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Saavedra J, González S, Murvartian L, Arias-Sánchez S. Psychosocial and vocational impact of an internship program for people diagnosed with severe mental illnesses. Disabil Rehabil 2024:1-9. [PMID: 38410839 DOI: 10.1080/09638288.2024.2319725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Unemployment is an obstacle in recovery for people with severe mental illnesses (SMI), both in reducing psychopathological symptoms and in achieving a high quality of life. The aim of this study was to explore the impact of an internship program for people diagnosed with SMI on psychosocial variables using a pre-test and post-test design. METHOD Four scales were administered to a sample of 127 study participants, all of whom were diagnosed with SMI. The results of standard and sheltered employment outcomes were obtained by comparing the number and type of contracts gained by participants up to one year after program completion. A repeated measures ANOVA analysis was carried out with intervention being an independent intra-subject variable and type of participant diagnosis being a between-subjects variable. RESULTS A limited increase in social functioning was found, as well as a significant decrease in psychiatric distress for users diagnosed with personality disorders. Participants in the internship program obtained a greater number of employment contracts than their peers who did not participate in the program, albeit with a low effect size. CONCLUSIONS Though results were positive, extension of internship length and provision of more intensive counselling for participants may be useful.
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Affiliation(s)
- Javier Saavedra
- Department Experimental Psychology, University of Seville C/Camilo José Cela, Seville, Spain
| | - Sergio González
- Andalusia's Public Foundation for the Social Integration of Persons with Mental Disorder (FAISEM) Avda. Las Ciencias, Seville, Spain
| | - Lara Murvartian
- Department Experimental Psychology, University of Seville C/Camilo José Cela, Seville, Spain
| | - Samuel Arias-Sánchez
- Department Experimental Psychology, University of Seville C/Camilo José Cela, Seville, Spain
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Santonja Ayuso L, Ruiz-Hontangas A, Cervantes JJG, Martínez CM, Pons EG, Pons SC, Pejó LA, Carmona-Simarro JV. The Promotion of Mental Health and Prevention of First-Episode Psychosis: A Pilot and Feasibility Non-Randomised Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7087. [PMID: 37998318 PMCID: PMC10671828 DOI: 10.3390/ijerph20227087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Mental-health-related stigma prevents active help seeking and therefore early therapeutic approaches and the recovery of functionality. National and international agencies recommend the implementation of prevention and mental health promotion programs that support the elimination of stigma in the classroom, since most mental health problems usually start in the adolescent stage. In view of the evidence that teachers present stigmatizing attitudes towards mental health, it has been considered as convenient to carry out an anti-stigma program with the main objective of evaluating the impact of an intervention based on the education and promotion of mental health, aimed at teachers and counsellors of a secondary school. The specific objectives were to get to know which were the most stigmatising attitudes that prevailed in the sample before and after the intervention; to evaluate the knowledge of the teaching staff and counsellors on psychosis before the intervention; to analyse correlations between clinically relevant variables; and assess whether this programme was beneficial and feasible for alphabetising counsellors/teachers of educational centres on stigma and FEP. METHODS This was a non-randomised clinical trial in which a nursing intervention was performed. TOOLS a psychosis test (pre), Stigma Attribution Questionnaire (AQ-27) (pre-post), and satisfaction survey (post) were used. The inferential analysis included the Wilcoxon and the Pearson Correlation Test. RESULTS In the sample (n = 22), the predominant stigmatising attitude was "Help". The p-values obtained in the Wilcoxon Test were statistically significant, except for "Responsibility" and "Pity". The following constructs of interest were faced: "Fear"-"Age" and "Professional experience"; and "Help"-"Psychosis test". CONCLUSIONS Despite the scores obtained in "Responsibility" and "Pity", the intervention was useful for reducing stigma in the sample. Implications for the profession: There are adolescents who have suffered stigma from their teachers, and consequently have minimized their symptoms and not asked for help. For this reason, we implemented a nursing intervention based on the education and promotion of mental health, with the aim of expanding knowledge and reducing stigma. In fact, this intervention, which we carried out on high school teachers, managed to reduce the majority of stigmatizing attitudes measured on the stigma attribution scale.
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Affiliation(s)
- Lucia Santonja Ayuso
- Department of Nursing, Faculty of Health Sciences, Universidad Jaume I, 12006 Castellón, Spain; (L.S.A.)
| | - Antonio Ruiz-Hontangas
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain
| | | | | | - Eva Gil Pons
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain
| | - Sonia Ciscar Pons
- Department of Nursing, Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain
| | - Laura Andreu Pejó
- Department of Nursing, Faculty of Health Sciences, Universidad Jaume I, 12006 Castellón, Spain; (L.S.A.)
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Goodman-Casanova JM, Cuesta-Lozano D, Alupoaei C, Grasa Bello EM, Herrera-Imbroda J, Mayoral-Cleries F, Guzman-Parra J. Psychometric validation of the 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP). Front Psychol 2023; 14:1178341. [PMID: 37484089 PMCID: PMC10356816 DOI: 10.3389/fpsyg.2023.1178341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/04/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Reliable and valid instruments are needed to measure the impact of mental health services and programs on the journeys of recovery of service users. The aim of this study was to explore the psychometric properties of the cross-culturally adapted 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP). Methods One hundred and ten participants from three locations in Spain (Málaga, Barcelona and Madrid), who were users of primary and specialized mental health services, were interviewed from October 2021 to June 2022. Results The internal consistency obtained was excellent: ω =.93 and α =.92. Temporal reliability using intraclass correlation coefficients was moderate (ICC=.684, p <.000). Regarding convergent validity, the QPR-15-SP had a moderate correlation with the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) (ρ =-.500, p <.000), a Visual Numeric Recovery Scale (VNRS) (ρ =.591, p <.000), and the Stages of Recovery Instrument (STORI) (r =.566, p <.000). Correlations between advanced stages of recovery and higher QPR-15-SP scores were found (Moratorium: ρ =-.579, p <.000; Awareness: ρ =-.130, p =.189; Preparation: r =-.043, P=.665; Rebuilding: r =.460, p <.000; Growth: ρ =.697, p <.000). In terms of divergent validity, the QPR-15-SP had low correlation with the DUKE-UNC Functional Social Support Scale (ρ =.273, p <.005). The confirmatory factor analysis of the 1-factor structure obtained reasonable goodness of fit indexes. Discussion The QPR-15-SP has acceptable psychometric properties, providing support for measuring recovery in Spain and allowing international comparison research.
