CONSECUENCIAS PSICOLÓGICAS DE LOS ATENTADOS TERRORISTAS DEL 11-M EN MADRID. PLANTEAMIENTO GENERAL DE LOS ESTUDIOS Y RESULTADOS EN LA POBLACIÓN GENERAL

On the morning of March 11 of 2004, Madrid city suffered the most violent terrorist attack occurred in the modern European history. Ten bombs exploded in four commuter trains at morning rush hour, when many people went to Madrid down-town, resulted in 191 deaths and 1800 persons in-jured. After terrorist attacks, we started out three longitudinal studies with the aim of assessing the psychological impact of this event in the Madrid city population, and focused on: (1) general population, (2) victims and relatives, and (3) emergency person-nel and rescue workers. Among other variables, it is explored the onset and evolution of different psycho-logical pathologies such as panic attack, PTSD, and depression. In this study a representative sample of Madrid city residents of 1,589 subjects (1,265 resi-dents of the 21 Madrid city districts plus an over-sampling of 324 residents in the affected areas) is addressed. Research design and telephone interview used in this study are similar to those employed by Galea et al. (2002) in the study of September 11, 2001, terrorist attacks in NYC. Among psycho-pathological prevalence rates, there are remarkable data regarding the 10,9% of panic attack, the 8% of major depression, and the 4% of PTSD after March 11, and the 2,3% of PTSD directed attributable to terrorist attacks.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40311/2/Miguel-Tobal_Consecuencias Psicologicas De Los Atentados_2004.pd

PTSD and Depression After the Madrid March 11 Train Bombings

The March 11, 2004, train bombings in Madrid, Spain, caused the largest loss of life from a single terrorist attack in modern European history.We used a cross-sectional random digit dial survey ofMadrid residents to assess the prevalence of posttraumatic stress disorder (PTSD) and major depression in the general population of Madrid 1 to 3 months after the March 11 train bombings. Of respondents 2.3% reported symptoms consistent with PTSD related to the March 11 bombings and 8.0% of respondents reported symptoms consistent with major depression. The prevalence of PTSD was substantially lower, but the prevalence of depression was comparable to estimates reported after the September 11 attacks in Manhattan. The findings suggest that across cities, the magnitude of a terrorist attack may be the primary determinant of the prevalence of PTSD in the general population, but other factors may be responsible for determining the population prevalence of depression.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40310/2/Miguel-Tobal_PTSD and Depression After the Madrid_2006.pd

The PHQ-PD as a screening tool for panicdisorder in theprimarcarsetting in Spain.

INTRODUCTION Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres. METHOD We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed. RESULTS The operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83). CONCLUSION Although the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes

Transdiagnostic cognitive behavioral therapy versus treatment as usual in adult patients with emotional disorders in the primary care setting (PsicAP study) : protocol for a randomized controlled trial

Demand for primary care (PC) services in Spain exceeds available resources. Part of this strong demand is due to the high prevalence of emotional disorders (EDs)-anxiety, depression, and somatic symptom disorders-and related comorbidities such as pain or chronic illnesses. EDs are often under- or misdiagnosed by general practitioners (GPs) and, consequently, treatment is frequently inadequate. We aim to compare the short- and long-term effectiveness of group-delivered transdiagnostic cognitive behavioral therapy (TD-CBT) versus treatment as usual (TAU) in the treatment of EDs in the PC setting in Spain. We also aim to compare the effect of these treatments on disability, quality of life, cognitive-emotional factors, and treatment satisfaction. Here we present the study design of a two-arm, single-blind, randomized controlled trial (N=1126) to compare TAU to TD-CBT for EDs. TAU will consist primarily of pharmacological treatment and practical advice from the GP while TD-CBT will be administered in seven 90-minute group sessions held over a period ranging from 12 to 14 weeks. Psychological assessments are carried out at baseline (ie, pretreatment); posttreatment; and at 3-, 6-, and 12-month follow-up. The study is conducted in approximately 26 PC centers from the National Health System in Spain. This study was initiated in December 2013 and will remain open to new participants until recruitment and follow-up has been completed. We expect all posttreatment evaluations to be completed by December 2017, and follow-up will end in December 2018. We expect the TD-CBT group to have better results compared to TAU on all posttreatment measures and that this improvement will be maintained during follow-up. This project could serve as a model for use in other areas or services of the National Health System in Spain and even in other countries. International Standard Randomized Controlled Trial Number (ISRCTN): 58437086; http://www.isrctn.com/ISRCTN58437086 (Archived by WebCite at http://www.webcitation.org/6mbYjQSn3

