Search

Las certificaciones ambientales son condiciones que permiten realizar obras de construcción, implementando así estrategias que aseguren procesos mas limpios para la mejora o conservación del medio ambiente. A través de un trabajo analítico y comparativo, este trabajo identificará las similitudes y diferencias entre los sistemas descubiertos y así poder determinar si se corresponden con la realidad actual del Ecuador, un país que cuenta con grandes diferencias socioculturales en cada una de las cuatro regiones geográficas. En el caso de nuestro país, Ecuador… como en casi todos los países en vías de desarrollo, la construcción de obras civiles tiene un gran impacto en el medio ambiente. Desde pequeñas casas hasta grandes proyectos, alteran el medio ambiente con consecuencias para todos. El tiempo relativamente corto que lleva implementar las normas para garantizar que la construcción sea respetuosa con el medio ambiente indica que todas las etapas de un proyecto, vivienda, edificio, carretera, hidráulica o de otro tipo, se ven desde una perspectiva ambiental racional. Los resultados muestran que las certificaciones ambientales emitidos por el Ministerio del Ambiente ecuatoriano son Green Point y carbono neutral y muestran que un gran porcentaje de las empresas ecuatorianas aún no cuentan con estos certificados, siendo esta una razón por la cual aún no se cuenta con ellos. tener las habilidades que se aplican a estas certificaciones. Se dice que las certificaciones ambientales ayudan a las empresas a aumentar su competitividad a través del beneficio económico y aumentar los ingresos, mejorar la imagen de la empresa, reducir la generación de residuos y atraer nuevos clientes.

The most widely used instrument to assess meaning in life is the Meaning in Life Questionnaire (MLQ). To date, no study has analyzed the psychometric characteristics in the Spanish adult population. Our aim is to analyze the psychometric properties of the MLQ in a sample of Spanish participants. The sample consisted of 683 adults, 80.4% women, from Spain. CFA and factorial invariance of the factors obtained as a function of the gender and age of the participants was studied. The data had a good fit to a model with two factors called Presence and Search. The two factors showed a low and positive correlation (.19); however, we cannot assume factorial invariance for gender and age groups. The MLQ showed adequate convergent validity with measures of purpose in life, anxiety, and depression. The present research provides support for the good psychometric properties and reliability of the MLQ in adult Spanish participants to assess meaning in life.

El autoinforme más utilizado para evaluar el sentido en la vida es el “Cuestionario de sentido en la vida” (MLQ). Hasta la fecha, ningún estudio ha analizado las características psicométricas del MLQ en población adulta española. Por tanto, nuestro objetivo fue analizar las propiedades psicométricas del MLQ en una muestra de adultos españoles. Participaron 683 personas, 80,4% mujeres. Se realizó un análisis factorial confirmatorio y un estudio de la invarianza factorial de los factores obtenidos en función del sexo y la edad de los participantes. Los datos ajustaron bien a un modelo con dos factores denominados Presencia y Búsqueda. Los dos factores estuvieron correlacionados de manera baja y positiva (0,19), sin embargo, no podemos asumir invarianza factorial para grupos de sexo y edad. El MLQ mostró una adecuada validez convergente con medidas de propósito en la vida, ansiedad y depresión. La presente investigación respalda las buenas propiedades psicométricas y la fiabilidad del MLQ en participantes adultos españoles para evaluar el sentido la vida.

Background: Suicide is a serious health problem, affecting not only the persons who experience it, but also their family members. Although there are few empirically supported interventions to help family members. The programme for relatives of people with Borderline personality disorder and dysregulation that has received the most empirical support is Family Connections. This is a cross-disciplinary skills training programme and contains 12 two-hour sessions held once a week. The specific objectives of the present study were: a) to adapt Family Connections program for relatives of patients with suicidal behaviour and test the efficacy of the intervention for relativesin a pilot study; b) to analyze the feasibility and acceptance of the intervention in the relatives; c) to analyze whether the changes produced in the psychological variables in the relatives after the intervention are related to changes in the psychological variables of the patients. Method: The study sample contained 10 relatives and nine patients. The relatives were assessed before and after the intervention. The evaluation protocol consisted of the BAS, DASS-21, FES, scale of expectations and opinions about the treatment, and a critical incidents log, as well as a focus group. Regarding the data analysis, Student's t-test for related samples was conducted to examine whether there were differences between before and after the intervention, and Cohen's d was calculated as an effect size measure. Results: Improvements were observed in most of the constructs assessed in the relatives, such as burden, concern, guilt, and depression. The relatives’ level of acceptance and satisfaction with the programme was high. In addition, patients decreased their suicidal behaviour, self-harm, visits to the emergency room, or number of verbal or physical arguments. Conclusions: The results show the usefulness of the intervention in relatives of people with suicidal behaviour and also confirm its good acceptance by family members. Its efficacy is confirmed, also in patients. This is a population that, has few empirically validated interventions, and none that also analyse the effect of the intervention on patients. Therefore, it is possible to argue that this is a good programme to prevent suicidal behaviour in the family environment. Trial registration: ClinicalTrials.gov ID: NCT05157607. Registered 15 December 2021. https://clinicaltrials.gov/ct2/show/NCT05157607?recrs=ab&cntry=ES&draw=2&rank=8

