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Altres ajuts: Delegación del Gobierno para el Plan Nacional sobre Drogas (2021I031) Food addiction (FA) and substance use (SU) in eating disorders (ED) have been associated with a more dysfunctional clinical and psychopathological profile. However, their impact on treatment outcomes has been poorly explored. Therefore, this transdiagnostic study is aimed at examining whether the presence of FA and/or SU is associated with treatment outcomes in patients with different ED types. The results were not able to reveal significant differences in treatment outcomes between patients with and without FA and/or SU; however, the effect sizes suggest higher dropout rates in the group with both FA and SU. The predictive models of treatment outcomes showed different features associated with each group. High persistence (i.e., tendency to perseverance and inflexibility) was the personality trait most associated with poor treatment outcomes in patients without addictions. High harm avoidance and younger age at ED onset were the variables most related to poor outcomes in patients with FA or SU. Finally, in the group with both addictive behaviors (FA and SU), the younger patients presented the poorest outcomes. In conclusion, our results suggest that, regardless of presenting addictive behaviors, patients with ED may similarly benefit from treatment. However, it may be important to consider the differential predictors of each group that might guide certain treatment targets.

Obesity is characterized by cardiometabolic and neurocognitive changes. However, how these two factors relate to each other in this population is unknown. We tested the association that cardiometabolic measures may have with impulse behaviors and white matter microstructure in adolescents with and without an excess weight. One hundred and eight adolescents (43 normal-weight and 65 overweight/obesity; 11–19 years old) were medically and psychologically (Temperament Character Inventory Revised, Three-Factor Eating Questionnaire-R18, Conners’ Continuous Performance Test-II, Stroop Color and Word Test, Wisconsin Card Sorting Test, Kirby Delay Discounting Task) evaluated. A subsample of participants (n = 56) underwent a brain magnetic resonance imaging acquisition. In adolescents, higher triglycerides and having a body mass index indicative of overweight/obesity predicted a more impulsive performance in Conners’ Continuous Performance Test-II (higher commission errors). In addition, higher glucose and diastolic blood pressure values predicted increments in the Three-Factor Eating Questionnaire-R18 emotional eating scale. Neuroanatomically, cingulum fractional anisotropy showed a negative relationship with glycated hemoglobin. The evaluation of the neurocognitive differences associated with obesity, usually based on body mass index, should be complemented with cardiometabolic measures.

Addiccions comportamentals; Conductes; Prevalença Adicciones comportamentales; Conductas; Prevalencia Behavioral addictions; Conducts; Prevalence Aquesta Guia operativa és una eina pensada per tal que els professionals de les unitats d’addiccions comportamentals i dels centres d’atenció i seguiment a les drogodependències coneguin el funcionament de l’aplicatiu del Sistema d’Informació sobre Drogodependències de Catalunya (SIDC) i puguin notificar-ne els inicis de tractament per addiccions comportamentals.

Addiccions comportamentals; Conductes; Prevalença Adicciones comportamentales; Conductas; Prevalencia Behavioral addictions; Prevalence; Behaviors En aquest Informe es presenten els resultats de la prevalença de les conductes que poden generar un problema o una addicció comportamental en la població de Catalunya a partir de les dades de les dues enquestes estatals biennals que es duen a terme en anys alterns, conjuntament amb el Plan Nacional sobre Drogas: una enquesta s’adreça a la població general "Enquesta domiciliària sobre alcohol i drogues a Espanya (EDADES)" i l’altra està enfocada a la població escolar "Enquesta estatal sobre l’ús de drogues en ensenyaments secundaris (ESTUDES)". A la segona part de l’Informe, es presenta la informació sobre els tractaments de les persones diagnosticades de trastorn per addiccions o problemes comportamentals o sense substància que s’han atès a les unitats especialitzades d’atenció a aquestes addiccions, les unitats d’addiccions comportamentals (UAC) i centres d’atenció i seguiment de les drogodependències (CAS).

Obsessive-compulsive disorder (OCD) is a disabling disorder that can be successfully treated. However, individuals with OCD do not seek or delay seeking treatment. This delay may be explained by poor mental health literacy and stigmatizing attitudes toward OCD in community. In order to work on these variables, a gamified mental health mobile application (app) called esTOCma has been developed. The purpose of this study is to describe the protocol for a study to test the efficacy of esTOCma, increasing mental health literacy and help-seeking intention, reducing the stigmatizing attitudes and social distance suffered by people with OCD, as well as the distress associated with obsessive-compulsive symptoms.A randomized controlled trial with a crossover design with two conditions (immediate-use App group versus delayed-use App group) will be conducted on a non-clinical adult sample of the community of a minimum size of 200 participants. Participants in the immediate-use App group will start using the app at baseline until completion (10 days); whereas participants in the delayed-use App group will wait 10 days, and then start using the app until completion (10 days). The outcomes will be measured at four assessment points (baseline; 10 days from baseline; and 20 days from baseline; and after 3 months). The following instruments will be administered: Attribution Questionnaire, General Help-Seeking Questionnaire, Social Distance Scale, Mental Health Literacy, Psychoeducation Questionnaire, Social Desirability Scale, Single-Item Self-esteem Scale, and Obsessive-Compulsive Inventory-Revised.This protocol presents the first study to describe a randomized control trial of a mental health app focused on changing mental health literacy, stigmatizing attitudes, social distance and help-seeking intention associated with OCD. An app intervention of these characteristics is especially relevant nowadays as the COVID-19 pandemic has increased obsessive-compulsive symptoms and severity. An improvement in general knowledge about OCD and a reduction in stigma could be associated with earlier OCD detection and an increase in help-seeking intention, which could result in greater wellbeing. Moreover, normalizing intrusions and knowledge about the cognitive OCD model could serve as a protective variable in vulnerable individuals.ClinicalTrials.gov identifier: NCT04777292. Registered February 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04777292.

Larger thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and children with clinical-level symptoms within the general population. Particular thalamic subregions may drive these differences. The ENIGMA-OCD working group conducted mega- and meta-analyses to study thalamic subregional volume in OCD across the lifespan. Structural T1-weighted brain magnetic resonance imaging (MRI) scans from 2649 OCD patients and 2774 healthy controls across 29 sites (50 datasets) were processed using the FreeSurfer built-in ThalamicNuclei pipeline to extract five thalamic subregions. Volume measures were harmonized for site effects using ComBat before running separate multiple linear regression models for children, adolescents, and adults to estimate volumetric group differences. All analyses were pre-registered ( https://osf.io/73dvy ) and adjusted for age, sex and intracranial volume. Unmedicated pediatric OCD patients (, Translational Psychiatry, 12 (1), ISSN:2158-3188

We have here assessed, using Δ9-tetrahydrocannabinol (Δ9-THC) for comparison, the effect of Δ9-tetrahydrocannabinolic acid (Δ9-THCA) and of Δ9-tetrahydrocannabivarin (Δ9-THCV) that is mediated by human versions of CB1, CB2, and CB1-CB2 receptor functional units, expressed in a heterologous system. Binding to the CB1 and CB2 receptors was addressed in living cells by means of a homogeneous assay. A biphasic competition curve for the binding to the CB2 receptor, was obtained for Δ9-THCV in cells expressing the two receptors. Signaling studies included cAMP level determination, activation of the mitogen-activated protein kinase pathway and ß-arrestin recruitment were performed. The signaling triggered by Δ9-THCA and Δ9-THCV via individual receptors or receptor heteromers disclosed differential bias, i.e. the bias observed using a given phytocannabinoid depended on the receptor (CB1, CB2 or CB1-CB2) and on the compound used as reference to calculate the bias factor (Δ9-THC, a selective agonist or a non-selective agonist). These results are consistent with different binding modes leading to differential functional selectivity depending on the agonist structure, and the state (monomeric or heteromeric) of the cannabinoid receptor. In addition, on studying Gi-coupling we showed that Δ9-THCV and Δ9-THCA and Δ9-THCV were able to revert the effect of a selective CB2 receptor agonist, but only Δ9-THCV, and not Δ9-THCA, reverted the effect of arachidonyl-2'-chloroethylamide (ACEA 100 nM) a selective agonist of the CB1 receptor. Overall, these results indicate that cannabinoids may have a variety of binding modes that results in qualitatively different effects depending on the signaling pathway that is engaged upon cannabinoid receptor activation.