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Affiliation(s)
- Jessica Marian Goodman-Casanova
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Madrid, Spain
| | | | - Catalina Alupoaei
- Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Madrid, Spain
| | - Eva María Grasa Bello
- Mental Health, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBESAM), Madrid, Spain
| | - Jesús Herrera-Imbroda
- Grupo de Neuropsicofarmacología, Hospital Regional Universitario de Málaga - Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina–IBIMA Plataforma Bionand, Málaga, Spain
- Departamento Farmacología y Pediatría, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Fermin Mayoral-Cleries
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jose Guzman-Parra
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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A comparison of mental health of student and not student emerging adults living in Ecuador. Sci Rep 2023; 13:1487. [PMID: 36707675 PMCID: PMC9880921 DOI: 10.1038/s41598-023-27695-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Most of the studies about mental health and quality of life of emerging adults have been conducted in developed countries and non-students' population has been neglected, limiting the generalisation of the results to other socioeconomic realities. This paper reports the results of an observational study on differences between the two cohorts (students vs non-students) both on mental health and quality of life measures but also on demographic, lifestyle and mental health variables in emerging adults living in a middle-income country. Associations between variables and interactions in the prediction of both outcomes scores were explored to understand how much other variables may contribute to differences between the two groups. We found poorer mental health and worse health-related quality of life in the students than the non-students, although effect sizes were small. Differences between the groups on some sociodemographic predictor variables were statistically significant, showing fairly strong effects, for social status, sleeping hours and parenting, however, none of the predictor variables showed confounding with group effects on both outcomes. Developing countries are growing and work forces are changing, creating a huge global need to understand these changes and the effects on the mental health and quality of life of this evolving population.Registration: ClinicalTrials.gov (NCT04596345).
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Dogmanas D, Arias MA, Gago F, de Álava L, Roussos A. Implementation of a psychological treatment outcomes evaluation system for young people at Uruguay's National Health System: Using
CORE‐OM. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Denisse Dogmanas
- Facultad de Psicología Universidad de la República Montevideo Uruguay
| | | | - Fiorella Gago
- Facultad de Psicología Universidad de la República Montevideo Uruguay
| | - Laura de Álava
- Facultad de Psicología Universidad de la República Montevideo Uruguay
| | - Andres Roussos
- CONICET, Universidad de Buenos Aires Buenos Aires Argentina
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Montesano A, Medina JC, Paz C, García-Mieres H, Niño-Robles N, García-Grau E, Crespillo JC, García-Gutiérrez A, Alabèrnia-Segura M, Feixas G. Does virtual reality increase the efficacy of psychotherapy for young adults with mild-to-moderate depression? A study protocol for a multicenter randomized clinical trial. Trials 2021; 22:916. [PMID: 34903251 PMCID: PMC8666832 DOI: 10.1186/s13063-021-05809-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The improvement of psychological treatments for depression in young adults is a pressing issue highlighted in the literature. Its relevance is determined not only because young adults are underrepresented in research, but also to prevent chronic severe mental health disorders later in life. Engagement is considered a key factor for a good therapeutic outcome, especially among young patients. In this sense, virtual reality could be particularly suited to engage young adults in the therapy process. This project aims to improve the psychological treatment of mild-to-moderate depression in young adults by testing out the efficacy of virtual reality-enhanced personal construct therapy (PCT-VR), as compared to personal construct therapy alone (PCT) and to the reference standard cognitive behavioral therapy (CBT). In contrast to CBT, PCT neither educates patients about depression nor gives them directions on the changes to be made in their dysfunctional behaviors or cognitions. Rather, PCT explores the coherence (or conflicts) of thoughts and behaviors with respect to the person's sense of identity and focuses on meaning-making processes. METHODS The efficacy of this innovative intervention (PCT-VR) will be compared to PCT and to CBT in a randomized clinical trial. The study includes an appraisal of therapists' adherence and independent assessments to preserve internal validity. The Beck Depression Inventory-II is the primary outcome measure for calculating both statistical and clinical significance, but other outcomes will also be assessed (e.g., functioning, well-being, anxiety, stress) at pre- and post-therapy and at 6-month follow-up. The trial will be conducted in a naturalistic context, mostly at the usual health care center of each patient. A sample of 225 participants is targeted to reach enough statistical power to accomplish the goals of the study. DISCUSSION We expect that providing evidence for PCT-VR will widen the repertoire of evidence-based technology-based psychotherapeutic interventions for young adults and contribute to the prevention of deteriorating courses of the disorder. TRIAL REGISTRATION ClinicalTrials.gov NCT04321525 . Registered on 18 February 2020.
