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The prevalence of diagnosed cases of autism has increased rapidly, which has raised interest in studying the variables related to the well-being of these families. The purpose of this paper is to review the recent literature on other variables related to family well-being, such as parenting styles. We conducted a systematic review using the PRISMA check list and bias assessment with the aim of analyzing if the concepts of autism, well-being and parenting style are related. We screened 755 references from relevant databases like Scopus, Pubmed, PscyInfo EBSCO, Web of Science and Dialnet, updated on May 2024. Sixteen full text articles and abstracts were read. It was identified that the authoritative parenting style, as well as those based on warmth, establishing relationships and emotional bonding, and low expressed emotion were positively related to family well-being. On the other hand, authoritarian, permissive and overprotective styles, as well as critical, punishing and training-based, were negatively associated with well-being and quality of family life.

(1) Background: Mindfulness-based interventions (MBIs) have shown interesting preliminary effects on self-regulation processes in early adolescence. However, programs have typically combined different types of interventions with no understanding of the specific effect of each intervention type on attentional, emotional, and behavioral regulation. The objective of this research was to evaluate the effect of two MBIs—one focused on classic attentional practices and another focused on the recognition and expression of emotions—on attentional, emotional, and behavioral self-regulation in early adolescents. (2) Method: An experimental paradigm was used. A sample of 74 children aged between 8 and 12 years old were randomly assigned to three experimental conditions: (1) an MBI with a focus on attentional practices, (2) an MBI with a focus on recognition and expression of emotions, and (3) a control group. The interventions lasted 8 weeks, with a weekly, 1 h online synchronous session plus home practices. Children were evaluated before starting the intervention and at the end of the 8-week period. The assessed outcomes were (1) mindfulness; (2) emotional regulation; (3) attentional regulation, and (4) behavioral regulation. (3) Results: Children who participated in both intervention programs increased their mindfulness and emotional and behavioral regulation scores. Only children who participated in the MBI with a focus on attention showed significant changes in their ability to self-regulate attention. (4) Conclusions: The use of online MBIs, with attention to external and internal stimuli practices, can be a good strategy to strengthen self-regulation skills for attention, emotions, and behavior in early adolescence.

Family functioning, understood as cohesion and adaptability, is critical in families with adolescent children, given the changes that this stage implies at the family level. Time perspective is one variable that can facilitate better family functioning through the way people give meaning to the process they live. In this study, we examined the relationship between family functioning and the time perspective of adolescent children’s parents. The FACES IV and ZTPI were administered to 276 parents of adolescents. Regression analyses indicated that the past positive, past negative, and future scores predicted family cohesion and adaptability, explaining at least 20% of the variance. Balanced families, with greater cohesion and adaptability, presented a higher level of past positive and future-oriented temporal perspectives, compared to unbalanced families, which presented a greater orientation to the past negative and deviated from the balanced temporal profile. The importance of considering the inter-relationship between family functioning and time perspective was discussed, considering its impact on the health and well-being of families with adolescents.

Intervention programs based on self-compassion have demonstrated their efficacy both in reducing psychological distress and increasing well-being. The goal of this study was to test the efficacy of an online intervention to increase mindfulness and self-compassion levels in a non-clinical sample in a highly stressful context: the ten weeks of lockdown imposed in the early stages of the COVID-19 pandemic. The intervention sessions consisted of thirty-minute guided meditations followed by thirty minutes of inquiry. Sixty-one participants completed two thirds of the sessions or more, and 65 individuals participated in a waiting-list (WL) control group. Self-compassion, anxiety, depression and stress levels were assessed. The analysis of pre-post results suggests that the interventions increased self-compassion levels and decreased anxiety, depression and stress levels, whereas the WL group did not show any significant changes. The emotional changes in the intervention group were associated with the increase in self-compassion. However, at follow-up, the scores of emotional distress variables returned to the initial pre-intervention scores. These data can be interpreted in line with previous results that have shown the efficacy of self-compassion-based intervention programs. Given that this efficacy was not maintained at follow-up, data are discussed according to the pervasive role of a highly stressful context and—as described in other studies—the need for regular practice to maintain the benefits obtained.

Abstract Objective The aim of the present study is to identify factors associated with patient empowerment in people living with type 2 diabetes mellitus (T2DM) in the Canary Islands (Spain). Methods Secondary cross‐sectional analysis was carried out of data obtained in the INDICA study: A 24‐month cluster randomized‐controlled trial evaluating the effectiveness of educational interventions supported by new technology decision tools for T2DM patients. Sociodemographic variables, clinical data (years since diagnosis, glycated haemoglobin level, creatine, triglycerides, waist hip index, body mass index and number of comorbidities), diabetes knowledge (DIATEK), affective outcomes (Beck Depression Inventory‐II, the State subscale of the State‐Trait Anxiety Inventory and The Diabetes Distress Scale) and diabetes‐related quality of life (The Audit of Diabetes‐Dependent Quality of life) were assessed as potential correlates of patient empowerment, assessed using the Diabetes Empowerment Scale‐Short Form. Multilevel mixed linear regression models on patient empowerment were developed. Results The analysis included the baseline data of 2334 patients. Results showed that age (B = −0.14; p

