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Fernández-Álvarez J, Colombo D, Gómez Penedo JM, Pierantonelli M, Baños RM, Botella C. Studies of Social Anxiety Using Ambulatory Assessment: Systematic Review. JMIR Ment Health 2024; 11:e46593. [PMID: 38574359 PMCID: PMC11027061 DOI: 10.2196/46593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND There has been an increased interest in understanding social anxiety (SA) and SA disorder (SAD) antecedents and consequences as they occur in real time, resulting in a proliferation of studies using ambulatory assessment (AA). Despite the exponential growth of research in this area, these studies have not been synthesized yet. OBJECTIVE This review aimed to identify and describe the latest advances in the understanding of SA and SAD through the use of AA. METHODS Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic literature search was conducted in Scopus, PubMed, and Web of Science. RESULTS A total of 70 articles met the inclusion criteria. The qualitative synthesis of these studies showed that AA permitted the exploration of the emotional, cognitive, and behavioral dynamics associated with the experience of SA and SAD. In line with the available models of SA and SAD, emotion regulation, perseverative cognition, cognitive factors, substance use, and interactional patterns were the principal topics of the included studies. In addition, the incorporation of AA to study psychological interventions, multimodal assessment using sensors and biosensors, and transcultural differences were some of the identified emerging topics. CONCLUSIONS AA constitutes a very powerful methodology to grasp SA from a complementary perspective to laboratory experiments and usual self-report measures, shedding light on the cognitive, emotional, and behavioral antecedents and consequences of SA and the development and maintenance of SAD as a mental disorder.
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Affiliation(s)
- Javier Fernández-Álvarez
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon de la Plana, Spain
- Fundación Aiglé, Buenos Aires, Argentina
| | - Desirée Colombo
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon de la Plana, Spain
| | | | | | - Rosa María Baños
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
- Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellon de la Plana, Spain
- Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Madrid, Spain
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2
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Quintana P, Bouchard S, Botella C, Robillard G, Serrano B, Rodriguez-Ortega A, Torp Ernst M, Rey B, Berthiaume M, Corno G. Engaging in Awkward Social Interactions in a Virtual Environment Designed for Exposure-Based Psychotherapy for People with Generalized Social Anxiety Disorder: An International Multisite Study. J Clin Med 2023; 12:4525. [PMID: 37445561 DOI: 10.3390/jcm12134525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/11/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications.
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Affiliation(s)
- Pamela Quintana
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada
| | - Stéphane Bouchard
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada
- Department of Psychology, University of Ottawa, Ottawa, ON K1S 5L5, Canada
| | - Cristina Botella
- Universitat Jaume, 12006 Castellón de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28031 Madrid, Spain
| | - Geneviève Robillard
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada
| | - Berenice Serrano
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28031 Madrid, Spain
| | | | - Mathias Torp Ernst
- Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark
| | - Beatriz Rey
- Departamento de Ingeniería Gráfica, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Maxine Berthiaume
- Department of Psychology, University of Ottawa, Ottawa, ON K1S 5L5, Canada
| | - Giulia Corno
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada
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Guillén V, Arnal A, Pérez S, Garcia-Alandete J, Fernandez-Felipe I, Grau A, Botella C, Marco JH. Family connections in the treatment of relatives of people with eating disorders and personality disorders: study protocol of a randomized control trial. BMC Psychol 2023; 11:88. [PMID: 36998024 PMCID: PMC10064734 DOI: 10.1186/s40359-023-01138-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are serious disorders that significantly affect not only the lives of patients, but also those of their family members who often experience high levels of burden, suffering and helplessness. If, in addition to ED, the patient has a personality disorder (PD), the psychological distress experienced by family members can be devastating. However, few treatments have been developed for family members of people with ED and PD. Family Connections (FC) is a programme that has been shown to be effective for family members of people with borderline personality disorder. The overall aims of this work are: (a) to adapt FC for application to family members of patients with BPD-PD (FC: ED-PD); (b) to analyse, in a randomised controlled clinical trial, the efficacy of this programme in a Spanish population, compared to a control condition consisting of treatment as usual optimised treatment (TAU-O); (c) to analyse the feasibility of the intervention protocol; (d) to analyse whether the changes that may occur in relatives are related to improvements in the family climate and/or improvements observed in patients; and (e) to analyse the perceptions and opinions of relatives and patients about the two intervention protocols. METHODS The study uses a two-arm randomised controlled clinical trial with two experimental conditions: adaptation of FC programme (FC: ED-PD) or Treatment as usual optimised (TAU-O). Participants will be family members of patients who meet DSM-5 criteria for ED and PD or dysfunctional personality traits. Participants will be assessed before and after treatment and at one-year follow-up. The intention-to-treat principle will be used when analysing the data. DISCUSSION The results obtained are expected to confirm the effectiveness of the programme and its good acceptance by family members. Trial registration ClinicalTrials.gov Identifier: NCT05404035. Accepted: May 2022.
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Affiliation(s)
- Verónica Guillén
- Universidad de Valencia, Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Avda. Blasco Ibañez, 21, CP 46010, Valencia, Spain.
- Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, Spain.
| | - Antonio Arnal
- Universidad de Valencia, Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Avda. Blasco Ibañez, 21, CP 46010, Valencia, Spain
| | - Sandra Pérez
- Universidad de Valencia, Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Avda. Blasco Ibañez, 21, CP 46010, Valencia, Spain
| | - Joaquín Garcia-Alandete
- Universidad de Valencia, Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Avda. Blasco Ibañez, 21, CP 46010, Valencia, Spain
| | - Isabel Fernandez-Felipe
- Universitat Jaume I de Castelló, Facultad de Ciencias de la Salud, Avda Sos Baynat, S/N, Castellón de la Plana, Castellón, Spain
| | - Antoni Grau
- Ita-Salud Mental, Especialistas en Salud Mental, C/Tavern, 61, 08006, Barcelona, Spain
| | - Cristina Botella
- Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, Spain
- Universitat Jaume I de Castelló, Facultad de Ciencias de la Salud, Avda Sos Baynat, S/N, Castellón de la Plana, Castellón, Spain
| | - José Heliodoro Marco
- Universidad de Valencia, Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Avda. Blasco Ibañez, 21, CP 46010, Valencia, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Madrid, Spain
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4
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Guillén V, Bolo S, Fonseca-Baeza S, Pérez S, García-Alandete J, Botella C, Marco JH. Psychological assessment of parents of people diagnosed with borderline personality disorder and comparison with parents of people without psychological disorders. Front Psychol 2023; 13:1097959. [PMID: 36710828 PMCID: PMC9880188 DOI: 10.3389/fpsyg.2022.1097959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023] Open
Abstract
BackgroundTo date, several evidence-based interventions have been created to help relatives of people with Borderline Personality Disorder (BPD), but few studies have analyzed the clinical situation of the family members. The aim of this study was twofold: (1) to explore the clinical symptomatology in a sample of parents of people diagnosed with BPD and compare them with a sample of a sample of people without a relative with a personality disorder, (2) to explore whether the parents of people diagnosed with BPD have psychopathology related to personality disorders (PD) or meet the diagnostic criteria for PD.MethodParticipants were 42 (39.6%) fathers and 64 (60.4%) were mothers and mothers (n = XX, −%) of people diagnosed with BPD, who were selected from a specialized PD unit for treatment. The sample of people without a relative with a PD was obtained from social network announcements. To test for differences between the two groups, Student’s t tests were performed for quantitative variables, and Chi-square tests were performed for categorical variables. Cohen’s d was calculated as a measure of the effect size.ResultsParents of people with BPD showed greater depressive and anxious symptomatology, higher levels of expressed emotion, and worse quality of life than the sample of people without a relative with a personality disorder. In addition, a high percentage of the parents of people diagnosed with BPD (50%) met the diagnostic criteria for different PD.ConclusionParents of people diagnosed with BPD may need psychological help in various aspects. Therapists are therefore advised to bear in mind the importance of carrying out a psychological assessment of family members and, if necessary, to offer psychological intervention. It is crucial to invite the family to be part of the treatment, since they can be part of the solution.Clinical Trial registration: ClinicalTrials.gov ID, NCT04160871 (registered November 15, 2019).
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Affiliation(s)
- Verónica Guillén
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Carlos, Spain,*Correspondence: Verónica Guillén,
| | - Sara Bolo
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Sara Fonseca-Baeza
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Sandra Pérez
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Joaquín García-Alandete
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Cristina Botella
- Ciber Fisiopatologia Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Carlos, Spain,Department of Psicología Básica, Clínica y Psicobiología, Universidad Jaime I de Castellón, Plana, Spain
| | - José Heliodoro Marco
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Carlos, Spain
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5
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González-Robles A, Roca P, Díaz-García A, García-Palacios A, Botella C. Long-term Effectiveness and Predictors of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy for Emotional Disorders in Specialized Care: Secondary Analysis of a Randomized Controlled Trial. JMIR Ment Health 2022; 9:e40268. [PMID: 36315227 PMCID: PMC9664329 DOI: 10.2196/40268] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Transdiagnostic internet-delivered cognitive behavioral therapy (iCBT) for emotional disorders has been shown to be effective in specialized care in the short term. However, less is known about its long-term effects in this specific setting. In addition, predictors of long-term effectiveness may help to identify what treatments are more suitable for certain individuals. OBJECTIVE This study aimed to analyze the long-term effectiveness of transdiagnostic iCBT compared with that of treatment as usual (TAU) in specialized care and explore predictors of long-term effectiveness. METHODS Mixed models were performed to analyze the long-term effectiveness and predictors of transdiagnostic iCBT (n=99) versus TAU (n=101) in public specialized mental health care. Outcomes included symptoms of depression and anxiety, health-related quality of life (QoL), behavioral inhibition and behavioral activation, comorbidity, and diagnostic status (ie, loss of principal diagnosis) from baseline to 1-year follow-up. Sociodemographic characteristics (sex, age, and education) and clinical variables (principal diagnosis, comorbidity, and symptom severity at baseline) were selected as predictors of long-term changes. RESULTS Compared with baseline, transdiagnostic iCBT was more effective than TAU in improving symptoms of depression (b=-4.16, SE 1.80, 95% CI -7.68 to -0.67), health-related QoL (b=7.63, SE 3.41, 95% CI 1.00-14.28), diagnostic status (b=-0.24, SE 0.09, 95% CI -1.00 to -0.15), and comorbidity at 1-year follow-up (b=-0.58, SE 0.22, 95% CI -1.00 to -0.15). From pretreatment assessment to follow-up, anxiety symptoms improved in both transdiagnostic iCBT and TAU groups, but no significant differences were found between the groups. Regarding the predictors of the long-term effectiveness of transdiagnostic iCBT compared with that of TAU, higher health-related QoL at follow-up was predicted by a baseline diagnosis of anxiety, male sex, and the use of psychiatric medication; fewer comorbid disorders at follow-up were predicted by older age and higher baseline scores on health-related QoL; and fewer depressive symptoms at follow-up were predicted by baseline diagnosis of depression. However, this pattern was not observed for baseline anxiety diagnoses and anxiety symptoms. CONCLUSIONS The results suggest that transdiagnostic iCBT is more effective than TAU to target depressive symptoms among patients with emotional disorders. Anxiety symptoms remained stable at 1-year follow-up, with no differences between the groups. Results on predictors suggest that some groups of patients may obtain specific gains after transdiagnostic iCBT. Specifically, and consistent with the literature, patients with baseline depression improved their depression scores at follow-up. However, this pattern was not found for baseline anxiety disorders. More studies on the predictor role of sociodemographic and clinical variables in long-term outcomes of transdiagnostic iCBT are warranted. Future studies should focus on studying the implementation of transdiagnostic iCBT in Spanish public specialized mental health care. TRIAL REGISTRATION ClinicalTrials.gov NCT02345668; https://clinicaltrials.gov/ct2/show/NCT02345668.
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Affiliation(s)
| | - Pablo Roca
- Department of Psychology, Universidad Villanueva, Madrid, Spain
| | - Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza, Teruel, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
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6
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Guillén V, Fonseca-Baeza S, Fernández-Felipe I, Botella C, Baños R, García-Palacios A, Marco J. Effectiveness of family connections intervention for family members of persons with personality disorders in two different formats: Online vs face-to-face. Internet Interv 2022; 28:100532. [PMID: 35646607 PMCID: PMC9136357 DOI: 10.1016/j.invent.2022.100532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD). AIM The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified. METHOD This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention. RESULTS There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (μ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134); depression, anxiety, and stress (η 2 = 0.087); family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219); and quality of life (η 2 = 0.006), respectively). CONCLUSIONS This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.
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Affiliation(s)
- V. Guillén
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain,Corresponding author at: Dep. of Personality, Evaluation and Psychological Treatments, University of Valencia, Av. Blasco Ibañez 21, 46010, Spain.
| | | | - I. Fernández-Felipe
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - C. Botella
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - R. Baños
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - A. García-Palacios
- Universitat Jaume I de Castellón, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
| | - J.H. Marco
- Universidad de Valencia, Spain,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Spain
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7
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Jensen ES, Ladegaard N, Mellentin AI, Ebert DD, Titzler I, Araya R, Cerga Pashoja A, Hazo JB, Holtzmann J, Cieslak R, Smoktunowicz E, Baños R, Herrero R, García-Palacios A, Botella C, Berger T, Krieger T, Holmberg TT, Topooco N, Andersson G, van Straten A, Kemmeren L, Kleiboer A, Riper H, Mathiasen K. Effect of Sleep Disturbance Symptoms on Treatment Outcome in Blended Cognitive Behavioral Therapy for Depression (E-COMPARED Study): Secondary Analysis. J Med Internet Res 2022; 24:e30231. [PMID: 35311687 PMCID: PMC8981003 DOI: 10.2196/30231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/23/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background Sleep disturbance symptoms are common in major depressive disorder (MDD) and have been found to hamper the treatment effect of conventional face-to-face psychological treatments such as cognitive behavioral therapy. To increase the dissemination of evidence-based treatment, blended cognitive behavioral therapy (bCBT) consisting of web-based and face-to-face treatment is on the rise for patients with MDD. To date, no study has examined whether sleep disturbance symptoms have an impact on bCBT treatment outcomes and whether it affects bCBT and treatment-as-usual (TAU) equally. Objective The objectives of this study are to investigate whether baseline sleep disturbance symptoms have an impact on treatment outcomes independent of treatment modality and whether sleep disturbance symptoms impact bCBT and TAU in routine care equally. Methods The study was based on data from the E-COMPARED (European Comparative Effectiveness Research on Blended Depression Treatment Versus Treatment-as-Usual) study, a 2-arm, multisite, parallel randomized controlled, noninferiority trial. A total of 943 outpatients with MDD were randomized to either bCBT (476/943, 50.5%) or TAU consisting of routine clinical MDD treatment (467/943, 49.5%). The primary outcome of this study was the change in depression symptom severity at the 12-month follow-up. The secondary outcomes were the change in depression symptom severity at the 3- and 6-month follow-up and MDD diagnoses at the 12-month follow-up, assessed using the Patient Health Questionnaire-9 and Mini-International Neuropsychiatric Interview, respectively. Mixed effects models were used to examine the association of sleep disturbance symptoms with treatment outcome and treatment modality over time. Results Of the 943 patients recruited for the study, 558 (59.2%) completed the 12-month follow-up assessment. In the total sample, baseline sleep disturbance symptoms did not significantly affect change in depressive symptom severity at the 12-month follow-up (β=.16, 95% CI –0.04 to 0.36). However, baseline sleep disturbance symptoms were negatively associated with treatment outcome for bCBT (β=.49, 95% CI 0.22-0.76) but not for TAU (β=–.23, 95% CI −0.50 to 0.05) at the 12-month follow-up, even when adjusting for baseline depression symptom severity. The same result was seen for the effect of sleep disturbance symptoms on the presence of depression measured with Mini-International Neuropsychiatric Interview at the 12-month follow-up. However, for both treatment formats, baseline sleep disturbance symptoms were not associated with depression symptom severity at either the 3- (β=.06, 95% CI −0.11 to 0.23) or 6-month (β=.09, 95% CI −0.10 to 0.28) follow-up. Conclusions Baseline sleep disturbance symptoms may have a negative impact on long-term treatment outcomes in bCBT for MDD. This effect was not observed for TAU. These findings suggest that special attention to sleep disturbance symptoms might be warranted when MDD is treated with bCBT. Future studies should investigate the effect of implementing modules specifically targeting sleep disturbance symptoms in bCBT for MDD to improve long-term prognosis.
