Effectiveness of the Unified Barlow Protocol (UP) and neuropsychological treatment in cancer survivors for cognitive impairments: study protocol for a randomized controlled trial.

BACKGROUND: Cancer survivors frequently develop cognitive impairment, which negatively affects their quality of life and emotional well-being. This study compares the effectiveness of a well-established treatment (neuropsychological treatment) with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to reduce these cognitive deficits and evaluate the effect of both treatments on anxiety-depressive symptoms and the quality of life of cancer survivors. METHODS: A three-arm, randomized superiority clinical trial with a pre-post and repeated follow-up measures intergroup design using a 1:1:1 allocation ratio will be performed. One hundred and twenty-three cancer survivors with mild to moderate cognitive impairment will be randomly assigned to one of the study interventions: a cognitive rehabilitation intervention group, an intervention group with UP intervention, or a control group on the waiting list. The primary outcome is to observe a significant improvement in cognitive function in both intervention groups and a significant decrease in emotional impairments in comparison with the waitlist group. Improvements in anxiety, depression, and quality of life are also expected as secondary outcomes. These results will be maintained at 6 months of follow-up. DISCUSSION: The aim of this trial is to test the efficacy of the UP intervention in reducing cognitive deficits in breast cancer survivors. The results of this trial may be useful in reducing the presence of cognitive problems in cancer survivors and improving their emotional state and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT05289258. Registered 12 March 2022, v01.

Visual preference for social vs. non-social images in young children with autism spectrum disorders. An eye tracking study.

Autism Spectrum Disorders (ASD) are associated to social attention (SA) impairments. A gaze bias to non-social objects over faces has been proposed as an early marker of ASD. This bias may be related to the concomitant circumscribed interests (CI), which question the role of competing objects in this atypical visual behavior. The aim of this study was to compare visual attention patterns to social and non-social images in young children with ASD and matched typical controls (N = 36; age range 41-73 months) assessing the role of emotion in facial stimuli and the type of competing object. A paired preference task was designed pairing happy, angry, and neutral faces with two types of objects (related or not related to autism CI). Eye tracking data were collected, and three indexes were considered as dependent variables: prioritization (attentional orientation), preference, and duration (sustained attention). Results showed that both groups had similar visual pattern to faces (prioritization, more attention and longer visits to faces paired with objects non-related to their CI); however, the ASD group attended to faces significantly less than controls. Children with ASD showed an emotional bias (late orientation to angry faces and typical preference for happy faces). Finally, objects related to their CI captured attention in both groups, significantly reducing SA in children with ASD. Atypical SA is present in young children with ASD regardless the competing non-social object. Identifying strengths and difficulties in SA in this population may have substantial repercussion for early diagnosis, intervention, and ultimately prognosis.

Mindfulness-based stress reduction in adolescents with mental disorders: a randome / Reducción del estrés basada en mindfulness en adolescentes con trastornos mentales: un ensayo clínico aleatorio

BACKGROUND: Currently, there is a strong movement to implement mindfulness interventions with young people. The objective of this randomised clinical trial was to assess the potential effects of a mindfulness-based stress reduction (MBSR) programme for adolescent outpatients in mental health facilities in Cordoba, Spain. METHOD: A total of 101 adolescents aged 13-16 years old, receiving psychological or psychiatric treatment for various disorders, were eligible for the study. The participants' scores on mindfulness, self-esteem, perceived stress, state-trait anxiety and other psychological symptoms were examined at two time-points. Eighty adolescents completed the study (MBSR+TAU group = 41; TAU group = 39). RESULTS: The MBSR+TAU group showed a statistically significant decrease in anxiety state compared to the treatment-as-usual (TAU) group. No statistically significant differences were found between groups on the other scores, but the intervention was observed to have a greater impact on the MBSR+TAU group than in the TAU group, especially in reducing symptoms of depression, anxiety, paranoia and perceived stress. CONCLUSION: These results suggest that MBSR may be a useful adjunct treatment for adolescents in mental health facilities

