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Previous studies have reported dysbiosis in the gut microbiota (GM) of children with autism spectrum disorders (ASD), which may be a determining factor on child development through the microbiota-gut-brain axis. However, it is not clear if there is a specific group of dysbiotic bacteria in ASD. The aim of this study was to carry out a meta-analysis on the studies that analyze GM in children with ASD. 18 studies fulfilled our selection criteria. Our results showed a lower relative abundance of Streptococcus (SMD(+) = - 0.999; 95% CI - 1.549, - 0.449) and Bifidobacterium genera (SMD(+) = - 0.513; 95% CI - 0.953, - 0.073) in children with ASD. Overall, the Bifidobacterium genera is involved. However, differences found between studies are attributed to factors such as reporting bias.

Objective: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well-established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure of these dimensions in unselected schoolchildren and in children with OCD. Method: We estimated the network structure of OCD symptom dimensions in 6,991 schoolchildren and 704 children diagnosed with OCD from 18 sites across 6 countries. All participants completed the Obsessive-Compulsive Inventory−Child Version. Results: In both the school-based and clinic-based samples, the OCD dimensions formed an interconnected network with doubting/checking emerging as a highly central node, that is, having strong connections to other symptom dimensions in the network. The centrality of the doubting/checking dimension was consistent across countries, sexes, age groups, clinical status, and tic disorder comorbidity. Network differences were observed for age and sex in the school-based but not the clinic-based samples. Conclusion: The centrality of doubting/checking in the network structure of childhood OCD adds to classic and recent conceptualizations of the disorder in which the important role of doubt in disorder severity and maintenance is highlighted. The present results suggest that doubting/checking is a potentially important target for further research into the etiology and treatment of childhood OCD. Mr. Cervin has received funding from L.J. Boëthius Foundation, Lindhaga Foundation, Jerring Foundation, and Region Skåne that made possible the preparation of the present manuscript. Original data was collected in part by support from grants from the National Institute of Mental Health (NIMH) to Drs. Storch (1R01MH093381) and Geller (5R01MH093402).

In recent years, there has been an increase in studies of the implications of the gut microbiota (GM) in children with autism spectrum disorder (ASD). There is a hypothesis which propose a relationship between the emotional state and the abundance of intestinal microbes through the so-called microbiota-intestine-brain axis. In this sense, dysbiotic GM could be a contributing factor to the appearance of ASD. This systematic review article analyzes the results of the intervention using prebiotics (carrot powder, vitamin A, partially hydrolyzed guar gum, galactooligosaccharides, etc.), probiotics (mainly: Lactobacillus, Bifidobacterium, etc.) and transplantation of fecal microbiota in ASD children. In conclusion, the results of the initial studies suggest changes in ASD symptoms, gastro-intestinal symptoms and GM composition after the interventions. However, the results should be taken with caution because there are very few studies that analyze the efficacy of long-term treatments and the different combinations of them.

En los últimos años ha habido un aumento en los estudios sobre las implicaciones de la microbiota intestinal (MI) en niños con trastorno del espectro autista (TEA). La hipótesis es que existe una posible relación entre el estado emocional, la abundancia y/o la proporción de diferentes colonias bacterianas intestinales, aunque no haya cambios en la cantidad total, a través del llamado eje microbiota-intestino-cerebro. En este sentido, la MI disbiótica podría ser un factor que contribuye a la aparición del TEA. En este artículo de revisión sistemática se analizan los resultados de la intervención mediante prebióticos (polvo de zanahoria, vitamina A, goma guar parcialmente hidrolizada, galactooligosacáridos, etc.), probióticos (fundamentalmente: Lactobacillus, Bifidobacterium, etc.) y trasplante de microbiota fecal en niños con TEA. En general, los resultados de los estudios iniciales sugieren cambios en los síntomas TEA, síntomas gastrointestinales y composición de la MI intestinal tras las intervenciones. Sin embargo, los resultados deben tomarse con cautela dado que son muy pocos los estudios que analizan la eficacia de los tratamientos a largo plazo y las diferentes combinaciones de los mismos. In recent years, there has been an increase in studies of the implications of the gut microbiota (GM) in children with autism spectrum disorder (ASD). There is a hypothesis which propose a relationship between the emotional state and the abundance of intestinal microbes through the so-called microbiota-intestine-brain axis. In this sense, dysbiotic GM could be a contributing factor to the appearance of ASD. This systematic review article analyzes the results of the intervention using prebiotics (carrot powder, vitamin A, partially hydrolyzed guar gum, galactooligosaccharides, etc.), probiotics (mainly: Lactobacillus, Bifidobacterium, etc.) and transplantation of fecal microbiota in ASD children. In conclusion, the results of the initial studies suggest changes in ASD symptoms, gastro-intestinal symptoms and GM composition after the interventions. However, the results should be taken with caution because there are very few studies that analyze the efficacy of long-term treatments and the different combinations of them.

Background Symptoms of depression and anxiety are common in children with obsessive-compulsive disorder (OCD) and associated with more severe OCD, greater impairment, and worse treatment outcome. Beyond twin studies showing that genetic factors contribute to the high co-occurrence, few studies have examined how OCD, depression, and anxiety are linked in youth, and current studies often fail to account for OCD and anxiety heterogeneity. Methods Network analysis was used to investigate how OCD were linked to depression and anxiety in multinational youth diagnosed with OCD (total n = 419) and in school-recruited, community-based samples of youth (total n = 2 991). Results Initial results aligned with earlier work showing that severity of obsession-related symptoms are important in linking OCD to depression in youth with OCD. However, when symptom content of OCD (e.g., washing, ordering) was fully taken into account and when measures of anxiety were included, specific OCD symptom dimensions (primarily obsessing and doubting/checking) were linked to specific anxiety dimensions (primarily panic and generalized anxiety) which in turn were linked to depression. These results were replicated in three separate community-based samples from Chile, Italy, and Spain using different measures of anxiety and depression. Limitations Cross-sectional data were analyzed which precludes causal inference. Self-report measures were used. Conclusions Youth with OCD with symptoms related to doubting/checking and obsessing should be carefully assessed for symptoms of panic and generalized anxiety. Non-responders to standard OCD treatment may benefit from interventions targeting panic and generalized anxiety, but more research is needed to test this hypothesis.

