Análisis de variables transdiagnósticas en el consumo problemático de alcohol y depresión en Ecuador

Abstract

Contextualization: Low/middle-income countries like Ecuador feature both high prevalence of problematic alcohol consumption and depression, as well as a deficit of specialized professionals to address these problems who, in addition, mostly adopt a biomedical model of mental health focused on the diagnosis and treatment of mental disorders, not on prevention. Objectives: The aim of this dissertation is threefold: 1) Describe the characteristics and effectiveness of programs for the prevention of problematic alcohol consumption in young adults; 2) Analyze the predictive value and the conditional mediation and moderation relationships of transdiagnostic variables in problematic alcohol consumption in young Ecuadorian adults; and 3) Explain the differences according to sex in depression based on the analysis of transdiagnostic variables in a sample of the Ecuadorian adult general population. Results: 1) The effectiveness of prevention programs for problematic alcohol use in young adults in controlled studies is inconsistent. Furthermore, such programs focus on non-specific interventions based on increasing social skills and parental control to reduce the availability and accessibility of alcohol, without including transdiagnostic variables; 2) On the other hand, psychological stress and psychological inflexibility predicted a higher risk of alcohol consumption in young adults, both in men and women in Ecuador; and the impact of stress on problematic consumption was mediated by psychological inflexibility and moderated by sex; and 3) Psychological stress or perception of lack of control, was also the best predictor of depression in adults in Ecuador, being loneliness one of the main stressors, highlighting the need to strengthen social relationships to exert greater control over our lives. Conclusions: Psychological stress is the best predictor of problematic alcohol consumption and depression in Ecuador. Loneliness is a very powerful specific stressor that underlines our social nature. And psychological (in)flexibility underlines the importance of coping patterns of aversive/stressful events. Taken together, the results are consistent with the importance of the role of transdiagnostic variables in the design of future programs aimed at the prevention and promotion of mental health in Ecuador.