El bienestar psicológico y la felicidad como variables protectoras en los Trastornos Adaptativos. Un estudio exploratorio

III Jornades d’Investigació per a l’Alumnat de la Facultat de Ciències de la SalutIntroducción: La relación existente entre la satisfacción con la vida y la felicidad conrespecto a variables psicológicas clínicas ha sido ampliamente estudiada. Existen estudiosque muestran al afecto positivo como amortiguador del estrés y de otros síntomasclínicos, así como potenciador de comportamientos saludables y calidad de vida.Objetivo: Explorar las relaciones existentes entre las variables de satisfacción con lavida y felicidad subjetiva como factores protectores de síntomas clínicos en una muestrade pacientes diagnosticados de Trastorno Adaptativo (TA). Método: La muestraincluyó 46 participantes (media de edad= 33.2; DT= 8.47). Como medidas positivas seincluyeron las escalas de felicidad subjetiva (SHS) y satisfacción con la vida (SWLS).Las medidas clínicas fueron: depresión, síntomas de estrés y pérdida y percepción decapacidad para afrontar el problema. Resultados: Se obtuvieron correlaciones significativasen la dirección esperada entre las variables positivas y las variables clínicasde depresión y autoeficacia. Los síntomas de estrés y pérdida solamente correlacionaronsignificativamente con la felicidad. Los resultados posteriores mediante regresiónlineal reflejaron que ambas variables positivas predecían la gravedad de la sintomatologíadepresiva. Además, la satisfacción con la vida predecía el grado deautoeficacia para afrontar el problema, mientras que la felicidad subjetiva fue predictorade menos síntomas de estrés y pérdida asociados al mismo. Conclusión: Losresultados preliminares obtenidos están en la línea de los hallados en otros trabajos yreflejan la importancia de atender, en pacientes con diagnóstico de TA, a variablespsicológicas positivas como las incluidas en este estudio.Introduction: The relationship between satisfaction with life and the growing happinessof clinical psychological variables has been thoroughly studied. Some studiesshow positive affection as a shock absorber of stress and other clinical symptoms, aswell as an enhancer of healthy behaviors and quality of life. Objective: To explore therelationship between life satisfaction and subjective happiness as protective factors forclinical symptoms in a sample of patients diagnosed with Adjustment Disorder (AD).Method: The sample included 46 participants (mean age = 33.2, SD = 8.47). Positivemeasures included subjective happiness (SHS) and satisfaction with life (SWLS)scales. The clinical measures were: depression, symptoms of stress and loss, and perceptionof the ability to cope with the problem. Results: Significant correlations wereobtained in the expected direction between the positive variables and the clinical variablesof depression and self-efficacy. Symptoms of stress and loss only correlatedsignificantly with happiness. Subsequent linear regression results showed that bothpositive variables predicted the severity of depressive symptoms. In addition, satisfactionwith life predicted the degree of self-efficacy to cope with the problem, while subjectivehappiness was predictive of less symptoms of stress and loss associated with it.Conclusion: The preliminary results obtained are in line with those found in other studiesand reflect the importance of attending, in patients with a diagnosis of AD, positivepsychological variables such as those included in this study

Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Adults with Prolonged Grief Disorder (PGD): A Study Protocol for a Randomized Feasibility Trial

Introduction Grief is an emotional reaction to the loss of a loved one with a natural recovery. Approximately 10% of people who lose a loved one develop prolonged grief disorder (PGD). Internet-based and computer-based interventions (ie, internet-delivered cognitive-behavioural therapy, iCBT) are a cost-effective alternative that makes it possible to reach more people with PGD. The main aim of this study is to assess the feasibility of a new iCBT-called GROw-for PGD. As a secondary objective, the potential effectiveness of GROw will be explored. Methods and analysis This study is a two-arm feasibility randomised trial. A total of 48 adults with PGD who meet the eligibility criteria will be randomised to the experimental group (iCBT: GROw) or the active control group (face-to-face CBT treatment). The treatment is organised sequentially in eight modules in the iCBT format and 8-10 sessions in the face-to-face format, and both formats have the same therapeutic components. There will be five assessment points with qualitative and quantitative evaluations: screening, baseline, after the intervention, 3-month follow-up and 12-month follow-up. Consistent with the objectives, the measures are related to the feasibility outcomes for the main aim of the study (participant adherence, expectations and satisfaction with the treatment, preferences, alliance and utility) and psychological and mental health outcomes for secondary analyses (symptoms of grief, symptoms of depression, symptoms of anxiety, affectivity, quality of life, work and social adaptation, post-traumatic growth, purpose in life, mindfulness and compassion). Ethics and dissemination The Ethics Committee of the Universitat Jaume I (Castellon, Spain) granted approval for the study (CD/002/2019). Dissemination will include publications and presentations at national and international conferences