The study of gut microbiota’s (GM) role in autism spectrum disorder (ASD) is a new and expanding research field, and bibliometric reviews can be very useful to interpret the scientific production and research trends within it. To that end, this work presents a scientometric study on ASD and GM based on 1069 publications, published between 1992 and 2020, that were found in the Web of Science© database. Journal, author, and institution productivity patterns were found using Lotka’s law and Plos One, USA, and University College Cork (Ireland) were the most productive journal, country, and institution, respectively. Keyword analysis revealed a close relationship between GM, brain, and behavior in ASD, making this a novel research field with interdisciplinary implications.

Objective: This study aimed to determine the link between Parental Acceptance-Rejection (PAR) and empathy and self-compassion in mothers of children with intellectual and developmental disabilities (IDDs). Method: The sample consists of 161 mothers who received pre-school education with children diagnosed with IDDs in Iran. The parental acceptance-rejection questionnaire, empathy questionnaire, and self-compassion scale were used as the data collection instruments, which have been analyzed through canonical correlation test. Results: There is a positive correlation between children's self-empathy and self-compassion and the PAR, and there is no significant relationship between mother's affection levels and empathy levels, but there is a significant negative relationship between mother's affection levels and child's self-compassion levels. Conclusion: when the PAR level increases, self-compassion level decreases. It provides support to predict a significant relationship between the mothers’ acceptance-rejection variables who have an IDD child and empathy and self-compassion.

The relationship between emotion regulation, social interaction and different types of restricted and repetitive behaviors is poorly understood. In the present study, structural equation modeling based on information about 239 individuals with autism was used to examine whether emotion regulation and social communication were associated with self-injury and stereotyped behaviors. Results showed that poor emotion regulation had a unique association with self-injury while difficulties with social communication was uniquely associated with stereotyped behaviors. Emotion regulation and social communication were strongly associated and self-injury and stereotyped behaviors moderately associated. This implies that these types of behaviors are often expressions of broader negative emotional states in autism. Treatments that help improve coping and social communication strategies may benefit individuals with autism. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.

In recent years, there has been an increase in studies on the implications of gut microbiota (GM) on the behaviour of children with autism spectrum disorders (ASD) due to a dysbiosis in GM that can trigger onset, development or progression of ASD through the microbiota–gut–brain axis. The aim of this study is to carry out a systematic review of articles from the last 6 years that analyse GM in children with ASD compared to GM in control groups. Children with ASD showed a higher abundance of Roseburia and Candida genera, and lower abundance of Dialister, Bilophila, Veillonella, Streptococcus, Coprococcus and Prevotella genera. Those differences can be attributed to factors such as different nationalities, nature of control groups, place where the sample was taken, gastrointestinal (GI) problems or bacterial detection methods. It is still too early to define a specific GM profile of children with ASD, and future studies should focus on homogenizing the characteristics of samples and control groups. Furthermore, new multicentre studies should also focus on the impact of GM on GI physiology, neurophysiology and behaviour of children with ASD, and on performing psychometric analyses of the correlation between the severity of ASD behavioural symptoms and GM profiles.

According to Ekman’s model, the basic emotions are anger, disgust, fear, happiness, sadness, and surprise. These emotions are universal and have an adaptative function. However, studies on these emotions among individuals with moderate intellectual disability (MID) are limited, mainly owing to issues in sample size and sample homogeneity. The present study aimed to explore differences between a MID group (n = 10) and a non-MID control group (n = 10) in 1) the identification of basic emotions; and 2) the physiological response with images related to fear, happiness, sadness, anger, and disgust, as well as images with neutral and sexual content. A total of 29 images from The International Affective Picture System and a biofeedback measurement system were used. The results showed no statistically significant differences in the identification of the basic emotions of fear, sadness, and disgust. However, statistically significant differences were found for happiness (p = .008), anger (p = .02), and neutral images (p = .02), and minor statistically significant differences were found for images with sexual content (p < .01) in MID individuals with respect to the control group. The MID group’s physiological response was lower compared with the control group, with statistically significant differences for all emotional visual stimuli. This preliminary study showed important and interesting results for the study of emotions and sexuality in MID. Future studies should consider the sample size, sex and age comparisons, and the different levels of intellectual disability.

Background: The COVID-19 pandemic has generated a global crisis that has affected the emotional health of both the general and the clinical population. Method: The present study aimed to analyze the differences between the emotional states of a group of individuals with ASD and a neurotypical group both during and after the COVID-19 confinement. The study also examined the changes in autistic symptoms between a group of individuals with ASD who were confined during the COVID-19 pandemic and another group of individuals with ASD who were studied prior to the COVID-19 pandemic period. Results: Higher levels of aggression, irritability, hyperactivity and impulsivity, lack of attention and anxiety, among other symptoms, were found in individuals with ASD during confinement when compared to healthy controls (p < .05; p < .01). Higher levels of repetitive, restrictive, and stereotyped behaviors were also found in pandemic-era ASD individuals when compared to the group of individuals with ASD who were assessed prior to the pandemic (p < .01). Conclusions: the confinement is related to an increase in symptomatology and dysfunctional behaviours characteristic of ASD, and therefore it is necessary to implement actions that help to reduce this impact now, as well as in future crisis events.

The Revised Child Anxiety and Depression Scale (RCADS) has excellent psychometric properties and is one of the most commonly used instruments throughout the world. The present study aimed to analyze the psychometric properties of the RCADS-30 in a non-clinical sample of Chilean children and adolescents using confirmatory factor analysis and multidimensional Rasch analysis. A community sample of 1034 Chilean adolescents completed the RCADS-30. Different reliability and consistency measures, confirmatory factor analysis and multidimensional Rasch analysis were employed. The results confirmed the 6-factor model, high internal consistency values, and moderate-to-high test-retest reliability of the RCADS-30 in Chilean adolescents. A low Average Variance Extracted (AVE) value was detected in one factor. With respect to multidimensional Rasch analysis, the correlation of residuals were appropriate to indicate the local independence, 6 items showed slight misfit values in a rating scale structure, and no Differential Item Functioning (DIF) was detected by gender. The RCADS-30 is an appropriate instrument to measure emotional disorders in Chilean adolescents, and it can be used for early detection of emotional symptoms in the adolescent’s population. Future studies will have to study the convergent validity and analyze the psychometric properties of RCADS-30 in adolescent clinical population, in order to address measurement precision.