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Affiliation(s)
- Adrián Montesano
- School of Psychology and Educational Sciences, Open University of Catalonia, Barcelona, Spain
| | - Joan C. Medina
- School of Psychology and Educational Sciences, Open University of Catalonia, Barcelona, Spain
| | - Clara Paz
- School of Psychology and Education, Universidad de Las Américas, Quito, Ecuador
| | - Helena García-Mieres
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Noelia Niño-Robles
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Eugeni García-Grau
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Josep Cañete Crespillo
- Department of Mental Health, Consorci Sanitari del Maresme, Hospital de Mataró, Mataró, Spain
| | | | - Miquel Alabèrnia-Segura
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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7
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Andrade-González N, Rodrigo-Holgado I, Fernández-Rozas J, Cáncer PF, Lahera G, Fernández-Liria A, Rubio G, Miller SD. Spanish Versions of the Outcome Rating Scale and the Session Rating Scale: Normative Data, Reliability, and Validity. Front Psychol 2021; 12:663791. [PMID: 34484027 PMCID: PMC8414252 DOI: 10.3389/fpsyg.2021.663791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/30/2021] [Indexed: 12/01/2022] Open
Abstract
Routine outcome monitoring (ROM) uses standardized measures to both track and inform mental health service delivery. Use of ROM has been shown to improve the outcome of psychotherapy when applied to different types of patients. The present research was designed to determine the reliability and validity of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) in a sample of Spanish patients. After a controlled process of translation into the Spanish that is spoken and written in Spain (i.e., in Europe, as distinct from, e.g., Latin American Spanish), both measures were completed by patients of an outpatient mental health unit during eight sessions of psychotherapy. Sixty mental health patients filled out the ORS and 59 the SRS. In addition, the ORS was completed by 33 people who constituted the non-clinical sample. The cut-off of the ORS was 24.52 points, and the Reliable Change Index (RCI) was 9.15 points. ORS and SRS scores exhibited excellent internal consistency. The temporal stability of the SRS was adequate. The convergent and discriminant validity of the two measures were adequate. Regarding the factorial validity of the ORS and the SRS, in the third psychotherapy session, confirmatory factor analyses evidenced the existence of a unifactorial model. The predictive validity of SRS was acceptable. The ORS was sensitive to changes in patients’ symptoms. In conclusion, compared to the original English versions of the ORS and SRS measures, the Spanish versions of the measures are also reliable and valid.
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Affiliation(s)
- Nelson Andrade-González
- Relational Processes and Psychotherapy Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | | | | | - Pablo F Cáncer
- Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Guillermo Lahera
- Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain.,Biomedical Research Networking Center for Mental Health Network, Ramón y Cajal Institute for Health Research, Madrid, Spain.,Príncipe de Asturias University Hospital, Alcalá de Henares, Spain
| | | | - Gabriel Rubio
- 12 de Octubre University Hospital, Madrid, Spain.,12 de Octubre Research Institute, Madrid, Spain.,Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Scott D Miller
- The International Center for Clinical Excellence, Chicago, IL, United States
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8
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Longitudinal Distress among Brazilian University Workers during Pandemics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179072. [PMID: 34501661 PMCID: PMC8430478 DOI: 10.3390/ijerph18179072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022]
Abstract
The present study aimed to examine changes in mental distress in Brazilian university workers during the pandemic. All workers (n ≃ 1850) of an institution were invited to respond to a survey that took place in three stages, with collections in May (n = 407), June/July (n = 258), and August (n = 207) 2020, and included questions on demographic, health, general and psychological support, and psychometric assessment of mental distress (Clinical Outcome Routine Evaluation- CORE-OM) combined with an open question about major concerns. The results of the Multilevel Modeling analysis pointed to the absence of significant differences across the repeated measures of distress. The only variable associated with increased psychological distress over time was a lower level of support for household chores. Qualitative analysis of the reported major concerns was carried out with a sub-sample who showed reliable deterioration in CORE-OM across time (n = 17). The diversity of concerns reported by this group reinforced that work–life imbalance contributes to mental distress of university workers during the pandemic. Low response rate, although not unexpected due to the circumstances, limits the generalization of findings. The present data suggest that in addition to issues related to contagion and specific restricted measures to contain the spread of the disease, the personal reorganization of life required to maintain activities at home and work can be an important contributor to pandemic-related psychological distress.
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Evans C, Paz C, Mascialino G. " Infeliz" or " Triste": A Paradigm for Mixed Methods Exploration of Outcome Measures Adaptation Across Language Variants. Front Psychol 2021; 12:695893. [PMID: 34434145 PMCID: PMC8381247 DOI: 10.3389/fpsyg.2021.695893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
The literature on measure translation tends to hold, overtly or covertly, a questionable assumption about the possibility of exact translation and almost completely ignores issues of within language variation. Equally, psychometric methods used to assess cross-cultural validity after translation focus on large sample tests of cross-sectional measurement invariance. Such invariance is often not found and is of dubious pertinence to change/outcome measures usually used in psychotherapy research. We present a sequential process of three substudies using quantitative and qualitative procedures to explore whether an outcome measure needs to be changed when used across language variation. Qualitative data confirmed that an item was not ideal in the new context. However, quantitative exploration showed that, although statistically significant and affected by gender and item order, the impact of changing the item in the overall score was small, allowing retention of the existing Spanish translation. We argue that the myth of perfect translation and over-reliance on large-sample psychometric testing pursuing measurement invariance limit exploration of language effects. We recommend that these be used in the companion of user-based, sequential, mixed-method exploration to support the development of a richer field of understanding of outcomes and change self-report measures across languages and cultures and both across and within languages.
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Affiliation(s)
- Chris Evans
- Department of Psychology, The University of Sheffield, Sheffield, United Kingdom
| | - Clara Paz
- Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador
| | - Guido Mascialino
- Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador
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10
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Paz C, Hermosa-Bosano C, Evans C. What Happens When Individuals Answer Questionnaires in Two Different Languages. Front Psychol 2021; 12:688397. [PMID: 34248794 PMCID: PMC8260934 DOI: 10.3389/fpsyg.2021.688397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of the present study was to compare scores from the English and the Spanish versions of two well-known measures of psychological distress using a within-subject approach. This method involved bilingual participants completing both measures in four conditions. For two groups of people, measures were offered in the same language both times and for the other two groups, each language version was offered, the order differing between the groups. The measures were the Clinical Outcomes in Routine Evaluation-Outcome Measure and the Schwartz Outcome Scale-10, both originally created in English and then translated to Spanish. In total, 109 bilingual participants (69.7% women) completed the measures in two occasions and were randomly allocated to the four conditions (English-English, English-Spanish, Spanish-English and Spanish-Spanish). Linear mixed effects models were performed to provide a formal null hypothesis test of the effect of language, order of completion and their interaction for each measure. The results indicate that for the total score of the Clinical Outcomes in Routine Evaluation-Outcome Measure just language had a significant effect, but no significant effects were found for completion order or the language by order interaction. For the Schwartz Outcome Scale-10 scores, none of these effects were statistically significant. This method offers some clear advantages over the more prevalent psychometric methods of testing score comparability across measure translations.