An Internet-based treatment for Flying Phobia using 360° images: study protocol for a feasibility pilot study

Background: Flying Phobia (FP) is a prevalent disorder that can cause serious interference in a person’s life. ICBT interventions have already shown their efficacy in several studies, but studies in the field of specific phobias are still scarce. Moreover, few studies have investigated the feasibility of using different types of images in exposure scenarios in ICBTs and no studies have been carried out on the role of sense of presence and reality judgement. The aim of the present study is to explore the feasibility of an ICBT for FP (NO-FEAR Airlines) using two types of images with different levels of immersion (still and navigable images). A secondary aim is to explore the potential effectiveness of the two experimental conditions using two types of images compared to a waiting list control group. Finally, the role of navigable images compared to the still images in the level of anxiety, sense of presence, and reality judgement will also be explored. This paper presents the study protocol. Methods: This study is a three-armed feasibility pilot study with the following conditions: NO-FEAR Airlines with navigable images, NO-FEAR Airlines with still images, and a waiting list group. A minimum of 60 participants will be recruited. The intervention will have a maximum duration of 6 weeks. Measurements will be taken at four different moments: baseline, post-intervention, and two follow-ups (3- and 12-month). Participants’ opinions, preference, satisfaction and acceptance regarding the images used in the exposure scenarios will be assessed. FP symptomatology outcomes will also be considered for secondary analyses. The anxiety, sense of presence, and reality judgement in the exposure scenarios will also be analysed. Discussion: This study will conduct a pilot study on the feasibility of an ICBT for FP and it is the first one to explore the evaluation of patients of the two type of images (still and navigable) and the role of presence and reality judgement in exposure scenarios delivered through the Internet. Research in this field can have an impact on the way these scenarios are designed and developed, as well as helping to explore whether they have any effect on adherence

Internet- and mobile-based interventions for the treatment of specific phobia: A systematic review and preliminary meta-analysis

Internet- and mobile-based interventions (IMIs) are being developed for a wide range of psychological disorders and they showed their effectiveness in multiple studies. Specific phobia (SP) is one of the most common anxiety disorders, and research about IMIs for their treatment has also been conducted in recent years. The aim of this paper was to conduct a systematic review and preliminary meta-analysis exploring IMIs for the treatment of SP. A comprehensive search conducted in five different databases identified 9 studies (4 pre-post studies, 5 randomized controlled trials) with 7 Internet-based interventions and 2 mobile-based interventions. Results showed that exposure was the main component of all interventions, and that animal phobia was the most common subtype. Samples included children, adolescents, and adults. A preliminary meta-analysis of the included studies showed that participants receiving IMIs experienced a significant reduction of SP symptoms from pre- to post-treatment (g = 1.15). This systematic review found that there is already some evidence in the literature supporting the potential benefits of IMIs for SP. However, the number of studies included is small and more research should be carried out in the field

Can between-session homework be delivered digitally? A pilot randomized clinical trial of CBT for adjustment disorders

Adjustment disorder (AjD) is one of the most common disorders in clinical practice, and its symptoms are severe enough to cause great distress and functional impairment. The AjD CBT protocol specifically developed for this disorder has shown positive results when delivered face to face and through virtual reality. Despite existing evidence supporting the benefits of therapeutic homework as part of a psychological intervention, little is known about how to increase homework engagement in psychotherapy. This study examines the feasibility (doability, initial efficacy and acceptability) of a digital support system to deliver homework via the Internet in the treatment of AjD. Participants were randomly assigned to a traditional homework condition or a digital support system condition. Both interventions resulted in statistically significant improvements, with large effect sizes, in all the outcome measures at post-treatment, with no significant differences between groups. At 12-month follow-up, these therapeutic gains were maintained, and an improvement was even observed in both conditions, with no significant differences between groups. Additionally, treatment satisfaction predicted efficacy in both groups separately and when the whole group was considered. This is the first study to explore the feasibility an initial efficacy of delivering a therapeutic homework component for AjD through the Internet

Blended transdiagnostic group CBT for emotional disorders: a feasibility trial protocol

Emotional disorders (anxiety and depressive disorders) are a relevant public health concern associated with high prevalence, high costs, and important disability. Therefore, research priorities include designing and testing cost-effective interventions to reach everyone in need. Internet-delivered interventions for emotional disorders are effective and can help to disseminate and implement evidence-based treatments. However, although these treatments are generally effective, not all patients benefit from this treatment format equally. Blended treatments are a new form of intervention that combines the strengths of face-to-face and Internet approaches. Nevertheless, research on blended interventions has focused primarily on individual therapy, and less attention has been paid to the potential of using this format in group psychotherapy. This study aims to analyze the feasibility of blended transdiagnostic group CBT for emotional disorders. The current article describes the study protocol for this trial