[spa] El trauma psicológico ha sido identificado como un factor de riesgo para el inicio, curso y pronostico de los trastornos relacionados con sustancias (TRS). Sin embargo, los datos sobre su prevalencia e impacto clínico en los trastornos duales son escasos y poco concluyentes. Además, existe poca evidencia de intervenciones centradas en el trauma psicológico en esta población. Estudios previos en los que se ha aplicado la terapia de desensibilización y reprocesamiento por movimientos oculares (EMDR) han mostrado resultados positivos en cuanto a la mejora de los síntomas clínicos en los pacientes con TRS, sin embargo, hasta la fecha no hay ningún estudio realizado con pacientes duales. Asimismo, estos estudios presentan limitaciones metodológicas importantes por lo que es necesario llevar a cabo mas ensayos clínicos controlados aleatorizados con muestras mas amplias. Esta tesis pretende profundizar en el conocimiento de la prevalencia del trauma psicológico y su tratamiento en pacientes tanto diagnosticados con un TRS como con un trastorno dual. Para ello se han llevado a cabo dos estudios independientes, ambos multicéntricos. El objetivo del primer estudio ha sido analizar las tasas de prevalencia de trauma psicológico en pacientes con patología dual y compararlos con pacientes con solo un TRS, así como analizar las características del trauma psicológico y su relación con variables clínicas y de consumo. El objetivo del segundo estudio ha sido probar la eficacia de la terapia EMDR, en pacientes con TRS o un trastorno dual y antecedentes de trauma psicológico, en relación con la reducción del consumo de sustancias como en la mejora de los síntomas psicológicos relacionados con el trauma, los síntomas psicopatológicos y la funcionalidad general de estos pacientes. En el primer estudio se reclutaron 150 pacientes hospitalizados en 3 unidades de patología dual y se evaluaron transversalmente en relación con la gravedad del consumo de sustancias, los síntomas de trauma psicológico, las comorbilidades y la gravedad clínica. 100 pacientes cumplieron los criterios de un diagnostico dual y 50 pacientes fueron diagnosticados solo de un TRS. La muestra del segundo estudio incluyo 37 pacientes ambulatorios con un TRS y antecedentes de trauma psicológico que fueron aleatorizados y asignados a la rama EMDR+TAU (n=19} o de tratamiento habitual (TAU} (n=18}. La aleatorización se realizo teniendo en cuenta el centro, la edad, el sexo, el diagnostico (duales vs no duales) y el numero de sustancias consumidas en el ultimo mes. Los pacientes del grupo EMDR+TAU recibieron 20 sesiones de 60 minutos de duración durante 6 meses. La evaluación se realizó en el momento basal, post-tratamiento y en la visita de seguimiento al año. Adicionalmente, el uso de sustancias se midió a los 3 meses de la inclusion en el estudio. Los resultados del primer trabajo mostraron que de toda la muestra un 94% refirió haber sufrido como mínimo un evento estresante a lo largo de la vida y un 20% cumplió criterios diagnosticas para el trastorno de estrés postraumático (TEPT}. Los pacientes con patología dual presentaron mas eventos adversos, mas trauma infantil, mas síntomas disociativos y un perfil clínico mas grave que los pacientes con solo un TRS. Los datos mostraron que el maltrato infantil fue un predictor para desarrollar un diagnostico dual. Los resultados del segundo estudio mostraron una disminución significativa tanto en los niveles de perturbación y del impacto del trauma como en los síntomas de evitación, de hiperactivación y de disociación en el grupo EMDR+TAU en comparación con el grupo TAU en la visita postratamiento. Sin embargo, no se hallaron diferencias significativas en la reducción del consumo de sustancias entre los grupos. En conclusion, nuestros resultados desafían la practica clínica habitual, al demostrar el impacto negativo que tiene el trauma psicológico en los pacientes diagnosticados de un trastorno dual o solo un TRS. Por ello, hay que destacar la importancia de implementar evaluaciones exhaustivas e incorporar terapias adicionales centradas en el trauma para mejorar el pronostico y el curso de la enfermedad en estos pacientes., [eng] Psychological trauma has been identified as a risk factor far the initiation, course, and prognosis of substance-related disorders (SRD). However, data on its prevalence and clinical impact in dual disorders are scarce and inconclusive. Furthermore, there is little evidence of interventions focused on psychological trauma in this population. Previous studies, in which eye movement desensitization and reprocessing therapy (EMDR) has been applied, have shown positive results in terms of improving clinical symptoms in patients with SRD however, to date there have been no studies with dual patients. Likewise, these studies have important methodological limitations, which is why it is necessary to carry out more randomized controlled clinical trials with larger samples. This thesis aims to deepen the knowledge of the prevalence of psychological trauma and its treatment in patients both diagnosed with SRD and with a dual disorder. Far this, two independent studies have been carried out, both múltiple centers. The objective of the first study was to analyze the prevalence rates of psychological trauma in patients with dual pathology and to compare them with patients with only SRD, as well as to analyze the characteristics of psychological trauma and its relationship with clinical and consumption variables. The objective of the second study was to test the efficacy of EMDR therapy, in patients with SRD ora dual disorder as well as a history of psychological trauma, in relation to the reduction of substance use, the improvement of trauma-related psychological symptoms, the psychopathological symptoms and the general functionality of these patients. In the first study, 150 inpatients in 3 dual pathology units were recruited and cross-sectionally evaluated in relation to the severity of substance use, symptoms of psychological trauma, comorbidities, and clinical severity. 100 patients met the criteria far a dual diagnosis and 50 patients were diagnosed with SRD alone. The sample from the second study included 37 outpatients with SRD anda history of psychological trauma who were randomized and assigned to the EMDR+TAU (n=19) or usual treatment (TAU) (n=18). The randomization was carried out taking into account the center, age, sex, diagnosis (dual vs. non-dual) and the number of substances consumed in the last month. Patients in the EMDR+TAU group received twenty 60-minute sessions over 6 months. The evaluation was carried out at baseline, post-treatment, and at the one-year fallow-up visit. Additionally, substance use was measured 3 months after inclusion in the study. The results of the first study showed that, of the entire sample, 94% reported having suffered at least one stressful event throughout their lives and 20% met diagnostic criteria far post-traumatic stress disorder (PTSD). Patients with dual pathology presented more adverse events, more childhood trauma, more dissociative symptoms, and a more severe clinical profile than patients with only SRD. The data showed that child abuse was a predictor far developing a dual diagnosis. The results of the second study showed a significant decrease in both the levels of disturbance and the impact of trauma, and in the symptoms of avoidance, hyperarousal and dissociation in the EMDR+TAU group compared to the TAU group at the post-treatment visit. However, no significant differences were found in the reduction of substance use between the groups. In conclusion, our results challenge routine clinical practice, by demonstrating the negative impact that psychological trauma has on patients diagnosed with a dual disorder or justa SRD. Therefore, the importance of implementing comprehensive evaluations and incorporating additional trauma-focused therapies to improve the prognosis and course of the disease in these patients should be emphasized.

Gambling disorder (GD) is a modestly prevalent and severe condition for which neurobiology is not yet fully understood. Although alterations in signals involved in energy homeostasis have been studied in substance use disorders, they have yet to be examined in detail in GD. The aims of the present study were to compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC) and to explore endocrine interactions with neuropsychological and clinical variables. A case–control design was performed in 297 individuals with GD and 41 individuals without (healthy controls; HCs), assessed through a semi-structured clinical interview and a psychometric battery. For the evaluation of endocrine and anthropometric variables, 38 HCs were added to the 41 HCs initially evaluated. Individuals with GD presented higher fasting plasma ghrelin (p < 0.001) and lower LEAP2 and adiponectin concentrations (p < 0.001) than HCs, after adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in the GD group, some impaired cognitive dimensions (i.e., WAIS Vocabulary test and WCST Perseverative errors) and lower LEAP2 concentrations statistically predicted GD presence. The findings from the present study suggest that distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD and predict GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.

Addiccions comportamentals; Conductes; Prevalença Adicciones comportamentales; Conductas; Prevalencia Behavioral addictions; Prevalence; Behaviors En aquest informe es presenten els resultats de la prevalença de les conductes que poden generar un problema o una addicció comportamental en la població de Catalunya a partir de les dades de les dues enquestes estatals biennals en anys alterns que es duen a terme conjuntament amb el Plan Nacional sobre Drogas: una enquesta s’adreça a la població general ─Enquesta domiciliària sobre alcohol i drogues a Espanya (EDADES)─ i l’altra està enfocada a la població escolar ─Enquesta estatal sobre l’ús de drogues en ensenyaments secundaris (ESTUDES).

According to the food addiction (FA) model, the consumption of certain types of food could be potentially addictive and can lead to changes in intake regulation. We aimed to describe metabolic parameters, dietary characteristics, and affective and neurocognitive vulnerabilities of individuals with and without FA, and to explore its influences on weight loss progression. The sample included 448 adults (55-75 years) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus cognition sub-study. Cognitive and psychopathological assessments, as well as dietary, biochemical, and metabolic measurements, were assessed at baseline. Weight progression was evaluated after a 3-year follow up. The presence of FA was associated with higher depressive symptomatology, neurocognitive decline, low quality of life, high body mass index (BMI), and high waist circumference, but not with metabolic comorbidities. No differences were observed in the dietary characteristics except for the saturated and monounsaturated fatty acids consumption. After three years, the presence of FA at baseline resulted in a significantly higher weight regain. FA is associated with worse psychological and neurocognitive state and higher weight regain in adults with metabolic syndrome. This condition could be an indicator of bad prognosis in the search for a successful weight loss process. We thank CERCA Programme/Generalitat de Catalunya for institutional support and partial support was also provided by SLT006/17/00246, funded by the Department of Health of the Generalitat de Catalunya by the calls “Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut” and “Pla estratègic de recerca i innovació en salut (PERIS)”. This research was also partially funded by EU-H2020 Grants (Eat2beNICE/ H2020-SFS-2016-2; Ref 728018; and PRIME/ H2020-SC1-BHC-2018-2020; Ref: 847879). IP-G receives a grant from the Spanish Ministry of Education, Culture and Sports (FPU 17/01925). C.G.-M. receives a predoctoral grant from the University of Rovira i Virgili (2020PMF-PIPF-37); J.S-S. is partially supported by ICREA under the ICREA Academia program.

