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Introduction: The COVID-19 pandemic has had a direct impact on mental health. Inter national organisations have emphasised the vulnerability of indigenous people. Digital Mental Health approaches deliver online therapy as an evidence-based, effective, and accessible treat ment option for common mental health problems. However, the evidence regarding these ap proaches is limited in indigenous populations. The objective of this study is to describe the design, development, and evaluation of the efficacy of a self-applied online intervention regarding the psychological symptoms of depression, anxiety, and fear of COVID-19 in a sample of the Maya population. Method: A prospective longitudinal quantitative study was designed, where a single group was measured before and after receiving the online intervention. This study took place from April to September 2021 and consisted of six sessions delivered via WhatsApp in Spanish and Mayan. Results: The initial assessment was implemented with 82 participants who were evaluated using the Patient Health Questionnaire, Scale for Generalised Anxiety Disorder and the Fear of COVID-19 Scale; 18 participants remained in the intervention for the post-as sessment. Statistical differences were observed in PRE and POST measures of depression and anxiety, but not in fear of COVID-19. Conclusions: This study produced positive results for the first online mental health intervention implemented in the Latin American indigenous pop ulation. Future studies might consider developing similar interventions for other indigenous communities in Latin America.

Introducción: La pandemia de COVID-19 tuvo impacto directo en la salud mental. Organizaciones internacionales han enfatizado la vulnerabilidad de los pueblos indígenas. Los enfoques de salud mental digital brindan terapia en línea como una opción de tratamiento basada en evidencia, efectiva y accesible; sin embargo, los datos son limitados en población indígena. El objetivo de este estudio fue describir el diseño, desarrollo y evaluación de la eficacia de una intervención en línea autoaplicada sobre síntomas psicológicos de depresión, ansiedad y miedo al COVID-19 en una muestra de población maya. Método: Se diseñó un es tudio cuantitativo longitudinal prospectivo, donde se midió a un solo grupo antes y después de recibir la intervención en línea, implementada de abril a septiembre de 2021, que constó de seis sesiones impartidas vía WhatsApp, en español y maya. Resultados: La evaluación inicial se implementó con 82 participantes que fueron evaluados mediante el Cuestionario de Salud del Paciente, Escala para el Trastorno de Ansiedad Generalizada y Escala de Miedo al COVID-19; 18 participantes permanecieron para la evaluación posterior. Se observaron di ferencias estadísticas en las medidas pre- y post- de depresión y ansiedad, pero no miedo al COVID-19. Conclusiones: Este estudio arrojó resultados positivos de la primera intervención de salud mental en línea implementada en la población indígena latinoamericana. Estudios futuros podrían considerar el desarrollo de intervenciones similares para otras comunidades indígenas en América Latina.

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•Mexican individuals received via telehealth the unified protocol for anxiety, depression, and trauma related disorders.•Online unified protocol reduced depression, anxiety, emotional issues, uncertainty intolerance, and psychological distress.•The transdiagnostic unified protocol is well-suited to train therapists for emotional, trauma, and stressor-related disorders.

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Healthcare workers have been one of the groups most severely affected by the COVID-19 pandemic, leaving them with serious psychological effects. Some of these effects have not been treated promptly, leading to further psychological symptoms. The objective of this study was to evaluate suicide risk in healthcare workers seeking psychological help during the COVID-19 pandemic, and factors associated with this risk on participants that were searching for treatment during the COVID-19 pandemic. This is a cross-sectional study analyzing data from 626 Mexican healthcare workers seeking psychological help due to the COVID-19 pandemic through the www.personalcovid.com platform. Before they entered treatment, the Plutchik Suicide Risk Scale, the Depression Scale of the Center for Epidemiologic Studies, the Pittsburgh Sleep Quality Index, and the Professional Quality of Life Measure, were administered. Results: 49.4% (n = 308) presented suicide risk. The most severely affected groups were nurses (62%, n = 98) and physicians (52.7%, n = 96). Predictors of suicide risk in healthcare workers were secondary traumatic stress, high depressive affect, low positive affect, emotional insecurity and interpersonal problems, and medication use. Conclusions: The suicidal risk detected was high, found mostly in nurses and doctors. This study suggests the presence of psychological effects on healthcare workers, despite the time that has elapsed since the onset of the pandemic.

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ABSTRACT Background: The Intolerance of Uncertainty Scale short version (IUS-12) has proven to be a robust self-report measure to assess intolerance of uncertainty. While previous psychometric analyses of the IUS-12 have established a stable two-factor structure corresponding to the prospective and inhibitory factors of intolerance of uncertainty, recent studies suggest that the bifactor model may better explain its factor structure. Objective: The aim of the current study was to culturally adapt and validate the IUS-12 in a Mexican population. Method: The aim of the current study was to culturally adapt and validate the IUS-12 in a Mexican population. Result: Confirmatory factor analyses supported a bifactor model and a good internal consistency. Invariance testing indicated partial invariance across women and men. Convergent validity tests showed that the IUS-12 was related to measures of worry, as well as depression and anxiety. Conclusion: These findings provide evidence for the reliability and validity of the adapted version of the IUS-12 in Mexico.