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Affiliation(s)
- Clara Paz
- Escuela de Psicología, Universidad de Las Américas, Quito, Ecuador
| | | | - Chris Evans
- Department of Psychology, The University of Sheffield, Sheffield, United Kingdom
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11
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Grau Touriño A, Feixas G, Medina JC, Paz C, Evans C. Effectiveness of integrated treatment for eating disorders in Spain: protocol for a multicentre, naturalistic, observational study. BMJ Open 2021; 11:e043152. [PMID: 34006027 PMCID: PMC7942235 DOI: 10.1136/bmjopen-2020-043152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Eating disorders (EDs) are complex pathologies which require equally complex treatment strategies. These strategies should be multidisciplinary, personalised interventions, performed in appropriate settings along a healthcare continuum from inpatient to community care. Personalisation, and the complexity of levels of care and interventions make evaluation of treatments difficult. The present study aims to measure the effectiveness of a complex treatment programme for EDs which includes hospitalisation, day hospital and outpatient settings. Our purpose is to assess the complete therapeutic process of each patient through all these levels of care, capturing the multiplicity of trajectories that a programme of these characteristics involves. METHODS AND ANALYSIS This protocol describes a multicentre, naturalistic, observational study. All patients starting between November 2017 and October 2020 in a healthcare network for EDs in Spain are being invited to participate. The first phase of intensive change monitoring to November 2020 is followed by lower intensity follow-up until October 2025. In the first phase progress of all participants is assessed every 3 weeks using specific measures for ED and the Clinical Outcomes Routine Evaluation system, a family of instruments specifically designed to measure change in psychotherapy. In the second phase data collection will happen quarterly. Both cross-sectional and longitudinal analyses will be conducted, with a special focus on patterns and predictors of change studied through multilevel linear models. ETHICS AND DISSEMINATION The study has been approved by the Research Bioethics Committee of the University of Barcelona (no. IRB00003099) and the ethical committee of ITA Mental Health, the organisation to which all participating centres belong. Dissemination will be in papers for peer-reviewed research journals and to clinicians working with ED. TRIAL REGISTRATION NUMBER NCT04127214.
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Affiliation(s)
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Section of Personality, Evaluation and Psychological Treatment, Psychology Faculty, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Joan Carles Medina
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Clara Paz
- School of Psychology, Universidad de Las Americas, Quito, Ecuador
| | - Chris Evans
- Department of Psychology, The University of Sheffield, Sheffield, UK
- Department of Psychology, University of Roehampton, London, UK
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12
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Castells-Sánchez A, Roig-Coll F, Dacosta-Aguayo R, Lamonja-Vicente N, Sawicka AK, Torán-Monserrat P, Pera G, Montero-Alía P, Heras-Tebar A, Domènech S, Via M, Erickson KI, Mataró M. Exercise and Fitness Neuroprotective Effects: Molecular, Brain Volume and Psychological Correlates and Their Mediating Role in Healthy Late-Middle-Aged Women and Men. Front Aging Neurosci 2021; 13:615247. [PMID: 33776741 PMCID: PMC7989549 DOI: 10.3389/fnagi.2021.615247] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Although exercise is known to have a neuroprotective effect in aging, the mediators underlying the exercise-cognition association remain poorly understood. In this paper we aimed to study the molecular, brain, and behavioral changes related to physical activity and their potential role as mediators. Methods: We obtained demographic, physical activity outcomes [sportive physical activity and cardiorespiratory fitness (CRF)], plasma biomarkers (TNF-α, ICAM-1, HGF, SDF1-α, and BDNF), structural-MRI (brain volume areas), psychological and sleep health (mood, depressive and distress symptoms, and sleep quality), and multi-domain cognitive data from 115 adults aged 50-70 years. We conducted linear regression models and mediation analyses stratifying results by sex in a final sample of 104 individuals [65 women (age = 56.75 ± 4.96) and 39 men (age = 58.59 ± 5.86)]. Results: Women engaging in greater amounts of exercising showed lower TNF-α levels and greater dorsolateral prefrontal cortex and temporal lobe volumes. Men engaging in greater amounts of exercise showed greater temporal lobe volumes. CRF levels were not related to any of the analyzed outcomes in women but in men higher CRF was associated with lower TNF-α, HGF and ventricle volumes, greater volume of temporal and parietal lobes and fewer depressive symptoms and better mood. In men, reduced TNF-α and HGF levels mediated brain and cognitive CRF-related benefits. Conclusion: Our results show that exercise is a promising approach for influencing inflammation and brain volume and also contributes to ongoing discussions about the physiological mediators for the association between CRF and cognition in men.