[spa] Esta tesis busca contribuir al estudio de los correlatos neurobiológicos de los síntomas obsesivos-compulsivos subclínicos (SOCS) con la esperanza de que sus hallazgos puedan ser eventualmente vinculados al desarrollo del trastorno obsesivo-compulsivo (TOC) y servir para identificar individuos vulnerables a desarrollarlo. Para ello, presentamos tres estudios realizados en una muestra de niños sanos, en los que utilizamos un enfoque multidimensional de los síntomas e implementamos distintas modalidades de neuroimagen, así como la combinación de datos de neuroimagen y genética, para aportar una visión integral de los factores que subyacen los SOCS. En el primer estudio, analizamos cambios volumétricos en la sustancia gris y blanca asociados a los SOCS y, en el segundo, evaluamos alteraciones de conectividad funcional asociadas a estos síntomas. En ambos, estudiamos el efecto de la edad y el sexo en dichas asociaciones. Finalmente, en el tercer estudio, identificamos nodos cerebrales en los que la conectividad funcional dinámica tiende a reverberar (atractores) y estudiamos su relación con los SOCS y su base genética. Nuestros resultados vinculan los SOCS totales con alteraciones en el circuito cortico-estriato- talamo-cortical (CSTC), hecho que concuerda con el modelo neurobiológico del TOC, pero también en regiones límbicas fuera de este circuito. También observamos que diferentes síntomas se asocian a alteraciones neurobiológicas distintas, lo que coincide con el modelo multidimensional del trastorno. Además, encontramos que los cambios estructurales relacionados con los síntomas de orden eran específicos de niños menores de 10 años, mientras que los cambios estructurales y funcionales asociados con los síntomas de acumulación eran específicos de sujetos de más de 10 años, especialmente en niñas, lo que sugiere que estos grupos demográficos pueden ser especialmente vulnerables a desarrollar dichos síntomas. Finalmente, identificamos polimorfismos en los genes GRM7 y GNAQ, implicados en la modulación de la neurotransmisión glutamatérgica, y PARVA, asociado a la regulación del citoesqueleto de actina, que predisponen al aumento de la capacidad atractora del hipocampo, vinculada a los SOCS totales. Del mismo modo, hallamos polimorfismos en los genes ATP1B1 y TESC, implicados en el mantenimiento de gradientes electroquímicos, que predisponen y protegen, respectivamente, al aumento de las propiedades atractoras del córtex parietal superior, relacionadas con los síntomas de orden., [eng] Obsessive-compulsive disorder (OCD) is characterized by the presence of intrusive thoughts that cause anxiety (obsessions) and lead to repetitive behaviors or mental acts aimed at reducing this anxiety (compulsions). Although OCD has been associated with alterations in the cortico-striato- thalamo-cortical (CSTC) circuits, the clinical heterogeneity of the disorder makes its neurobiology difficult to investigate. Given that the evidence suggests that different OCD symptoms could arise from distinct neurobiological alterations, the use of the multidimensional model, which allows characterizing different symptom dimensions, could help define more homogeneous subgroups of patients and identify more robust endophenotypes. However, the studies that have used this approach have given heterogeneous findings, possibly due to differences between patients in terms of medication, chronicity, or comorbidities. Notably, epidemiological studies show that obsessive-compulsive symptoms (OCSs) in childhood predispose to developing OCD in adulthood. Furthermore, the symptom profile observed in adulthood is consistent with the same symptom precursors in childhood. Therefore, OCSs could be studied in samples of healthy children from a dimensional perspective, thus avoiding the confounding factors typically observed in clinical samples. This thesis seeks to contribute to the study of the neurobiological correlates of OCSs in hopes that its findings may eventually be linked to the development of OCD and serve to characterize at-risk individuals. With that aim, we present three studies assessing a sample of healthy children, in which we use a multidimensional approach and implement different neuroimaging modalities and techniques, as well as the combination of neuroimaging and genetic data, to provide a comprehensive view of the factors underlying OCSs. In the first study, we analyzed volumetric changes in gray and white matter associated with total and dimensional OCSs whereas, in the second one, we evaluated functional connectivity alterations associated with total and dimensional OCSs. In both studies, we also assessed the effect of age and sex on these associations. In the third one, we identified brain nodes in which dynamic functional connectivity tends to reverberate (attractors) and we studied their relationship with total and dimensional OCSs. Furthermore, by combining neuroimaging and gene expression data, we identified genetic variants that moderated the relationship between OCSs and attractors. Our results link total OCSs with alterations in the CSTC circuit, which concurs with the prevailing neurobiological model of OCD, but also in limbic regions outside of this circuit. We also observed that different symptoms were associated with distinct neurobiological alterations: obsessing symptoms were related to alterations in limbic regions; doubt/checking symptoms were associated with changes in the ventral cognitive CSTC loop, the insula and regions mediating frontal processing; ordering symptoms were associated with alterations in the ventral cognitive and sensorimotor CSTC loops and the superior parietal cortex; hoarding symptoms were related to alterations in different CSTC loops, suggesting a larger CSTC alteration. Structural changes related to ordering symptoms were specific to boys under 10 years of age, whereas structural and functional changes associated with hoarding symptoms were specific to children over 10 years of age, especially to girls, which suggests that these demographic groups may be more susceptible to developing such symptoms. Finally, we identified polymorphisms in the GRM7 and GNAQ genes, involved in the modulation of glutamate neurotransmission, and in the PARVA gene, associated with the regulation of the actin cytoskeleton, that predisposed to an increase in the attractor properties of the hippocampus, linked to total OCSs. We also found polymorphisms in the ATP1B1 and TESC genes, involved in the maintenance of electrochemical gradients, that predisposed and protected, respectively, to an increase in the attractor properties of the superior parietal cortex, related to ordering symptoms.

Tractament; Addiccions comportamentals; Addicció Tratamiento; Adicciones comportamentales; Adicción Treatment; Behavioral addictions; Addiction L’objectiu principal de la informació recollida per l’indicador ‘Inicis de tractament per addiccions comportamentals o sense substància’ és descriure la situació i la tendència temporal de les característiques sociodemogràfiques, els patrons de comportament i els problemes associats de les persones que inicien tractament per trastorns comportamentals no relacionats amb substàncies químiques. Un altre objectiu és contribuir, juntament amb altres indicadors (indicador ‘Inicis de tractament, enquestes d’estudiants i de la població general’), a entendre millor la situació global de les addiccions a Catalunya amb la finalitat d’aportar informació útil per dissenyar i implementar polítiques públiques en aquest marc. La informació sol·licitada per a aquest indicador s’hauria de recopilar poc després que el pacient contacti amb els centres de tractament, habitualment en el moment d’inici del tractament. La informació obtinguda en cada inici de tractament hauria de reflectir els patrons de comportament abans de l’impacte que pugui tenir el tractament en les addiccions o els problemes comportamentals en el pacient.

The rapid advance of the coronavirus COVID-19 pandemic has significantly increased mortality but also has demonstrated considerable potential to negatively impact mental health, including in the young [1,2]. From a public mental health perspective, guidelines for responding to mass trauma and disaster emphasize the importance of focusing on resilience. In the immediate and ongoing response, consensus guidelines emphasize the importance of interventions that maintain calm, build community, and sustain hope [3,4]. ISSN:0010-440X ISSN:1532-8384

Brain structural covariance networks reflect covariation in morphology of different brain areas and are thought to reflect common trajectories in brain development and maturation. Large-scale investigation of structural covariance networks in obsessive-compulsive disorder (OCD) may provide clues to the pathophysiology of this neurodevelopmental disorder. Using T1-weighted MRI scans acquired from 1616 individuals with OCD and 1463 healthy controls across 37 datasets participating in the ENIGMA-OCD Working Group, we calculated intra-individual brain structural covariance networks (using the bilaterally-averaged values of 33 cortical surface areas, 33 cortical thickness values, and six subcortical volumes), in which edge weights were proportional to the similarity between two brain morphological features in terms of deviation from healthy controls (i.e. z-score transformed). Global networks were characterized using measures of network segregation (clustering and modularity), network integration (global efficiency), and their balance (small-worldness), and their community membership was assessed. Hub profiling of regional networks was undertaken using measures of betweenness, closeness, and eigenvector centrality. Individually calculated network measures were integrated across the 37 datasets using a meta-analytical approach. These network measures were summated across the network density range of K = 0.10-0.25 per participant, and were integrated across the 37 datasets using a meta-analytical approach. Compared with healthy controls, at a global level, the structural covariance networks of OCD showed lower clustering (P

Background and aims The main aim of this study was to analyze and describe the clinical characteristics and shared personality traits in different impulsivity–compulsivity spectrum disorders: substance use disorders (SUD), gambling disorder (GD), and bulimia nervosa (BN). The specific aims were to compare personality differences among individuals with pure SUD, BN with and without SUD, and GD with and without SUD. In addition, we assessed the differential predictive capacity of clinical and personality variables in relation to diagnostic subtype. Methods The sample comprised 998 subjects diagnosed according to DSM-IV-TR criteria: 101 patients were diagnosed with SUD, 482 with GD, 359 with BN, 11 with GD + SUD, and 45 patients with BN + SUD. Various assessment instruments were administered, as well as other clinical measures, to evaluate their predictive capacity. Results Marked differences in personality traits were observed between groups. Novelty seeking, harm avoidance, self-directedness, cooperation, and self-transcendence best differentiated the groups. Notably, novelty seeking was significantly higher in the two dual pathology subgroups. Patients with dual pathology showed the most dysfunctional personality profiles. Discussion and conclusion Our results indicate the existence of shared dysfunctional personality traits among the groups studied, especially in novelty seeking and self-directedness.

Background Behavioral addiction (BA) is a recent concept in psychiatry. Few studies have investigated the relationship between BA and early maladaptive schemas (EMSs). EMS is the core of Schema Therapy (ST). According to the ST model, psychiatric disorders result from the development of EMSs in response to unmet emotional needs in childhood. Bach et al. (2018) grouped the 18 EMSs into four domains: (1) disconnection and rejection; (2) impaired autonomy and performance; (3) excessive responsibility and standards; and (4) impaired limits. This study aims to assess the possible association of the most frequent BAs with EMSs in a large group of late adolescents and young adults and to evaluate their self-perceived quality of life (QoL). Methods A battery of psychological tests assessing food addiction (FA), gambling disorder (GD), internet addiction (IA), and QoL was administered to 1,075 late adolescents and young adults (N = 637; 59.3% women). A forward-stepwise logistic regression model was run to identify which variables were associated with BAs. Results Food addiction was more frequent among women and GD among men, while IA was equally distributed. Regarding the EMSs, participants with FA or IA showed significantly higher scores on all four-schema domains, whereas those with GD exhibited higher scores on impaired autonomy and performance and impaired limits. Besides, average scores of all domains increased with the association of two or more comorbid BAs. Self-perceived QoL was lower for participants with FA and IA, but not for those with GD; the presence of comorbid BAs was associated with lower Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Finally, specific EMS domains and demographic variables were associated with each BA. Conclusion Late adolescents and young adults with FA or IA have a lower perception of their mental and physical health. The most striking result is that FA appears to be associated with the disconnection and rejection schema domain, IA with all the schema domains (except for impaired autonomy and performance), and GD with impaired autonomy and performance schema domain. In conclusion, our findings suggest that EMS should be systematically assessed during psychotherapy of patients with BAs.

