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Liu Y, Chen J, Wu T, He J, Wang B, Li P, Ning N, Chen H. Effects of nurses-led multidisciplinary-based psychological management in spinal surgery: a retrospective, propensity-score-matching comparative study. BMC Nurs 2024; 23:217. [PMID: 38549159 PMCID: PMC10979556 DOI: 10.1186/s12912-024-01842-y] [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] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/03/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Patients in spine surgery often have emotional disorders which is caused by multi-factors. Therefore, a multidisciplinary and multimodal intervention program is required to improve emotional disorders during the perioperative period. However, related studies were rare. This study aimed to confirm that the multidisciplinary-based psychological management leading by nurses was effective in treating emotional disorders and show the assignments of the members of the multidisciplinary team with the orientations of nurses. DESIGN A retrospective, comparative study. METHOD This study was a retrospective cohort research and compared the results between the intervention group and control group using the Huaxi Emotional Distress Index (HEI) which was used to evaluate emotional disorders. The intervention group consisted of patients who underwent surgery between January 2018 and December 2020 after psychological management was implemented. The control group consisted of patients with regular care who underwent surgery between January 2015 and December 2017. To improve comparability between the two groups, baseline data from the recruited patients were analyzed using propensity-score-matching (PSM) based on age, sex, marital status, education, and disease region. RESULTS A total of 539 (11.5%) people developed emotional disorders, of which 319 (6.8%), 151 (3.2%) and 69 (1.5%) had mild, moderate mood and severe emotional disorders, respectively. 2107 pairs of patients were matched after PSM. Scores of HEI in the intervention group were heightened compared with those in the control group (P<0.001) after matching. Moreover, the incidence of emotional disorders in patients decreased after implementing psychological management (P = 0.001). The severity of emotional disorders was alleviated with statistical significance as well (P = 0.010). CONCLUSIONS Nurses-led Multidisciplinary-Based psychological management was able to reduce the incidence of emotional disorders and improve the severity of these in spine surgery patients.
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Affiliation(s)
- Ying Liu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Jiali Chen
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Tingkui Wu
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Junbo He
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Beiyu Wang
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Peifang Li
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China
| | - Ning Ning
- Department of Orthopedic Surgery, West China Hospital, Sichuan University/School of Nursing, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China.
| | - Hong Chen
- West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, Sichuan, 610041, P.R. China.
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Hovmand OR, Reinholt N, Christensen AB, Eskildsen A, Bach B, Arendt M, Poulsen S, Hvenegaard M, Arnfred SM. Affectivity in danish patients with emotional disorders: assessing the validity of the Positive and Negative Affect Schedule (PANAS). BMC Psychiatry 2023; 23:943. [PMID: 38093282 PMCID: PMC10720164 DOI: 10.1186/s12888-023-05450-z] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The Positive and Negative Affect Schedule (PANAS) was designed to measure trait positive affect (PA) and trait negative affect (NA). METHODS The Danish PANAS was administered to outpatients with depression and anxiety disorders. Internal consistency was assessed using Cronbach's alpha and McDonald's omega and factorial structure was evaluated using confirmatory factor analysis (CFA). Convergent validity was evaluated by means of correlations with the negative affectivity and the detachment domain of the Personality Inventory for DSM-5 Short Form (PID-5-SF), the Hamilton Anxiety Rating Scale 6 (HARS-6) and the Hamilton Depression Rating Scale 6 (HDRS-6). RESULTS PANAS Scores of 256 patients were analyzed. Cronbach's alpha and McDonald's omega showed good internal consistency for both the PA score (alpha = .84 and omega = .89) and the NA score (alpha = .86 and omega = .90). CFA analysis confirmed a structure with two factors corresponding to the PA and NA factors. PA was negatively correlated with the detachment domain of PID-5 (r = -.47), HARS-6 (r = -.15) and HDRS-6 (r = -.37). NA was positively correlated with PID-5-SF negative affectivity domain (r = .43), HARS-6 (r = .51) and HDRS-6 (r = .52). DISCUSSION The Danish PANAS has promising internal consistency and construct validity, which are comparable to other studies of the instrument.
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Affiliation(s)
- Oliver Rumle Hovmand
- Psychiatric Research Unit, Region Zealand Mental Health Service, Faelledvej 6, 4200, Slagelse, Denmark.
- Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark.
- Psychiatry South, Region Zealand Mental Health Services, Copenhagen, Denmark.
| | - Nina Reinholt
- Psychiatric Research Unit, Region Zealand Mental Health Service, Faelledvej 6, 4200, Slagelse, Denmark
| | | | - Anita Eskildsen
- Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Bo Bach
- Psychiatric Research Unit, Region Zealand Mental Health Services, Copenhagen, Denmark
| | - Mikkel Arendt
- Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Morten Hvenegaard
- Neurocentre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sidse M Arnfred
- Psychiatric Research Unit, Region Zealand Mental Health Service, Faelledvej 6, 4200, Slagelse, Denmark
- Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Research Unit, Region Zealand Mental Health Services, Copenhagen, Denmark
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López-Pinar C, Selaskowski B, Braun N, Fornés-Ferrer V, Euscher R, Matthies S, Jans T, van Elst LT, Jacob C, Huss M, Sobanski E, Retz W, Roesler M, Retz-Junginger P, Alm B, Kis B, Abdel-Hamid M, Colla M, Berger M, Lux S, Philipsen A. Exploring the efficacy of dialectical behaviour therapy and methylphenidate on emotional comorbid symptoms in adults with attention Deficit/Hyperactivity disorder: Results of the COMPAS multicentre randomised controlled trial. Psychiatry Res 2023; 330:115610. [PMID: 37992514 DOI: 10.1016/j.psychres.2023.115610] [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: 06/16/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023]
Abstract
This study evaluated the efficacy of dialectical behaviour group therapy (GPT) vs. individual clinical management (CM) and methylphenidate (MPH) vs. placebo (PLB) on emotional symptoms in adults with ADHD. This longitudinal multicentre RCT compared four groups (GPT+MPH, GPT+PLB, CM+MPH, and CM+PLB) over five assessment periods, from baseline to week 130. Emotional symptomatology was assessed using SCL-90-R subscales. Of the 433 randomised participants, 371 remained for final analysis. At week 13, the GPT+MPH group showed smaller reductions in anxiety symptoms than the CM groups, but the differences disappeared at subsequent assessments. Improvements in emotional symptom were significantly predicted by reductions in core ADHD symptoms in all groups except the GPT+MPH group. The unexpected lack of between-group differences may be explained by a "floor effect", different intervention settings (group vs. individual), and psychotherapy type. Multiple regression analyses suggest a more specific effect of combined interventions (GPT+MPH). Implications for clinical practice are discussed. Clinical trial registration: ISRCTN54096201 (Current Controlled Trials).
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Affiliation(s)
- Carlos López-Pinar
- Department of Psychobiology and Basic Psychology, University of Valencia, Valencia, Spain; Department of Psychology, European University of Valencia, Valencia, Spain.
| | | | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | | | - Rebekka Euscher
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Swantje Matthies
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Centre Freiburg, University of Freiburg, Germany
| | - Thomas Jans
- Centre of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Centre Freiburg, University of Freiburg, Germany
| | - Christian Jacob
- Department of Psychiatry and Psychotherapy, Medius Hospital of Kirchheim, Kirchheim unter Teck, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Mainz, Mainz, Germany
| | - Esther Sobanski
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Mainz, Mainz, Germany; Institute for Forensic Psychology and Psychiatry, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Wolfgang Retz
- Institute for Forensic Psychology and Psychiatry, Saarland University Faculty of Medicine, Homburg/Saar, Germany; Department of Psychiatry and Psychotherapy, University Medical Centre Mainz, Mainz, Germany
| | - Michael Roesler
- Institute for Forensic Psychology and Psychiatry, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Petra Retz-Junginger
- Institute for Forensic Psychology and Psychiatry, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Barbara Alm
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bernhard Kis
- Department of Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, St. Elisabeth Hospital Niederwenigern, Contilia Group, Hattingen, Germany; LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Mona Abdel-Hamid
- Department of Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany; LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Michael Colla
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Switzerland
| | - Mathias Berger
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Medical Centre Freiburg, University of Freiburg, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
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Moreira H, Góis AC, Pereira AM, Pereira B, Caiado B, Nepomuceno MI, Pereira AI. Parents' acceptability of blended psychological interventions for children with emotional disorders. Internet Interv 2023; 34:100687. [PMID: 38023966 PMCID: PMC10654020 DOI: 10.1016/j.invent.2023.100687] [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: 02/20/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study aims to (1) describe parents' knowledge and use of online resources to address children's mental health issues and the family's general internet and technology usage patterns; (2) examine parents' acceptance of blended interventions for children with emotional disorders (ED); and (3) analyse the predictors of parents' intention to use a blended intervention if their children experienced an ED. Method The sample included 164 Portuguese parents (95.7 % mothers) of children between the ages of 6 and 13 years who completed an online survey. The study was disseminated through social networks, personal contacts of the researchers, and among parents participating in a randomized controlled trial investigating the efficacy of a psychological intervention for children with ED. Results Only 4.3 % of parents knew about online psychological interventions for children, and only 1.2 % had used them before. Most parents (73.2 %) reported that they would choose face-to-face individual therapy as their first option if their child had any ED, followed by blended therapy (14.8 %). Regression analyses showed that higher levels of parents' intention to use a blended intervention were predicted by their perceptions of the utility or efficacy of this type of delivery format. Discussion/conclusion These results suggest that although most parents show unfamiliarity with blended psychological interventions for children, they consider it a treatment modality to which they would resort if their children had emotional difficulties. Their intention to use such an intervention seems to be more likely if they perceive it as useful and effective.
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Affiliation(s)
- Helena Moreira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Ana Carolina Góis
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Ana Maria Pereira
- University of Coimbra, Faculty of Psychology and Educational Sciences, Portugal
| | - Bárbara Pereira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Brígida Caiado
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
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Salguero JM, Ramos-Cejudo J. A multi-study examination of the relevance of the metacognitive beliefs about uncontrollability in emotion regulation and clinical symptoms. J Affect Disord 2023; 340:812-819. [PMID: 37611642 DOI: 10.1016/j.jad.2023.08.090] [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: 06/06/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023]
Abstract
Transdiagnostic approaches to psychopathology have postulated that factors related to perceived control are particularly relevant to mental health. Here we focused on a specific perceived control-related construct: metacognitive beliefs about uncontrollability. Evidence suggests that dysfunctional metacognitive beliefs play a role in the activation and maintenance of maladaptive emotion regulation strategies and emotional distress. Metacognitive beliefs about the uncontrollability and danger of worry are the most strongly associated with psychopathology. In this multi-study research, we hypothesized that metacognitive beliefs about uncontrollability make a specific contribution to emotion regulation strategies and clinical symptoms. We tested our hypotheses in four different studies, both cross-sectionally and longitudinally (N = 2224). Participants completed measures of metacognitive beliefs, maladaptive strategies (e.g., worry, thought suppression), and clinical symptoms (e.g., generalized anxiety, emotional distress, depressive and anxiety symptoms). Our results showed that uncontrollability beliefs were the strongest variable associated with maladaptive emotion regulation strategies and clinical symptoms (cross-sectionally), and the only ones that predicted them in the long term. We discuss the theoretical and clinical implications of these results in the light of the metacognitive model and control-related theories.
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Affiliation(s)
- José M Salguero
- Department of Personality, Evaluation, and Psychological Treatment, University of Malaga, Spain.