Tradicionalmente la educación ha dejado de lado las aportaciones procedentes del ámbito de la medicina, y en concreto de la neurociencia, centrándose principalmente en el proceso de enseñanza y aprendizaje. Sin embargo, en los últimos años han ido surgiendo contribuciones y modelos teóricos desde la neuropsicología, que han dado lugar a la aparición de la neuroeducación o neurociencia educacional. Se trata de un campo científico interdisciplinar que estudia la interacción entre los procesos neuronales, psicológicos y la educación con el propósito de mejorar el proceso de enseñanza y aprendizaje en el estudiante. El presente estudio tiene el objetivo de realizar una revisión de los hallazgos de la neurociencia que pueden ayudar a la mejora del currículo educativo en las distintas competencias educativas y al proceso de enseñanza-aprendizaje en estudiantes con y sin necesidades educativas especiales. Los resultados de los estudios neuropsicológicos han mostrado la eficacia de las técnicas neuropsicológicas. Por lo tanto, se concluye que es el momento de incluir de forma transversal las aportaciones de la neurociencia en las aulas. Traditionally, education has left aside the contributions coming from the field of medicine, and specifically from neuroscience, focusing mainly on the teaching and learning process. However, in recent years contributions and theoretical models have been emerging from neuropsychology, which have led to the emergence of neuroeducation or educational neuroscience. It is an interdisciplinary scientific field that studies the interaction between neuronal, psychological processes and education with the purpose of improving the teaching and learning process in the student. The present study aims to review the findings of neuroscience that can help improve the educational curriculum in the different educational competencies and the teaching-learning process in students with and without special educational needs. The results of neuropsychological studies have shown the efficacy of neuropsychological techniques. Therefore, it is concluded that it is time to include transversally the contributions of neuroscience in the classrooms.

Estudios recientes han indicado que los comportamientos de riesgo para la salud y los problemas de comportamiento aparecen cada vez más a una edad más temprana en la población latinoamericana. El Inventory of School Difficulties in Adolescents (ISDA. Martínez-González y Vera-Villarroel, 2013) es una nueva escala de 13 ítems que evalúa los problemas de conducta y las conductas de riesgo comunes de gran relevancia dentro del entorno educativo, especialmente en relación con el fracaso escolar. El objetivo de este estudio es examinar las propiedades psicométricas y la estructura de factores del ISDA. En este estudio se aplicaron el ISDA, un cuestionario sociodemográfico y una medida de ansiedad-depresión a una muestra de 719 adolescentes chilenos. Los resultados indican que el ISDA contiene una estructura bifactorial: problemas de comportamiento y conductas de riesgo para la salud. Las estimaciones de consistencia interna y fiabilidad test-retest y evidencias de validez convergente-discriminante fueron adecuadas. Por lo tanto, el ISDA es una herramienta de evaluación válida para evaluar los comportamientos de riesgo y los problemas de conducta de los adolescentes chilenos dentro de un entorno escolar.

Abstract. Evidence-based assessment is necessary as a first step for developing psychopathological studies and assessing the effectiveness of empirically validated treatments. There are several measures of obsessive-compulsive disorder (OCD) and/or symptomatology in children and adolescents, but all of them present some limitations. The Obsessive-Compulsive Inventory-Revised (OCI-R) by Foa and her colleagues has showed to be a good self-report measure to capture the dimensionality of OCD in adults and adolescents. The child version of the OCI (OCI-CV) was validated for clinical children and adolescents in 2010, showing excellent psychometric properties. The objective of this study was to examine the factor structure and invariance of the OCI-CV in the general population. Results showed a six-factor structure with one second-order factor, good consistency values, and invariance across region, age, and sex. The OCI-CV is an excellent inventory for assessing the dimensions of OCD symptomatology in general populations of children and adolescents. The invariance across sex and age warrants its utilization for research purposes.

The Social Emotional Health Survey-Secondary (SEHS-S), which is a measure of core psychological assets based on a higher-order model of Covitality, is comprised of 36 items and four latent traits (with three measured subscales): belief in self (self-efficacy, self-awareness, and persistence), belief in others (school support, family coherence, and peer support), emotional competence (emotional regulation, behavioral self-control, and empathy), and engaged living (gratitude, zest, and optimism). Previous international studies have supported the psychometric properties of the SEHS-S. The present study extended this research by examining the psychometric properties of a Spanish-language adaptation with a sample of 1042 Spanish adolescents (Mage = 14.49, SD = 1.65.). Confirmatory factor analyses replicated the original factorial structure, with hierarchical omega between 0.66&ndash, 0.93, with 0.94 for the total score. Factorial invariance across genders revealed small latent mean differences. A path model evaluated concurrent validity, which revealed a significant association between Covitality and bidimensional mental health (psychological distress and well-being). Specifically, correlational analyses showed a negative association with internalizing/externalizing symptoms, and positive associations with subjective well-being, health-related quality of life, and prosocial behaviors. This study provides an example of a culturally relevant adaptation of an international tool to measure student strengths, which is critical to planning school programming and policy.

El sistema educativo permite que alumnos con necesidades educativas especiales que tienen el diagnóstico de Trastorno del Espectro Autista puedan beneficiarse de la escolarización tanto en un colegio ordinario como en un colegio de educación especial. Sin embargo, la comunidad científica considera que las personas con TEA pueden presentar diferentes niveles de severidad que determinan la adaptación al centro educativo. El presente artículo pretende analizar las diferencias en el tipo de TEA, la gravedad del TEA, la gravedad de la discapacidad intelectual y el nivel de supervisión; comunicación social; y comportamiento repetitivo en función del contexto educativo al que pertenece una muestra de 232 personas con TEA entre 3 y 63 años de edad. En el presente estudio se emplearon el Cuestionario de comunicación social, Repetitive Behavior Scale-Revised y el Inventory for Client and Agency Planning. Los resultados indican que los colegios de educación especial presentan alumnos con mayor gravedad de los síntomas TEA, gravedad de la discapacidad intelectual, conductas estereotipadas, autolesiones, problemas de comunicación y mayores niveles de supervisión en el aula. Estos resultados tienen repercusiones en el sistema educativo. The educational system allows students with special educational needs who are diagnosed with Autism Spectrum Disorder to benefit from schooling in both an ordinary school and a special education school. However, the scientific community considers that people with ASD may present different levels of severity that determine the adaptation to the educational center. This article aims to analyze the differences according to the educational context in the type of ASD, the severity of the ASD, the severity of the intellectual disability and the level of supervision; social communication; and repetitive behavior of a sample of 232 people with ASD between 3 and 63 years old. In the present study, the Social Communication Questionnaire, Repetitive Behavior Scale-Revised and the Inventory for Client and Agency Planning were used. The results indicate that special education schools have students with more serious symptoms of ASD, severity of intellectual disability, stereotyped behaviors, self-harm, communication problems and higher levels of supervision in the classroom. These results have repercussions in the education system.