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Affiliation(s)
- Esben Skov Jensen
- Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.,Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Nicolai Ladegaard
- Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Angelina Isabella Mellentin
- Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.,Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - David Daniel Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany
| | - Ingrid Titzler
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Ricardo Araya
- Centre for Global Mental Health, King's College London, London, United Kingdom
| | - Arlinda Cerga Pashoja
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Global Public Health, Public Health England, London, United Kingdom
| | - Jean-Baptiste Hazo
- URC Eco Ile-de-France (AP-HP), Hotel Dieu, Paris, France.,Assistance Publique-Hôpitaux de Paris, Health Economics Research Unit, University of Paris, Paris, France
| | - Jérôme Holtzmann
- Fondation FondaMental, Créteil, France.,Service de Psychiatrie de l'adulte, Centre Expert Dépression Résistante FondaMental, Grenoble University Hospital, Grenoble, France
| | - Roman Cieslak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, CO, United States
| | - Ewelina Smoktunowicz
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Rosa Baños
- Instituto Polibienestar, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Rocio Herrero
- Instituto Polibienestar, University of Valencia, Valencia, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Azucena García-Palacios
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain.,Department of Basic Psychology, Clinic and Psychobiology, University Jaume I, Castellón, Spain
| | - Cristina Botella
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain.,Department of Basic Psychology, Clinic and Psychobiology, University Jaume I, Castellón, Spain
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tobias Krieger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Trine Theresa Holmberg
- Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.,Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Naira Topooco
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Center for m2Health, Palo Alto University, Palo Alto, CA, United States
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Annemieke van Straten
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lise Kemmeren
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Annet Kleiboer
- Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Heleen Riper
- Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.,Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Kim Mathiasen
- Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark.,Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
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8
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Mor S, Botella C, Campos D, Carlbring P, Tur C, Quero S. An internet-based treatment for flying phobia using 360° images: A feasibility pilot study. Internet Interv 2022; 28:100510. [PMID: 35242593 PMCID: PMC8866141 DOI: 10.1016/j.invent.2022.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND More research is needed in the field of Internet-delivered Cognitive Behavioral Treatments (ICBTs) for specific phobia in order to understand which characteristics are important in online exposure scenarios. The aim of the present work was to conduct a feasibility pilot study to explore participants' opinions, preferences, and acceptability ratings of two types of images (still images vs 360° navigable images) in an ICBT for Flying Phobia (FP). A secondary aim was to test the potential effectiveness of the two active treatment arms compared to a waiting list control group. An exploratory aim was to compare the role of navigable images vs. still images in the level of sense of presence and reality judgment and explore their possible mediation in treatment effectiveness. METHODS Participants were randomly allocated to three conditions: NO-FEAR Airlines with still images (n = 26), NO-FEAR Airlines with still and navigable images (n = 26), and a waiting list group (n = 26). Primary outcome measures were participants' opinions, preferences, satisfaction, and acceptance regarding the images used in the exposure scenarios. Secondary outcome measures included FP symptomatology outcomes and measures of sense of presence and reality judgment. RESULTS Participants in the study preferred navigable images over still images before and after treatment (over 84%), and they considered them more effective and logical for the treatment of their problem. However, adherence in the experimental conditions was low (42.3% dropout rate), and more participants withdrew from the group that included navigable images compared to the group that only included still images (14 vs. 8), with no statistical differences in attrition between the two conditions. NO-FEAR Airlines proved to be effective in reducing FP symptomatology compared to the control group, with large between-group effect sizes on all FP measures (ranging from 0.76 to 2.79). No significant mediation effect was found for sense of presence or reality judgment in treatment effectiveness. DISCUSSION The results of the current study suggest that participants prefer more immersive images in exposure scenarios, providing data that can help to design useful exposure scenarios to treat specific phobias in the future. They also provide evidence supporting the effectiveness of an ICBT for FP. TRIAL REGISTRATION Registered at Clinicaltrials.gov (NCT03900559) on April 9, 2019. Retrospectively registered.
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Affiliation(s)
- Sonia Mor
- Universitat Jaume I, Castellón, Spain
| | - Cristina Botella
- Universitat Jaume I, Castellón, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain,Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | | | - Soledad Quero
- Universitat Jaume I, Castellón, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain,Corresponding author at: Universitat Jaume I, Av. Vicente Sos Baynat s/n, 12006 Castellón, Spain.
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9
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van Genugten CR, Schuurmans J, Hoogendoorn AW, Araya R, Andersson G, Baños RM, Berger T, Botella C, Cerga Pashoja A, Cieslak R, Ebert DD, García-Palacios A, Hazo JB, Herrero R, Holtzmann J, Kemmeren L, Kleiboer A, Krieger T, Rogala A, Titzler I, Topooco N, Smit JH, Riper H. A Data-Driven Clustering Method for Discovering Profiles in the Dynamics of Major Depressive Disorder Using a Smartphone-Based Ecological Momentary Assessment of Mood. Front Psychiatry 2022; 13:755809. [PMID: 35370856 PMCID: PMC8968132 DOI: 10.3389/fpsyt.2022.755809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although major depressive disorder (MDD) is characterized by a pervasive negative mood, research indicates that the mood of depressed patients is rarely entirely stagnant. It is often dynamic, distinguished by highs and lows, and it is highly responsive to external and internal regulatory processes. Mood dynamics can be defined as a combination of mood variability (the magnitude of the mood changes) and emotional inertia (the speed of mood shifts). The purpose of this study is to explore various distinctive profiles in real-time monitored mood dynamics among MDD patients in routine mental healthcare. METHODS Ecological momentary assessment (EMA) data were collected as part of the cross-European E-COMPARED trial, in which approximately half of the patients were randomly assigned to receive the blended Cognitive Behavioral Therapy (bCBT). In this study a subsample of the bCBT group was included (n = 287). As part of bCBT, patients were prompted to rate their current mood (on a 1-10 scale) using a smartphone-based EMA application. During the first week of treatment, the patients were prompted to rate their mood on three separate occasions during the day. Latent profile analyses were subsequently applied to identify distinct profiles based on average mood, mood variability, and emotional inertia across the monitoring period. RESULTS Overall, four profiles were identified, which we labeled as: (1) "very negative and least variable mood" (n = 14) (2) "negative and moderate variable mood" (n = 204), (3) "positive and moderate variable mood" (n = 41), and (4) "negative and highest variable mood" (n = 28). The degree of emotional inertia was virtually identical across the profiles. CONCLUSIONS The real-time monitoring conducted in the present study provides some preliminary indications of different patterns of both average mood and mood variability among MDD patients in treatment in mental health settings. Such varying patterns were not found for emotional inertia.
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Affiliation(s)
- Claire R van Genugten
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Josien Schuurmans
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Ricardo Araya
- Institute of Psychiatry Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Rosa M Baños
- Polibienestar Research Institute, University of Valencia, Valencia, Spain.,CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Thomas Berger
- Department of Clinical Psychology, University of Bern, Bern, Switzerland
| | - Cristina Botella
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Arlinda Cerga Pashoja
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Roman Cieslak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Lyda Hill Institute for Human Resilience, Colorado Springs, CO, United States
| | - David D Ebert
- Department for Sport and Health Sciences, Technical University (TU) Munich, Munich, Germany
| | - Azucena García-Palacios
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Jean-Baptiste Hazo
- Eceve, Unit 1123, Inserm, University of Paris, Health Economics Research Unit, Assistance Publique-Hôpitaux de Paris, Paris, France.,Unité de Recherche en Economie de la Santé, Assistance Publique, Hôpitaux de Paris, Paris, France
| | - Rocío Herrero
- Polibienestar Research Institute, University of Valencia, Valencia, Spain.,CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | - Jérôme Holtzmann
- Mood Disorders and Emotional Pathologies Unit, Centre Expert Depression Résistante Fondation Fondamental, Pôle de Psychiatrie, Neurologie et Rééducation Neurologique, University Hospital Grenoble Alpes, Grenoble, France
| | - Lise Kemmeren
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Annet Kleiboer
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Tobias Krieger
- Department of Clinical Psychology, University of Bern, Bern, Switzerland
| | - Anna Rogala
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Ingrid Titzler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Naira Topooco
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Center for m2Health, Palo Alto, CA, United States
| | - Johannes H Smit
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Heleen Riper
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands.,Institute of Telepsychiatry, University of Southern Denmark, Odense, Denmark.,University of Turku, Faculty of Medicine, Turku, Finland
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10
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Fernández-Alvarez J, Grassi M, Colombo D, Botella C, Cipresso P, Perna G, Riva G. Efficacy of bio- and neurofeedback for depression: a meta-analysis. Psychol Med 2022; 52:201-216. [PMID: 34776024 PMCID: PMC8842225 DOI: 10.1017/s0033291721004396] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 09/29/2021] [Accepted: 10/07/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND For many years, biofeedback and neurofeedback have been implemented in the treatment of depression. However, the effectiveness of these techniques on depressive symptomatology is still controversial. Hence, we conducted a meta-analysis of studies extracted from PubMed, Scopus, Web of Science and Embase. METHODS Two different strings were considered for each of the two objectives of the study: A first group comprising studies patients with major depressive disorder (MDD) and a second group including studies targeting depressive symptomatology reduction in other mental or medical conditions. RESULTS In the first group of studies including patients with MDD, the within-group analyses yielded an effect size of Hedges' g = 0.717, while the between-group analysis an effect size of Hedges' g = 1.050. Moderator analyses indicate that treatment efficacy is only significant when accounting for experimental design, in favor of randomized controlled trials (RCTs) in comparison to non RCTs, whereas the type of neurofeedback, trial design, year of publication, number of sessions, age, sex and quality of study did not influence treatment efficacy. In the second group of studies, a small but significant effect between groups was found (Hedges' g = 0.303) in favor of bio- and neurofeedback against control groups. Moderator analyses revealed that treatment efficacy was not moderated by any of the sociodemographic and clinical variables. CONCLUSIONS Heart rate variability (HRV) biofeedback and neurofeedback are associated with a reduction in self-reported depression. Despite the fact that the field has still a large room for improvement in terms of research quality, the results presented in this study suggests that both modalities may become relevant complementary strategies for the treatment of MDD and depressive symptomatology in the coming years.
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Affiliation(s)
- J. Fernández-Alvarez
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - M. Grassi
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, Albese con Cassano, Como, Italy
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - D. Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - C. Botella
- Ciber Fisiopatología Obesidad y Nutrición, CB06/03 Instituto Salud Carlos III, Madrid, Spain
| | - P. Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | - G. Perna
- Department of Clinical Neurosciences, Hermanas Hospitalarias, Villa San Benedetto Menni Hospital, FoRiPsi, Albese con Cassano, Como, Italy
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
- Research Institute of Mental Health and Neuroscience and Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands
| | - G. Riva
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
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11
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Testa G, Mora-Maltas B, Camacho-Barcia L, Granero R, Lucas I, Agüera Z, Jiménez-Murcia S, Baños R, Bertaina-Anglade V, Botella C, Bulló M, Casanueva FF, Dalsgaard S, Fernández-Real JM, Franke B, Frühbeck G, Fitó M, Gómez-Martínez C, Pintó X, Poelmans G, Tinahones FJ, de la Torre R, Salas-Salvadó J, Serra-Majem L, Vos S, Wimberley T, Fernández-Aranda F. Transdiagnostic Perspective of Impulsivity and Compulsivity in Obesity: From Cognitive Profile to Self-Reported Dimensions in Clinical Samples with and without Diabetes. Nutrients 2021; 13:nu13124426. [PMID: 34959979 PMCID: PMC8707121 DOI: 10.3390/nu13124426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022] Open
Abstract
Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive–compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity.
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Affiliation(s)
- Giulia Testa
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
| | - Bernat Mora-Maltas
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Lucía Camacho-Barcia
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
| | - Roser Granero
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Ignacio Lucas
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Rosa Baños
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Instituto Polibienestar, Universitat de Valencia, 46010 Valencia, Spain
| | | | - Cristina Botella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Basic Psychology Clinic and Psychobiology, Universitat Jaume I, Castellón de la Plana, 12071 Castellón, Spain
| | - Mònica Bulló
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, University Rovira i Virgili (URV), 43201 Reus, Spain
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, 43204 Reus, Spain
| | - Felipe F. Casanueva
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Molecular and Cellular Endocrinology Group, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS), Santiago de Compostela University (USC) and Centro de Investigacion Biomedica en Red Fisiopatologia de la Obesidad Y Nutricion (Ciberobn), 15705 Santiago de Compostela A Coruña, Spain
| | - Søren Dalsgaard
- National Centre for Register-Based Research, Department of Economics and Business Economics, Business and Social Sciences, Aarhus University and iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (Copenhagen-Aarhus), DK-8210 Aarhus, Denmark;
| | - José-Manuel Fernández-Real
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Medical Sciences, School of Medicine, Hospital of Girona Dr. Josep Trueta, University of Girona, 17004 Girona, Spain
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Gema Frühbeck
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Endocrinology, Instituto de Investigación Sanitaria de Navarra, University of Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Montserrat Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Unit of Cardiovascular Risk and Nutrition, Hospital del Mar Institute for Medical Research (IMIM), 08003 Barcelona, Spain
| | - Carlos Gómez-Martínez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, 43204 Reus, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, 43201 Reus, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Geert Poelmans
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Francisco J. Tinahones
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, 29016 Málaga, Spain
| | - Rafael de la Torre
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Integrative Pharmacology and Systems Neurosciences Research Group, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), 08003 Barcelona, Spain
- IMIM-Hospital del Mar Medical Research Institute and CIBER of Physiopathology of Obesity and Nutrition (CIBEROBN), University Pompeu Fabra (DCEXS-UPF), 08003 Barcelona, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Hospital Universitari de Sant Joan de Reus, 43204 Reus, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, 43201 Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, 43204 Reus, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain
| | - Stephanie Vos
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, 6211 LK Maastricht, The Netherlands;
| | - Theresa Wimberley
- National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, DK-8000 Aarhus, Denmark;
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (G.T.); (B.M.-M.); (L.C.-B.); (I.L.); (Z.A.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (R.G.); (R.B.); (C.B.); (M.B.); (F.F.C.); (J.-M.F.-R.); (G.F.); (M.F.); (C.G.-M.); (X.P.); (F.J.T.); (R.d.l.T.); (J.S.-S.); (L.S.-M.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-2607227
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12
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van Genugten CR, Schuurmans J, Hoogendoorn AW, Araya R, Andersson G, Baños R, Botella C, Cerga Pashoja A, Cieslak R, Ebert DD, García-Palacios A, Hazo JB, Herrero R, Holtzmann J, Kemmeren L, Kleiboer A, Krieger T, Smoktunowicz E, Titzler I, Topooco N, Urech A, Smit JH, Riper H. Examining the Theoretical Framework of Behavioral Activation for Major Depressive Disorder: Smartphone-Based Ecological Momentary Assessment Study. JMIR Ment Health 2021; 8:e32007. [PMID: 34874888 PMCID: PMC8727050 DOI: 10.2196/32007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/06/2021] [Accepted: 10/28/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Behavioral activation (BA), either as a stand-alone treatment or as part of cognitive behavioral therapy, has been shown to be effective for treating depression. The theoretical underpinnings of BA derive from Lewinsohn et al's theory of depression. The central premise of BA is that having patients engage in more pleasant activities leads to them experiencing more pleasure and elevates their mood, which, in turn, leads to further (behavioral) activation. However, there is a dearth of empirical evidence about the theoretical framework of BA. OBJECTIVE This study aims to examine the assumed (temporal) associations of the 3 constructs in the theoretical framework of BA. METHODS Data were collected as part of the "European Comparative Effectiveness Research on Internet-based Depression Treatment versus treatment-as-usual" trial among patients who were randomly assigned to receive blended cognitive behavioral therapy (bCBT). As part of bCBT, patients completed weekly assessments of their level of engagement in pleasant activities, the pleasure they experienced as a result of these activities, and their mood over the course of the treatment using a smartphone-based ecological momentary assessment (EMA) application. Longitudinal cross-lagged and cross-sectional associations of 240 patients were examined using random intercept cross-lagged panel models. RESULTS The analyses did not reveal any statistically significant cross-lagged coefficients (all P>.05). Statistically significant cross-sectional positive associations between activities, pleasure, and mood levels were identified. Moreover, the levels of engagement in activities, pleasure, and mood slightly increased over the duration of the treatment. In addition, mood seemed to carry over, over time, while both levels of engagement in activities and pleasurable experiences did not. CONCLUSIONS The results were partially in accordance with the theoretical framework of BA, insofar as the analyses revealed cross-sectional relationships between levels of engagement in activities, pleasurable experiences deriving from these activities, and enhanced mood. However, given that no statistically significant temporal relationships were revealed, no conclusions could be drawn about potential causality. A shorter measurement interval (eg, daily rather than weekly EMA reports) might be more attuned to detecting potential underlying temporal pathways. Future research should use an EMA methodology to further investigate temporal associations, based on theory and how treatments are presented to patients. TRIAL REGISTRATION ClinicalTrials.gov, NCT02542891, https://clinicaltrials.gov/ct2/show/NCT02542891; German Clinical Trials Register, DRKS00006866, https://tinyurl.com/ybja3xz7; Netherlands Trials Register, NTR4962, https://www.trialregister.nl/trial/4838; ClinicalTrials.Gov, NCT02389660, https://clinicaltrials.gov/ct2/show/NCT02389660; ClinicalTrials.gov, NCT02361684, https://clinicaltrials.gov/ct2/show/NCT02361684; ClinicalTrials.gov, NCT02449447, https://clinicaltrials.gov/ct2/show/NCT02449447; ClinicalTrials.gov, NCT02410616, https://clinicaltrials.gov/ct2/show/NCT02410616; ISRCTN registry, ISRCTN12388725, https://www.isrctn.com/ISRCTN12388725.