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6
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Celleri M, Cremades CF, Etchevers MJ, Garay CJ. Effectiveness of the Unified Protocol for the transdiagnostic treatment of emotional disorders in online and group format in Argentina: study protocol for a randomized controlled trial. Trials 2023; 24:678. [PMID: 37858249 PMCID: PMC10588128 DOI: 10.1186/s13063-023-07428-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/03/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The Unified Protocol (UP) is a transdiagnostic intervention based on emotional regulation for the treatment of emotional disorders. Its application in individual and group formats has been studied worldwide, obtaining similar results to specific protocols but with a lower drop-out rate and improving the cost-benefit ratio, since a larger number of patients can benefit from it. Moreover, the inclusion of digital technologies in psychotherapy aims to improve the accessibility of treatments, especially since the pandemic of COVID-19 that forced the implementation of treatments through teletherapy increasing its use. To date, no studies have been carried out in Argentina on the application of the UP in a group format and through teletherapy. The aim of the present study is to evaluate the efficacy of the UP in a group format and through teletherapy in the Argentine population. METHODS A parallel-group, controlled, randomized trial, with pre-post and repeated follow-up measures intergroup design will be conducted. One hundred eighty patients will be randomized to one of the following conditions: an online, group-based UP intervention or a waiting list. The Beck Depression Inventory-II and the Beck Anxiety Inventory will be used to compare primary outcomes and the Beck Hopelessness Scale, Difficulties in Emotion Regulation Scale, Positive Affect and Negative Affect Scale, and Multicultural Quality of Life Index will be administered for secondary outcomes at baseline, post-intervention, and 3 months follow-up. Ad-hoc questionnaires will be used to assess patients' experiences and treatment satisfaction. DISCUSSION The purpose of this trial is to evaluate the efficacy of the online and group application of the UP in the Argentine population, as well as to evaluate the patient's experience and satisfaction with the treatment. It is expected that the findings of this study will be useful in reducing anxious and depressive symptomatology, will allow us to adapt the UP to our culture, and will improve accessibility to treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT05275322. Registered on 11 March 2022.
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Affiliation(s)
- Milagros Celleri
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Camila F Cremades
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Martin J Etchevers
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Cristian J Garay
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Argentina
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Carpallo-González M, Muñoz-Navarro R, González-Blanch C, Cano-Vindel A. Symptoms of emotional disorders and sociodemographic factors as moderators of dropout in psychological treatment: A meta-review. Int J Clin Health Psychol 2023; 23:100379. [PMID: 36922928 PMCID: PMC10009192 DOI: 10.1016/j.ijchp.2023.100379] [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: 08/26/2022] [Accepted: 02/08/2023] [Indexed: 03/07/2023] Open
Abstract
Objective Dropout from psychological treatment is an important problem that substantially limits treatment effectiveness. A better understanding of this phenomenon, could help to minimize it. Therefore, we performed a systematic review of meta-analyses (MA) on dropout from psychological treatments to (1) determine the estimated overall dropout rate (DR) and (2) to examine potential predictors of dropout, including clinical symptoms (anxiety and depression) and sociodemographic factors. Method A literature search of the PubMed PsycINFO, Embase, Scopus and Google Scholar databases was conducted. We identified 196 MAs on dropout from psychological treatment carried out primarily in adult patients or mixed samples (adults and children) between 1990 and 2022. Of these, 12 met all inclusion criteria. Two forest plots were created to visualize the DR and the relationship between DR and the disorder. Results The DR ranged from 15.9% to 46.8% and was significantly moderated by symptoms of emotional disorders. The highest DR were observed in younger, unmarried patients, and those with lower educational and income levels. Conclusions DR in patients undergoing psychological treatment is highly heterogeneous, but higher in individuals presenting symptoms of anxiety and/or depression, especially the latter. Given that high DR undermine the effectiveness of psychological interventions, it is clear that greater efforts are needed to reduce dropout, particularly among individuals with symptoms of emotional disorders.
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Affiliation(s)
| | | | - César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain
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8
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David OA, Fodor LA. Are gains in emotional symptoms and emotion-regulation competencies after the REThink therapeutic game maintained in the long run? A 6-month follow-up. Eur Child Adolesc Psychiatry 2023; 32:1853-1862. [PMID: 35593966 DOI: 10.1007/s00787-022-02002-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/30/2022] [Indexed: 11/29/2022]
Abstract
Emotional disorders are the most prevalent mental health conditions affecting children and adolescents. Thus, it becomes essential to develop and test early intervention strategies that are accessible, attractive, and can effectively improve their emotional functioning. A randomized control trial compared the prevention effects of the REThink therapeutic game to those of a standard face-to-face prevention program, and a waitlist which was transformed at follow-up into care as usual. Out of 142 healthy children and adolescents who completed the intervention stage, 137 (mean age: 12.84, SD: 1.97) completed a follow-up assessment measuring emotional symptoms, depressive mood and emotion regulation. We also tested potential moderators of its long-term effects, such as parental psychological control, parent attachment and childhood trauma. Our results highlighted the fact that the REThink intervention had a durable impact on the children's mental health and their ability to regulate their emotions. Moreover, we found that trauma, parent psychological control and parent attachment moderated the maintenance of the improvements. Future research needs to further document how to personalize the game and prevention program components to better address the characteristics of the youths at risk for mental health problems. ClinicalTrials.gov NCT03308981, from 13.10.2017.
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Affiliation(s)
- Oana A David
- DATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania.
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, No. 37, Republicii Street, 400015, Cluj-Napoca, Romania.
| | - Liviu A Fodor
- DATA Lab, International Institute for Advanced Studies in Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
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9
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Lau-Zhu A, Williams F, Steel C. Attachment patterns and autobiographical episodic memory functioning: A systemic review of adult studies to advance clinical psychological science. Clin Psychol Rev 2023; 101:102254. [PMID: 36804184 DOI: 10.1016/j.cpr.2023.102254] [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] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Patterns of insecure attachment are associated with psychopathology but the mechanisms involved remain poorly understood. Cognitive science proposes that attachment patterns are influenced by the autobiographical memory system and in turn influence its ongoing functioning. Disturbances in autobiographical memory represent cognitive risks for later emotional difficulties. We systemically reviewed 33 studies (in 28 articles) examining the association between attachment patterns and autobiographical episodic memory (AEM) in individuals from the age of 16 (i.e., from young to older adulthood). Attachment patterns were associated with key areas of AEM phenomenology, including intensity and arousal; detail, specificity, and vividness; coherence and fragmentation; and accuracy and latency. These associations appeared to be moderated by contextual and individual factors; mediated by emotional regulation and schema-based processing; linked to mental health outcomes. Attachment patterns may also influence the impact of certain AEM-based manipulations. We conclude by providing a critical discussion and a research agenda for bringing together attachment, memory, and emotion, with a view to promote mechanism-driven treatment innovation in clinical psychology.
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Affiliation(s)
- A Lau-Zhu
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom; Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom.
| | - F Williams
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - C Steel
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
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10
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Peris-Baquero Ó, Moreno-Pérez JD, Navarro-Haro MV, Díaz-García A, Osma J. Emotion dysregulation and neuroticism as moderators of group Unified Protocol effectiveness outcomes for treating emotional disorders. J Affect Disord 2023; 331:313-321. [PMID: 36977435 DOI: 10.1016/j.jad.2023.03.079] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 02/27/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND The personality dimension neuroticism and difficulties in emotional regulation (ER) are two variables closely related to the onset, course, and maintenance of emotional disorders (EDs). The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is a treatment specifically designed to address neuroticism by training in adaptive ER skills and has been shown to be effective in reducing difficulties in ER. However, the specific impact of these variables on treatment outcomes is not entirely clear. The aim of the present study was to explore the moderating role of neuroticism and difficulties in ER regarding the evolution of depressive and anxiety symptoms and quality of life. METHODS This secondary study included 140 participants diagnosed with EDs, who received the UP in group format as part of an RCT being conducted in different Spanish Public Mental Health Units. RESULTS The results of this study found that high scores in neuroticism and difficulties in ER were associated with greater severity of depression and anxiety symptomatology, and with poorer quality of life. In addition, difficulties in ER moderated the efficacy of UP regarding anxiety symptoms, and quality of life. No moderating effects were found for depression (p > 0.5). LIMITATIONS We only evaluated two moderators that may influence UP effectivenes; other key moderators should be analyzed in future. CONCLUSIONS The identification of specific moderators affecting transdiagnostic interventions outcomes will allow the development of personalized interventions and provide useful information to improve the psychopathology and well-being of people with EDs.
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Affiliation(s)
- Ó Peris-Baquero
- Universidad de Zaragoza, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | | | - M V Navarro-Haro
- Universidad de Zaragoza, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - A Díaz-García
- Universidad de Zaragoza, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - J Osma
- Universidad de Zaragoza, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
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Faccini J, Joshi V, Graziani P, Del-Monte J. Beliefs about sleep: links with ruminations, nightmare, and anxiety. BMC Psychiatry 2023; 23:198. [PMID: 36964569 PMCID: PMC10039486 DOI: 10.1186/s12888-023-04672-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/11/2023] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVE Dysfunctional cognitions related to sleep play a major role in insomnia but also in nightmares. Moreover, they are closely related to anxiety. To our knowledge, no study has probed the impact of non-constructive ruminations on these dimensions in their harmful interplay with sleep. The aim of this study is to provide new insights into the processes underlying the dysfunctional cognitions-insomnia relationship. METHOD Four hundred twenty nine French participants completed an anonymous online survey using Qualtrics® software. For the assessment of variables, we used the Mini Cambridge-Exeter Repetitive Thought Scale, the Nightmare Distress Questionnaire, the Beck Anxiety Inventory and the Sleep Condition Indicator. The frequency of nightmares was assessed subjectively via an item. Participants were divided into two groups according to their score on the insomnia assessment: good sleepers and poor sleepers. RESULT Anxiety was found to be a common mediator of the relationship between dysfunctional beliefs and attitudes toward sleep and insomnia between good (20.8%) and poor sleepers (24.6%). However, for poor sleepers, nightmare frequency (15.2%) and non-constructive ruminations (16.6%) emerged as mediators of this relationship. CONCLUSION The results gathered through this study bring interesting perspectives regarding the theoretical and etiological conceptualization of insomnia. We showed a positive association between dysfunctional beliefs and attitudes towards sleep and non-constructive ruminations in their contributory role to insomnia.
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Affiliation(s)
- Julie Faccini
- LSP Laboratory, University of Nîmes, Aix-Marseille University, UR 849, 29 Avenue Robert Schuman, Aix-en-Provence, 13621, France.
| | - Vrutti Joshi
- LSP Laboratory, University of Nîmes, Aix-Marseille University, UR 849, 29 Avenue Robert Schuman, Aix-en-Provence, 13621, France
| | - Pierluigi Graziani
- LSP Laboratory, University of Nîmes, Aix-Marseille University, UR 849, 29 Avenue Robert Schuman, Aix-en-Provence, 13621, France
| | - Jonathan Del-Monte
- LSP Laboratory, University of Nîmes, Aix-Marseille University, UR 849, 29 Avenue Robert Schuman, Aix-en-Provence, 13621, France
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12
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Corpas J, Moriana JA, Venceslá JF, Gálvez-Lara M. Cognitive processes associated with emotional disorders: implications for efficient psychological treatments. J Ment Health 2023; 32:54-62. [PMID: 33989506 DOI: 10.1080/09638237.2021.1922651] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Emotional disorders (EDs) are the most prevalent worldwide. Despite psychotherapies are their treatment of choice, there are difficulties to apply them properly in mental health services. Since literature shows that cognitive processes are associated with anxiety and depressive symptoms, more information is needed in order to improve psychological treatments. AIMS To determine the relation between cognitive factors with specific and non-specific ED symptoms in order to promote the development of accurate psychological treatments. METHODS We analyzed the relation between rumination, worry, and metacognition with generalized anxiety, panic, and depression disorder symptoms from a clinical sample of 116 individuals through correlation and linear regression analyses. RESULTS Although each specific disorder had a closer link with a particular cognitive process, all general ED symptoms were associated with the three cognitive factors studied. CONCLUSIONS For "pure" disorders, targeting a concrete cognitive process might be an optimal therapeutic option. However, due to the high comorbidity among EDs, we support the dissemination of the transdiagnostic treatment approach in which all cognitive factors are taken into account.