Longitudinal changes in gambling, buying and materialism in adolescents: A population-based study

Gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values lead to impaired functioning in important areas of life. The aims of the present longitudinal study are (1) to evaluate the change produced after one year in those mentioned variables and (2) to examine the gender role in these changes and to analyze the mediational mechanisms among the variables of the study. The sample was composed of 182 adolescents (103 females and 79 males) from secondary education Spanish institutions who completed self-administered questionnaires. Structural equation modeling has been used to explore associations between the different variables. Our results show significant decreases in compulsive buying, materialism, and cognitive biases related to gambling after one year. Gambling disorder severity was directly related to cognitive distortions of gambling and being a man. Compulsive buying was associated with older age and the female gender. Materialism was associated with compulsive buying and the male gender. In conclusion, gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values change over time in different ways, according to gender. The understanding of gambling disorder and compulsive buying in adolescents could potentially lead to early prevention and treatment programs for the specific needs of gender and age

EL AFRONTAMIENTO DE LA ANSIEDAD EN LAS DROGODEPENDENCIAS

In this paper, a cognitive (appraisal and coping), interactive (person x situation interaction) and multidimensional (three response systems) perspective of anxiety, stress and emotions is presented. According to it, anxiety is conceptualized as a negative or unpleasant emotion characterized by subjective distress, high physiological activation, unadapted motor responses; at the same time, anxiety is linked to individual differences in certain situational areas (specific traits). Anxiety reactions appear due to subject perceives that a certain situation seems threating (situation's appraisal), with no apparent solution due to a lack of resources (coping abilities). For somebody, certain consummatory behaviors such as eating, alcohol consumption, smoking, or drug abuse could relieve distress symptoms or reduce physiological activation producing by anxiety. However, such consumption behaviors could become more and more necessary in order to alleviate anxiety symptoms or avoiding the withdrawal, which is a clinical syndrome including intense anxiety manifestations. The possibility to stop the consumption is interpreted as a threatening situation which provokes more anxiety; the only coping response available is to maintain consumption. Regarding addiction treatments, there are significant interactions between type of treatment x type of patient. Anxiety is on of the variables evaluated in order to design more effective treatments matched with the characteristics of the patient.En este trabajo se defiende una concepción cognitiva (valoración y afrontamiento), interactiva (persona por situación) y multidimensional (triple sistema de respuesta) de la ansiedad, el estrés y las emociones, según la cual, la ansiedad se entiende como una emoción negativa o desagradable, caracterizada por malestar subjetivo, alta activación fisiológica, e inquietud motora; a su vez, la ansiedad está ligada a diferencias individuales en ciertas áreas situacionales (rasgos específicos), y surge porque el sujeto percibe que una determinada situación representa una amenaza para él (valoración de la situación), sin que pueda remediarlo por escasez de recursos (afrontamiento). En algunas personas, determinadas conductas consumatorias tales como comer, beber bebidas alcohólicas, fumar, tomar tranquilizantes u otras sustancias, etc., pueden disminuir el malestar y reducir la activación fisiológica, producidos por la ansiedad. Sin embargo, estos consumos pueden hacerse cada vez más necesarios para aliviar los síntomas de ansiedad, o incluso para evitar el síndrome de abstinencia, un cuadro clínico con intensas respuestas de ansiedad. La posibilidad de no poder seguir consumiendo se interpretaría como una amenaza que produce más ansiedad afrontada mediante el consumo. En relación al tratamiento de los problemas de adicción se han encontrado interacciones significativas entre el tipo de tratamiento y de paciente. Una de las variables a evaluar para poder diseñar tratamientos más eficaces concordantes con las características del paciente es la ansiedad

