Los trastornos de la conducta alimentaria y el espectro obsesivo-compulsivo: intrusiones mentales, egodistonía y creencias

Las investigaciones a nivel psicopatológicos de la relación entre los Trastornos Alimentarios (TA) y el Trastorno Obsesivo-Compulsivo (TOC) son muy escasas. La presente tesis se enmarca precisamente dentro del análisis de dicha relación. Objetivos: 1.Analizar la Egosintonía y Egodistonía asociada a las intrusiones mentales de TA y TOC. 2.Analizar las creencias nucleares y creencias asociadas al TOC y su relación con Egosintonía y Egodistonía. Participantes: Un grupo de población general (n=349), de donde se extrajeron: Población subclínica-TA (n=12), población subclínica-TOC (n=18), y población sin riesgo de TA ni TOC(n=50). Contamos con dos muestras de mujeres con diagnóstico de TA (DSM-IV-TR), la primera compuesta por 106 pacientes (61 españolas y 45 inglesas), y la segunda, compuesta por 76 mujeres españolas. También se contó con un grupo de 20 mujeres recuperadas de TA. Instrumentos: Actitudes hacia la comida(EAT-26), Cuestionario de Relaciones Multidimensionales Cuerpo-mí mismo(MBSRQ), Actitudes frente al Cambio(ACTA), Inventario de Obsesiones y Compulsiones de Clark-Beck(CBOCI), Inventario de Depresión de Beck(BDI-II), Inventario de Ansiedad de Beck(BAI), Inventario de Creencias Obsesivas(ICO), Cuestionario de Esquemas de Young(YSQ), Escala de Ideas Sobrevaloradas(OVIS), Inventario de Pensamientos Intrusos Obsesivos(INPIOS) y el Inventario de Pensamientos Intrusos Alimentarios(INPIAS). Resultados: Se construyeron dos cuestionarios para evaluar Egosintonía(CES) y Egodistonía(CED-Reducido) de las intrusiones mentales. Los AFE y AFC mostraron una estructura de tres factores en espejo (CED-R: F1.Indeseabilidad del pensamiento. F2.Irracionalidad e incoherencia con la personalidad. F3.Inmoralidad. CES: F1.Deseabilidad. F2.Racionalidad y coherencia. F3.Moralidad). Los ANOVAS con el INPIAS mostraron un continuo: las pacientes obtuvieron puntuaciones significativamente más altas, seguido por el grupo subclínico-TA, y las mujeres recuperadas y población sin riesgo. Sin embargo, todos menos el grupo sin riesgo valoraron sus intrusiones alimentarias como Racionales e Indeseables. En pacientes, la egosintonía se asoció a estar ocupado con el pensamiento, interfiriendo en su concentración(R2=0,14), y a hacer lo que indica la intrusión(R2=0,20). Mientras que en el grupo sin riesgo se asoció a la frecuencia(R2=0,24) y a la importancia otorgada al mismo(R2=0,11). La Egodistonía fue predicha en pacientes por valorar el pensamiento como inaceptable(R2=0,16), y por el empleo de estrategias de control tipo ansioso(R2=0,20). En población sin riesgo destaca la relación con los intentos de supresión(R2=0,20). Además, en pacientes la Egosintonía se asoció(p<0,001) principalmente a una baja motivación al cambio y la preocupación por el sobrepeso, mientras que la Egodistonía se asoció(p<0,001) a la satisfacción por la apariencia. A nivel subclínico TA y TOC, ambos grupos evaluaron sus intrusiones como Racionales e Indeseables. Finalmente, Egosintonía/Egodistonía no se relacionaron con creencias nucleares, aunque la Egosintonía si correlacionó(p<0,01) con creencias TOC(Importancia de controlar los pensamientos, Intolerancia a la incertidumbre y Perfeccionismo). Conclusiones: Los datos señalan que las intrusiones alimentarias no son completamente Egosintónicas, al menos en todos los aspectos. Además, la Egodistonía parece ser un factor de buen pronóstico, mientras que la Egosintonía se asocia a un bajo insight. Tanto pacientes como mujeres recuperadas de TA valoran de manera similar la Egosintonía y Egodistonía, quizá señalando un posible factor de vulnerabilidad. Por otra parte, en población no clínica, la Egosintonía de las intrusiones se asocia a un mayor riesgo de TA.Objectives: 1.To examine Egosyntonicity and Egodystonicity of Eating Disorder (ED) and Obsessive-Compulsive Disorder (OCD) unwanted intrusive cognitions. 2.To analyze core beliefs and obsessive beliefs and their relationships with egosyntonicity/egodystonicity. Participants: The sample consisted of a general population group (n=349), a Subclinical-ED group (n=12), a Subclinical-OCD group (n=18), and people without risk of ED or OCD (n=50). The clinical samples included two groups of ED patients (DSM-IV-TR): 106 ED patients (61 Spanish-45 English), and 76 Spanish ED patients. Finally, a group of 20 women had recovered from ED. Instruments: EAT-26, MBSRQ, Attitudes towards change in ED (ACTA), CBOCI, BDI-II, BAI, Obsessive Beliefs Inventory (ICO), Young Schema Questionnaire (YSQ), Overvalued Idea Scale (OVIS), Eating Intrusive Thoughts Inventory (INPIAS), and Obsessive Intrusive Thoughts Inventory (INPIOS). Results: The Egosyntonicity Questionnaire (CES) and Egodystonicity Questionnaire (CED-Reduced) showed that these constructs are better represented as two different dimensions but with common aspects. Patients showed the highest scores on intrusive thoughts and associated variables, followed by the Subclinical-ED, Recovered, and no-risk groups. Every group except the no-risk group rated their intrusions as Rational (Egosyntonicity) and Undesirable (Egodystonicity). In patients and no-risk groups Egosyntonicity/Egodystonicity showed a different pattern of associations, but in both cases the relationships with thought control strategies stand out. Egosyntonicity and Egodystonicity were not associated with core beliefs, but with some obsessive beliefs. Conclusions: Our data indicate that Eating intrusive thoughts are not completely Egosyntonic. Egodystonicity seems to be a good prognosis factor, whereas Egosyntonicity is associated with low insight. In the non clinical population, egosyntonicity is related to a higher risk of developing an ED