Introducción. Existe gran interés en los estudios sobre las implicaciones que la microbiota intestinal ejerce en el comportamiento de personas con trastornos del espectro autista (TEA) a través del eje microbiota-intestino-cerebro. La mayoría de los estudios sobre microbiota están enfocados en la posible implicación de las bacterias sobre personas con TEA, pero pocos versan sobre el efecto de los microorganismos del reino Fungi. Sujetos y métodos. Se realiza una revisión sistemática mediante el protocolo PRISMA de la presencia de Candida spp. en las personas con TEA. Resultados. Se encontró un total de tres artículos tras aplicar los criterios de exclusión e inclusión de la revisión sistemática. Dos estudios coincidieron en mostrar diferencias significativas en el aumento de la frecuencia del género Candida spp. en personas con TEA, mientras que en otro no se hallaron diferencias. Conclusiones. Pese a que existe una clara falta de investigación tanto del género Candida ssp. como de todo el reino Fungi en las personas con TEA, los estudios apuntan a una importante presencia de dicho género en este colectivo. Concretamente, en los resultados encontrados se destaca la mayor prevalencia del género C. albicans en los niños con TEA. Sin embargo, aún se sabe poco sobre la implicación de Candida spp. y otros tipos de hongos sobre los síntomas gastrointestinales y la sintomatología del autismo en niños con TEA. Introduction. There is great interest in studies on the implications that gut microbiota exerts on the behavior of people with autism spectrum disorders (ASD), through the microbiota-gut-brain axis. Most studies on microbiota are focused on the possible involvement of bacteria on people with ASD, but few of them are focussed on the effect of microorganisms in the Fungi kingdom. Subjects and methods. The present study performs a systematic review of the presence of Candida spp. in people with ASD using the PRISMA method. Results. A total of three articles were found after applying the exclusion and inclusion criteria of the systematic review. Two studies coincided in reporting significant differences in the increase in the frequency of the Candida spp. genus in people with ASD. while the third study did not report significant differences of Candida spp. genus between people with ASD. Conclusions. Although there is a clear lack of investigation of both the Candida ssp. genus and the whole Fungi kingdom in people with ASD, the studies point to an important presence of this genre in this group. Specifically, in the results found in this review, the highest prevalence of the C. albicans in children with ASD stands out. However, little is still known about the involvement of Candida spp., and other types of fungi, on gastrointestinal symptoms and ASD symptoms, in children with ASD.

Background and objectives: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired communication, social interaction disorder, and repetitive behavior. Dysbiotic gut microbiota (GM) could be a contributing factor to the appearance of ASD, as gastrointestinal (GI) symptoms are comorbidities frequently reported in ASD. As there is a lack of reviews about the role played by GM in the GI symptoms of ASD, this work aimed to carry out a systematic review of current studies comparing the GM of children with ASD and GI symptoms with those of healthy controls in the last six years. Materials and Methods: The systematic review was performed following the PRISMA guidelines. The databases chosen were Web of Science, Scopus, PubMed, and PsycINFO, and the keywords were (gut* OR intestine* OR bowel* OR gastrointestinal*) AND (microbiota* OR microflora* OR bacteria* OR microbiome* OR flora* OR bacterial* OR bacteria* OR microorganism* OR feces* OR stool*) AND (autistic* OR autism* OR ASD*). Results: A total of 16 articles were included. Ten articles performed correlations analysis between GI symptoms and ASD. Among those 10 articles, 7 found differences between the GI symptoms present in children with ASD and healthy controls. The most common GI symptom was constipation. Among the seven articles that found differences, three performed correlations analysis between GI symptoms and gut microbe abundance. Candida, Prevotella, Streptococcus, and Veillonella showed higher and lower abundance, respectively, in children with ASD and GI symptoms in more than one article. Bacteroidetes, Firmicutes, Actinomyces, Dorea, Lactobacillus, Faecalibacterium prausnitzii, and Bacteroidetes/Firmicutes ratios showed abundance discrepancies. Conclusions: It is still too early to draw a conclusion about the gut microbes involved in GI symptoms of ASD. Future research should consider the relationship between ASD behavior, GM, and GI symptoms in a multidisciplinary way and homogenize sample characteristics.

espanolEl bio-feedback es una herramienta util para evaluar la actividad del sistema nervioso y analizar el estado emocional de las personas con Trastorno del Espectro Autista (TEA). Existen pocos estudios que analicen las variables fisiologicas y la conducta adaptativa de las personas con TEA. El presente estudio tiene el objetivo de analizar las diferencias en la conducta agresiva, nivel de anticipacion, gravedad de las conductas repetitivas, niveles de ansiedad y su relacion con la adaptacion escolar de un caso de autismo grave con discapacidad intelectual severa. El sujeto presenta niveles de cortisol altos y problemas en la microbiota intestinal. Los resultados indican un aumento de los niveles de ansiedad, gravedad de la conducta agresiva, estereotipias y autolesiones relacionadas con la inadaptacion escolar. Se halla una disminucion de respuesta fisiologica tras la intervencion neuroeducativa. Futuros estudios deberan estudiar las relaciones entre variables fisiologicas, conductuales, gastro-intestinales y la eficacia de los tratamientos. EnglishBio-feedback is a useful tool for assessing the activity of the nervous system and analyzing the emotional state of people with Autism Spectrum Disorder (ASD). There are few studies that analyze the physiological variables and the adaptive behavior of people with ASD. The present study aims to analyze the differences in aggressive behavior, anticipation level, severity of repetitive behaviors, anxiety level and its relation to the school adaptation of a case of severe autism with severe intellectual disability. The participant has high levels of cortisol and problems in the intestinal microbiota. The results indicate an increase in anxiety levels, aggressive behavior, stereotypies and self-injury related to school maladjustment. There is a decrease in physiological response after the neuroeducational intervention. Future studies should study the relationships between physiological, behavioral, gastro-intestinal variables and the efficacy of treatments.