Sex-comparative study of gambling disorder regarding alexithymia and symptoms of depression, anxiety and hostility

Background and aims: Alexithymia and psychological symptomatology have been closely associated with gambling disorder (GD). However, sex differences remain underexplored. This study aims, firstly, to explore the differences between groups (GD and no-GD) and sexes (women vs. men) in alexithymia and psychological symptomatology (depression, anxiety and hostility). Secondly, the relationship between alexithymia and psychological symptomatology was analysed by gambling and sex groups. Thirdly, it examines the moderation role of sex and gambling in the relationship between alexithymia and each psychological symptom. Method: The sample was composed of 80 people with GD diagnosis and 80 without GD (40 women and 40 men in each group). Results: The results showed that alexithymia is positively related to depression, anxiety and hostility, with significantly higher scores in people with GD. Moderation analyses showed a threefold interaction, in which higher alexithymia was related to higher depression for men with GD but not for GD-women. However, in women with GD, depression levels are higher than in people without GD and tend to be more stable over time, despite the lack of effect of alexithymia. Conclusions: These results provide evidence indicating that dysfunctional psychological symptomatology affects people with GD to a greater extent than people without GD, but also that the aetiology and effect of underlying vulnerability factors on gambling is different according to sex. The need of prevention and treatment programmes that consider different psychological aspects depending on sex is reinforced

Transdiagnostic cognitive behavioral therapy versus treatment as usual in adult patients with emotional disorders in the primary care setting (PsicAP study) : protocol for a randomized controlled trial

Demand for primary care (PC) services in Spain exceeds available resources. Part of this strong demand is due to the high prevalence of emotional disorders (EDs)-anxiety, depression, and somatic symptom disorders-and related comorbidities such as pain or chronic illnesses. EDs are often under- or misdiagnosed by general practitioners (GPs) and, consequently, treatment is frequently inadequate. We aim to compare the short- and long-term effectiveness of group-delivered transdiagnostic cognitive behavioral therapy (TD-CBT) versus treatment as usual (TAU) in the treatment of EDs in the PC setting in Spain. We also aim to compare the effect of these treatments on disability, quality of life, cognitive-emotional factors, and treatment satisfaction. Here we present the study design of a two-arm, single-blind, randomized controlled trial (N=1126) to compare TAU to TD-CBT for EDs. TAU will consist primarily of pharmacological treatment and practical advice from the GP while TD-CBT will be administered in seven 90-minute group sessions held over a period ranging from 12 to 14 weeks. Psychological assessments are carried out at baseline (ie, pretreatment); posttreatment; and at 3-, 6-, and 12-month follow-up. The study is conducted in approximately 26 PC centers from the National Health System in Spain. This study was initiated in December 2013 and will remain open to new participants until recruitment and follow-up has been completed. We expect all posttreatment evaluations to be completed by December 2017, and follow-up will end in December 2018. We expect the TD-CBT group to have better results compared to TAU on all posttreatment measures and that this improvement will be maintained during follow-up. This project could serve as a model for use in other areas or services of the National Health System in Spain and even in other countries. International Standard Randomized Controlled Trial Number (ISRCTN): 58437086; http://www.isrctn.com/ISRCTN58437086 (Archived by WebCite at http://www.webcitation.org/6mbYjQSn3

Operational characteristics of the PHQ-TP, sensitivity and specificity, positive and negative predictive value, and positive and negative likelihood ratio.

<p>Operational characteristics of the PHQ-TP, sensitivity and specificity, positive and negative predictive value, and positive and negative likelihood ratio.</p