Background Family members of patients with eating disorders (ED) often experience high levels of burden, suffering, grief, and helplessness. If, in addition to ED, the patient has a personality disorder (PD), the psychological distress experienced by family members can be devastating. However, few treatments have been developed for family members of people with ED and PD. Family Connections (FC) is a program that has been shown to be effective in relatives of people with borderline personality disorder. The general objectives of this research project are: (a) to adapt and test the FC intervention protocol designed specifically for family members of patients with ED-PD in the Spanish population (FC: ED-PD); (b) to analyze, in a randomized controlled trial, the efficacy of the FC: ED-PD program versus a control condition consisting of optimized treatment as usual (TAU-O); (c) to analyze the feasibility and acceptability of the intervention protocol; (d) to analyze whether the changes that may occur in family members are related to improvements in the family climate and/or improvements observed in patients; and (e) to analyze the perceptions and opinions of families and patients about the two intervention protocols. Methods The study design consists of a two-arm randomized controlled trial with two conditions: FC: ED-PD or Treatment as usual optimized (TAU-O). Participants will be relatives of patients who meet DSM-5 criteria for ED and PD or dysfunctional personality traits. Participants will be assessed at pre- and post-treatment and one-year follow-up. The intention-to-treat principle will be used when analyzing the data. Discussion These results will also confirm the program’s efficacy and acceptance by family members. Trial registration ClinicalTrials.gov Identifier: NCT05404035. Accepted: May 2022.

espanolLos familiares de pacientes con trastorno limite de la personalidad (TLP) experimentan ansiedad y depresion, y estan inmersos en un clima familiar disfuncional. Aunque existen tratamientos eficaces para el TLP, se ha prestado menos atencion a los familiares. El objetivo de este trabajo fue adaptar para familiares el entrenamiento grupal en habilidades de la terapia dialectica comportamental, en 14 sesiones. La muestra estuvo formada por 12 familiares: 50% madres, 41,7% padres y 8,3% parejas. Se evaluaron los niveles de depresion (BDI-II), ansiedad (OASIS) y emocion expresada (LEE-S) antes y despues de la intervencion. Los resultados indican que tras la intervencion se produce una mejoria estadistica y clinica significativa en depresion; clinica en ansiedad, hostilidad, tolerancia a la frustracion y emocion expresada; y estadistica de la actitud negativa hacia la enfermedad. La intrusion aumenta tanto estadistica como clinicamente, sin embargo, sus niveles son similares a los de la poblacion general. Resulta imprescindible seguir investigando sobre la eficacia de las intervenciones para familiares. EnglishFamily members of patients with borderline personality disorder (BPD) experience suffering, anxiety, and depression, and are involved in a dysfunctional family atmosphere. Although effective treatments for patients with BPD have been developed, family members have received less attention. The aim of this paper was to adapt the dialectical behaviour therapy skills training group for family members in 14 sessions. The sample comprised 12 family members: 50% mothers, 41.7% fathers, and 8.3% partners. The levels of depression (BDI-II), anxiety (OASIS) and expressed emotion (LEE-S) were measured before and after the intervention. The results show a statistical and clinical improvement in depression, and a clinically significant improvement in anxiety, hostility, lack of tolerance and expressed emotion after the intervention. Negative attitude toward illness presents a statistical improvement. Furthermore, intrusion increases both statistically and clinically. However, the levels of intrusion are equal to those in the general population. Further research into the effectiveness of family interventions is essential.

Family members of people with borderline personality disorder (BPD) are seriously affected by the disease and it is common for them to ask for professional help. The main objective of this study is to assess, in an open clinical trial, a treatment protocol based on Dialectical Behaviour Therapy (DBT) strategies for relatives of individuals with BPD, compared to the same protocol plus a mindfulness component (DBT-M).The interventions were conducted in a sample of 108 relatives of 83 patients diagnosed with BPD from a Specialized Unit for Personality Disorders. Relatives and patients completed the assessment protocol before and after the intervention.Significant improvements in almost all the relevant variables tested were observed after the treatment in both the relatives and the patients. However, there were only statistically significant differences between the groups in the negative attitude towards the illness, where relatives in the DBT-M condition showed greater improvement than those in the DBT condition.The results indicate that the intervention helps both patients and relatives to improve on key issues. It is essential to consider and offer support to the families of people with severe psychological disorders.

Emotional dysregulation is a key symptom in participants with personality disorders. The Emotional Regulation Questionnaire (ERQ) has been studied with nonclinical samples; however, it is necessary to confirm the factorial structure of the ERQ in participants with personality disorders. The aims of the present study were to confirm the factorial structure of the Spanish version of the ERQ and analyse its psychometric properties as well as the association between the ERQ and the Borderline Symptoms List (BSL-23) and the Difficulties in Emotion Regulation Scale (DERS). The overall sample was composed of 250 patients with personality disorders, of whom 195 met the criteria for borderline personality disorder. Confirmatory factor analysis was conducted. The two-factor model showed an acceptable fit, similar to the original structure, in the participants with personality disorders and with borderline personality disorder. Cognitive reappraisal was negatively correlated with the DERS and BSL-23, and expressive suppression was positively correlated with the BSL-23. The ERQ is a reliable and valid instrument to evaluate emotional dysregulation in participants with personality disorders and participants with borderline personality disorder.