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Affiliation(s)
- Alba Castells-Sánchez
- Departament of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Francesca Roig-Coll
- Departament of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Rosalia Dacosta-Aguayo
- Departament of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Noemí Lamonja-Vicente
- Departament of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Angelika K Sawicka
- Applied Cognitive Neuroscience Lab, Department of Human Physiology, Medical University of Gdansk, Gdansk, Poland
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Guillem Pera
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Pilar Montero-Alía
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Antonio Heras-Tebar
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Sira Domènech
- Institut de Diagnòstic per la Imatge, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Marc Via
- Departament of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Maria Mataró
- Departament of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
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13
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Suarez V, Feixas G. Cognitive Conflict in Borderline Personality Disorder: A Study Protocol. Behav Sci (Basel) 2020; 10:bs10120180. [PMID: 33256053 PMCID: PMC7761325 DOI: 10.3390/bs10120180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/16/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022] Open
Abstract
Borderline personality disorder (BPD) represents a severe mental condition that is usually characterized by distressing identity disturbances. Although most prevailing explanatory models and psychotherapy approaches consider and intervene on self-concept, they seem not to recognize or explore idiosyncratic cognitive conflicts that patients may experience. These conflicts, which have been conceptualized as “implicative dilemmas” and “dilemmatic constructs” by personal construct theorists, could be considered as key elements of the explanatory model for BPD to provide a better understanding of this disorder and possibly enhance the effectiveness of contemporary psychotherapeutic approaches. The current study (Identifier: NCT04498104) aims to examine the characteristics of the interpersonal cognitive system of a group of patients diagnosed with BPD, using the repertory grid technique, and to compare them with those of a community sample. We will test if BPD participants are more affected by cognitive conflicts than controls. Additionally, we will gauge the association between cognitive conflicts and symptom severity as well as their predictive capacity of treatment outcome. The obtained results will be a necessary step to determine if cognitive conflicts have a substantial role on the explanation of BPD. It could also help to consider the development of a conflict resolution intervention module for this disorder.
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14
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Roig-Coll F, Castells-Sánchez A, Lamonja-Vicente N, Torán-Monserrat P, Pera G, García-Molina A, Tormos JM, Montero-Alía P, Alzamora MT, Dacosta-Aguayo R, Soriano-Raya JJ, Cáceres C, Erickson KI, Mataró M. Effects of Aerobic Exercise, Cognitive and Combined Training on Cognition in Physically Inactive Healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial. Front Aging Neurosci 2020; 12:590168. [PMID: 33192485 PMCID: PMC7664521 DOI: 10.3389/fnagi.2020.590168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
Background Lifestyle interventions are promising strategies to promote cognitive health in aging. Projecte Moviment examines if aerobic exercise (AE), computerized cognitive training (CCT), and their combination (COMB) improves cognition, psychological health, and physical status compared to a control group. We assessed the moderating role of age and sex and the mediating effects of cardiorespiratory fitness (CRF), physical activity (PA), and psychological health on intervention-related cognitive benefits. Methods This was a 12-week multi-domain, single-blind, proof-of-concept randomized controlled trial (RCT). 96 healthy adults aged 50-70 years were assigned to AE, CCT, COMB, and a wait-list control group. The per protocol sample, which completed the intervention with a level of adherence > 80%, consisted of 82 participants (62% female; age = 58.38 ± 5.47). We assessed cognition, psychological health, CRF, and energy expenditure in PA at baseline and after the intervention. We regressed change in each outcome on the treatment variables, baseline score, sex, age, and education. We used PROCESS Macro to perform the mediation and moderation analyses. Results AE benefited Working Memory (SMD = 0.29, p = 0.037) and Attention (SMD = 0.33, p = 0.028) including the Attention-Speed (SMD = 0.31, p = 0.042) domain, compared to Control. COMB improved Attention (SMD = 0.30, p = 0.043), Speed (SMD = 0.30, p = 0.044), and the Attention-Speed (SMD = 0.30, p = 0.041) domain. CTT group did not show any cognitive change compared to Control. Sportive PA (S-PA) and CRF increased in AE and COMB. Age and sex did not moderate intervention-related cognitive benefits. Change in S-PA, but not in CRF, significantly mediated improvements on Attention-Speed in AE. Conclusion A 12-week AE program improved Executive Function and Attention-Speed in healthy late-middle-aged adults. Combining it with CCT did not provide further benefits. Our results add support to the clinical relevance of even short-term AE as an intervention to enhance cognition and highlight the mediating role of change in S-PA in these benefits. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT03123900.
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Affiliation(s)
- Francesca Roig-Coll
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Alba Castells-Sánchez
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Noemí Lamonja-Vicente
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Guillem Pera
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Alberto García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Maria Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Montero-Alía
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Maria Teresa Alzamora
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Rosalía Dacosta-Aguayo
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Juan José Soriano-Raya
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Cynthia Cáceres
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States.,Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia
| | - Maria Mataró
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.,Institut de Neurociències, University of Barcelona, Barcelona, Spain.,Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
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15
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Exploration of the psychometric properties of the Clinical Outcomes in Routine Evaluation-Outcome Measure in Ecuador. BMC Psychol 2020; 8:94. [PMID: 32873334 PMCID: PMC7465405 DOI: 10.1186/s40359-020-00443-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 07/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is a pan-theoretical and pan-diagnostic measure of mental health designed to cover issues that people wish to change in psychotherapy. The objective of this study was to explore the psychometric properties of the Spanish translation of the CORE-OM, in a country, Ecuador for which there is not a single measure suitable for this purpose with empirically demonstrated local acceptability and psychometric properties. Methods In total, 886 adults not currently receiving psychotherapy treatment or taking psychotropic medication were included in the analysis. The analyses broadly followed and compared with results from previous studies. These analyses consisted of assessment of acceptability, internal consistency, test-retest reliability, influences of demographic variables, correlations between domain scores, and convergent validity with Spanish versions of the Outcome Questionnaire 45.2 and Schwartz Outcome Scale-10. Results The questionnaire showed good acceptability (overall omission rate of 0.56%), good reliability (α = .93 [.92, .94], test-retest correlations ranged from .59 to .85), and good convergent validity with the Outcome Questionnaire 45.2 (r = .84) and the Schwartz Outcome Scale-10 (r = −.73). Statistically significant gender differences were found in two domains: females scored higher on Well-being (M = 1.23) than males (M = 1.01), though effect size was small (g = 0.31); and males (M = 0.31) scored higher than females on Risk (M = 0.25), with even smaller effect size (g = 0.06). Age was negatively correlated with psychological distress in all domains and coefficients ranged from −.14 for Risk to −.29 for Functioning. Conclusions The results support the use of the CORE-OM as a valid and reliable instrument in a non-clinical Ecuadorean population. Exploration of the psychometric properties in a clinical population is recommended to assure its use in clinical settings.