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Affiliation(s)
- Jorge Corpas
- Department of Psychology, University of Córdoba, Córdoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Juan A Moriana
- Department of Psychology, University of Córdoba, Córdoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Jose F Venceslá
- Department of Psychology, University of Córdoba, Córdoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Mario Gálvez-Lara
- Department of Psychology, University of Córdoba, Córdoba, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
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13
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Minihan S, Kwok C, Schweizer S. Social rejection sensitivity and its role in adolescent emotional disorder symptomatology. Child Adolesc Psychiatry Ment Health 2023; 17:8. [PMID: 36647142 PMCID: PMC9843960 DOI: 10.1186/s13034-022-00555-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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/31/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Most emotional disorders first emerge during adolescence, a time characterized by heightened sensitivity to social information, especially social rejection. Social rejection sensitivity (SRS), then, may be a promising intervention target. METHODS To explore this, 357 participants (M (SD) age = 19.40 (4.18), 63% female) completed self-report measures of SRS, its proposed antecedent, perceived parenting style, its proposed behavioral correlate, negative interpretation bias, and its proposed clinical correlate, emotional disorder symptoms. Participants additionally completed a single session of a social interpretation bias modification task, the ambiguous social scenarios task (ASST). RESULTS SRS was associated with perceived parental rejection, while controlling for other types of maladaptive parenting. SRS partially accounted for variance in the relationship between perceived parental rejection and emotional disorder symptomatology, as well as the relationship between negative interpretation bias and emotional disorder symptoms. Learning rates (i.e., change in reaction time across the task) on the ASST differed as a function of age and SRS, such that younger participants with higher SRS showed the slowest rate of learning. Moreover, individual differences in SRS accounted for the magnitude of change in negative interpretation bias before and after the ASST. Individuals with greater SRS showed less change in interpretation bias. CONCLUSIONS SRS appears strongly associated with emotional disorder symptoms in adolescents. Importantly, SRS was associated with the malleability of negative interpretation bias, which may help account for the mixed findings on the effectiveness of interpretation-bias-modification-paradigms in adolescents.
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Affiliation(s)
- Savannah Minihan
- grid.1005.40000 0004 4902 0432Developmental Affective Science Lab, School of Psychology, University of New South Wales, Kensington, Australia
| | - Cassandra Kwok
- grid.1005.40000 0004 4902 0432Developmental Affective Science Lab, School of Psychology, University of New South Wales, Kensington, Australia
| | - Susanne Schweizer
- Developmental Affective Science Lab, School of Psychology, University of New South Wales, Kensington, Australia. .,Developmental Cognitive Neuroscience Group, Department of Psychology, University of Cambridge, Cambridge, UK.
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14
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Gual-Montolio P, Suso-Ribera C, García-Palacios A, Castilla D, Zaragoza I, Bretón-López J. Enhancing Internet-based psychotherapy for adults with emotional disorders using ecological momentary assessments and interventions: Study protocol of a feasibility trial with "My EMI, Emotional Well-being" app. Internet Interv 2023; 31:100601. [PMID: 36686334 PMCID: PMC9852876 DOI: 10.1016/j.invent.2023.100601] [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: 10/20/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Emotional disorders are the most frequent mental health problems globally. To ensure the dissemination of psychological treatments for these conditions, novel forms of delivery (e.g., Internet or mobile apps) and more scalable forms of psychotherapy (e.g., transdiagnostic interventions) have become increasingly popular. Research, however, shows that a significant number of patients, around 40 % according to some studies, do not respond to the interventions as expected (i.e., not-on-track patients). Ecological momentary assessments (EMAs) and ecological momentary interventions (EMIs) could simplify tailoring treatments to the patients' progress and rapidly respond to undesired outcomes during psychotherapy. Therefore, these would facilitate measurement-based care with little therapist involvement. This study aims to explore the feasibility of an app-based system called My EMI, Emotional Well-being for people with emotional disorders. According to daily EMAs, the app will provide personalized EMIs while participants receive a self-applied online transdiagnostic treatment. The app will be used as an add-tool to the online intervention to address emotion dysregulation, foster adherence, and reinforce contents. The current study describes the study protocol for this trial. METHOD AND ANALYSIS A single-group, open trial design will be used. Participants will be 30 adults suffering from emotional disorders. Primary outcomes will be app usability, acceptability, and response rates. Secondary outcomes will be either evaluated in Qualtrics at pre-treatment, post-treatment, and 3-month follow-up (depression and anxiety severity, and transdiagnostic dimensions of emotional disorders) or daily throughout the study with the app (EMAs of mood and five transdiagnostic mechanisms of therapeutic change). EMIs will consist of brief, evidence-based transdiagnostic CBT digital content (images, infographics, or videos) delivered just-in-time. Only if problems persist, short phone calls or episodic videocalls will be conducted. The Ethics Committee of the Jaume I University approved the study and all its procedures (CD/111/2021) in December 2021. DISCUSSION Identifying personalized and scalable interventions is paramount to improve mental health care, especially its accessibility, and to reduce the psychological distress of people with mental health problems. Feasibility data of the app (EMA and EMI system) supported by a self-applied online transdiagnostic intervention will be important to explore whether this modern approach is a real option to move forward personalized psychological interventions for persons with emotional disorders. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05109780. Registered 05 November 2021, https://clinicaltrials.gov/ct2/show/NCT05109780.
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Affiliation(s)
- Patricia Gual-Montolio
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain,Corresponding author at: Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain.
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Diana Castilla
- Department of Personality, Assessment, and Psychological Treatments, Universidad de Valencia, 46010 Valencia, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Irene Zaragoza
- Department of Personality, Assessment, and Psychological Treatments, Universidad de Valencia, 46010 Valencia, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Juana Bretón-López
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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15
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Osma J, Martínez-Loredo V, Quilez-Orden A, Peris-Baquero O, Ferreres-Galán V, Prado-Abril J, Torres-Alfosea MA, Rosellini AJ. Multidimensional emotional disorders inventory: Reliability and validity in a Spanish clinical sample. J Affect Disord 2023; 320:65-73. [PMID: 36183816 DOI: 10.1016/j.jad.2022.09.140] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The categorical approach to diagnosing mental disorders has been criticized for a number of reasons (e.g., high rates of comorbidity; larger number of diagnostic categories and combination). Diverse alternatives have been proposed using a hybrid or totally dimensional perspective. Despite the evidence supporting use of the Multidimensional Emotional Disorders Inventory (MEDI) for assessing the transdiagnostic dimensions of Emotional Disorders using a dimensional-categorical hybrid approach, no data exist on Spanish clinical samples. The present study explores the validity and reliability of the 49-item MEDI in a clinical sample and provides data for its use. METHODS A total of 280 outpatients with emotional disorders attended in different Spanish public Mental Health Units in Spain filled out all questionnaires during the assessment phase and the MEDI again one week after. The instruments used evaluate four main constructs: personality, mood, anxiety and avoidance. RESULTS The nine original factors were confirmed and showed adequate reliability (α: 0.66-0.91) and stability (r = 0.76-0.87). No differences in mean scores by sex were presented in any subscale (p ≥ .07). The MEDI subscales correlated significantly with the scales of each of the selected constructs (0.45 < r < 0.76). LIMITATIONS The main limitations of this study were the limited sample size and not being able to count on MEDI scores post-transdiagnostic intervention. CONCLUSIONS The MEDI demonstrates adequate reliability and validity. It allows to assess diverse symptoms efficiently, thus being of interest for clinical studies and practice.
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Affiliation(s)
- J Osma
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
| | - V Martínez-Loredo
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - A Quilez-Orden
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain; Unidad de Salud Mental Moncayo, Tarazona, Spain
| | - O Peris-Baquero
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - V Ferreres-Galán
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain; Hospital Comarcal de Vinaròs, Castellón, Spain
| | - J Prado-Abril
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain; Hospital Miguel Servet, Zaragoza, Spain
| | | | - A J Rosellini
- Boston University, Department of Psychological and Brain Sciences, Boston, USA
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16
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Paredes-Mealla M, Martínez-Borba V, Miragall M, García-Palacios A, Baños RM, Suso-Ribera C. Is there evidence that emotional reasoning processing underlies emotional disorders in adults? A systematic review. Curr Psychol 2022; 42:1-17. [PMID: 36406838 PMCID: PMC9644006 DOI: 10.1007/s12144-022-03884-4] [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] [Accepted: 10/12/2022] [Indexed: 11/11/2022]
Abstract
The prevalence of emotional disorders has increased in recent times. Emotional Reasoning (ER), which is a transdiagnostic process, occurs when feelings, rather than objective evidence, are used as a source of information to make judgements about the valence of a situation. Differences in ER may explain the existence and maintenance of emotional disorders. The objective is to systematically review the role of ER in the occurrence and severity of emotional disorders. Following PRISMA guidelines, we searched through: PubMed, PsycInfo, Scopus and The Cochrane Library. Search terms were "Emotional Reasoning", "ex-consequentia reasoning", "Affect-as-information"; and "emotional disorders", "anxiety", "depression", "depressive". Nine articles were included. An association was demonstrated between ER and a greater degree of anxious symptomatological severity. In depressive symptomatology, no significant differences were found. One study reported the effect of Cognitive Behavioural Therapy on ER bias, finding no changes after the intervention. Finally, another study evaluated the efficacy of computerised experiential training in reducing ER bias, showing significant differences. There are few studies on ER and its evolution in research has not been uniform over time. Encouragingly, though, research to date suggests that ER is a transdiagnostic process involved in several anxiety disorders. More investigation is needed to dilucidate whether ER also underlies the onset and maintenance of depressive disorders.
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Affiliation(s)
- Macarena Paredes-Mealla
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain
| | - Verónica Martínez-Borba
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain
| | - Marta Miragall
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain
| | - Rosa Mª Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain
- Instituto Polibienestar, University of Valencia, Valencia, Spain
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto Carlos III, Madrid, Spain
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17
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Weinzimmer SA, Goetz AR, Guzick AG, Hana LM, Cepeda SL, Schneider SC, Kennedy SM, Amos Nwankwo GN, Christian CC, Shaw AM, Salloum A, Shah AA, Goodman WK, Ehrenreich-May J, Storch EA. Primary Outcomes for Adults Receiving the Unified Protocol after Hurricane Harvey in an Integrated Healthcare Setting. Community Ment Health J 2022; 58:1522-1534. [PMID: 35377090 PMCID: PMC9962349 DOI: 10.1007/s10597-022-00967-1] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/16/2022] [Indexed: 01/27/2023]
Abstract
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy for treating anxiety and depression. However, there are limited effectiveness data when conducted in real-world settings with diverse populations, including those with trauma. We evaluated treatment outcomes in a naturalistic, community setting among 279 adults who received UP following Hurricane Harvey. We examined change in overall clinical severity, depression and anxiety symptoms, functional impairment, and baseline outcome predictors (i.e., demographic characteristics, impact from Hurricane Harvey, co-occurrence of depression and anxiety symptoms). Global clinical severity, depression and anxiety symptoms, and functional impairment decreased by end-of-treatment. Participants experienced global symptom improvement to a lesser degree than demonstrated in efficacy trials. Participants who experienced greater storm impact reported larger reductions in anxiety symptoms than those less impacted by Harvey. Further studies evaluating the effectiveness of the UP post-disaster and with diverse samples are needed.
