Camino hacia el coraje: terapia de constructos personales en un caso de depresión mayor, fibromialgia y otras comorbilidades

Se presenta el caso de Sara, una mujer con fibromialgia, depresión, y otras comorbilidades. A nivel psicológico, una de sus mayores dificultades estriba en poner límites a los demás. Ello perjudica la relación que mantiene tanto con sus seres queridos como con ella misma. Analizando sus constructos personales con la técnica de rejilla y la autocaracterización se observa que vive como incompatibles la satisfacción de sus necesidades y el acceder a las demandas de los demás. Termina por ceder con el fin de preservar para sí misma una imagen de buena persona que resulta central en su sentido de identidad y nuclear en su sistema de constructos. La terapia de constructos personales realizada en un formato breve aborda este dilema y se producen algunos cambios significativos que perduran al seguimiento

Content analysis of the construction of self and others in women with bulimia nervosa

The purpose of this study was to explore the content of personal constructs in people diagnosed with bulimia nervosa (BN). We expected to find differences in the predominant content of the construct systems between women with and without BN. We analyzed the constructs elicited using the repertory grid technique from 120 women aged between 18 to 45 years, divided into two groups: a clinical group of women diagnosed with bulimia (n = 62) and a control group of university students (n = 58). The constructs were categorized using the Classification System for Personal Constructs (CSPC), composed of six themes which are broken down into 45 categories. For this study, a new area called 'Physical' was included, and it consists of three categories. The results indicated that women diagnosed with bulimia used significantly more constructs related to the body, while the control group used more constructs from the personal area. In addition, the congruent constructs from the clinical sample were predominantly moral, or related to values and interests, while discrepant constructs were personal and physical. The findings provide evidence for the clinical use of the CSPC as an instrument for exploring the content of personal meaning systems. Understanding the patient's personal constructions about herself and others is useful for treatment. Moreover, it is important for clinicians to explore the content of constructs related to symptomatic areas, which could be hindering change, and focus on them to facilitate improvement

Terapia sistémica de pareja de la depresión. Un estudio de caso único

En este estudio de caso único se presenta el tratamiento de una mujer diagnosticada de depresión mayor con terapia sistémica de pareja. Esta modalidad de terapia supone la inclusión de la pareja en todas las sesiones de tratamiento, en las que se trabaja con ambos de forma conjunta. A medida que avanza la terapia se van explicitando los significados relacionales de los síntomas y las dificultades de relación, y se trabaja de forma conjunta para remediarlas. El proceso terapéutico se completó con 11 sesiones, la mayoría quincenales, y los resultados de la evaluación al terminar el tratamiento mostraron un descenso notable de los síntomas depresivos de la paciente (según el BDI-II) con respecto a la evaluación inicial. Asimismo, en la entrevista diagnóstica post-tratamiento no cumplía tampoco los criterios de depresión mayor. En cuanto a la pareja, ambos percibieron la relación como más armónica (según el DAS). Dentro de las limitaciones propias de los estudios de caso único, este trabajo permite ilustrar las potencialidades del enfoque sistémico en el tratamiento de la depresión.In this case study, the treatment of a woman with the diagnosis of major depression using systemic couple therapy is presented. In this kind of therapy the partner is included in the all the treatment sessions working in a conjoint format. As therapy progresses, the relational meanings of the symptoms are made explicit, some relationship difficulties emerge, and joint work is made to find solutions. This therapy was completed after 11 mostly two-weekly sessions, and the results at the post-therapy assessment showed a substantial decrease in her depressive symptoms (measured with BDI-II) as compared to pre-therapy assessment. Also, in the structured diagnostic post-therapy interview she did not fulfil anymore the criteria for major depression. For the couple, both perceived their relationship as more harmonious (according to their scores on the DAS). Within the characteristic limitations of a single case study design, this work illustrates the potentials of systemic couple therapy for the treatment of depression

Cognitive Factors in Fibromyalgia: The Role of Self-Concept and Identity Related Conflicts

Fibromyalgia is a syndrome characterized by the presence of diffuse and chronic musculoskeletal pain of unknown etiology. Clinical diagnosis and the merely palliative treatments considerably affect the patient's experience and the chronic course of the disease. Therefore, several authors have emphasized the need to explore issues related to self in these patients. The repertory grid technique (RGT), derived from personal construct theory, is a method designed to assess the patient's construction of self and others. A group of women with fibromyalgia (n = 30) and a control group (n = 30) were assessed using RGT. Women with fibromyalgia also completed the Fibromyalgia Impact Questionnaire and a visualanalogue scale for pain, and painful tender points were explored. Results suggest that these women had a higher present self–ideal self discrepancy and a lower perceived adequacy of others, and it was more likely to find implicative dilemmas among them compared to controls. These dilemmas are a type of cognitive conflict in which the symptom is construed as “enmeshed” with positive characteristics of the self. Finally, implications of these results for the psychological treatment of fibromyalgia are suggested to give a more central role to self-identity issues and to the related cognitive conflicts