Recent studies have indicated that health-risk behaviors and behavioral problems are appearing increasingly at a younger age within the Latin-American population. The Inventory of School Difficulties in Adolescents (ISDA. Martinez-Gonzalez & Vera-Villarroel, 2013) is a new screening scale of 13 items that assesses behavioral problems and common risky behaviors highly relevant within educational settings, especially related to school failure. The aim of this study is to examine the psychometric properties and factor structure of the ISDA. The ISDA, a social-demographic questionnaire and a measure of anxiety and depression symptoms were applied to a sample of 719 Chilean adolescents. The results indicate that the ISDA contains a bi-factor structure: behavioral problems and risky behaviors for health. Estimations of internal consistency and test-retest reliability, as well as evidences of convergent-discriminant validity were adequate. Therefore, the ISDA is an adequate screening tool for assessing risky behaviors and behavioral problems for Chilean adolescents within school settings.

Introduction: There is controversy over the real existence of differences in mental health and academic performance between the Mapuche ethnic minority male adolescents and the male adolescents not belonging to this ethnicity in Chile. Objective: In consequence, the aim of this study was to investigate the differences in emotional and behavioural symptoms, risky behaviours and academic success on the Chilean Mapuche and non-Mapuche adolescents. Design: The sample consisted of 233 adolescents of which 119 were Mapuche adolescents and 114 were non-Mapuche adolescents. Results: The results showed that the Mapuche adolescents do not have more anxiety problems and depression than the non-Mapuche adolescents. Furthermore, the Mapuche adolescents present less drug consumption and behavioural problems. Moreover, there were no differences in academic performance. Conclusions: This study provides social interest data of the adolescents' mental health, which can be useful for the country's socio-sanitary and political decisions. Future studies should investigate these and other variables related to the mental health of minorities in greater depth.

Introduction Traditionally, research and practice addressing mental health has been conducted within a unidimensional model, explaining mental health as the presence/absence of psychological problems (distress or psychopathological symptoms). More recently, accumulative evidence has supported a bi-dimensional model, which conceptualises psychological problems and psychological strengths (well-being) as related-yet-distinct continua that, when considered together, yields a more comprehensive understanding of individuals. The DetectaWeb Project is a web-based early detection assessment of the mental health continuum (MHC) for children and adolescents and aims to: develop a web-based platform for screening of the MHC, including both psychological problems (anxiety, depression and suicidality) and personal strengths (emotional, cognitive/psychological and social aspects); examine the prevalence of the MHC among children and adolescents; and analyse key determinants (risk and protective factors) of the MHC. Methods and analysis We will conduct an ongoing, multicentre observational, cross-sectional study of Spanish children and adolescents. Participants will be assessed through a web-based platform. In order to validate the web-based screening system, a clinical reappraisal will be completed among a subsample of respondents. To elucidate youth’s levels of subjective distress and well-being, we will include measures of anxiety, depression, suicidality, well-being, externalising problems and socio-demographic variables. Ethics and dissemination Ethical approval has been obtained at all sites. All participants will sign a free and informed consent form before the assessment. Results of the study will be communicated during national and international meetings in the field of clinical and health psychology with children and adolescents. Publications will be sought in journals usually read by psychologists or psychiatrists involved in the development of epidemiological studies and interventions for mental health promotion based on resilience building for children and adolescents. Detecta Web Project is a funded project by the Vicerrectorado for Research and Technological Development from Miguel Hernández University (BANCAJA-UMH, call 2010), the Department of Health Care (Consejeria de Sanidad) from the Valencian Community (SMI 10/2014), and a grant for the hiring of predoctoral research assistant granted the third author (ProgramVALi+d, Department of Education, Research, Culture and Sport from the Valencian Community).

Restricted and repetitive behavior (RRB) is one of the two key diagnostic features of autism spectrum disorder (ASD). DSM-5 highlights the importance of severity-based diagnostic modifiers assigned on the basis of intensity of needed supports. Therefore, there is a need for available measures that assess the severity of RRB. The repetitive behavior scale-revised (RBS-R) is probably the most used informant-based rating scale for the assessment of RRB and interests observed in ASD. The present study examined the psychometric properties of the Spanish version of the RBS-R in a sample of 233 participants with ASD, aged 3 to 63 years. Results revealed a six-factor model, good internal consistency, and concurrent-divergent validity. These findings suggest the utility of the Spanish version of RBS-R.

For several years, studies have investigated the appearance and prevalence of symptoms typical of Attention-Deficit/ Hyperactivity Disorder in children with epilepsy. Traditional intervention methods to treat Attention-Deficit/ Hyperactivity Disorder symptoms include pharmacology and psychological therapy in children and parents. The present study assessed cognitive processes in a child with epilepsy and Attention-Deficit/ Hyperactivity Disorder symptoms after one year of neuropsychological rehabilitation and cognitive-behavioural family therapy. The results show an improvement in cognitive processes such as attention, short-term and long-term verbal and non-verbal memory, and executive function. There was also a slight improvement among parents in their perception of hyperactivity and impulsivity symptoms. This study suggests that comprehensive intervention is a promising approach in children with epilepsy and Attention-Deficit/ Hyperactivity Disorder symptoms. Future studies should include a larger sample of patients with cognitive impairment and similar brain lesions.

Este estudio analizó la relación entre conducta prosocial y las estrategias de aprendizaje en una muestra de 2.022 estudiantes españoles (51.1% varones) de Educación Secundaria Obligatoria (ESO). La conducta prosocial fue medida con la escala de Conducta Prosocial del Teenage Inventory of Social Skills (TISS) y las estrategias de aprendizaje fueron medidas con el Learning and Study Strategies Inventory-High School (LASSI-HS). Los análisis de regresión logística revelaron que la conducta prosocial es un predictor positivo y estadísticamente significativo de puntuaciones altas en las siguientes estrategias y habilidades de estudio: actitud hacia el éxito académico, motivación, procesamiento de la información, selección de ideas principales, ayudas al estudio, autoevaluación y estrategias de evaluación. Además, la conducta prosocial fue un predictor negativo y estadísticamente significativo de puntuaciones altas en ansiedad. Estos resultados fueron encontrados en varones, mujeres y en estudiantes de todos los cursos de ESO. Sin embargo, la conducta prosocial sólo fue un predictor positivo y estadísticamente significativo de altas puntuaciones en control del tiempo (en las muestras de 2º y 4º de ESO) y en concentración (en las muestras de chicos y 4º de ESO). This study analyzed the relationship between prosocial behavior and learning strategies in a sample of 2022 Spanish students (51.1% males) of Compulsory Secondary Education. The prosocial behavior was measured with the Prosocial Behaviour scale of the Teenage Inventory of Social Skills (TISS) and learning strategies were measured with the Learning and Study Strategies Inventory-High School (LASSI). Logistic regression analyses revealed that prosocial behavior is a positive and significant statistically predictor of high scores on the following learning strategies: attitude toward academic success, motivation, information processing, selecting main ideas, self-assessment, and evaluation strategies. In addition, prosocial behaviour was a negative and statistically significant predictor of high scores on anxiety. These results were found in males, females and students at all of Compulsory Secondary Education (CSE). However, prosocial behaviour was only a positive and statistically significant predictor of high scores in control of time (in samples of 2º and 4º CSE) and concentration (in samples of boy and students of 4º CSE). Este trabajo ha sido realizado a través del proyecto SEJ 2004-07311/EDUC perteneciente al Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica del M.E.C. concedido al primer autor.