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Affiliation(s)
- Claire Rosalie van Genugten
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Josien Schuurmans
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands
| | - Adriaan W Hoogendoorn
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands
| | - Ricardo Araya
- Institute of Psychiatry Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rosa Baños
- Polibienestar Research Institute, University of Valencia, Valencia, Spain.,Institute of Health Carlos III, CIBERObn CB06 03/0052, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Cristina Botella
- Institute of Health Carlos III, CIBERObn CB06 03/0052, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Arlinda Cerga Pashoja
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Roman Cieslak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Lyda Hill Institute for Human Resilience, Colorado Springs, Colorado Springs, CO, United States
| | - David Daniel Ebert
- Department for Sport and Health Sciences, Technical University Munich, Munich, Germany
| | - Azucena García-Palacios
- Institute of Health Carlos III, CIBERObn CB06 03/0052, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Jean-Baptiste Hazo
- Eceve, Unit 1123, Inserm, University of Paris, Paris, France.,Health Economics Research Unit, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Rocío Herrero
- Polibienestar Research Institute, University of Valencia, Valencia, Spain.,Institute of Health Carlos III, CIBERObn CB06 03/0052, Madrid, Spain
| | - Jérôme Holtzmann
- Mood Disorders and Emotional Pathologies Unit, Pôle de Psychiatrie, Neurologie et Rééducation Neurologique, University Hospital Grenoble Alpes, Grenoble, France
| | - Lise Kemmeren
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands
| | - Annet Kleiboer
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
| | - Tobias Krieger
- Department of Clinical Psychology, University of Bern, Bern, Switzerland
| | - Ewelina Smoktunowicz
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Ingrid Titzler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Naira Topooco
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Centre for m2health, Palo Alto University, Palo Alto, CA, United States
| | - Antoine Urech
- Department of Clinical Psychology, University of Bern, Bern, Switzerland
| | - Johannes H Smit
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands
| | - Heleen Riper
- Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands.,Institute of Telepsychiatry, University of Southern Denmark, Odense, Denmark.,Faculty of Medicine, University of Turku, Turku, Finland
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13
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Mor S, Grimaldos J, Tur C, Miguel C, Cuijpers P, Botella C, Quero S. Internet- and mobile-based interventions for the treatment of specific phobia: A systematic review and preliminary meta-analysis. Internet Interv 2021; 26:100462. [PMID: 34646752 PMCID: PMC8501502 DOI: 10.1016/j.invent.2021.100462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 12/19/2022] Open
Abstract
Internet- and mobile-based interventions (IMIs) are being developed for a wide range of psychological disorders and they showed their effectiveness in multiple studies. Specific phobia (SP) is one of the most common anxiety disorders, and research about IMIs for their treatment has also been conducted in recent years. The aim of this paper was to conduct a systematic review and preliminary meta-analysis exploring IMIs for the treatment of SP. A comprehensive search conducted in five different databases identified 9 studies (4 pre-post studies, 5 randomized controlled trials) with 7 Internet-based interventions and 2 mobile-based interventions. Results showed that exposure was the main component of all interventions, and that animal phobia was the most common subtype. Samples included children, adolescents, and adults. A preliminary meta-analysis of the included studies showed that participants receiving IMIs experienced a significant reduction of SP symptoms from pre- to post-treatment (g = 1.15). This systematic review found that there is already some evidence in the literature supporting the potential benefits of IMIs for SP. However, the number of studies included is small and more research should be carried out in the field.
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Affiliation(s)
- Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Jorge Grimaldos
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Cintia Tur
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Cristina Botella
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain,Corresponding author at: Universitat Jaume I, Av. Vicente Sos Baynat s/n, 12006 Castellón, (Spain).
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14
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Irish M, Kuso S, Simek M, Zeiler M, Potterton R, Musiat P, Nitsch M, Wagner G, Karwautz A, Bolinski F, Karyotaki E, Rovira CS, Etchemendy E, Herrero R, Mira A, Cormo G, Baños R, Garcia-Palacios A, Ebert DD, Franke M, Zarski AC, Weisel K, Berger T, Dey M, Schaub MP, Jacobi C, Botella C, Oliver E, Gordon G, Spencer L, Waldherr K, Schmidt U. Online prevention programmes for university students: stakeholder perspectives from six European countries. Eur J Public Health 2021; 31:i64-i70. [PMID: 34240152 PMCID: PMC8495721 DOI: 10.1093/eurpub/ckab040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Students beginning university are at a heightened risk for developing mental
health disorders. Online prevention and early intervention programmes
targeting mental health have the potential to reduce this risk, however,
previous research has shown uptake to be rather poor. Understanding
university stakeholders’ (e.g. governing level and delivery staff
[DS] and students) views and attitudes towards such online prevention
programmes could help with their development, implementation and
dissemination within university settings. Methods Semi-structured interviews, focus groups and online surveys were completed
with staff at a governing level, university students and DS (i.e. student
health or teaching staff) from six European countries. They were asked about
their experiences with, and needs and attitudes towards, online prevention
programmes, as well as the factors that influence the translation of these
programmes into real-world settings. Results were analyzed using thematic
analysis. Results Participating stakeholders knew little about online prevention programmes for
university settings; however, they viewed them as acceptable. The main
themes to emerge were the basic conditions and content of the programmes,
the awareness and engagement, the resources needed, the usability and the
responsibility and ongoing efforts to increase reach. Conclusions Overall, although these stakeholders had little knowledge about online
prevention programmes, they were open to the idea of introducing them. They
could see the potential benefits that these programmes might bring to a
university setting as a whole and the individual students and staff
members.
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Affiliation(s)
- Madeleine Irish
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Stefanie Kuso
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
| | - Monika Simek
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Michael Zeiler
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Rachel Potterton
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Peter Musiat
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Martina Nitsch
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
| | - Gudrun Wagner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Andreas Karwautz
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Felix Bolinski
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Ernestina Etchemendy
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Rocio Herrero
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
| | | | - Giulia Cormo
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Rosa Baños
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
| | | | - David D Ebert
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Marvin Franke
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anna-Carlotta Zarski
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Kiona Weisel
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, Universität Bern, Bern, Switzerland
| | - Michelle Dey
- Universität Zürich, Schweizer Institut für Sucht- und Gesundheitsforschung, Zurich, Switzerland
| | - Michael P Schaub
- Universität Zürich, Schweizer Institut für Sucht- und Gesundheitsforschung, Zurich, Switzerland
| | - Corinna Jacobi
- Department of Psychology, Technische Universität Dresden, School of Science, Chair of Clinical Psychology and E-Mental-Health, Dresden, Germany
| | | | | | - Gemma Gordon
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Lucy Spencer
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Karin Waldherr
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
| | - Ulrike Schmidt
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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15
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Ma L, Mor S, Anderson PL, Baños RM, Botella C, Bouchard S, Cárdenas-López G, Donker T, Fernández-Álvarez J, Lindner P, Mühlberger A, Powers MB, Quero S, Rothbaum B, Wiederhold BK, Carlbring P. Integrating virtual realities and psychotherapy: SWOT analysis on VR and MR based treatments of anxiety and stress-related disorders. Cogn Behav Ther 2021; 50:509-526. [PMID: 34342251 DOI: 10.1080/16506073.2021.1939410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments.Abbreviations: AR: Augmented Reality; MR: Mixed Reality; RCT: Randomised Controlled Trial; SWOT: Strengths, Weaknesses, Opportunities, and Threats; VR: Virtual Reality; VR-EBT: Virtual Reality Exposure-Based Therapy.
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Affiliation(s)
- Lichen Ma
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Sonia Mor
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Page L Anderson
- Department of Psychology, Georgia State University, Atlanta, USA
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Stephane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
| | | | - Tara Donker
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Albert-LudwigsUniversität Freiburg, Freiburg, Germany
| | - Javier Fernández-Álvarez
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Philip Lindner
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Healthcare Services, Sweden
| | | | | | - Soledad Quero
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Barbara Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, USA
| | | | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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16
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Zeiler M, Kuso S, Nitsch M, Simek M, Adamcik T, Herrero R, Etchemendy E, Mira A, Oliver E, Jones Bell M, Karwautz A, Wagner G, Baños Rivera RM, Botella C, Waldherr K. Online interventions to prevent mental health problems implemented in school settings: the perspectives from key stakeholders in Austria and Spain. Eur J Public Health 2021; 31:i71-i79. [PMID: 34240156 PMCID: PMC8266540 DOI: 10.1093/eurpub/ckab039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Schools are key settings for delivering mental illness prevention in adolescents. Data on stakeholders' attitudes and factors relevant for the implementation of Internet-based prevention programmes are scarce. METHODS Stakeholders in the school setting from Austria and Spain were consulted. Potential facilitators (e.g. teachers and school psychologists) completed an online questionnaire (N=50), policy makers (e.g. representatives of the ministry of education and health professional associations) participated in semi-structured interviews (N=9) and pupils (N=29, 14-19 years) participated in focus groups. Thematic analysis was used to identify experiences with, attitudes and needs towards Internet-based prevention programmes, underserved groups, as well as barriers and facilitators for reach, adoption, implementation and maintenance. RESULTS Experiences with Internet-based prevention programmes were low across all stakeholder groups. Better reach of the target groups was seen as main advantage whereas lack of personal contact, privacy concerns, risk for misuse and potential stigmatization when implemented during school hours were regarded as disadvantages. Relevant needs towards Internet-based programmes involved attributes of the development process, general requirements for safety and performance, presentation of content, media/tools and contact options of online programmes. Positive attitudes of school staff, low effort for schools and compatibility to schools' curriculum were seen as key factors for successful adoption and implementation. A sound implementation of the programme in the school routine and continued improvement could facilitate maintenance of online prevention initiatives in schools. CONCLUSIONS Attitudes towards Internet-based mental illness prevention programmes in school settings are positive across all stakeholder groups. However, especially safety concerns have to be considered.
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Affiliation(s)
- Michael Zeiler
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Stefanie Kuso
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
| | - Martina Nitsch
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
| | - Monika Simek
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Tanja Adamcik
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
| | - Rocio Herrero
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III, Institute of Health, Av. Monforte de Lemos, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Facultad de Psicología, Universidad de Valencia, València, Spain
| | - Ernestina Etchemendy
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III, Institute of Health, Av. Monforte de Lemos, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Facultad de Psicología, Universidad de Valencia, València, Spain
| | - Adriana Mira
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
- Department of Pychology and Sociology, Universidad de Zaragoza. Facultad de Ciencias Sociales y Humanas., Calle Cdad. Escolar, Teruel, Spain
| | - Elia Oliver
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III, Institute of Health, Av. Monforte de Lemos, Madrid, Spain
| | - Megan Jones Bell
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Andreas Karwautz
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gudrun Wagner
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Rosa Maria Baños Rivera
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III, Institute of Health, Av. Monforte de Lemos, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Facultad de Psicología, Universidad de Valencia, València, Spain
| | - Cristina Botella
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III, Institute of Health, Av. Monforte de Lemos, Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Karin Waldherr
- Ferdinand Porsche FernFH-Distance Learning University of Applied Sciences, Wiener Neustadt, Austria
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Díaz-García A, Franke M, Herrero R, Ebert DD, Botella C. Theoretical adequacy, methodological quality and efficacy of online interventions targeting resilience: a systematic review and meta-analysis. Eur J Public Health 2021; 31:i11-i18. [PMID: 34240159 PMCID: PMC8266533 DOI: 10.1093/eurpub/ckaa255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is a growing interest in the promotion of mental health, and concepts as resilience are re-emerging and taking relevance. In addition, Information and Communication Technologies can provide potential benefits in the field of mental health, and the treatment of mental disorders in particular. This study aims to synthesize the evidence of internet-based resilience interventions, analyzing the theoretical adequacy, methodological quality and efficacy. METHODS A systematic search was performed. The eligibility criteria stated for this article were: randomized controlled trials targeted at adults or adolescents and including any psychological intervention focussing on resilience in its rationale or design. Studies with direct (e.g. resilience scales) and proximal resilience measures (e.g. scales on well-being) were included. Risk of bias was assessed for each trial using Cochrane's Collaboration Tool. Two reviewers worked independently in order to identify potential articles. A total of 11 articles were selected. A random-effects pooling model using the Hartung-Knapp-Sidik-Jonkman method based on direct and proximal resilience measures at post-test was used. RESULTS The overall effects of online resilience training compared to control groups at post-test were not significant; the effect size concerning the improvement of resilience was g=0.12 (95% CI: -0.14 to 0.38). In addition, a potential association between the type of outcome and the effect size could be revealed. CONCLUSIONS The results of the present meta-analysis showed that the overall effect of online resilience trainings was not significant. Nonetheless, a tendency for a higher benefit for resilience was found in the studies with a clear assessment theory, indicating some promising effects. REGISTRATION NUMBER PROSPERO CRD42018083339.
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Affiliation(s)
- Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza (Campus de Teruel), Teruel
| | - Marvin Franke
- Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany
| | - Rocio Herrero
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - David Daniel Ebert
- Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen Nuremberg, Erlangen, Germany
| | - Cristina Botella
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Universitat Jaume I, Castellón, Spain
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Colombo D, Serino S, Suso-Ribera C, Fernández-Álvarez J, Cipresso P, García-Palacios A, Riva G, Botella C. The Moderating Role of Emotion Regulation in the Recall of Negative Autobiographical Memories. Int J Environ Res Public Health 2021; 18:7122. [PMID: 34281058 PMCID: PMC8296894 DOI: 10.3390/ijerph18137122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/22/2022]
Abstract
When facing a negative event, people implement different strategies to regulate ongoing emotions. Although the previous literature has suggested that the emotional intensity of a negative episode is associated with the characteristics of the subsequent autobiographical memory, it is still unknown whether emotion regulation (ER) moderates this relationship. In the present study, we provided undergraduate students with a smartphone-based diary to report a negative episode immediately after its occurrence and rate the momentary use of two ER strategies: cognitive reappraisal and rumination. To explore autobiographical memory, two "surprise" recall tasks were performed one week and one month after the event. According to the results, cognitive reappraisal was linked with better memory performances, and a tendency to retrospectively underestimate the negativity of highly intense events was observed only in participants adopting high rates of this strategy. Conversely, intense rumination was found to be associated with less detailed memories of emotionally intense events, as well as with higher emotional involvement with negative episodes over time, regardless of their intensity. Together, our results support the maladaptive role of rumination and the adaptive influence of cognitive reappraisal on autobiographical memory.