RESUMEN Introducción: La Escala de Intolerancia a la Incertidumbre versión corta (IUS-12) ha demostrado ser una medida robusta de autoinforme para evaluar la intolerancia a la incertidumbre. A pesar de que los análisis psicométricos anteriores de la IUS-12 han establecido una estructura de dos factores correlacionados que corresponde a los factores prospectivo e inhibitorio de la intolerancia a la incertidumbre, estudios recientes sugieren que el modelo bifactorial puede explicar mejor su estructura factorial. Objetivo: El objetivo del estudio actual fue adaptar culturalmente y validar la IUS-12 para su uso en la población mexicana. Método: El estudio se llevó a cabo con una muestra comunitaria no probabilística por conveniencia de 405 adultos con edades comprendidas entre los 18 y 70 años. Resultados: Los análisis factoriales confirmatorios respaldaron un modelo bifactor y una buena consistencia interna. Las pruebas de invarianza indicaron invarianza parcial entre mujeres y hombres. Las pruebas de validez convergente mostraron que la IUS-12 estaba relacionada con medidas de preocupación, así como con depresión y ansiedad. Conclusión: Estos hallazgos proporcionan evidencia de la fiabilidad y validez de la versión adaptada de la IUS-12 en México.

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BACKGROUND: Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. METHODS: A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. DISCUSSION: The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. TRIAL REGISTRATION: ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.

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The COVID-19 pandemic is one of the greatest challenges in modern history, with more than four million confirmed deaths worldwide. To date, evidence regarding the psychological impact of the COVID-19 pandemic on grievers is scarce for developing countries such as Mexico. This study aimed to assess the levels of anxiety and associated concerns in a sample of Mexican adults bereaved during the COVID-19 outbreak. A cross-sectional study was conducted through the Duelo COVID (COVID Grief) platform, which is a self-guided online treatment. A total of 5,224 participants reported their anxiety, depression, sleep quality, avoidance, and arousal, prolonged grief symptoms, and medication consumption. Independent sample Mann-Whitney U-tests, chi-square tests, and Kruskal-Wallis tests, as well as multinomial logistic regression, were conducted. Results indicated that 90.4% of the participants reported clinical levels of anxiety, depression, and sleep affectations. The people who lost someone during the last 5 months scored higher in normal grief symptoms compared to the people whose loss was 6 months ago or more, and 9.8% of individuals reported the use of prescription medication, with anxiolytics and antidepressants being the most common. Females, younger respondents, unemployed people with a lower educational level, and participants who disclosed a recent suicide attempt were among those who reported medication consumption. Sleep problems were more frequent in older participants.

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Background: The Emotion Regulation Questionnaire (ERQ) is the most widely used measure of cognitive reappraisal and expressive suppression, two core emotion regulation strategies. However, the original ERQ has complex wording, which may make it difficult for readers of lower educational levels. Objective: We aimed to examine the psychometric properties of a simplified version of the ERQ, initially designed for children and adolescents: the ERQ-CA. Method: A sample of 397 Mexican adults was studied (77.3% women, 22.7% men; mean age = 22.84). A confirmatory factor analysis, as well as a graded response model, were used to study the internal functioning of the instrument. In addition, its associations with three psychopathological variables (anxiety, depression, and suicidal ideation) were examined. Results: A 9-item version of the ERQ-CA showed adequate fit (CFI = .95, RMSEA = .06), as well as good reliability (ωreappraisal = .76; ωsuppression = .75). Both subscales performed better at levels closer to the mean of their respective constructs. Finally, significant correlations were found between both subscales and the psychopathological variables. Conclusion: The 9-item ERQ-CA constitutes a promising alternative to measure cognitive reappraisal and expressive suppression in the Mexican adult population.