espanolSegun estudios previos el sentido en la vida esta asociado negativamente con la psicopatologia, el riesgo de suicido y la inestabilidad emocional en personas con trastornos alimentarios (TA). El objetivo de este estudio fue analizar el papel mediador del sentido de la vida y sus dimensiones en la relacion entre la insatisfaccion corporal y la sintomatologia del TA y aportar pruebas que apoyen un modelo de elaboracion del sentido de los trastornos alimentarios (MESTA). 292 personas diagnosticadas con TA (93,5% mujeres) contestaron el “Test de proposito en la vida” (PIL), el “Test de actitudes hacia la comida” (EAT) y el “Cuestionario multidimensional de relaciones entre el cuerpo y el yo” (MBSRQAS). Se realizaron analisis de mediacion multiple. El sentido en la vida medio la asociacion entre la insatisfaccion corporal y la psicopatologia del TA. La dimension de Satisfaccion y sentido tuvo un papel mediador mayor. El sentido en la vida podria ser una variable importante en el mantenimiento de los TA. El MESTA puede ser un modelo util para la comprension de la psicopatologia de los TA EnglishStudies of people with eating disorders (ED) have indicated that meaning in life is negatively associated with psychopathology, suicide risk, and emotional instability in people with ED. The aim of this study was to analyze the mediating role of meaning in life and its dimensions in the relationship between body dissatisfaction and the symptoms of ED, and to provide evidence that supports the meaning making model of eating disorders (MESTA, in Spanish). 292 Participants diagnosed with ED completed the Purpose in Life Test (PIL), the Eating Attitudes Test (EAT), and the Multidimensional Body-Self Relations Questionnaire (MBSRQ-AS). Multiple mediation analyses were performed. Meaning in life was a mediator between body dissatisfaction and ED psychopathology. The dimension of Satisfaction and meaning in life had a greater mediating role. Meaning in life could be an important variable in the maintenance of ED. The MESTA could be a useful model for understanding the psychopathology of ED.

Background: Dialectical Behavior Therapy (DBT) has shown evidence of its effectiveness in the treatment of borderline personality disorder (BPD) and eating disorders (EDs) separately, and there is preliminary evidence for co-occurrent BPD and EDs. However, the long-term effectiveness of DBT for this specific population is still unknown. The main goal of this study was to assess long-term treatment effectiveness in people diagnosed with BPD and ED. Methods: Participants (N = 109) had previously received a 6-month treatment during a clinical trial (DBT = 64 vs. Treatment as Usual, Cognitive Behavior Therapy; TAU CBT = 45). Outcome measures (emotional eating, depressive symptoms, anger, emotion regulation, impulsiveness, and resilience) were evaluated prospectively at 4- and 6-year follow-ups. Results: There was a statistically significant improvement in most study outcomes from pre-treatment to the follow-ups in the DBT condition, and in depression, resilience and trait anger in the TAU CBT. No statistically significant between-group differences were found. Nonetheless, a high percentage of participants showed a clinically significant improvement over time in the DBT condition. Conclusions: Findings of this study contribute to determinate the long-term treatment effectiveness of DBT for people with BPD and ED in routine psychotherapeutic practice. Longitudinal studies with larger sample sizes are needed to confirm these results.

The COVID-19 pandemic has had a significant impact on the family environment due to the difficulties that have been generated by job losses, deaths, increase rates of family and domestic violence, poor mental health outcomes, and estrangement in personal relationships. “Family Connections” (FC) is an internationally renowned DBT-based program that supports the families and caregivers of people with borderline personality disorder. The study took place at a Specialized Health Centre in Spain. A focus group with seven participants was organized for people who had previously attended an FC group. The participants were asked about their experiences during the confinement periods that was caused by COVID-19 as well as their experiences and opinions on relatives, skills practiced, their need to and the advantages of attending the group, and satisfaction with the FC group. The qualitative research web program Dedoose was used for the thematic analysis of the data. The results showed that the participants experienced various experiences during confinement; validation and radical acceptance were determined to be the most useful skills; the importance of professionals and the content as well as the sincerity of attendees and having a safe space were determined to be the greatest benefits of the programs; and the participants all indicated great satisfaction of the program. This study allowed us to explore the experiences of family members of people with BPD with their loved ones during the confinement period caused by the COVID-19 pandemic. We evaluated the use of the FC program skills in the family environment during confinement, and we analyzed the acceptability and satisfaction with the FC program.

BackgroundThwarted Belongingness (TB) and Perceived Burdensomeness (PB) are considered risk factors of suicide behavior in the Interpersonal Theory of Suicide and constitute the main factors of the Interpersonal Needs Questionnaire—INQ.AimsThe present study analyzes the internal consistency, construct validity, and invariance across sex and age of the INQ-15, which comprises two subscales, in a sample of Spanish community adolescents.MethodsParticipants were 1,536 adolescents from 12 to 19 years old. The INQ-15, the total number of non-suicidal self-injuries (NSSI), the Hopelessness Scale, and the Purpose in Life Test-Adolescents (PIL-A) were used.ResultsThe INQ-15 showed good internal consistency for TB (ω¯ = 0.88) and PB (ω¯ = 0.78) subscales and construct and concurrent/discriminant validity in the whole sample. Both the PB and TB subscales showed a good fit {SBχ2(9) = 6.448, p = 0.694, CFI = 1.000, RMSEA = 0.000 [90% CI (0.000, 0.022)] and SBχ2(27) = 248.973, p = 0.000, CFI = 0.922, RMSEA = 0.073 [90% CI (0.065, 0.082)]}, respectively. Regarding the invariance analyses, we found (1) non-invariance in the PB subscale across sex groups and metric, scalar, and stric invariance across age groups, and (2) that it was not possible to perform the invariance analysis for the TB subscale across both sex and age because the fit was not adequate for both boys and 12–15 years old groups. Positive and significant relationships were found between the INQ-15 subscales and hopelessness and NSSI frequency, and negative and significant correlations with meaning in life.ConclusionsThe INQ-15 is a valid instrument for assessing TB and PB in Spanish adolescents. Future studies should analyze the invariance of this instrument in adolescents across sex and age.

