Applying the unified protocol to a single case of major depression with schizoid and depressive personality traits

Background: The study presents the use of the Unified Protocol (UP) in a case of a male diagnosed with major depressive disorder and schizoid and depressive personality traits. The therapeutic focus of UP is to identify maladaptive behaviors of emotion regulation and to train new regulation strategies such as cognitive re-appraisal or emotional exposure exercises. Method: This is a single-case research study. The intervention was carried out in twenty 1-hour sessions for 6 months. After treatment completion, follow-ups were conducted at three, six, and twelve months. Results: The results of the 12-month follow-up revealed a clinically significant change in depressive symptomatology (RCIBDI-II = -5.51), negative affect (RCINEGATIVE (PANAS) 3.61), quality of life (RCIICV-Sp = 4.61) and schizoid (RCIMCMI-III-Schizoid = -4.36) and depressive (RCIMCMI-III-Depressive = -5.24) personality traits. Schizoid and depressive personality traits did not interfere with the application, course, and compliance with treatment. These results are discussed with regard to similar studies, also based on the use of the UP to work on emotion regulation in the treatment of emotional disorders with clinical comorbidity. Conclusions: The training of emotion regulation strategies through UP could be an effective proposal to treat emotional disorders with pathological personality traits comorbidity

Influence of vulnerability factors in panic disorder severity

Background: We studied herein the predictive value for panic severity of three well-based vulnerability factors: personality traits (neuroticism and extraversion; NEO-PI-R), anxiety sensitivity (ASI), and perceived control (ACQ-R). Method: The sample was composed of 52 participants diagnosed with panic disorder, with or without agoraphobia, according to DSM-IV-TR criteria. Results: Our results revealed that the anxiety facet is a better predictor of panic severity than neuroticism. Anxiety sensitivity increases the predictive value for panic severity and, finally, perception of control of emotions is the only perception control subscale that increases the predictive value for panic severity more than the anxiety facet and anxiety sensitivity. Conclusions: This finding supports the assumption of the importance of taking into account the assessment of the lower order dimensions of the vulnerability factors in the field of psychopathology studies. Furthermore, the predictive value of perception of control of emotions indicates the importance of this specific vulnerability factor in the etiology of panic disorder (with or without agoraphobia) and, thus, shows the necessity to include emotion regulation strategies in the psychological treatments

Emotion dysregulation and neuroticism as moderators of group Unified Protocol effectiveness outcomes for treating emotional disorders

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 ED

Validity evidence of the multidimensional emotional disorders inventory among non-clinical spanish university students

The current diagnostic systems for mental health disorders are categorical, which, it has been argued, poorly reflect the reality of mental health problems. This is especially relevant in emotional disorders (EDs), especially due to the existing comorbidity between supposedly different disorders. To address this, Brown and Barlow developed a hybrid dimensional−categorical approach to EDs that can be evaluated with the Multidimensional Emotional Disorder Inventory (MEDI), a transdiagnostic self-report questionnaire. This study aims to adapt and explore the sources of validity evidence of the MEDI in a non-clinical sample of Spanish university students (n = 455). Two confirmatory analyses were performed: one with a four-dimensional structure obtained with an exploratory analysis and another with the original nine-dimensional structure of the MEDI. The latter obtained a better fit. The descriptive data, including percentiles, T-scores, and sex differences in total scores are also provided, together with sources of validity evidence. These revealed significant moderate interrelations between factors and with related measures (e.g., personality, depression, and anxiety). This study adapted the MEDI for use in Spanish, provides further support about its factor structure, and offers novel data about its validity sources. The MEDI makes the evaluation of dimensional and transdiagnostic models easier, which might be fundamental in present and future research and clinical practice

Arteriovenous malformations of the lung: diagnosis by thin-section HRCT and Cine-MRI

We report a case in which a solitary large and multiple group of small pulmonary arteriovenous malformations were demonstrated by computed tomography and magnetic resonance images that could aid diagnosis and therapeutic planning without the need for catheter angiography

Diagnosing rotator cuff tears (clinical tests and imaging). Current concepts review