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Paz C, Aguilera M, Salla M, Compañ V, Medina JC, Bados A, García-Grau E, Castel A, Cañete Crespillo J, Montesano A, Medeiros-Ferreira L, Feixas G. Personal Construct Therapy vs Cognitive Behavioral Therapy in the Treatment of Depression in Women with Fibromyalgia: Study Protocol for a Multicenter Randomized Controlled Trial. Neuropsychiatr Dis Treat 2020; 16:301-311. [PMID: 32021219 PMCID: PMC6987966 DOI: 10.2147/ndt.s235161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Fibromyalgia (FM) is a debilitating syndrome, more prevalent in women, which is aggravated by the presence of depressive symptoms. In the last decade, cognitive behavioral therapy (CBT) has demonstrated to reduce such depressive symptoms and pain in these patients, but there are still a considerable number of them who do not respond to interventions. The complexity of the disorder requires the consideration of the unique psychological characteristics of each patient to attain good outcomes. One approach that could accomplish this goal might be personal construct therapy (PCT), an idiographic approach that considers identity features and interpersonal meanings as their main target of intervention. Then, the aim of the study is to test the efficacy of PCT as compared to a well-established treatment in the reduction of depressive symptoms in women with fibromyalgia. METHODS AND ANALYSIS This is a multicenter randomized controlled trial. In each condition participants will attend up to eighteen 1-hr weekly therapy sessions and up to three 1-hr booster sessions during the following 3-5 months after the end of treatment. The depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) will be the primary outcome measure and it will be assessed at baseline, at the end of therapy, and at 6-month follow-up. Other secondary measures will be applied following the same schedule. Participants will be 18- to 70-years-old women with a diagnosis of FM, presenting depressive symptoms evinced by scores above seven in depression items of the HADS-D. Intention-to-treat and complete case analyses will be performed for the main statistical tests. Linear mixed models will be used to analyze and to compare the treatment effects of both conditions. TRIAL REGISTRATION ClinicalTrials.gov: NCT02711020.
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Affiliation(s)
- Clara Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - Mari Aguilera
- Department of Cognition, Development and Educational Psychology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Marta Salla
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Victoria Compañ
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Joan C Medina
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - Arturo Bados
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Eugeni García-Grau
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Castel
- Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain
| | | | - Adrián Montesano
- Faculty of Psychology and Educational Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
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Zeldovich M, Alexandrowicz RW. Comparing outcomes: The Clinical Outcome in Routine Evaluation from an international point of view. Int J Methods Psychiatr Res 2019; 28:e1774. [PMID: 30779267 PMCID: PMC6849827 DOI: 10.1002/mpr.1774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 01/07/2019] [Accepted: 01/12/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM) is a freely accessible self-assessment questionnaire with a total of 34 items measuring the progress of psychological or psychotherapeutic treatments according to four scales (well-being, problems, functioning, and risk). The CORE-OM originated in the United Kingdom and has been translated into 54 languages and dialects. The aim of this study is to systematically compare the translated versions. METHOD A total of 21 translations were compared using methods of systematic review and meta-analysis. RESULTS The results show a certain heterogeneity between the studies; however, the 21 translations can be declared as equivalent. CONCLUSION The factorial structure could not be replicated in any of translations. Therefore, further analysis of the CORE-OM domains is recommended. In addition, some supplementary restrictions on the translation process, data collection, and reporting of results are necessary to ensure comparability and quality of CORE-OM translations.
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Affiliation(s)
- Marina Zeldovich
- Institute of Psychology, Alpen-Adria Universität Klagenfurt, Klagenfurt, Austria
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18
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Castells-Sánchez A, Roig-Coll F, Lamonja-Vicente N, Altés-Magret M, Torán-Monserrat P, Via M, García-Molina A, Tormos JM, Heras A, Alzamora MT, Forés R, Pera G, Dacosta-Aguayo R, Soriano-Raya JJ, Cáceres C, Montero-Alía P, Montero-Alía JJ, Jimenez-Gonzalez MM, Hernández-Pérez M, Perera A, Grove GA, Munuera J, Domènech S, Erickson KI, Mataró M. Effects and Mechanisms of Cognitive, Aerobic Exercise, and Combined Training on Cognition, Health, and Brain Outcomes in Physically Inactive Older Adults: The Projecte Moviment Protocol. Front Aging Neurosci 2019; 11:216. [PMID: 31481889 PMCID: PMC6711364 DOI: 10.3389/fnagi.2019.00216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/30/2019] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Age-related health, brain, and cognitive impairment is a great challenge in current society. Cognitive training, aerobic exercise and their combination have been shown to benefit health, brain, cognition and psychological status in healthy older adults. Inconsistent results across studies may be related to several variables. We need to better identify cognitive changes, individual variables that may predict the effect of these interventions, and changes in structural and functional brain outcomes as well as physiological molecular correlates that may be mediating these effects. Projecte Moviment is a multi-domain randomized trial examining the effect of these interventions applied 5 days per week for 3 months compared to a passive control group. The aim of this paper is to describe the sample, procedures and planned analyses. METHODS One hundred and forty healthy physically inactive older adults will be randomly assigned to computerized cognitive training (CCT), aerobic exercise (AE), combined training (COMB), or a control group. The intervention consists of a 3 month home-based program 5 days per week in sessions of 45 min. Data from cognitive, physical, and psychological tests, cardiovascular risk factors, structural and functional brain scans, and blood samples will be obtained before and after the intervention. RESULTS Effects of the interventions on cognitive outcomes will be described in intention-to-treat and per protocol analyses. We will also analyze potential genetic, demographic, brain, and physiological molecular correlates that may predict the effects of intervention, as well as the association between cognitive effects and changes in these variables using the per protocol sample. DISCUSSION Projecte Moviment is a multi-domain intervention trial based on prior evidence that aims to understand the effects of CCT, AE, and COMB on cognitive and psychological outcomes compared to a passive control group, and to determine related biological correlates and predictors of the intervention effects.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03123900.
