Despersonalización en una muestra comunitaria y en personas con trastornos de ansiedad: el rol de las interpretaciones catastróficas y de la evitación experiencial

This study explored the relación among catastrophic interpretations, experiential avoidance and different subtypes of depersonalization (DP) in 70 individuals of the community and 70 individuals with anxiety disorders. Patients answered questionnaires that measured catastropihc interpretations, experiential avoidance and DP. Catastrophic interpretations predicted the global intensity of DP and also the subtypes anomalous corporal experiences, anomalous recall experiencies and derealization. On the opposite, experiential avoidance was not a predictor of DP. Results are commented in light of the progress in the conceptualization of DP. Este estudio exploró la relación entre interpretaciones catastróficas, evitación experiencial y los diferentes subtipos de despersonalización (DP) en 70 participantes de la comunidad y 70 pacientes con trastornos de ansiedad. Los pacientes completaron instrumentos que medían interpretaciones catastróficas, evitación experiencial y DP. Las interpretaciones catastróficas predijeron la intensidad global de la DP y los subtipos experiencias corporales anómalas, experiencias anómalas del recordar, y desrealización. Contrariamente, la evitación experiencial no apareció como un predictor de DP. Los resultados son discutidos a la luz de los últimos avances en la conceptualización de la DP

Prolonged exposure for the treatment of Spanish-speaking Puerto Ricans with posttraumatic stress disorder: a feasibility study

<p>Abstract</p> <p>Background</p> <p>Most of the empirical studies that support the efficacy of prolonged exposure (PE) for treating posttraumatic stress disorder (PTSD) have been conducted on white mainstream English-speaking populations. Although high PTSD rates have been reported for Puerto Ricans, the appropriateness of PE for this population remains unclear. The purpose of this study was to examine the feasibility of providing PE to Spanish speaking Puerto Ricans with PTSD. Particular attention was also focused on identifying challenges faced by clinicians with limited experience in PE. This information is relevant to help inform practice implications for training Spanish-speaking clinicians in PE.</p> <p>Results</p> <p>Fourteen patients with PTSD were randomly assigned to receive PE (n = 7) or usual care (UC) (n = 7). PE therapy consisted of 15 weekly sessions focused on gradually confronting and emotionally processing distressing trauma-related memories and reminders. Five patients completed PE treatment; all patients attended the 15 sessions available to them. In UC, patients received mental health services available within the health care setting where they were recruited. They also had the option of self-referring to a mental health provider outside the study setting. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline, mid-treatment, and post-treatment to assess PTSD symptom severity. Treatment completers in the PE group demonstrated significantly greater reductions in PTSD symptoms than the UC group. Forty percent of the PE patients showed clinically meaningful reductions in PTSD symptoms from pre- to post-treatment.</p> <p>Conclusions</p> <p>PE appears to be viable for treating Puerto Rican Spanish-speaking patients with PTSD. This therapy had good patient acceptability and led to improvements in PTSD symptoms. Attention to the clinicians' training process contributed strongly to helping them overcome the challenges posed by the intervention and increased their acceptance of PE.</p

Despersonalización en una muestra comunitaria y en personas con trastornos de ansiedad: el rol de las interpretaciones catastróficas y de la evitación experiencial

Este estudio exploró la relación entre interpretaciones catastróficas, evitación experiencial y los diferentes subtipos de despersonalización (DP) en 70 participantes de la comunidad y 70 pacientes con trastornos de ansiedad. Los pacientes completaron instrumentos que medían interpretaciones catastróficas, evitación experiencial y DP. Las interpretaciones catastróficas predijeron la intensidad global de la DP y los subtipos experiencias corporales anómalas, experiencias anómalas del recordar, y desrealización. Contrariamente, la evitación experiencial no apareció como un predictor de DP. Los resultados son discutidos a la luz de los últimos avances en la conceptualización de la DP.This study explored the relación among catastrophic interpretations, experiential avoidance and different subtypes of depersonalization (DP) in 70 individuals of the community and 70 individuals with anxiety disorders. Patients answered questionnaires that measured catastropihc interpretations, experiential avoidance and DP. Catastrophic interpretations predicted the global intensity of DP and also the subtypes anomalous corporal experiences, anomalous recall experiencies and derealization. On the opposite, experiential avoidance was not a predictor of DP. Results are commented in light of the progress in the conceptualization of DP.

Despersonalización en una muestra comunitaria y en personas con trastornos de ansiedad: el rol de las interpretaciones catastróficas y de la evitación experiencial

Este estudio exploró la relación entre interpretaciones catastróficas, evitación experiencial y los diferentes subtipos de despersonalización (DP) en 70 participantes de la comunidad y 70 pacientes con trastornos de ansiedad. Los pacientes completaron instrumentos que medían interpretaciones catastróficas, evitación experiencial y DP. Las interpretaciones catastróficas predijeron la intensidad global de la DP y los subtipos experiencias corporales anómalas, experiencias anómalas del recordar, y desrealización. Contrariamente, la evitación experiencial no apareció como un predictor de DP. Los resultados son discutidos a la luz de los últimos avances en la conceptualización de la DP.</div

Moral cognition about harm in anxiety disorders: The Importance of Experienced Emotion