BACKGROUND: The severity of Obsessive-Compulsive Disorder (OCD) varies significantly among probands. No study has specifically investigated the genetic base of OCD severity. A previous study from our group found an OCD polygenic risk score to predict pre- and post-treatment severity. This study explores the genomic bases of OCD severity. METHODS: We administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to 401 patients at their first visit to our clinic to measure their OCD severity. Genotyping data was collected by using the Infinium PsychArray-24 BeadChip kit (Illumina). We analyzed genetic association with OCD severity in a linear regression analysis at single-nucleotide polymorphism (SNP)- and gene-levels, this last also considering rare variants. Enrichment analyses were performed from gene-based analyses' results. RESULTS: No SNP reached significant association (p < 10-8) with the YBOCS. Six markers showed suggestive association (p < 10-5). The top SNP was an intergenic variant in chromosome 2: rs7578149 (p < 1.89 × 10-6), located in a region suggestively associated with MDD. Linkage disequilibrium was found for two clusters of SNPs located between SLC16A14 and SP110 in chromosome 2, all of them forming one peak of association. Enrichment analyses revealed OCD genes to be associated with porin activity (FDR = 0.01) and transmembrane structure (FDR = 0.04). LIMITATIONS: The size of the sample and the transversal nature of the severity measure are limitations of this study. CONCLUSION: This study contributes to better characterize OCD at an individual level, helping to know more about the prognosis of the disorder and develop more individualized treatments This study was supported in part by the Carlos III Health Institute (PI16/00950, PI18/00856); FEDER funds (‘A way to build Europe’) and by the Agency for Management of University and Research Grants of the Catalan Government (2014SGR1672). MA was supported by the Secretariat for Universities and Research of the Ministry of Business and Knowledge of the Government of Catalonia. Grant co-funded by the European Social Fund (ESF) “ESF, Investing in your future” (2017 FI_B 00327). ER was supported by a Juan Rodés contract (JR14/00038)

In this position statement, developed by The International College of Obsessive-Compulsive Spectrum Disorders, a group of international experts responds to recent developments in the evidence-based management of obsessive-compulsive disorder (OCD). The article presents those selected therapeutic advances judged to be of utmost relevance to the treatment of OCD, based on new and emerging evidence from clinical and translational science. Areas covered include refinement in the methods of clinical assessment, the importance of early intervention based on new staging models and the need to provide sustained well-being involving effective relapse prevention. The relative benefits of psychological, pharmacological and somatic treatments are reviewed and novel treatment strategies for difficult to treat OCD, including neurostimulation, as well as new areas for research such as problematic internet use, novel digital interventions, immunological therapies, pharmacogenetics and novel forms of psychotherapy are discussed., International Clinical Psychopharmacology, 35 (4), ISSN:0268-1315, ISSN:1473-5857

Este trabajo de investigación contiene elementos de juicio a partir de un problema que estamos viendo en la sociedad actualmente y en particular en Colombia, la publicidad que es trasmitida en eventos deportivos y en general en todos los medios de comunicación está llevando a las personas a generar hábitos de ludopatía ocasionados por realizar apuestas en línea. Por lo anterior, nuestro trabajo se basó en traer a colación el marco teórico para entender acerca de la Ludopatía y de una metodología de investigación a partir de encuestas a varias personas y una entrevista a un psicólogo especialista en casos de ludopatía, para evaluar si la publicidad trasmitida en eventos deportivos incita a las personas a realizar apuestas en línea y en consecuencia aumenta la población de personas con ludopatía por apuestas deportivas. This research work contains elements of judgment based on a problem that we are seeing in society today and in particular in Colombia, the advertising that is transmitted in sporting events and in general in all the media is leading people to generate Gambling habits caused by placing bets online. Therefore, our work was based on bringing up the theoretical framework to understand about Gambling and a research methodology based on surveys of several people and an interview with a psychologist specializing in gambling, to assess whether the Advertising broadcast at sporting events encourages people to place bets online and consequently increases the population of people with gambling for sports betting. Especialista en Gerencia de Mercadeo

Background: Empirical data suggests a high comorbid occurrence of eating disorders (EDs) and substance use disorders (SUDs), as well as neurological and psychological shared characteristics. However, no prior study has identified the neuropsychological features of this subgroup. This study examines the prevalence of alcohol and/or drug abuse (A/DA) symptoms in ED patients. It also compares the clinical features and neuropsychological performance of ED patients with and without A/DA symptoms. Methods: 145 participants (74.5% females) with various forms of diagnosed EDs underwent a comprehensive clinical (TCI-R, SCL-90-R and EDI-2) and neuropsychological assessment (Stroop, WCST and IGT). Results: Approximately 19% of ED patients (across ED subtypes) had A/DA symptoms. Those with A/DA symptoms showed more impulsive behaviours and higher levels of interoceptive awareness (EDI-2), somatisation (SCL-90-R) and novelty seeking (TCI-R). This group also had a lower score in the Stroop-words measure, made more perseverative errors in the WCST and showed a weaker learning trajectory in the IGT. Conclusions: ED patients with A/DA symptoms display a specific phenotype characterised by greater impulsive personality, emotional dysregulation and problems with executive control. Patients with these temperamental traits may be at high risk of developing a SUD.

[eng] Dimensional theoretical models suggest that gambling disorder and eating disorders have two essential shared risk factors: impulsivity and compulsivity. In order to delve into the association between these factors, the main objectives of this thesis were: To study the interaction between different types of impulsivity in gambling and eating disorders. To evaluate the association between impulsivity and DSM-5 criteria used for the diagnosis of gambling disorder, the criterion of illegal acts and the three levels of severity of the disorder. To examine dimensions of compulsivity and the interaction between them and impulsivity levels in the specific case of the gambling disorder. The following conclusions can be drawn: 1) Clinical heterogeneity has been observed, especially taking into account impulsivity levels, between patients with anorexia nervosa of the restrictive subtype and anorexia nervosa of the binge eating/purge subtype. Therefore, the importance of separating the two subtypes of anorexia nervosa is confirmed. 2) Impulsivity and compulsivity can be considered two independent domains in gambling disorder, supporting the dimensional perspective of the impulsive-compulsive spectrum. 3) The multifactorial nature of both domains has been tested. 4) Impulsivity and compulsivity do not contribute to gambling disorder equitably, and impulsivity is more strongly associated with the disorder. 5) All dimensions of impulsivity seem to be interrelated. 6) An association between choice and trait impulsivity has been observed in young patients, corroborating that age is a key factor. 7) Response impulsivity is not significantly associated with the severity of gambling disorder. 8) There is a proven association between impulsivity, gambling disorder, and the commission of criminal acts related to gambling behavior. 9) Impulsive traits may be related to response to treatment for gambling disorder. 10) It was not possible to demonstrate that greater severity was associated with better treatment response, which would question the clinical applicability of DSM-5 criteria., [spa] Los modelos teóricos dimensionales sugieren que el trastorno del juego y los trastornos de la conducta alimentaria tienen dos factores de riesgo compartidos esenciales: impulsividad y compulsividad. Para ahondar en la asociación entre estos factores, los principales objetivos de esta tesis fueron: Estudiar la interacción entre los diferentes tipos de impulsividad en el trastorno de juego y los trastornos de la conducta alimentaria. Evaluar la asociación entre la impulsividad y los criterios del DSM-5 utilizados para el diagnóstico del trastorno del juego, específicamente el criterio de actos ilegales y los tres niveles de gravedad del trastorno. Examinar las dimensiones de la compulsividad y la interacción entre ellas y los niveles de impulsividad en el caso específico del trastorno del juego. Se concluyó: 1) Se ha observado heterogeneidad clínica, especialmente teniendo en cuenta los niveles de impulsividad, entre pacientes con anorexia nerviosa del subtipo restrictivo y anorexia nerviosa del subtipo bulímico-purgativo. Por lo tanto, se confirma la importancia de separar los dos subtipos de anorexia nerviosa. 2) La impulsividad y la compulsividad pueden considerarse dos dominios independientes en el trastorno del juego, apoyando la perspectiva dimensional del espectro impulsivo compulsivo. 3) Se ha comprobado el carácter multifactorial de ambos constructos. 4) La impulsividad y la compulsividad no contribuyen al trastorno del juego de manera equitativa, siendo la impulsividad la más fuertemente asociada al trastorno. 5) Todas las dimensiones de la impulsividad parecen estar interrelacionadas. 6) Se ha observado una asociación entre la impulsividad de elección y la impulsividad rasgo en pacientes jóvenes, corroborando que la edad es un factor esencial. 7) La impulsividad de respuesta no está asociada significativamente con la gravedad del trastorno del juego. 8) Existe una asociación entre la impulsividad, el trastorno del juego y la comisión de delitos relacionados con la conducta de juego. 9) Los rasgos impulsivos están relacionados con la respuesta al tratamiento para el trastorno de juego. 10) No fue posible demostrar que una mayor gravedad estaba asociada con una mejor respuesta al tratamiento, lo que cuestionaría la aplicabilidad clínica de los criterios del DSM-5.

ilustraciones, gráficos, tablas ; 28 cm. Este artículo se desarrolló con base en el análisis de distintas referencias de trabajos investigativos previos acerca de las conductas adictivas. Se busca dar al lector una base para la implementación de actividades que permitan generar factores protectores que mitiguen el impacto de los factores de riesgo para el desarrollo de conductas adictivas en su núcleo familiar. This article was developed based on the analysis of different references of previous research papers about addictive behaviors. It seeks to give the reader a basis for the implementation of activities that allow generating protective factors that mitigate the impact of risk factors for the development of addictive behaviors in their family nucleus. Pregrado Psicólogo Psicología