Human development implies deep changes in cognitive, attentional, emotional, and behavioral skills. Therefore, Mindfulness-Based Interventions (MBIs) should be adapted in terms of dose, frequency, kind of exercises, assessment methods, and expected effects regarding the abilities and limitations of each developmental period. The present review seeks to describe and compare MBIs characteristics, assessment methods, and effects in youth between 3 and 18 years old considering four developmental periods. A systematic review was carried out including experimental primary studies published during the last five years. Results show that the frequency of the sessions and program duration varies widely. Differences were observed in instructors’ training and in assessment strategies. Discrepancies were observed regarding the effects of MBIs both within and between periods in cognitive, socio-emotional, symptoms, and mindfulness variables. Consistency was observed in prosocial behaviors for preschoolers, and in emotional and behavioral problems and hyperactivity in ages between preschool and early adolescence. Nevertheless, it was impossible to compare most results and determine consistency or discrepancy due to the lack of studies. Regarding mindfulness, it is defined and assessed in different ways in each period. Orientations are suggested to move from a compartmentalized view of isolated MBIs, towards an integrative perspective that allows tracing developmental trajectories for mindfulness and other key cognitive and socioemotional skills for children and adolescents.

La reexperimentación emocional (re) permite dar sentido a hechos traumáticos o estresantes mediante un proceso dirigi-do por instrucciones verbales o escritas, y por ello puede generar beneficios en el bienestar psicológico y la salud física autoinformada. El objetivo del presente estudio fue evaluar la comprensión de tres tipos de instrucciones experimentales (re tradicional, re con claves de aceptación y compromiso, y re psicosocial) y una instrucción para el grupo control (retrivial), mediante técnicas de validación cognitiva (pruebas centradas en el significado y verbalización de pensamiento) en personas expuestas a hechos de violencia política en Colombia. Para ello, se desarrolló un estudio de tipo cualitativo con corte instrumental, en el que se entrevistó a 42 colombianos víctimas de violencia política, en su mayoría mujeres, elegidos con un muestro por conveniencia. Las entrevistas fueron transcritas y codificadas mediante un análisis categorial mixto que tomó como referente procedimientos del Movimiento de Aspectos Cognitivos de la Metodología de Encuestas. Como resultado, los participantes comprendieron de manera diferencial las instrucciones dadas en cada protocolo, enfocándose en aspectos como el contexto sociopolítico en el caso del protocolo psicosocial, y en respuestas asociadas a la aceptación en el protocolo con claves de aceptación y compromiso. Se identificaron dificultades en la comprensión de algunas secciones de los protocolos, las cuales fueron ajustadas. Finalmente, se enfatiza la importancia de implementar técnicas de validación cognitiva para verificar la comprensión de instrucciones, protocolos o instrumentos, dado que el desempeño de los partici-pantes y la calidad de las medidas de las intervenciones pueden verse afectados por la comprensión e interpretación de las instrucciones propuestas.

IntroductionThe aim of this systematic review is to assess the relationship between patient empowerment and other empowerment-related constructs, and affective symptoms and quality of life in patients with type 2 diabetes.MethodsA systematic review of the literature was conducted, according to the PRISMA guidelines. Studies addressing adult patients with type 2 diabetes and reporting the association between empowerment-related constructs and subjective measures of anxiety, depression and distress, as well as self-reported quality of life were included. The following electronic databases were consulted from inception to July 2022: Medline, Embase, PsycINFO, and Cochrane Library. The methodological quality of the included studies was analyzed using validated tools adapted to each study design. Meta-analyses of correlations were performed using an inverse variance restricted maximum likelihood random-effects.ResultsThe initial search yielded 2463 references and seventy-one studies were finally included. We found a weak-to-moderate inverse association between patient empowerment-related constructs and both anxiety (r = −0.22) and depression (r = −0.29). Moreover, empowerment-related constructs were moderately negatively correlated with distress (r = −0.31) and moderately positively correlated with general quality of life (r = 0.32). Small associations between empowerment-related constructs and both mental (r = 0.23) and physical quality of life (r = 0.13) were also reported.DiscussionThis evidence is mostly from cross-sectional studies. High-quality prospective studies are needed not only to better understand the role of patient empowerment but to assess causal associations. The results of the study highlight the importance of patient empowerment and other empowerment-related constructs such as self-efficacy or perceived control in diabetes care. Thus, they should be considered in the design, development and implementation of effective interventions and policies aimed at improving psychosocial outcomes in patients with type 2 diabetes.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192429, identifier CRD42020192429.

Background: The aims of the study were to establish an adjustment model to analyze the relationship among mindfulness, balanced time perspective (BTP) and psychological well-being (PWB) in college students and to explore gender differences among the variables. Method: The sample consisted of 380 college students, 220 women and 160 men, uniformly distributed according to the university’s faculties. Results: The results indicate that the synergy between mindfulness and BTP predicts the variance of PWB by 55%. Regarding gender differences, it was found that women have a greater tendency towards Past Positive than men and men a higher tendency towards Present Hedonistic than women. In addition, in the group of women, a stronger relationship was found among the variables and, consequently, a greater predictive value for PWB (58%), displaying an enhanced disposition to high PWB compared to men. Conclusions: Together, mindfulness and BTP promote optimal psychological functioning and alleviate or reduce discomfort. Thus, their promotion and training in universities is especially important given the high prevalence of anxiety and depressive symptoms in college students.

