Carlos Castilla del Pino, mentor y maestro de una generación / Carlos Castilla del Pino, Mentor and Teacher of a Generation

El artículo glosa la importancia del magisterio de Carlos Castilla del Pino en la cultura española, especialmente como mentor que fue de toda la generación que impulsó el cambio. Lo hace siguiendo las obras de su período intelectual sesentaiochista, libros y artículos que tuvieron una enorme acogida entre la juventud que luego protagonizó ese cambio. Carlos Castilla fue, en España y también en Hispanoamérica, el maestro de toda una generación que lo leyó con avidez y contó con sus análisis críticos y su terminología. Se convirtió en el superego de toda una élite intelectual mediante sus escritos de esos años década en particular, 1968-1975. (AU)

The article discusses the importance of Carlos Castilla del Pino's teaching in Spanish culture, especially as a mentor for the whole generation that promoted the chan-ge. This is done by following the works of his intellectual period in the sixties, books and articles that had an enormous acceptance among the youth that later played a leading 184Amelia Valcárcelrole in that change. Carlos Castilla was, in Spain and also in Latin America, the teacher of a whole generation that read him avidly and relied on his critical analysis and terminology. He became the super-ego of an entire intellectual elite through his writings of those years, particularly during the 1968-1975 period. (AU)

Perceived Criticism in Relation to the Dialectical Behaviour Therapy Network Training in a Residential Program: A Pre-Post Study

Perceived Criticism is a transdiagnostic construct that captures the patients’ perception of criticism. PC seems to be a reliable predictor of negative clinical outcomes concerning recurrence of symptoms or relapse in a broad range of stress-related psychiatric disorders and is thought to be related to underlying stress-related psychobiological vulnerabilities. Dialectical Behavior Therapy (DBT) is a treatment targeting these stress-related psychobiological vulnerabilities. In this pilot study we focus on the possible change in Perceived Criticism due to a (residential) DBT network training. This study follows a pre-post design where PC is recorded in 33 patients (mean age 25 years) and 61 relatives during 8 group sessions of a DBT network training, as part of a residential DBT program. The degree of perceived criticism is systematically assessed using the Perceived Criticism Measure, a two item self-report questionnaire that assesses mutual (perceived) criticism from patients and network members. Overall scores of the perceived criticism measure decrease significantly for both patients and relatives after following the DBT network training. More specific, item scores of both patients and relatives concerning how critical they are towards the other and how critical they thought the other was of them also decreased significantly after following the DBT network training. Findings suggest that a DBT network training as part of a residential DBT program may be instrumental in decreasing levels of perceived criticism. We recommend further exploration of Perceived Criticism as a possible moderator in effect size studies in randomized controlled clinical trials on DBT and in more fundamental research on the putative mechanisms of behavioural change such as improved perspective taking, and the evaluation of social cues (AU)

Adaptation of a DBT Intervention to Reduce Self-harm in Borderline Personality Disorder

Borderline Personality Disorder (BPD) is characterized by instability that often leads to Non-Suicidal Self-Injury (NSSI) and greater healthcare utilization. Dialectical Behavioral Therapy (DBT) is useful although its long duration and the need for specialized therapists make it difficult to implement in low-resources settings, so brief interventions can complement DBT. The objective of the present study was to undertake cultural adaptation of a Brief, Manualized Intervention to reduce NSSI in the Mexican population with BPD. An experimental design with a single-case pilot study with replicas was used with seven women with a BPD diagnosis. Five to six online sessions were implemented and emotional dysregulation, experiential avoidance and NSSI were measured weekly. NAP index was calculated to assess the effect of the intervention. Most participants showed a large effect size in reducing NSSI and a moderate effect size in reducing emotional dysregulation. Moderate and small effect sizes were obtained in experiential avoidance. The intervention adapted and validated seems to be useful and serve as an additional therapeutically tool to complement usual treatment of patients with BPD (AU)

Una introducción a la Terapia Dialéctico Conductual Radicalmente Abierta y una revisión sistemática de las evidencias de su eficacia / An introduction to Radically Open Dialectical Behavioral Therapy and a systematic review of the evidence for its effectiveness

La Terapia Dialéctico Conductual Radicalmente Abierta (RO-DBT) es un tratamiento transdiagnóstico dirigido a pacientes con problemas de sobre-control. Estas personas se caracterizan por presentar inhibición emocional, control de impulsos, necesidad compulsiva de estructura, rigidez cognitiva y conducta gobernada por reglas. Esta terapia centra su trabajo en patologías crónicas y resistentes a tratamiento, como depresión, anorexia nerviosa y trastornos de personalidad del cluster A y C. Para promover el bienestar psicológico, desarrolla la apertura radical y el entrenamiento en déficit en señalización social. El presente trabajo es una revisión bibliográfica sobre la literatura científica de la RO-DBT. Se ofrece una explicación sobre sus fundamentos, objetivos y metodología, con el fin de vislumbrar las novedades que la RO-DBT aporta. Se recogen también diversos estudios sobre la aplicación del tratamiento y los resultados obtenidos (AU)

