outcomes for Adolescents With Behavior Problems

Despite the availability of evidence-based treatment models for adolescent behavior problems, little is known about the effectiveness of these programs for adolescents with callous-unemotional (CU) traits. Defined by lack of empathy, lack of guilt, flattened affect and lack of caring, CU traits have been linked to long-term anti-social behavior and unfavorable treatment outcomes and might be negatively related to outcomes in evidence-based programs such as Functional Family Therapy (FFT). This study used a single-group pre-post evaluation design with a sample of 407 adolescents (49.1% female, mean age = 14.4 years, SD = 1.9) receiving FFT to investigate whether outcomes in FFT are predicted by CU traits and to what extent reliable changes in CU traits can be observed. The results showed that although CU traits are related to increased problem severity at baseline, they predicted neither treatment dropout nor post-treatment externalizing behavior and family functioning. CU traits were related to diminished improvement ratings, in particular with respect to parental supervision. Reductions in CU traits were observed across the time of treatment, and these were most profound among adolescents with elevated levels of CU traits at baseline. Further research should investigate whether certain evidence-based treatment components are more suited for adolescents with CU, and if the addition of specific intervention elements for reducing CU-traits could further improve outcomes for this high-risk population.