Autolesión no suicida en adultos jóvenes con y sin trastorno límite de la personalidad: el papel de la desregulación emocional y la urgencia negativa

Non-suicidal self-injury (NSSI) is defined as self-inflicted pain, and it is used as a mechanism to alleviate psychological distress. Although NSSI is prevalent in Borderline Personality Disorder (BPD), it is also an increasing concern among college student populations. While emotion dysregulation and negative urgency are associated with NSSI, little is known about which dimensions specifically predict the motivations (NSSI-functions) and frequency of self-harm. The current study explored the relationship between emotion dysregulation, negative urgency, and NSSI in 86 young adults, divided into three groups: college students with NSSI, BPD patients with NSSI, and a healthy control group without NSSI. We conducted multiple regression analyses to predicted NSSI-functions and NSSI-frequency. Non-acceptance of emotions, a specific dimension of emotion dysregulation, uniquely predicted intrapersonal NSSI-functions (e.g., regulating distressing emotions), but not interpersonal NSSI-functions (e.g., communicating distress). Lastly, poor emotion regulation strategies predicted NSSI-frequency only in individuals with high negative urgency, that is, individuals who tend to act impulsively when experiencing negative emotions, but not in those with low negative urgency. Findings shed light on the underlying motivations for engaging in self-injury, and they reveal facets of emotion dysregulation relevant for NSSI treatment.La Autolesión No Suicida (ANS) se define como un dolor auto-infligido que se utiliza como un mecanismo para aliviar la angustia psicológica. Aunque ANS es común en el trastorno límite de la personalidad (TLP), también es un problema creciente en estudiantes universitarios. Si bien la desregulación emocional y la urgencia negativa están asociadas con ANS, poco se sabe sobre las dimensiones específicas que predicen la motivación (funciones) y la frecuencia de las autolesiones. Se exploró la relación entre la desregulación emocional, la urgencia negativa, y ANS en 86 adultos jóvenes, divididos en tres grupos: estudiantes universitarios con ANS, pacientes TLP con ANS y un grupo de control sano sin ANS. Realizamos análisis de regresión múltiple para predecir las funciones y frecuencia de ANS. La no aceptación de las emociones, una dimensión especifica de la desregulación emocional, predijo de manera única las funciones intrapersonales de ANS, pero no las funciones interpersonales. Por último, la falta de estrategias de regulación emocional predijo la frecuencia de ANS solo en individuos con una alta urgencia negativa, es decir, individuos que tienden a actuar impulsivamente cuando experimentan emociones negativas, pero no en aquellos con una baja urgencia negativa. Los hallazgos resaltan las motivaciones subyacentes a la autolesión y revelan facetas de la desregulación emocional relevantes para el tratamiento de ANS

Online psychological interventions to improve symptoms in multiple sclerosis : A systematic review

The aim of this systematic review was to assess the effectiveness of Internet-based psychological interventions in the treatment of physical, socio-affective and cognitive symptoms and quality of life (QoL) in people with multiple sclerosis (pwMS) to provide currently available evidence. Systematic searches for eligible studies were carried out in four databases (August 2021) using key words. Studies were screened, data extracted, quality appraised and analysed by three independent reviewers, using predefined criteria and following the PRISMA rules. Study quality was assessed using Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields QUALSYST tool. Physical, socio-affective and cognitive symptoms and QoL were the primary outcomes. Thirteen studies were included. Two principal approaches were reported: Cognitive behavioural therapy (CBT) and mindfulness-based interventions (MBI). Interventions varied from tailored versions to videoconference by a clinician, duration mean 8 weeks, delivered via individually and groups, all online. The review found that iCBT interventions were effective for improve depression, anxiety, fatigue and QoL, and slightly in cognitive functioning in pwMS, whereas MBI interventions reported benefits in depression, anxiety, stress and QoL, and less evidence in fatigue. Generally, study quality was acceptable in most studies; eleven of the studies scored a low risk of bias on all items in the Qualsyst Tool, whereas only two studies were considered unacceptable. Psychological online interventions may improve physical, socio-affective and cognitive symptoms as well as QoL in pwMS, overcoming the face-to-face barriers (i.e. disability). Contact with the therapist and groups sessions have been identified as enablers of the online interventions. Nevertheless, the limited number of studies and the heterogeneity of health outcomes reported made difficult to afford robust conclusions on psychological intervention effects in pwMS

Borderline personality traits mediate the relationship between low perceived social support and non-suicidal self-injury in a clinical sample of adolescents

Altres ajuts: Acord transformatiu CRUE-CSICNon-suicidal self-injury (NSSI) is a serious public health concern among adolescents, especially in clinical settings. Social support plays a critical role in the onset and maintenance of NSSI in adolescence. NSSI is closely associated with borderline personality disorder (BPD), yet no previous work has analyzed the mediating role of borderline traits in the relationship between perceived social support (PSS) and NSSI. This study aimed to address this gap