Therapeutic efficacy of β-sitosterol treatment on Trypanosoma congolense infection, anemia development, and trans-sialidase (TconTS1) gene expression

BackgroundAfrican animal trypanosomiasis hinders sustainable livestock productivity in sub-Saharan Africa. About 17 million infected cattle are treated with trypanocides annually but most of the drugs are associated with drawbacks, necessitating the search for a promising chemotherapeutic agent.ObjectivesIn this study, the effects of β-sitosterol on Trypanosoma congolense infection were investigated along with its effect on the trans-sialidase gene expressions.ResultsOral treatment with β-sitosterol at 15 and 30 mg/kg body weight (BW) for 14 days significantly (p < 0.05) reduced parasitemia and ameliorated the parasite-induced anemia. Also, the parasite-induced increase in serum urea level and renal histopathological damage scores in addition to renal hypertrophy was significantly (p < 0.05) reverted following treatment with 30 mg/kg BW β-sitosterol. The compound also significantly (p < 0.05) down-regulated the expression of TconTS1 but not TconTS2, TconTS3, and TconTS4. Correlation analysis between free serum sialic acid with the TconTS1 and TconTS2 gene variants revealed negative correlations in the β-sitosterol-treated groups although they were non-significant (p > 0.05) in the group treated with 15 mg/kg BW β-sitosterol. Similarly, a non-significant negative (p > 0.05) correlation between the biomolecule and the TconTS3 and TconTS4 gene variants was observed in the β-sitosterol-treated groups while positive correlations were observed in the infected untreated control group.ConclusionThe observed effect of β-sitosterol on T. congolense infection could make the compound a possible template for the design of novel trypanocides

La evolución de los pacientes con trastorno de la conducta alimentaria tres años después de ingresar a hospital de día

Course of eating disorders (ED) in patients treated in Day Hospital is analyzed by evaluating 24 women at baseline and approximately 3 years after initial assessment, in several variables: personality factors, motivation, psychological symptoms, severity, self-esteem, self-construction, construction of parental figures and polarization. Clinical variables of the history of the disorder are also included. 70.8% of the patients completed treatment and, 3 years after intake, 47.06% relapsed. The following factors seem to be associated with negative course: severity of ED, high scores on relapse (Transtheoretical Model of Change) and opening to experience, long period between onset of symptoms and first treatment, self-perception of fatness body image? low self-esteem prior to ED, and negative perception of their mother

Impact of desert dust on new particle formation events and the cloud condensation nuclei budget in dust-influenced areas

Detailed knowledge on the formation of new aerosol particles in the atmosphere from precursor gases, and their subsequent growth, commonly known as new particle formation (NPF) events, is one of the largest challenges in atmospheric aerosol science. High pre-existing particle loadings are expected to suppress the formation of new atmospheric aerosol particles due to high coagulation and condensation (CS) sinks. However, NPF events are regularly observed in conditions with high concentrations of pre-existing particles and even during intense desert dust intrusions that imply discrepancies between the observations and theory. In this study, we present a multi-site analysis of the occurrence of NPF events under the presence of desert dust particles in dust-influenced areas. Characterization of NPF events at five different locations highly influenced by desert dust outbreaks was done under dusty and non-dusty conditions using continuous measurements of aerosol size distribution in both fine and coarse size fractions. Contrary to common thought, our results show that the occurrence of NPF events is highly frequent during desert dust outbreaks, showing that NPF event frequencies during dusty conditions are similar to those observed during non-dusty conditions. Furthermore, our results show that NPF events also occur during intense desert dust outbreaks at all the studied sites, even at remote sites where the amounts of precursor vapours are expected to be low. Our results show that the condensation sink associated with coarse particles (CSC) represents up to the 60 % of the total CS during dusty conditions, which highlights the importance of considering coarse-fraction particles for NPF studies in desert-dust-influenced areas. However, we did not find a clear pattern of the effect of desert dust outbreaks on the strength of NPF events, with differences from site to site. The particle growth rate (GR) did not present a clear dependence on the CS during dusty and non-dusty conditions. This result, together with the fact that desert dust has different effects on the growth and formation rates at each site, suggests different formation and growth mechanisms at each site between dusty and non-dusty conditions, probably due to differences in precursor vapours' origins and concentrations as well as changes in the oxidative capacity of pre-existing particles and their effectiveness acting as CS. Further investigation based on multiplatform measurement campaigns and chamber experiments with state-of-the-art gaseous and particulate physical and chemical properties measurements is needed to better understand the role of catalyst components present in desert dust particles in NPF. Finally, our results reveal a significant impact of NPF events on the cloud condensation nuclei (CCN) budget during desert dust outbreaks at the studied sites. Therefore, since desert dust contributes to a major fraction of the global aerosol mass load, and since there is a foreseeable increase in the frequency, duration and intensity of desert dust episodes due to climate change, it is imperative to improve our understanding of the effect of desert dust outbreaks on NPF and the CCN budget for better climate change prediction.Juan Andrés Casquero-Vera is funded by FJC2021-047873-I, by MCIN/AEI/10.13039/501100011033 and NextGenerationEU/PRTR, by Spanish Ministry of Universities and the European Union – NextGenerationEU, and by the Academy of Finland through ACCC Flagship (Atmosphere and Climate Competence Center, project no. 337549). This research has been partially supported by the Spanish Ministry of Science and Innovation (grant nos. PID2020-120015RB-I00, RED2022-134824-E, PID2019-108990RB-I00 and PID2021-128757OB-I00 funded by MCIN/AEI/10.13039/501100011033) and by the European Union's Horizon 2020 Research and Innovation programme through projects ACTRIS IMP (grant no. 871115) and ATMO ACCESS (grant no. 101008004) and via Horizon Europe through “Non-CO2 Forcers and their Climate, Weather, Air Quality and Health Impacts”, FOCI (project no. 101056783). This research was also partially supported by Plan Propio of University of Granada through EMERALD project (PPJIA2022-15) and the Singular Laboratory AGORA programme (LS2022-1) and Scientific Units of Excellence Program (grant no. UCE-PP2017-02) and by the Consejo Superior de Investigaciones Científicas (CSIC) under project 202030E261. Measurements at Hada Al Sham were funded by the Deanship of Scientific Research (DSR; grant no I-122-430) at King Abdulaziz University (KAU).Peer reviewe