Resulta de gran dificultad establecer una etiología de los niveles altos de ansiedad en niños con autismo. Diferentes estudios han señalado la relación entre niveles de cortisol altos, así como la relación entre ciertas bacterias con el autismo. Adicionalmente, la ansiedad presenta conductas repetitivas como las autolesiones pueden ser perjudiciales dentro del aula y las relaciones con los iguales. Los profesionales pueden tener dificultades para identificar los niveles de ansiedad altos en los niños con diagnóstico de TEA severo, discapacidad intelectual profunda o severa y no presentan comunicación verbal. El niño puede refugiarse en sus conductas repetitivas y no adaptarse a las tareas que se van a realizar en el aula. El objetivo de este estudio es presentar un método subjetivo de evaluación de la ansiedad del niño con autismo severo y discapacidad intelectual severa; y presentar las diferencias en los niveles de ansiedad cuando el niño tiene un tratamiento farmacológico adecuado y hay una habituación a realizar las tareas de tipo atencional en el aula. Los resultados señalan una disminución de los niveles de ansiedad cuando se utiliza la instigación con la aplicación de hábitos incompatibles y una disminución mayor añadiendo tratamiento farmacológico. It is very difficult to establish an etiology of the high levels of anxiety in children with autism. Different studies have pointed out the relationship between high cortisol levels as well as the relationship between the presence of bacterias and autism. Additional symptoms of anxiety are repetitive behaviors such as self-injury which can be harmful within the classroom and peer relationship. Professionals may have difficulty identifying the high anxiety levels in children diagnosed with severe ASD or severe intellectual disability and no verbal communication. The child can take refuge in this repetitive behavior and not adapt to the classroom environment. The objective of this study is to present a subjective method of assessing the anxiety of the child with severe autism and severe intellectual disability; and to present the differences in anxiety levels when the pharmacological treatment of the child is apropriate. The results indicate a decrease in anxiety levels and a better adaptation when the professor instigates the task and applies habit reversal treatment and in conjunction with pharmacological treatment.

En la actualidad, pocas discapacidades despiertan tanta preocupación e inquietud como los Trastornos del Espectro Autista. Este trastorno que hasta hace pocos años era conocido solo por las familias de los afectados y unos pocos profesionales, en la actualidad ha pasado a ser motivo de preocupación científica y social. El objetivo de este trabajo es examinar la eficacia de la musicoterapia con técnicas pasivas, mediante la audición de música clásica, con el fin de disminuir las conductas repetitivas que presentan este colectivo. Para ello, se realizó durante tres meses un estudio cuasi-experimental, con diseño pretest-postest, disponiendo de una muestra de 36 personas, de las cuales 20 formaron el grupo experimental y 16 el grupo control. Para la evaluación y selección de usuarios, se utilizó la Escala de Conductas Repetitivas (Repetitive Behavior Scale-Revised) y un registro de musicoterapia para cada sesión. Los resultados indicaron parámetros que muestran una leve mejoría en el postest respecto del pretest en el grupo de tratamiento y un incremento en todas las puntuaciones del registro de musicoterapia utilizado en cada sesión y cumplimentado por el equipo de atención directa del recurso de alojamiento y convivencia donde se realiza este estudio. Teniendo en cuenta el corto tiempo de la intervención y los resultados obtenidos, se puede plantear que se trata de una terapia efectiva a la hora de aliviar dichas conductas y aumentar su bienestar y calidad de vida. No obstante, es preciso realizar más estudios al respecto. Currently, few disabilities aroused so much concern and alarm as Autism Spectrum Disorders. This disorder, until a few years ago was known only by families of affected people and few professionals, has currently become a scientific and social concern. The aim of this study is to examine the efficacy of Music Therapy with passive techniques, by listening classical music, to reduce repetitive behaviors among this group. For it, it was conducted three months quasi-experimental study with a pretest-posttest control group design, featuring a sample of 36 participants, of which 20 formed the experimental group and 16 the control group. The evaluation and selection of users was by means of Repetitive Behavior Scale-Revised and a record of music therapy for each session filled out by the staff from the centers where this study was carried out. The results indicated a slight improvement on the posttest against the pretest scores in the treatment group and an increase in all scores from the register of music therapy used in each session. Considering the short time of intervention and the obtained findings, it can be assert that Music Therapy is an effective therapy to relieve these behaviors and increase well-being and quality of life in people with Autism. However, it is necessary to carry out further studies in this field.

The authors make an analysis of the present situation of the topic on negative emotions and health. First of all, they talked about the concept of emotion and then the main characteristics of negative emotions. Later they deal with the relation between negative emotions and health-sickness, and they finally end with some ideas that summarize what was dealt with in the whole article.

"En este artículo se ha intentado mostrar una síntesis de los datos relativos a la influencia de los factores emocionales, específicamente la ansiedad y la depresión, en el proceso de salud-enfermedad. Estos factores se han asociado con las enfermedades crónicas como variables influyentes en el inicio, desarrollo y mantenimiento. Se han hipotetizado básicamente dos vías explicativas generales. La primera hace referencia a la influencia de la ansiedad y de la depresi ón en la conducta, de manera que interfieren en los hábitos saludables y fomentan el desarrollo de conductas inadecuadas que ponen en peligro nuestra salud. El segundo mecanismo se refiere a la repercusión de la activación psicofisiológica en los sistemas orgánicos, afectando a la inmunidad, por ejemplo. Pero no sólo existe una relación en el curso de la enfermedad, sino que también se conoce una alta comorbilidad de estas enfermedades con los trastornos ansiosos y depresivos, frecuentemente como consecuencia del padecimiento de las mismas. Por último, también se han revisado las intervenciones que han demostrado su eficacia en el tratamiento de la sintomatología ansiosa y depresiva en enfermos crónicos. "

