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1. Effectiveness of the Unified Protocol for the transdiagnostic treatment of emotional disorders in online and group format in Argentina: study protocol for a randomized controlled trial

Author

Milagros Celleri, Camila F. Cremades, Martin J. Etchevers, and Cristian J. Garay

Subjects
Unified Protocol, Emotional disorders, Group therapy, Online, Argentina, Medicine (General), R5-920
Abstract

Abstract Background The Unified Protocol (UP) is a transdiagnostic intervention based on emotional regulation for the treatment of emotional disorders. Its application in individual and group formats has been studied worldwide, obtaining similar results to specific protocols but with a lower drop-out rate and improving the cost–benefit ratio, since a larger number of patients can benefit from it. Moreover, the inclusion of digital technologies in psychotherapy aims to improve the accessibility of treatments, especially since the pandemic of COVID-19 that forced the implementation of treatments through teletherapy increasing its use. To date, no studies have been carried out in Argentina on the application of the UP in a group format and through teletherapy. The aim of the present study is to evaluate the efficacy of the UP in a group format and through teletherapy in the Argentine population. Methods A parallel-group, controlled, randomized trial, with pre-post and repeated follow-up measures intergroup design will be conducted. One hundred eighty patients will be randomized to one of the following conditions: an online, group-based UP intervention or a waiting list. The Beck Depression Inventory-II and the Beck Anxiety Inventory will be used to compare primary outcomes and the Beck Hopelessness Scale, Difficulties in Emotion Regulation Scale, Positive Affect and Negative Affect Scale, and Multicultural Quality of Life Index will be administered for secondary outcomes at baseline, post-intervention, and 3 months follow-up. Ad-hoc questionnaires will be used to assess patients’ experiences and treatment satisfaction. Discussion The purpose of this trial is to evaluate the efficacy of the online and group application of the UP in the Argentine population, as well as to evaluate the patient’s experience and satisfaction with the treatment. It is expected that the findings of this study will be useful in reducing anxious and depressive symptomatology, will allow us to adapt the UP to our culture, and will improve accessibility to treatment. Trial registration ClinicalTrials.gov NCT05275322. Registered on 11 March 2022.

Published
2023
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2. Results of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism

Author

Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico de Berardis, Sergio Zamora Delgado, David de Lucena, Avinash de Sousa, Ramona di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jacobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar A. Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva-Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Michael Berk, Sarah Levaj, Daria Smirnova, Fountoulakis, Konstantinos N [0000-0001-5503-0811], N. Karakatsoulis, Grigorios [0000-0002-4786-1217], Castilla-Puentes, Ruby [0000-0002-0597-6155], Fountoulakis, Nikolaos K [0000-0002-5965-707X], Smirnova, Daria [0000-0002-9591-4918], and Apollo - University of Cambridge Repository

Subjects
Psychiatry, Health (social science), Social Psychology, Depression, Epidemiology, Conspiracy theories, COVID-19, Anxiety, Health professionals, Mental disorders, Mental health, Suicidality, Psychiatry and Mental health
Abstract

Introduction: The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. Materials and methods: The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. Statistical analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. Results: Clinical depression was detected in 13.16% with male doctors and ‘non-binary genders’ having the lowest rates (7.89 and 5.88% respectively) and ‘non-binary gender’ nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). Conclusions: The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

Published
2023

3. The effect of different degrees of lockdown and self-identified gender on anxiety, depression and suicidality during the COVID-19 pandemic: Data from the international COMET-G study

Author

Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jacobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova, Karakatsoulis, Grigorios N [0000-0002-4786-1217], Alarcón, Renato D [0000-0002-7316-1185], Berk, Michael [0000-0002-5554-6946], Apollo - University of Cambridge Repository, Psychiatry 1, RS: MHeNs - R2 - Mental Health, and Psychiatrie & Neuropsychologie

Subjects
Male, Mental health, lockdown, anxiety, mental health history, Depression, Depression/epidemiology, COVID-19, Suicidality, Anxiety, Psychiatry and Mental health, Suicide, Communicable Disease Control, Humans, Female, Pandemics, Biological Psychiatry, Anxiety/epidemiology
Abstract