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Affiliation(s)
- Alba Castells-Sánchez
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Francesca Roig-Coll
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Noemí Lamonja-Vicente
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Marina Altés-Magret
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Marc Via
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Alberto García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Maria Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antonio Heras
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Maite T. Alzamora
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Rosa Forés
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Guillem Pera
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Rosalia Dacosta-Aguayo
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Juan José Soriano-Raya
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Cynthia Cáceres
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Pilar Montero-Alía
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Juan José Montero-Alía
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Maria Mercedes Jimenez-Gonzalez
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Maria Hernández-Pérez
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Alexandre Perera
- B2SLab, Departament d’Enginyeria de Sistemes, Automàtica i Informàtica Industrial, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - George A. Grove
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Josep Munuera
- Diagnostic Imaging Department, Fundació de Recerca, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Sira Domènech
- Institut de Diagnòstic per la Imatge, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Maria Mataró
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Barcelona, Spain
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Gonzalez-Mercado VJ, Saligan LN, Rodriguez CS, Ortiz D, Pedro E, McMillan SC. Validation of the Spanish version of the Cancer Symptom Scale in Hispanic cancer patients. Int J Nurs Pract 2018; 24:e12700. [PMID: 30284336 DOI: 10.1111/ijn.12700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 12/27/2022]
Abstract
AIM To assess the validity of the translated Spanish Cancer Symptom Scale. BACKGROUND Instruments to facilitate comprehensive and objective assessments of the cancer symptom experience in underrepresented populations are essential. METHODS The Cancer Symptom Scale was translated into Spanish, and a back translation was conducted. During June 2016, a sample of 121 Hispanic Puerto Rican patients with any cancer diagnosis, all undergoing cancer treatments, completed four paper surveys. A subgroup of 15 patients agreed to complete the Spanish Cancer Symptom Scale a second time after a short delay of 1 to 2 hours. Construct validity and reliability (internal consistency via Cronbach alpha and test-retest reliability) was evaluated. RESULTS All the Intensity Items of the Spanish Cancer Symptom Scale correlated significantly with the matched items on the MD Anderson Symptom Inventory. In a subgroup of 77 participants, each Cancer Symptom Scale subscale total of scores correlated significantly with the total scores from the Functional Assessment of Cancer Therapy-General. Discriminant validity was demonstrated between those receiving chemotherapy and those from post treatment. The Spanish Cancer Symptom Scale internal consistency reliability was 0.98. CONCLUSION The Spanish Cancer Symptom Scale has excellent evidence of validity and reliability for assessing cancer-therapy-related symptoms.
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Affiliation(s)
| | - Leorey N Saligan
- National Institute of Nursing Research Intramural Research Program, Bethesda, Maryland, USA
| | | | | | - Elsa Pedro
- School of Pharmacy, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico
| | - Susan C McMillan
- University of South Florida College of Nursing, Tampa, Florida, USA
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Falkenström F, Kumar M, Zahid A, Kuria M, Othieno C. Factor analysis of the Clinical Outcomes in Routine Evaluation - Outcome Measures (CORE-OM) in a Kenyan sample. BMC Psychol 2018; 6:48. [PMID: 30285848 PMCID: PMC6167850 DOI: 10.1186/s40359-018-0260-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 09/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is no generic psychotherapy outcome measure validated for Kenyan populations. The objective of this study was to test the acceptability and factor structure of the Clinical Outcomes in Routine Evaluation - Outcome Measure in patients attending psychiatric clinics at two state-owned hospitals in Nairobi. METHODS Three hundred and forty-five patients filled out the CORE-OM after their initial therapy session. Confirmatory and Exploratory Factor Analysis (CFA/EFA) were used to study the factor structure of the CORE-OM. RESULTS The English version of the CORE-OM seemed acceptable and understandable to psychiatric patients seeking treatment at the state-owned hospitals in Nairobi. Factor analyses showed that a model with a general distress factor, a risk factor, and a method factor for positively framed items fit the data best according to both CFA and EFA analysis. Coefficient Omega Hierarchical showed that the general distress factor was reliably measured even if differential responding to positively framed items was regarded as error variance. CONCLUSIONS The English language version of the CORE-OM can be used with psychiatric patients attending psychiatric treatment in Nairobi. The factor structure was more or less the same as has been shown in previous studies. The most important limitation is the relatively small sample size.
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Affiliation(s)
- Fredrik Falkenström
- Department of Behavioural Sciences and Learning, Linköping University, SE-581 83, Linköping, Sweden
| | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, P.O. Box 19676, Nairobi, 00202, Kenya. .,Honorary Research Fellow, Research Dept of Clinical Health and Educational Psychology, University College London, London, WC1E 7BT, UK.
| | - Aiysha Zahid
- Queen Mary's College, Miles End, London, E1 4NS, UK
| | - Mary Kuria
- Department of Psychiatry, University of Nairobi, P.O. Box 19676, Nairobi, 00202, Kenya
| | - Caleb Othieno
- Department of Psychiatry, University of Nairobi, P.O. Box 19676, Nairobi, 00202, Kenya
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Honkalampi K, Laitila A, Juntunen H, Lehmus K, Piiparinen A, Törmänen I, Inkinen M, Evans C. The Finnish Clinical Outcome in Routine Evaluation Outcome Measure: psychometric exploration in clinical and non-clinical samples. Nord J Psychiatry 2017; 71:589-597. [PMID: 28836472 DOI: 10.1080/08039488.2017.1365378] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) is a 34-item self-report measure designed to monitor changes in psychiatric patients. It has been translated into 25 languages, including Finnish. This is the first psychometric exploration of Finnish CORE-OM data. The aim of the study is to examine acceptability, internal consistency and convergent validity of the Finnish CORE-OM scores. Translation of the CORE-OM from English to Finnish was undertaken according to recommended protocols. Psychometric exploration was conducted in two samples: psychiatric patients (N = 201) and non-clinical participants (N = 209). Participation was voluntary and involved completion of all scales. Convergent validity was tested in terms of the mean score differences between clinical and non-clinical samples and correlations against the Beck Depression Inventory (BDI) and the Symptom Checklist (SCL-90). Among the clinical sample, all domains showed good or acceptable internal reliability. In the non-clinical sample, the alphas of domains were good or acceptable, with only the alphas of the Risk domain registering as low. There were no marked gender or age effects. CORE-OM scores correlated strongly with both the BDI and SCL-90, particularly in patients' data. Some possible effects of Finnish language were found. The Finnish translation of the CORE-OM is psychometrically sound and can be recommended for use in Finnish mental health and clinical settings. However, further investigation in larger and different samples will clarify the generalizability its psychometric properties. Clinical services are encouraged to contribute to the creation of a collaborative Finnish CORE practice research network.
