The three attachment prototypes that predicted improvement in psychoticism (secure, preoccupied and dismissing) share the existence of at least one positive psychological model (either about self or about others). It may be that the psychosocial intervention helped ARMS patients to disconfirm negative models and/or reinforce positive ones. Patients' attachment styles were not related to baseline clinical severity but impacted improvement of positive symptoms. These findings appear consistent with evidence that impaired self-esteem and dysfunctional self and others schemas constitute risk factors for reality distortion.

Hallucination-like experiences (HLEs) are typically defined as sensory perceptions in the absence of external stimuli. Multidimensional tools, able to assess different facets of HLEs, are helpful for a better characterization of hallucination proneness and to investigate the cross-national variation in the frequencies of HLEs. The current study set out to establish the validity, factor structure, and measurement invariance of the Launay-Slade Hallucinations Scale-Extended (LSHS-E), a tool to assess HLEs. A total of 4419 respondents from 10 countries were enrolled. Network analyses between the LSHS-E and the 3 dimensions of the Community Assessment of Psychic Experiences (CAPE) were performed to assess convergent and divergent validity of the LSHS-E. Confirmatory factor analysis was used to test its measurement invariance. The best fit was a 4-factor model, which proved invariant by country and clinical status, indicating cross-national stability of the hallucination-proneness construct. Among the different components of hallucination-proneness, auditory-visual HLEs had the strongest association with the positive dimension of the CAPE, compared with the depression and negative dimensions. Participants who reported a diagnosis of a mental disorder scored higher on the 4 LSHS-E factors. Small effect size differences by country were found in the scores of the 4 LSHS-E factors even after taking into account the role of socio-demographic and clinical variables. Due to its good psychometric properties, the LSHS-E is a strong candidate tool for large investigations of HLEs.

The results of a comparative study of social inequality and mental health show that Chile and Colombia, which have enormous social gaps despite their economic growth, are characterized by poor mental health indicators and social discontent, while the better equity indicators in Ecuador are not clearly linked to mental health. The concept of social defeat is suggested as a mediator between social inequality and individual and collective mental health, and participation and empowerment are suggested as ways of improving social well-being. Los resultados de un estudio comparativo de desigualdad social y salud mental muestran que Chile y Colombia, que tienen enormes brechas sociales a pesar de su crecimiento económico, se caracterizan por indicadores de salud mental deficientes y descontento social, mientras que los mejores indicadores de equidad en Ecuador no están claramente vinculados a la salud mental. El concepto de derrota social se sugiere como un mediador entre la desigualdad social y la salud mental individual y colectiva, y la participación y el empoderamiento se sugieren como formas de mejorar el bienestar social.

It is possible to detect and to provide early treatment to patients with prodromal symptoms if the whole matrix of the community--including the social services--contributes to the process. The utilization of a screening instrument and a two-phase strategy--the second carried out by the specialized team--seems to be an appropriate approach for early psychosis and ARMS detection.

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