Fountoulakis K.N., Karakatsoulis G.N., Abraham S., Adorjan K., Ahmed H.U., Alarcón R.D., Arai K., Auwal S.S., Berk M., Bjedov S., Bobes J., Bobes-Bascaran T., Bourgin-Duchesnay J., Bredicean C.A., Bukelskis L., Burkadze A., Abud I.I.C., Castilla-Puentes R., Cetkovich M., Colon-Rivera H., Corral R., Cortez-Vergara C., Crepin P., De Berardis D., Delgado S.Z., De Lucena D., De Sousa A., Stefano R.D., Dodd S., Elek L.P., Elissa A., Erdelyi-Hamza B., Erzin G., Etchevers M.J., Falkai P., Farcas A., Fedotov I., Filatova V., Fountoulakis N.K., Frankova I., Franza F., Frias P., Galako T., Garay C.J., Garcia-Álvarez L., García-Portilla M.P., Gonda X., Gondek T.M., González D.M., Gould H., Grandinetti P., Grau A., Groudeva V., Hagin M., Harada T., Hasan T.M., Hashim N.A., Hilbig J., Hossain S., Iakimova R., Ibrahim M., Iftene F., Ignatenko Y., Irarrazaval M., Ismail Z., Ismayilova J., Jacobs A., Jakovljević M., Jakšić N., Javed A., Kafali H.Y., Karia S., Kazakova O., Khalifa D., Khaustova O., Koh S., Kopishinskaia S., Kosenko K., Koupidis S.A., Kovacs I., Kulig B., Lalljee A., Liewig J., Majid A., Malashonkova E., Malik K., Malik N.I., Mammadzada G., Mandalia B., Marazziti D., Marčinko D., Martinez S., Matiekus E., Mejia G., Memon R.S., Martínez X.E.M., Mickevičiūtė D., Milev R., Mohammed M., Molina-López A., Morozov P., Muhammad N.S., Mustač F., Naor M.S., Nassieb A., Navickas A., Okasha T., Pandova M., Panfil A.-L., Panteleeva L., Papava I., Patsali M.E., Pavlichenko A., Pejuskovic B., Da Costa M.P., Popkov M., Popovic D., Raduan N.J.N., Ramírez F.V., Rancans E., Razali S., Rebok F., Rewekant A., Flores E.N.R., Rivera-Encinas M.T., Saiz P., de Carmona M.S., Martínez D.S., Saw J.A., Saygili G., Schneidereit P., Shah B., Shirasaka T., Silagadze K., Sitanggang S., Skugarevsky O., Spikina A., Mahalingappa S.S., Stoyanova M., Szczegielniak A., Tamasan S.C., Tavormina G., Tavormina M.G.M., Theodorakis P.N., Tohen M., Tsapakis E.M., Tukhvatullina D., Ullah I., Vaidya R., Vega-Dienstmaier J.M., Vrublevska J., Vukovic O., Vysotska O., Widiasih N., Yashikhina A., Prezerakos P.E., Smirnova D.

Published
2022
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4. Results of the COVID-19 mental health international for the general population (COMET-G) study

