Atención plena (mindfulness): por qué es posible que funcione y por qué es seguro que triunfe / [Mindfulness: Why It Might Work and Why It's Sure to Succeed]

La atención plena (mindfulness) ha desbordado el ámbito clínico y comienza a aplicarse con entusiasmo en la escuela, el deporte o la empresa. La sospecha de que estamos ante una intervención que, aunque probablemente eficaz, tenga un tamaño de efecto pequeño, lo que obliga a realizar investigaciones con gran rigor. Así, solo conociendo los procesos psicológicos implicados en la atención plena podremos tener una visión más realista de su utilidad ante los diferentes problemas. Ante esto, ¿cómo explicar el extraordinario éxito que está obteniendo en Occidente la atención plena, tanto a nivel académico como mundano? Se presentan tres principios conductuales que se practican durante el entrenamiento en atención plena y se denuncia su uso ideológico, que aparece enmarcado, no en la mística existencial ni en el conductismo contextual, sino en la psicología positiva y su agenda neoliberal.

Mindfulness has gone beyond clinical applications and is beginning to be enthusiastically applied in schools, sport, and business settings. It seems to be a type of intervention that, while probably effective, has a small effect size, which calls for rigorous research. Understanding the psychological processes involved in mindfulness is essential in order to achieve a more realistic picture of its usefulness for some behavioral disorders. How can we explain the extraordinary success of mindfulness in western societies, both in academia and in popular culture? We present three behavioral principles and ideological reasons for applying mindfulness. Nowadays, mindfulness is framed not by mystical existentialism or contextual behaviorism, but by positive psychology and its neoliberal agenda.

Skipping breakfast, sedentarism and overweight in children.

To show by use of path analysis how in children of 9 and 10 years of age the known relationship between breakfast and high body mass index (BMI) is mediated by sedentary leisure time activities. A random sample of 291 9-year-old and 10-year-old school children from the Principality of Asturias (Spain) was taken. A transversal design was used, their weight and height were measured and an individual standardized interview was carried out in which they were asked about their breakfast habits and the time they spent each week on sedentary leisure activities. Using path analysis, a model was tested in which breakfast habits and leisure time were the independent variables and the BMI was the dependent variable. The results showed that there was an inverse correlation between number of breakfasts and BMI and a direct correlation between the time spent on sedentary leisure activities and BMI. Path analysis showed that the relationship between the frequency with which breakfast was eaten and BMI was mediated by the time spent on sedentary leisure activities. The above appears to confirm the direct role played by failing to have breakfast in the pandemic of obesity as this habit tends to increase children's BMI. This relationship is, however, mediated by sedentary leisure. According to the data compiled, being overweight in children can only be prevented by modifying not just one of the habits that have been associated with it, but rather the whole group of habits as these appear to make up an obesogenic cluster in which sedentary leisure and not having breakfast are included.

Effects of voucher-based intervention on abstinence and retention in an outpatient treatment for cocaine addiction: a randomized controlled trial.

The aims of this study were to assess whether voucher magnitude improved cocaine abstinence and retention in an outpatient treatment for cocaine dependence, and to determine the effectiveness of a contingency management intervention in a European cultural context. A randomized controlled trial was conducted in which 96 participants who were randomly assigned to 1 of 3 treatment conditions in a community setting: standard outpatient treatment, community reinforcement approach (CRA) plus low monetary value vouchers (each point earned was equivalent to 0.125 Euro, US$ 0.18), and CRA plus high monetary value vouchers (each point was worth 0.25 Euro, US$ 0.36). In the standard treatment group, mean percentage of cocaine-negative samples was 88.45%, versus 96.09% in the CRA plus low-vouchers group, and 97.07% in the CRA plus high-vouchers group. Retention rate at 6 months was 36.5% in the standard treatment group, 53.3% in the CRA plus low-vouchers group, and 69.0% in the CRA plus high-vouchers group. The CRA plus vouchers groups obtained better results than the standard program. This study showed that treating cocaine addiction by combining CRA with vouchers was more effective than standard treatment in community outpatient programs in Spain.

[The school and family risk factors in attendance at family-based programmes for the prevention of drug use]. / El colegio y los factores de riesgo familiar en la asistencia a programas de prevención familiar del consumo de drogas.