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
| | - Silvia Serino
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (S.S.); (J.F.-Á.); (G.R.)
| | - Carlos Suso-Ribera
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
| | - Javier Fernández-Álvarez
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (S.S.); (J.F.-Á.); (G.R.)
| | - Pietro Cipresso
- Department of Psychology, Università di Torino, 10124 Torino, Italy;
| | - Azucena García-Palacios
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (S.S.); (J.F.-Á.); (G.R.)
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
| | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain
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Colombo D, Díaz-García A, Fernandez-Álvarez J, Botella C. Virtual reality for the enhancement of emotion regulation. Clin Psychol Psychother 2021; 28:519-537. [PMID: 34048621 DOI: 10.1002/cpp.2618] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/22/2021] [Accepted: 05/21/2021] [Indexed: 01/21/2023]
Abstract
In recent decades, a growing body of literature has focused on emotion regulation (ER), which refers to the ability to implement strategies in order to modulate emotional responses and reach desirable goals. To date, impaired ER (i.e., emotion dysregulation) has been identified as a transdiagnostic factor across a wide range of psychopathological conditions, which shows the importance of improving patients' ability to regulate negative and positive emotions in clinical practice. In addition to the increasing evidence showing its efficacy in the treatment of several clinical conditions, virtual reality (VR) has recently emerged as a potentially powerful tool for enhancing ER, thus breaking new ground in the development of cutting-edge transdiagnostic interventions. In the present narrative review, we will provide an overview of the existing evidence about VR-based interventions in the field of ER, emphasizing the promising findings and the barriers that still have to be addressed. To this aim, the available VR-based literature will be analysed in relation to four categories of ER strategies: situational strategies, attentional strategies, cognitive strategies, and response modulation strategies. Furthermore, new emerging fields of research targeting innovative aspects of ER will be highlighted, including the use of VR to promote positive emotions and interpersonal ER skills. Besides, its cost-effectiveness will be discussed, taking into account the costs for both developers (e.g., clinicians and researchers) and end-users. Finally, future directions in this promising field of research will be outlined.
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | - Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
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20
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González-Robles A, Suso-Ribera C, Díaz-García A, García-Palacios A, Castilla D, Botella C. Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement. Internet Interv 2021; 25:100420. [PMID: 34401379 PMCID: PMC8350608 DOI: 10.1016/j.invent.2021.100420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Transdiagnostic iCBT has been shown to be effective for the treatment of emotional disorders. Less is known about the optimal level of therapist and patient involvement in these interventions. Specific characteristics of Internet-delivered interventions include treatment adherence (e.g., amount of review of the materials) and guidance (e.g., amount of therapist support). Exploring the importance of these elements in treatment outcome may help to maximize the efficiency of Internet-delivered psychological interventions. AIM In this study, we aimed to analyze the relationship between patient and therapist involvement (i.e., platform usage and amount of therapist guidance) in a sample of patients with emotional disorders who received transdiagnostic iCBT in Spanish public specialized mental healthcare services. METHOD This is a secondary analysis of a randomized controlled trial. The sample included 63 patients who completed transdiagnostic iCBT for emotional disorders. Platform usage metrics included number of logins into the platform and number of times the participants reviewed the modules. Therapist guidance was measured as the number of support phone calls with a therapist and their total duration (minutes). Logistic regressions and ROC analyses were performed to explore the predictive value of platform usage and therapist guidance in symptom reduction. Clinical outcomes included depressive and anxiety symptoms assessed at baseline and post-intervention. The bivariate relationship between the platform usage and therapist guidance variables was also explored. RESULTS Overall, platform usage and therapist guidance were not associated with symptom improvement. However, the patient and therapist involvement parameters were intercorrelated. Specifically, the number of calls and their duration were associated with a greater number of logins (r = 0.61; p < .001) and more frequent reviews of the modules (0.46 ≤ r ≤ 0.60; p < .001). Higher baseline depression and anxiety were, respectively, associated with greater improvements in depression (r = -0.37, p = .003) and anxiety after treatment completion (r = -0.48, p < .001). DISCUSSION The results suggest that there is no reliable cut-off point for platform usage and therapist guidance in predicting optimal symptom reduction. However, significant associations were found between platform usage and guidance variables that warrant additional research. More research on this topic is necessary to further clarify the role of these and other platform usage and guidance variables in Internet-delivered iCBT outcomes.
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Affiliation(s)
- Alberto González-Robles
- Department of Psychology and Sociology, Universidad de Zaragoza (Campus de Teruel), Teruel, Spain
- Corresponding author at: C/ Ciudad Escolar, s/n, 44001 Teruel, Spain.
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
| | - Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza (Campus de Teruel), Teruel, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Diana Castilla
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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Guillén V, Tormo ME, Fonseca-Baeza S, Botella C, Baños R, García-Palacios A, Marco JH. Resilience as a predictor of quality of life in participants with borderline personality disorder before and after treatment. BMC Psychiatry 2021; 21:305. [PMID: 34118905 PMCID: PMC8199796 DOI: 10.1186/s12888-021-03312-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 01/13/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. OBJECTIVES a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre-treatment and posttreatment. METHOD The sample comprised 403 participants (n = 202 participants diagnosed with BPD and n = 201 non-clinical). Participants filled out the Quality of Life Index, Resilience Scale, and Beck Depression Inventory. The clinical participants received one of these possible treatments, DBT, STEPPS, or CBT-TAU. MANOVA and regression analyses were performed. RESULTS a) participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population; b) all three forms of psychotherapy statistically improved QoL, but there were no statistically significant differences between DBT, STEPPS, and CBT-TAU in the improvement of QoL; c) participants did not show clinically significant improvements in QoL after treatment; d) resilience was associated with QoL before and after treatment; and e) resilience was a predictor of QoL before and after treatment. CONCLUSION It is necessary to assess QoL and Resilience in studies on psychotherapy with BPD patients.
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Affiliation(s)
- Verónica Guillén
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Av. Blasco Ibañez 21, 46010, Valencia, Spain.
- CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain.
| | - Mireia Esplugues Tormo
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Av. Blasco Ibañez 21, 46010, Valencia, Spain
| | - Sara Fonseca-Baeza
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Av. Blasco Ibañez 21, 46010, Valencia, Spain
| | - Cristina Botella
- CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University of Castellon, Castellon, Spain
| | - Rosa Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Av. Blasco Ibañez 21, 46010, Valencia, Spain
- CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain
| | - Azucena García-Palacios
- CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University of Castellon, Castellon, Spain
| | - José Heliodoro Marco
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Av. Blasco Ibañez 21, 46010, Valencia, Spain
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Fernandez-Alvarez J, Colombo D, Suso-Ribera C, Chirico A, Serino S, Di Lernia D, Palacios AG, Riva G, Botella C. Using virtual reality to target positive autobiographical memory in individuals with moderate-to-moderately severe depressive symptoms: A single case experimental design. Internet Interv 2021; 25:100407. [PMID: 34401366 PMCID: PMC8350590 DOI: 10.1016/j.invent.2021.100407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/16/2021] [Accepted: 05/21/2021] [Indexed: 01/03/2023] Open
Abstract
So far, several aspects of autobiographical memory (AM) have been found to be impaired in depression. Among others, depressed patients show the tendency to recall more negative than positive events (i.e., negative bias) and usually retrieve memories that lack of specificity and details (i.e., overgeneral memories). Based on this, we designed an AM task enhanced by the use of virtual reality (VR) to specifically train the recall of positive memories. Using a single-case, multiple baseline experimental design, we explored the effects of a brief intervention consisting of two sessions of this training in a sample of 18 individuals with moderate-to-moderately severe depressive symptoms. According to the results, changes occurred at the short term only. In particular, almost all participants reported a significant improvement in at least one outcome measure 0-3 days after the intervention. However, these clinical gains were not maintained in the mid-term (from day 4 to 10). The present findings do not support the efficacy of our VR-based AM recall treatment as a standalone intervention. Nevertheless, it might represent a suitable procedure to obtain immediate and/or short-term improvements. It might also serve as a valid component to be integrated in broader protocols for patients with moderate-to-moderately severe depressive symptoms.
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Affiliation(s)
| | - Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universidad Jaume I, Castellon, Spain,Corresponding author at: Universitat Jaume I, Av. Sos Baynat, s/n, 12071, Castellón, Spain.
| | - Carlos Suso-Ribera
- Department of Basic Psychology, Clinic and Psychobiology, Universidad Jaume I, Castellon, Spain
| | | | - Silvia Serino
- Humane Technology Lab., Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Lab., Università Cattolica del Sacro Cuore, Milan, Italy
| | - Azucena García Palacios
- Department of Basic Psychology, Clinic and Psychobiology, Universidad Jaume I, Castellon, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Giuseppe Riva
- Humane Technology Lab., Università Cattolica del Sacro Cuore, Milan, Italy,Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Universidad Jaume I, Castellon, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
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Colombo D, Pavani JB, Fernandez-Alvarez J, Garcia-Palacios A, Botella C. Savoring the present: The reciprocal influence between positive emotions and positive emotion regulation in everyday life. PLoS One 2021; 16:e0251561. [PMID: 33974680 PMCID: PMC8112694 DOI: 10.1371/journal.pone.0251561] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/28/2021] [Indexed: 01/22/2023] Open
Abstract
A growing body of research has investigated the regulation of negative emotions in ecological settings, but little is known about the mechanisms underlying positive emotion regulation in everyday life. Although some evidence suggests that adopting positive strategies is beneficial for emotional well-being, the literature is inconsistent about the effects of positive emotions on subsequent regulatory processes. In the present study, we adopted a two-week ecological momentary assessment to explore the association between positive emotions and positive emotion regulation in daily life. According to our results, the less individuals felt positive emotions at one point, the more they tended to enhance their use of positive strategies from this time to the next, which in turn resulted in subsequent higher levels of positive emotions. This prototype of positive regulation can be seen as a highly adaptive mechanism that makes it possible to compensate for a lack of positive emotions by enhancing the deployment of positive strategies. The theoretical and clinical implications of these findings are discussed.
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón, Spain
| | - Jean-Baptiste Pavani
- Center for Research on the Psychology of Cognition, Language and Emotion (PSYCLE), Aix Marseille University, Marseille, France
| | | | - Azucena Garcia-Palacios
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
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Dursap T, Vettori M, Botella C, Regreny P, Blanchard N, Gendry M, Chauvin N, Bugnet M, Danescu A, Penuelas J. Wurtzite phase control for self-assisted GaAs nanowires grown by molecular beam epitaxy. Nanotechnology 2021; 32:155602. [PMID: 33429384 DOI: 10.1088/1361-6528/abda75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The accurate control of the crystal phase in III-V semiconductor nanowires (NWs) is an important milestone for device applications. Although cubic zinc-blende (ZB) GaAs is a well-established material in microelectronics, the controlled growth of hexagonal wurtzite (WZ) GaAs has thus far not been achieved successfully. Specifically, the prospect of growing defect-free and gold catalyst-free wurtzite GaAs would pave the way towards integration on silicon substrate and new device applications. In this article, we present a method to select and maintain the WZ crystal phase in self-assisted NWs by molecular beam epitaxy. By choosing a specific regime where the NW growth process is a self-regulated system, the main experimental parameter to select the ZB or WZ phase is the V/III flux ratio. Using an analytical growth model, we show that the V/III flux ratio can be finely tuned by changing the As flux, thus driving the system toward a stationary regime where the wetting angle of the Ga droplet can be maintained in the range of values allowing the formation of pure WZ phase. The analysis of the in situ reflection high energy electron diffraction evolution, combined with high-resolution scanning transmission electron microscopy (TEM), dark field TEM, and photoluminescence all confirm the control of an extended pure WZ segment, more than a micrometer long, obtained by molecular beam epitaxy growth of self- assisted GaAs NWs with a V/III flux ratio of 4.0. This successful controlled growth of WZ GaAs suggests potential benefits for electronics and opto-electronics applications.
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Affiliation(s)
- T Dursap
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, F-69134 Ecully cedex, France
| | - M Vettori
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, F-69134 Ecully cedex, France
| | - C Botella
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, F-69134 Ecully cedex, France
| | - P Regreny
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, F-69134 Ecully cedex, France
| | - N Blanchard
- Université de Lyon, Université Claude Bernard Lyon 1, CNRS, Institut Lumière Matière, F-69622 Villeurbanne, France
| | - M Gendry
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, F-69134 Ecully cedex, France
| | - N Chauvin
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, INSA de Lyon, 7 Avenue Jean Capelle F-69621, Villeurbanne Cedex, France
| | - M Bugnet
- Université de Lyon, INSA de Lyon, Université Claude Bernard Lyon 1, MATEIS, UMR 5510 CNRS, Avenue Jean Capelle, F-69621 Villeurbanne, France
| | - A Danescu
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, F-69134 Ecully cedex, France
| | - J Penuelas
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, Ecole Centrale de Lyon, 36 Avenue Guy de Collongue, F-69134 Ecully cedex, France
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Joly L, Bossu Estour C, Rossi F, Brighenti N, Wauthy D, Zulian M, Torrès S, Tardy E, Botella C. Objectif 2000 kcal : sommes-nous bien dans notre assiette ? NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mor S, Botella C, Campos D, Tur C, Castilla D, Soler C, Quero S. An Internet-based treatment for Flying Phobia using 360° images: Study protocol for a feasibility pilot study. Internet Interv 2021; 24:100387. [PMID: 33936953 PMCID: PMC8076687 DOI: 10.1016/j.invent.2021.100387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Flying Phobia (FP) is a prevalent disorder that can cause serious interference in a person's life. ICBT interventions have already shown their efficacy in several studies, but studies in the field of specific phobias are still scarce. Moreover, few studies have investigated the feasibility of using different types of images in exposure scenarios in ICBTs and no studies have been carried out on the role of sense of presence and reality judgement. The aim of the present study is to explore the feasibility of an ICBT for FP (NO-FEAR Airlines) using two types of images with different levels of immersion (still and navigable images). A secondary aim is to explore the potential effectiveness of the two experimental conditions using two types of images compared to a waiting list control group. Finally, the role of navigable images compared to the still images in the level of anxiety, sense of presence, and reality judgement will also be explored. This paper presents the study protocol. METHODS This study is a three-armed feasibility pilot study with the following conditions: NO-FEAR Airlines with navigable images, NO-FEAR Airlines with still images, and a waiting list group. A minimum of 60 participants will be recruited. The intervention will have a maximum duration of 6 weeks. Measurements will be taken at four different moments: baseline, post-intervention, and two follow-ups (3- and 12-month). Participants' opinions, preference, satisfaction and acceptance regarding the images used in the exposure scenarios will be assessed. FP symptomatology outcomes will also be considered for secondary analyses. The anxiety, sense of presence, and reality judgement in the exposure scenarios will also be analysed. DISCUSSION This study will conduct a pilot study on the feasibility of an ICBT for FP and it is the first one to explore the evaluation of patients of the two type of images (still and navigable) and the role of presence and reality judgement in exposure scenarios delivered through the Internet. Research in this field can have an impact on the way these scenarios are designed and developed, as well as helping to explore whether they have any effect on adherence. TRIAL REGISTRATION NCT03900559. Trial Registration date 3 April 2019, retrospectively registered.
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Affiliation(s)
- Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Cristina Botella
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Cintia Tur
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | | | | | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
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Guillén Botella V, García-Palacios A, Bolo Miñana S, Baños R, Botella C, Marco JH. Exploring the Effectiveness of Dialectical Behavior Therapy Versus Systems Training for Emotional Predictability and Problem Solving in a Sample of Patients With Borderline Personality Disorder. J Pers Disord 2021; 35:21-38. [PMID: 32250206 DOI: 10.1521/pedi_2020_34_477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dialectical behavior therapy (DBT) and systems training for emotional predictability and problem solving (STEPPS) are two treatment protocols for people with borderline personality disorder (BPD) that have received important empirical support. However, their possible differential effectiveness has not yet been studied. The objective of this study is to explore the effectiveness of these two treatment programs. A nonrandomized clinical trial was carried out in which both treatments were applied for six months. The sample consisted of 72 patients diagnosed with BPD. The results indicate that both groups experienced a statistically significant reduction in BPD symptom, emotional regulation, impulsiveness, dissociative experiences, suicidal risk, depression, or anger. However, the DBT condition obtained statistically significant differences in BPD behavioral symptoms and fear of suicide. DBT and STEPPS treatment are effective treatments for participants with BPD, and DBT was more effective for the behavioral symptoms of BPD.
