Uso de las tecnologías de la información y la comunicación en psicología clínica

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Análisis bibliométrico de las revistas relacionadas con psicología de la salud editadas en castellano

En este trabajo se realiza un análisis bibliométrico de cuatro revistas relacionadas de manera directa con la Psicología de la Salud y la Salud Mental editadas en castellano (Revista Internacional de Psicología Clínica y de la Salud / International Journal of Clinical and Health Psychology, Clínica y Salud, Salud Mental, y Psicología y Salud), en los años 2001 y 2002. En estas revistas se analiza el número de artículos publicados en el periodo de años seleccionado, la nacionalidad de los autores de los artículos, el número de autores que participan en cada uno de los trabajos y el área a la que pertenecen los contenidos de los mismos según la clasificación realizada por los autores en función del tipo de artículos analizados; dicha clasificación incluye: Salud Mental, donde se clasificaron los artículos referentes a las intervenciones psiquiátricas o psicológicas relacionadas con los procesos mentales, su atención, prevención y promoción; Salud Física, en esta área se clasificaron los artículos relacionados con intervenciones psiquiátricas y psicológicas sobre alteraciones físicas; Neurociencias: dentro de esta categoría se clasificaron los artículos relacionados con la neuropsicología, la psiquiatría experimental, neuro y psicofisiología, farmacología y áreas afines con los procesos básicos de funcionamiento cerebral. Por último, se plateó una categoría denominada Inter-área para dar cabida a aquellos trabajos que por sus características no podían considerarse como propios o específicos de una única área del conocimiento. Los datos encontrados tras el análisis, reflejan que existen diferencias entre las revistas en cuanto al número de artículos que se publican en las mismas, de manera que destaca la revista Salud Mental con un total de 85 artículos publicados en estos dos años. Este dato hace pensar que aunque podría esperarse que a mayor número de ediciones anuales mayor número de artículos, esto no ocurre así necesariamente y responde entonces a otras características e intereses de las diferentes revistas.A bibliometric analysis is achieved in the present work. Moreover, it is made on the basis of four journals which are directly related to Health Psychology and Mental Health published in Spanish (Revista Internacional de Psicología Clínica y de la Salud / International Journal of Clinical and Health Psychology, Clínica y Salud, Salud Mental, y Psicología y Salud) during 2001-2002. Several factors have been taken into account when dealing with the detailed study of these journals. In these journals, first of all, it has been analysed, the number of articles which have been published in the selected and previously specified period of time; secondly, the nationality of the authors who have written the different articles, and after, the number of authors who have taken part in each of the works and the area to which their contents belong according to the classification achieved by the authors and bearing in mind the type of examined articles. Different sections are included under this classification; so, it’s worth mentioning Mental Health, to begin with. Under this heading should be included all those articles focused on psychiatric or psychological interventions related to the mental processes, their attention, prevention and promotion. The second place of the classification is occupied by the heading of physical Health. In this area are grouped all those written articles regarding psychiatric and psychological interventions focused on physical alterations. In the third place, and under the category of Neurosciences, have been classified the articles focussed on the neuropsychology, experimental psychiatry, neuro and psychophysiology, prescribed drugs and all those areas concerned with the basic processes of the functioning of the brain. Finally, another category was added up. It was the so-called Inter-Area that included all those works that due to their characteristics, could not be considered as proper or specific of a single area of knowledge. Information obtained after the analysis, reflects the fact that there are substantial differences between the journals, in regard to the number of articles being published. In such a way, it is worth mentioning the detached journals of Salud Mental with a total of 85 articles published in these two years. We are lead to think that a having a larger number of annual editions implies to publish a larger number of written articles, though this is not necessarily the case. It is, rather, a consequence of other priorities and characteristics pertaining to different journals

Effectiveness of a projection-based augmented reality exposure system in treating cockroach phobia: study protocol of a randomised controlled trial