21 Páginas ; 28 cm. La ansiedad en la vida del ser humano permite el impulso de acciones dependiendo el contexto en el cual se encuentra en el tiempo, se codifica y crea un desajuste. El siguiente artículo hace una reflexión que va desde lo general, partiendo del concepto del Trastorno Obsesivo Compulsivo, sus factores desencadenantes, factores de mantenimiento, sintomatología; también se ilustran las raíces de la Terapia Cognitivo Conductual (TCC) haciendo un breve recorrido histórico de su formación, y termina en lo particular aterrizando la TCC en el manejo terapéutico y su intervención frente al Trastorno Obsesivo Compulsivo (TOC) en el individuo adulto. Consideraciones generales.-- Pregunta de investigación.-- Objetivo de investigación.-- Justificación.-- Marco referencial.-- Metodología.-- Resultados.-- Conclusiones.-- Recomendaciones.-- Bibliografía. Pregrado Psicólogo Psicología

Este estudio investiga el valor predictivo de la impulsividad como rasgo (evaluada con la escala de conducta impulsiva UPPS-P) y de covariados relevantes (variables sociodemográficas, severidad del juego de azar, estado de ánimo disfórico, otras conductas adictivas e inteligencia no verbal), con respecto al abandono del tratamiento y los niveles de cumplimiento de las prescripciones terapéuticas en pacientes con trastorno por juego de azar. Sesenta y seis pacientes con este trastorno, participantes del proyecto G-Brain, fueron evaluados inicialmente en impulsividad rasgo y en los covariados mencionados. Dicha evaluación se realizó durante los seis primeros meses desde el inicio de su tratamiento. En el seguimiento realizado a los 6 meses, 24 pacientes habían abandonado (grupo ABD) y 42 continuaban el tratamiento (grupo NABD). Los análisis multivariados con las subescalas de impulsividad mostraron diferencias prospectivas entre ambos grupos. Aparentemente, estas diferencias son atribuibles a las dimensiones afectivas de impulsividad (urgencias positiva y negativa). Entre ambas dimensiones, solo la urgencia positiva fue un predictor independiente de un ligero incremento en la probabilidad de abandono. Dentro del grupo NABD, un mayor grado de adherencia terapéutica vino predicho, de manera independiente, tanto por una baja búsqueda de sensaciones como por una mayor conciencia de los problemas vinculados al juego. Estos resultados sugieren que los rasgos de impulsividad de origen afectivo son predictores de abandono del tratamiento en pacientes con trastorno por juego. La conciencia de problemas asociados al juego de azar y una baja búsqueda de sensaciones predisponen a una mayor adherencia a las prescripciones terapéuticas., This study investigates the predictive value of impulsivity traits (as measured by the UPPS-P impulsive behaviour scale) and relevant covariates (sociodemographics, gambling severity, dysphoric mood, other potentially addictive behaviours, and non-verbal intelligence) with regard to treatment dropout and level of adherence to therapy guidelines and instructions in patients with gambling disorder. Sixtysix patients seeking treatment for gambling disorder, and recruited to participate in a larger protocol (G-Brain), were initially assessed in impulsivity traits and relevant covariates in the first six months after admission. 24 patients dropped out (DO) and 42 patients remained in therapy (NDO) during the subsequent 6-month follow-up period. A multivariate analysis of impulsivity subscales suggested prospective differences between DO and NDO, with affect-driven dimensions (positive and negative urgency) seemingly driving these differences. Among these, only positive urgency independently predicted a slight increase in the drop-out probability. In the NDO group, a higher degree of adherence to therapy was independently predicted by lower sensation-seeking scores and stronger awareness of gambling-related problems. Results suggest the presence of affect-driven impulsivity traits as dropout predictors in patients with gambling disorder. Awareness of gambling-related problems and lower sensation-seeking enhanced compliance with therapeutic guidelines and instructions.

The Internet is now all-pervasive across much of the globe. While it has positive uses (e.g. prompt access to information, rapid news dissemination), many individuals develop Problematic Use of the Internet (PUI), an umbrella term incorporating a range of repetitive impairing behaviours. The Internet can act as a conduit for, and may contribute to, functionally impairing behaviours including excessive and compulsive video gaming, compulsive sexual behaviour, buying, gambling, streaming or social networks use. There is growing public and National health authority concern about the health and societal costs of PUI across the lifespan. Gaming Disorder is being considered for inclusion as a mental disorder in diagnostic classification systems, and was listed in the ICD-11 version released for consideration by Member States (http://www.who.int/classifications/icd/revision/timeline/en/). More research is needed into disorder definitions, validation of clinical tools, prevalence, clinical parameters, brain-based biology, socio-health-economic impact, and empirically validated intervention and policy approaches. Potential cultural differences in the magnitudes and natures of types and patterns of PUI need to be better understood, to inform optimal health policy and service development. To this end, the EU under Horizon 2020 has launched a new four-year European Cooperation in Science and Technology (COST) Action Programme (CA 16207), bringing together scientists and clinicians from across the fields of impulsive, compulsive, and addictive disorders, to advance networked interdisciplinary research into PUI across Europe and beyond, ultimately seeking to inform regulatory policies and clinical practice. This paper describes nine critical and achievable research priorities identified by the Network, needed in order to advance understanding of PUI, with a view towards identifying vulnerable individuals for early intervention. The network shall enable collaborative research networks, shared multinational databases, multicentre studies and joint publications. ISSN:0924-977X ISSN:1873-7862

Background: Emotion (dys)regulation as well as the interventions for improving these difficulties have received growing attention in the literature. The aim of the present paper was to systematically review current evidence on the clinical changes and benefits related to mindfulness-based interventions (MBIs) in both substance and behavioral addictions. Method: A literature search was conducted using Cochrane, PubMed and Web of Science. Fifty-four randomized controlled trials published in English since 2009 to April 2017 were included into a narrative synthesis. Results: MBIs were applied in a wide range of addictions, including substance use disorders (from smoking to alcohol, among others) and behavioral addictions (namely gambling disorder). These treatments were successful for reducing dependence, craving and other addiction-related symptoms by also improving mood state and emotion dysregulation. Among the most commonly used MBIs approaches were: Mindfulness-Based Relapse Prevention (MBRP), Mindfulness Training for Smokers (MTS) or Mindfulness-Oriented Recovery Enhancement (MORE) and the most frequent control group in the included studies was Treatment as Usual (TAU). The most effective approach was the combination de MBIs with TAU or other active treatment. However, there is a lack of studies showing the maintenance of the effect over time. Therfore, studies with longer follow-ups are needed. Conclusions: The revised literature shows support for the effectiveness of the mindfulness-based interventions. Future research should focus on longer follow-up assessments as well as on adolescence and young population, as they are a vulnerable population for developing problems associated with alcohol, drugs or other addictions. Key words: mindfulness, addiction, behavioral addiction, substance use, gambling.

A major problem in treating obesity is the high rate of relapse to abnormal food-taking habits after maintaining an energy balanced diet. Alterations of eating behavior such as compulsive-like behavior and lack of self-control over food intake play a critical role in relapse. In this study, we used an operant paradigm of food-seeking behavior on two different diet-induced obesity models, a free-choice chocolate-mixture diet and a high-fat diet with face validity for a rapid development of obesity or for unhealthy food regularly consumed in our societies. A reduced operant performance and motivation for the hedonic value of palatable chocolate pellets was revealed in both obesity mouse models. However, only mice exposed to high-fat diet showed an increased compulsive-like behavior in the absence of the reinforcer further characterized by impaired operant learning, enhanced impulsivity and intensified inflexibility. We used principal component analysis to globally identify the specific behaviors responsible for the differences among diet groups. Learning impairment and inflexible behaviors contributed to a first principal component, explaining the largest proportion of the variance in the high-fat diet mice phenotype. Reinforcement, impulsion and compulsion were the main contributors to the second principal component explaining the differences in the chocolate-mixture mice behavioral phenotype. These behaviors were not exclusive of chocolate group because some high-fat individuals showed similar values on this component. These data indicate that extended access to hypercaloric diets differentially modifies operant behavior learning, behavioral flexibility, impulsive-like and compulsive-like behavior, and these effects were dependent on the exposure to each specific diet. This work was supported by the DG Research of the European Commission FP7 (#HEALTH-F2 2013-602891 and PHECOMP #LHSM-CT-2007-037669), the Spanish ‘RETICS-Instituto de Salud Carlos III’ (#RD16/0017/0020), the Spanish ‘Ministerio de Economia y Competitividad’ (#SAF-2014-59648P), the ‘Plan nacional sobre drogas’ (#PNSD-2013-5068), the Catalan Government ‘AGAUR-Generalitat de Catalunya’ (#2014-SGR-1547) and the Catalan foundation ‘La Marató de TV3’ (#2016/20-30). The laboratory of M.D. is supported by DIUE de la Generalitat de Catalunya (Grups consolidats SGR 2014/1125). This work was supported by Fondation Jérôme Lejeune (Paris, France), MINECO (SAF2013-49129-C2-1-R), CDTI (‘Smartfoods’) and EU (Era Net Neuron PCIN-2013-060). The CRG is a Center of Excellence Severo Ochoa SEV-2012-0208. The CIBER of Rare Diseases is an initiative of the ISCIII. The laboratory of C.N. acknowledges the funding from the Spanish Ministry of Economy and Finance (MINECO), grant number BFU2011-28575. J.E. receivedthe FI grant from Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR) de la Generalitat de Catalunya

