El trastorno límite e histriónico de la personalidad y sus estrategias de regulación emocional: una revisión sistemática y crítica desde el modelo dimensional

Personality disorders are scarcely attended to in real clinical practice, despite that their prevalence is high and they cause high interference and emotional distress in those who suffer from them. The objective of this study is to carry out a systematic review on borderline personality disorder (BPD) and histrionic personality disorder (HPD) from the dimensional models, as well as the emotional regulation strategies used by people who suffer from these disorders. The review has been carried out in compliance with the PRISMA guidelines, selecting a total of fourteen articles published between 2012 and 2022. The clear trend shown in the results is that people who suffer from BPD display the greatest severity, use more maladaptive emotional regulation strategies and have a series of pathological traits in common with HPD, whereas people with HPD show less severity. Future lines of research should focus on expanding studies on dimensional models and how they can be an alternative to traditional categorical diagnosis.Los trastornos de la personalidad están escasamente atendidos en la práctica clínica real, a pesar de que su prevalencia es elevada y causan altas interferencias y malestar emocional en aquellas personas que los padecen. El objetivo de este estudio es llevar a cabo una revisión sistemática sobre el trastorno límite de la personalidad (TLP) y el trastorno histriónico de la personalidad (THP) desde los modelos dimensionales, así como de las estrategias de regulación emocional (RE) empleadas por las personas que padecen estos trastornos. La revisión se ha realizado siguiendo la guía de las normas PRISMA, seleccionando un total de catorce artículos publicados entre el año 2012 y 2022. Los resultados muestran que las personas que sufren TLP son las que presentan mayor gravedad, usan más estrategias de RE desadaptativas y tienen una serie de rasgos patológicos comunes con el THP; mientras, las personas que sufren THP muestran una menor gravedad. Líneas futuras de investigación deberían centrarse en ampliar los estudios sobre los modelos dimensionales y en cómo estos pueden ser una alternativa al diagnóstico categorial tradicional

Emotion Regulation as a Moderator of Outcomes of Transdiagnostic Group Cognitive-Behavioral Therapy for Emotional Disorders

The aim of this study was to examine the potential moderating effect of baseline emotion regulation skills¿cognitive reappraisal and expressive suppression¿on the relation- ship between treatment allocation and treatment outcomes in primary care patients with emotional symptoms. A total of 631 participants completed scales to evaluate emotion regulation, anxiety, depression, functioning, and quality of life (QOL). The moderation analysis was carried out using the SPSS PROCESS macro, version 3.5. Expressive suppression was a significant moderator in the relationship between treatment allocation and treatment outcomes in terms of symptoms of anxiety (b = 0.530, p = .026), depression (b = 0.812, p = .004), and QOL (b = 0.156, p = .048). Cognitive reappraisal acted as a moderator only in terms of QOL (b = 0.217, p = .028). The findings of this study show that participants with higher scores of expres- sive suppression benefited more from the addition of trans- diagnostic cognitive-behavioral therapy to treatment as usual (TAU) in terms of anxiety and depressive symptoms, and QOL. Individuals with higher levels of cognitive reappraisal obtained a greater benefit in terms of QOL from the addition of psychological treatment to TAU. These results underscore the relevant role that emotion regulation skills play in the outcomes of psychological therapy for emotional symptoms

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

Background: Emotional disorders are common, and they have become more prevalent since the COVID‐19 pan‐ demic. 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 perpetu‐ ate 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 usu‐ ally 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 calcu‐ late 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

Evaluación y diseño de los procedimientos de análisis de inserción laboral de los Graduados en información y documentación. El servicio de información sobre empleo (SISE) de la Facultad de Ciencias de la Documentación (UCM)

Proyecto de innovación y mejora de Gestión de la Calidad que pretende reforzar el Sistema de Garantía Interna de Calidad de la Facultad de Ciencias de la Documentación de la UCM, y de un modo específico, el diseño de herramientas e instrumentos para la recogida de información sobre la inserción laboral de los egresados en Documentación

Protocolo transdiagnóstico PsicAP de entrenamiento cognitivo-conductual en grupo para trastornos emocionales