BackgroundTo assess three dimensions of Meaning in Life (comprehension, purpose, and mattering) the Multidimensional Existential Meaning Scale (MEMS) was developed, however, the MEMS's factorial structure has not yet been confirmed in a Spanish-speaking sample. A question that remains unanswered is which of the three dimensions of MiL are associated with psychopathology in clinical samples.Aims(1) to analyze the psychometric properties of the MEMS in a Spanish non-clinical population, and (2) to identify which of the three dimensions of MiL shows the strongest relationship with depression, anxiety and positive affect in a clinical population.MethodThe non-clinical sample, consisted of N = 1106 Spanish adults, and the clinical sample consisted of 88 adults diagnosed with mental disorders. A Confirmatory Factor Analysis and regression analysis were carried out.ResultsThe three-factor model for the MEMS showed an acceptable fit, and full invariance across gender groups. In the clinical sample, the mattering dimension had the highest association with depression and anxiety, and purpose with positive affect.ConclusionThe MEMS is an adequate instrument to assess the three dimensions of meaning in Spanish-speaking participants. These results support the importance of evaluating the MiL construct from a multidimensional perspective in clinical samples.

Conocemos gran parte de la producción poética de Gregorio Silvestre gracias a la labor de Pedro de Cáceres, el editor de la primera edición de Las Obras del poeta, en 1582. El proyecto, que se llevó a cabo 12 años después de la muerte del autor y músico, favoreció otras dos ediciones más, que también vieron la luz en el transcurso de los últimos veinte años del siglo XVI. El estudio de la transmisión por vía impresa de la obra de este autor puede ayudar a dar prioridad a alguna de estas tres ediciones preparadas por personas cercanas al poeta y, en consecuencia, arrojar algo de luz al proceso de fijación del texto.

The involvement evaluation questionnaire (IEQ) was created to evaluate the caregiver's experience of burden and the consequences of providing care to people with psychotic disorders. To date, the IEQ has not been validated with caregivers of people diagnosed with borderline personality disorder (BPD). The main objective of the study was to confirm the psychometric properties and factorial structure of the Spanish version of the IEQ in 151 caregivers of people with BPD, with an average age of 54.52 (SD = 9.91). Two models were tested by means of confirmatory factor analysis, following the original factor structure. The Models 1 and 2 displayed adequate fit, with comparative fit index and Tucker-Lewis index > 0.90 and root-mean-square root of approximation < 0.08; however, Model 2 was more parsimonious. The Cronbach's alphas are adequate, ranging from 0.70 to 0.85. The consequences of providing care to people with BPD had a low or moderate association with the Level of Expressed Emotion scores. IEQ scores of caregivers of people diagnosed with BPD with psychiatric comorbidity did not differ from those of caregivers of people diagnosed with BPD without psychiatric comorbidity. The IEQ has adequate psychometric properties and can be utilized to assess burden in caregivers of people with BPD.

Background: Adolescence is a developmental stage when there is a high risk of engaging in non-suicidal self-injury (NSSI). There is recent interest in the study of thwarted belongingness and perceived burdensome as variables associated with the frequency of NSSI in adolescents. Meaning in life (MIL) might be negatively associated with thwarted belongingness and perceived burdensomeness. To date, no studies have analyzed the buffering role of MIL in the association between thwarted belongingness and perceived burdensomeness and the frequency of lifetime NSSI in Spanish adolescents. Aims: (a) To test whether thwarted belongingness and perceived burdensomeness are associated with frequency of lifetime NSSI; (b) to test whether MIL moderates the association between thwarted belongingness and frequency of lifetime NSSI; and (c) to test whether MIL moderates the association between perceived burdensomeness and frequency of lifetime NSSI. Method: The sample consisted of N = 1531 participants (n = 736, 48.1%, were men, and n = 795, 51.9%, were women) between 12 and 18 years old from Spain. The participants filled out the Inventory of Statements about Self-Injury, Purpose-In-Life Test-Adolescent Version, and Interpersonal Needs Questionnaire. Moderation analyses were performed. Results: No statistically significant differences were found in the frequency of lifetime NSSI in the adolescents based on gender. Thwarted belongingness and perceived burdensomeness were positively associated with the frequency of lifetime NSSI in Spanish adolescents. MIL was a moderating variable between thwarted belongingness and the frequency of lifetime NSSI, and between perceived burdensomeness and the frequency of lifetime NSSI. Conclusions: Thwarted belongingness and perceived burdensomeness might be positively associated with the frequency of lifetime NSSI, and MIL might be negatively associated with the frequency of lifetime NSSI. Thus, adding these variables to current descriptive theories of NSSI in adolescents would allow us to improve assessment and treatment protocols for adolescents with NSSI. Keywords: Spanish adolescents; meaning in life; non-suicidal self-injuries; perceived burdensomeness; thwarted belongingness.