Shared decision making (SDM) aims to involve patients in the decisions about their care, considering their preferences, values and concerns about the different treatment options. However, research shows that people with mental health problems have considerable unmet information needs about their condition. This community-based cross-sectional study explores the SDM process and information needs among people with Generalized Anxiety Disorder (GAD), as an initial step in the design and development of a Patient Decision Aid for this population. Seventy participants completed an online survey with the Control Preference Scale, and questions about the perceived difficulty of past treatment decisions and the use of the Internet for searching for GAD-related information. Most participants preferred an active (42.9%) or collaborative role (41.4%) in the SDM process, and 53% did not perceive their preferred role. Information provided by healthcare professionals was considered insufficient by 28% of the sample, and over 30% reported using the Internet to look for GAD-related information at least once a week or more. The most relevant GAD-related information needs were general information (71.4%), information on self-help groups (65.7%), recommendations on how to face this disorder (61.4%) and information on treatment options (50%). Exploratory analyses showed that patients who perceived an active participation were more likely to search for information frequently (p = 0.038), and those who felt more involved than desired tended to search for more themes (p = 0.049). In summary, the study showed that a considerable percentage of GAD patients have unmet needs related to decision-making participation and information.

El suicidio es una de las principales causas de muerte en el mundo, problema que en los últimos años ha venido en aumento sostenido para la población adolescente. En particular, la ideación suicida se ha relacionado fuertemente con el intento suicida, un predictor directo del suicidio; sin embargo, se encuentran escasas estrategias para disminuir la ideación suicida diseñadas principalmente para la depresión. Considerando las posibilidades terapéuticas de la teoría de Zimbardo sobre la perspectiva temporal equilibrada, en el presente estudio se diseñó una intervención breve basada en la perspectiva del tiempo para adolescentes con el objetivo de evaluar el efecto de una intervención de perspectiva temporal en la modificación de indicadores de ideación y conducta suicida en adolescentes. De este modo, se realizó un estudio experimental, donde 82 participantes de 15 a 19 años fueron asignados a una intervención experimental o a un grupo control. Los participantes del grupo experimental (n= 43) participaron durante 8 sesiones del programa de intervención de perspectiva del tiempo de-nominado “Serenamente”. Las mediciones pre-post se realizaron sobre las variables de ideación suicida (Okasha), el perfil temporal (ztpi) y la calidad de vida (SF-36). Como resultados, se encontró que la intervención reduce la ideación suicida en un 41 %; y que, posiblemente, mejora la salud física de quienes reciben este tipo de tratamiento. Los resultados son un avance promisorio con fines preventivos en contextos educativos y de salud.

Abstract Background Generalized anxiety disorder (GAD) is one of the most common mental disorders in primary care (PC). GAD has low remission and high relapse rates over long follow-up periods. Qualitative evidence was synthesized to understand the implementation of care and treatment options for people with GAD in PC. Methods Research published from 2008 to September 2020 was searched in five databases (MEDLINE, EMBASE, CINAHL, WOS and PsycArticles). Studies that used qualitative methods for data collection and analysis to investigate the implementation of care and treatment options for people with GAD in PC and outpatient settings were included. Non-qualitative studies, mixed methods studies that did not separately report qualitative findings and studies in languages other than English or Spanish were excluded. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to assess the overall confidence in the findings. Results The results with a moderate level of confidence showed that the trajectory of care for people with GAD in PC and outpatient settings is long and fluctuates over time, involving multiple difficulties in accessing and maintaining initial treatment or successive treatment options. In addition, there are wide variations in the preferences for and acceptability of different treatment options. The results with a high level of confidence indicated that more information on GAD and its treatment options is needed for PC practitioners, GAD patients and their carers. The results with a low level of confidence suggested that patients use antidepressants for longer than recommended and that the interruption of treatment is not usually planned. Conclusions Initial resistance to new treatments among people with GAD can make access and adherence to treatment difficult. Improving care may require patients to be informed of possible trajectories in stepped care pathways before the initiation of treatment so they are aware that they may need to try a number of options until the most effective treatment for them is found. Increased awareness of and information materials on GAD may facilitate both appropriate diagnosis and long-term care.

Objective: There has been a growing interest in the study of the effectiveness of mindfulness-based interventions (MBIs). Many clinical trials and experimental designs have been implemented, with different samples and diverse MBI procedures. Reviews have shown unclear results, apart from a tendency to identify low-to-moderate effectiveness. The purpose of this review is to examine the effectiveness of MBIs on anxiety complaints, analyzing available systematic reviews and meta-analyses. Method: The literature search was done in MEDLINE (PubMed) and PsycINFO, from the first available review in 2003 until March 2020. From 82 initial references, 12 reviews were selected. Results: Reviews confirmed a moderate effect size of MBIs in improving anxiety symptoms. This efficacy was similar to that of well-established therapies for reducing anxiety symptoms, such as cognitive behavioral therapies. A large effect size was found when well-developed MBI protocols were applied. Discussion: More refined clinical trials are needed to establish clear conditions of MBI effectiveness (protocols, samples, psychological mechanisms, etc.). In addition, considering mindfulness processes, new outcome measures are needed (such as acceptance, self-awareness, or well-being) to test the incremental value of MBIs.