Mindfulness Component in a Dialectical Behavioural Therapy Group Intervention for Family Members of Borderline Personality Disorder Patients / Mindfulness en una Intervención Grupal de Terapia Dialéctica Conductual para Familiares de Pacientes con Trastorno Límite de la Personalidad

Background: Family members of people with borderline personality disorder (BPD) are seriously affected by the disease and it is common for them to ask for professional help. The main objective of this study is to assess, in an open clinical trial, a treatment protocol based on Dialectical Behaviour Therapy (DBT) strategies for relatives of individuals with BPD, compared to the same protocol plus a mindfulness component (DBT-M). Method: The interventions were conducted in a sample of 108 relatives of 83 patients diagnosed with BPD from a Specialized Unit for Personality Disorders. Relatives and patients completed the assessment protocol before and after the intervention. Results: Significant improvements in almost all the relevant variables tested were observed after the treatment in both the relatives and the patients. However, there were only statistically significant differences between the groups in the negative attitude towards the illness, where relatives in the DBT-M condition showed greater improvement than those in the DBT condition. Conclusions: The results indicate that the intervention helps both patients and relatives to improve on key issues. It is essential to consider and offer support to the families of people with severe psychological disorders.(AU)

Antecedentes: Los familiares de las personas con trastorno límite de la personalidad (TLP) son unos de los grandes afectados por el trastorno, y resulta frecuente que soliciten ayuda profesional. El objetivo estudio es evaluar un protocolo de tratamiento basado en estrategias de Terapia Dialéctica Conductual (DBT) para familiares de personas con TLP, en comparación con el mismo protocolo más un componente de mindfulness (DBT-M). Método: Las intervenciones se realizaron en una Unidad Especializada en Trastornos de la Personalidad, en una muestra 108 familiares de 83 pacientes diagnosticados de TLP. Familiares y pacientes completaron el protocolo de evaluación antes y después de la intervención. Resultados: Se observan mejoras significativas tanto en los familiares como en los pacientes tras el tratamiento, en casi todas las variables relevantes. Sin embargo, sólo hubo diferencias estadísticamente significativas entre las dos condiciones en la actitud negativa hacia la enfermedad, donde los familiares en la condición DBT-M mostraron una mejoría mayor que los de la condición DBT. Conclusiones: Los resultados indican que la intervención ayuda, tanto a los pacientes como a los familiares, a mejorar en aspectos clave. Resulta fundamental tener en cuenta y ofrecer apoyo a los familiares de personas con trastornos psicológicos graves.(AU)

Dialéctica o erística. la aproximación hermenéutica a la ética biomédica como problema o como solución / Dialectics or eristics. the hermeneutic approach to biomedical ethics as a problem or as a solution

El presente trabajo se dirige a poner de manifiesto las condiciones en que la aproximación hermenéutica puede efectuar una insustituible aportación a la ética biomédica. Esta aportación se entiende a la luz de una de las principales deficiencias que presentan las metodologías al uso (en este trabajo nos referiremos básicamente al principialismo y al casuismo), que, en el fondo, actúan como meras cadenas de transmisión de los prejuicios del agente moral. Si bien los prejuicios no se pueden evitar, esto no significa que no se puedan superar, si es que, con Gadamer, entendemos que la comprensión está de algún modo dirigida a la verdad de las cosas. Este postulado nos permite poner en conexión la hermenéutica gadameriana con la ética aristotélica cosa que ya hace el propio Gadamer, pero sólo a los efectos de deslindar su noción de comprensión, e intentar ofrecer una salida para la mencionada deficiencia de las metodologías al uso

This paper aims to highlight the conditions in which the hermeneutical approach can make an irreplaceable contribution to biomedical ethics. This contribution is understood in the light of one of the main shortcomings of current methodologies (in this work we will refer basically to Principlism and Casuistics), which ultimately operate as mere chains of transmission of the moral agent’s prejudges. Although prejudices cannot be avoided, however, it does not mean that they cannot be overcome, if, with Gadamer, we realize that understanding is in some way directed towards the truth of things. This postulate allows us to connect Gadamerian Hermeneutics with Aristotelian Ethics -something which Gadamer himself does, but only to the effects of defining his notion of understanding- and to try to offer a way out for the afore-mentioned weakness of current methodologies