11 páginas. El siguiente escrito se refiere a la adicional trabajo , un problema que indudablemente tiene consecuencias claras sobre la salud de quienes la sufren y sobre su calidad productiva, por tanto el objetivo de este contenido es presentar al lector las posibles acciones a nivel empresarial y gerencial sobre el manejo de esta adicción, la cual se viene presentando cada vez con mayor incidencia , además se hará referencia a las posibles consecuencias que este suceso puede llegar a tener no solo en el desempeño laboral sino también a nivel personal, grupal y familiar. En este escrito se hace referencia al papel que juega el gerente en el tratamiento y prevención de la adicción al trabajo. The following writing refers to the additional work, a problem that undoubtedly has clear consequences on the health of those who suffer it and on its productive quality, therefore the objective of this content is to present to the reader the possible actions at the corporate and managerial level on the management of this addiction, which is being presented with increasing incidence, in addition will be referred to the possible consequences that this event can have not only in the work performance but also at the personal, group and family level. This paper refers to the role of the manager in the treatment and prevention of addiction to work

Background and aims: abnormal cognitions are among the most salient domain-specific features of gambling disorder. The aims of this study were: (a) to examine and validate a Spanish version of the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004) and (b) to examine associations between cognitive distortion levels, impulsivity, and gambling behavior. Methods: this study first recruited a convenience sample of 500 adults who had gambled during the previous year. Participants were assessed using the Spanish version of GRCS (GRCS-S) questionnaire, the UPPS-P impulsivity questionnaire, measures of gambling behavior, and potentially relevant confounders. Robust confirmatory factor analysis methods on half the sample were used to select the best models from a hypothesis-driven set. The best solutions were validated on the other half, and the resulting factors were later correlated with impulsivity dimensions (in the whole n = 500 factor analysis sample) and clinically relevant gambling indices (in a separate convenience sample of 137 disordered and non-disordered gamblers; validity sample). Results: this study supports the original five-factor model, suggests an alternative four-factor solution, and confirms the psychometric soundness of the GRCS-S. Importantly, cognitive distortions consistently correlated with affect-or motivation-driven aspects of impulsivity (urgency and sensation seeking), but not with cognitive impulsivity (lack of premeditation and lack of perseverance). Discussion and conclusions: our findings suggest that the GRCS-S is a valid and reliable instrument to identify gambling cognitions in Spanish samples. Our results expand upon previous research signaling specific associations between gambling-related distortions and affect-driven impulsivity in line with models of motivated reasoning.

Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET); a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives of this study were threefold: 1) To validate the Spanish version of the CET; 2) To compare eating disorder diagnostic subtypes and a healthy control group in terms of the factors that drive compulsive exercise as defined by the CET; 3) To explore how the dimensions evaluated in the CET are associated with eating disorder symptoms and general psychopathology. Methods: The CET was administered to a total of 157 patients with an eating disorder (40 anorexia nervosa, 56 bulimia nervosa, 61 eating disorder not-otherwise-specified (EDNOS)) and 128 healthy weight/eating controls. Patients were assessed via a semi-structured interview to reach a DSM-IV-TR diagnosis. Additionally, all participants completed the Symptom Checklist-90-Revised (SCL-90R) and the Eating Disorders Inventory-2 (EDI-2). Results: Confirmatory factor analysis demonstrated adequate goodness-of-fit to the original five-factor model of the CET. Bulimia nervosa and EDNOS patients scored higher in the avoidance and rule-driven behavior, weight control and total CET scales in comparison to the healthy controls, and higher across all scales apart from the exercise rigidity scale compared to the anorexia nervosa patients. Mean scores of the anorexia nervosa patients did not differ to those of the control participants, except for the mood improvement scale where the anorexia nervosa patients obtained a lower mean score. Mean scores between the bulimia nervosa and EDNOS patients were equivalent. The CET scales avoidance and rule-driven behavior, weight of control and total CET scores were positively correlated with the clinical assessment measures of the SCL-90R and EDI-2. Conclusion: Compulsive exercise is a multidimensional construct and the factors driving compulsive exercise differ according to the eating disorder diagnostic subtype. This should be taken into account when addressing compulsive exercise during the treatment of eating disorders.

Objective: To determine the prevalence of binge eating disorder and assess food consumption in individuals with excess weight. Methods: This is an observational crosssectional study conducted with patients with BMI equal to or greater than 25kg/m2, aged 20 to 59 years, attending two Family Health Care Centers in the heart of the city of Quixeré, Ceará. The sample comprised 100 people. An interview was carried out in order to screen for binge eating disorder. Participants answered a questionnaire on socioeconomic aspects, underwent anthropometric (weight, height) assessment, and food consumption was assessed based on two dietary recalls. Results: Among respondents, 3% were diagnosed with severe BED, 20% with moderate BED and 77% did not have Binge Eating Disorder. Patients with higher degrees of BED presented greater excess weight, which as not statistically significant (p=0.257). Respondents with moderate and severe binge eating disorder, when compared to those without BED, presented a greater and unbalanced food consumption in terms of quality of food consumption; however, this was not significant (p ranging from 0.171 to 0.567). Conclusion: One third of participants had some degree of binge eating disorder, which was not related to changes in nutritional status, although participants with moderate and severe binge eating disorder showed a dietary pattern with more calories and less fiber. Objetivo: Verificar la prevalencia de compulsión alimentaria periódica (CAP) y valorar el consumo alimentario de indivíduos con exceso de peso. Métodos: Se trata de un estudio observacional de carácter transversal realizado con pacientes con el IMC igual o mayor que 25Kg/m2 en la franja de edad entre 20 y 59 años asistidos en las dos Unidades de Salud de la Familia del centro de la ciudad de Quixeré-Ceará. La muestra consistió de 100 personas. Se realizó una entrevista la para selección de la compulsión alimentaria periódica. Los participantes contestaron a una encuesta sobre los aspectos socioeconómicos y participaron de una evaluación antropométrica (peso, altura) y la ingesta de alimentos fue valorada basándose en dos recordatorios de alimentos. Resultados: El 3% de los entrevistados recibió el diagnóstico de CAP grave, el 20% de CAP moderada y el 77% no presentaron Compulsión Alimentaria Periódica. Los pacientes com grados más elevados de CAP presentaron más exceso ponderal estadísticamente no significativo (p=0,257). Los entrevistados con compulsión de moderada a grave comparados a los sin CAP, presentaron mayor consumo de alimentos y en desequilíbrio respecto la calidad del consumo de alimentos pero no significativo (variación de p entre 0,171 y 0,567). Conclusión: Un tercio de los participantes presentó algún grado de compulsión alimentaria sin relación con la alteración del estado nutricional aunque los participantes con compulsión alimentaria periódica moderada y grave presentaron un patrón alimentario con más calorías y menos fibras. Objetivo: Verificar a prevalência de compulsão alimentar periódica e avaliar o consumo alimentar de indivíduos com excesso de peso. Métodos: Trata-se de um estudo observacional, de caráter transversal, realizado com pacientes com IMC igual ou superior a 25Kg/m2, pertencentes à faixa etária de 20 a 59 anos, atendidos nas duas Unidades de Saúde da Família do centro da cidade de Quixeré-CE. A amostra consistiu de 100 pessoas. Foi realizada uma entrevista para triagem da compulsão alimentar periódica. Os participantes responderam a um questionário sobre aspectos socioeconômicos, foram submetidos a uma avaliação antropométrica (peso, altura) e a ingestão alimentar foi avaliada com base em dois recordatórios alimentares. Resultados: Entre os entrevistados, 3% foram diagnosticados com CAP grave, 20% com CAP moderada e 77% não tinham Compulsão Alimentar Periódica. Pacientes com graus mais elevados de CAP apresentaram-se com maior excesso ponderal (p=0,03). Os entrevistados com a compulsão moderada e grave, em comparação àqueles sem CAP, mostraram ter um consumo alimentar maior e em desequilíbrio, em se tratando de qualidade de consumo alimentar, para calorias e fibras (p=0,000 e p=0,047, respectivamente). Conclusão: Um terço dos participantes apresentou algum grau de compulsão alimentar, relacionado com alteração de estado nutricional, destacando que os participantes com compulsão alimentar periódica moderada e grave apresentaram um padrão alimentar com mais calorias e menos fibra.

Treball Final de Grau en Psicologia. Codi: PS1048. Curs: 2015/2016 El juego patológico implica un comportamiento problemático, persistente y recurrente de juego con importantes pérdidas de dinero, que expone a la persona a consecuencias negativas en el plano social, profesional e individual. En el juego patológico existen una serie de factores implicados como factores predisponentes y variables relacionadas. El presente trabajo analiza la relación de las variables de regulación emocional e impulsividad con los trastornos del juego. Se llevó a cabo un estudio exploratorio con 12 pacientes que pertenecían a la asociación PATIM (Asociación para la Intervención e Integración en Adicciones y Otras Conductas). Todos los participantes complementaron un cuestionario de Screening de adicción al juego, la Escala de Dificultades en la Regulación Emocional (DERS) y la Escala de Impulsividad de Barratt (BISS-11). Se observaron puntuaciones por encima de la puntuación normativa en la variable de regulación emocional, tanto en la puntuación total como en las subescalas. Sin embargo, en la impulsividad, las puntuaciones se encontraban por debajo de la puntuación normativa. Por último, los resultados del Focus Group muestran la repercusión de las emociones en dicha adicción comportamental. El presente estudio revela que las dificultades en regulación emocional tienen una importancia en el juego patológico. Por el contrario, en la impulsividad, no se encuentran medidas superiores a la puntuación de corte en población normal en la muestra de juego patológico del estudio. La relevancia del manejo de las emociones nos sugiere la importancia del desarrollo de estrategias de regulación emocional como propuesta de tratamiento. Gambling disorder implies a problematic, persistent and recurrent behavior of game with significant losses of money, which exposes a person to negative consequences at a social, professional and individual level. There are a series of elements involved as predisposed factors and related variables in gambling disorders. This study analyzes the variables of emotional regulation and impulsivity related to the gambling behavior. An exploratory study with 12 patients who belong to the PATIM Association (Association for intervention and integration in addictions and other behaviors) has been carried out. The participants completed a questionnaire for Screening of addiction to the game, the Difficulties in Emotion Regulation Scale (DERS) and Barratt Impulsiveness Scale (BISS-11). Scores were observed above the normative score in the variable of emotional regulation, both in the total score and subscales. However, in impulsiveness, the scores were below the standard score. Finally, the Focus Group results show the impact of emotions on such behavior. The present study reveals that emotional regulation difficulties are of importance in the pathological gambling. On the contrary, in the impulsivity, don´t find scores higher than measure of cut score in normal poblation in the sample of pathological gambling in the study. To sum up, the relevance of the handling of the emotions suggests the importance of the development of emotional regulation as a proposal of treatment strategies.