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Affiliation(s)
| | - Azucena García-Palacios
- Universitat Jaume I de Castellón, Castellón, Spain.,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Madrid, Spain
| | | | - Rosa Baños
- Universidad de Valencia, Valencia, Spain.,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Madrid, Spain
| | - Cristina Botella
- Universitat Jaume I de Castellón, Castellón, Spain.,Ciber Fisiopatologia Obesidad y Nutricion (CB06/03 Instituto Salud Carlos III), Madrid, Spain
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Guillén V, Díaz-García A, Mira A, García-Palacios A, Escrivá-Martínez T, Baños R, Botella C. Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review. Fam Process 2021; 60:134-144. [PMID: 32304101 DOI: 10.1111/famp.12537] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full-text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.
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Affiliation(s)
- Verónica Guillén
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, València, Spain
- CIBER of Physiopathology of Obesity and Nutrition, Madrid, Spain
| | - Amanda Díaz-García
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain
| | - Adriana Mira
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, València, Spain
| | - Azucena García-Palacios
- CIBER of Physiopathology of Obesity and Nutrition, Madrid, Spain
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain
| | - Tamara Escrivá-Martínez
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, València, Spain
| | - Rosa Baños
- Department of Personality, Evaluation, and Psychological Treatment, University of Valencia, València, Spain
- CIBER of Physiopathology of Obesity and Nutrition, Madrid, Spain
| | - Cristina Botella
- CIBER of Physiopathology of Obesity and Nutrition, Madrid, Spain
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain
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Quiñonez-Freire C, Vara MD, Herrero R, Mira A, García-Palacios A, Botella C, Baños RM. Cultural adaptation of the Smiling is Fun program for the treatment of depression in the Ecuadorian public health care system: A study protocol for a randomized controlled trial. Internet Interv 2021; 23:100352. [PMID: 33335847 PMCID: PMC7733006 DOI: 10.1016/j.invent.2020.100352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/13/2020] [Accepted: 10/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Depression is one of the world's major health problems. Due to its high prevalence, it constitutes the first cause of disability among the Americas, where only a very low percentage of the population receives the adequate evidence-based psychological treatment. Internet-Based Interventions (IBIs) are a great alternative to reduce the treatment gap for mental disorders. Although there are several studies in low-and middle-income countries proving IBIs' feasibility and acceptability, there is still little evidence of the effectiveness in diverse social and cultural contexts such as Latin America. METHODS Two studies will be described: Study 1 is focused on the cultural adaptation of a cognitive-behavioral IBI Smiling is Fun (Botella et al. 2012, 2015) for Ecuadorian population with depression based on the procedure by Salamanca-Sanabria et al. (2018). Study 2 describes the design of a randomized controlled trial to test the preliminary efficacy of the culturally adapted intervention in a Public Health Care setting. A total of 153 patients with mild to moderate degree of depression as assessed with the Mini-International Neuropsychiatric Interview (M.I.N.I.) and the Patient Health Questionnaire-9 (PHQ-9) will be randomly assigned to either an IBI group using only automated support by the system; an IBI group including also minimal human support; or a waiting list group. The primary outcome (depression) and secondary outcomes (e.g., anxiety, affect, quality of life) will be collected at baseline, 3, 6 and 12 months. Mixed-model analyses with no ad hoc imputations will be conducted. DISCUSSION This paper is pioneering in exploring the role of an Internet-based culturally adapted intervention for depression in a public care context in Ecuador. Results obtained will offer new insights into the viability and effectiveness of digital technologies for the psychological treatment of mental illnesses in developing countries.
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Key Words
- APOI, Attitudes Towards Psychological Online Interventions
- AQoL-6D, Assessment of Quality of Life 6 Dimensions
- BDI-II, Beck Depression Inventory-II
- CEQ, Credibility and Expectancy Questionnaire
- CONSORT, Consolidated Standards of Reporting Trials
- CRQ, Cultural Relevance Questionnaire
- CSQ, Client Satisfaction Questionnaire
- Cultural adaptation
- Depression
- E-SF, Ecuadorian Cultural Version of Smiling is Fun
- EBPTs, Evidence-Based Psychological Treatments
- GAD-7, Generalized Anxiety Disorder-7
- IBIs, Internet-Based Interventions
- ICD-10, International Classification of Diseases-10
- ICERs, Incremental Cost-Effectiveness Ratios
- Internet-based intervention
- Latin America
- M.I.N.I. 5.0, MINI International Neuropsychiatric Interview 5.0
- MCAR, Missing Completely at Random
- OASIS, Overall Anxiety Severity and Impairment Scale
- ODSIS, Overall Depression Severity and Impairment Scale
- PANAS, Positive and Negative Affect Schedule
- PC, Primary Care
- PHC, Public Health Care
- PHQ-9, Patient Health Questionnaire-9
- Public Health Care
- QALYs, Quality-Adjusted Life-Years
- RCI, Reliable Change Index
- RCT, Randomized Control Trial
- Randomized Controlled Trial
- SPIRIT, Recommendations for Interventional Trials
- SUS, System Usability Scale
- TiC-P, Trimbos/iMTA Questionnaire on Costs on Psychiatric Illnesses
- WAI-TECH-SF, Working Alliance Inventory for Online Intervention-Short Form
- WL, Waiting List
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Affiliation(s)
- Carlos Quiñonez-Freire
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- Mental Health Unit, Hospital Dr, Gustavo Dominguez Z, Santo Domingo, Ecuador
| | - M. Dolores Vara
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - Rocío Herrero
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - Adriana Mira
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Azucena García-Palacios
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain
| | - Cristina Botella
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón, Spain
| | - Rosa M. Baños
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- CIBER Pathophysiology of Obesity and Nutrition (CB06/03), Carlos III Institute of Health, Madrid, Spain
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
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Díaz-García A, González-Robles A, García-Palacios A, Fernández-Felipe I, Tur C, Castilla D, Botella C. Blended transdiagnostic group CBT for emotional disorders: A feasibility trial protocol. Internet Interv 2021; 23:100363. [PMID: 33520670 PMCID: PMC7820549 DOI: 10.1016/j.invent.2021.100363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/21/2020] [Accepted: 12/29/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Emotional disorders (anxiety and depressive disorders) are a relevant public health concern associated with high prevalence, high costs, and important disability. Therefore, research priorities include designing and testing cost-effective interventions to reach everyone in need. Internet-delivered interventions for emotional disorders are effective and can help to disseminate and implement evidence-based treatments. However, although these treatments are generally effective, not all patients benefit from this treatment format equally. Blended treatments are a new form of intervention that combines the strengths of face-to-face and Internet approaches. Nevertheless, research on blended interventions has focused primarily on individual therapy, and less attention has been paid to the potential of using this format in group psychotherapy. This study aims to analyze the feasibility of blended transdiagnostic group CBT for emotional disorders. The current article describes the study protocol for this trial. METHOD AND ANALYSIS A one-armed pilot trial will be conducted. Participants will be 30 adults suffering from DSM-5 anxiety and/or depressive disorders. The treatment consists of a blended transdiagnostic group intervention delivered during a period of 24 weeks. Groups of 6 to 10 patients will attend a total of eight 2-hour, face-to-face sessions, alternated with the use of an online platform where they will find the contents of the treatment protocol. The intervention has four core components: present-focused awareness, cognitive flexibility, identification and modification of behavioral and cognitive patterns of emotional avoidance, and interoceptive and situational exposure. These components are delivered in 16 modules. Assessments will be performed at baseline, during the treatment, at post-treatment, and at 3-month follow-up. Clinical and treatment acceptability outcomes will be included. Quantitative and qualitative data (participants' views about blended group psychotherapy) will be analyzed. ETHICS AND DISSEMINATION The trial has received ethical approval from the Ethics Committee of Universitat Jaume I (September 2019) and will be conducted in accordance with the study protocol, the Declaration of Helsinki, and good clinical practice. The results of this study will be disseminated by presentation at conferences and will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04008576. Registered 05 July 2019, https://clinicaltrials.gov/ct2/show/NCT04008576.
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Affiliation(s)
- Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza (Campus de Teruel), Teruel, Spain
| | - Alberto González-Robles
- Department of Psychology and Sociology, Universidad de Zaragoza (Campus de Teruel), Teruel, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Isabel Fernández-Felipe
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
| | - Cintia Tur
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
| | - Diana Castilla
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellon, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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Castro A, García-Palacios A, López-Del-Hoyo Y, Mayoral F, Pérez-Ara MÁ, Baños RM, García-Campayo J, Hurtado MM, Botella C, Barceló-Soler A, Villena A, Roca M, Gili M. Predictors of Adherence in Three Low-Intensity Intervention Programs Applied by ICTs for Depression in Primary Care. Int J Environ Res Public Health 2021; 18:ijerph18041774. [PMID: 33670353 PMCID: PMC7918657 DOI: 10.3390/ijerph18041774] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/29/2021] [Accepted: 02/07/2021] [Indexed: 12/26/2022]
Abstract
Depression is one of the most common disorders in psychiatric and primary care settings, and is associated with disability, loss in quality of life, and economic costs. Internet-based psychological interventions have been shown to be effective in depression treatment but present problems with a low degree of adherence. The main aim of this study is to analyze the adherence predictors in three low-intensity interventions programs applied by Information and Communication Technologies (ICTs) for depression. A multi-center, randomized, controlled clinical trial was conducted with 164 participants with depression, who were allocated to: Healthy Lifestyle Program, Positive Affect Promotion Program or Mindfulness Program. Sociodemographic characteristics, Patient Health Questionnaire-9, Visual Analog Scale, Short Form Health Survey, Positive and Negative Affect Schedule, Five Facets Mindfulness Questionnaire, Pemberton Happiness Index and Treatment Expectancy Questionnaire were used to study adherence. Results showed that positive affect resulted in a predictor variable for Healthy Lifestyle Program and Positive Affect Promotion Program. Perceived health was also a negative adherence predictor for the Positive Affect Promotion Program. Our findings demonstrate that there are differences in clinical variables between treatment completers and non-completers and we provide adherence predictors in two intervention groups. Although new additional predictors have been examined, further research is essential in order to improve tailored interventions and increase adherence treatment.
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Affiliation(s)
- Adoración Castro
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-971-259-888
| | - Azucena García-Palacios
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, University Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
- CIBER Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, 28029 Madrid, Spain;
| | - Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS), Hospital Miguel Servet, 50009 Zaragoza, Spain; (Y.L.-D.-H.); (J.G.-C.); (A.B.-S.)
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Fermín Mayoral
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, 29010 Málaga, Spain; (F.M.); (M.M.H.); (A.V.)
| | - María Ángeles Pérez-Ara
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
| | - Rosa Mª Baños
- CIBER Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, 28029 Madrid, Spain;
- Department of Psychological, Personality, Evaluation and Treatment, University of Valencia, 46010 Valencia, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS), Hospital Miguel Servet, 50009 Zaragoza, Spain; (Y.L.-D.-H.); (J.G.-C.); (A.B.-S.)
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | - María M. Hurtado
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, 29010 Málaga, Spain; (F.M.); (M.M.H.); (A.V.)
| | - Cristina Botella
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, University Jaume I, 12071 Castellón, Spain; (A.G.-P.); (C.B.)
- CIBER Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, 28029 Madrid, Spain;
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS), Hospital Miguel Servet, 50009 Zaragoza, Spain; (Y.L.-D.-H.); (J.G.-C.); (A.B.-S.)
| | - Amelia Villena
- Mental Health Department, Institute of Biomedicine of Malaga, University Regional Hospital of Malaga, 29010 Málaga, Spain; (F.M.); (M.M.H.); (A.V.)
| | - Miquel Roca
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | - Margalida Gili
- Research Institute of Health Sciences (IUNICS), University of Balearic Islands, 07122 Palma de Mallorca, Spain; (M.Á.P.-A.); (M.R.); (M.G.)
- Health Research Institute of the Balearic Islands (IdiSBa), 07120 Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
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Díaz-García A, González-Robles A, García-Palacios A, Fernández-Álvarez J, Castilla D, Bretón JM, Baños RM, Quero S, Botella C. Negative and Positive Affect Regulation in a Transdiagnostic Internet-Based Protocol for Emotional Disorders: Randomized Controlled Trial. J Med Internet Res 2021; 23:e21335. [PMID: 33522977 PMCID: PMC7884218 DOI: 10.2196/21335] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/10/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Emotional disorders (EDs) are among the most prevalent mental disorders. Existing evidence-based psychological treatments are not sufficient to reduce the disease burden of mental disorders. It is therefore essential to implement innovative solutions to achieve a successful dissemination of psychological treatment protocols, and in this regard, the use of information and communication technologies such as the internet can be very useful. Furthermore, the literature suggests that not everyone with an ED receives the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which attempts to address the underlying processes common to EDs. Most of these transdiagnostic interventions focus primarily on downregulating negative affectivity (NA), and less attention has been paid to strengths and the upregulation of positive affectivity, despite its importance for well-being and mental health. OBJECTIVE This study aims to evaluate the efficacy of a transdiagnostic internet-based treatment for EDs in a community sample. METHODS A 3-armed randomized controlled trial was conducted. A total of 216 participants were randomly assigned to a transdiagnostic internet-based protocol (TIBP), a TIBP+ positive affect (PA) component, or a waiting list (WL) control group. The treatment protocol contained core components mainly addressed to downregulate NA (ie, present-focused emotional awareness and acceptance, cognitive flexibility, behavioral and emotional avoidance patterns, and interoceptive and situational exposure) as well as a PA regulation component to promote psychological strengths and enhance well-being. Data on depression, anxiety, quality of life, neuroticism and extraversion, and PA/NA before and after treatment were analyzed. Expectations and opinions of treatment were also analyzed. RESULTS Within-group comparisons indicated significant pre-post reductions in the two experimental conditions. In the TIBP+PA condition, the effect sizes were large for all primary outcomes (d=1.42, Beck Depression Inventory [BDI-II]; d=0.91, Beck Anxiety Inventory [BAI]; d=1.27, Positive and Negative Affect Schedule-Positive [PANAS-P]; d=1.26, Positive and Negative Affect Schedule-Negative [PANAS-N]), whereas the TIBP condition yielded large effect sizes for BDI-II (d=1.19) and PANAS-N (d=1.28) and medium effect sizes for BAI (d=0.63) and PANAS-P (d=0.69). Between-group comparisons revealed that participants who received one of the two active treatments scored better at posttreatment than WL participants. Although there were no statistically significant differences between the two intervention groups on the PA measure, effect sizes were consistently larger in the TIBP+PA condition than in the standard transdiagnostic protocol. CONCLUSIONS Overall, the findings indicate that EDs can be effectively treated with a transdiagnostic intervention via the internet, as significant improvements in depression, anxiety, and quality of life measures were observed. Regarding PA measures, promising effects were found, but more research is needed to study the role of PA as a therapeutic component. TRIAL REGISTRATION ClinicalTrials.gov NCT02578758; https://clinicaltrials.gov/ct2/show/NCT02578758. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-017-1297-z.