Según estudios previos el sentido en la vida está asociado negativamente con la psicopatología, el riesgo de suicido y la inestabilidad emocional en personas con trastornos alimentarios (TA). El objetivo de este estudio fue analizar el papel mediador del sentido de la vida y sus dimensiones en la relación entre la insatisfacción corporal y la sintomatología del TA y aportar pruebas que apoyen un modelo de elaboración del sentido de los trastornos alimentarios (MESTA). 292 personas diagnosticadas con TA (93,5% mujeres) contestaron el “Test de propósito en la vida” (PIL), el “Test de actitudes hacia la comida” (EAT) y el “Cuestionario multidimensional de relaciones entre el cuerpo y el yo” (MBSRQ-AS). Se realizaron análisis de mediación múltiple. El sentido en la vida medió la asociación entre la insatisfacción corporal y la psicopatología del TA. La dimensión de Satisfacción y sentido tuvo un papel mediador mayor. El sentido en la vida podría ser una variable importante en el mantenimiento de los TA. El MESTA puede ser un modelo útil para la comprensión de la psicopatología de los TA. Studies of people with eating disorders (ED) have indicated that meaning in life is negatively associated with psychopathology, suicide risk, and emotional instability in people with ED. The aim of this study was to analyze the mediating role of meaning in life and its dimensions in the relationship between body dissatisfaction and the symptoms of ED, and to provide evidence that supports the meaning making model of eating disorders (MESTA, in Spanish). 292 Participants diagnosed with ED completed the Purpose in Life Test (PIL), the Eating Attitudes Test (EAT), and the Multidimensional Body-Self Relations Questionnaire (MBSRQ-AS). Multiple mediation analyses were performed. Meaning in life was a mediator between body dissatisfaction and ED psychopathology. The dimension of Satisfaction and meaning in life had a greater mediating role. Meaning in life could be an important variable in the maintenance of ED. The MESTA could be a useful model for understanding the psychopathology of ED.

Background Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre-treatment and posttreatment. Method The sample comprised 403 participants (n = 202 participants diagnosed with BPD and n = 201 non-clinical). Participants filled out the Quality of Life Index, Resilience Scale, and Beck Depression Inventory. The clinical participants received one of these possible treatments, DBT, STEPPS, or CBT-TAU. MANOVA and regression analyses were performed. Results a) participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population; b) all three forms of psychotherapy statistically improved QoL, but there were no statistically significant differences between DBT, STEPPS, and CBT-TAU in the improvement of QoL; c) participants did not show clinically significant improvements in QoL after treatment; d) resilience was associated with QoL before and after treatment; and e) resilience was a predictor of QoL before and after treatment. Conclusion It is necessary to assess QoL and Resilience in studies on psychotherapy with BPD patients.

Background Studies suggested that psychotherapy improved QoL of participants with BPD. However, there are no studies about the differential efficacy of treatments in the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between DBT, STEPPS, and TAU-CBT in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether the resilience is a predictor of QoL at pre-treatment and posttreatment. Method: The sample comprised 403 participants (n = 202 participants diagnosed with BPD, and n = 201 non-clinical). MANOVA and regression analysis were performed. Results: participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population, all forms of psychotherapy improved QoL, but there was no clinical change after the treatments, resilience was associated with QoL before and after the treatment of BPD and, resilience was a predictor of QoL before and after the treatment. Conclusion It is necessary to assess QoL in studies of psychotherapy with BPD.

Background Patients with borderline personality disorder (BPD) experience significant affect regulation difficulties that cause serious consequences in their work, emotional, and social environments. This dysfunctional pattern also produces great suffering and a heavy burden on their relatives. Fortunately, some studies show that treatment of relatives of people with BPD begins to be important in the patients’ recovery and in improving family dynamics. One of the treatments that has obtained the most empirical support is Family connections (FC). This 12-session program is an adaptation of different Dialectical Behavior Therapy strategies. To test the efficacy of FC, five uncontrolled clinical trials were conducted, with pre-post treatment and follow-up assessments. The results of these studies and subsequent replications showed an improvement in family attitudes and caregiver burnout. Our research team adapted FC for delivery in the Spanish population. We intend to test the efficacy of this program versus a treatment as usual condition. Moreover, we aim to test the efficacy of this program and study its effectiveness (in terms of participants’ acceptance). This paper presents the study protocol. Methods The study is a randomized controlled trial. The participants will be recruited in a Personality Disorders Unit and randomly assigned to one of two treatment conditions: Family Connections group (FC) or Treatment As Usual (TAU). Primary outcome measures will be the BAS and FAD-GFS. Secondary outcomes will include DASS-21, FES, GS, and QLI. Participants’ treatment acceptance and degree of satisfaction will also be measured. Participants will be assessed at pre-, post-treatment, and 6-month follow-up. Intention to treat and per protocol analyses will be performed. Discussion This is the first study on FC for relatives of people with borderline personality disorder (BPD) compared to an active condition (TAU), and this is the first time relatives’ and patients’ data will be analyzed. In addition, it is the first study to test the efficacy of the program in Spain. This intervention could contribute to improving the efficiency and effectiveness of current treatment programs for relatives of people with BPD, help to decrease burden, and improve the family connection. Trial registration ClinicalTrials.gov ID: NCT04160871. Registered November 15th 2019.

