Online positive interventions to promote well-being and resilience in the adolescent population: A narrative review

Numerous studies have shown an alarming prevalence of depression, anxiety, and behavior disorders in youth. Thus, prevention of psychological problems in this population becomes crucial. According to the World Health Organization (1), prevention should also include the promotion and development of the individual''s strengths in order to reduce vulnerability to suffering from mental disorders. In addition, other key elements of prevention are the reach, adoption, implementation, and maintenance of interventions. The information and communication technologies, especially the Internet, have much to offer in terms of the prevention and promotion of positive mental health in adolescents. This paper reviews these fields of research-prevention, positive psychology, Internet, and adolescents-and discusses the potential of positive interventions delivered over the Internet as effective and sustainable health promotion tools. The paper provides a brief description of the systems developed so far and a summary of selected features of the studies detected in the literature review. The overall conclusions are that there is a need for more controlled studies with long-term follow-ups, the interventions should be designed considering the specific features of the target users and the specific contexts where the interventions will be delivered, and they could be enhanced by the use of other technologies, such as smartphones, sensors, or social networks

The acceptability of an internet-based exposure treatment for flying phobia with and without therapist guidance: Patients’ expectations, satisfaction, treatment preferences, and usability

Purpose: Internet-based treatments have been tested for several psychological disorders. However, few studies have directly assessed the acceptability of these self-applied interventions in terms of expectations, satisfaction, treatment preferences, and usability. Moreover, no studies provide this type of data on Internet-based treatment for flying phobia (FP), with or without therapist guidance. The aim of this study was to analyze the acceptability of an Internet-based treatment for FP (NO-FEAR Airlines) that includes exposure scenarios composed of images and real sounds. A secondary aim was to compare patients’ acceptance of two ways of delivering this treatment (with or without therapist guidance). Patients and methods: The sample included 46 participants from a randomized controlled trial who had received the self-applied intervention with (n = 23) or without (n = 23) therapist guidance. All participants completed an assessment protocol conducted online and by telephone at both pre- and posttreatment. Results: Results showed good expectations, satisfaction, opinion, and usability, regardless of the presence of therapist guidance, including low aversiveness levels from before to after the intervention. However, participants generally preferred the therapist-supported condition. Conclusion: NO-FEAR Airlines is a well-accepted Internet-based treatment that can help enhance the application of the exposure technique, improving patient acceptance and access to FP treatment

Compassion-based meditation quality practice and its impact on the positive attitudes toward others

Objectives: The authors report on the initial development and validation of the Compassion Practice Quality Scale (CPQS), a measure to assess the quality of compassion-based meditation (CBM). It is conceptualized and operationalized via two factors measuring mental imagery and somatic perception/response. Methods: The total sample was composed of 205 university students who underwent a CBM and completed pre-test/post-test assessment of compassion and related constructs. Results from a series of preliminary psychometric analyses of the CPQS were examined, including factor analysis, internal consistency, and convergent/discriminant validity. Results: The data supported a 12-item and 10-item (without reference to gestures and self-instructions) CPQS of which imagery and somatic perception emerged as two significant reliable subscales, with Cronbach’s alpha values of.90 and.88 respectively. Practice quality factors assessed by the CPQS correlated in expected ways with fear of compassion, imagery variables, and self-criticism, as well as predicted compassion outcome (i.e., feeling positive attitudes toward others). Conclusions: Our findings contribute to identifying two key components of high-quality meditation in CBM (i.e., mental imagery and somatic perception/response) for use in pedagogical development and further research and to offer a reliable self-report measure to assess them for the first time. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature

