Azahara Leonor Miranda Gálvez

Background/Objectives: Loneliness is a relevant social determinant of health in older age and has been associated with adverse physical, psychological and social outcomes. This study aimed to estimate the prevalence of severe loneliness and to identify its epidemiological and clinical correlates among community-dwelling older adults at risk of falls in Andalusia, Spain. Methods: A cross-sectional analytical study was conducted with 237 adults aged 65 years and older living in private households. Loneliness was assessed using the 10-item version of the UCLA Loneliness Scale, which showed excellent internal consistency in this sample (Cronbach’s alpha = 0.900). After reviewing the scoring direction of the instrument, severe loneliness was operationally defined using the corrected UCLA total score, with higher scores indicating greater loneliness. Sociodemographic and clinical variables included age, sex, living arrangements, economic level, family relationships, pain, sleep quality, depression history, physical exercise, outings from home, polymedication and analgesic use. Bivariate analyses were performed to compare participants with and without severe loneliness, and logistic regression was used to examine independent correlates of severe loneliness. Results: Severe loneliness was identified in 51 participants, corresponding to 21.5% of the analytical sample. The corrected UCLA-10 loneliness burden score ranged from 0 to 30, with higher scores indicating greater loneliness. Participants with severe loneliness were more likely to report poorer sleep quality and severe pain. In the adjusted logistic regression model including age, sex, sleep quality and severe pain, better sleep quality was associated with lower odds of severe loneliness (OR = 0.46, 95% CI: 0.30–0.72, p = 0.001), while severe pain was associated with higher odds of severe loneliness (OR = 3.15, 95% CI: 1.56–6.35, p = 0.001). Age (OR = 1.03, 95% CI: 0.99–1.07, p = 0.184) and female sex (OR = 2.00, 95% CI: 0.83–4.81, p = 0.124) were not statistically significant in the fully adjusted model. Conclusions: Severe loneliness affected a clinically relevant proportion of community-dwelling older adults at risk of falls in Andalusia. The findings should be interpreted as cross-sectional associations and not as evidence of causal pathways. Sleep quality and severe pain emerged as the main independent clinical correlates of severe loneliness in the adjusted model, supporting the relevance of multidimensional assessment in frail older adults.

Background/Objectives: The COVID-19 pandemic and related public health measures significantly disrupted daily life, with profound consequences for individuals with Autism Spectrum Disorder (ASD). Young adults with ASD faced unique challenges due to disruptions in routines, employment instability, limited access to essential services, and increased social isolation. While some individuals benefited from reduced social pressures and the adoption of remote work, many experienced heightened anxiety, behavioral difficulties, and declines in autonomy. This systematic review examines the impact of the pandemic on young adults with ASD, focusing on key domains such as autonomy, employment, service accessibility, socialization, emotional regulation, and overall well-being. Methods: This review followed the PRISMA 2020 guidelines, and its protocol was pre-registered in the PROSPERO database. A search was conducted in four databases—PubMed, Scous, Web of Science, and PsycInfo—as well as in specialized journals in the field. Results: Eight studies met the inclusion criteria and were included in the final synthesis. The findings highlight significant disruptions in daily life, increased dependence on caregivers, and difficulties in maintaining structured activities. However, technology-assisted interventions, including virtual therapies and remote work opportunities, played a role in mitigating some adverse effects. Conclusions: Despite the heterogeneity in methodologies, this review underscores the urgent need for targeted interventions to support young adults with ASD during crises. Future research should focus on long-term consequences and developing inclusive policies that enhance resilience, access to services, and social integration.

La investigación sobre la toma de decisiones, la salud, el temperamento y la psicopatología de los reclusos destaca la importancia de la salud mental y la rehabilitación en las prisiones. El estudio se centra en la alta prevalencia de trastornos mentales, examinando la personalidad y la toma de decisiones, particularmente en aquellos con antecedentes de abuso de sustancias y violencia doméstica. Se enfatiza la necesidad de intervenciones específicas en los entornos penitenciarios. Este estudio evaluó la toma de decisiones bajo ambigüedad y riesgo en 51 reclusos varones de la Prisión Provincial de Granada, incluyendo a aquellos con antecedentes de abuso de drogas, violencia doméstica o ninguno de estos. La toma de decisiones se evaluó mediante la tarea de Iowa Gambling, mientras que la salud mental y física se midió con el SF-36, la personalidad con el TCI-R, y la psicopatología con el MCMI-IV. No se encontraron diferencias significativas en la toma de decisiones entre los grupos de reclusos. Sin embargo, aquellos con antecedentes de abuso de sustancias y violencia doméstica mostraron una toma de decisiones consistentemente deficiente. El grupo de violencia doméstica obtuvo puntuaciones significativamente más bajas en el Bloque 5 en comparación con aquellos sin tales antecedentes. Este grupo también presentó mayores limitaciones físicas, dependencia emocional y comportamientos compulsivos. El grupo de abuso de sustancias mostró mayor búsqueda de novedad, comportamiento antisocial, agresividad, síntomas de trastorno de personalidad límite, abuso de alcohol y depresión. El estudio subraya el impacto del abuso de sustancias y la violencia doméstica en la toma de decisiones, los rasgos psicológicos y la salud física entre los hombres encarcelados. Destaca la necesidad de intervenciones personalizadas para abordar problemas cognitivos y conductuales específicos, lo que podría mejorar los resultados de la rehabilitación y reducir la reincidencia.

Background: In psychopathologies characterized by compulsive decision-making, core impairments include cognitive inflexibility and excessive sensitivity to rewards. It has been posited that traits shared by nonclinical individuals and psychiatric patients could help explain the pathogenesis of compulsive decision-making.Methods: To investigate whether cognitive inflexibility predisposes nonclinical individuals to poor choices and hyper-reactivity to reward, we recruited people with high and low scores for cognitive persistence and used the Iowa Gambling Task to assess decision-making and cardiac reactivity to monetary gains/losses.Results: As is frequently observed in psychophysiological research, the data indicated discrepancies among self-reports, behavior, and physiology. Cognitive inflexibility was not related to worse performance; however, monetary gains, in line with the literature, prompted marked cardiac accelerations. Consistent with our research goal, only inflexible participants showed large cardiac accelerations during the largest monetary wins.Discussion: Taken together, the data confirm an association between cognitive persistence and physiological reward sensitivity in a nonclinical population. The findings are in line with recent theories on the development of compulsive behaviors that consider cognitive inflexibility as a transdiagnostic impairment and predisposing factor for excessive reactivity to rewards, and might act both as a preexisting individual trait and drug-induced deficit.