Author

Kiyomi Arai, Anca Livia Panfil, Darko Marčinko, J. Vrublevska, Muftau Mohammed, Dalia Mickevičiūtė, Piirika Crepin, Görkem Saygili, Nor Jannah Nasution Raduan, Seetal Dodd, Anna Yashikhina, Daniela Morera González, Elmars Rancans, Cristian Javier Garay, Helal Uddin Ahmed, Khamelia Malik, Eimantas Matiekus, Tomohiro Shirasaka, Paolo Grandinetti, Tasdik M. Hasan, Sotirios A. Koupidis, Nurul Azreen Hashim, Pilar A. Saiz, David Saucedo Martínez, Arturo Grau, Alejandro Molina-López, Jo Anne Saw, Dina Tukhvatullina, Felicia Iftene, Renato D. Alarcón, Svetlana Kopishinskaia, Sahadat Hossain, Olivera Vuković, Mika S. Naor, Satti Sitanggang, Sridevi Sira Mahalingappa, Leticia García-Álvarez, Manuel Sanchez de Carmona, Liliya Panteleeva, Olga Kazakova, Jan Hilbig, Johann M. Vega-Dienstmaier, Francesco Franza, Matias Irarrazaval, Pavlos N. Theodorakis, Sani Salihu Auwal, Alvydas Navickas, Domenico De Berardis, Viktoriia Filatova, David Freitas de Lucena, Miro Jakovljevic, Afzal Javed, Gulay Mammadzada, Olena Khaustova, Adriana Farcas, Steve Koh, Ruby C. Castilla-Puentes, Panagiotis E. Prezerakos, Gamze Erzin, Takayuki Harada, Pedro Frias, Tatiana Galako, Kristina Adorjan, Hector Colon-Rivera, Justine Liewig, Oleg Skugarevsky, Indira Indiana Cabrera Abud, Sarah Bjedov, Berta Erdelyi-Hamza, Korneliia Kosenko, Barbara Kulig, Xarah Elenne Meza Martínez, Bojana Pejuskovic, Ratnaraj Vaidya, Elena Ninoska Reyes Flores, Sergio Zamora Delgado, Marcelo Cetkovich, Avinash De Sousa, Eva Maria Tsapakis, Iryna Frankova, Federico Rebok, Petr Morozov, Amira Nassieb, Bilvesh Mandalia, Alexey Pavlichenko, Mariana Pinto da Costa, Anna Rewekant, Patricia Schneidereit, Olga Vysotska, Roumen Milev, Maria Stoyanova, Laurynas Bukelskis, Roha Saeed Memon, Ricardo Corral, Nuru Suleiman Muhammad, Donatella Marazziti, Michal Hagin, María Teresa Rivera-Encinas, Julie Bourgin-Duchesnay, Giuseppe Tavormina, Jamila Ismayilova, Mauricio Tohen, Helin Yilmaz Kafali, María Paz García-Portilla, Violeta Groudeva, Daria Smirnova, Mikaella E. Patsali, Ramona Di Stefano, Filip Mustač, Nikolaos K. Fountoulakis, Dina Popovic, Abdul Majid, Michael Berk, Anna Spikina, Alisha Lalljee, Zaliha Ismail, Mikhail Popkov, Xenia Gonda, Julio Bobes, Sagar Karia, Salmi Razali, Carla Cortez-Vergara, Konstantinos N. Fountoulakis, Rossitza Iakimova, Francisca Vargas Ramírez, Maurilio Giuseppe Maria Tavormina, Asaf Jakobs, Najma Iqbal Malik, Teresa Bobes-Bascarán, Illés Kovács, Hilary Gould, Tarek Okasha, Anna Szczegielniak, Peter Falkai, Nenad Jakšić, Livia Priyanka Elek, Evgeniia Malashonkova, C. Bredicean, Yulia Ignatenko, Bhumika Shah, Akaki Burkadze, Seri Abraham, Anna Elissa, Ion Papava, Mona Ibrahim, Doaa Ahmed Khalifa, Milena Pandova, Gabriela Mejia, Tomasz M. Gondek, Simona Claudia Tamasan, Grigorios N Karakatsoulis, Ketevan Silagadze, Stephanie Martinez, Ilya Fedotov, Martin J. Etchevers, Irfan Ullah, Natalia Widiasih, Berk, Michael [0000-0002-5554-6946], Bobes-Bascaran, Teresa [0000-0002-5279-504X], and Apollo - University of Cambridge Repository

Subjects
Male, Psychological intervention, Anxiety, Mental disorders, Suicidality, Global Burden of Disease, COVID-19 / epidemiology, 0302 clinical medicine, Anxiety / epidemiology, COVID-19, depression, suicidality, mental health, conspiracy theories, mental disorders, psychiatry, anxiety, Pharmacology (medical), 030212 general & internal medicine, Depression (differential diagnoses), Psychiatry, education.field_of_study, Depression, Anxiety / etiology, Conspiracy theories, Mental Health, Middle Aged, Depression / etiology, 3. Good health, Psychiatry and Mental health, Distress, COVID-19 / complications, Neurology, Female, Mental health, medicine.symptom, Clinical psychology, Adult, COVID-19 / psychology, Population, Article, Suicidal Ideation, 03 medical and health sciences, medicine, Humans, Bipolar disorder, education, Pandemics, Biological Psychiatry, Depression / epidemiology, Pharmacology, business.industry, SARS-CoV-2, Stress, Psychological / etiology, medicine.disease, Relative risk, Neurology (clinical), business, 030217 neurology & neurosurgery, Stress, Psychological
Abstract

Introduction: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. ----- Material and methods: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. ----- Statistical analysis: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. ----- Results: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. ----- Conclusions: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.