Anxiety disorders and depression are highly prevalent today. The PsicAP clinical trial showed that adding 7 sessions of group cognitive-behavioural training with a transdiagnostic approach to the usual treatment of emotional disorders in adult primary care patients increased efficacy and cost-effectiveness in reducing symptom levels, reduced disability and improved quality of life. In this work, these 7 sessions of the PsicAP protocol of transdiagnostic treatment are described, aimed at intervening on the factors common to the different disorders: cognitive distortions and emotional regulation strategies. It is an intervention based on learning through psychoeducation, cognitive restructuring, relaxation, behavioural techniques and relapse prevention. It concludes by arguing about the usefulness of this protocol to reduce the gap between research and clinical practice, something necessary in today's societyLos trastornos de ansiedad y la depresión son altamente prevalentes en la sociedad actual. El ensayo clínico PsicAP demostró que añadir 7 sesiones de entrenamiento cognitivo-conductual en grupo con enfoque transdiagnóstico al tratamiento habitual de trastornos emocionales en pacientes adultos de atención primaria aumentó la eficacia y coste-efectividad para reducir los niveles de síntomas, redujo la discapacidad y mejoró la calidad de vida. En este trabajo se describen esas 7 sesiones del protocolo PsicAP de tratamiento transdiagnóstico, dirigido a la intervención sobre los factores comunes a los distintos trastornos: las distorsiones cognitivas y las estrategias de regulación emocional. Se trata de una intervención basada en el aprendizaje mediante psicoeducación, reestructuración cognitiva, relajación, técnicas conductuales y prevención de recaídas. Se concluye argumentando sobre la utilidad de este protocolo para reducir la brecha entre investigación y práctica clínica, algo necesario en la sociedad actua

Quid est liber: Proyecto de innovación para la docencia en Libro Antiguo y Patrimonio Bibliográfico

Fac. de Ciencias de la DocumentaciónFALSEsubmitte

Problemática en Atención Primaria: tratamiento y aherencia

When discussing anxiety and mood disorders, which are the most frequent in primary care services, there are two problems regarding their treatment. The first one is the lack of controlled, evidence-based studies that seek to implement an empirically validated psychological treatment in Primary Care. The second and most forgotten one, is the essential role that adherence plays, because without it there are neither treatment nor results. To promote therapeutic adherence and, therefore, treatment effectiveness, interventions must be adapted to each patient and to his/her own way of experiencing the disorder. Adherence must be taken into account as well as the factors that have an influence on it, which in turn are interrelated. These factors have to do with the patient and his/her environment; the healthcare staff and health services; and factors related to the disorder as well as the treatment. A specific intervention is also required regarding the type of adherence required and its strongest supportive pillar. Future investigations should provide more detailed information about the reasons underlying attrition in order to improve the adherence and thus optimize treatment effectivenessCuando se habla de trastornos de ansiedad y del estado de ánimo, que se encuentran entre los más frecuentes en los servicios de Atención Primaria, surgen dos inconvenientes respecto a su tratamiento. El primero de ellos es que apenas existan estudios controlados y basados en la evidencia que traten de implantar en Atención Primaria un tratamiento psicológico empíricamente validado. El segundo y más olvidado, es el papel de vital importancia que juega la adherencia, pues sin ella no hay tratamiento ni resultados. Para fomentar la adherencia terapéutica y, así, la eficacia del tratamiento, las intervenciones deben adaptarse a cada paciente en particular, a cómo experimenta su enfermedad. Deben tenerse en cuenta la adherencia y también los factores que la influencian, que están interrelacionados entre sí: factores derivados del paciente y de su entorno, delpersonal asistencial y de los servicios de salud y del trastorno y del tratamiento. También se requiere una intervención específica respecto al tipo de adherencia a fomentar y a la fuente de apoyo más influyente para ella. Es necesario que futuras investigaciones proporcionen información más detallada sobre el abandono del tratamiento para poder incrementar la adherencia y optimizar así la efectividad de los tratamientos