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Affiliation(s)
- Saira A Weinzimmer
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Amy R Goetz
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Andrew G Guzick
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Lynn M Hana
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Sandra L Cepeda
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
- Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124, USA
| | - Sophie C Schneider
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Sarah M Kennedy
- School of Medicine, University of Colorado, 1635 Aurora Ct, Aurora, CO, 80045, USA
| | - Gifty N Amos Nwankwo
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Catherine C Christian
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Ashley M Shaw
- Center for Children and Families, Florida International University, 11200 Southwest 8th Street, AHC1 140, Miami, FL, 33199, USA
| | - Alison Salloum
- College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Asim A Shah
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA
| | - Jill Ehrenreich-May
- Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA.
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18
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Osma J, Martínez-García L, Prado-Abril J, Peris-Baquero Ó, González-Pérez A. Developing a smartphone App based on the Unified Protocol for the transdiagnostic treatment of emotional disorders: A qualitative analysis of users and professionals' perspectives. Internet Interv 2022; 30:100577. [PMID: 36213084 PMCID: PMC9535424 DOI: 10.1016/j.invent.2022.100577] [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: 03/20/2022] [Revised: 09/05/2022] [Accepted: 09/27/2022] [Indexed: 12/01/2022] Open
Abstract
Emotional Disorders have become the most prevalent mental disorders in the world. In relation to their high prevalence, mental health care from public health services faces major challenges. Consequently, finding solutions to deliver cost-effective evidence-based treatments has become a main goal of today's clinical psychology. Smartphone apps for mental health have emerged as a potential tool to deal with it. However, despite their effectiveness and advantages, several studies suggest the need to involve patients and professionals in the design of these apps from the first stage of the development process. Thus, this study aimed to identify, from both a group of users and professionals, the needs, opinions, expectations and design aspects of a future smartphone app based in the Unified Protocol (UP), that will allow to develop the subsequent technical work of the app engineers. Two focus groups were conducted, one with 7 professionals and the other with 9 users, both groups familiar with the UP. A thematic content analysis based in grounded theory was performed in order to define emergent categories of analysis derived from the interview data. The results revealed 8 common topics in both focus groups and 5 specific key topics were identified in the professionals' focus group. Of the total proposals, 93 % of the professionals' and 78 % of the users' are implemented in the preliminary version of the app.
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Affiliation(s)
- Jorge Osma
- University of Zaragoza, Department of Psicology and Sociology, Faculty of Social and Human Sciences, C/Atarazanas, 4, 44003 Teruel, Spain
- Health Research Institute of Aragon, Biomedic Research Center of Aragon (CIBA), Av. San Juan Bosco, 13, 50009 Zaragoza, Spain
- Corresponding author at: Universidad de Zaragoza, Departamento de Psicología y Sociología, Facultad de Ciencias Sociales y Humanas, C/Atarazanas, 4, 44003 Teruel, Spain.
| | - Laura Martínez-García
- University of Zaragoza, Department of Psicology and Sociology, Faculty of Social and Human Sciences, C/Atarazanas, 4, 44003 Teruel, Spain
- Health Research Institute of Aragon, Biomedic Research Center of Aragon (CIBA), Av. San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Javier Prado-Abril
- Health Research Institute of Aragon, Biomedic Research Center of Aragon (CIBA), Av. San Juan Bosco, 13, 50009 Zaragoza, Spain
- Miguel Servet University Hospital, Zaragoza, Spain
| | - Óscar Peris-Baquero
- University of Zaragoza, Department of Psicology and Sociology, Faculty of Social and Human Sciences, C/Atarazanas, 4, 44003 Teruel, Spain
- Health Research Institute of Aragon, Biomedic Research Center of Aragon (CIBA), Av. San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Alberto González-Pérez
- Institute of New Imaging Technologies, Universitat Jaume I, Av. Vicente Sos Baynat s/n, 12071 Castellón, Spain
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19
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de la Rosa-Gómez A, Flores-Plata LA, Esquivel-Santoveña EE, Santillán Torres Torija C, García-Flores R, Dominguez-Rodriguez A, Arenas-Landgrave P, Castellanos-Vargas RO, Berra-Ruiz E, Silvestre-Ramírez R, Miranda-Díaz GA, Díaz-Sosa DM, Hernández-Posadas A, Flores-Elvira AI, Valencia PD, Vázquez-Sánchez MF. Efficacy of a transdiagnostic guided internet-delivered intervention for emotional, trauma and stress-related disorders in Mexican population: study protocol for a randomized controlled trial. BMC Psychiatry 2022; 22:537. [PMID: 35941557 PMCID: PMC9360670 DOI: 10.1186/s12888-022-04132-6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. METHODS A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. DISCUSSION The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. TRIAL REGISTRATION ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.
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Affiliation(s)
- Anabel de la Rosa-Gómez
- Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico.
| | - Lorena A. Flores-Plata
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
| | | | - Carolina Santillán Torres Torija
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
| | - Raquel García-Flores
- grid.466844.c0000 0000 9963 8346Department of Psychology, Technological Institute of Sonora, Sonora, Mexico
| | | | - Paulina Arenas-Landgrave
- grid.9486.30000 0001 2159 0001Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Rosa O. Castellanos-Vargas
- grid.441213.10000 0001 1526 9481Health Sciences Department, Autonomous University of Ciudad Juarez, Ciudad Juárez, Mexico
| | - Enrique Berra-Ruiz
- grid.412852.80000 0001 2192 0509Faculty of Health Sciences, Autonomous University of Baja California, Tijuana Baja California, Mexico
| | | | - Germán Alejandro Miranda-Díaz
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
| | - Dulce M. Díaz-Sosa
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
| | - Alejandrina Hernández-Posadas
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
| | - Alicia I. Flores-Elvira
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
| | - Pablo D. Valencia
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
| | - Mario F. Vázquez-Sánchez
- grid.9486.30000 0001 2159 0001Faculty of Higher Studies Iztacala, National Autonomous University of Mexico, State of Mexico, Mexico
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Lorentzen V, Fagermo K, Handegård BH, Neumer SP, Skre I. Long-term effectiveness and trajectories of change after treatment with SMART, a transdiagnostic CBT for adolescents with emotional problems. BMC Psychol 2022; 10:167. [PMID: 35791020 PMCID: PMC9258229 DOI: 10.1186/s40359-022-00872-y] [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] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
Background There is a need for long-term effectiveness trials of transdiagnostic treatments. This study investigates the effectiveness and diagnosis-specific trajectories of change in adolescent patients attending SMART, a 6-week transdiagnostic CBT for anxiety and depression, with 6-month follow-up. Methods A randomized controlled trial with waiting list control (WLC) was performed at three child and adolescent mental health outpatient services (CAMHS) in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% females) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to treatment or to WLC. Long-term follow-up (N = 83, baseline age = 15.57, 94% females) was performed 6 months after treatment completion (Mean = 7.1 months, SD = 2.5). Linear mixed model analysis was used to assess time by group effects in patients with no diagnosis, probable anxiety, depressive disorder, and combined anxiety and depressive disorder. Results Almost one third (31%) obtained full recovery according to the inclusion criterium (SDQ emotional). There was highly significant change in all outcome variables. Effect sizes (ES) were largest for general functioning, measured with CGAS (ES: d = 2.19), and on emotional problems measured with SDQ (ES: d = 2.10), while CORE-17, BDI-II and CGAS all obtained ES’s close to 1. There were no significant time by diagnostic group interactions for any outcomes, indicating similar trajectories of change, regardless of diagnostic group. Waiting 6 weeks for treatment had no significant impact on long-term treatment effects. Limitations Possible regression to the mean. Attrition from baseline to follow-up. Conclusions Six weeks of transdiagnostic treatment for adolescents with emotional problems showed highly significant change in emotional symptoms and functioning at 6-month follow-up. Patients with anxiety, depression, combined anxiety and depression, and emotional problems with no specific diagnoses, all had similar trajectories of change. Hence this transdiagnostic SMART treatment can be recommended for adolescent patients with symptoms within the broad spectrum of emotional problems. Trial registration: ClinicalTrials.gov Identifier: NCT02150265. First registered May 29, 2014.
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Affiliation(s)
- Veronica Lorentzen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway. .,Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway.
| | - Kenneth Fagermo
- Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Simon-Peter Neumer
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, 0484, Oslo, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Department of General Psychiatry, University Hospital of North-Norway, P.O. Box 6124, 9291, Tromsø, Norway
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21
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Shershever AS, Boreiko VB. Mental disorders as an indication for surgical treatment of drug-resistant temporal lobe epilepsy. Prog Brain Res 2022; 272:125-141. [PMID: 35667798 DOI: 10.1016/bs.pbr.2022.03.007] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study recruited 82 patients with temporal lobe epilepsy (TLE): 41 men and 41 women, who underwent an open epilepsy surgery to remove the epileptic focus from 1963 to 1970. The patients before surgery were divided into two groups: group I included 49 patients with minor mental disorders and group II included 33 patients with major mental disorders. Features of mental disorders in patients with monotemporal lobe epilepsy were identified. The significance of mental disorders for topical diagnosis of the epileptic focus has been emphasized. The course of mental disorders in patients with TLE after open surgery for epileptic focus removal was carefully monitored. The role of mental disorders as an indication for surgical treatment of TLE has been shown. The patients were followed up for 14±6years.
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Affiliation(s)
- Alexander S Shershever
- Department of Neurology, Neurosurgery, and Medical Genetics, Ural State Medical University, Yekaterinburg, Russia; Sverdlovsk Regional Clinical Neuropsychiatric Hospital for War Veterans, Yekaterinburg, Russia.
| | - Valerii B Boreiko
- Sverdlovsk Regional Clinical Neuropsychiatric Hospital for War Veterans, Yekaterinburg, Russia
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22
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Li J, Pu F, Peng C, Wang Y, Zhang Y, Wu S, Wang S, Shen X, Cheng R, He F. Antibiotic cocktail-induced gut microbiota depletion in different stages could cause host cognitive impairment and emotional disorders in adulthood in different manners. Neurobiol Dis 2022; 170:105757. [PMID: 35588989 DOI: 10.1016/j.nbd.2022.105757] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 02/11/2022] [Revised: 04/23/2022] [Accepted: 05/11/2022] [Indexed: 02/08/2023] Open
Abstract
Gut microbiota depletion may result in cognitive impairment and emotional disorder. This study aimed to determine the possible association between host gut microbiota, cognitive function, and emotion in various life stages and its related underlying mechanisms. Seventy-five neonatal mice were randomly divided into five groups (n = 15 per group). Mice in the vehicle group were administered distilled water from birth to death, and those in the last four groups were administered antibiotic cocktail from birth to death, from birth to postnatal day (PND) 21 (infancy), from PND 21 to 56 (adolescence), and from PND 57 to 84 (adulthood), respectively. Antibiotic exposure consistently altered the gut microbiota composition and decreased the diversity of gut microbiota. Proteobacteria were the predominant bacteria instead of Firmicutes and Bacteroidetes after antibiotic exposure in different life stages. Long-term and infant gut microbiota depletion resulted in anxiety- and depression-like behaviors, memory impairments, and increased expression of γ-aminobutyric acid type A receptor α1 of adult mice. Long-term antibiotic exposure also significantly decreased serum interleukin (IL)-1β, IL-10, and corticosterone of adult mice. Gut microbiota depletion in adolescence resulted in anxiety-like behaviors, short-term memory decline, decreased serum interferon-γ (IFN-γ), mRNA expression of 5-hydroxytryptamine receptor 1A, and neuropeptide Y receptor Y2 in the prefrontal cortex of adult mice. Antibiotic exposure in adulthood damaged short-term memory and decreased serum IL-10, IFN-γ, and increased γ-aminobutyric acid type B receptor 1 mRNA expression of adult mice. These results suggest that antibiotic-induced gut microbiota depletion in the long term and infancy resulted in the most severe cognitive and emotional disorders followed by depletion in adolescence and adulthood. These results also suggest that gut microbes could influence host cognitive function and emotion in a life stage-dependent manner by affecting the function of the immune system, hypothalamic-pituitary-adrenal axis, and the expression of neurochemicals in the brain.