In recent years, there has been a considerable increase in the development of assessment tools for obsessive-compulsive symptomatology in children and adolescents. The Obsessive Compulsive Inventory-Child Version (OCI-CV) is a well-established assessment self-report, with special interest for the assessment of dimensions of Obsessive Compulsive Disorder (OCD). This instrument has shown to be useful for clinical and non-clinical populations in two languages (English and European Spanish). Thus, the aim of this study was to analyze the psychometric properties of the OCI-CV in a Chilean community sample. The sample consisted of 816 children and adolescents with a mean age of 14.54 years (SD = 2.21; range = 10–18 years). Factor structure, internal consistency, test-retest reliability, convergent/divergent validity, and gender/age differences were examined. Confirmatory factor analysis showed a 6-factor structure (Doubting/Checking, Obsessing, Hoarding, Washing, Ordering, and Neutralizing) with one second-order factor. Good estimates of reliability (including internal consistency and test-retest), evidence supporting the validity, and small age and gender differences (higher levels of OCD symptomatology among older participants and women, respectively) are found. The OCI-CV is also an adequate scale for the assessment of obsessions and compulsions in a general population of Chilean children and adolescents. SCHOLARSHIPS IBEROAMERICA for Young Teachers and Researchers (Santander Universities. 2013).

En las últimas décadas los estudios neuropsicológicos han hallado déficit para atención, memoria y función ejecutiva en sujetos con trastorno obsesivo-compulsivo. Del mismo, modo la literatura ha descrito los tratamientos más eficaces para disminuir la sintomatología obsesiva. Se han evidenciado cambios en el cerebro tras un tratamiento psicológico en el trastorno obsesivo-compulsivo. En el presente estudio se evalúan los procesos neuropsicológicos y la sintomatología obsesivo-compulsiva tras seis meses de intervención psicológica en un joven-adulto con trastorno obsesivo-compulsivo. Los resultados muestran una mejora de los procesos cognitivos como la memoria verbal a corto y largo plazo, capacidad de aprendizaje, así como la función ejecutiva. Conclusiones: Este estudio obtiene resultados sobre los efectos de la intervención psicológica en los procesos neuropsicológicos. Futuros estudios deben incluir una muestra mayor de sujetos para ver los efectos neuropsicológicos de los diferentes tratamientos a largo plazo. In recent decades, studies have found neuropsychological deficit in attention, memory and executive function in subjects with obsessive-compulsive disorder. The same way the literature has described the most effective treatments to reduce obsessive symptoms. They have shown changes in the brain after a psychological treatment in obsessive-compulsive disorder. In the present study the neuropsychological processes and obsessive-compulsive symptoms after six months of psychological intervention in a young adult with obsessive-compulsive disorder are evaluated. The results show an improvement in cognitive processes such as verbal short and long term, learning ability and executive function memory. Conclusions: This study obtained results on the effects of psychological intervention on neuropsychological processes. Future studies should include a larger sample of subjects to see the neuropsychological effects of different treatments over time.

This study examines the long-term effectiveness of a combined cognitive-behavioral and neuropsychological intervention in a woman of 19 years old with multiple sclerosis, by evaluating functional neuroimaging, neuropsychological and psychometric testing. The results showed a partial improvement in some brain areas and brain inflammatory activity. There was an increase in attention, verbal memory, and nonverbal executive functioning as well as in the emotional state at posttest and one-year follow-up. This study indicates the need for including components of both cognitive-behavioral therapy and neuropsychological rehabilitation based on an individualized and tailored plan in standard treatments for multiple sclerosis. Future studies should further develop these contributions.

En las últimas décadas los estudios neurocientíficos han evidenciado la capacidad del cerebro humano para la neurogénesis y la mejora cognitiva tras la rehabilitación neuropsicológica. En el presente estudio se evalúan los procesos cognitivos tras dos años de rehabilitación neuropsicológica y logopédica de un caso de traumatismo cráneo-encefálico y trastorno orgánico de la personalidad. Los resultados muestran una mejora de los procesos cognitivos como la atención, memoria verbal y no verbal a corto y largo plazo, capacidad perceptiva y visoconstructiva, así como en algunos aspectos de la función ejecutiva como la fluencia verbal. Conclusiones: Este estudio obtiene resultados esperanzadores con una intervención integral y ecológica pasados cuatro años sin intervención alguna en el paciente. Futuros estudios deben incluir una muestra mayor de sujetos con un deterioro cognitivo y lesiones cerebrales similares. Over the last decades neuroscientific studies have showed the capacity of the human brain for neurogenesis and cognitive improvement following neuropsychological rehabilitation. This study evaluates the cognitive processes after two years of neuropsychological rehabilitation and speech therapy in a case with traumatic brain injury and organic personality disorder. The results show an improvement of cognitive processes such as attention, short and long term verbal and nonverbal memory, and viso-perceptive ability as well as some aspects of executive function and verbal fluency. Conclusions: This study obtained encouraging results with an integral and ecological intervention after four years without any intervention on the patient. Future studies should include a larger sample of subjects with similar cognitive impairment and brain injuries.

Este estudio analizó la relación entre conducta prosocial y metas académicas en una muestra de 2.022 estudiantes españoles. La conducta prosocial fue medida con la escala de conducta prosocial del Teenage Inventory of Social Skills (TISS) y las metas académicas mediante el Achievement Goal Tendencies Questionnaire (AGTQ). Los resultados revelaron que los estudiantes con alta conducta prosocial presentaron puntuaciones significativamente más altas en metas de aprendizaje y logro. La conducta prosocial fue un predictor positivo y estadísticamente significativo de metas de aprendizaje y logro. Además, las metas de aprendizaje y logro fueron predictores positivos y estadísticamente significativos de la conducta prosocial, mientras que las metas de refuerzo social fueron un predictor negativo y estadísticamente significativo de la conducta prosocial. This study analyzed the relationship between prosocial behaviour and academic goals in a sample of 2,022 Spanish compulsory secondary education students. The prosocial behaviour was measured with the Prosocial Behaviour scale of the Teenage Inventory of Social Skills (TISS) and academic goals were measured with the Achievement Goal Tendencies Questionnaire (AGTQ). The results revealed that students with high prosocial behaviour presented higher significantly scores in learning and performance goals. The prosocial behaviour was a positive and statistically significant predictor of learning and performance goals. Furthermore, learning and performance goals were positive and statistically significant predictors of the prosocial behaviour, whereas social reinforcement goals were a negative and statistically significant predictor of prosocial behaviour.