Validity of brief scales for assessing transdiagnostic cognitive emotion regulation strategies in primary care patients with emotional disorders

Este trabajo fue publicado en línea el 29 de abril de 2020, y posteriormente publicado en el año 2021 en el volumen 37(2):86-94Cognitive emotion regulation strategies have been proposed as an explanation for transdiagnostic vulnerability to emotional disorders, which are highly prevalent in the primary care setting. The use of brief psychological instruments to detect cognitive-emotional factors—such as worry, rumination, interpretative and attentional distortions, and metacognitions—could provide valuable clinical data to better guide treatment in primary care. The aim of the present study was to evaluate the psychometric properties of four brief scales derived from the full versions of four assessment instruments (PSWQ, RRS, IACTA, and MCQ-30). The brief scales were completed by 1,250 primary care patients with an emotional disorder diagnosed by a general practitioner. The following characteristics of the scales were assessed: (a) internal structure (assessed by confirmatory factor analysis), (b) internal consistency, (c) convergent validity, (d) metric invariance across gender and age, and (e) predictive validity. The results showed a unifactorial structure for all of the tested scales, with an acceptable internal consistency and convergent validity, and invariance across gender and age. The brief scales presented predictive validity using the PHQ-4, a 4-item scale used to detect depression and generalized anxiety disorders, suggesting that these brief scales are optimal for use in the primary care setting.Depto. de Psicología Experimental, Procesos Cognitivos y LogopediaFac. de Trabajo SocialTRUEpu

Worry, rumination and negative metacognitive beliefs as moderators of outcomes of Transdiagnostic group cognitive-behavioural therapy in emotional disorders

2023 Acuerdos transformativos CRUEBackground: Despite the relevance of cognitive processes such as rumination, worry, negative metacognitive beliefs in emotional disorders, the existing literature about how these cognitive processes moderate the effect of treatment in treatment outcomes is limited. The aim of the present study was to explore the potential moderator effect of baseline cognitive processes—worry, rumination and negative metacognitive beliefs—on the relationship between treatment allocation (transdiagnostic cognitive-behavioural therapy —TD-CBT plus treatment as usual—TAU vs. TAU alone) and treatment outcomes (anxiety and depressive symptoms, quality of life [QoL], and functioning) in primary care patients with emotional disorders. Methods: A total of 631 participants completed scales to evaluate worry, rumination, negative metacognitive beliefs, QoL, functioning, and anxiety and depressive symptoms. Results: Worry and rumination acted as moderators on the effect of treatment for anxiety (b = 1.25, p =.003; b = 0.98, p =.048 respectively) and depressive symptoms (b = 1.21, p =.017; b = 1.34, p =.024 respectively). Individuals with higher baseline levels of worry and rumination obtained a greater reduction in emotional symptoms from the addition TD-CBT to TAU. Negative metacognitive beliefs were not a significant moderator of any treatment outcome. Limitations: The study assesses cognitive processes over a relatively short period of time and uses self-reported instruments. In addition, it only includes individuals with mild or moderate anxiety or depressive disorders, which limits generalization to other populations. Conclusions: These results underscore the generalization of the TD-CBT to individuals with emotional disorders in primary care with different cognitive profiles, especially those with high levels of worry and rumination.Instituto de Investigación ValdecillaAgencia Estatal de Investigación (España)Depto. de Psicología Experimental, Procesos Cognitivos y LogopediaFac. de PsicologíaTRUEpubAPC financiada por la UC

Los proyectos de trabajo en el aula

Recopilación de siete proyectos: 'El universo' (Educación Infantil), 'Los canguros' (Educación Infantil), 'La alimentación' (Educación Primaria), 'Con el periódico aprendemos matemáticas' (Educación Primaria), 'La piscina' (Educación Infantil), 'La psicomotricidad y los proyectos de investigación' (Educación Infantil) y 'Los juguetes' (Educación Infantil). Con estas experiencias se pretende ofrecer al profesorado fórmulas de aprendizaje abiertas que despierten en los alumnos curiosidad por las cosas cotidianas.ExtremaduraES