UNLABELLED: Several studies have indicated that certain aspects of schools may influence parents decision to participate in preventive interventions related to the health of their children. OBJECTIVES: 1) To study the relationship between parental rating of calls for participation sent from the school and family risk factors. 2) To study differences in parents attendance and drop-out for a family-based drug-use prevention programme according to their rating of the calls for participation sent out by the school. SAMPLE: 339 families of children aged 12-14 from 3 state (public) secondary schools in the region of Asturias (Spain). RESULTS AND CONCLUSIONS: It is noteworthy that parents with higher educational level present better parenting practices, and therefore, fewer risk factors in relation to drug use in their children. Furthermore, the presence of fewer risk factors correlated with the items related to attendance and calls for participation and the interest shown in such calls, indicating that the children least likely to use drugs are those whose parents are most actively involved in their education. As regards the effect of the calls for participation on programme attendance and drop-out, we found that parents who attended several sessions have had previous and satisfactory experience of some kind of preventive intervention, and receive with great interest the calls for participation from the school.

Prevención familiar del consumo de drogas: el programa «Familias que funcionan» / Family-based drug use prevention: The «Familias que Funcionan [Families that work]» program

«Familias que Funcionan» es un programa de prevención familiar del consumo de drogas, fruto de la adaptación a España del prestigioso programa norteamericano «Strengthening Families Program 10- 14». El programa se aplicó en cuatro Institutos de Enseñanza Secundaria de Asturias con una muestra de 380 alumnos de 1º y 2º de ESO. Se presenta en este artículo la evaluación de tal aplicación tras dos años de seguimiento, referidos a su eficacia en la reducción del consumo de drogas entre adolescentes y a sus efectos sobre ciertos factores de riesgo familiares. Los resultados muestran que el programa «Familias que Funcionan» es eficaz para reducir el incremento en el consumo de drogas adolescente a partir de la asistencia a 7 sesiones, tanto en el seguimiento a un año (t= -2,73; p<,05) como a dos años (t= -4,58; p<,005) y para reducir algunos de los factores de riesgo familiares (AU)

«Familias que Funcionan»[Families that work] is a family-based drug-use prevention program resulting from the adaptation to the Spanish context of the prestigious North-American «Strengthening Families Program 10-14». The program was applied at four secondary schools (N = 380 pupils) in Asturias (northern Spain). This article presents the results of the assessment of this application after a two-year follow-up, regarding its effectiveness in the reduction of drug use among adolescents and its effects on certain family risk factors. Consistent attendance in the «Familias que Funcionan» program proved effective for reducing both rates (t= -2.73, p<.05 and t= -4.58, p<.005, for the 1- and 2-year follow-ups, respectively) of increase in adolescent drug use and some family risk factors (AU)

El colegio y los factores de riesgo familiar en la asistencia a programas de prevención familiar del consumo de drogas / The school and family risk factors in attendance at family-based programmes for the prevention of drug use

Varios estudios señalan que ciertos aspectos de los centros escolares pueden influir en la decisión de los padres de participar en intervenciones preventivas relacionadas con la salud de sus hijos. Objetivos: 1) Estudiar la relación entre la valoración parental de las convocatorias remitidas desde el centro escolar y los factores de riesgo familiar. 2) Estudiar la existencia de diferencias en la asistencia y abandono de los padres de un programa de prevención familiar del consumo de drogas en función de su valoración de las convocatorias remitidas desde el centro escolar. Muestra: 339 familias de alumnos de 1ºy 2º de ESO procedentes de 3 I.E.S. de Asturias. Resultados: cabe destacar que los padres con mayor formación académica tienen mejores prácticas parentales y, por lo tanto, menores factores de riesgo para el consumo de drogas de sus hijos. Así mismo, la presencia de menos factores de riesgo correlaciona con los ítems relacionados con la asistencia a las convocatorias del centro escolar y el interés de tales convocatorias, lo que indica que los chicos menos consumidores son aquéllos cuyos padres están más involucrados en su educación escolar. Respecto del efecto de las convocatorias sobre la asistencia y abandono del programa, encontramos que los padres que acudieron a varias sesiones han tenido experiencias previas y satisfactorias con algún tipo de intervenciones preventivas y reciben con gran interés las convocatorias provenientes del centro escolar (AU)

Several studies have indicated that certain aspects of schools may influence parents’ decision to participate in preventive interventions related to the health of their children. Objectives: 1) To study the relationship between parental rating of calls for participation sent from the school and family risk factors. 2) To study differences in parents’attendance and drop-out for a family-based drug-use prevention programme according to their rating of the calls for participation sent out by the school. Sample: 339 families of children aged 12-14 from 3state (public) secondary schools in the region of Asturias (Spain). Results and conclusions: It is noteworthy that parents with higher educational level present better parenting practices, and therefore, fewer risk factors in relation to drug use in their children. Furthermore, the presence of fewer risk factors correlated with the items related to attendance and calls for participation and the interest shown in such calls, indicating that the children least likely to use drugs are those whose parents are most actively involved in their education. As regards the effect of the calls for participation on programme attendance and drop-out, we found that parents who attended several sessions have had previous and satisfactory experience of some kind of preventive intervention, and receive with great interest the calls for participation from the school (AU)