Antecedentes: El Cuestionario de Regulación Emocional (ERQ) es la medida más utilizada para la reevaluación cognitiva y la supresión expresiva, dos estrategias centrales de regulación emocional. Sin embargo, el ERQ original tiene una redacción compleja, lo que puede dificultar su lectura a los lectores de menor nivel educativo. Objetivo: Se buscó examinar las propiedades psicométricas de una versión simplificada del ERQ, inicialmente diseñada para niños y adolescentes: el ERQ-CA. Método: Una muestra de 397 adultos mexicanos fue estudiada (77.3% mujeres, 22.7% hombres; edad promedio = 22.84). Se utilizó un análisis factorial confirmatorio, así como un modelo de respuesta graduada, para estudiar el funcionamiento interno del instrumento. Además, se examinaron sus asociaciones con tres variables psicopatológicas (ansiedad, depresión e ideación suicida). Resultados: Una versión de 9 ítems del ERQ-CA mostró un ajuste adecuado (CFI = .95, RMSEA = .06), así como una buena fiabilidad (ωreevaluación = .76; ωsupresión = .75). Ambas subescalas se comportaron mejor en los niveles más cercanos a la media de sus respectivos constructos. Finalmente, se encontraron correlaciones significativas entre ambas subescalas y las variables psicopatológicas. Conclusión: El ERQ-CA de 9 ítems constituye una alternativa prometedora para medir la reevaluación cognitiva y la supresión expresiva en la población adulta mexicana.

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Background: COVID-19 has taken many lives worldwide and due to this, millions of persons are in grief. When the grief process lasts longer than 6 months, the person is in risk of developing Complicated Grief Disorder (CGD). The CGD is related to serious health consequences. To reduce the probability of developing CGD a preventive intervention could be applied. In developing countries like Mexico, the psychological services are scarce, self-applied interventions could provide support to solve this problem and reduce the health impact even after the pandemic has already finished. Aims: To design and implement a self-applied intervention composed of 12 modules focused on the decrease of the risk of developing CGD, and increasing the life quality, and as a secondary objective to reduce the symptomatology of anxiety, depression, and increase of sleep quality. The Intervention Duelo COVID (Grief COVID) follows the principles of User Experience (UX) and is designed according to the needs and desires of a sample of the objective participants, to increase the adherence to the self-applied intervention, considered one of the main weaknesses of online interventions. Methods: A Randomized Controlled Trial will be conducted from the 22nd of December of 2020 to the first of June 2021. The participants will be assigned to an intervention with elements of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness and Positive Psychology. The control group will be a wait-list condition, that will receive the intervention 1.5-2 months after the pre-measurement were taken. The Power Size Calculation conducted through G*Power indicated the need for a total of 42 participants, which will be divided by 21 participants in each group. The platform will be delivered through responsive design assuring with this that the intervention will adapt to the screen size of cellphones, tablets, and computers. Ethics and Dissemination: The study counts with the approval of the Research Ethics Committee of the Autonomous University of Ciudad Juárez, México, and it is registered in Clinical Trials (NCT04638842). The article is sent and registered in clinical trials before the recruitment started. The results will be reported in future conferences, scientific publications, and media.

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BACKGROUND: The COVID-19 pandemic has become a public health emergency of international concern; it has not only threatened people's physical health but has also affected their mental health and psychological well-being. It is necessary to develop and offer strategies to reduce the psychological impact of the outbreak and promote adaptive coping. OBJECTIVE: This study protocol aims to describe a self-administered web-based intervention (Mental Health COVID-19) based on the principles of positive psychology supported by elements of cognitive behavioral therapy and behavioral activation therapy to reduce the symptoms of anxiety and depression and increase positive emotions and sleep quality during and after the COVID-19 outbreak through a telepsychology system. METHODS: A randomized controlled clinical superiority trial with two independent groups will be performed, with intrasubject measures at four evaluation periods: pretest, posttest, 3-month follow-up, and 6-month follow-up. Participants will be randomly assigned to one of two groups: self-administered intervention with assistance via chat or self-administered intervention without assistance via chat. The total required sample size will be 166 participants (83 per group). RESULTS: The clinical trial is ongoing. This protocol was approved by the Research Ethics Board of the Free School of Psychology-University of Behavioral Sciences (Escuela libre de Psicología-Universidad de Ciencias del Comportamiento). The aim is to publish the preliminary results in December 2020. A conservative approach will be adopted, and the size effect will be estimated using the Cohen d index with a significance level (α) of .05 (95% reliability) and a conventional 80% power statistic. CONCLUSIONS: The central mechanism of action will be to investigate the effectiveness of an intervention based on positive psychology through a web platform that can be delivered through computers and tablets, with content that has been rigorously contextualized to the Mexican culture to provide functional strategies to help the target users cope with the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/ct2/show/NCT04468893. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/23117.

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Open Educational Resources (OERs) include different web formats, such as audio, video, images and text that can be modified, redistributed and used for learning about a specific topic, however, it became pertinent to create an OER evaluation tool with content validity. The present work gives an account of the content validation process using a 41-criteria rubric, each one with three performance levels, developed from a documentary search on relevant aspects to be included in a learning object. Six expert judges were contacted and decided whether each criterion was essential, useful but not essential or not necessary. Based on this, the Content Validity Reason (CVR) was calculated, obtaining 32 validated criteria. Among some conclusions, it can be mentioned that the validation process of contents allowed the identification of those criteria that require modifications or, if necessary, can be discarded to increase the validity of the heading in its whole.