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full-text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.Los familiares de pacientes con trastorno límite de la personalidad (TLP) experimentan elevados niveles de estrés. Se han llevado a cabo varios estudios sobre intervenciones diseñadas para disminuir su carga. Sin embargo, los datos obtenidos de estos estudios no se han expuesto. El objetivo de este trabajo es explorar la utilidad clínica de las intervenciones desarrolladas para los familiares de los pacientes con TLP. Se realizó una revisión sistemática siguiendo las directrices de PRISMA (número de registro CRD42018107318), que incluyó intervenciones psicológicas centradas en los familiares de los pacientes con TLP. Se utilizaron las siguientes bases de datos: PsycINFO, PubMed, EBSCOhost, y Web of Science. Dos investigadores independientes revisaron los estudios para determinar si se cumplían los criterios de elegibilidad. Se identificaron un total de 2303 resúmenes. Después de extraer los duplicados, se evaluaron 1746 estudios. Finalmente, se revisaron 433 artículos de texto completo, lo que dio lugar a 11 estudios que cumplían los criterios de inclusión. Los resultados demuestran que estas intervenciones con diferentes formatos y orientaciones clínicas son eficaces. La calidad de los estudios incluidos varía, y el apoyo empírico para estos programas es todavía preliminar. Los resultados contribuyen a establecer un marco general para las intervenciones desarrolladas específicamente para los familiares de los pacientes con TLP, pero se deberían realizar esfuerzos adicionales para mejorar la calidad metodológica de este campo de investigación y determinar con mayor solidez la utilidad de estas intervenciones. Dada la escasez de datos hasta el momento, esta información puede abrir nuevas líneas de investigación para mejorar la eficacia de los futuros programas para los cuidadores de los pacientes con TLP y ayudar a reducir su carga.家庭社会经济地位经常与儿童的早期发展相关联。将 SES 视为聚合变量存在许多问题，因为 SES 的不同组成部分可能通过不同的机制与子结果相关。本研究的目的是调查父母参与家庭学习活动和儿童参与课外活动（EAs）发挥的作用是否是促使了SES的单个组成部分和儿童入学准备相关联起来。为开展本研究特在中国广东省共招募了588个学龄前儿童家庭。在三个时间点分别对儿童的接受性词汇、汉语阅读和早期数学技能进行了评估，孩子们的社交技能由家长来评定。家长们报告他们和孩子一起参与在家的学习活动，以及他们的孩子参与课外活动（EAs）的情况。结果表明家庭SES的所有三个组成部分都与儿童入学准备的多个方面有关，但途径不同。父母收入情况只是通过课外活动参与情况与儿童入学准备程度相关，父母教育程度和职业地位通过父母参与和儿童课外活动参与两方面与入学准备程度相关联。研究结果表明，单独地考虑SES组成部分可以增进对不同途径的细微差别的理解， 这些途径都能将SES和儿童入学准备程度相关联起来。中国政府可以为低SES家庭提供侧重认知刺激这个方面的家长教育项目，以促进儿童的入学前的准备。此外，政府需要确保儿童获得平等的机会参与到课外活动EAs，这样可以防止来自不同社会经济背景的儿童之间的发展差距越来越大。.

Dialectical behavior therapy (DBT) and systems training for emotional predictability and problem solving (STEPPS) are two treatment protocols for people with borderline personality disorder (BPD) that have received important empirical support. However, their possible differential effectiveness has not yet been studied. The objective of this study is to explore the effectiveness of these two treatment programs. A nonrandomized clinical trial was carried out in which both treatments were applied for six months. The sample consisted of 72 patients diagnosed with BPD. The results indicate that both groups experienced a statistically significant reduction in BPD symptom, emotional regulation, impulsiveness, dissociative experiences, suicidal risk, depression, or anger. However, the DBT condition obtained statistically significant differences in BPD behavioral symptoms and fear of suicide. DBT and STEPPS treatment are effective treatments for participants with BPD, and DBT was more effective for the behavioral symptoms of BPD.

Los familiares de pacientes con trastornos alimentarios (TA) experimentan frecuentemente un elevado sufrimiento, ansiedad, e impotencia. Si, además del TA, el paciente padece trastorno de la personalidad (TP), el agotamiento emocional puede ser devastador. Sin embargo, no se ha descrito ningún tratamiento para aliviar el impacto en familiares de pacientes con ambos trastornos. El objetivo fue analizar la eficacia de un programa de tratamiento basado en estrategias de psicoeducación y resolución de problemas para familiares de pacientes con TA comórbidos con un TP. Método: Participaron 115 familiares (62.6% mujeres) de los cuales la mayoría eran madres (56.5%), seguidos de padres (28.7%), parejas/maridos (7%), hermanos (5.2%) y tíos (2.6%). Los participantes completaron la Escala de Zarit y la Escala General de Autoeficacia (EGA) antes y después del tratamiento. Resultados: Se encontraron diferencias significativas en la subescala Persistencia (EGA), y una tendencia a la mejoría en la Escala de Zarit. Conclusión: Estos resultados sugieren que el tratamiento fue efectivo. Además, los familiares mejoraron significativamente en aspectos clave: la sobrecarga por enfermedad y la persistencia en el cuidado y atención del paciente. Resulta fundamental profundizar en esta línea y analizar qué estrategias de tratamiento puedan resultar de mayor utilidad.

Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31–1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.

Dialectical behavior therapy (DBT) has been shown to be successful in the treatment of borderline personality disorder and eating disorders separately. The present study compares Standard Dialectical Behavior Therapy with a Treatment as Usual Cognitive Behavior Therapy (TAU CBT) for the treatment of borderline personality disorder and eating disorders comorbid features. A total of 118 women diagnosed with borderline personality disorders and eating disorders were assigned to one of two treatment groups in a naturalistic setting (DBT = 71; TAU CBT = 47). DBT showed a greater decrease in dysfunctional behaviors used to regulate emotions and related to borderline personality disorder (i.e. substance abuse, impulsive money spending, unprotected sex, etc.), non-suicidal self-injuries, and depressive symptoms, as well as an increase in cognitive reappraisal and global functioning. DBT and TAU CBT showed similar improvements in suicide attempts, dysfunctional eating behaviors (i.e. binge eating, purgative behaviors, and restriction), hospitalizations, negative and positive affect, and expressive suppression. Results of this study support the utility and effectiveness of standard DBT for comorbid borderline personality disorder and eating disorders in naturalistic settings. Replications of this study and randomized controlled trials are needed.

El objetivo de la presente investigación fue probar la Escala de Evaluación de la Atención Selectiva (EEAS) en lactantes sanos sin sospecha de daño neurológico, con la finalidad de obtener parámetros iniciales de normalidad para el uso del instrumento. La muestra estuvo integrada por 200 lactantes con un rango de edad entre dos y ocho meses, adscritos al sistema de guarderías del InstitutoMexicano del Seguro Social. Para obtener los parámetros iniciales de normalidad se utilizó estadística descriptiva para calcular la media, la desviación estándar, puntajes máximos y mínimos y percentiles. La EEAS permite identificar retrasos en el desarrollo del proceso de atención al comparar un puntaje individual contra su grupo de edad en tablas. Los hallazgos de este estudio sugieren que la EEAS es un instrumento útil para evaluar el desarrollo del proceso de atención durante la infancia.

This review is designed to systematically examine the available evidence about virtual reality exposure therapy's (VRET) efficacy for phobias, critically describe some of the most important challenges in the field and discuss possible directions. Evidence reveals that virtual reality (VR) is an effective treatment for phobias and useful for studying specific issues, such as pharmacological compounds and behavioral manipulations, that can enhance treatment outcomes. In addition, some variables, such as sense of presence in virtual environments, have a significant influence on outcomes, but further research is needed to better understand their role in therapeutic outcomes. We conclude that VR is a useful tool to improve exposure therapy and it can be a good option to analyze the processes and mechanisms involved in exposure therapy and the ways this strategy can be enhanced. In the coming years, there will be a significant expansion of VR in routine practice in clinical contexts.

In the last 20 years there have been two important developments of great importance to the field of psychological treatments. On the one hand, this meant the movement of positive psychology, and on the other, the introduction of information and communication technologies (ICT) to improve the daily clinical practice. In this paper a new field of study that attempts to strengthen ties and build bridges between them is introduced: Positive Technologies. This perspective seeks to promote the use of technology to foster personal growth and the development of human virtues and strengths, thus contributing to social and cultural development. In this chapter, we present four positive technologies: (1) ‘EMMA’s World’, a virtual reality system developed for the treatment of stress-related disorders. It can provide to the user meaningful virtual environments capable of activating and enhancing the emotional processing of the event experienced, and fostering a more positive projection toward the future. As a positive technology, it can be classified at the eudaimonic level; (2) ‘EARTH of Well-Being’, a virtual reality application designed to induce positive emotions in a controlled way and reinforce psychological resources, covering the hedonic and eudaimonic levels; (3) ‘Smiling is Fun’, a positive technology intervention designed to generate coping resources and foster psychological well-being at both at the hedonic and eudaimonic levels; and (4) ‘BUTLER’, which aims to contribute to improve the quality of life of the elderly. It includes the most popular Internet services integrated into a single platform, adapting its characteristics to the needs of the elderly population. It is designed to cover the three levels of positive technologies: hedonic, eudaimonic, and social interaction. All these applications are presented and the different possibilities and advantages that this perspective may involve are analysed.

Meaning in life has been found to be a protective factor against suicidal ideation. The aim of this study was to investigate whether meaning in life can moderate and buffer the association between suicide risk factors and hopelessness in women with borderline personality disorders. One hundred twenty-four women diagnosed with borderline personality disorder completed self-report measures of suicide risk factors, hopelessness, and meaning in life. The main result from this study was that meaning in life moderated the association between suicide risk factors and hopelessness. Meaning in life is an important variable in the prevention and treatment of risk of suicide in women with borderline personality disorder.