The objective of this study was to analyze the neurostructural abnormalities of brain areas responsible for the acquisition and maintenance of fear in small animal phobia by comparing gray matter volume (GMV) in individuals with phobia and non-fearful controls. Structural magnetic resonance imaging was obtained from 62 adults (79% female) assigned to one of two groups: 31 were diagnosed with small animal phobia and 31 were non-fearful controls. To investigate structural alterations, a whole-brain voxel-based morphometry analysis was conducted to compare the GMV of the brain areas involved in fear between both groups. The results indicated that individuals with a small animal specific phobia showed smaller GMV in cortical regions, such as the orbitofrontal (OFC) and medial frontal cortex, and greater GMV in the putamen than non-fearful controls. These brain areas are responsible for avoidant behavior (putamen) and emotional regulation processes or inhibitory control (prefrontal cortex (PFC)), which might suggest a greater vulnerability of phobic individuals to acquiring non-adaptive conditioned responses and emotional dysregulation. The findings provide preliminary support for the involvement of structural deficits in OFC and medial frontal cortex in phobia, contributing to clarify the neurobiological substrates for phobias.

This study relates emotional regulation strategies with dispositional mindfulness and the mediating role of time perspective. It is based on the fact that one of the mechanisms of mindfulness consists in providing protective emotional regulation strategies. At the same time, a direct relationship between dispositional mindfulness and time perspective has been observed. To do this, a representative sample of 320 Chilean adolescents from the city of Talcahuano, whose age ranged between 14 and 17 years old, and who were attending high school, was evaluated. The Zimbardo Time Perspective Inventory, the Difficulties in Emotion Regulation Scale, and the Five Facet Mindfulness Questionnaire were applied. Regression analysis results verified the close relationship between emotional regulation and dispositional mindfulness (R2 = 0.54), as well as with the factors of time perspective (R2 = 0.41), explaining, between both of them, 60% of the variance of difficulties in emotional regulation. The possible mediational role of time perspective between dispositional mindfulness and emotional regulation is established.

Cognitive behavioral therapy (CBT) packages for anxiety disorders, such as phobias, usually include gradual exposure to anxious contexts, positive self-verbalizations, and relaxation breathing. The objective of this research was to analyze the specific neural activation produced by the self-verbalizations (S) and breathing (B) included in CBT. Thirty participants with clinical levels of a specific phobia to small animals were randomly assigned to three fMRI conditions in which individuals were exposed to phobic stimuli in real images: a group underwent S as a technique to reduce anxiety; a second group underwent B; and a control group underwent exposure only (E). Simple effects showed higher brain activation comparing E > S, E > B, and S > B. In particular, in the E group, compared to the experimental conditions, an activation was observed in sensory-perceptive and prefrontal and in other regions involved in the triggering of emotion (i.e., amygdala, supplementary motor area, and cingulate gyrus) as well as an activation associated with interoceptive sensitivity (i.e., insula and cingulate cortex). According to the specific tool used, discrepancies in the neural changes of CBT efficacy were observed. We discuss the theoretical implications according to the dual model of CBT as a set of therapeutic tools that activate different processes.

Research has shown that the COVID-19 pandemic has caused a mental health burden worldwide. Most studies have focused on the factors associated with a higher risk of mental health problems, and only a few studies have looked at the potential protective factors. The general objective of this study was to determine whether self-compassion has a protective effect against the risk of mental health problems and especially on perceived infectability. If so, we intended to determine which of the three specific facets of self-compassion (i.e., mindfulness vs. over-identification; self-kindness vs. self-judgment; common humanity vs. isolation;) has the greatest weight in predicting emotional distress. We conducted a cross-sectional study through an online survey completed by 855 participants in Spain. Results confirmed that the three facets of self-compassion reduce the negative correlation between perceived infectability and emotional distress, diminishing its role in predicting emotional distress. These results are discussed in relation to the protective role of self-compassion and the need to further explore the variables associated with a lower risk of mental problems derived from the SARS-CoV-2 pandemic.

El Trastorno de Ansiedad Generalizada (TAG) es uno de los trastornos de ansiedad más comunes y representa un porcentaje elevado en el ámbito de atención primaria (AP). Conocer los valores y preferencias de las personas con TAG en relación a los tratamientos disponibles facilita su elección y mejora las condiciones de salud. Objetivo: Realizar un estudio cualitativo para conocer la experiencia, valores y preferencias de las personas con TAG respecto a los tratamientos e incluir los resultados en las recomendaciones de una Guía de Práctica Clínica. Método: Diseño cualitativo con entrevistas semiestructuradas. Resultados: A partir del análisis narrativo se identificaron 5 temas: 1) Acceso al cuidado: diagnóstico, tratamiento farmacológico y atención especializada; 2) Aceptabilidad de los tratamientos; 3) Valores y preferencias; 4) La atención en atención primaria; 5) Conocimien0to para la autogestión y necesidades de información. Conclusiones: La aceptabilidad de los tratamientos es variable y el diagnóstico es más frecuente fuera de entornos de AP. Existe una necesidad de información en relación al TAG y a sus tratamientos.

Little is known about the impact of mindfulness on psychological wellbeing, anxiety, and avoidance in couple relationships. In emerging adulthood, intimate relationships are associated with life satisfaction and changes that can cause psychological maladjustment. This study seeks to determine if dispositional mindfulness acts as a protective variable between psychological wellbeing, anxiety, and avoidance and identify the factors that are protectors. A sample was obtained of 391 young university students between 18 and 25 years old. The Five-Facet Mindfulness Questionnaire, the Ryff Scales of Psychological Wellbeing, and the Experiences in Close Relationships Scale were used. The results show that the highest levels of dispositional mindfulness are associated with greater psychological wellbeing. Dispositional mindfulness cannot act as a protective variable against anxiety and avoidance, and values were non-significant in intimate relationships. It is necessary to continue investigating the most protective facets of mindfulness for both anxiety and avoidance.