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Affiliation(s)
- Jinxing Li
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China
| | - Fangfang Pu
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Chenrui Peng
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China
| | - Yimei Wang
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China
| | - Yujie Zhang
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China
| | - Simou Wu
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China
| | - Silu Wang
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China
| | - Xi Shen
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China
| | - Ruyue Cheng
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China.
| | - Fang He
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041 Chengdu, Sichuan, PR China.
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Aguilera-Martín Á, Gálvez-Lara M, Cuadrado F, Moreno E, García-Torres F, Venceslá JF, Corpas J, Jurado-González FJ, Muñoz-Navarro R, González-Blanch C, Ruiz-Rodríguez P, Barrio-Martínez S, Prieto-Vila M, Carpallo-González M, Cano-Vindel A, Moriana JA. Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol. BMC Psychiatry 2022; 22:99. [PMID: 35139809 DOI: 10.1186/s12888-022-03726-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU). METHODS A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios. DISCUSSION This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems. TRIAL REGISTRATION ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021).
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Rowland DP, Casey LM, Ganapathy A, Cassimatis M, Clough BA. A Decade in Review: A Systematic Review of Virtual Reality Interventions for Emotional Disorders. Psychosoc Interv 2022; 31:1-20. [PMID: 37362616 PMCID: PMC10268557 DOI: 10.5093/pi2021a8] [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] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/22/2021] [Indexed: 06/28/2023]
Abstract
Research is increasingly demonstrating the therapeutic benefits of virtual reality interventions for various mental health conditions, though these rarely translate from research to application in clinical settings. This systematic review aims to examine the efficacy of current virtual reality interventions for emotional disorders, with a focus on clinical and technological features that influence translation of treatments from research to clinical practice. A comprehensive systematic literature search was conducted following PRISMA guidelines, for studies including the application of a virtual reality intervention to a clinical population of adults with an emotional disorder. Thirty-seven eligible studies were identified, appraised, and assessed for bias. Treatment effects were typically large across studies, with virtual reality being considered an efficacious treatment modality for various anxiety disorders and post-traumatic stress disorder. Virtual reality interventions were typically used for delivering exposure in cognitive behavioural therapy approaches. Considerable variability was seen in cost, technological specifications, degree of therapist involvement, delivery format, dosage, duration, and frequency of treatment. Suboptimal methodological rigour was identified in some studies. Remote use of virtual reality was rare, despite increasing options for in home use. Virtual reality interventions have the potential to overcome barriers to care and better meet the needs of consumers. Future research should examine the efficacy of virtual reality for treatment of depressive disorders and obsesive compulsive disorder. Improved methodological reporting and development of transdiagnostic and remotely delivered virtual reality interventions, will likely increase the translation of this treatment modality.
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Affiliation(s)
- Dale P. Rowland
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Leanne M. Casey
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Aarthi Ganapathy
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Mandy Cassimatis
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
| | - Bonnie A. Clough
- Griffith UniversityQueenslandAustraliaGriffith University, Queensland, Australia
- Menzies Health InstituteQueenslandAustraliaMenzies Health Institute Queensland, Australia
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25
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Fergus TA, Weinzimmer SA, Schneider SC, Storch EA. Associations between self-absorption and working memory capacity: A preliminary examination of a transdiagnostic process spanning across emotional disorders. J Anxiety Disord 2021; 83:102457. [PMID: 34380084 PMCID: PMC8440467 DOI: 10.1016/j.janxdis.2021.102457] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
Considered a transdiagnostic process spanning across emotional disorders, self-absorption reflects self-focused processing that is excessive, sustained, and inflexible. Working memory capacity is critical for self-regulation, inclusive of mitigating perseverative thinking. Providing the first known examination of associations between self-absorption and working memory capacity, a negative association was expected. A sample of adults (N = 63; 70 % experiencing an anxiety or depressive disorder) completed the study protocol, which included completing a structured diagnostic interview, self-report measures, and a working memory capacity task. Self-absorption, as predicted, negatively correlated with working memory capacity, with an association found for the private, but not public, aspect of self-absorption. The association between private self-absorption and working memory capacity was not attributable to shared variance with public self-absorption or negative affectivity. Diagnostic status (anxiety disorder, depressive disorder, or either disorder) did not moderate the association. The results provide evidence that self-absorption relates to impairments in working memory capacity. Implications and future directions for how these results advance our understanding and treatment efforts of self-absorption are discussed.
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Affiliation(s)
| | - Saira A. Weinzimmer
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences One Baylor Plaza MS:350, Houston, TX, 77030, USA
| | - Sophie C. Schneider
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences One Baylor Plaza MS:350, Houston, TX, 77030, USA
| | - Eric A. Storch
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences One Baylor Plaza MS:350, Houston, TX, 77030, USA
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Wolitzky-Taylor K, Sewart A, Zinbarg R, Mineka S, Craske MG. Rumination and worry as putative mediators explaining the association between emotional disorders and alcohol use disorder in a longitudinal study. Addict Behav 2021; 119:106915. [PMID: 33770722 DOI: 10.1016/j.addbeh.2021.106915] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The high rate of comorbidity between alcohol use and emotional disorders is well demonstrated, but the mechanisms underlying their relationship remain largely unidentified. One possibility is maladaptive responding to negative affect, such as worry and rumination. The present study sought to examine worry and rumination as putative mediators explaining the link between emotional disorders and alcohol use disorders. Methods Mediational analyses were conducted using a sample (n = 232) derived from a larger late adolescence/early adulthood longitudinal dataset (Youth Emotion Project; Zinbarg et al., 2010). Results A significant indirect effect was observed for emotional disorder severity on alcohol use disorder severity via rumination, but not via worry or the shared variance between worry and rumination. Conclusions These findings suggest that rumination may specifically confer risk for the development of alcohol use disorder for individuals with emotional disorders. Further, ruminative thinking may serve as a specific treatment target to reduce vulnerability to alcohol use disorder.
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Affiliation(s)
- Kate Wolitzky-Taylor
- University of California - Los Angeles, Department of Psychiatry and Biobehavioral Sciences, USA.
| | - Amy Sewart
- California State University - Dominguez Hills, Department of Psychology, USA.
| | | | - Susan Mineka
- Northwestern University, Department of Psychology, USA
| | - Michelle G Craske
- University of California - Los Angeles, Department of Psychology, USA.
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Nieto I, Vazquez C. 'Relearning how to think': A brief online intervention to modify biased interpretations in emotional disorders-study protocol for a randomised controlled trial. Trials 2021; 22:510. [PMID: 34332616 PMCID: PMC8325786 DOI: 10.1186/s13063-021-05459-3] [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] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 07/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Cognitive biases play an important role in the development and maintenance of emotional disorders, such as depression and anxiety. Novel procedures, known as Cognitive Bias Modification (CBM), aim to reduce these dysfunctional information processing modes. This study develops a brief clinically based online intervention programme to modify biased interpretations in depression and anxiety (CBM-IClin), overcoming some methodological issues that have been addressed in previous literature. Methods Volunteer participants will be recruited via social media and posters at the university. They will be randomly assigned to an experimental group or a waiting list control group. Both groups will complete two assessment sessions (before and after the intervention) consisting of questionnaires measuring cognitive and emotional variables as well as experimental tasks measuring cognitive biases (i.e. attention, memory, and interpretation). After the first assessment session, only participants in the experimental group will receive a link to follow the four CBM-IClin sessions at home. All participants will receive, via email, follow-up questionnaires 2 weeks and 3 months after the second assessment. Discussion This study will test the 'Relearning how to think', an online programme potentially beneficial to modify cognitive biases in emotional disorders. Several limitations of previous CBM procedures are addressed, and the impact of the programme both on objective cognitive bias tasks and clinical symptoms will be explored. Trial registration ClinicalTrials.gov NCT03987477. Prospectively registered on June 17, 2019
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Affiliation(s)
- Inés Nieto
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223, Madrid, Spain.
| | - Carmelo Vazquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223, Madrid, Spain
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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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Muñoz-Moreno JA, Cysique LA, Rourke SB. Neuropsychiatric Disorders, Emotional Disturbances, and Their Associations with HIV-Associated Neurocognitive Disorder. Curr Top Behav Neurosci 2021. [PMID: 34081306 DOI: 10.1007/7854_2021_233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The current chapter provides a critical and narrative review of recent research on the neuropsychiatric disorders, emotional disturbances, and their associations with neurocognitive functioning in people living with HIV infection. We review a range of neuropsychiatric disorders including depression and anxiety disorders, but also emotional disturbances, which can be partly distinguished from depression and anxiety (apathy, alexithymia, and emotional processing impairment). While reviewing the research into the neuropsychiatric disorders and HIV-associated neurocognitive disorders, we also cover the questions of self-reported cognitive symptoms evaluation and interpretation. The chapter includes research on the role of coping skills, perceived stress and response to stressful life events, and connections to neurocognitive impairment in people living with HIV. Promising non-pharmacological interventions are highlighted. The chapter concludes with the clinical implications on how to best consider neuropsychiatric disorders and cognitive symptoms for the diagnosis of HIV-associated neurocognitive disorders, as well as future research directions.
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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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Gosar D, Košmrlj L, Musek PL, Meško T, Stropnik S, Krkoč V, Golli T, Butenko T, Loboda T, Osredkar D. Adaptive skills and mental health in children and adolescents with neuromuscular diseases. Eur J Paediatr Neurol 2021; 30:134-43. [PMID: 33109477 DOI: 10.1016/j.ejpn.2020.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/26/2020] [Accepted: 10/18/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Adaptive skills represent the ways that children and adolescents meet their basic needs for self-care, decision making, communication, and learning in their daily life. Having a neuromuscular disease (NMD) not only presents mental health issues, but also impacts these skills. AIMS Our study aimed to compare the adaptive skills and mental health of paediatric patients with the most common NMDs with their healthy peers and assess how NMDs shape the way patients form relationships with others, engage in leisure activities and take care of their daily living needs. METHODS We used the Adaptive Behaviour Assessment System (ABAS-3) and Achenbach Child Behaviour Checklist (CBCL) to compare the adaptive skills and mental health symptoms of 50 NMD patients to a demographically-matched control group of 298 peers. We examined specific outcomes of having myotonic dystrophy (DM), Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), spinal muscular atrophy (SMA) or a mixed group of other NMDs. RESULTS All NMD patients displayed poor practical adaptive skills. When the disease was more likely to involve the central nervous system (DM, DMD) they also showed additional deficits in their conceptual and social skills. Contrary to previous research no increased rate of psychopathological symptoms was found in NMD patients, with the exception of difficulties in the social domain among patients with DM. CONCLUSIONS Although most children with NMDs displayed more limited practical skills, the specific profile of adaptive skills for each patient group needs to be taken into consideration when planning school support and other psychosocial interventions.