This work was aimed at obtaining a profile of neuropsychological impairments in young Spanish participants with anorexia nervosa (AN) to demonstrate that right-hemisphere and frontal capacity impairments are present not only in the acute phase but also after weight recovery in a Spanish sample compared with a healthy control group. Twelve patients with AN in the acute phase (body mass index [BMI]= 17) matched by age, IQ, and educational level by utilizing a wide neuropsychological battery. Differences were found between AN groups only for long-term verbal memory, which worsens as BMI increases. Among participants with AN as a group, results showed differences in speed of information processing, working memory, visual memory, and inhibition, unrelated to attentional capabilities. We cannot support the hypothesis of a specific right cerebral dysfunction in patients with AN. A general cognitive dysfunction, primarily in information processing, working memory, visual and verbal memory, as well as frontal impairments such as impulsivity and poor behavioral control, appeared unrelated to BMI. We support previous works affirming that neuropsychological impairments in AN are not a consequence of the illness but a risk factor for it to develop.

Cristina Botella,1,2 Adriana Mira,1 Inés Moragrega,2,3 Azucena García-Palacios,1,2 Juana Bretón-López,1,2 Diana Castilla,1,2 Antonio Riera López del Amo,1 Carla Soler,1 Guadalupe Molinari,1 Soledad Quero,1,2 Verónica Guillén-Botella,2,3 Ignacio Miralles,1,2 Sara Nebot,1 Berenice Serrano,1,2 Dennis Majoe,4 Mariano Alcañiz,2,5 Rosa María Baños2,31Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume, Castellón, Spain; 2CIBER Physiopathology of Obesity and Nutrition, CIBERobn, Instituto de Salud Carlos III, Santiago de Compostela, Spain; 3Department of Personality, Evaluation and Psychological Treatment, Universidad de Valencia, Valencia, Spain; 4Native Systems Institute, ETH Zurich, Zurich, Switzerland; 5Human-Centered Technology Institute, Universidad Politécnica de Valencia, Valencia, Spain Purpose: Computerized cognitive behavioral therapy (CCBT) has been shown to be efficacious. Moreover, CCBT can be enhanced by using physiological and activity sensors, but there is no evidence about the acceptability of all these tools. The objective of this study is to examine the efficacy, expectations, satisfaction, and ease of use of an Internet-based CCBT program for preventing depression, with and without sensors (electroencephalography, electrocardiograhpy ECG, and actigraphy), in a high-risk population (unemployed men).Patients and methods: Sixty participants at risk of depression (unemployed men) were randomly assigned to three experimental conditions: 1) intervention program (N=22), 2) intervention program plus sensors (N=19), and 3) control group (N=19). Participants completed depression, anxiety, positive and negative affect, and perceived stress measures. Furthermore, they also completed the measures for expectation, satisfaction, and the ease of use of the program.Results: Results showed that the two intervention groups improved significantly more than the control group on the clinical variables, and the improvements were greater in the group that used sensors than in the group that did not use them. Furthermore, participants in both intervention groups scored high on expectations and satisfaction with the CCBT program (with and without sensors). The mean score for usability was 88 out of 100 (standard deviation =12.32). No significant differences were found between groups on any of these variables.Conclusion: This is the first study to analyze the efficacy, expectations, satisfaction, and ease of use of an Internet-based program using physiological and activity sensors. These results suggest that an Internet program for depression with or without physiological and activity sensors is effective, satisfactory, and easy to use. Keywords: depression, ease of use, efficacy, Internet, sensors, satisfaction

Background and Objectives: Mindfulness-based therapies have demonstrat- ed effectiveness in many clinical contexts. Various therapies that train mindfulness skills have proliferated in recent years. There is increasing interest in mindfulness-based thera- pies and in incorporating instruments that measure mindfulness in order to understand its role in clinical and basic research. The Five Facets of Mindfulness Questionnaire (FFMQ) is a questionnaire for measuring mindfulness; it was derived from a factor analysis of five different questionnaires that measure a trait-like general tendency to be mindful in daily life. The objective of this study is to validate the FFMQ in a Spanish sample. Methods: The FFMQ was administered to a sample of 462 subjects ranging from 18 to 63 years (X = 27.9; SD = 9.75). The sample was composed by clinical (n = 146) and non- clinical (n = 226) subsamples. Results: The internal reliability of the scales ranged from acceptable to very good. Con- vergent analysis was conducted by computing Pearson's correlations, showing high corre- lations. The factorial structure is the same as that proposed by Baer et al. Conclusions: The FFMQ proved to be an effective instrument for measuring mindful- ness in clinical and non-clinical Spanish samples.

This paper presents preliminary efficacy data in a controlled study of the use of a virtual reality (VR) system for treating stress-related disorders (Post-Traumatic Stress Disorder, or PTSD; Pathological Grief, or PG; and Adjustment Disorders, or AD). ''EMMA's World'' is a VR application in which patients can explore negative experiences to the degree required for their specific therapeutic needs. To accomplish therapeutic goals, a series of virtual elements is customized to be meaningful to the user; the elements contain the fundamental emotional components that the person must confront. Thirty-nine participants diagnosed with PTSD (N=10), PG (N=16), and AD (N=13) were randomly assigned to a standard cognitive-behavioral program (CBT) (N=20) or a CBT program driven by EMMA's World (N=19). Participants were assessed before and after treatment. Measurements related to anxiety, depression and other emotions, maladjustment and interference were applied. Results indicate that CBT with EMMA's World was as effective as the standard CBT program for the treatment of these disorders, and the statistically significant differences (depression, relaxation intensity and social area interference) were in favor of EMMA's World. We expect VR to provide a positive alternative that will draw in clients who do not seek traditional forms of treatment.