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Affiliation(s)
- Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza, Teruel, Spain
| | | | - Azucena García-Palacios
- Universitat Jaume I, Castellón de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | | | - Diana Castilla
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | | | - Rosa María Baños
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | | | - Cristina Botella
- Universitat Jaume I, Castellón de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
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Boix F, Legaz I, Minhas A, Alfaro R, Jiménez–Coll V, Mrowiec A, Martínez–Banaclocha H, Galián JA, Botella C, Moya–Quiles MR, Sanchez–Bueno F, Robles R, de la Peña–Moral J, Ramirez P, Pons JA, Minguela A, Muro M. Identification of peripheral CD154 + T cells and HLA-DRB1 as biomarkers of acute cellular rejection in adult liver transplant recipients. Clin Exp Immunol 2021; 203:315-328. [PMID: 33025622 PMCID: PMC7806417 DOI: 10.1111/cei.13533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/16/2022] Open
Abstract
Decreasing graft rejection and increasing graft and patient survival are great challenges facing liver transplantation (LT). Different T cell subsets participate in the acute cellular rejection (ACR) of the allograft. Cell-mediated immunity markers of the recipient could help to understand the mechanisms underlying acute rejection. This study aimed to analyse different surface antigens on T cells in a cohort of adult liver patients undergoing LT to determine the influence on ACR using multi-parametric flow cytometry functional assay. Thirty patients were monitored at baseline and during 1 year post-transplant. Two groups were established, with (ACR) and without (NACR) acute cellular rejection. Leukocyte, total lymphocyte, percentages of CD4+ CD154+ and CD8+ CD154+ T cells, human leukocyte antigen (HLA) mismatch between recipient-donor and their relation with ACR as well as the acute rejection frequencies were analysed. T cells were stimulated with concanavalin A (Con-A) and surface antigens were analysed by fluorescence activated cell sorter (FACS) analysis. A high percentage of CD4+ CD154+ T cells (P = 0·001) and a low percentage of CD8+ CD154+ T cells (P = 0·002) at baseline were statistically significant in ACR. A receiver operating characteristic analysis determined the cut-off values capable to stratify patients at high risk of ACR with high sensitivity and specificity for CD4+ CD154+ (P = 0·001) and CD8+ CD154+ T cells (P = 0·002). In logistic regression analysis, CD4+ CD154+ , CD8+ CD154+ and HLA mismatch were confirmed as independent risk factors to ACR. Post-transplant percentages of both T cell subsets were significantly higher in ACR, despite variations compared to pretransplant. These findings support the selection of candidates for LT based on the pretransplant percentages of CD4+ CD154+ and CD8+ CD154+ T cells in parallel with other transplant factors.
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Affiliation(s)
- F. Boix
- Haematology ServiceUniversity Hospital of SalamancaResearch Biomedical Institute of Salamanca (IBSAL)SalamancaSpain
| | - I. Legaz
- Department of Legal and Forensic MedicineFaculty of MedicineBiomedical Research Institute of Murcia (IMIB)Regional Campus of International Excellence ‘Campus Mare Nostrum’University of MurciaMurciaSpain
| | - A. Minhas
- Clinical Transplantation LaboratoryBarts Health NHS TrustLondonUK
| | - R. Alfaro
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - V. Jiménez–Coll
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - A. Mrowiec
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - H. Martínez–Banaclocha
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - J. A. Galián
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - C. Botella
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - M. R. Moya–Quiles
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - F. Sanchez–Bueno
- SurgeryUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - R. Robles
- SurgeryUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - J. de la Peña–Moral
- PathologyUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - P. Ramirez
- SurgeryUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - J. A. Pons
- Digestive Medicine ServicesUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - A. Minguela
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
| | - M. Muro
- Immunology ServiceUniversity Clinical Hospital Virgen de la Arrixaca–Biomedical Research Institute of Murcia (IMIB)MurciaSpain
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Cebolla A, Botella C, Galiana L, Fernández-Aranda F, Toledo E, Corella D, Salas-Salvadó J, Fitó M, Romaguera D, Wärnberg J, Serra-Majem LL, Pintó X, Buil-Cosiales P, Sorlí JV, Díaz-López A, De la Torre R, de Mott MF, Díaz González BV, Corbella E, Yañez A, Baños R. Psychometric properties of the Weight Locus of Control Scale (MWLCS): study with Spanish individuals of different anthropometric nutritional status. Eat Weight Disord 2020; 25:1533-1542. [PMID: 31605367 DOI: 10.1007/s40519-019-00788-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/26/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The Multidimensional Weight Locus of Control Scale (MWLCS) measures a person's beliefs regarding the locus of control or lack of locus of control over his/her body weight. PURPOSE We aim to evaluate the factorial structure and psychometric properties of the MWLCS with Spanish normal weight, overweight and obese samples. METHODS The research was carried out in two different studies. The first included a sample of 140 normal weight participants, selected out of a 274 sample recruited with an online survey. Study 2 was carried out in a sample of 633 participants recruited from the PREDIMED-Plus study. Out of them, 558 participants fulfilled the weight criteria and were categorized into: overweight (BMI 25 - < 29.99; N = 170), obese class I (BMI 30 - < 34.99; N = 266), and obese class II (BMI 35 - < 39.99; N = 122). Exploratory (EFA) and confirmatory (CFA) factor analyses were used to evaluate the factor structure of the MWLCS, and reliabilities and Spearman's correlations were estimated. Invariance measurement was tested across the three subgroups of weight in Study 2. RESULTS A three-factor structure indicating weight locus of control factors (internal, chance, and powerful others) was supported, both via EFA in the normal weight sample and CFA in the overweight and obese samples. In the normal weight sample, the powerful others dimension was positively related to BMI and the dimensions of the Dutch Eating Behaviors Questionnaire. Additionally, the scale showed evidence of scalar invariance across the groups with different weight conditions. CONCLUSIONS This scale seems to be a psychometrically appropriate instrument and its use is highly recommended when designing interventions for overweight or obese individuals. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- A Cebolla
- Department Personality, Evaluation and Psychological Treatment, Universitat de València, Avda. Blasco Ibáñez, 21, 46010, València, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - C Botella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castelló, Spain
| | - L Galiana
- Department of Methodology for the Behavioral Sciences, Universitat de València, València, Spain
| | - F Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - E Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Institute for Health Research, Pamplona, Spain
| | - D Corella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Biochemistry and Biotechnology, Nutrition unit; Institut d'Investigació Sanitària Pere Virgili (IISPV); University Hospital of Sant Joan de Reus, Nutrition Unit, Universitat Rovira i Virgili, Reus, Spain
| | - M Fitó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - D Romaguera
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Instituto de Investigación Sanitaria de Illes Balears (IdISBa), University Hospital of Son Espases, Palma de Mallorca, Spain
| | - J Wärnberg
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Nursing, University of Málaga-IBIMA, Málaga, Spain
| | - L L Serra-Majem
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - X Pintó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Lipid Unit, Department of Internal Medicine, Bellvitge BiomedicalResearch Institute (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - P Buil-Cosiales
- Servicio Navarro de Salud-Atención Primaria, Institute for Health Research, Pamplona, Spain
| | - J V Sorlí
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - A Díaz-López
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Biochemistry and Biotechnology, Nutrition unit; Institut d'Investigació Sanitària Pere Virgili (IISPV); University Hospital of Sant Joan de Reus, Nutrition Unit, Universitat Rovira i Virgili, Reus, Spain
| | - R De la Torre
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - M Fernández de Mott
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Nursing, University of Málaga-IBIMA, Málaga, Spain
| | - B V Díaz González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - E Corbella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Lipid Unit, Department of Internal Medicine, Bellvitge BiomedicalResearch Institute (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Yañez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.,Department of Nursing and Physiotherapy, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - R Baños
- Department Personality, Evaluation and Psychological Treatment, Universitat de València, Avda. Blasco Ibáñez, 21, 46010, València, Spain. .,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.
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Boissonneau S, Graillon T, Rolland A, Botella C, Pallud J, Dufour H. Management of patients suffering from hemorrhagic intracranial metastases: Propositions to help the neurosurgeon in emergency situations based on a literature review. Neurochirurgie 2020; 67:369-374. [PMID: 33232711 DOI: 10.1016/j.neuchi.2020.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 09/09/2020] [Accepted: 11/14/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Brain metastases are the most common intracranial neoplasm in adult patients, and one of the fearsome complications proves to be intratumoral hemorrhage. The neurosurgical management of patients harboring a bleeding brain metastasis is not fully established and there is still today an ongoing debate on the optimal management of these patients. The aim of this article is to provide the neurosurgeons with practical tools to assist in their decision-making process in the management of BMs. METHODS We conducted a literature review of the relevant Pubmed, Cochrane, and Google scholar-indexed articles published between 2000 and 2019. The following key words were entered in the Pubmed search engine: [metastasis], [metastases], [brain metastases], [brain metastasis], [hemorrhage], [hematoma], [blood clot], [intracerebral hemorrhage], [intracranial hemorrhage]. The review was performed in accordance with the PRISMA recommendations. RESULTS Based on PubMed, Cochrane, and Google scholar, 459 articles were retained, 392 were then removed because of their non-adequacy with the topic and, 9 articles were removed because they were not written in English language. So, 58 articles were analyzed. Radiological evaluation is crucial, but few traps exist. The frequency of overall brain tumor-related with intracranial hematoma is 7.2%, with a higher frequency for secondary tumors. The local recurrence rate after resection of a hemorrhagic metastasis seems to be better probably because of an easier "en bloc" resection thanks to the hematoma. An atypical presentation is reported in up to 4% in patients with chronic or acute subdural hematoma. Patients with subarachnoid hemorrhage and epidural hematoma are rare. A clear-cut correlation between the incidence of bleeding event in brain mets and prior stereotactic radiosurgery was not established. CONCLUSION The current literature pertaining to the neurosurgical management of acute bleeding in brain metastasis is scant and the level of evidence remains low (experts 'opinions; class C). Herein we suggest a flowchart to assist in dealing with those difficult patients.
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Affiliation(s)
- S Boissonneau
- Aix-Marseille Université, AP-HM, CHU Timone, Department of Neurosurgery, Marseille, France; Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille Univ, Marseille, France.
| | - T Graillon
- Aix-Marseille Université, AP-HM, CHU Timone, Department of Neurosurgery, Marseille, France; Aix-Marseille Université, inserm, MMG, Marseille, France
| | - A Rolland
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - C Botella
- Department of Neurosurgery, Centre Hospitalier Saint Anne, Paris, France
| | - J Pallud
- Department of Neurosurgery, Centre Hospitalier Saint Anne, Paris, France; UMR 1266 inserm, IMA-BRAIN, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - H Dufour
- Aix-Marseille Université, AP-HM, CHU Timone, Department of Neurosurgery, Marseille, France; Aix-Marseille Université, inserm, MMG, Marseille, France
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Rachyla I, Mor S, Cuijpers P, Botella C, Castilla D, Quero S. A guided Internet-delivered intervention for adjustment disorders: A randomized controlled trial. Clin Psychol Psychother 2020; 28:313-324. [PMID: 32959481 DOI: 10.1002/cpp.2518] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022]
Abstract
Evidence of self-help interventions for adjustment disorder (AjD) is limited. This study aims at testing in a randomized controlled trial (RCT) the effectiveness of a disorder-specific, Internet-delivered cognitive-behavioural therapy (ICBT) intervention for AjD. Participants were randomly allocated to either an ICBT with brief weekly telephone support (n = 34) or a waiting list group (n = 34). Beck's inventories for depression and anxiety were used as primary outcomes. The secondary outcomes were AjD symptoms, post-traumatic growth, positive and negative affect, and quality of life. In all, 76.5% of the participants completed the intervention. Compared with the control group, participants in the intervention condition showed significantly greater improvement in all outcomes (Cohen's d ranged from 0.54 to 1.21) except in anxiety symptoms measured by Beck Anxiety Inventory (d = 0.27). Only ICBT group showed a significant improvement in post-traumatic growth, positive and negative affect, and quality of life. The number of cases that achieved clinically meaningful change in all outcome measures was also higher in the ICBT group. All therapeutic gains were maintained at 3-, 6- and 12-month follow-ups. The current study provides evidence on the effectiveness of ICBT interventions to reduce the impact of AjD. Results suggest that brief self-help intervention with minimal therapist support is more effective than the mere passage of time in reducing the distress symptoms associated to the disorder and also can confer additional benefits.
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Affiliation(s)
- Iryna Rachyla
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cristina Botella
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,CIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, Spain
| | - Diana Castilla
- CIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Universidad de Valencia, Valencia, Spain
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,CIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, Spain
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Newbold A, Warren FC, Taylor RS, Hulme C, Burnett S, Aas B, Botella C, Burkhardt F, Ehring T, Fontaine JRJ, Frost M, Garcia-Palacios A, Greimel E, Hoessle C, Hovasapian A, Huyghe VEI, Lochner J, Molinari G, Pekrun R, Platt B, Rosenkranz T, Scherer KR, Schlegel K, Schulte-Korne G, Suso C, Voigt V, Watkins ER. Promotion of mental health in young adults via mobile phone app: study protocol of the ECoWeB (emotional competence for well-being in Young adults) cohort multiple randomised trials. BMC Psychiatry 2020; 20:458. [PMID: 32962684 PMCID: PMC7510072 DOI: 10.1186/s12888-020-02857-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/03/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence (EC) skills via a mobile app may be an effective, scalable and acceptable way to do this. However, few large-scale controlled trials have examined the efficacy of mobile apps in promoting mental health in young people; none have tailored the app to individual profiles. METHOD/DESIGN The Emotional Competence for Well-Being in Young Adults cohort multiple randomised controlled trial (cmRCT) involves a longitudinal prospective cohort to examine well-being, mental health and EC in 16-22 year olds across 12 months. Within the cohort, eligible participants are entered to either the PREVENT trial (if selected EC scores at baseline within worst-performing quartile) or to the PROMOTE trial (if selected EC scores not within worst-performing quartile). In both trials, participants are randomised (i) to continue with usual practice, repeated assessments and a self-monitoring app; (ii) to additionally receive generic cognitive-behavioural therapy self-help in app; (iii) to additionally receive personalised EC self-help in app. In total, 2142 participants aged 16 to 22 years, with no current or past history of major depression, bipolar disorder or psychosis will be recruited across UK, Germany, Spain, and Belgium. Assessments take place at baseline (pre-randomisation), 1, 3 and 12 months post-randomisation. Primary endpoint and outcome for PREVENT is level of depression symptoms on the Patient Health Questionnaire-9 at 3 months; primary endpoint and outcome for PROMOTE is emotional well-being assessed on the Warwick-Edinburgh Mental Wellbeing Scale at 3 months. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and cost-effectiveness are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored. CONCLUSIONS The trial aims to provide a better understanding of the causal role of learning EC skills using interventions delivered via mobile phone apps with respect to promoting well-being and preventing poor mental health in young people. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective Mobile-health public health strategies for preventing poor mental health and promoting well-being. TRIAL REGISTRATION ClinicalTrials.gov ( www.clinicaltrials.org ). Number of identification: NCT04148508 November 2019.