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Affiliation(s)
- Kirsi Honkalampi
- a Department of Education and Psychology , University of Eastern Finland , Joensuu , Finland
| | - Aarno Laitila
- b Department of Psychology, Faculty of Education and Psychology , University of Jyväskylä , Jyväskylä , Finland
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Feixas G, Bados A, García-Grau E, Paz C, Montesano A, Compañ V, Salla M, Aguilera M, Trujillo A, Cañete J, Medeiros-Ferreira L, Soriano J, Ibarra M, Medina JC, Ortíz E, Lana F. A DILEMMA-FOCUSED INTERVENTION FOR DEPRESSION: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL WITH A 3-MONTH FOLLOW-UP. Depress Anxiety 2016; 33:862-9. [PMID: 27103215 PMCID: PMC5074295 DOI: 10.1002/da.22510] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 03/22/2016] [Accepted: 03/26/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Since long ago it has been asserted that internal conflicts are relevant to the understanding and treatment of mental disorders, but little research has been conducted to support the claim. The aim of this study was to test the differential efficacy of group cognitive behavioral therapy (CBT) plus an intervention focused on the dilemma(s) detected for each patient versus group individual CBT plus individual CBT for treating depression. A comparative controlled trial with a 3-month follow-up was conducted. METHODS One hundred twenty-eight adults meeting criteria for MDD and/or dysthymia, presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct, assessed by the repertory grid technique) and who had completed seven sessions of group CBT were randomly assigned to eight sessions of individual manualized CBT or dilemma-focused therapy (DFT). The Beck Depression Inventory-II was administered at baseline, at the end of therapy and after 3 months' follow-up. RESULTS Multilevel mixed effects modeling yielded no significant differences between CBT and DFT with the intention-to-treat sample. Equivalent effect sizes, remission, and response rates were found with completers as well. In combination with group CBT, both individual CBT and DFT significantly reduced depressive symptoms. CONCLUSIONS Both conditions obtained comparable results to those in the literature. Thus, the superiority of the adjunctive DFT was not demonstrated. Working with dilemmas can be seen as a promising additional target in the psychotherapy of depression, but further research is still required.
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Affiliation(s)
- Guillem Feixas
- Faculty of Psychology, University of Barcelona, Barcelona, Spain.
- Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona, Barcelona, Spain.
| | - Arturo Bados
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | | | - Clara Paz
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona, Barcelona, Spain
| | - Adrián Montesano
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona, Barcelona, Spain
| | - Victoria Compañ
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Marta Salla
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Mari Aguilera
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Adriana Trujillo
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona, Barcelona, Spain
| | | | | | - José Soriano
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Joan C Medina
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona, Barcelona, Spain
| | - Eliana Ortíz
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona, Barcelona, Spain
| | - Fernando Lana
- Parc de Salut Mar, Santa Coloma de Gramenet, Barcelona, Spain
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Feixas G, Compañ V. Dilemma-focused intervention for unipolar depression: a treatment manual. BMC Psychiatry 2016; 16:235. [PMID: 27406383 PMCID: PMC4942888 DOI: 10.1186/s12888-016-0947-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 06/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This article introduces a new treatment protocol for depression. Based on previous research which indicated the presence of cognitive conflicts in depression, this study created an intervention manual to address these conflicts. METHOD The therapy manual for depressive patients followed the guideline for inclusion in clinical trials (stage II), which has received high recognition. A preliminary version (stage I) of this manual was formulated based on other, more general dilemma-focused therapy publications, inspired by personal construct theory (PCT), and input from clinical experience. The resulting version was then applied during the 8-session format of a pilot study with patients diagnosed with major depressive disorder or dysthymia. Finally, feedback was requested from seasoned and highly respected therapists, some of whom were familiar with PCT. RESULTS According to the mentioned guideline, the intervention manual selected the theoretical framework, in this case PCT, to include its conceptualization of depression and resolution of dilemmas (to foster clinical improvement) as a main treatment goal. The manual was then contrasted with psychoanalytic psychotherapy, cognitive-behavior therapy (CBT), motivational interviewing (MI), and other similar approaches such as cognitive-analytic therapy and coherence therapy. Following these conceptual clarifications, the specific interventions included in the manual were defined according to both categories: their unique and essential components and those conceived as common psychotherapeutic factors. Next, the general structure and content for each session were presented. The structure consisted of seven well-defined individual sessions with an additional session, which could complement any of the former sessions to address the patient's issues in greater depth, if needed. CONCLUSIONS This Dilemma-Focused Intervention manual aimed to improve the treatment outcome for depression by offering an intervention that could be combined with other general approaches. At its present level of definition, it allows for inclusion in controlled trials (eg, the current RCT combining group CBT with this intervention). Thus, this manual added to the existing resources in psychotherapeutic research and practice for treatment of depression.
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Affiliation(s)
- Guillem Feixas
- />Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Campus Mundet, Passeig Vall Hebron, 171, Barcelona, Spain
- />Institute of Neurosciences, Universitat de Barcelona, Campus Mundet, Passeig Vall Hebron, 171, Barcelona, Spain
| | - Victoria Compañ
- />Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universitat de Barcelona, Campus Mundet, Passeig Vall Hebron, 171, Barcelona, Spain
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