Enhancing mental health literacy in obsessive-compulsive disorder and reducing stigma via smartphone: A randomized controlled trial protocol

Background Obsessive-compulsive disorder (OCD) is a disabling disorder that can be successfully treated. However, individuals with OCD do not seek or delay seeking treatment. This delay may be explained by poor mental health literacy and stigmatizing attitudes toward OCD in community. In order to work on these variables, a gamified mental health mobile application (app) called esTOCma has been developed. The purpose of this study is to describe the protocol for a study to test the efficacy of esTOCma, increasing mental health literacy and help-seeking intention, reducing the stigmatizing attitudes and social distance suffered by people with OCD, as well as the distress associated with obsessive-compulsive symptoms. Methods A randomized controlled trial with a crossover design with two conditions (immediate-use App group versus delayed-use App group) will be conducted on a non-clinical adult sample of the community of a minimum size of 200 participants. Participants in the immediate-use App group will start using the app at baseline until completion (10 days); whereas participants in the delayed-use App group will wait 10 days, and then start using the app until completion (10 days). The outcomes will be measured at four assessment points (baseline; 10 days from baseline; and 20 days from baseline; and after 3 months). The following instruments will be administered: Attribution Questionnaire, General Help-Seeking Questionnaire, Social Distance Scale, Mental Health Literacy, Psychoeducation Questionnaire, Social Desirability Scale, Single-Item Self-esteem Scale, and Obsessive-Compulsive Inventory-Revised. Discussion This protocol presents the first study to describe a randomized control trial of a mental health app focused on changing mental health literacy, stigmatizing attitudes, social distance and help-seeking intention associated with OCD. An app intervention of these characteristics is especially relevant nowadays as the COVID-19 pandemic has increased obsessive-compulsive symptoms and severity. An improvement in general knowledge about OCD and a reduction in stigma could be associated with earlier OCD detection and an increase in help-seeking intention, which could result in greater wellbeing. Moreover, normalizing intrusions and knowledge about the cognitive OCD model could serve as a protective variable in vulnerable individuals

Spanish version of the Inferential Confusion Questionnaire-Expanded Version: Further support for the role of inferential confusion in obsessive-compulsive symptoms

Objective Some cognitive models of obsessive‐compulsive disorder (OCD) posit that intrusions exist on a continuum with obsessions; others consider that they may be unrelated phenomena that differ in the context where they occur. We aimed to examine and compare, at two different moments, the context of the occurrence of intrusions and obsessions. Method Sixty‐eight patients with OCD completed an interview appraising their most upsetting obsession and intrusion. Results At their onset, the obsessions/intrusions were associated with experiencing negative emotional states and life events, and they were more likely to appear in 'inappropriate' contexts. The context of the obsessions/intrusions differed the last time they were experienced. Autogenous obsessions/intrusions occurred more frequently in contexts with an indirect link. Conclusions The context distinguishes between intrusions and obsessions, not when they emerge, but when the obsession is already established. The results support that there is a continuum or progression from intrusions to obsessions