Intimate relationship conflicts in young people are crucial experiences for change. They can lead to more or less satisfactory relationships, depending on individuals’ skills to cope with these conflicts. This may or may not lead to violence in couples. Acceptance and self-regulation processes are an effective strategy to address individual factors such as avoidance and anxiety in intimate relationships of people in these age groups, thus preventing violence. The aim of this study was to assess the effects of an eight-session mindfulness and acceptance-based program (MAP). Participants (n = 40), who were aged from 18 to 25 years old, were randomly assigned to a group receiving the MAP or an active control group. Outcome measures were anxiety about abandonment, intimacy avoidance (Experiences in Close Relationships scale), well-being (Psychological Well-being Scale), dispositional mindfulness (Five Facet Mindfulness Questionnaire) and flexibility (Acceptance and Action Questionnaire-II). Measures were taken at pre-intervention, post-intervention and follow-up. Results showed that the MAP decreased anxiety (p = 0.025) and avoidance (p = 0.01) and increased mindfulness (p < 0.001) and flexibility (p = 0.001). In general, these improvements persisted at follow-up. Results are discussed in relation to the usefulness of mindfulness-acceptance strategies to cope with non-pathological intimate relationship conflicts.

Maternal cocaine abuse during pregnancy is associated to neglect, abuse, and mother-child bond disruption, which directlyaffects infant development; therefore, various neurobehavioral problems of children of drug-dependent parents could beattributed to inadequate maternal behavior or prenatal exposure to drugs. Thus, the aim of this research was to analyze theeffects of chronic cocaine administration during pregnancy on postpartum maternal behavior. To do this, 21 CD1 pregnantfemale mice were randomly assigned for administration of saline solution and cocaine (25 mg/kg/day and 50 mg/kg/day), from day 8 to 21 of gestation. After delivery, for 15 minutes a day, during 20 days, the frequency of occurrence of 16 behavioralpatterns of maternal behavior was individually recorded, using an ethogram. Cocaine slightly affected maternal behavior frequency, although it may have affected other parameters, such as latency, duration, and sequence of this behavior.

Antecedentes/Objetivo: En este estudio se exploran las características en neuroimagen de personas con fobia específica a peque ̃ nos animales (cucarachas), para determinar si existen diferencias en la actividad cerebral entre personas con y sin fobia a las cucarachas, bajo condi- ciones de estimulación fóbica y no fóbica. Método : Se estudiaron 24 adultos (12 con fobia). El diagnóstico de fobia específica se obtuvo mediante una entrevista estructurada y cuestionarios. Todos fueron expuestos a una presentación en video 3D durante una sesión de RMNf. Resultados: El grupo con fobia mostró activaciones diferenciales significativas, que fueron congruentes con el modelo de doble ruta en el procesamiento del miedo, a través del tálamo- amígdala (ruta I), y tálamo-corteza entorrinal-hipocampo-subículo-amígdala (ruta II). Además, se encontraron activaciones diferenciales en el globo pálido, en el giro hipocampal, ínsula, y en los pars orbitalis, triangularis y opercularis. Con respecto al grupo control, no se observaron activaciones de la ínsula ni el cingulado. Conclusiones: Parece evidenciarse un modelo de doble ruta en el procesamiento de estímulos fóbicos. Este doble proceso puede tener implicaciones para el tratamiento psicológico de las fobias específicas.

Antecedentes/Objetivo: Revisión sistemática para evaluar el efecto de las inter- venciones basadas en la atención plena y/o en el proceso de aceptación de pensamientos rumiativos en la depresión. Método: Búsquedas sistemáticas en Medline, Embase, Cochrane Central, PsycInfo y Cinahl hasta diciembre 2016 y búsquedas manuales identificaron once estu- dios. Resultados: Un metanálisis que comparó el efecto de la intervención basada en Mindfulness con la atención habitual mostró una reducción significativa y moderada de pensamientos rumia- tivos. Los hallazgos sugieren que los procesos de atención/aceptación producen cambios en las rumiaciones e influyen en el efecto clínico de las intervenciones. Otro metanálisis con estudios que compararon la intervención basada en Mindfulness con otros tratamientos activos (medi- cación, activación conductual y terapia cognitivo-conductual, respectivamente) no mostraron diferencias significativas ( g = − 0,02, 95% CI: − 0,39, 0,35; I 2 = 0%). Conclusiones: Mindfulness en comparación con la atención habitual, produce una reducción significativa y moderada en la rumia. Este efecto parece independiente de la fase de tratamiento o del número de episodios depresivos pasados, y se mantuvo un mes después del final del tratamiento. Sin embargo, se necesitan más estudios controlados con pacientes reales que comparen las técnicas cognitivo- conductuales más utilizadas para tratar los pensamientos rumiativos con técnicas de aceptación y atención plena.

Los efectos beneficiosos sobre la salud de la reexperimentación emocional mediante la utilización de la escritura expresiva de vivencias traumáticas están bien establecidos. La efectividad de la utilización de la reexperimentación parece verse afectada por ciertas condiciones. Entre las variables personales que han mostrado tener influencia sobre la recuperación de tales vivencias se ha destacado el optimismo y la alexitimia. El objetivo del presente trabajo fue evaluar los efectos de una intervención basada en la reexperimentación emocional sobre la salud mental. Se aplicó un diseño experimental intergrupo pre y posttratamiento. La muestra estuvo compuesta por un total de 60 participantes, de los que 40 llevaron a cabo un procedimiento de reexperimentación emocional mediante tres sesiones de escritura expresiva. El resto formaron el grupo control y escribieron sobre situaciones triviales. Todos fueron evaluados antes y después de la reexperimentación emocional en afecto positivo y negativo, ansiedad, depresión, pensamientos intrusivos y evitación cognitiva. Además, se controló el nivel de optimismo y la alexitimia. Los resultados mostraron la eficacia de la escritura expresiva sobre el afecto positivo y negativo y el nivel de depresión. Entre las covariables, únicamente el optimismo produjo un efecto significativo sobre las variables más emocionales. Se discuten las condiciones contextuales y personales que pueden favorecer el uso clínico de la reexperimentación emocional.