An internet-delivered Cognitive-Behavioral Therapy (iCBT) for Prolonged Grief Disorder (PGD) in adults: A multiple-baseline single-case experimental design study

The death of a loved one has physical, psychological, and social consequences. Between 9.8 and 21.5 % of people who lose a loved one develop Prolonged Grief Disorder (PGD). Internet- and computer-based interventions (i.e., Internet-delivered Cognitive-Behavioral Therapy, iCBT) are cost-effective and scalable alternatives that make it possible to reach more people with PGD. The main goal of the present investigation was to examine the effect and feasibility (usability and satisfaction) of an iCBT (GROw program) for adults with PGD. A secondary objective was to detect adherence to the app (Emotional Monitor) used to measure daily grief symptoms. The study had a single-case multiple-baseline AB design with six participants. The GROw program is organized sequentially in eight modules, and it is based on the dual-process model of coping with bereavement. Evaluations included a pre-to-post treatment assessment of depression, grief symptoms, and typical grief beliefs, along with daily measures of symptom frequency and intensity on the Emotional Monitor App. Treatment opinions and adherence to the App were also collected. Efficacy data were calculated using a Nonoverlap of All Pairs (NAP) analysis and Reliable Change Index (RCI). The mean age of the sample was 29.5 years (SD = 8.19). Two participants dropped out of the study. Adherence to the App varied across patients (4.8 % -77.8 %). Most participants (75 %) showed a clinically significant change (recovered) in depression, and 50 % obtained a clinically significant improvement (recovered) in symptoms of loss and typical beliefs in complicated grief. The participants reported high usability and satisfaction with the treatment content and format. In sum, the GROw program was very well accepted and generally feasible, and it has strong potential for treating PGD. The results support scaling up the treatment by using more complex designs with larger samples (i.e., randomized controlled trials comparing GROw with active conditions

Actitudes de los futuros profesionales de la psicología clínica sobre un sistema de terapia emocional online (TEO) para el tratamiento de los trastornos de adaptación

Treball final de Grau en Psicologia. Codi: PS1048. Curs acadèmic 2014-2015Las ventajas y utilidad de las TICs para aplicar los tratamientos psicológicos, concretamente Internet, han sido demostradas en numerosos estudios. Esta herramienta es bien aceptada por los pacientes. No obstante, existen pocas investigaciones centradas en la aceptación de las TICs por parte de profesionales y futuros profesionales de salud mental. Este estudio pretende analizar las actitudes de terapeutas y futuros terapeutas (N=60) hacia un programa computerizado basado en Internet (TEO: Terapia Emocional Online). Además, también se explora la relación entre estas actitudes y el perfil de uso de TICs. Se utilizaron tres cuestionarios desarrollados para esta investigación para evaluar la opinión de la plataforma del terapeuta del sistema, la opinión acerca de la plataforma del paciente y el perfil de uso de TICs. Los resultados indicaron que ambas plataformas fueron bien aceptadas por parte de los participantes, las percibían como útiles, beneficiosas, fáciles de usar, lógicas, atractivas y poco aversivas. La intención de uso de TEO fue alta y un 93,2% escogieron TEO frente al formato tradicional para realizar las tareas para casa entre sesiones. Los participantes mostraron un perfil de uso de TICs alto. Se obtuvieron correlaciones positivas y significativas entre el perfil de uso de TICs y la percepción de TEO como lógico, útil, capaz de mejorar el estado de ánimo de los pacientes y también con la intención de uso. En cuanto al uso de TEO como tratamiento autoaplicado, solo se encontró una relación significativa con el interés (no siendo así en el caso de sentirse bien y capaz con las TICs). La investigación en el ámbito de las TICs y su aceptación por parte de profesionales de salud mental es importante ya que son ellos los encargados de utilizar estas herramientas con sus pacientes y que, por tanto, puedan beneficiarse de ellas tanto pacientes como profesionales. Nota: Los datos de este estudio fueron obtenidos en dos fases. En la primera fase, realizada en el Laboratorio de Psicología y Tecnología (Labpsitec) de la Universitat Jaume I al que pertenece la tutora del presente trabajo, se recogieron los datos de 30 participantes. En la segunda fase, la alumna autora principal del estudio amplió la recogida de datos a otros 30 participantes.The advantages and utility of ICTs to apply psychological treatments, specifically Internet, have been demonstrated in numerous studies. This tool is well accepted by patients. However, there is little research focused on the acceptance of ICTs by future professionals and mental health professionals. This study aims to analyze the attitudes of therapists and future therapists (N = 60) towards a computerized Internet-based program (TEO: Emotional Therapy Online). Furthermore, the relationship between these attitudes and ICTs usage profile is explored. Three questionnaires were developed for this research to evaluate the opinion about therapist platform of the system, the opinion about patient platform and the ICTs usage profile. The results indicated that both platforms were well accepted by the participants, they perceived them as useful, beneficial, user-friendly, logical, attractive and little aversive. The intended use of TEO was high and 93.2% chose TEO over the traditional format for practicing homework assignments between sessions. Participants showed a high usage profile of ICTs. Positive and significant correlations were found between the profile of ICTs use and the perception of TEO as a logical, useful, and capable of improving the mood of patients and also with the intended use. Regarding the use TEO as a self-administered treatment, only a significant relationship with the interest (not to be so in the case of feeling well and capable with ICTs) was found. Research in the field of ICTs and its acceptance by mental health professionals is important since they are responsible for using these tools with their patients and, consequently, both patients and professionals could benefit from them