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Heilman KM. Emotion and mood disorders associated with epilepsy. Handb Clin Neurol 2021; 183:169-73. [PMID: 34389116 DOI: 10.1016/B978-0-12-822290-4.00008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Epilepsy is a disorder characterized by recurrent seizures. Epilepsy can alter mood and emotions. Treatments for epilepsy can also alter mood and emotions. This chapter reviews the emotional changes that can occur before, during, and after a seizure, such as fear and anger, the interictal mood disorders associated with epilepsy, such as depression and anxiety, as well as alterations of emotional processing including comprehending and expressing emotional prosody and faces. The possible treatments of these emotional and mood disorders are also reviewed.
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Abstract
Multiple sclerosis (MS) is associated with a high prevalence of emotional and mood disorders. Emotional disorders may worsen during illness progression and affect the quality of life of patients and their families. MS is often associated with depression, with an increased risk of suicide, poor adherence to treatment, decreased functional status, and quality of life. The diagnosis and treatment of emotional and mood disorders in these patients is often challenging since several symptoms of these disorders overlap with those of MS. Other prevalent emotional disorders in MS include bipolar disorder, anxiety disorders, emotional blunting (apathy), and pseudobulbar affect. Early recognition and treatment of these comorbidities could contribute to the reduction of disability and even to decreased mortality. The aim of this chapter is to provide an up-to-date review of mood and emotional disorders that are often associated with MS, focusing on their epidemiology, clinical features, pathogenesis, assessment, and treatment. The interplay between the psychosocial impact of the chronic disability and the demyelinating structural lesions of the brain in precipitating emotional and mood disorders is discussed, as well as its implications for diagnosis and treatment.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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Corpas J, Moriana JA, Venceslá JF, Gálvez-Lara M. Brief psychological treatments for emotional disorders in Primary and Specialized Care: A randomized controlled trial. Int J Clin Health Psychol 2021; 21:100203. [PMID: 33363586 PMCID: PMC7753034 DOI: 10.1016/j.ijchp.2020.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background/Objective Brief transdiagnostic psychotherapies are a possible treatment for emotional disorders. We aimed to determine their efficacy on mild/moderate emotional disorders compared with treatment as usual (TAU) based on pharmacological interventions. Method: This study was a single-blinded randomized controlled trial with parallel design of three groups. Patients (N = 102) were assigned to brief individual psychotherapy (n = 34), brief group psychotherapy (n = 34) or TAU (n = 34). Participants were assessed before and after the interventions with the following measures: PHQ-15, PHQ-9, PHQ-PD, GAD-7, STAI, BDI-II, BSI-18, and SCID. We conducted per protocol and intention-to-treat analyses. Results: Brief psychotherapies were more effective than TAU for the reduction of emotional disorders symptoms and diagnoses with moderate/high effect sizes. TAU was only effective in reducing depressive symptoms. Conclusions: Brief transdiagnostic psychotherapies might be the treatment of choice for mild/moderate emotional disorders and they seem suitable to be implemented within health care systems.
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Affiliation(s)
- Jorge Corpas
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Juan A. Moriana
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Jose F. Venceslá
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
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Marciano RC, Cardoso MGF, Vasconcelos MMA, Paula JJ, Oliveira EA, Lima EM. Depression, anxiety and quality of life impairment in parents of children with functional lower urinary tract dysfunction. J Pediatr Urol 2020; 16:838.e1-838.e7. [PMID: 33012646 DOI: 10.1016/j.jpurol.2020.09.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/20/2020] [Accepted: 09/14/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lower urinary tract dysfunction (LUTD) is a common clinical condition in children, frequently associated with emotional issues both among the patients and their families. The objective of the present study was to measure depressive and anxious symptoms and quality of life (QoL) in parents of LUTD patients. METHODS This cross-sectional study applied Beck Depression and Anxiety Inventories and WHOQOL-Bref to 88 caregivers of children with LUTD followed at a tertiary care center. The prevalence of mental disorders in children and adolescents was assessed using the Child Behavior Check List (CBCL 6-18) answered by their caregivers. The association of clinical features and emotional aspects related to the caregivers' quality of life was evaluated through non-parametric correlation (Spearman) and multiple linear regression analysis. RESULTS Most of the caregivers were mothers (88%), with a mean age of 41.5 (SD 8.7 years), 67% of them married or in a stable union, and 38% had not completed elementary school. Considering 19 as the cutoff point for the Beck scale, 44% of the sample had a clinical score for depressive symptoms and 43% for anxious symptoms. According to the parents' report, 56% of children with LUTD had a clinical score for behavioral problems in CBCL. Parents' QoL was impaired, and the predictors of poor QoL were the age of the patients and presence of depressive/anxious symptoms in caregivers. Parents' depression/anxiety symptoms and poor QoL significantly correlated with behavioral problems in their children. The CBCL total problems score correlated both to depression (r = 0.38, p < 0.01) and to anxiety in parents (r = 0.49, p < 0.01) (Figure). CONCLUSIONS These findings indicate a possible emotional impact of LUTD in patients' caregivers. Our study suggests that an approach to the family of LUTD patients' may be an important therapeutic resource for an effective clinical control of this condition.
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Affiliation(s)
- Renata C Marciano
- Department of Psychiatry, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maíra Gloria F Cardoso
- Department of Psychology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Monica M A Vasconcelos
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Jonas J Paula
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eduardo A Oliveira
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Eleonora M Lima
- Division of Pediatric Nephrourology, School of Medicine, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Lorentzen V, Handegård BH, Moen CM, Solem K, Lillevoll K, Skre I. CORE-OM as a routine outcome measure for adolescents with emotional disorders: factor structure and psychometric properties. BMC Psychol 2020; 8:86. [PMID: 32819424 PMCID: PMC7439542 DOI: 10.1186/s40359-020-00459-5] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 08/06/2020] [Indexed: 11/30/2022] Open
Abstract
Background Instruments for monitoring the clinical status of adolescents with emotional problems are needed. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) according to theory measures problems/symptoms, well-being, functioning and risk. Documentation of whether the theoretical factor structure for CORE-OM is applicable for adolescents is lacking. Methods This study examined the factor structure and psychometric properties of the CORE-OM based on two samples of adolescents (age 14–18): youths seeking treatment for emotional problems (N = 140) and high school students (N = 531). A split half approach was chosen. An exploratory factor analysis (EFA) was performed on the first half of the stratified samples to establish the suitability of the model. A Confirmatory Factor Analysis (CFA) with the chosen model from the EFA was performed on the second half. Internal consistency and clinical cut-off scores of the CORE-OM were investigated. Results The best fitting model only partially confirmed the theoretical model for the CORE-OM. The model consisted of five factors: 1) General problems, 2) risk to self, 3) positive resources 4) risk to others and 5) problems with others. The clinical cut-off score based on the all-item total was higher than in an adult sample. Both the all-item total and general problems cut-off scores showed gender differences. Conclusion The factor analysis on CORE-OM for adolescents resulted in a five-factor solution, and opens up for new subscales concerning positive resources and problems with others. A 17-item solution for the general problems/symptoms scale is suggested. We advise developers of self-report instruments not to reverse items, if they do not intend to measure a separate factor, since these seem to affect the dimensionality of the scales. Comparing means for gender in non-clinical samples should not be done without modification of the general emotional problem and the positive resources scales. Slightly elevated CORE-OM scores (up to 1.3) in adolescents may be normal fluctuations.
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Affiliation(s)
- Veronica Lorentzen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway. .,Department of Child and Adolescent Mental Health, Divisions of Child and Adolescent Health, University Hospital of North Norway, 9038, Tromsø, Norway.
| | - Bjørn Helge Handegård
- The Regional Centre for Child and Adolescent Mental Health - North, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Connie Malén Moen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway.,The Norwegian Labour and Welfare Administration (NAV), Employment Advisory Services in Troms and Finnmark, 9811, Vadsø, Norway
| | - Kenth Solem
- Substance use and Psychiatry unit, Department of Substance Use and Addiction Medicine, Clinic for Mental Health and Substance Use, Nordland Hospital, 8076, Bodø, Norway
| | - Kjersti Lillevoll
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, N-9037, Tromsø, Norway.,Clinic for Mental Health and Substance Use, University Hospital of North Norway, 9291, Tromsø, Norway
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De la Rosa-Cáceres A, Stasik-O'Brien S, Rojas AJ, Sanchez-Garcia M, Lozano OM, Díaz-Batanero C. Spanish Adaptation of the Inventory of Depression and Anxiety Symptoms (IDAS-II) and a study of its psychometric properties. J Affect Disord 2020; 271:81-90. [PMID: 32479335 DOI: 10.1016/j.jad.2020.03.187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/19/2019] [Revised: 01/29/2020] [Accepted: 03/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Inventory of Depression and Anxiety Symptoms (IDAS-II) is composed of 99 items organized into 18 specific scales that provides dimensional assessment of depression, anxiety and bipolar symptoms. To date, IDAS-II is only available in the English and Turkish population. The main purpose of this study is to adapt the IDAS-II to the Spanish population and to assess the psychometric properties. METHODS Participants included community adults (n = 620) and college students (n = 378). All participants completed the Beck Depression Inventory-II, Beck Anxiety Inventory, Hypomania Check List-32, Post-traumatic Stress Disorder Checklist-Civilian Version and Obsessive-Compulsive Inventory-Revised, in addition to the Spanish version of the IDAS-II. RESULTS The results indicate good internal consistency and high temporal stability of the Spanish version of the IDAS-II. Confirmatory factor analyses show for the first time that the three-factor structure of the IDAS-II (Distress, Obsessions/Fear, and Positive Mood) loads on a second order factor, labeled "Internalizing" according to the Hierarchical Taxonomy Of Psychopathology (HiTOP). LIMITATIONS Study was conducted exclusively on student and community samples and some of the measures used as gold-standard have presented limitations CONCLUSIONS: According to previous studies, the results supported the convergent and discriminant validity of the majority of IDAS-II scales. IDAS-II is useful in assessing the severity of depression, anxiety and bipolar symptoms in research contexts in a Spanish population according to the HiTOP model. However, more evidence is required to prove the adequate functioning of the IDAS-II in clinical samples.
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Affiliation(s)
- A De la Rosa-Cáceres
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | | | - A J Rojas
- Department of Psychology, University of Almería, Almería, Spain
| | - M Sanchez-Garcia
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain; Research Center for Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - O M Lozano
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain; Research Center for Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Carmen Díaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain; Research Center for Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain.