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Affiliation(s)
- A. Newbold
- grid.8391.30000 0004 1936 8024Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN UK
| | - F. C. Warren
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter, Exeter, UK
| | - R. S. Taylor
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter, Exeter, UK ,grid.8756.c0000 0001 2193 314XMRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - C. Hulme
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter, Exeter, UK
| | - S. Burnett
- grid.8391.30000 0004 1936 8024Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN UK
| | - B. Aas
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - C. Botella
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castelló de la Plana, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | | | - T. Ehring
- grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - J. R. J. Fontaine
- grid.5342.00000 0001 2069 7798Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - M. Frost
- Monsenso ApS, Copenhagen, Denmark
| | - A. Garcia-Palacios
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castelló de la Plana, Spain ,grid.413448.e0000 0000 9314 1427CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - E. Greimel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - C. Hoessle
- grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - A. Hovasapian
- grid.5342.00000 0001 2069 7798Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - VEI Huyghe
- grid.5342.00000 0001 2069 7798Department of Work, Organization and Society, Ghent University, Ghent, Belgium
| | - J. Lochner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany ,grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - G. Molinari
- grid.413448.e0000 0000 9314 1427CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - R. Pekrun
- grid.411958.00000 0001 2194 1270Department of Psychology, University of Essex, UK, and Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - B. Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - T. Rosenkranz
- grid.5252.00000 0004 1936 973XDepartment of Psychology, LMU Munich, Munich, Germany
| | - K. R. Scherer
- grid.8591.50000 0001 2322 4988University of Geneva, Geneva, Switzerland
| | - K. Schlegel
- grid.5734.50000 0001 0726 5157University of Bern, Bern, Switzerland
| | - G. Schulte-Korne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - C. Suso
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castelló de la Plana, Spain
| | - V. Voigt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - E. R. Watkins
- grid.8391.30000 0004 1936 8024Mood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN UK
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González-Robles A, Díaz-García A, García-Palacios A, Roca P, Ramos-Quiroga JA, Botella C. Effectiveness of a Transdiagnostic Guided Internet-Delivered Protocol for Emotional Disorders Versus Treatment as Usual in Specialized Care: Randomized Controlled Trial. J Med Internet Res 2020; 22:e18220. [PMID: 32673226 PMCID: PMC7381075 DOI: 10.2196/18220] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 12/20/2022] Open
Abstract
Background Anxiety disorders and depression (emotional disorders) are highly prevalent mental disorders. Extensive empirical evidence supports the efficacy of cognitive behavioral therapy (CBT) for the treatment of these disorders. However, there are still some barriers related to their dissemination and implementation, which make it difficult for patients to receive these treatments, especially in public health care settings where resources are limited. Recent advances in improving CBT dissemination encompass different perspectives. One is the transdiagnostic approach, which offers treatment protocols that can be used for a range of emotional disorders. Another approach is the use of the internet to reach a larger number of people who could benefit from CBT. Objective This study aimed to analyze the effectiveness and acceptability of a transdiagnostic internet-delivered protocol (EmotionRegulation) with human and automated guidance in patients from public specialized mental health care settings. Methods A 2-armed randomized controlled trial (RCT) was conducted to compare the effectiveness of EmotionRegulation with treatment as usual (TAU) in specialized mental health care. In all, 214 participants were randomly assigned to receive either EmotionRegulation (n=106) or TAU (n=108). Measurement assessments were conducted at pre- and postintervention and at a 3-month follow-up. Results The results revealed the superiority of EmotionRegulation over TAU on measures of depression (d=0.41), anxiety (d=0.35), and health-related quality of life (d=−0.45) at posttreatment, and these gains were maintained at the 3-month follow-up. Furthermore, the results for expectations and opinions showed that EmotionRegulation was well accepted by participants. Conclusions EmotionRegulation was more effective than TAU for the treatment of emotional disorders in the Spanish public mental health system. The implications of this RCT, limitations, and suggestions for future research are discussed. Trial Registration ClinicalTrials.gov NCT02345668; https://clinicaltrials.gov/ct2/show/NCT02345668
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Affiliation(s)
- Alberto González-Robles
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Amanda Díaz-García
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | - Pablo Roca
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
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Colombo D, Fernández-Álvarez J, Suso-Ribera C, Cipresso P, García-Palacios A, Riva G, Botella C. Biased Affective Forecasting: A Potential Mechanism That Enhances Resilience and Well-Being. Front Psychol 2020; 11:1333. [PMID: 32595578 PMCID: PMC7304283 DOI: 10.3389/fpsyg.2020.01333] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/20/2020] [Indexed: 01/05/2023] Open
Abstract
According to a growing body of studies, people's ability to forecast future emotional experiences is generally biased. Nonetheless, the existing literature has mainly explored affective forecasting in relation to specific events, whereas little is still known about the ability to make general estimations of future emotional states. Based on existing evidence suggesting future-oriented disposition as a key factor for mental health, the aims of the current study were (1) to investigate the relationship between negative (NA) and positive (PA) affective forecasting biases and perceived psychological well-being, and (2) to explore whether positively biased predictions are associated with resilience and foster one's skills to cope with stressful events. To do so, we asked 85 undergraduate students to forecast PA and NA over 2 weeks, as well as to report their daily affect through a web-based Ecological Momentary Assessment. According to the results, positively biased PA forecasting (i.e., overestimating positive emotional states) was associated with greater perceived psychological well-being and higher resilience. When high levels of stress were experienced, participants holding an optimistic, yet biased, estimation of future PA were more likely to successfully manage stressors, thus maintaining lower levels of NA and higher levels of positive emotions. We suggest that positively biased PA forecasting is an adaptive cognitive distortion that boosts people's resilience and mental health, thus opening new avenues for the promotion of psychological well-being.
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | | | - Carlos Suso-Ribera
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Pietro Cipresso
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Azucena García-Palacios
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
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Gili M, Castro A, García-Palacios A, Garcia-Campayo J, Mayoral-Cleries F, Botella C, Roca M, Barceló-Soler A, Hurtado MM, Navarro M, Villena A, Pérez-Ara MÁ, Riera-Serra P, Baños RM. Efficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial. J Med Internet Res 2020; 22:e15845. [PMID: 32501276 PMCID: PMC7305559 DOI: 10.2196/15845] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/03/2019] [Accepted: 02/04/2020] [Indexed: 12/12/2022] Open
Abstract
Background Primary care is a major access point for the initial treatment of depression, but the management of these patients is far from optimal. The lack of time in primary care is one of the major difficulties for the delivery of evidence-based psychotherapy. During the last decade, research has focused on the development of brief psychotherapy and cost-effective internet-based interventions mostly based on cognitive behavioral therapy (CBT). Very little research has focused on alternative methods of treatment for depression using CBT. Thus, there is a need for research into other therapeutic approaches. Objective This study aimed to assess the effectiveness of 3 low-intensity, internet-based psychological interventions (healthy lifestyle psychoeducational program [HLP], focused program on positive affect promotion [PAPP], and brief intervention based on mindfulness [MP]) compared with a control condition (improved treatment as usual [iTAU]). Methods A multicenter, 4-arm, parallel randomized controlled trial was conducted between March 2015 and March 2016, with a follow-up of 12 months. In total, 221 adults with mild or moderate major depression were recruited in primary care settings from 3 Spanish regions. Patients were randomly distributed to iTAU (n=57), HLP (n=54), PAPP (n=56), and MP (n=54). All patients received iTAU from their general practitioners. The main outcome was the Spanish version of the Patient Health Questionnaire-9 (PHQ-9) from pretreatment (time 1) to posttreatment (time 2) and up to 6 (time 3) and 12 (time 4) months’ follow-up. Secondary outcomes included the visual analog scale of the EuroQol, the Short-Form Health Survey (SF-12), the Positive and Negative Affect Schedule (PANAS), and the Pemberton Happiness Index (PHI). We conducted regression models to estimate outcome differences along study stages. Results A moderate decrease was detected in PHQ-9 scores from HLP (β=–3.05; P=.01) and MP (β=–3.00; P=.01) compared with iTAU at posttreatment. There were significant differences between all intervention groups and iTAU in physical SF-12 scores at 6 months after treatment. Regarding well-being, MP and PAPP reported better PHI results than iTAU at 6 months post treatment. PAPP intervention significantly decreased PANAS negative affect scores compared with iTAU 12 months after treatment. Conclusions The low-intensity, internet-based psychological interventions (HLP and MP) for the treatment of depression in primary care are more effective than iTAU at posttreatment. Moreover, all low-intensity psychological interventions are also effective in improving medium- and long-term quality of life. PAPP is effective for improving health-related quality of life, negative affect, and well-being in patients with depression. Nevertheless, it is important to examine possible reasons that could be implicated for PAPP not being effective in reducing depressive symptomatology; in addition, more research is still needed to assess the cost-effectiveness analysis of these interventions. Trial Registration ISRCTN Registry ISRCTN82388279; http://www.isrctn.com/ISRCTN82388279 International Registered Report Identifier (IRRID) RR2-10.1186/s12888-015-0475-0
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Affiliation(s)
- Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Adoración Castro
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain
| | - Azucena García-Palacios
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, Univeristy Jaume I, Castellón, Spain.,Biomedical Research Center Network (CIBER) Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain
| | - Javier Garcia-Campayo
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain.,Departament of Psychiatry, Hospital Miguel Servet, University of Zaragoza, Zaragoza, Spain
| | - Fermin Mayoral-Cleries
- Mental Heath Unit, Hospital Regional of Malaga, Biomedicine Research Institute (IBIMA), Málaga, Spain
| | - Cristina Botella
- Department of Clinical and Basic Psychology and Biopsychology, Faculty of Health Sciences, Univeristy Jaume I, Castellón, Spain.,Biomedical Research Center Network (CIBER) Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain
| | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | | | - María M Hurtado
- Mental Heath Unit, Hospital Regional of Malaga, Biomedicine Research Institute (IBIMA), Málaga, Spain
| | - MªTeresa Navarro
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Amelia Villena
- Mental Health Unit of Pozoblaco, Hospital Los Pedroches, Córdoba, Spain
| | - M Ángeles Pérez-Ara
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain
| | - Pau Riera-Serra
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Palma de Mallorca, Spain.,Institut d'Investigació Sanitaria Illes Balears, Palma de Mallorca, Spain
| | - Rosa Mª Baños
- Biomedical Research Center Network (CIBER) Physiopathology Obesity and Nutrition (CIBERobn), Carlos III Health Institute, Madrid, Spain.,Department of Psychological, Personality, Evaluation and Treatment, University of Valencia, Valencia, Spain
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41
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Smoktunowicz E, Barak A, Andersson G, Banos RM, Berger T, Botella C, Dear BF, Donker T, Ebert DD, Hadjistavropoulos H, Hodgins DC, Kaldo V, Mohr DC, Nordgreen T, Powers MB, Riper H, Ritterband LM, Rozental A, Schueller SM, Titov N, Weise C, Carlbring P. Consensus statement on the problem of terminology in psychological interventions using the internet or digital components. Internet Interv 2020; 21:100331. [PMID: 32577404 PMCID: PMC7305336 DOI: 10.1016/j.invent.2020.100331] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/18/2020] [Accepted: 05/31/2020] [Indexed: 12/21/2022] Open
Abstract
Since the emergence of psychological interventions delivered via the Internet they have differed in numerous ways. The wealth of formats, methods, and technological solutions has led to increased availability and cost-effectiveness of clinical care, however, it has simultaneously generated a multitude of terms. With this paper, we first aim to establish whether a terminology issue exists in the field of Internet-delivered psychological interventions. If so, we aim to determine its implications for research, education, and practice. Furthermore, we intend to discuss solutions to mitigate the problem; in particular, we propose the concept of a common glossary. We invited 23 experts in the field of Internet-delivered interventions to respond to four questions, and employed the Delphi method to facilitate a discussion. We found that experts overwhelmingly agreed that there were terminological challenges, and that it had significant consequences for conducting research, treating patients, educating students, and informing the general public about Internet-delivered interventions. A cautious agreement has been reached that formulating a common glossary would be beneficial for the field to address the terminology issue. We end with recommendations for the possible formats of the glossary and means to disseminate it in a way that maximizes the probability of broad acceptance for a variety of stakeholders.
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Affiliation(s)
- Ewelina Smoktunowicz
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19, 31 03-815 Warsaw, Poland,Department of Psychology, Stockholm University, Frescati Hagvag 8, 114 19 Stockholm, Sweden
| | - Azy Barak
- Department of Counseling and Human Development, University of Haifa, Israel
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rosa M. Banos
- Universidad de Valencia, Valencia, Spain,CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Madrid, Spain
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Switzerland
| | - Cristina Botella
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Madrid, Spain,Uiversitat Jaume I, Valencia, Spain
| | - Blake F. Dear
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Tara Donker
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - David D. Ebert
- Faculty of Behavioural and Movement Sciences, Clinical, Neuro- & Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | | | | | - Viktor Kaldo
- Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - David C. Mohr
- Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Tine Nordgreen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Lee M. Ritterband
- Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
| | - Alexander Rozental
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Institute of Child Health, UCL, London, UK
| | - Stephen M. Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Nickolai Titov
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Cornelia Weise
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps–University of Marburg, Marburg, Germany
| | - Per Carlbring
- Department of Psychology, Stockholm University, Frescati Hagvag 8, 114 19 Stockholm, Sweden,Corresponding author at: Department of Psychology, SE-106 91 Stockholm, Sweden.
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42
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Dursap T, Vettori M, Danescu A, Botella C, Regreny P, Patriarche G, Gendry M, Penuelas J. Crystal phase engineering of self-catalyzed GaAs nanowires using a RHEED diagram. Nanoscale Adv 2020; 2:2127-2134. [PMID: 36132505 PMCID: PMC9418245 DOI: 10.1039/d0na00273a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/09/2020] [Indexed: 06/12/2023]
Abstract
It is well known that the crystalline structure of the III-V nanowires (NWs) is mainly controlled by the wetting contact angle of the catalyst droplet which can be tuned by the III and V flux. In this work we present a method to control the wurtzite (WZ) or zinc-blende (ZB) structure in self-catalyzed GaAs NWs grown by molecular beam epitaxy, using in situ reflection high energy electron diffraction (RHEED) diagram analysis. Since the diffraction patterns of the ZB and WZ structures differ according to the azimuth [11̄0], it is possible to follow the evolution of the intensity of specific ZB and WZ diffraction spots during NW growth as a function of the growth parameters such as the Ga flux. By analyzing the evolution of the WZ and ZB spot intensities during NW growth with specific changes of the Ga flux, it is then possible to control the crystal structure of the NWs. ZB GaAs NWs with a controlled WZ segment have thus been realized. Using a semi-empirical model for the NW growth and our in situ RHEED measurements, the critical wetting angle of the Ga catalyst droplet for the structural transition is deduced.