El trastorn obsessivocompulsiu (TOC) es caracteritza per la presència de pensaments, imatges o impulsos intrusos i egodistònics que provoquen ansietat (obsessions) i que generalment porten a la realització de conductes repetitives amb l'objectiu de disminuir-la (compulsions). Estudis clínics han demostrat que el TOC no és un trastorn homogeni. S'han descrit diferències significatives en característiques clíniques del trastorn, com el contingut de les obsessions i les compulsions, la comorbilitat o la resposta al tractament, que han donat lloc a que diversos autors suggereixin diferents classificacions per al trastorn. L'etiologia del TOC, que encaixa en el model etiopatològic d'interacció gen-ambient acceptat per a la majoria de trastorns psiquiàtrics, inclou l'alteració dels circuits cerebrals corticoestriatals com a substrat neurobiològic més acceptat. De tota manera, encara que els estudis de neuroimatge han descrit de forma consistent alteracions a nivell estructural i funcional en els pacients amb TOC, els treballs que han intentat descriure les alteracions sotjacents als diferents subtipus clínics suggerits han reportat resultats poc consistents. En aquesta tesi, s'intenta aprofundir en el coneixement de la neurobiologia del TOC i descriure possibles característiques de neuroimatge estructural i funcional comuns a subgrups de pacients que s'han descrit homogenis a nivell clínic. D'aquesta manera, aquestes alteracions podrien constituir possibles marcadors de neuroimatge per aquests subgrups. Amb aquest objectiu, s'han portat a terme quatre treballs. En els tres primers, s'ha realitzat una anàlisi de ressonància magnètica (RM) estructural de les alteracions en el volum regional de substància grisa cerebral (SG) associada a tres propostes de classificació dels pacients, definides prèviament a nivell clínic. Així, s'ha comparat la distribució regional de SG entre els pacients amb obsessions autògenes i reactives, d'acord al model proposat per Lee & Kwon, entre aquells pacients que presenten o no fenòmens sensorials com a part de la seva simptomatologia obsessivocompulsiva i entre els pacients que refereixen algun factor vital estressant associat a l'inici del trastorn i aquells que no. Per altra banda, en el quart treball, ens hem proposat aprofundir en els correlats neurals sotjacents al model clínic multidimensional del TOC, el més estès tant a nivell clínic com d'investigació, mitjançant un estudi de la connectivitat funcional corticoestriatal durant un paradigma de provocació de símptomes. En resum, els resultats obtinguts permeten concloure que la classificació dels pacients en funció de les característiques de les seves obsessions (en autògenes i reactives), la presència de fenòmens sensorials precedint o acompanyant les compulsions, o la presència o absència d'algun antecedent vital estressant previ a l'inici del trastorn, s'associa a diferències específiques en la distribució regional de SG analitzada mitjançant RM estructural, involucrant sobretot estructures de tipus sensorimotor. Així mateix, l'expressió clínica del TOC estaria mediada per alteracions específiques en la connectivitat corticoestriatal, i alhora modulada, amb un grau d'especificitat variable, per la inducció de símptomes obsessivocompulsius. Així doncs, els resultat obtinguts reforcen la idea de que l'heterogeneïtat clínica observada en la pràctica diària podria tenir una traducció a nivell neural. Aquest accent en el caràcter biològic de la variabilitat fenotípica del TOC enllaça amb algunes perspectives a curt i mitjà termini. Per exemple, el plantejament d'estudis longitudinals, l'avaluació de diferents escenaris d'estrès sobre el desenvolupament de la simptomatologia obsessivocompulsiva, la caracterització àmplia dels pacients a nivell clínic però també cognitiu i neuropsicològic mitjançant protocols el més homogenis possibles entre grups de recerca, així com el coneixement de les estructures i circuits cerebrals implicats en manifestacions clíniques concretes ens haurien de permetre aconseguir una major personalització dels abordatges terapèutics. Alhora, es podria plantejar, en possibles assaigs clínics futurs, l'actuació sobre aquestes determinades regions o circuits cerebrals a través de teràpies físiques poc invasives com l'estimulació cerebral profunda, l'estimulació magnètica transcranial, l'estimulació per corrent elèctrica directa transcranial, o bé tècniques com la neuroretroalimentació en temps real mitjançant RM funcional., Obsessive compulsive disorder (OCD) is characterized by the presence of intrusive, egodystonic and anxiogenic thoughts or images (obsessions) and/or ritualized behaviors or mental acts (compulsions), performed to relieve such anxiety. Clinical studies have described a high heterogeneity for the disorder in terms of the content of the obsessions and compulsions, comorbidity or treatment response. Based on such variability, several authors have suggested different classifications for OCD. Although neuroimaging studies have consistently reported structural and functional brain alterations in OCD patients, mostly involving cortico-striatal regions and circuits, attempts to describe neural alterations associated to the OCD subgroups already described at a clinical level, have reported less consistent results. In this doctoral thesis, we aim to describe common structural and functional neuroimaging characteristics in clinically homogeneous subgroups. In this way, these alterations could be considered as neuroimaging biomarkers for such subgroups. With this objective, we developed four studies. In three, structural magnetic resonance analyses were performed to assess regional brain gray matter (GM) volume alterations associated with three different clinical classifications for the disorder. We compared the regional GM distribution between OCD-patient subgroups according to the presence of autogenous or reactive obsessions, sensory phenomena symptoms preceding or accompanying compulsions and stressful life events at the disorder's onset. On the other hand, in the fourth study, we tried to assess the neural correlates of the clinical multidimensional model of OCD, the most extensively used model at a clinical and research levels, via a functional connectivity study during a symptom provoking paradigm. In sum, our results suggest that the classification of the patients based on the content of their obsessions, the presence of sensory phenomena or the presence of any stressful life events as a trigger of the disorder are associated with specific differences in the GM distribution, mostly involving sensorimotor structures. Moreover, OCD clinical expression may be mediated by specific alterations in cortico-striatal connectivity, that in turn could be modulated, with a variable degree of specificity, by the induction of OCD symptoms.

Background: Frontostriatal and frontoamygdalar connectivity alterations in patients with obsessive–compulsive disorder (OCD) have been typically described in functional neuroimaging studies. However, structural covariance, or volumetric correlations across distant brain regions, also provides network-level information. Altered structural covariance has been described in patients with different psychiatric disorders, including OCD, but to our knowledge, alterations within frontostriatal and frontoamygdalar circuits have not been explored.Methods: We performed a mega-analysis pooling structural MRI scans from the Obsessive–compulsive Brain Imaging Consortium and assessed whole-brain voxel-wise structural covariance of 4 striatal regions (dorsal and ventral caudate nucleus, and dorsal-caudal and ventral-rostral putamen) and 2 amygdalar nuclei (basolateral and centromedial-superficial). Images were preprocessed with the standard pipeline of voxel-based morphometry studies using Statistical Parametric Mapping software.Results: Our analyses involved 329 patients with OCD and 316 healthy controls. Patients showed increased structural covariance between the left ventral-rostral putamen and the left inferior frontal gyrus/frontal operculum region. This finding had a significant interaction with age; the association held only in the subgroup of older participants. Patients with OCD also showed increased structural covariance between the right centromedial-superficial amygdala and the ventromedial prefrontal cortex.Limitations: This was a cross-sectional study. Because this is a multisite data set analysis, participant recruitment and image acquisition were performed in different centres. Most patients were taking medication, and treatment protocols differed across centres.Conclusion: Our results provide evidence for structural network–level alterations in patients with OCD involving 2 frontosubcortical circuits of relevance for the disorder and indicate that structural covariance contributes to fully characterizing brain alterations in patients with psychiatric disorders.

An assortment of human behaviors is thought to be driven by rewards including reinforcement learning, novelty processing, learning, decision making, economic choice, incentive motivation, and addiction. In each case the ventral tegmental area/ventral striatum (nucleus accumbens) (VTAVS) system has been implicated as a key structure by functional imaging studies, mostly on the basis of standard, univariate analyses. Here we propose that standard functional magnetic resonance imaging analysis needs to be complemented by methods that take into account the differential connectivity of the VTAVS system in the different behavioral contexts in order to describe reward based processes more appropriately. We fi rst consider the wider network for reward processing as it emerged from animal experimentation. Subsequently, an example for a method to assess functional connectivity is given. Finally, we illustrate the usefulness of such analyses by examples regarding reward valuation, reward expectation and the role of reward in addiction.

Treballs Finals de Grau de l'Escola Universitària d'Infermeria, Universitat de Barcelona, Curs: 2015-2016, Tutor: Amparo Del Pino Gutiérrez, Introducció: Diversos factors fan vulnerable a una persona a patir una addicció comportamental. Entre d’altres, la família resulta una de les més influenciables. Un funcionament familiar deficient amb conflictes, absència de comunicació i recolzament, pot perjudicar a la salut i contribuir a l’aparició de l’addicció. La infermera ha d’estar present per ajudar a prevenir i detectar precoçment l’addicció. Una avaluació del funcionament familiar ajudarà a identificar els factors que interfereixen en la relació. Mitjançant teràpies (cognitivo-conductual, familiar i motivacional) considerant a la família com a part del tractament, s’afavorirà la rehabilitació i s’evitaran les recaigudes. Objectiu: Esbrinar quines intervencions infermeres són més efectives en els familiars de pacients amb addicció comportamental. Metodologia: Recerca d’articles en bases de dades (PubMed, CINAHL, ProQuest), en relació a la influència familiar sobre persones amb addicció comportamental. Resultats: Obtenció de 10 articles que compleixen els criteris d’inclusió. Discussió: Mitjançant la revisió bibliogràfica dels articles, es va aconseguir conèixer la influència que pot tenir la família sobre les persones a patir una addicció comportamental o ajudar a la seva rehabilitació. Conclusions: La família és la primera línia en la que es pot detectar anomalies en la conducta d’una persona. La infermera ha d’estar present en tot moment, ja que juga un paper important a l’hora de prevenir, detectar, tractar i rehabilitar. Considerar el pacient i la família com una unitat ajudarà a la rehabilitació de la persona i el manteniment del canvi de la conducta esperada.