In the last decades psychological studies have demonstrated the effectiveness of the cognitive-behavioural therapy for most anxiety and depressive disorders. Recently, a different and complementary approach in terms of validation of cognitive-behavioural therapy has emerged: testing the efficacy of these therapies using functional neuroimaging techniques.Neurological studies evaluate the cerebral functioning causing the appearance of symptoms and monitoring the brain activity. In this revision study we show the implications of different brain structures (amygdala, cingulate cortex, thalamus, insula) with the characteristic symptoms of many mental disorders studied (obsessive-compulsive disorder, specific phobia, etc.) and the neurological changes after applying a cognitive-behavioural therapy.At the present there is a very limited number of studies due to the complexity in implementing this type of researches. However, data suggest changes in metabolic activity after cognitive-behavioural therapy at the same time as the decrease of symptoms. Future studies should control the influence of variables such as comorbidity and medication, which prevent more definitive conclusions.

A lo largo de esta última década el interés por el estudio de la Inteligencia Emocional y su relación con la salud ha aumentado notablemente. El presente artículo tiene el objetivo de presentar los resultados de los estudios más relevantes que relacionan la Inteligencia Emocional medida como rasgo con las condiciones de salud física y mental. Los resultados indican que niveles altos de Inteligencia Emocional están significativamente relacionados con una buena salud mental mientras que niveles bajos de Inteligencia Emocional se relacionan con ciertos trastornos psicológicos. Del mismo modo, la Inteligencia Emocional parece jugar un papel moderador sobre los síntomas y enfermedades médicas. Futuros estudios deberían profundizar en el conocimiento de la relación entre Inteligencia Emocional y variables psicológicas implicadas en la salud mental (por ejemplo, dimensiones de personalidad, conducta prosocial, etc.) y entre Inteligencia Emocional y enfermedades médicas (por ejemplo, dolor crónico, cáncer, etc.).

En este artículo detallamos los estudios que hablan del papel clave de los amigos y los padres en el bienestar emocional, físico, así como en el rendimiento académico y laboral a lo largo de la vida. Igualmente, hablamos de los estilos educativos de los padres y su influencia en el desarrollo del estado emocional, relación social y rendimiento académico. Destacamos la importancia de desarrollar una conducta prososocial en los jóvenes para desarrollar mejores niveles de estabilidad emocional y rendimiento académico.

El objetivo principal del presente artículo es clarificar el término "Emoción" y analizar hasta qué punto las cogniciones son parte esencial en su entendimiento. Para este motivo se realizó una revisión de estudios relacionados con la emoción desde las perspectivas biológica y cognitiva. Desde nuestro punto de vista, existe cierta confusión en el uso del término: por un lado no existe una definición unánimemente aceptada por los teóricos que trabajan en este campo y, por otro, las personas mencionan a menudo "estar emocionados" refiriéndose a situaciones vitales completamente diferentes, por lo que se efectuó además un repaso de la clasificación de las emociones y se concluye resaltando las implicaciones que todo esto tiene en un contexto terapéutico, pues el dominio de estos aspectos puede ayudar a escoger en un momento dado un tipo de terapia u otro (p.ej., exposición versus terapia cognitiva). Finalmente, también se propone la importancia de la "Psicoeducación" centrada en los mecanismos de la respuesta de ansiedad y su relación con las cogniciones como técnica cognitiva.

Introduccion. A lo largo de las ultimas decadas, los estudios psicologicos han demostrado la eficacia de la terapia cognitivo-conductual en la mayoria de los trastornos de ansiedad y depresion. Esto ha sido asi hasta tal punto que en la actualidad se ha pasado a un nivel diferente y complementario en cuanto a la validacion de este enfoque, es decir, se ha planteado comprobar la eficacia de dicha terapia utilizando tecnicas de neuroimagen funcional. Desarrollo. Los estudios neurologicos evaluan el funcionamiento cerebral, provocando la aparicion de sintomas y observando la actividad cerebral. En este estudio de revision mostramos las implicaciones de diferentes estructuras cerebrales (amigdala, cortex cingulado, talamos, insula, etc.) con los sintomas caracteristicos de muchos trastornos mentales estudiados (trastorno obsesivo-compulsivo, fobias especificas, etc.) y los cambios neurologicos tras aplicar una terapia de tipo cognitivo-conductual. Conclusiones. En la actualidad, existe un numero muy limitado de estudios, debido a la complejidad en la ejecucion de este tipo de investigaciones. Sin embargo, los datos de los que se dispone indican cambios en la actividad metabolica tras la terapia cognitivo-conductual, junto con la disminucion de sintomas. Futuros estudios deben controlar la influencia de variables, como la comorbilidad y la medicacion, que impiden obtener conclusiones mas definitivas.

Introduccion. Las investigaciones neurocientificas mas recientes han aportado evidencia sobre la existencia de alteraciones funcionales y estructurales en los circuitos frontoestriatales entre los pacientes con trastorno obsesivo-compulsivo (TOC). Tambien se ha planteado que dichas alteraciones podrian explicar tanto los deficit cognitivos como la sintomatologia clinica del trastorno. En este trabajo presentamos una revision de los estudios que han analizado el funcionamiento neurocognitivo (atencion, memoria y funciones ejecutivas) de los pacientes con TOC. Desarrollo. Los estudios muestran resultados contradictorios en cuanto a la atencion selectiva y la velocidad de procesamiento. Con respecto a las funciones ejecutivas, los pacientes con TOC presentan deficit para cambiar el foco de atencion hacia los estimulos, problemas en la inhibicion de respuestas y en la capacidad para generar estrategias de planificacion. Los estudios que evaluan el funcionamiento de la memoria indican que estos pacientes presentan una deficiencia evidente en la memoria no verbal, mientras no esta tan claro que se de en la memoria verbal. Este deficit de memoria parece relacionado con la pobreza en el uso eficaz de estrategias, con la excesiva necesidad de comprobacion y la aparicion del fenomeno de la duda. Conclusiones. La gran heterogeneidad del trastorno y las limitaciones de algunos estudios, que no controlan la influencia de variables como la comorbilidad y la medicacion, impiden obtener conclusiones mas definitivas, si bien la alteracion neuropsicologica que resulta mas consistente es el deficit de las funciones ejecutivas. Futuros estudios deben centrarse en el control de las variables extranas, asi como en la relacion entre los procesos cognitivos y la sintomatologia del TOC.