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Lee YC, Chen VCH, Yang YH, Kuo TY, Hung TH, Cheng YF, Huang KY. Association Between Emotional Disorders and Speech and Language Impairments: A National Population-Based Study. Child Psychiatry Hum Dev 2020; 51:355-365. [PMID: 31802296 DOI: 10.1007/s10578-019-00947-9] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Anxiety and depression are common emotional problems in children and adolescents. This study used a long-term tracking large database to investigate whether the proportion of children who were diagnosed with speech and language impairments were later diagnosed with anxiety or depression were significantly greater than that of matched group of the same age and gender without speech and language impairments. More than 4300 eligible children with speech and language impairments and matched controls were identified and assessed for anxiety and depression. The risk of anxiety and depressive disorders in children with speech and language impairments were examined with Cox regression analyses and adjusting for covariables (gender, age, and comorbidities). The results showed that speech and language impairments were positively associated with anxiety disorders (adjusted hazard ratio [AHR] 2.87, 95% confidence interval [CI] 2.20-3.76) and depressive disorders (AHR 2.51, 95% CI 1.52-4.13). The number of boys with speech and language impairments was more than twofold that of girls, but boys did not different from girls in the risk of anxiety disorders (AHR 0.95, 95% CI 0.75-1.20) and depressive disorders (AHR 0.72, 95% CI 0.47-1.11). Infantile autism and intellectual disabilities were positively associated with anxiety (AHR 1.54, 95% CI 1.07-2.21; AHR 1.47, 95% CI 1.09-1.98), and the latter was positively associated with depression (AHR 1.83, 95% CI 1.06-3.17). In addition to speech and language impairments interventions, our findings supported the necessity of identification and interventions in anxiety and depressive disorders among children with speech and language impairments from elementary school until youth.
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Affiliation(s)
- Yi-Chen Lee
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tai-Hsin Hung
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Chang Gung Institute of Technology, Taoyuan, Taiwan
| | - Yu-Fang Cheng
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Applied Science (Occupational Therapy), University of Western Sydney, Sydney, Australia
| | - Kuo-You Huang
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University and Hospital, No. 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan.
- Speech and Language Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Lorentzen V, Fagermo K, Handegård BH, Skre I, Neumer SP. A randomized controlled trial of a six-session cognitive behavioral treatment of emotional disorders in adolescents 14-17 years old in child and adolescent mental health services (CAMHS). BMC Psychol 2020; 8:25. [PMID: 32171328 PMCID: PMC7073009 DOI: 10.1186/s40359-020-0393-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/03/2020] [Indexed: 12/22/2022] Open
Abstract
Background This study aims to investigate effectiveness of a 6-week, transdiagnostic cognitive behavioral therapy (CBT) for anxiety and depression in adolescents, the Structured Material for Therapy (SMART), in naturalistic settings of child and adolescent mental health outpatient services (CAMHS). Methods A randomized controlled trial with waiting list control (WLC) was performed at three community CAMHS in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% girls) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to SMART or to WLC. Results In the treatment group (CBT), 32.9% improved in the main outcome measure (SDQ), compared to 11.6% in the WLC. Clinically significant and reliable change was experienced by 17.7% in the CBT condition, compared to 5.8% in the WLC. No patients deteriorated. Statistically significant treatment effects were achieved for internalization symptoms, anxiety symptoms and general functioning. Conclusions These promising findings indicate that SMART may be considered as a first step in a stepped care model for anxiety and/or depression treatment in CAMHS. The recovery rates imply that further investigations into the effectiveness of brief treatments should be made. Furthermore, there is a need for more comprehensive second-stage treatments for some of these patients. Trial registration ClinicalTrials.gov Identifier: NCT02150265. First registered May 292,014.
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Affiliation(s)
- Veronica Lorentzen
- Department of Psychology, Faculty of Health Sciences, UIT The Arctic University of Norway, 9037, Tromsø, Norway. .,Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway.
| | - Kenneth Fagermo
- Department of Child and Adolescent Psychiatry, Divisions of Child and Adolescent Health, University Hospital of North Norway, P.O. Box 19, 9038, Tromsø, Norway
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare, UIT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UIT The Arctic University of Norway, 9037, Tromsø, Norway.,Department of General Psychiatry, University Hospital of North Norway, P.O. Box 6124, 9291, Tromsø, Norway
| | - Simon-Peter Neumer
- Regional Centre for Child and Youth Mental Health and Child Welfare, UIT The Arctic University of Norway, 9037, Tromsø, Norway.,Regional Centre for Child and Adolescent Mental Health - Eastern and Southern Norway, 0484, Oslo, Norway
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Coto-Lesmes R, Fernández-Rodríguez C, González-Fernández S. Acceptance and Commitment Therapy in group format for anxiety and depression. A systematic review. J Affect Disord 2020; 263:107-120. [PMID: 31818766 DOI: 10.1016/j.jad.2019.11.154] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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: 04/04/2019] [Revised: 10/30/2019] [Accepted: 11/30/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Emotional disorders, such as anxiety and depression, are one of the main causes of disability worldwide. Recent reviews suggest that Acceptance and Commitment Therapy is effective in treating emotional disorders. However, they appraise mainly individual approaches. This review aimed to analyze published studies regarding the usefulness of Acceptance and Commitment Therapy, applied on a group basis, in the treatment of anxiety and depression. METHODS A systematic review of the literature was conducted using the Web of Science, from 2008 to 2019. Fifteen articles fulfilled the inclusion criteria. RESULTS Those patients who received interventions based on Acceptance and Commitment Therapy showed a better emotional state and greater psychological flexibility than patients in control groups without treatment. No differences are found with Cognitive Therapy and Cognitive-Behavioral Therapy. LIMITATIONS the studies reviewed show limitations, principally regarding sample characteristics, study design and manner in which mechanisms responsible for changes are evaluated. CONCLUSION Group-based Acceptance and Commitment Therapy proved to be useful in the psychological treatment of emotional disorders. However, the heterogeneity and limitations of the studies, make it impossible to determine the exact therapeutic elements, and if they are specific to the approach and procedure of this therapy. More research would be necessary to ascertain what patient and/or intervention characteristics might improve results and what the active and specific ingredients of the therapy are. This has clinical relevance because group-based interventions could be more cost-efficient, and it would help facilitate health-care decisions aimed at giving the public access to useful treatments.
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Affiliation(s)
- Rocío Coto-Lesmes
- Department of Psychology, University of Oviedo, Plaza Feijoo, Oviedo, 33003 Asturias, Spain.
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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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Xu L, Wang J. Food restriction in adolescence increases emotional disorder-like behaviors in adult rats. J Chem Neuroanat 2019; 104:101731. [PMID: 31862402 DOI: 10.1016/j.jchemneu.2019.101731] [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: 11/21/2019] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 10/25/2022]
Abstract
This study was designed to investigate the neuronal mechanism underlying the influence of early-life food restriction on the central nervous system and subsequent behaviors in adult rats. Several behavioral paradigms were tested in rats, including sucrose negative contrast test, forced swimming test (FST) and elevated plus maze test (EPM). in vivo intracellular electrophysiological recordings were conducted in the lateral nucleus of the amygdala (LAT). Finally, the levels of neuropeptide Y (NPY) were examined using immunohistochemistry. Food restriction during adolescence reduced sucrose preference in adult rats. Adolescent food restriction increased total immobile time in the FST and reduced the latency in rats to the first bout of immobility. In the EPM test, rats that experienced food restriction in adolescence and tested four weeks later spent less time than unrestricted controls in the open arm. In addition, chronic food restriction in adolescence increased in vivo LAT neuronal excitability in adulthood. Finally, NPY immunoreactivity in the LAT was reduced in rats that experienced chronic food restriction in adolescence compared to controls. Our results suggest that food restriction in adolescence increases emotional disorder-like behaviors in adult life, in which NPY production regulates the LAT-dependent behaviors and may underly the vulnerability to emotional disorders.
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Affiliation(s)
- Li Xu
- Department of Electrophysiological Examination, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, China
| | - Jinfeng Wang
- Department of Electrophysiological Examination, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, China.
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Snorrason I, Beard C, Christensen K, Bjornsson AS, Björgvinsson T. Body dysmorphic disorder and major depressive episode have comorbidity-independent associations with suicidality in an acute psychiatric setting. J Affect Disord 2019; 259:266-70. [PMID: 31450136 DOI: 10.1016/j.jad.2019.08.059] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/08/2019] [Accepted: 08/18/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study sought to examine whether mood, anxiety, and obsessive-compulsive spectrum disorders have unique (comorbidity-independent) associations with suicidal thoughts and behaviors in an acute psychiatric population. METHODS Patients (N = 498) were evaluated during admission to a partial hospital. Semi-structured interviews were used to assess current psychiatric diagnoses and past-month suicidal ideation and suicidal behaviors (e.g., suicide attempts). RESULTS After adjusting for age, gender and other psychiatric disorders, body dysmorphic disorder (BDD) had a significant association with suicidal ideation (odds ratio [OR] = 6.62; 95% CI, 1.92-22.79) and suicidal behaviors (OR = 2.45; 95% CI, 1.05-5.71). Similarly, major depressive episode was associated with suicidal ideation (OR = 3.00; 95% CI, 1.95-4.63) and suicidal behaviors (OR = 2.11; 95% CI, 1.12-3.98). When unipolar and bipolar depression were analyzed separately, unipolar depression was associated with suicidal ideation (OR = 1.82; 95% CI, 1.20-2.74), but not suicidal behaviors, whereas, bipolar depression was associated with suicidal ideation (OR = 2.71; 95% CI, 1.36-5.40) and marginally with suicidal behaviors (OR = 2.02; 95% CI, 0.99-4.13). Anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder were unrelated to suicidality in this sample after controlling for comorbid disorders. LIMITATIONS Cross-sectional design and a relatively small sample for analyses of low base-rate conditions. CONCLUSIONS Major depressive episode and BDD are unique markers of suicidality in an acute psychiatric setting. BDD is a common but often underdiagnosed condition, and clinicians should be aware of high rates of suicidality among these patients.
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Mohajerin B, Bakhtiyar M, Olesnycky OS, Dolatshahi B, Motabi F. Application of a transdiagnostic treatment for emotional disorders to body dysmorphic disorder: A randomized controlled trial. J Affect Disord 2019; 245:637-644. [PMID: 30445389 DOI: 10.1016/j.jad.2018.11.058] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 06/29/2018] [Revised: 09/14/2018] [Accepted: 11/03/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a common disorder which is associated with a high rate of comorbidity and functional impairment. Although research shows that cognitive-behavioral therapy can be an efficacious treatment for BDD, there is growing evidence that dysregulated emotion is a core deficit. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is a transdiagnostic, emotion focused cognitive-behavioral therapy protocol that has been developed to target emotion regulation processes that play an important role in the development and maintenance of many emotional disorders METHODS: : In the present study, 128 patients meeting criteria for BDD were randomized to either the UP (n = 64) or waitlist/treatment-as-usual (WL/TAU) condition. Diagnoses were determined using semi-structural interviews and patients also completed the Brown Assessment of Beliefs Scale (BABS), the Appearance Anxiety Inventory (AAI), the Difficulties in Emotion Regulation Scale (DERS), the Beck Depression Inventory (BDI) and the Clinical Global Impression (CGI). RESULTS Repeated measure ANOVA indicated that the UP significantly decreased depression, BDD symptoms and body-related anxiety, as well as significantly improving emotional regulation all with large effect sizes compared to the TAU/WL condition. Treatment gains as well as remission of comorbid conditions were maintained at the three-month follow-up. LIMITATIONS Our study limitations include restricted follow-up periods and excluding participants who were actively suicidal. CONCLUSIONS To our knowledge, this is the first examination of the UP for BDD, and results suggest that this disorder shares common mechanisms with other disorders of emotion, and that the UP may be an additional efficacious treatment for this condition.