ANTECEDENTES: actualmente, existe un fuerte movimiento respecto a la implantación de las intervenciones de mindfulness con adolescentes. El objetivo de este ensayo clínico fue evaluar el efecto potencial de un programa de reducción del estrés basado en la atención plena (MBSR) para pacientes ambulatorios adolescentes en los servicios de salud mental de Córdoba, España. MÉTODO: un total de 101 adolescentes (13-16 años) con trastornos heterogéneos que recibían tratamiento psicológico o psiquiátrico fueron seleccionados para participar en el estudio. Las puntuaciones de los participantes en mindfulness, autoestima, estrés percibido, ansiedad estado-rasgo y otros síntomas psicológicos fueron evaluados en dos momentos. Ochenta adolescentes completaron el estudio (grupo-MBSR+TAU = 41, grupo-TAU = 39). RESULTADOS: el grupo MBSR+TAU muestra una disminución estadísticamente significativa en ansiedad-estado comparado con el grupo de tratamiento habitual (grupo-TAU). No hay diferencias estadísticamente significativas entre los grupos en el resto de puntuaciones, pero hemos encontrado un mayor impacto de la intervención en el grupo MBSR+TAU que en el grupo TAU, especialmente en la reducción de los síntomas de depresión, ansiedad, paranoia y estrés percibido. CONCLUSIÓN: estos resultados sugieren que MBSR puede ser un tratamiento complementario útil para los adolescentes en los servicios de salud mental

Mindfulness-based stress reduction in adolescents with mental disorders: A randomised clinical trial.

BACKGROUND: Currently, there is a strong movement to implement mindfulness interventions with young people. The objective of this randomised clinical trial was to assess the potential effects of a mindfulness-based stress reduction (MBSR) programme for adolescent outpatients in mental health facilities in Cordoba, Spain. METHOD: A total of 101 adolescents aged 13-16 years old, receiving psychological or psychiatric treatment for various disorders, were eligible for the study. The participants’ scores on mindfulness, self-esteem, perceived stress, state-trait anxiety and other psychological symptoms were examined at two time-points. Eighty adolescents completed the study (MBSR+TAU group = 41; TAU group = 39). RESULTS: The MBSR+TAU group showed a statistically significant decrease in anxiety state compared to the treatment-as-usual (TAU) group. No statistically significant differences were found between groups on the other scores, but the intervention was observed to have a greater impact on the MBSR+TAU group than in the TAU group, especially in reducing symptoms of depression, anxiety, paranoia and perceived stress. CONCLUSION: These results suggest that MBSR may be a useful adjunct treatment for adolescents in mental health facilities.

Psychological Treatments for Mental Disorders in Children and Adolescents: A Review of the Evidence of Leading International Organizations.

In recent decades, the evidence on psychological treatments for children and adolescents has increased considerably. Several organizations have proposed different criteria to evaluate the evidence of psychological treatment in this age group. The aim of this study was to analyze evidence-based treatments drawn from RCTs, reviews, meta-analyses, guides and lists provided by four leading international organizations. The institutions reviewed were the National Institute for Health and Care Excellence, the Society of Clinical Child and Adolescent Psychology (Division 53) of the American Psychological Association, Cochrane Collaboration and the Australian Psychological Society in relation to mental disorders in children and adolescents. A total of 137 treatments were analyzed for 17 mental disorders and compared to determine the level of agreement among the organizations. The results indicate that, in most cases, there is little agreement among organizations and that there are several discrepancies within certain disorders. These results require reflection on the meaning attributed to evidence-based treatments with regard to psychological treatments in children and adolescents. The possible reasons for these differences could be explained by a combination of different issues: the procedures or committees may be biased, different studies were reviewed, different criteria are used by the organizations or the reviews of existing evidence were conducted in different time periods.

Procesos atencionales en pacientes escolares con TDAH / Attention processes in school-age patients with ADHD

El Trastorno por Déficit de Atención e Hiperactividad (TDAH) es una patología compleja y heterogénea. Su sintomatología discurre por ámbitos epistemológicamente diferentes: biológicos, cognitivos, conductuales, impulsivos y contextuales entre los más relevantes. En su diagnóstico clínico no podemos obviar el análisis de esta amplitud disciplinar, y cuando se hace caemos en el sobre o infradiagnóstico. Se debe perfilar con rigor, como se está haciendo por muchos investigadores, desde la definición criterial al modo de evaluación. Objetivo: en este trabajo se pretende, en una muestra de 50 sujetos, indagar en algunas variables atencionales (atención sostenida, dividida y selectiva) que están significativamente dañadas en este trastorno y que en este aspecto pueden aportar más datos complementarios para un diagnóstico clínico más acertado y sistemático. Resultados: podemos observar en los resultados que no son muchas las diferencias encontradas entre los grupos, y esto es precisamente lo que lleva a confusión en la mayoría de los casos. Conclusiones: la revisión de los criterios junto a una evaluación neuropsicológica más potente y refinada puede ser el camino para perfilar y establecer, desde la clínica, una mayor precisión en los grupos de esta compleja patología