Background and aims: Gray's Reinforcement Sensitivity Theory has been widely applied to different clinical populations, but few studies have reported empirical evidence based on this theory for treatment outcomes in patients with gambling disorder (GD) and compulsive buying (CB). The aims of this study were to explore the association between clinical variables and personality traits with reward and punishment sensitivity (RPS) levels in women (n = 88) who met diagnostic criteria for GD (n = 61) and CB (n = 27), and to determine the predictive capacity of RPS for primary short-term outcomes in a cognitive-behavioral therapy (CBT) intervention. Methods: the CBT intervention consisted of 12 weekly sessions. Data on patients' personality traits, RPS levels, psychopathology, sociodemographic factors, GD, and CB behavior were used in our analysis. Results: high RPS levels were associated with higher psychopathology in both CB and GD, and were a risk factor for dropout in the CB group. In the GD group, higher reward sensitivity scores increased the risk of dropout. Discussion and conclusions: our findings suggest that both sensitivity to reward and sensitivity to punishment independently condition patients' response to treatment for behavioral addictions. The authors uphold that CBT interventions for such addictions could potentially be enhanced by taking RPS into consideration.

Treball Final de Màster Universitari en Psicopatologia, Salut i Neuropsicologia. Codi: SAL132. Curs: 2014/2015 Por comer emocional se entiende la tendencia a comer con el objetivo de regular emociones negativas, entre ellas el aburrimiento sin atender a las necesidades de hambre. El objetivo del presente estudio es examinar las relaciones existentes entre la tendencia al aburrimiento, los estilos de ingesta y la regulación emocional. Método: La muestra consiste en 123 personas adultas. Las medidas utilizadas incluyen los estilos de ingesta medidos a través del Dutch Eating Beahavior Questionnaire (DEBQ), la tendencia al aburrimiento, a través del Boredom Proneness Scale (BPS), la regulación emocional mediante el Emotion Regulation Questionnaire (ERQ) y la alexitimia, a través del Toronto Alexthymia Scale(TAS-20). Resultados: Los resultados analizados, muestran una correlación negativa significativa entre la falta de estimulación interna (mayor experiencia de aburrimiento) y el comer emocional, con una mayor incapacidad para identificar las emociones. Por otro lado, se observan correlaciones significativas positivas entre la falta de estimulación externa y la dificultad para regular emociones, además de problemas para identificar los sentimientos y la dificultad para verbalizarlos. Conclusiones: La tendencia a sentir aburrimiento por la falta de estimulación interna, parece que se relaciona con una mayor tendencia a comer para regular emociones y la dificultad de etiquetarlas. El estudio del comer emocional y su relación con el aburrimiento, puede ser de gran ayuda a la hora de plantear intervenciones que tengan como objetivo la pérdida de peso o el cambio de estilos de vida. Emotional eating refers to the tendency to eat with the aim of regulating negative emotions like boredom without taking care of the hunger necessities. The objective of the present study is to examine the relations between boredom proneness, the eating styles and emotional regulation. Method: The sample consists of 123 adult people. The measures used include eating styles measured through Dutch Eating Behaviour Questionnaire (DEBQ), Boredom Proneness with Boredom Proneness Scale (BPS), the emotional regulation by the Emotion Regulation Questionnaire and the Alexithymia though Toronto Alexthymia Scale (TAS-20). Results: The results show significant negative correlation between the lack of internal stimulation (greater experience of boredom) and emotional eating, with a greater incapacity to identify emotions. On the other hand, it is observed significant positive correlations between the lack of external stimulation and the difficulties in emotion regulation, in addiction, problems to identify feelings and the difficulty to verbalize them. Conclusions: The tendency to feel boredom by the lack of internal stimulation is related to a greater tendency to eat for regulating emotions and the problems to label them. The research of emotional eating and its relation with boredom, can helpful to design interventions that target the weight loss or change lifestyles.

Treball Final de Grau en Psicologia. Codi: PS1048.Curs: 2014/2015 El juego patológico (JP) es un problema de salud que comporta graves consecuencias a las personas que lo padecen y a sus familiares. Se ha observado que existe una relación entre el JP y determinados factores de personalidad y sintomatología clínica, que podrían actuar tanto de mantenedores como de predisponentes. El principal objetivo del presente estudio es comprobar la relación entre el JP y los trastornos de personalidad, en una muestra de pacientes con diagnóstico de juego patológico pertenecientes a la asociación PATIM. Por otro lado, se establecen objetivos concretos como conocer la relación del JP con las variables impulsividad, ansiedad, depresión y búsqueda de sensaciones; y conocer cuáles son los perfiles de personalidad patológica y la sintomatología clínica que más se relacionan con el JP. Para ello, se ha llevado a cabo un estudio correlacional en el que se utilizan el Cuestionario de Juego Patológico de South Oaks (SOGS), el Inventario Clínico Multiaxial de Millon-III (MCMI-III), la Escala de Impulsividad de Barratt (BIS-11), la Escala de Búsqueda de Sensaciones forma V (SSS-V), el Inventario de Depresión de Beck (BDI) y la Escala de Ansiedad Estado-Rasgo (STAI). Los principales resultados de este estudio muestran que existe correlación del JP con patrones clínicos de personalidad y con síndromes clínicos determinados. Además, cabe destacar una importante predisposición genética del JP con trastornos del estado de ánimo, trastornos de personalidad y trastornos por uso de sustancias y/o alcohol. Finalmente, mencionar que, en nuestra muestra, las variables que alargarían en mayor medida la duración del juego patológico serían el síndrome clínico de ansiedad, el trastorno del pensamiento y el estrés posttraumático, siendo esta última la que mayor impacto tendría. Pathological gambling (PG) is a health problem that implies serious consequences for people who suffer from it and their families. It has been observed that there is a relation between the PG and certain personality factors and clinical symptoms, which could act as an underlying factor or maintaining factor. The main objective of this study is to confirm the relation between PG and personality disorders in a sample of patients diagnosed with pathological gambling, belonging to the PATIM association. On the other hand, specific objectives are established as to know the relation between PG and the variables of impulsivity, anxiety, depression and sensation seeking; and to know which are the most strongly pathological personality profiles and clinical symptoms associated with PG. For this objective, it has carried out a correlational 5 study in which are used the South Oaks Gambling Screen (SOGS), the Millon Clinical Multiaxial Inventory-III (MCMI-III), the Barratt Impulsiveness Scale (BIS -11), the Sensation Seeking Scale, form V (SSS-V), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). The main results of this study show that there is a correlation between PG and clinical personality patterns and specific clinical syndromes. Besides, it notes an important genetic predisposition of PG with mood disorders, personality disorders and substance or alcohol disorders. Finally, it is important to mention that, in our sample, the variables that stretch on the pathological gambling length would be the clinical syndrome of anxiety, thought disorder and post-traumatic stress, being this last variable which has the biggest impact on PG.

Altres ajuts: The work was supported by grant number Fondo de Investigaci\xf3n Sanitaria-FIS (PI11/210; PI14/290). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.' In the present study, we investigated the association between Non-Suicidal Self-Injury (NSSI) and the UPPS-P impulsivity facets in eating disorder patients and healthy controls. The prevalence of NSSI in eating disorder (ED) patients ranged from 17% in restrictive anorexia nervosa (AN-R) patients to 43% in patients with bulimia nervosa (BN). In healthy controls (HC), the prevalence of NSSI was 19%. Eating disorder patients from the binge eating/purging type showed significantly more NSSI compared to restrictive ED and HC participants. Binge-eating/purging ED patients also scored significantly higher on Negative/Positive Urgency, Lack of Premeditation and Lack of Perseverance compared to HC and restrictive ED patients. Comparable findings were found between ED patients and HC with and without NSSI; ED patients and HC with NSSI scored significantly higher in four of the five UPPS-P dimensions compared to participants without NSSI; Sensation Seeking was the exception. Finally, the presence of NSSI in HC/ED patients was particularly predicted by low levels of Perseverance. Therefore, the treatment of ED patients with NSSI certainly needs to focus on the training of effortful control.

Objective. We studied the prevalences of video game use (VGU) and addiction (VGA) in gambling disorder (GD) patients and compared them with subjects with non-video game use (non-VGU) in relation to their gambling behavior, psychopathology, and personality characteristics.Method. A sample of 193 GD patients (121 non-VGU, 43 VGU, and 29 VGA) consecutively admitted to our pathological gambling unit participated in the study.Assessment. Measures included the video game dependency test (VDT), symptom checklist-90-revised, and the temperament and character inventory-revised, as well as a number of other GD indices.Results. In GD, the observed prevalence of VG (use or addiction) was 37.3% (95% CI:30.7%÷44.3),VGU 22.3% (95% CI:17.0%÷28.7), and VGA 15% (95% CI:10.7%÷20.7). Orthogonal polynomial contrast into logistic regression showed positive linear trends for VG level and GD severity and other measures of general psychopathology. After structural equation modeling, higher VG total scores were associated with younger age, general psychopathology, and specific personality traits, but not with GD severity. Patients’ sex and age were involved in the mediational pathways between personality traits and VG impairment.Conclusions. GD patients with VG are younger and present more dysfunctional personality traits, and more general psychopathology. The presence of VG did not affect the severity of GD.