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Affiliation(s)
- Banafsheh Mohajerin
- Department of Clinical Psychology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Bakhtiyar
- Department of Clinical Psychology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Olenka S Olesnycky
- Center for Anxiety and Related Disorders, Boston University, Massachusetts, USA
| | - Behrouz Dolatshahi
- Department of Psychology, Iranian Research Center for Substance Abuse and Dependence, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fereshteh Motabi
- Family Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Eckhardt S, Martell C, Duncombe Lowe K, Le Grange D, Ehrenreich-May J. An ARFID case report combining family-based treatment with the unified protocol for Transdiagnostic treatment of emotional disorders in children. J Eat Disord 2019; 7:34. [PMID: 31666952 DOI: 10.1186/s40337-019-0267-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/02/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This case report discusses the presentation and treatment of a nine-year-old female with a history of significant weight loss and food refusal using a combined approach of Family-Based Treatment (FBT) and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C). CASE PRESENTATION The patient was diagnosed with avoidant/restrictive food intake disorder (ARFID), separation anxiety disorder, and a specific phobia of choking, and subsequently treated with a modified version of FBT, in conjunction with the UP-C. At the end of treatment, improvements were seen in the patient's weight and willingness to eat a full range of foods. Decreases in anxiety regarding eating/choking, fears of food being contaminated with gluten, and fears of eating while being away from parents were also observed. CONCLUSIONS These findings highlight promising results from this combined treatment approach, referred to as FBT + UP for ARFID. Further research is needed to evaluate the use of this treatment in patients presenting with a variety of ARFID symptoms.
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Steele SJ, Farchione TJ, Cassiello-Robbins C, Ametaj A, Sbi S, Sauer-Zavala S, Barlow DH. Efficacy of the Unified Protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. J Psychiatr Res 2018; 104:211-216. [PMID: 30103069 PMCID: PMC6219859 DOI: 10.1016/j.jpsychires.2018.08.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/25/2018] [Accepted: 08/02/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study aimed to examine whether the Unified Protocol (UP), a transdiagnostic cognitive-behavioral therapy for emotional disorders (i.e., anxiety, mood, and related disorders), is efficacious in the treatment of co-occurring emotional disorders compared to established single disorder protocols (SDPs) that target specific disorders (e.g., panic disorder). METHOD Participants included 179 adults seeking outpatient psychotherapy. Participant age ranged from 18 to 66 years, with an average of 30.66 years (SD = 10.77). The sample was 55% female and mostly Caucasian (83%). Diagnostic assessments were completed with the Anxiety Disorder Interview Schedule (ADIS), and disorder-specific, clinician-rated measures for the comorbid diagnoses of interest. RESULTS In both treatment conditions, participants' mean number of diagnoses dropped significantly from baseline to posttreatment, and baseline to 12-month follow-up. Additionally, large effects were observed for changes in comorbid generalized anxiety (ESSG: UP = -1.72; SDP = -1.98), social anxiety (ESSG: UP = -1.33, -0.86; SDP = -1.60, -1.54), and depression (ESSG: UP = -0.83; SDP = -0.84). Significant differences were not observed in between-group comparisons. CONCLUSIONS Results suggest that both the UP and SDPs are efficacious in reducing symptoms of comorbid emotional disorders. The clinical, practical, and cost-effective advantages of transdiagnostic CBT are discussed.
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Affiliation(s)
- Stephanie Jarvi Steele
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA.
| | - Todd J Farchione
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA.
| | - Clair Cassiello-Robbins
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA.
| | - Amantia Ametaj
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA.
| | - Sophia Sbi
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA.
| | - Shannon Sauer-Zavala
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA.
| | - David H Barlow
- Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, 6th Floor, Boston, MA, 02215, USA.
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Cano-Vindel A, Muñoz-Navarro R, Medrano LA, Ruiz-Rodríguez P, González-Blanch C, Gómez-Castillo MD, Capafons A, Chacón F, Santolaya F; PsicAP Research Group. A computerized version of the Patient Health Questionnaire-4 as an ultra-brief screening tool to detect emotional disorders in primary care. J Affect Disord 2018; 234:247-55. [PMID: 29549826 DOI: 10.1016/j.jad.2018.01.030] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/19/2017] [Accepted: 01/28/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report consisting of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). The aim of the present study is to determine the psychometric properties of a computerized version of the PHQ-4 used to detect emotional disorders (anxiety and depression) in the primary care setting. METHOD A total of 1052 patients with suspected anxiety, depression, or somatic symptoms were recruited from 28 primary care centres participating in the PsicAP trial and completed the full version of the computerized PHQ. In addition, 178 of these patients also underwent in clinical interviews as a gold standard. RESULTS Confirmatory factor analyses showed very good fit indices for a two-factor solution. This model was structurally invariant among the various age and gender groups and internal consistency was acceptable (PHQ-4; α = .83, PHQ-2; α = .86, and GAD-2; α = .76). The best cut-off points to obtain high sensitivity values was 3, on both the PHQ-2 (major depressive disorder) and the GAD-2 (generalized anxiety disorder). The criterion validity (sensitivity and specificity) for the PHQ-2 were .90 and .61 and for the GAD-2, .88 and 0.61. LIMITATIONS The study was not designed as a prevalence study. Therefore, does not contain information on patients whose general practitioners do not consider them to suffer emotional disorders. CONCLUSION This is the first study to provide evidence for the reliability and validity of a computerized version of the PHQ-4. This computerized tool can be used to detect depression and anxiety in a primary care setting.
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Abstract
BACKGROUND In psychotherapy research unified, transdiagnostic and modular treatments have emerged. This is true for both cognitive-behavioral therapy and psychodynamic therapy. Recently, two unified psychodynamic protocols were presented, one for anxiety disorders, another for depressive disorders. Integrating the treatment principles for these two highly prevalent disorder groups into one protocol for "emotional disorders" may be useful for both clinical practice and training in psychotherapy. METHODS After updating the evidence for psychodynamic therapy in anxiety and depressive disorders in terms of randomized controlled trials (RCTs) by a systematic search, the treatment elements applied in those RCTs providing evidence for the efficacy of psychodynamic therapy in depressive or anxiety disorders were reviewed and compared. RESULTS Twenty-seven RCTs for anxiety or depressive disorders were identified. A review revealed a high overlap between the principles used for the psychodynamic treatment of anxiety and depressive disorders, reflecting the transdiagnostic nature of psychodynamic therapy. The overlap suggested to integrate the identified treatment principles into one unified psychodynamic protocol for "emotional disorders" (UPP-EMO). As a result, seven treatment principles or modules were distilled which can be flexibly applied depending on the patient´s symptoms and needs. In addition, a separate module addresses diagnostic assessment. Across modules, a focus on resources has been included. LIMITATIONS Despite being based on RCTs, UPP-EMO has not yet been examined in an RCT - which is planned as a next step. CONCLUSIONS As psychodynamic therapy is transdiagnostic in origin focusing on core underlying processes of mental disorders, acceptability of UPP-EMO among psychodynamic psychotherapists is likely to be high.
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Affiliation(s)
- Falk Leichsenring
- Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Germany.
| | - Christiane Steinert
- Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Germany; MSB Medical School Berlin, Department of Psychology, Germany
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Osma J, Suso-Ribera C, García-Palacios A, Crespo-Delgado E, Robert-Flor C, Sánchez-Guerrero A, Ferreres-Galan V, Pérez-Ayerra L, Malea-Fernández A, Torres-Alfosea MÁ. Efficacy of the unified protocol for the treatment of emotional disorders in the Spanish public mental health system using a group format: study protocol for a multicenter, randomized, non-inferiority controlled trial. Health Qual Life Outcomes 2018. [PMID: 29530035 PMCID: PMC5848595 DOI: 10.1186/s12955-018-0866-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Emotional disorders, which include both anxiety and depressive disorders, are the most prevalent psychological disorders according to recent epidemiological studies. Consequently, public costs associated with their treatment have become a matter of concern for public health systems, which face long waiting lists. Because of their high prevalence in the population, finding an effective treatment for emotional disorders has become a key goal of today’s clinical psychology. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders might serve the aforementioned purpose, as it can be applied to a variety of disorders simultaneously and it can be easily performed in a group format. Methods The study is a multicenter, randomized, non-inferiority controlled clinical trial. Participants will be 220 individuals with emotional disorders, who are randomized to either a treatment as usual (individual cognitive behavioral therapy) or to a Unified Protocol condition in group format. Depression, anxiety, and diagnostic criteria are the primary outcome measures. Secondary measures include the assessment of positive and negative affect, anxiety control, personality traits, overall adjustment, and quality of life. An analysis of treatment satisfaction is also conducted. Assessment points include baseline, post-treatment, and three follow-ups at 3, 6, and 12 months. To control for missing data and possible biases, intention-to-treat and per-protocol analyses will be performed. Discussion This is the first randomized, controlled clinical trial to test the effectiveness of a transdiagnostic intervention in a group format for the treatment of emotional disorders in public settings in Spain. Results obtained from this study may have important clinical, social, and economic implications for public mental health settings in Spain. Trial registration Retrospectively registered at https://clinicaltrials.gov/. Trial NCT03064477 (March 10, 2017). The trial is active and recruitment is ongoing. Recruitment is expected to finish by January 2020.
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Affiliation(s)
- Jorge Osma
- University of Zaragoza, Teruel, Spain. .,Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain. .,Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, C/ Ciudad Escolar s/n, 44003, Teruel, Spain.
| | - Carlos Suso-Ribera
- Universitat Jaume I. Edificio de Investigación II, Av. Vicente SosBaynat s/n, 12006, Castellón, Spain
| | - Azucena García-Palacios
- CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Instituto de Salud Carlos III, Castellón, Spain
| | - Elena Crespo-Delgado
- Universitat Jaume I. Edificio de Investigación II, Av. Vicente SosBaynat s/n, 12006, Castellón, Spain
| | - Cristina Robert-Flor
- Unidad de Salud Mental La Fuente de San Luís, C/ Arabista Ambrosio Huici, 30, 46013, Valencia, Spain
| | - Ana Sánchez-Guerrero
- Unidad de Salud Mental La Fuente de San Luís, C/ Arabista Ambrosio Huici, 30, 46013, Valencia, Spain
| | - Vanesa Ferreres-Galan
- Hospital Comarcal de Vinaròs, Avinguda Gil d'Atrosillo, s/n, 12500, Castellón, Spain
| | - Luisa Pérez-Ayerra
- Centro de Salud Mental La Milagrosa, C/ Julián Gayarre, 1A, 31005, Pamplona, Spain
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Trojano L, Papagno C. Cognitive and behavioral disorders in Parkinson's disease: an update. II: behavioral disorders. Neurol Sci 2017; 39:53-61. [PMID: 29038946 DOI: 10.1007/s10072-017-3155-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
Patients with Parkinson's disease (PD) can experience several behavioral symptoms, such as apathy, agitation, hypersexuality, stereotypic movements, pathological gambling, abuse of antiparkinsonian drugs, and REM sleep behavioral disorders. Psychoses and hallucinations, depression and anxiety disorders, and difficulties in recognizing and experiencing emotions also impair behavior and can cause severe psychosocial problems in patients with PD. Symptoms can be present since early stages of the disease, sometimes even before the appearance of classical motor symptoms, likely in relation to dopamine depletion in basal ganglia and/or to dysfunctions of other neurotrasmitter systems, and others can develop later, in some cases in relation to dopaminergic treatment. In this paper, we review recent literature, with particular attention to the last 5 years, on the main behavioral and emotional disturbances described in PD patients as well as the hypothesized neurofunctional substrate of such impairments. Finally, we provide some suggestions on the most suitable instruments to check and assess PD-associated behavioral defects over time.
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Affiliation(s)
- Luigi Trojano
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Viale Ellittico 31, 81100, Caserta, Italy.
- ICS Maugeri, IRCCS, Telese Terme, Italy.
| | - Costanza Papagno
- CIMeC, University of Trento, Trento, Italy.
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo 1, 02100, Milan, Italy.
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