Emotion has long been understood to play an important role in motivating moral beliefs and behavior. Recent work has shown that level of emotional arousal exerts a strong influence on decision-making in sacrificial moral dilemmas, with heightened levels of arousal associated with increased aversion to committing moral transgressions to maximize utilitarian outcomes. Patients with anxiety disorders share the common experience of pathologically heightened states of arousal, which generates the hypothesis that anxious patients would exhibit reduced proclivities to endorse utilitarian responses on such dilemmas. Limited extant work has shown mixed evidence, however, and most investigations have focused on only specific diagnostic groups, such as Obsessive-Compulsive Disorder. We investigated a cohort of 95 patients from across the spectrum of anxiety disorders to test this hypothesis. Results showed no group differences between patients and controls on endorsement of utilitarian sacrificial action or on reported experience of emotionality during the experiment. Potential explanations for these null findings are explored

Moral cognition about harm in anxiety disorders: The Importance of Experienced Emotion

Emotion has long been understood to play an important role in motivating moral beliefs and behavior. Recent work has shown that level of emotional arousal exerts a strong influence on decision-making in sacrificial moral dilemmas, with heightened levels of arousal associated with increased aversion to committing moral transgressions to maximize utilitarian outcomes. Patients with anxiety disorders share the common experience of pathologically heightened states of arousal, which generates the hypothesis that anxious patients would exhibit reduced proclivities to endorse utilitarian responses on such dilemmas. Limited extant work has shown mixed evidence, however, and most investigations have focused on only specific diagnostic groups, such as Obsessive-Compulsive Disorder. We investigated a cohort of 95 patients from across the spectrum of anxiety disorders to test this hypothesis. Results showed no group differences between patients and controls on endorsement of utilitarian sacrificial action or on reported experience of emotionality during the experiment. Potential explanations for these null findings are explored

The roles of interoceptive sensitivity and metacognitive interoception in panic

Background: Interoception refers to the ability to sense body signals. Two interoceptive dimensions have been recently proposed: (a) interoceptive sensitivity (IS) –objective accuracy in detecting internal bodily sensations (e.g., heartbeat, breathing)–; and (b) metacognitive interoception (MI) –explicit beliefs and worries about one’s own interoceptive sensitivity and internal sensations. Current models of panic assume a possible influence of interoception on the development of panic attacks. Hypervigilance to body symptoms is one of the most characteristic manifestations of panic disorders. Some explanations propose that patients have abnormal IS, whereas other accounts suggest that misinterpretations or catastrophic beliefs play a pivotal role in the development of their psychopathology. Our goal was to evaluate these theoretical proposals by examining whether patients differed from controls in IS, MI, or both. Twenty-one anxiety disorders patients with panic attacks and 13 healthy controls completed a behavioral measure of IS motor heartbeat detection (HBD) and two questionnaires measuring MI. Findings: Patients did not differ from controls in IS. However, significant differences were found in MI measures. Patients presented increased worries in their beliefs about somatic sensations compared to controls. These results reflect a discrepancy between direct body sensing (IS) and reflexive thoughts about body states (MI). Conclusion: Our findings support the idea that hypervigilance to body symptoms is not necessarily a bottom-up dispositional tendency (where patients are hypersensitive about bodily signals), but rather a metacognitive process related to threatening beliefs about body/somatic sensations.6 page(s

Children and adolescents with Tourette’s disorder in the USA versus Argentina: behavioral differences may reflect cultural factors

To explore behavioral differences as possible cultural factors in presentation of psychiatric comorbidity in two clinically referred, consecutively ascertained samples of youth with Tourette’s disorder (TD) from New York and Buenos Aires. Subjects were evaluated between 2002 and 2010 at the Tics and Tourette’s Clinical and Research Program at the New York University Child Study Center in New York and the Interdisciplinary Center for Tourette’s, Obsessive Compulsive Disorder (OCD) and Associated Disorders (CITTTA)/Institute of Cognitive Psychology (INECO) in Buenos Aires. Demographic, diagnostic, tic severity (Yale Global Tic Severity Scale; YGTSS), clinical (Child Behavior Check List-Parent version; CBCL), and global functioning (Global Assessment of Functioning; GAF) data were compared using descriptive statistics. The sample included 111 subjects ages 6–17 years, who met DSM-IV-TR diagnostic criteria for TD. Findings revealed that the BA sample (n = 35) was significantly older at initial evaluation at the tic specialty clinic, and had higher frequency of oppositional defiant disorder (ODD), mood and non-OCD anxiety disorders than the NY sample (n = 76). There were no differences in gender distribution, age at tic onset or TD diagnosis, tic severity, proportion with current diagnoses of OCD/OC behavior or attention deficit hyperactivity disorder (ADHD), CBCL internalizing, externalizing, or total problems scores, YGTSS scores, or GAF scores. The observed similarities in demographic features, clinical presentation, rates of ADHD and OCD/OCB, and global impairment may reflect similar phenomenology and illness-related characteristics of TD in these referred youth. Differences in age at initial specialty clinic evaluation and rates of ODD, mood and non-OCD anxiety disorders may need further exploration before they may be considered to reflect cultural factors. Because of these limitations (e.g. small sample size), these results can be regarded only as preliminary