Validation of the Spanish version of the Fear of Self Questionnaire

Cognitive models, from both the appraisal and inferential confusion perspectives, propose that the self is a relevant variable in the development and maintenance of obsessive-compulsive (OC) disorder. In this study, we examined the psychometric properties of the Spanish version of the Fear of Self Questionnaire (FSQ) and analyzed the role of the fear of self (the sort of person we are afraid of becoming) as a predictor of OC beliefs and symptoms. A sample of 359 non-clinical participants completed a set of questionnaires, including the FSQ. Confirmatory factor analysis replicated the original one-factor solution for both the FSQ-8- and 20-item versions. The FSQ demonstrated excellent reliability, and fear of self predicted OC symptoms and cognitions, especially unacceptable obsessions

Analysis of the Effectiveness of Cognitive Remediation and Emotional Skills Training in a Group format. Preliminary results in patients with eating disorders

Eating disorders (ED) are associated with cognitive and emotional impairments. Cognitive and Emotional Remediation Skill Training (CREST) was developed as an intervention program targeting patients' thinking styles and their skills in recognizing and managing emotions. AIM: to analyze the effects of the CREST intervention in a group format in females with ED. METHOD: eight females underwent a CREST program (eight 90-minute sessions) targeting cognitive (central coherence, set shifting, problem solving) and emotional (recognizing emotions, managing emotions) difficulties. It was assessed cognitive flexibility (Wisconsin Card Sorting Test), decision-making (Iowa Gambling Task), central coherence (Group embedded Figures Test), alexithymia (Toronto Alexithymia Scale), affect (Positive and Negative Affect Schedule), ED symptomatology (Eating Attitudes Test). RESULTS: Results showed improvements in cognitive flexibility, decision-making, and central coherence, a decrease in depression, anxiety, negative affect, and alexithymia, and an improvement in quality of life. CONCLUSION: The results of this study on patients with ED suggest that the CREST can reduce ED symptomatology and could increase adherence to psychological treatments

Entrenamiento en remediación cognitiva y habilidades emocionales en formato grupal para pacientes con obesidad: un estudio piloto

Resumen: El entrenamiento en remediación cognitiva y habilidades emocionales fue diseñado inicialmente por el grupo de Tchanturia para la intervención individual de pacientes con trastornos alimentarios. El objetivo del presente trabajo es exponer su adaptación a pacientes con obesidad en formato grupal. Se estructura en 8 sesiones semanales en las que se trabaja funciones de ejecutivo central, la relación entre emoción y pensamiento, y el manejo emocional en un mismo y en los demás. Además, presentamos los resultados preliminares de su aplicación a un grupo de 5 participantes con obesidad mórbida con el fin de valorar su posible eficacia. Los resultados indican que tras la intervención, las pacientes mostraron una mejoría en sus habilidades cognitivas y emocionales, así como en las conductas relacionadas con la alimentación y el peso. Este programa puede ser una intervención útil complemento del tratamiento de la obesidad en sus fases iniciales

Casos clínics psicopatologia aplicada a la logopèdia

El document forma part dels materials docents programats mitjançant l'ajut del Servei de Política Lingüística de la Universitat de ValènciaActivitat de Casos clínics per a la assignatura Psicopatologia aplicada a la logopèdia del Grau en LogopèdiaClinical Cases activity for the subject Psychopathology applied to Speech Therapy of the Degree in Speech Therap

Psychopathology exercise book 2nd semester

El document ha sigut revisat pel Servei de Política Lingüística de la Universitat de ValènciaEl siguiente folleto tiene un objetivo modesto pero necesario en el contexto universitario de la enseñanza de psicopatología, una disciplina básica para cualquier profesional futuro en psicología: proporcionar ejemplos reales de diversas formas de presentación de psicopatologías, para que los estudiantes puedan familiarizarse con ellos y relacionarlos con ellos. Los conocimientos adquiridos en la enseñanza teórica.The following booklet has a modest but necessary objective in the university context of teaching psychopathology, a basic discipline for any future professional in psychology: to provide real examples of various presentation forms of psychopathologies, so that students can familiarize themselves with them and relate them to the acquired knowledge in theoretical teaching