Attention deficit hyperactivity disorder (ADHD) is a complex and heterogeneous pathology. Its symptoms encompass different epistemological fields of study such as biological, cognitive, behavioral, impulsive and contextual amongst the most relevant ones. Since it is easy to fall into over or underdiagnosis, a multidisciplinary approach is needed for the clinical diagnosis. It must be designed with rigor, as it is considered by many researchers, from the criterial definition to the means of assessment. Aim: the aim of this study, with a sample of 50 patients, is to investigate about some attentional variables (sustained, divided and selective attention) which are significantly impaired in this disorder and can contribute to providing complementary data in order to obtain a more systematic and pertinent diagnosis. Results: the results establish that it is hard to find many differences between the groups, which is precisely misleading in most cases. Conclusions: the revision of the criteria alongside a refined and stronger neuropsychological assessment may be the way to become clear and establish a greater precision, in clinical settings, within the groups of this complex pathology

Neuropsychiatric symptoms and intelligence quotient in autosomal dominant Segawa disease.

Segawa disease is a rare dystonia due to autosomal dominant guanosine triphosphate cyclohydrolase I (adGTPCH) deficiency, affecting dopamine and serotonin biosynthesis. Recently, the clinical phenotype was expanded to include psychiatric manifestations, such as depression, anxiety, obsessive-compulsive disorder, and sleep disturbances. Although cognitive and neuropsychiatric symptoms may be attributable to dopamine deficiency in the prefrontal cortex and frontostriatal circuitry, intelligence is considered normal in Segawa disease. Our aim was to investigate neuropsychiatric symptoms and intelligence quotients (IQ) in a series of individuals with adGTPCH deficiency. The assessment included a structured clinical interview following the DSM-IV-TR's guidelines, Beck's Depression Inventory, the State-Trait Anxiety Inventory, the Maudsley Obsessive-Compulsive Questionnaire, the Barratt Impulsiveness Scale-11 (BIS-11), the Oviedo Sleep Questionnaire, the Pittsburgh Sleep Quality Index, and the Wechsler Adult Intelligence Scale-Third Edition. Equivalent tests were applied to pediatric patients as appropriate for their age group. Fourteen patients with adGTPCH deficiency were evaluated (seven adult and seven pediatric patients). Depression, anxiety, and obsessive-compulsive symptoms were not more common than expected in the general population. However, the seven adults showed impulsivity in the BIS-11; nine individuals had an IQ in the range of borderline intellectual functioning to mild mental retardation, and sleep disturbances were found in four individuals. We found no differences between these results and the motor impairment. In conclusion, our findings would suggest that cognitive impairment, and impulsivity in adults, may be associated with Segawa disease.

Procedimiento para la enseñanza de la discriminación entre derecha e izquierda. Estudio de caso para un niño con deficiencia visual y discapacidad intelectual / No disponible

El objetivo del estudio era la enseñanza de la discriminación entre derecha e izquierdaa un niño de 7 años con deficiencia visual y discapacidad intelectual. Se abordóla enseñanza desde la perspectiva del análisis de los estímulos implicados en las discriminaciones.El programa de aprendizaje consistió en la enseñanza explícita de unadiscriminación simple, que incluyó un estímulo, una respuesta y una consecuencia y seprobó (test) la transferencia a la discriminación condicional que incluyó dos estímulos,una respuesta y una consecuencia. Los resultados pusieron de manifiesto la transferenciadel aprendizaje sin un entrenamiento explícito. El aprendizaje fue mantenido a los seismeses de seguimiento. El procedimiento descrito puede ser un método fácil de aplicar,que reduce el esfuerzo de los participantes

The aim of the research was the teaching of the discrimination between right andlelf in a seven-year-old child with visual impairment and intellectual disability. The teachingwas approached from the perspective of the analysis of the stimuli implied in thediscriminations. The learning procedure consisted of the explicit teaching of the simplediscrimination which included a stimulus, an answer and a consequence testing the transferto the condicional discrimination that included two stimuli, an answer and a consequence.The results showed the transfer of the learning without an explicit training. The learning was maintained during the six months of the follow-up. The procedure discribed can be a method, easy to apply, that reduces the effort of the participants