ABSTRACT
BACKGROUND: The benefits of cognitive-behavioral treatment (CBT) and positive psychology therapy (PPT) in patients with cardiovascular disease are still not well defined. We assessed the efficacy of CBT and PPT on psychological outcomes in coronary artery disease (CAD) patients. METHODS: Randomized controlled trials evaluating CBT or PPT in CAD patients published until May 2018 were systematically analyzed. Primary outcomes were depression, stress, anxiety, anger, happiness, and vital satisfaction. Random effects meta-analyses using the inverse variance method were performed. Effects were expressed as standardized mean difference (SMD) or mean differences (MD) with their 95% confidence intervals (CIs); risk of bias was assessed with the Cochrane tool. RESULTS: Nineteen trials were included (n = 1956); sixteen evaluated CBT (n = 1732), and three PPT (n = 224). Compared with control groups, depressive symptoms (13 trials; SMD -0.80; 95% CI -1.33 to -0.26), and anxiety (11 trials; SMD -1.26; 95% CI -2.11 to -0.41) improved after the PI, and depression (6 trials; SMD -2.08; 95% CI -3.22 to -0.94), anxiety (5 trials; SMD -1.33; 95% CI -2.38 to -0.29), and stress (3 trials; SMD -3.72; 95% CI -5.91 to -1.52) improved at the end of follow-up. Vital satisfaction was significantly increased at follow-up (MD 1.30, 0.27, 2.33). Non-significant effects on secondary outcomes were found. Subgroup analyses were consistent with overall analyses. CONCLUSION: CBT and PPT improve several psychological outcomes in CAD patients. Depression and anxiety improved immediately after the intervention while stress and vital satisfaction improve in the mid-term. Future research should assess the individual role of CBT and PPT in CAD populations.
Subject(s)
Cognitive Behavioral Therapy , Coronary Artery Disease/psychology , Psychosocial Intervention , Anxiety/therapy , Depression/therapy , Humans , Stress, Psychological/psychologyABSTRACT
El presente trabajo pretende revisar el protagonismo de procesos psicológicos básicos en la actual conceptualización de los trastornos de personalidad (TTPP), sus modelos explicativos más relevantes y las terapias cognitivo-conductuales centradas en estos trastornos. Para ello se revisará la tendencia actual a una aproximación más dimensional que categorial a los TTPP señalando la mayor relevancia implícita que en esa perspectiva tendrán los procesos psicológicos básicos. Para revisar el protagonismo de estos procesos se presentarán distintos modelos teóricos: el modelo de los siete factores, la aproximación desde el modelo de los cinco grandes, el modelo biosocial, y aproximación desde los modelos cognitivos. También se presentarán los principios de las dos terapias cognitivo-conductuales propias de los TTPP. Una vez presentado el estado actual de la cuestión se revisa el papel de la percepción, la atención, la memoria, el aprendizaje, la emoción y la impulsividad y su afrontamiento y regulación en la los modelos y terapias cognitivo-conductuales presentados, discutiendo sobre la necesidad de darles mayor protagonismo (AU)
This paper is a review of the key role played by basic psychological processes in the current conceptualisation of personality disorders, the most outstanding models, and the cognitive-behavioral therapies. Currently, there is an increasing tendency towards more dimensional approaches at the expense of more categorical ones. Basic psychological processes are more relevant for dimensional approaches. In this regard, a number of models will be described: the 7 factor model, the Big Five model, the biosocial model, and the cognitive models. Likewise, the basics of both cognitive-behavioral approaches to personality disorders will be outlined. Finally, the role of perception, attention, memory, learning, impulsivity, and the way cognitive-behavioral therapies cope with them will also be reviewed. All these processes should be given due relevance (AU)