PsychoMSS Study: Stress and Psychosocial Factors in Multiple Sclerosis

The stress effect on Multiple Sclerosis (MS) has yielded disparate results. One reason may be the heterogeneity in the stress measure and the presence of potential moderators/mediators. Aims: to analyse the stress effect on MS under a transactional approach and to elucidate the role of coping, social support, anxiety, alexithymia and early-life stress in this relationship. Methods: the study consisted in three phases: a systematic review, a case-control study (n= 82), and a longitudinal one year follow-up study (n=26). Linear and Multiple Hierarchical models were conducted. Results: people with MS (pwMS) showed more passive coping, less perceived social support and greater anxiety and alexithymia. The bidirectional hypothesis was confirmed with self-reported stress and functionality. Coping and anxiety showed a moderator effect. Conclusions: stress and MS may follow a deteriorating cycle. Psychotherapeutic interventions should be conducted in early stages of MS to improve functionality and quality of life in pwMS.L’efecte de l’estrès en l’Esclerosi Múltiple (EM) ha mostrat resultats diversos. L’heterogeneïtat en l’avaluació de l’estrès i la presencia de factors mediadors/moderadors poden ser-ne la causa. Objectius: analitzar l’efecte de l’estrès en l’EM (aproximació transaccional) i explicar el paper moderador de l’afrontament, el suport social, l’ansietat, l’alexitimia i l’estrès primerenc. Mètodes: l’estudi té tres fases; una revisió sistemàtica, un estudi cas-control (n=82), i un estudi longitudinal de seguiment d’un any (n=26). L’anàlisi va incloure models jeràrquics lineals i mixtes. Resultats: les persones amb EM van mostrar un afrontament més passiu, menys suport social i més ansietat i alexitimia. La hipòtesi bidireccional es confirmà amb mesures auto-reportades d’estrès i funcionalitat. L’afrontament i l’ansietat mostraren un efecte moderador. Conclusions: l’estrès i l’EM poden seguir un cicle deteriorant. Les intervencions psicoterapèutiques s’haurien d’implementar en els primers estadis de l’EM per millorar la funcionalitat i la qualitat de vida en les persones amb EM

A case-control study of psychosocial factors and their relationship to impairment and functionality in multiple sclerosis

The stress effect on multiple sclerosis remains unclear. Moderating psychosocial factors may be involved. This study compares some of them in people with multiple sclerosis and healthy controls, and their association with disease parameters. Coping style, social support, anxiety, alexithymia and early-life stress were measured, along with impairment and functionality. People with multiple sclerosis scored significantly higher on anxiety, alexithymia, and avoidance and instinctive coping but lower in social support. No differences were found in early-life stress. Impairment was related to avoidance, and functionality to avoidance and anxiety. Psychotherapeutic approaches focused on these psychosocial factors may improve functionality, impairment and quality of life in people with multiple sclerosis

A case-control study of psychosocial factors and their relationship to impairment and functionality in multiple sclerosis

The stress effect on multiple sclerosis remains unclear. Moderating psychosocial factors may be involved. This study compares some of them in people with multiple sclerosis and healthy controls, and their association with disease parameters. Coping style, social support, anxiety, alexithymia and early-life stress were measured, along with impairment and functionality. People with multiple sclerosis scored significantly higher on anxiety, alexithymia, and avoidance and instinctive coping but lower in social support. No differences were found in early-life stress. Impairment was related to avoidance, and functionality to avoidance and anxiety. Psychotherapeutic approaches focused on these psychosocial factors may improve functionality, impairment and quality of life in people with multiple sclerosis

A genome-wide methylation study reveals X chromosome and childhood trauma methylation alterations associated with borderline personality disorder

Borderline personality disorder (BPD) is a severe and highly prevalent psychiatric disorder, more common in females than in males and with notable differences in presentation between genders. Recent studies have shown that epigenetic modifications such as DNA methylation may modulate gene × environment interactions and impact on neurodevelopment. We conducted an epigenome wide study (Illumina Infinium HumanMethylation450k beadchip) in a group of BPD patients with (N = 49) and without (N = 47) childhood traumas and in a control group (N = 44). Results were confirmed in a replication cohort (N = 293 BPD patients and N = 114 controls) using EpiTYPER assays. Differentially methylated CpG sites were observed in several genes and intragenic regions in the X chromosome (PQBP1, ZNF41, RPL10, cg07810091 and cg24395855) and in chromosome 6 (TAP2). BPD patients showed significantly lower methylation levels in these CpG sites than healthy controls. These differences seemed to be increased by the existence of childhood trauma. Comparisons between BPD patients with childhood trauma and patients and controls without revealed significant differences in four genes (POU5F1, GGT6, TNFRSF13C and FAM113B), none of them in the X chromosome. Gene set enrichment analyses revealed that epigenetic alterations were more frequently found in genes controlling oestrogen regulation, neurogenesis and cell differentiation. These results suggest that epigenetic alterations in the X chromosome and oestrogen-regulation genes may contribute to the development of BPD and explain the differences in presentation between genders. Furthermore, childhood trauma events may modulate the magnitude of the epigenetic alterations contributing to BPD