Brain regions involved in small-animal phobia include subcortical and cortical areas. The present study explored the neuronal correlates of small-animal phobia through fMRI data to determine whether a manipulation of number and proximity parameters affects the neurobiology of the processing of feared stimuli. The participants were 40 individuals with phobia and 40 individuals without phobia (28.7% male and 71.3% female). They watched videos of real and virtual images of spiders, cockroaches and lizards in motion presented more or less nearby with one or three stimuli in the different conditions. The results suggested a differential brain activity between participants with and without phobia depending on the proximity and number of phobic stimuli. Proximity activated the motor response marked by the precentral gyrus and the cingulate gyrus. By contrast, the number of stimuli was associated with significant sensory activity in the postcentral gyrus and ventromedial prefrontal cortex. We also observed a greater activity in the occipital cortex when exploring the number compared to the proximity factor. Threatening stimuli presented nearby and those presented in greater numbers generated an intense phobic response, suggesting a different emotion regulation strategy. Based on these findings, exposure therapies might consider including proximity to the threat and number of stimuli as key factors in treatment.

El objetivo de este estudio fue analizar los efectos de la Exposición Prenatal a Cocaína (EPC) (0,25 o 50 mg/kg/día) en la conducta emocional de ratones hembras y machos en la adolescencia y la adultez temprana. Se asignaron 27 ratones CD1 hembras gestantes a 3 condiciones experimentales: un grupo control que se le administró solución salina y 2 experimentales a los que se le administró cocaína 25 mg/ kg/día y 50 mg/kg/día, desde el día octavo al veintiunavo de gestación. La conducta emocional de los hijos de estas madres se evaluó en la adolescencia y en la adultez temprana (5.ª y 7.ª semana de edad, respetivamente) por medio del tablero de agujeros y el laberinto en cruz a través de diferentes índices de actividad exploratoria. Los datos se analizaron por medio de MANOVAS y ANOVAS con un valor α de 0.05. La EPC alteró de forma dosis-relacionada la conducta emocional; los sujetos sometidos a EPC 50 mg/kg/día exhibieron mayor ansiedad y temor, en cambio los tratados con EPC 25 mg/kg/día exploraron más, mostrando conductas de alto riesgo, características de la impulsividad e hiperactividad. Los efectos encontrados se mantuvieron en el tiempo, por lo que se concluye que la EPC perturbó permanente y significativamente la emoción.

La Escala de Adherencia a la Medicación de Morisky-8 ítems (MMAS-8) es una medida auto-informada estructurada de la conducta de toma de la medicación ampliamente utilizada en diferentes culturas. No existen estudios en España que analicen sus propiedades psicométricas en población psiquiátrica. El objetivo de este estudio es determinar las propiedades psicométricas de la versión española de la MMAS-8 en una muestra de 967 pacientes psiquiátricos en régimen ambulatorio. Los resultados mostraron una adecuada validez de constructo, con una clara tendencia a una solución monofactorial, donde todos los ítems colaboraron en el índice final de adherencia. La MMAS-8 alcanzó correlaciones significativas con el Inventario de Actitudes hacia la Medicación-10 ítems, con la forma C de la Escala Multidimensional de Locus de Control sobre la Salud, y la Escala de Reactancia Psicológica. También la MMAS-8 permitió diferenciar el nivel de adherencia entre diferentes trastornos psicopatológicos. Los hallazgos de este estudio indican que la MMAS-8 es una medida fiable y válida para medir la adherencia a la medicación y que puede ser utilizada con muestras de pacientes psiquiátricos.

El objetivo de esta investigación es analizar la literatura científica sobre los tratamientos farmacológicos, somáticos y/o psicológicos en adultos con diagnóstico de un trastorno depresivo mayor que no han respondido al menos a un tratamiento con antidepresivos. Se llevó a cabo una revisión sistemática sin limitación temporal para identificar las revisiones sistemáticas y meta-análisis publicados hasta febrero de 2012 en DRT. Sesenta estudios fueron seleccionados de entre los cuales quedaron incluidos dieciséis al cumplir con los criterios de inclusión. Se sintetizan ocho temas principales entre los que cabe destacar la definición, resultados a largo plazo y diferentes estrategias de tratamiento, incluyendo las llamadas terapias somáticas. Actualmente existe una necesidad de estandarizar la definición para la DRT con el fin de homogeneizar su conceptualización. Esto permitirá un mayor entendimiento entre los clínicos e investigadores en el campo, la promoción de una metodología de investigación homogénea y la obtención de resultados más fiables y comparables. Esto tendrá también un impacto positivo en los pacientes que sufren de DRT, sus familias y los sistemas sociales y de salud. © 2013 Asociación Española de Psicología Conductual. Publicado por Elsevier España, S.L. Todos los derechos reservados.