Background: Despite being the treatment of choice for phobic disorders, in vivo exposure treatment (IVET) presents some important limitations related mainly to low acceptance and high drop-out rates. Augmented reality (AR) technologies can help to overcome these limitations. Evidence supports the use of AR in exposure treatment for small animal phobia. A new projection-based AR exposure treatment system (P-ARET) that offers the possibility of projecting the animals in a natural and non-intrusive environment has been developed. There are no randomised controlled trials (RCTs) available that have tested the efficacy of this system in cockroach phobia. This paper aims to present the protocol of an RCT that evaluates the efficacy of the P-ARET, versus an IVET group and a waiting list control group (WL), in carrying out exposure treatment for cockroach phobia. Methods/design: Participants will be randomly allocated to one of three conditions: (1) P-ARET, (2) IVET and (3) WL. Both treatment conditions will follow the ‘one-session treatment’ guidelines. As a diagnostic measure, the Anxiety Disorders Interview Schedule for Diagnostic and Statistical Manual for Mental Health Disorders-Version 5 will be used. The Behavioral Avoidance Test will be used as the primary outcome measure. Secondary outcome measures will include an attentional biases task (measured using eye-tracking technology), the Fear of Cockroaches Questionnaire, Cockroach Phobia Beliefs Questionnaire, Fear and Avoidance Scales, Beck Depression Inventory second edition, Disgust Propensity and Sensitivity Scale-Revised-12, State-Trait Anxiety Inventory, Clinician Severity Scale, and Expectation and Satisfaction with the Treatment Scale. The evaluation protocol will include pretreatment and post-treatment evaluations and 1, 6 and 12 months of follow-ups. Intention-to-treat and per-protocol analyses will be performed. Ethics and dissemination: This study has been approved by the Ethics Committee of Universitat Jaume I (Castellón, Spain; 13 December 2019). The results of the presented RCT will be disseminated in presentations at international scientific meetings and peer-reviewed scientific journals.Funding for the study was provided by Grant Ministerio de Ciencia, Innovación y Universidades (Spain) (Programa Estatal I+D+I) (grant number: RTI2018-100993-B-100) funded by MCIN/AEI/10.13039/501100011033 and by 'ERDF A way of making Europe', by the European Union.Funding for the study was provided by Grant Ministerio de Ciencia, Innovación y Universidades (Spain) (Programa Estatal I+D+i RTI2018-100993-B-100) funded by MCIN/AEI/ 10.13039/501100011033 and by 'ERDF A way of making Europe', by the 'European Union'

Improving the efficacy of exposure therapy using projection-based augmented reality for the treatment of cockroach phobia: a randomised clinical trial protocol

Introduction: In vivo exposure is the treatment of choice for specific phobia (SP), but this technique presents limitations related to access and acceptability. Augmented reality (AR) offers advantages like maximising strategies such as ‘variability’ (varying stimuli, durations, levels of intensity or the order of the items), control by the therapist, or ‘exposure to multiple contexts’, which can produce positive effects in terms of fear renewal and generalisation of the results. The aim of this study is to test the efficacy of varying the phobic stimuli during treatment with AR: using multiple stimuli (MS) versus a single stimulus (SS) in participants with SP. Methods and analysis: Participants (N=80) with a diagnosis of an SP of cockroaches will be randomised into two conditions: (1) projection-based AR exposure therapy with MS (P-ARET MS); (2) P-ARET with an SS (P-ARET SS). The measures are related to the efficacy results (fear, avoidance and negative thoughts, performance on the behavioural avoidance test (BAT) and preferences). The primary outcome measure is the BAT, and the secondary outcome measures are the BAT through AR, Fear of Cockroaches Questionnaire, Cockroach Phobia Beliefs Questionnaire, Fear and Avoidance Scales Patient’s Improvement Scale, and Beck Depression Inventory Second Edition. Five evaluation moments will be included: preintervention, postintervention, and 1-month, 6-month, and 12-month follow-ups. The treatment will follow the guidelines of the ‘one-session treatment’. Student’s t-tests to compare the two groups on the post-test will be applied. In addition, two-way analysis of variances with repeated measures in one of the two factors (pretest, post-test and follow-ups) will be carried out to compare intragroup differences. Ethics and dissemination: The Universitat Jaume I Ethics Committee (Castellón, Spain) granted approval for the study (CD/64/2019). Dissemination will include publications and presentations at national and international conferences

How are information and communication technologies supporting routine outcome monitoring and measurement-based care in psychotherapy? A systematic review

Psychotherapy has proven to be effective for a wide range of mental health problems. However, not all patients respond to the treatment as expected (not-on-track patients). Routine outcome monitoring (ROM) and measurement-based care (MBC), which consist of monitoring patients between appointments and using this data to guide the intervention, have been shown to be particularly useful for these not-on-track patients. Traditionally, though, ROM and MBC have been challenging, due to the difficulties associated with repeated monitoring of patients and providing real-time feedback to therapists. The use of information and communication technologies (ICTs) might help reduce these challenges. Therefore, we systematically reviewed evidence regarding the use of ICTs for ROM and MBC in face-to-face psychological interventions for mental health problems. The search included published and unpublished studies indexed in the electronic databases PubMed, PsycINFO, and SCOPUS. Main search terms were variations of the terms "psychological treatment", "progress monitoring or measurement-based care", and "technology". Eighteen studies met eligibility criteria. In these, ICTs were frequently handheld technologies, such as smartphone apps, tablets, or laptops, which were involved in the whole process (assessment and feedback). Overall, the use of technology for ROM and MBC during psychological interventions was feasible and acceptable. In addition, the use of ICTs was found to be effective, particularly for not-on-track patients, which is consistent with similar non-ICT research. Given the heterogeneity of reviewed studies, more research and replication is needed to obtain robust findings with different technological solutions and to facilitate the generalization of findings to different mental health populations