Tratamientos psicológicos a través de internet para el duelo: Un estudio de revisión

Treball Final de Màster Universitari en Psicologia General Sanitària. Codi: SBF018. Curs: 2017/2018Introduction: Grief is an intense emotional reaction to the loss of a loved one. It produces feelings of regret and longing that usually dec rease over time. However, some people have difficulty adapting to the loss and develop Prolonged Grief Disorder (PGD). There are effective cognitive - behavioral treatments (CBT) to treat PGD, but this does not ensure that people who need treatment can access to it. The use of the I nternet can be an alternative to this problem since it allows reaching a greater number of unattended people. In addition, i nternet - based treatments have effect sizes comparable to traditional face - to - face interventions. The aim of this study is to carry out a review of the literature on psychological interventions through the internet for PGD . Method: A keyword search was cond ucted in three databases; PubMed, Web of Science and PubPsych, and studies were included according to the selection criteria for further analysis. Results: Studies show that online treatments for PGD show predominantly positive results in terms of reducing grief symptoms and other symptoms of general psychopathology. Conclusions: This review has limitations so more resear ch is needed in this line. Even so, the results are promising and suggest that online treatments for PGD are effective.Introducción: El duelo es una reacción emocional intensa ante la pérdida de un ser querido. Produce sentimientos de lamento y anhelo que normalmente disminuyen con el tiempo. Sin embargo, algunas personas tienen dificultad para adaptarse a la pérdida y desarrollan Tras torno de Duelo Prolongado (TDP). Existen tratamientos cognitivo - conductuales (TCC) eficaces para tratar el TDP, pero esto no asegura que las personas que necesitan tratamiento pueda acceder al mismo. El uso de internet puede ser una alternativa a este prob lema, ya que permite llegar a un mayor número de personas desatendidas. Además, los tratamientos a través de internet tienen tamaños del efecto comparables con intervenciones cara a cara tradicionales. El objetivo de este estudio es llevar a cabo una revis ión de la literatura sobre las intervenciones psicológicas a través de internet para personas con TDP . Método: Se realizó una búsqueda de palabras clave en tres bases de datos; PubMed, Web of Science y PubPsych, y se incluyeron los estudios acordes a los criterios de selección para su posterior análisis. Resultados: Los estudios muestran que los tratamientos a través de internet para el TDP arrojan resultados predominantemente positivos en cuanto a la reducción de síntomas de duelo y otr os síntomas de p sicopatología general. Conclusiones: Esta revisión tiene ciertas limitaciones por lo que se necesitan más inv e stig a ciones en esta línea. Aun así, los resultados son prometedores y sugieren que los tratamientos a través de internet para el duelo son eficace s

GROw, an Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Adults with Prolonged Grief Disorder (PGD)

Compendi d'articles, Doctorat internacionalLosing a loved one is a painful process with physical, psychological, and social consequences. Between 9.8 and 21.5% of bereaved adults are at risk of developing Prolonged Grief Disorder (PGD). There are effective treatments for PGD, but this does not ensure that the treatments reach the people who need them. The aim of this thesis was to explore the feasibility and the potential effectiveness of GROw, a novel Internet-delivered cognitive-behavioral therapy (iCBT) for adults with PGD. This tesis includes a literature review of published studies that have tested an Internet-based treatment for PGD, a multiple-baseline single-case experimental study and a randomized feasibility trial study. The results showed that GROw was feasible and well-accepted in terms of adherence, preferences, expectations, satisfaction, and qualitative opinions about the usefulness of the intervention. In addition, GROw showed strong potential in treating grief-related symptomatology, compared to the same intervention delivered face-to-face through videoconference.Programa de Doctorat en Psicologi