En este estudio se comparó la eficacia de la exposición a estímulos virtuales combinada con terapia cognitivo-conductual (VRET) con un programa tradicional cognitivo-conductual (CBT) para reducir la sintomatología fóbica en una muestra de personas con agorafobia de larga evolución. Se utilizó un diseño entre sujetos con tres condiciones experimentales (grupo VRET, N = 30; grupo CBT, N = 30; y grupo con sólo medicación, N = 20) y medidas repetidas (pre, post- tratamiento y seguimiento a los seis meses). Todos los pacientes estaban tomando antidepresivos. Los resultados mostraron que todas las terapias fueron estadísticamente eficaces, tanto en el post-tratamiento como en el seguimiento. El grupo VRET mostró mayores mejoras clínicas en el seguimiento. El grupo CBT mostró las tasas más altas de abandono. VRET probablemente juega un papel intermedio para una exposición eficiente a los estímulos fóbicos. Más allá de las ventajas de un procedimiento VRET para el tratamiento de la agorafobia en términos de coste-beneficios, este estudio también destaca los posibles beneficios en la mejora en la motivación y adherencia al tratamiento.

El uso de las nuevas tecnologías en el tratamiento psicológico tiene hoy día un desarrollo importante. Desde un punto de vista experimental, los mayores desarrollos los ha tenido el uso de la realidad virtual y los programas servidos vía internet. En el presente trabajo se analizan ambos recursos, haciendo especial hincapié en los programas de tratamiento psicológico por medio de internet. En el caso de la realidad virtual, su desarrollo se ha dirigido especialmente al tratamiento de las fobias, mostrando una eficacia comparable a los tratamientos tradicionales y, en algunos casos, una eficacia clínica superior. El tratamiento psicológico vía internet ha tenido un desarrollo más extenso, aunque con mayor aplicación a los problemas de ansiedad y depresión. De las revisiones sistemáticas y meta-análisis se concluye que, a pesar de la disparidad de estudios, algunos programas han mostrado su eficacia, especialmente cuando se contrastan con un grupo sin tratamiento y cuando se tiene algún tipo de contacto con un terapeuta. Este tipo de recursos han mostrado una serie de ventajas en relación con los métodos tradicionales en relación con una mayor accesibilidad, versatilidad y costes económicos. Sin embargo, todavía permanecen algunas dificultades metodológicas para garantizar la viabilidad clínica de estos recursos tecnológicos.

Actualmente, se consideran tratamientos eficaces para la agorafobia algunos psicofármacos, la terapia cognitiva conductual (TCC) y la combinación de ambos. Entre los tratamientos psicológicos se han desarrollado nuevas alternativas terapéuticas, tales como técnicas de exposición con realidad virtual (TERV). El objetivo de este estudio experimental ha sido evaluar, en una muestra de pacientes con agorafobia (N = 64), la eficacia de la TERV combinada con dos psicofármacos (venlafaxina y paroxetina), utilizando un sistema virtual formado por siete escenarios. Para ello, se compararon cinco tipos de tratamiento: cuatro grupos de tratamientos combinados y un grupo de tratamiento psicofarmacológico. Se tomaron medidas en el pre-tratamiento, post-tratamiento y en el seguimiento a los seis meses, y como variables dependientes se consideraron medidas de agorafobia y ansiedad. Los resultados mostraron que todos los grupos eran estadísticamente significativos, tanto en el postratamiento como en el seguimiento a los seis meses. Atendiendo a la eficacia clínica, los resultados mostraron que los grupos de tratamiento combinado con TERV disminuyeron las puntuaciones de agorafobia y ansiedad, manteniéndolas en el tiempo, más que las técnicas de tratamiento tradicional.

La exposición a estímulos virtuales se ha verificado como un procedimiento útil en el tratamiento de los trastornos fóbicos. Sin embargo, existe una serie de problemas en la aplicación a la agorafobia (estímulos a utilizar, presencia de avatares, etc.). El propósito de este estudio experimental consiste en comparar la eficacia de un tratamiento combinado, exposición a la realidad virtual y tratamiento cognitivo conductual (VRET), con un acercamiento tradicional cognitivo-conductual (CBT). Quince pacientes con agorafobia crónica recibieron un tratamiento VRET en 3D y 13 pacientes recibieron un tratamiento CBT. Los dos grupos recibieron 11 sesiones. Las medidas postratamiento incluyeron un breve test de evitación conductual (BAT). Los resultados mostraron una significativa mejoría en los síntomas de la agorafobia (cogniciones, sensaciones corporales, nivel de ansiedad y depresión) para los dos grupos que, en general, permanecieron en un seguimiento a tres meses. Los BAT mostraron la capacidad de los pacientes para exponerse a los estímulos fóbicos. Adicionalmente, el grupo VRET mostró mayores mejorías, aunque ligeras, en comparación con el grupo CBT. Estos resultados se discuten en relación con las dificultades del VRET para la agorafobia y en relación con la viabilidad de los siete ambientes fóbicos virtuales para generar una exposición aceptable a los estímulos fóbicos.