Self construction, cognitive conflicts and polarization in bulimia nervosa

This study explores the cognitive structures, understood as construct systems, of patients suffering from bulimia nervosa (BN). Previous studies investigated the construct systems of disordered eaters suggesting that they had a higher distance between their construction of the self and the «ideal self», and also more rigidity. In addition to these aspects, this study explored the presence of implicative dilemmas (ID). Thirty two women who met criteria for BN and were treated in a specialized center were compared to a non clinical group composed by 32 women matched by age. All participants were assessed using Repertory Grid Technique (RGT). In BN patients it was more common (71.9%) to find IDs than in controls (18.8%). They also showed higher polarization and higher self-ideal discrepancies (even more for those with a long history of BN). The measures provided by the RGT can be useful for the assessment of self-construction and cognitive conflicts in BN patients and to appreciate their role in this disorder. In addition, this technique could be helpful for clinicians to explore the patient"s constructs system, and specially to identify IDs that could be maintaining the symptoms or hindering change in order to focus on them to facilitate improvement

Terapia sistémica de pareja en la depresión: un estudio de caso único

En este estudio de caso único se presenta el tratamiento de una mujer diagnosticada de depresión mayor con terapia sistémica de pareja. Esta modalidad de terapia supone la inclusión de la pareja en todas las sesiones de tratamiento, en las que se trabaja con ambos de forma conjunta. A medida que avanza la terapia se van explicitando los significados relacionales de los síntomas y las dificultades de relación, y se trabaja de forma conjunta para remediarlas. El proceso terapéutico se completó con 11 sesiones, la mayoría quincenales, y los resultados de la evaluación al terminar el tratamiento mostraron un descenso notable de los síntomas depresivos de la paciente (según el BDI-II) con respecto a la evaluación inicial. Asimismo, en la entrevista diagnóstica post-tratamiento no cumplía tampoco los criterios de depresión mayor. En cuanto a la pareja, ambos percibieron la relación como más armónica (según el DAS). Dentro de las limitaciones propias de los estudios de caso único, este trabajo permite ilustrar las potencialidades del enfoque sistémico en el tratamiento de la depresión

Changes in the construct systems of first-year university students: impact on psychological symptoms and problem-solving skills

An early version of this article was published in the journal Psychologica in Portuguese. We thank the editors of that journal for their permission to publish versions in other languages.This article studies the levels of psychological symptoms, problem-solving skills and self-construction in 28 freshmen, as assessed at the beginning and end of their first year at university. The repertory grid technique was used to assess self–ideal discrepancy, cognitive differentiation, and existence of implicative dilemmas. Results showed an improvement in psychological symptoms and self–ideal discrepancy, an increase in differentiation, but no significant differences in problem-solving skills. One or more implicative dilemmas were found in over half of the sample at the initial assessment and only in one-third at the final one, although this difference was not significant. Psychological symptoms at the end of the first year were predicted only by the initial reported symptoms. However, problem-solving skills at the end were predicted by a model including both initial skills and implicative dilemmas at the beginning of the year. Some implications for the adaptation of students during the first year at university are discussed.Ministero de Ciencia e Innovacion (Ref. PSIZ008-00406