Ontologies for Intelligent e-Theraoy: Application to Obesity

[EN] In this paper we propose a new approach for mental e-health treatments named intelligent e-therapy (e-it) with capabilities for ambient intelligence and ubiquitous computing. The proposed e-it system supposes an evolution of cybertherapy and telepsychology tools used up to now. The e-it system is based in a knowledge base that includes all the knowledge related to the disorder and its treatment. We introduce the use of ontologies as the best option for the design of this knowledge base. We also present a fist e-it system for obesity treatment called etiobeZaragozá Álvarez, I.; Guixeres Provinciale, J.; Alcañiz Raya, ML. (2009). Ontologies for Intelligent e-Theraoy: Application to Obesity. Lecture Notes in Computer Science. 5518:894-901. doi:10.1007/978-3-642-02481-8_136S8949015518Baños, R.M., Botella, C., Perpiñá, C., Alcañiz, M., Lozano, J.A., Osma, J., Gallardo, M.: Virtual reality treatment of flying phobia. IEEE Transactions on Information Technology in Biomedicine 6(3), 206–212 (2002)Botella, C., Baños, R.M., Perpiña, C., et al.: Virtual reality treatment of claustrophobia: a case report. Behaviour Research & Therapy 36, 239–246 (1998)Hu, B., Dasmahapatra, S., Dupplaw, D., Lewis, P., Shadbolt, N.: Reflections on a medical ontology. International Journal of Human- Computer Studies 65(2007), 569–582 (2007)Rubin, D.L., Shah, N.H., Noy, N.F.: Biomedical ontologies: a functional perspective. Briefings in bioinformatics 9(1), 75–90 (2007)Stevens, R., Egaña Aranguren, M., Wolstencroft, K., Sattler, U., Drummond, N., Horridge, M., Rector, A.: Using OWL to model biological knowledge. International Journal of Human-Computer Studies 65(2007), 583–594 (2007)Park, S., Lee, J.K.: Rule identification using ontology while acquiring rules from Web pages. International Journal of Human-Computer Studies 65(2007), 644–658 (2007)Clark, K.L., McCabe, F.G.: Ontology schema for an agent belief store. International Journal of Human-Computer Studies 65(2007), 625–643 (2007)Gruber, T.R.: A Translation Approach to Portable Ontology Specifications. Knowledge Acquisition 5(2), 199–220 (1993)Franco, C., Bengtsson, B., Johannsson, G.: The GH/IGF-1 Axis in Obesity: Physiological and Pathological aspects. Metabolic syndrome and Related Disorders 4, 51–56 (2006

Ecological momentary assessment for chronic pain in fibromyalgia using a smartphone: A randomized crossover study

Background Daily diaries are a useful way of measuring fluctuations in pain-related symptoms. However, traditional diaries do not assure the gathering of data in real time, not solving the problem of retrospective assessment. Ecological momentary assessment (EMA) by means of electronic diaries helps to improve repeated assessment. However, it is important to test its feasibility in specific populations in order to reach a wider number of people who could benefit from these procedures. Methods The present study compares the compliance and acceptability of an electronic diary running on a smartphone using a crossover design for a sample with a specific pain condition, fibromyalgia and low familiarity with technology. Forty-seven participants were randomly assigned to one of two conditions: (1) paper diary smartphone diary and (2) smartphone diary paper diary, using each assessment method for 1 week. Results The findings of this study showed that the smartphone diary made it possible to gather more accurate and complete ratings. Besides, this method was well accepted by a sample of patients with fibromyalgia referred by a public hospital, with an important proportion of participants with low level of education and low familiarity with technology. Conclusions The findings of this study support the use of smartphones for EMA even in specific populations with a specific pain condition, fibromyalgia and with low familiarity with technology. These methods could help clinicians and researchers to gather more accurate ratings of relevant pain-related variables even in populations with low familiarity with technology.The research presented in this paper was funded in part by Fundacio La Marato de TV3 (Ajuts de la Marato de TV3 2006), Plan de Promocion de la investigacion Universitat Jaume I, (Fundacio Caixa Castello-Bancaixa, P11B2009-30) and by Generalitat Valenciana, Redes de Excelencia ISIC (ISIC/2012/012).Garcia-Palacios, A.; Herrero, R.; Belmonte, M.; Castilla, D.; Guixeres Provinciale, J.; Molinari, G.; Baños, R.... (2014). Ecological momentary assessment for chronic pain in fibromyalgia using a smartphone: A randomized crossover study. European Journal of Pain. 18(6):862-872. https://doi.org/10.1002/j.1532-2149.2013.00425.xS86287218

Interventions of computerized psychotherapies for depression in Primary Care in Spain