Hay dificultad en lograr un adecuado diagnóstico clínico en la patología subacromial y del manguito de los rotadores, y es importante reconocer estas razones: el patrón de dolor en el hombro no es específico de ninguna enfermedad; los problemas del manguito de los rotadores presentan diferentes formas de presentación y de patología, y rara vez se encuentran de forma aislada; las pruebas clínicas descritas inicialmente para una patología específica del hombro son positivas para determinar una gran variedad de trastornos, sin lograr diferenciarlos, y algunas alteraciones anatómicas no son sintomáticas y no necesitan ningún tratamiento. La realización e interpretación de una adecuada exploración física más la utilización de las ayudas imagenológicas pertinentes permitirán la orientación adecuada en la patología del manguito de los rotadores para decidir la mejor opción médico-quirúrgica para nuestros pacientes. Nivel de evidencia clínica: Nivel IV.It is difficult to achieve an appropriate clinical diagnosis in subacromial pathology that involve the rotator cuff. It is important to recognize the following reasons: the pattern of shoulder pain is not specific to any disease; rotator cuff problems have different presentations and pathologies, rarely found isolated;the initially described clinicaltests for a specific shoulderpathology are a positive way to determine a variety of disorders, without differentiating them, and some anatomical alterations may not be symptomatic and need no treatment. The performance and interpretation of an adequate physical examination plus the use of relevant imaging aids will allow to properly approach and assess the rotator cuff pathology in order to decide the best medical-surgical option for any patient. Evidence level: IV

Psychometric properties and validation of the Spanish versions of the overall anxiety and depression severity and impairment scales

Background: Anxiety and depressive disorders are the most frequent disorders for which patients seek care in public health settings in Spain. This study aimed at validating the Overall Anxiety Severity and Impairment Scale (OASIS) and the Overall Depression Severity and Impairment Scale (ODSIS), which are brief screening scales for anxiety and depression consisting of only five items each. Methods: The study was conducted in a Spanish clinical sample receiving outpatient mental health treatment (N = 339). A subsample of participants (n = 219) was assessed before and after receiving a course of cognitive-behavioral treatment. Results: The results revealed excellent internal consistency estimates (Cronbach's alpha for the OASIS and the ODSIS was 0.87 and 0.94, respectively), along with promising convergent and discriminant validity and test-criterion relationships (i.e., moderate correlation with other measures of depression and anxiety, as well as with neuroticism, quality of life, adjustment, and negative affect). A one-dimensional structure was obtained for the OASIS and the ODSIS. The ROC analyses indicated an area under the curve of 0.83 for the OASIS and the ODSIS when predicting moderate-to-severe anxiety and depression, respectively. Good sensitivity to therapeutic change was also evidence and the analysis of the sensitivity as a function of 1-specificity area suggested a cutoff value of 10 for both scales. Limitations: Inter-rater reliability of diagnoses with the ADIS-IV interview could not be investigated and the results obtained may not be generalizable to other samples and health settings. Conclusions: The availability of these two short and psychometrically sound measures should make screening of anxiety and depressive symptoms in routine care more feasible

Multidimensional emotional disorders inventory: Reliability and validity in a Spanish clinical sample

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

Self-energy of image states on copper surfaces

We report extensive calculations of the imaginary part of the electron self-energy in the vicinity of the (100) and (111) surfaces of Cu. The quasiparticle self-energy is computed by going beyond a free-electron description of the metal surface, either within the GW approximation of many-body theory or with inclusion, within the GW$\Gamma$ approximation, of short-range exchange-correlation effects. Calculations of the decay rate of the first three image states on Cu(100) and the first image state on Cu(111) are also reported, and the impact of both band structure and many-body effects on the electron relaxation process is discussed.Comment: 8 pages, 5 figures, to appear in Phys. Rev.

Magnetite Nanoparticles Functionalized with RNases against Intracellular Infection of Pseudomonas aeruginosa

Altres ajuts: Fundació La Marató de TV3/20180310Current treatments against bacterial infections have severe limitations, mainly due to the emergence of resistance to conventional antibiotics. In the specific case of Pseudomonas aeruginosa strains, they have shown a number of resistance mechanisms to counter most antibiotics. Human secretory RNases from the RNase A superfamily are proteins involved in a wide variety of biological functions, including antimicrobial activity. The objective of this work was to explore the intracellular antimicrobial action of an RNase 3/1 hybrid protein that combines RNase 1 high catalytic and RNase 3 bactericidal activities. To achieve this, we immobilized the RNase 3/1 hybrid on Polyetheramine (PEA)-modified magnetite nanoparticles (MNPs). The obtained nanobioconjugates were tested in macrophage-derived THP-1 cells infected with Pseudomonas aeruginosa PAO1. The obtained results show high antimicrobial activity of the functionalized hybrid protein (MNP-RNase 3/1) against the intracellular growth of P. aeruginosa of the functionalized hybrid protein. Moreover, the immobilization of RNase 3/1 enhances its antimicrobial and cell-penetrating activities without generating any significant cell damage. Considering the observed antibacterial activity, the immobilization of the RNase A superfamily and derived proteins represents an innovative approach for the development of new strategies using nanoparticles to deliver antimicrobials that counteract P. aeruginosa intracellular infection