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Affiliation(s)
- T Dursap
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, École Centrale de Lyon 36 avenue Guy de Collongue F-69134 Ecully cedex France
| | - M Vettori
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, École Centrale de Lyon 36 avenue Guy de Collongue F-69134 Ecully cedex France
| | - A Danescu
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, École Centrale de Lyon 36 avenue Guy de Collongue F-69134 Ecully cedex France
| | - C Botella
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, École Centrale de Lyon 36 avenue Guy de Collongue F-69134 Ecully cedex France
| | - P Regreny
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, École Centrale de Lyon 36 avenue Guy de Collongue F-69134 Ecully cedex France
| | - G Patriarche
- Université Paris-Saclay, CNRS, Centre de Nanosciences et de Nanotechnologies 91120 Palaiseau France
| | - M Gendry
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, École Centrale de Lyon 36 avenue Guy de Collongue F-69134 Ecully cedex France
| | - J Penuelas
- Institut des Nanotechnologies de Lyon-INL, UMR 5270 CNRS, Université de Lyon, École Centrale de Lyon 36 avenue Guy de Collongue F-69134 Ecully cedex France
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Colombo D, Fernández-Álvarez J, Suso-Ribera C, Cipresso P, Valev H, Leufkens T, Sas C, Garcia-Palacios A, Riva G, Botella C. The need for change: Understanding emotion regulation antecedents and consequences using ecological momentary assessment. ACTA ACUST UNITED AC 2020; 20:30-36. [PMID: 31961174 DOI: 10.1037/emo0000671] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In recent decades, emotion regulation (ER) has been one of the most widely studied constructs within the psychological field. Nevertheless, laboratory experiments and retrospective assessments have been the 2 most common strands of ER research; thus, leaving open several crucial questions about ER antecedents and consequences in daily life. Beyond traditional methods, ecological momentary assessment (EMA) has the potential to capture ER dynamics during the flow of daily experiences, in real-life settings and through repeated measurements. Here, we discuss what we currently know about ER antecedents and consequences. We will compare findings from previous literature to findings from EMA studies, pointing out both similarities and differences, as well as questions that can be answered better with the EMA approach. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University
| | | | - Carlos Suso-Ribera
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University
| | - Pietro Cipresso
- Department of Psychology, Catholic University of the Sacred Heart
| | | | | | - Corina Sas
- School of Computing and Communications, Lancaster University
| | | | - Giuseppe Riva
- Department of Psychology, Catholic University of the Sacred Heart
| | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University
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44
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Lisón JF, Palomar G, Mensorio MS, Baños RM, Cebolla-Martí A, Botella C, Benavent-Caballer V, Rodilla E. Impact of a Web-Based Exercise and Nutritional Education Intervention in Patients Who Are Obese With Hypertension: Randomized Wait-List Controlled Trial. J Med Internet Res 2020; 22:e14196. [PMID: 32286232 PMCID: PMC7189251 DOI: 10.2196/14196] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 10/31/2019] [Accepted: 02/09/2020] [Indexed: 12/24/2022] Open
Abstract
Background Internet-based interventions are a promising strategy for promoting healthy lifestyle behaviors. These have a tremendous potential for delivering electronic health interventions in scalable and cost-effective ways. There is strong evidence that the use of these programs can lead to weight loss and can lower patients’ average blood pressure (BP) levels. So far, few studies have investigated the effects of internet-based programs on patients who are obese with hypertension (HTN). Objective The aim of this study is to investigate the short- and long-term efficacy, in terms of body composition and BP parameters, of a self-administered internet-based intervention involving different modules and learning techniques aimed at promoting lifestyle changes (both physical activity and healthy eating) in patients who are obese with HTN. Methods A randomized wait-list controlled trial design was used. We recruited 105 adults with HTN who were overweight or obese and randomly assigned them to either a 3-month internet-based intervention group (n=55) or the wait-list control group (n=50). We assessed BMI (primary outcome), body fat mass (BFM), systolic (S)BP and diastolic (D)BP, blood glucose and insulin levels, physical activity levels, and functional capacity for aerobic exercise at Time 0 (preintervention) and Time 1 (postintervention). All the patients in the wait-list control group subsequently received the intervention, and a secondary within-group analysis, which also included these participants, was conducted at Time 2 (12-month follow-up). Results A 2-way mixed analysis of covariance showed a significant decrease in BMI, BFM, and blood glucose at 3 months in the internet-based intervention group; the effect size for the BMI and BFM parameters was moderate to large, and there was also a borderline significant trend for DBP and insulin. These results were either maintained or improved upon at Time 2 and showed significant changes for BMI (mean difference −0.4, 95% CI −0.1 to −0.6; P=.005), BFM (mean difference −2.4, 95% CI −1.1 to −3.6; P<.001), DBP (mean difference −1.8, 95% CI −0.2 to −3.3; P=.03), and blood glucose (mean difference −2, 95% CI 0 to −4; P=.04). Conclusions Implementation of our self-administered internet-based intervention, which involved different learning techniques aimed to promote lifestyle changes, resulted in positive short- and long-term health benefits in patients who are obese with HTN. Trial Registration ClinicalTrials.gov NCT03396302; https://clinicaltrials.gov/ct2/show/NCT03396302
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Affiliation(s)
- Juan Francisco Lisón
- Department of Medicine, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain.,Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain
| | | | - Marinna S Mensorio
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Foundation, Brasilia, Brazil.,Department of Personality, Assessment and Psychological Treatment, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Rosa M Baños
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain.,Department of Personality, Assessment and Psychological Treatment, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Ausiàs Cebolla-Martí
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain.,Department of Personality, Assessment and Psychological Treatment, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Cristina Botella
- Centro de Investigación Biomédica en Red Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain.,Universitat Jaume I, Castellón, Spain
| | - Vicent Benavent-Caballer
- Department of Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain
| | - Enrique Rodilla
- Department of Medicine, Universidad Cardenal Herrera CEU, CEU Universities, Valencia, Spain.,Hypertension and Vascular Risk Unit, Hospital de Sagunto, Sagunto, Spain
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45
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Palma-Gómez A, Herrero R, Baños R, García-Palacios A, Castañeiras C, Fernandez GL, Llull DM, Torres LC, Barranco LA, Cárdenas-Gómez L, Botella C. Efficacy of a self-applied online program to promote resilience and coping skills in university students in four Spanish-speaking countries: study protocol for a randomized controlled trial. BMC Psychiatry 2020; 20:148. [PMID: 32248795 PMCID: PMC7133009 DOI: 10.1186/s12888-020-02536-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 03/06/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND There is evidence of a high prevalence of depression and anxiety in university students. Therefore, college time is a key period where prevention of mental disorders through interventions that promote resilience and mental health can be relevant. Currently, there are interventions available, but these are insufficient for those who need them. Online interventions are tools that can facilitate global accessibility and are easy for young people to use. CORE (Cultivating Our Resilience) is a self-administered online program, based on Ryff's psychological well-being model, to promote resilience and coping skills in university students at risk of developing symptoms of depression or anxiety. The objective is to evaluate the effectiveness of this intervention protocol in comparison with an active control condition targeting healthy lifestyle, and a waiting list control condition. The study will be conducted in four populations of Spanish-speaking university students (Spain, Argentina, Colombia, and Mexico). METHODS The study design is a randomized controlled trial (RCT). At least 324 university students will be randomly assigned to three conditions: 1) CORE, a 6-week training program to improve resilience; 2) HLP, a 6-week training to promote a healthy lifestyle; and 3) WL, waiting list control condition. The primary outcome measure will be the Connor-Davidson resilience scale. Additionally, measures of anxiety, depression, quality of life and socio-demographic variables (age, sex, incomes, marital status, among others) will be collected. Participants will be evaluated at pre-treatment, after each module, 6 weeks after allocation, and at 3-month follow-up. Intention-to-treat and per-protocol analyses will be performed. DISCUSSION The results of this study will contribute to research on Internet-administered interventions and the implementation of a protocol that includes a series of components designed to improve resilience and coping skills, increase psychological well-being, and prevent depression and anxiety disorders in Spanish-speaking university students. In addition, avenues will be opened up for new research on the effectiveness of these interventions focused on the prevention and promotion of mental health in Spanish-speaking countries. TRIAL REGISTRATION Registered at ClinicalTrials.gov NCT03903978 on April 2, 2019.
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Affiliation(s)
| | - Rocío Herrero
- CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain. .,Universidad de Valencia, Av. Blasco Ibañez, 21, 46021, Valencia, Spain.
| | - Rosa Baños
- grid.413448.e0000 0000 9314 1427CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain ,grid.5338.d0000 0001 2173 938XUniversidad de Valencia, Av. Blasco Ibañez, 21, 46021 Valencia, Spain
| | - Azucena García-Palacios
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castellón, Spain ,grid.413448.e0000 0000 9314 1427CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain
| | - Claudia Castañeiras
- grid.412221.60000 0000 9969 0902Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | | | - Dario Martín Llull
- grid.412221.60000 0000 9969 0902Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
| | | | | | | | - Cristina Botella
- grid.9612.c0000 0001 1957 9153Universitat Jaume I, Castellón, Spain ,grid.413448.e0000 0000 9314 1427CIBER of Physiopathology of Obesity and Nutrition (CB06/03) Instituto Salud Carlos III, Madrid, Spain
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46
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Díaz-García A, González-Robles A, Mor S, Mira A, Quero S, García-Palacios A, Baños RM, Botella C. Positive and Negative Affect Schedule (PANAS): psychometric properties of the online Spanish version in a clinical sample with emotional disorders. BMC Psychiatry 2020; 20:56. [PMID: 32039720 PMCID: PMC7008531 DOI: 10.1186/s12888-020-2472-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The Positive and Negative Affect Schedule (PANAS) is the most widely and frequently used scale to assess positive and negative affect. The PANAS has been validated in several languages, and it has shown excellent psychometric properties in the general population and some clinical samples, such as forensic samples, substance users, and adult women with fibromyalgia. Nevertheless, the psychometric properties of the scale have not yet been examined in clinical samples with anxiety, depressive, and adjustment disorders. In addition, the proliferation of Internet-based treatments has led to the development of a wide range of assessments conducted online with digital versions of pen and paper self-report questionnaires. However, no validations have been carried out to analyze the psychometric properties of the online version of the PANAS. The present study investigates the psychometric properties of the online Spanish version of the PANAS in a clinical sample of individuals with emotional disorders. METHODS The sample was composed of 595 Spanish adult volunteers with a diagnosis of depressive disorder (n = 237), anxiety disorder (n = 284), or adjustment disorder (n = 74). Factor structure, construct validity, internal consistency, and sensitivity to change were analyzed. RESULTS Confirmatory factor analysis yielded a latent structure of two independent factors, consistent with previous validations of the instrument. The analyses showed adequate convergent and discriminant validity, good internal consistency as well as sensitivity to change. CONCLUSIONS Overall, the results obtained in this study show that the online version of the PANAS has adequate psychometric properties for the assessment of positive and negative affect in a Spanish clinical population.
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Affiliation(s)
- Amanda Díaz-García
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Alberto González-Robles
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Sonia Mor
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Adriana Mira
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Soledad Quero
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | - Rosa María Baños
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
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47
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Paslakis G, Agüera Z, Granero R, Sánchez I, Riesco N, Jiménez-Murcia S, Fernández-García JC, Garrido-Sánchez L, Tinahones FJ, Casanueva FF, Baños RM, Botella C, Crujeiras AB, Torre RDL, Fernández-Real JM, Frühbeck G, Ortega FJ, Rodríguez A, Serra-Majem L, Fitó M, Menchón JM, Fernández-Aranda F. Associations between neuropsychological performance and appetite-regulating hormones in anorexia nervosa and healthy controls: Ghrelin's putative role as a mediator of decision-making. Mol Cell Endocrinol 2019; 497:110441. [PMID: 31121263 DOI: 10.1016/j.mce.2019.04.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 12/28/2022]
Abstract
Anorexia nervosa (AN) is a severe eating disorder accompanied by alterations in endocrinological circuits and deficits in neuropsychological performance. In this study, a series of appetite-regulating hormones (ghrelin, leptin, cholecystokinin, PYY, adiponectin, and visfatin) were measured under fasting conditions in female patients with AN and female healthy controls. All of the participants also underwent a battery of neuropsychological assessment [namely the Iowa Gambling Task (IGT), the Wisconsin Card Sorting Test (WCST), and the Stroop Color and Word Test (SCWT)]. As the main finding, we found that higher ghrelin levels predict better performance in the IGT. Ghrelin may be a putative mediator of decision-making, a finding that has not been described so far. The role of ghrelin in decision-making can only be described as speculative, as there are hardly any additional evidence-based data published up to date. Further studies are warranted.
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Affiliation(s)
- Georgios Paslakis
- Toronto General Hospital, University Health Network, Toronto, Ontario, M5G 2C4, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Nadine Riesco
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jose C Fernández-García
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Lourdes Garrido-Sánchez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Francisco J Tinahones
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Felipe F Casanueva
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Medicine, Endocrinology Division, Santiago de Compostela University, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Rosa M Baños
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychological, Personality, Evaluation and Treatment of the University of Valencia, Valencia, Spain
| | - Cristina Botella
- Department of Psychological, Personality, Evaluation and Treatment of the University of Valencia, Valencia, Spain
| | - Ana B Crujeiras
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Medicine, Endocrinology Division, Santiago de Compostela University, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Rafael de la Torre
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Integrated Pharmacology and Systems Neurosciences Research Group, Neuroscience Research Program Organization IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Health and Experimental Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jose M Fernández-Real
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta, Girona, Spain
| | - Gema Frühbeck
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Metabolic Research Laboratory, Clínica Universidad de Navarra, University of Navarra-IdiSNA, Pamplona, Spain
| | - Francisco J Ortega
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta, Girona, Spain
| | - Amaia Rodríguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Metabolic Research Laboratory, Clínica Universidad de Navarra, University of Navarra-IdiSNA, Pamplona, Spain
| | - Luís Serra-Majem
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Cardiovascular Risk and Nutrition Research Group, Inflammatory and Cardiovascular Disorders Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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48
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Barceló-Soler A, Baños RM, López-Del-Hoyo Y, Mayoral F, Gili M, García-Palacios A, García-Campayo J, Botella C. Interventions of computerized psychotherapies for depression in Primary Care in Spain. Actas Esp Psiquiatr 2019; 47:236-246. [PMID: 31869424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Currently, depression is a global health problem recognized by the WHO. The prevalence of this pathology in Primary Care is estimated at 19.5% worldwide, and 20.2% in Spain. In addition, the current intervention policies and protocols involve significant costs, both personal and economic, for people suffering from this disorder, as well as for society in general. On the other hand, the relapse rates after pharmacological interventions that are currently applied and the lack of effective specialized attention in mental health services reflect the need to develop new therapeutic strategies that are more accessible and profitable. Therefore, one of the proposals that are being investigated in different parts of the world is the design and evaluation of therapeutic protocols applied through Information and Communication Technologies, especially through the Internet and computer programs. The objective of this work was to present the current situation in Spain regarding the use of these interventions for the treatment of depression in Primary Care. The main conclusion is that although there is scientific evidence on the effectiveness of these programs, there are still important barriers that hinder their application in the public system, and also the need to develop implementation studies that facilitate the transition from research to clinical practice.
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Affiliation(s)
| | - Rosa M Baños
- Universidad de Valencia, Valencia, España CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España
| | | | - Fermín Mayoral
- Hospital Regional Universitario de Málaga, Málaga, España Instituto de Investigación Médica de Málaga (IBIMA), Málaga, España
| | - Margalida Gili
- IUNICS-IDISBA, Universitat de les Illes Balears, Palma, España
| | - Azucena García-Palacios
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España Universitat Jaume I, Castellón, España
| | - Javier García-Campayo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, España Universidad de Zaragoza, Zaragoza, España Hospital Universitario Miguel Servet, Zaragoza, España
| | - Cristina Botella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, España Universitat Jaume I, Castellón, España
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49
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Molinari G, Miragall M, Enrique Á, Botella C, Baños RM, García‐Palacios A. How and for whom does a positive affect intervention work in fibromyalgia: An analysis of mediators and moderators. Eur J Pain 2019; 24:248-262. [DOI: 10.1002/ejp.1481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Guadalupe Molinari
- CIBER of Physiopathology of Obesity and Nutrition CIBERObn Instituto de Salud Carlos III Madrid Spain
| | - Marta Miragall
- CIBER of Physiopathology of Obesity and Nutrition CIBERObn Instituto de Salud Carlos III Madrid Spain
- Department of Personality, Evaluation and Psychological Treatment University of Valencia Valencia Spain
| | | | - Cristina Botella
- CIBER of Physiopathology of Obesity and Nutrition CIBERObn Instituto de Salud Carlos III Madrid Spain
- Department of Psicología Básica Universitat Jaume I Clínica y Psicobiología Castellón Spain
| | - Rosa María Baños
- CIBER of Physiopathology of Obesity and Nutrition CIBERObn Instituto de Salud Carlos III Madrid Spain
- Department of Personality, Evaluation and Psychological Treatment University of Valencia Valencia Spain
| | - Azucena García‐Palacios
- CIBER of Physiopathology of Obesity and Nutrition CIBERObn Instituto de Salud Carlos III Madrid Spain
- Department of Psicología Básica Universitat Jaume I Clínica y Psicobiología Castellón Spain
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50
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Quero S, Rachyla I, Molés M, Mor S, Tur C, Cuijpers P, López-Montoyo A, Botella C. Can Between-Session Homework Be Delivered Digitally? A Pilot Randomized Clinical Trial of CBT for Adjustment Disorders. Int J Environ Res Public Health 2019; 16:E3842. [PMID: 31614596 PMCID: PMC6843437 DOI: 10.3390/ijerph16203842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/28/2019] [Accepted: 10/08/2019] [Indexed: 12/20/2022]
Abstract
Adjustment disorder (AjD) is one of the most common disorders in clinical practice, and its symptoms are severe enough to cause great distress and functional impairment. The AjD CBT protocol specifically developed for this disorder has shown positive results when delivered face to face and through virtual reality. Despite existing evidence supporting the benefits of therapeutic homework as part of a psychological intervention, little is known about how to increase homework engagement in psychotherapy. This study examines the feasibility (doability, initial efficacy and acceptability) of a digital support system to deliver homework via the Internet in the treatment of AjD. Participants were randomly assigned to a traditional homework condition or a digital support system condition. Both interventions resulted in statistically significant improvements, with large effect sizes, in all the outcome measures at post-treatment, with no significant differences between groups. At 12-month follow-up, these therapeutic gains were maintained, and an improvement was even observed in both conditions, with no significant differences between groups. Additionally, treatment satisfaction predicted efficacy in both groups separately and when the whole group was considered. This is the first study to explore the feasibility an initial efficacy of delivering a therapeutic homework component for AjD through the Internet.
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Affiliation(s)
- Soledad Quero
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto Salud Carlos III, 28029 Madrid, Spain.
| | - Iryna Rachyla
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Mar Molés
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Sonia Mor
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Cintia Tur
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081BT Amsterdam, The Netherlands.
| | - Alba López-Montoyo
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Cristina Botella
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto Salud Carlos III, 28029 Madrid, Spain.
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