Currently, depression is a global health problem recognized by the WHO. The prevalence of this pathology in Primary Care is estimated at 19.5% worldwide, and 20.2% in Spain. In addition, the current intervention policies and protocols involve significant costs, both personal and economic, for people suffering from this disorder, as well as for society in general. On the other hand, the relapse rates after pharmacological interventions that are currently applied and the lack of effective specialized attention in mental health services reflect the need to develop new therapeutic strategies that are more accessible and profitable. Therefore, one of the proposals that are being investigated in different parts of the world is the design and evaluation of therapeutic protocols applied through Information and Communication Technologies, especially through the Internet and computer programs. The objective of this work was to present the current situation in Spain regarding the use of these interventions for the treatment of depression in Primary Care. The main conclusion is that although there is scientific evidence on the effectiveness of these programs, there are still important barriers that hinder their application in the public system, and also the need to develop implementation studies that facilitate the transition from research to clinical practice

Negative and positive affect regulation in a transdiagnostic internet-based protocol for emotional disorders: Randomized controlled trial

Background: Emotional disorders (EDs) are among the most prevalent mental disorders. Existing evidence-based psychological treatments are not sufficient to reduce the disease burden of mental disorders. It is therefore essential to implement innovative solutions to achieve a successful dissemination of psychological treatment protocols, and in this regard, the use of information and communication technologies such as the internet can be very useful. Furthermore, the literature suggests that not everyone with an ED receives the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which attempts to address the underlying processes common to EDs. Most of these transdiagnostic interventions focus primarily on downregulating negative affectivity (NA), and less attention has been paid to strengths and the upregulation of positive affectivity, despite its importance for well-being and mental health. Objective: This study aims to evaluate the efficacy of a transdiagnostic internet-based treatment for EDs in a community sample. Methods: A 3-armed randomized controlled trial was conducted. A total of 216 participants were randomly assigned to a transdiagnostic internet-based protocol (TIBP), a TIBP+ positive affect (PA) component, or a waiting list (WL) control group. The treatment protocol contained core components mainly addressed to downregulate NA (ie, present-focused emotional awareness and acceptance, cognitive flexibility, behavioral and emotional avoidance patterns, and interoceptive and situational exposure) as well as a PA regulation component to promote psychological strengths and enhance well-being. Data on depression, anxiety, quality of life, neuroticism and extraversion, and PA/NA before and after treatment were analyzed. Expectations and opinions of treatment were also analyzed. Results: Within-group comparisons indicated significant pre-post reductions in the two experimental conditions. In the TIBP+PA condition, the effect sizes were large for all primary outcomes (d=1.42, Beck Depression Inventory [BDI-II]; d=0.91, Beck Anxiety Inventory [BAI]; d=1.27, Positive and Negative Affect Schedule-Positive [PANAS-P]; d=1.26, Positive and Negative Affect Schedule-Negative [PANAS-N]), whereas the TIBP condition yielded large effect sizes for BDI-II (d=1.19) and PANAS-N (d=1.28) and medium effect sizes for BAI (d=0.63) and PANAS-P (d=0.69). Between-group comparisons revealed that participants who received one of the two active treatments scored better at posttreatment than WL participants. Although there were no statistically significant differences between the two intervention groups on the PA measure, effect sizes were consistently larger in the TIBP+PA condition than in the standard transdiagnostic protocol. Conclusions: Overall, the findings indicate that EDs can be effectively treated with a transdiagnostic intervention via the internet, as significant improvements in depression, anxiety, and quality of life measures were observed. Regarding PA measures, promising effects were found, but more research is needed to study the role of PA as a therapeutic component

A low-intensity internet-based intervention focused on the promotion of positive affect for the treatment of depression in Spanish primary care: Secondary analysis of a randomized controlled trial

Background: A large number of low-intensity Internet-based interventions (IBIs) for the treatment of depression have emerged in Primary Care; most of them focused on decreasing negative emotions. However, recent studies have highlighted the importance of addressing positive affect (PA) as well. This study is a secondary analysis of a randomized control trial. We examine the role of an IBI focused on promoting PA in patients with depression in Primary Care (PC). The specific objectives were to explore the profile of the patients who benefit the most and to analyze the change mechanisms that predict a significantly greater improvement in positive functioning measures. Methods: 56 patients were included. Measures of depression, affect, well-being, health-related quality of life, and health status were administered. Results: Participants who benefited the most were those who had lower incomes and education levels and worse mental health scores and well-being at baseline (7.9%–39.5% of explained variance). Improvements in depression severity and PA were significant predictors of long-term change in well-being, F (3, 55) = 17.78, p < 0.001, R2 = 47.8%. Conclusions: This study highlights the importance of implementing IBIs in PC and the relevance of PA as a key target in Major Depressive Disorder treatment

Efficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial

BACKGROUND: Primary care is a major access point for the initial treatment of depression, but the management of these patients is far from optimal. The lack of time in primary care is one of the major difficulties for the delivery of evidence-based psychotherapy. During the last decade, research has focused on the development of brief psychotherapy and cost-effective internet-based interventions mostly based on cognitive behavioral therapy (CBT). Very little research has focused on alternative methods of treatment for depression using CBT. Thus, there is a need for research into other therapeutic approaches. OBJECTIVE: This study aimed to assess the effectiveness of 3 low-intensity, internet-based psychological interventions (healthy lifestyle psychoeducational program [HLP], focused program on positive affect promotion [PAPP], and brief intervention based on mindfulness [MP]) compared with a control condition (improved treatment as usual [iTAU]). METHODS: A multicenter, 4-arm, parallel randomized controlled trial was conducted between March 2015 and March 2016, with a follow-up of 12 months. In total, 221 adults with mild or moderate major depression were recruited in primary care settings from 3 Spanish regions. Patients were randomly distributed to iTAU (n=57), HLP (n=54), PAPP (n=56), and MP (n=54). All patients received iTAU from their general practitioners. The main outcome was the Spanish version of the Patient Health Questionnaire-9 (PHQ-9) from pretreatment (time 1) to posttreatment (time 2) and up to 6 (time 3) and 12 (time 4) months'' follow-up. Secondary outcomes included the visual analog scale of the EuroQol, the Short-Form Health Survey (SF-12), the Positive and Negative Affect Schedule (PANAS), and the Pemberton Happiness Index (PHI). We conducted regression models to estimate outcome differences along study stages. RESULTS: A moderate decrease was detected in PHQ-9 scores from HLP (ß=-3.05; P=.01) and MP (ß=-3.00; P=.01) compared with iTAU at posttreatment. There were significant differences between all intervention groups and iTAU in physical SF-12 scores at 6 months after treatment. Regarding well-being, MP and PAPP reported better PHI results than iTAU at 6 months post treatment. PAPP intervention significantly decreased PANAS negative affect scores compared with iTAU 12 months after treatment. CONCLUSIONS: The low-intensity, internet-based psychological interventions (HLP and MP) for the treatment of depression in primary care are more effective than iTAU at posttreatment. Moreover, all low-intensity psychological interventions are also effective in improving medium- and long-term quality of life. PAPP is effective for improving health-related quality of life, negative affect, and well-being in patients with depression. Nevertheless, it is important to examine possible reasons that could be implicated for PAPP not being effective in reducing depressive symptomatology; in addition, more research is still needed to assess the cost-effectiveness analysis of these interventions

Efeitos da quitosana no desenvolvimento in vitro de videiras cv. merlot e no crescimento micelial do fungo elsinoe ampelina.

Objetivou-se, neste trabalho, avaliar o efeito da quitosana no desenvolvimento in vitro de plântulas de videira cv. Merlot e sua atividade antifúngica sobre Elsinoe ampelina. No primeiro experimento, explantes da cultivar Merlot foram transferidos para meio de cultura DSD1, acrescido das concentrações 0; 25; 50,100; 150 e 200 mg L-1 de quitosana. Após 90 dias de cultivo in vitro, as plântulas foram avaliadas quanto ao número de raízes e de folhas, porcentagem de enraizamento e brotação, comprimento de raízes e de parte aérea, massa fresca da planta. No segundo experimento, incorporou-se às concentrações 0, 60, 120, 180, 240 e 300 mg L-1 de quitosana ao meio BDA, onde inoculou-se o fungo. Posteriormente, avaliou-se o crescimento micelial aos 6 e 9 dias de incubação a 25º C no escuro. No primeiro experimento para as variáveis comprimento médio da parte aérea, massa fresca da planta inteira, porcentagem de enraizamento e porcentagem de estacas brotadas houve decréscimo linear em função das concentrações de quitosana. No segundo experimento, houve efeito linear negativo em função das concentrações crescentes de quitosana, sendo que a inibição do crescimento micelial foi de 81,7%, demonstrando o grande potencial do uso de quitosana no controle da antracnose da videira