Validation of a Spanish Adaptation of the Gambling Symptom Assessment Scale (G-SAS) in Persons with Recent History of Gambling

Gambling is becoming increasingly frequent and problematic, especially due to the explosion of online alternatives. Evaluating the severity of gambling symptomatology is therefore more important than ever. However, innovations in the gambling field have generally focused on its treatment rather than its evaluation. The Gambling Symptom Assessment Scale (G-SAS) is a well-established measure of gambling-related symptomatology (e.g., gambling urges, gambling-related thoughts and behaviours, and interpersonal functioning). The aim of this study is to validate a Spanish adaptation of the G-SAS so that individual differences in gambling symptomatology can be assessed by clinicians and researchers. The internal structure of the G-SAS was investigated using an exploratory factor analysis with a sample of 364 individuals from the general population in Spain (mean age=28.84 years, SD=11.73; 54% males). A four-factor structure was preferred considering fit indices (Chi-square=22.62, p=.162, RMSEA=0.030, CFI=0.998, TLI=0.995) and internal consistency estimates (0.67≤α≤0.89). The factors were labelled gambling-related symptoms, control of gambling urges/thoughts, interference, and arousal. Regarding construct validity, the four factors of the G-SAS were positively and significantly (all p<.001) correlated with measures of problematic gambling severity (0.40≤r≤.73), problematic gambling diagnostic (0.40≤r≤.67), gambling cognitions (0.48≤r≤.57), impulsivity (0.26≤r≤.42), anxiety (0.22≤r≤.38), and depression (0.16≤r≤.42), and negatively with quality of life (-0.24≤r≤-.42). In sum, this study provides Spanish clinicians and researchers with a tool that serves to assess the status of individuals in relation to gambling symptomatology, which can be used to screen for at-risk profiles and evaluate treatment response.Funding for open access charge: CRUE-Universitat Jaume

AwarNS: A framework for developing context-aware reactive mobile applications for health and mental health

In recent years, interest and investment in health and mental health smartphone apps have grown significantly. However, this growth has not been followed by an increase in quality and the incorporation of more advanced features in such applications. This can be explained by an expanding fragmentation of existing mobile platforms along with more restrictive privacy and battery consumption policies, with a consequent higher complexity of developing such smartphone applications. To help overcome these barriers, there is a need for robust, well-designed software development frameworks which are designed to be reliable, power-efficient and ethical with respect to data collection practices, and which support the sense-analyse-act paradigm typically employed in reactive mHealth applications. In this article, we present the AwarNS Framework, a context-aware modular software development framework for Android smartphones, which facilitates transparent, reliable, passive and active data sampling running in the background (sense), on-device and server-side data analysis (analyse), and context-aware just-in-time offline and online intervention capabilities (act). It is based on the principles of versatility, reliability, privacy, reusability, and testability. It offers built-in modules for capturing smartphone and associated wearable sensor data (e.g. IMU sensors, geolocation, Wi-Fi and Bluetooth scans, physical activity, battery level, heart rate), analysis modules for data transformation, selection and filtering, performing geofencing analysis and machine learning regression and classification, and act modules for persistence and various notification deliveries. We describe the framework’s design principles and architecture design, explain its capabilities and implementation, and demonstrate its use at the hand of real-life case studies implementing various mobile interventions for different mental disorders used in clinical practice

Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial

Gambling Disorder is a prevalent non-substance use disorder, which contrasts with the low number of people requesting treatment. Information and Communication Technologies (ICT) could help to enhance the dissemi- nation of evidence-based treatments and considerably reduce the costs. The current study seeks to assess the efficacy of an online psychological intervention for people suffering from gambling problems in Spain. The proposed study will be a two-arm, parallel-group, randomized controlled trial. A total of 134 participants (problem and pathological gamblers) will be randomly allocated to a waiting list control group (N = 67) or an intervention group (N = 67). The intervention program includes 8 modules, and it is based on motivational interviewing, cognitive-behavioral therapy (CBT), and extensions and innovations of CBT. It includes several complementary tools that are present throughout the entire intervention. Therapeutic support will be provided once a week through a phone call with a maximum length of 10 min. The primary outcome measure will be gambling severity and gambling-related cognitions, and secondary outcome measures will be readiness to change, and gambling self-efficacy. Other variables that will be considered are depression and anxiety symptoms, positive and negative affect, difficulties in emotion regulation strategies, impulsivity, and quality of life. In- dividuals will be assessed at baseline, post-treatment, and 3-, 6-, and 12-month follow-ups. During the treatment, participants will also respond to a daily Ecological Momentary Intervention (EMI) in order to evaluate urges to gamble, self-efficacy to cope with gambling urges, gambling urge frequency, and whether gambling behaviour occurs. The EMI includes immediate automatic feedback depending on the participant's responses. Treatment acceptance and satisfaction will also be assessed. The data will be analysed both per protocol and by Intention-to- treat. As far as we know, this is the first randomized controlled trial of an online psychological intervention for gambling disorder in Spain. It will expand our knowledge about treatments delivered via the Internet and contribute to improving treatment dissemination, reaching people suffering from this problem who otherwise would not receive help. Trial registration: Clinicaltrials.gov as NCT04074681. Registered 22 July 2019

Smiling is Fun, an online intervention for the prevention and treatment of emotional disorders

Los trastornos emocionales representan una problemática en Salud Mental que conlleva un elevado costo personal y social, por lo que diseñar herramientas para su tratamiento y prevención es uno de los desafíos actuales de la psicología clínica. El programa Sonreír es Divertido es un sistema online diseñado bajo la perspectiva transdiagnóstica y el protocolo unificado de Barlow. En este trabajo se presenta una descripción del programa y datos preliminares de su eficacia, obtenidos en un estudio piloto llevado a cabo en España. El programa se muestra capaz de disminuir la sintomatología depresiva y ansiosa, así como de mejorar el afecto positivo y negativo de los participantes. Estos datos preliminares nos muestran el potencial de este tipo de intervenciones que se encuentran con gran desarrollo en muchos de países de Europa, en Norteamérica y Australia. Sonreír es Divertido es el primer programa en español que posee datos de eficacia. En Latinoamérica hay muy pocos trabajos publicados con estas características, pero ya hay investigadores que están trabajando en la región, por lo tanto se espera que los desarrollos bajo esta línea de investigación crezcan en los próximos años. Emotional disorders represent a Mental Health problem that carries a high personal and social cost. Designing tools for treatment and prevention is one of the current challenges of clinical psychology. The program Smiling is Fun is an online system designed taking in account the transdiagnostic perspective and based on the Unified Protocol of Barlow. This paper presents a description of the program and preliminary data of its effectiveness obtained in a pilot study conducted in Spain. The program is shown able to decrease depressive and anxiety symptoms, as well as to improve the positive and negative affect of the participants. This preliminary data shows the potential of this type of interventions that are being developed in many countries around Europe, in North America, and Australia. Smiling is Fun is the first program in Spanish that has efficacy data already being published. In Latin America there are very few published papers with these features, but there are already some researchers who are working in this region, therefore it is expected that developments under this line of research will grow up in the coming years.

Revisión de aplicaciones de las tecnologías de la información y la comunicación en psicología clínica y de la salud en infancia y adolescencia

Las tecnologías de la información y la comunicación (TICs) han supuesto un cambio radical en una diversidad de disciplinas, entre ellas está la Psicología Clínica y de la Salud. En la infancia y adolescencia la interacción con las TICs es frecuente y habitual y se ve facilitada porque son nativos digitales que se identifican de forma natural con los avances tecnológicos. La última década ha supuesto una clara revolución respecto a la utilización de diferentes tecnologías para la aplicación de tratamientos psicológicos y la promoción de la salud, de manera que se facilite y mejore el aprendizaje de una diversidad de competencias emocionales y conductas saludables en estas poblaciones que están en continuo proceso de desarrollo y cambio. La orientación cognitivo-comportamental y los tratamientos psicológicos basados en la evidencia han sido transferidos con éxito a las TICs y existen numerosos estudios que lo ponen de manifiesto. El presente artículo aborda una revisión de las principales aplicaciones basadas en TICs para el tratamiento de diferentes trastornos psicológicos en la infancia y adolescencia, así como en otras áreas destacadas de la salud en estas edades. Se analizan las implicaciones que esto puede tener y, además, se plantean retos futuros para optimizar estos recursos y abrir nuevas líneas de investigación relevantes para esta temática