Se pretende con este estudio llevar a cabo una estimación de la prevalencia de los trastornos mentales agrupados tanto en categorías generales como en categorías diagnósticas específicas. Se utilizó un diseño por conglomerados bietápico, llevando a cabo una selección aleatoria de la muestra en dos fases. La muestra en 1ª fase estuvo constituida por 800 personas, mayores de 18 años. En 2ª fase se trabajó con 114 personas. Como instrumentos de evaluación se administraron el GHQ-28 y la entrevista estructurada CIDI. Los resultados indican una prevalencia estimada del 18,42% para el total de la muestra. Se obtiene una mayor prevalencia de trastornos en las mujeres. Por categorías específicas, los trastornos de ansiedad son los más prevalentes, seguidos por los trastornos relacionados con sustancias y de los trastornos del estado de ánimo. Se destaca que los trastornos relacionados con el uso de sustancias ocupan un segundo lugar, desplazando a los trastornos del estado de ánimo, lo que concuerda con otros estudios realizados con metodología similar.

El presente estudio ex post facto trata de poner a prueba cómo algunos predictores del nivel de depresión también son una función de la medida utilizada. Los predictores tenidos en cuenta corresponden al nivel de actividad, el estilo atribucional y las actitudes disfuncionales. Para medir la depresión se han utilizado el BDI, con una representación importante de los contenidos relacionados con la distorsión cognitiva y el CBD-r con contenidos relacionados con la afectividad triste. A una muestra de 123 estudiantes se les administraron, además del BDI y el CBD-r, los siguientes cuestionarios: la escala relacionada al estado de ánimo del cuestionario de eventos agradables (PES-MR), el Cuestionario de Estilos Atribucionales (ASQ) y la Escala de Actitudes Disfuncionales (DAS). Los resultados muestran parcialmente la relación predicha entre predictores y medidas de la depresión, ya que el nivel de actividad está relacionado con cualquiera de las dos medidas, pero parece observarse que, mientras a nivel atribucional está más cercano a la medida del CBD-r, las actitudes disfuncionales están más vinculadas a la depresión medida por el BDI. Estos resultados se discuten de acuerdo con los distintos componentes de la depresión y en qué medida la búsqueda de sus predictores es también la búsqueda de la compleja composición del fenómeno depresivo.

El Inventario de Padua (IP) se ha convertido en uno de los más usados, de entre los disponibles, con fines clínicos y de investigación en los trastornos obsesivo-compulsivos. En general, posee unas propiedades psicométricas aceptables. Los diferentes estudios transculturales tienden a confirmar su estructura tetrafactorial. Este trabajo tiene por objeto aportar nuevos datos sobre la estructura factorial y consistencia interna con una muestra española. Los resultados del análisis factorial exploratorio y confirmatorio sobre una muestra de 356 adultos concluyen la adecuación de la estructura tetrafactorial propuesta por Sanavio. El IP muestra una estructura similar, que no idéntica, a la de Sanavio. La consistencia interna de la escala y subescalas es alta. Se propone para futuros estudios constatar la validez discriminante de los factores de pérdida de control sobre la actividad mental y comprobación, y considerar la existencia del quinto posible factor denominado en otros estudios precisión.

Abstract Maternal cocaine abuse during pregnancy is associated to neglect, abuse, and mother-child bond disruption, which directly affects infant development; therefore, various neurobehavioral problems of children of drug-dependent parents could be attributed to inadequate maternal behavior or prenatal exposure to drugs. Thus, the aim of this research was to analyze the effects of chronic cocaine administration during pregnancy on postpartum maternal behavior. To do this, 21 CD1 pregnant female mice were randomly assigned for administration of saline solution and cocaine (25 mg/kg/day and 50 mg/kg/day), from day 8 to 21 of gestation. After delivery, for 15 minutes a day, during 20 days, the frequency of occurrence of 16 behavioral patterns of maternal behavior was individually recorded, using an ethogram. Cocaine slightly affected maternal behavior frequency, although it may have affected other parameters, such as latency, duration, and sequence of this behavior.

El desarrollo de nuevas tecnologías ha alcanzado prácticamente a todo el desarrollo humano. En el caso de la psicología clínica, ha significado nuevos avances en el conocimiento, evaluación y tratamientos psicológicos de diferentes problemas y trastornos. En este trabajo se revisan cuatro desarrollos que han tenido una expansión importante: el uso de internet para el tratamiento psicológico, el uso de la realidad virtual, el neurofeedback y la estimulación magnética transcraneal. Se presenta brevemente cada técnica o procedimiento, su aplicación a problemas concretos, sus ventajas y sus inconvenientes. Finalmente se discute el desarrollo de estos recursos y la necesidad de seguir aportando conocimientos que vayan mejorando su eficacia y su eficiencia, de acuerdo con tipos de pacientes, patologías, procedimiento específico, así como evitar efectos indeseables.

This study analyzed the role of psychological processes predicting depressed patients' preferences in clinical decision-making about psychiatric treatment. 462 patients diagnosed with depressive disorders, acute or recurrent, participated in a crosssectional survey. Most participants preferred collaborative-passive or totally passive roles. Results showed no significant differences between acute and recurrent patients in their preference of participation in decision-making, but longer treatment duration was associated with a more passive style. MANCOVA, controlling age, educational level and treatment duration variables, showed that collaborative and passive patients had a greater locus of control focused on their psychiatrist than active patients. Gender differences were found. Men showed greater internal locus of control and psychological reactance, while women showed greater external locus of control focused on chance. Regression analysis indicated that, for men, passive preferred role was explained by external locus centered on their psychiatrist. However, age registered the highest weight for women' passive decision-making, followed by the locus focused on chance, locus focused on the psychiatrist and lower self-efficacy. Our findings suggest the need to study shared decision-making from a differential perspective that involves psychological processes and the impact of these processes in adherence to medical treatments.