Published
2021

5. Tratamiento de la desregulación emocional en hospitales del área metropolitana de Buenos Aires: una encuesta a profesionales

Author

Camila F. Cremades, Cristian J. Garay, and Martín J. Etchevers

Subjects
Psychology, BF1-990
Abstract

El proceso de regulación emocional está siendo foco de gran cantidad de investigaciones en la actualidad. Se estima que se encuentra asociada al desarrollo y mantenimiento del 75 % de los trastornos mentales del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM, por sus siglas en inglés). En esta línea se han estado estudiando en los últimos años, a nivel global, protocolos transdiagnósticos que tienen, como foco de tratamiento, dicho proceso. El objetivo de este estudio consistió en explorar la familiaridad de los profesionales de la salud mental, de hospitales públicos del área metropolitana de Buenos Aires, con el constructo de la desregulación emocional y los protocolos diseñados para el tratamiento de pacientes con dichas características. A su vez, se buscó conocer el grado de acercamiento de los profesionales clínicos a las investigaciones sobre psicoterapias. A estos fines, se diseñó un cuestionario con 40 preguntas de respuestas abiertas y opción múltiple que fue completado por 75 profesionales (psicólogos y psiquiatras) de hospitales públicos del área metropolitana de Buenos Aires. La mayoría reportó conocer el constructo de desregulación emocional, pero al pedirles que conceptualicen un caso diseñado para este estudio muy pocos utilizaron el constructo. En cuanto a los protocolos transdiagnósticos diseñados para intervenir en la desregulación emocional, son muy poco implementados. Por su parte, menos de la mitad reportó haber leído investigaciones empíricas. Los cursos elegidos para continuar la formación son en su mayoría psicoanalíticos y la participación en congresos internacionales es escasa. Se propone la necesidad de fomentar el uso de intervenciones basadas en evidencia en hospitales públicos y la divulgación de protocolos transdiagnósticos con evidencia para la desregulación emocional.

Published
2022

6. The Mental Health Ecosystem: Extending Symptom Networks With Risk and Protective Factors

Author

Gabriela Lunansky, Claudia D. van Borkulo, Jonas M. B. Haslbeck, Max A. van der Linden, Cristian J. Garay, Martín J. Etchevers, and Denny Borsboom

Subjects
dynamical systems, psychopathology, resilience, complexity, biopsychosocial, Psychiatry, RC435-571
Abstract

Inspired by modeling approaches from the ecosystems literature, in this paper, we expand the network approach to psychopathology with risk and protective factors to arrive at an integrated analysis of resilience. We take a complexity approach to investigate the multifactorial nature of resilience and present a system in which a network of interacting psychiatric symptoms is targeted by risk and protective factors. These risk and protective factors influence symptom development patterns and thereby increase or decrease the probability that the symptom network is pulled toward a healthy or disorder state. In this way, risk and protective factors influence the resilience of the network. We take a step forward in formalizing the proposed system by implementing it in a statistical model and translating different influences from risk and protective factors to specific targets on the node and edge parameters of the symptom network. To analyze the behavior of the system under different targets, we present two novel network resilience metrics: Expected Symptom Activity (ESA, which indicates how many symptoms are active or inactive) and Symptom Activity Stability (SAS, which indicates how stable the symptom activity patterns are). These metrics follow standard practices in the resilience literature, combined with ideas from ecology and physics, and characterize resilience in terms of the stability of the system's healthy state. By discussing the advantages and limitations of our proposed system and metrics, we provide concrete suggestions for the further development of a comprehensive modeling approach to study the complex relationship between risk and protective factors and resilience.

Published
2021
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