[Family-based drug use prevention: the "Familias que Funcionan" ["Families that Work"] program]. / Prevención familiar del consumo de drogas: el programa <>

Family-based drug use prevention: The <> program.. <>[Families that work] is a family-based drug-use prevention program resulting from the adaptation to the Spanish context of the prestigious North-American <>. The program was applied at four secondary schools (N = 380 pupils) in Asturias (northern Spain). This article presents the results of the assessment of this application after a two-year follow-up, regarding its effectiveness in the reduction of drug use among adolescents and its effects on certain family risk factors. Consistent attendance in the <> program proved effective for reducing both rates (t= -2.73, p<.05 and t= -4.58, p<.005, for the 1- and 2-year follow-ups, respectively) of increase in adolescent drug use and some family risk factors.

Differences among substance abusers in Spain who recovered with treatment or on their own.

This exploratory study compared the differences among substance abusers in Spain who recovered with treatment or on their own. Advertisements were used to recruit 58 individuals (29 self-changers and 29 treatment-changers) who had had problems with alcohol or drugs, and who had been recovered for at least one year. The groups differed significantly in severity of dependence, psychiatric treatment prior to recovery, and coping strategies to maintain recovery. Consistent with previous studies, those who had recovered through treatment had a more serious substance use history than those who changed on their own. In addition, social support was associated with maintenance of change for both groups. These findings parallel those for English-speaking populations.

[Effect of incentives on retention in an outpatient treatment for cocaine addicts]. / Efecto de los incentivos sobre la retención en un tratamiento ambulatorio para adictos a la cocaína.

The high drop-out rate in treatment programs is one of the most important problems in the area of drug addictions. This study evaluated the effect of the use of incentives on retention in an outpatient program for cocaine addicts. The effect of individual variables on program drop-out was also analysed. Participants were 66 subjects who were randomly assigned to one of three treatment groups: standard treatment, treatment with incentives I, and treatment with incentives II. The patients of these two groups received incentives contingent on cocaine abstinence with two different magnitudes. Retention rate at six months was 35% in the standard treatment, 78.6% in the treatment with incentives I, and 53.3% in the treatment with incentives II. The global prognostic capacity of the individual variables (sociodemographic, history and consumption pattern, psychopathological variables, and EuropASI scores) was 85.7%, with the psychopathological variables being more closely related to retention. These results suggest that the use of incentives may be an effective strategy to improve retention in outpatient treatments for cocaine addiction.

Efecto de los incentivos sobre la retención en un tratamiento ambulatorio para adictos a la cocaína / Effect of incentives on retention in an outpatient treatment for cocaine addicts

La alta tasa de abandonos en los programas de tratamiento es uno de los problemas más graves en el ámbito de las drogodependencias. En este estudio se analiza el efecto del uso de incentivos sobre la retención en un programa ambulatorio para adictos a la cocaína. También se analiza el efecto de determinadas variables individuales sobre el abandono del programa. Participaron 66 sujetos que fueron distribuidos aleatoriamente a tres grupos de tratamiento: tratamiento estándar, tratamiento con incentivos I, y tratamiento con incentivos II. Los pacientes de estos dos grupos recibían incentivos contingentes a la abstinencia de cocaína con dos magnitudes diferentes. La tasa de retención a los seis meses de tratamiento fue del 35% en el tratamiento estándar, del 78,6% en el tratamiento con incentivos I, y del 53,3% en el tratamiento con incentivos II. La capacidad pronóstica global de las variables individuales (sociodemográficas, historia y patrón de consumo, psicopatológicas y puntuaciones del EuropASI) fue del 85,7%, siendo las psicopatológicas las más relacionadas con la retención. Estos resultados sugieren que el uso de incentivos puede ser una estrategia eficaz para mejorar la retención en los tratamientos ambulatorios para la adicción a la cocaína

The high drop-out rate in treatment programs is one of the most important problems in the area of drug addictions. This study evaluated the effect of the use of incentives on retention in an outpatient program for cocaine addicts. The effect of individual variables on program drop-out was also analysed. Participants were 66 subjects who were randomly assigned to one of three treatment groups: standard treatment, treatment with incentives I, and treatment with incentives II. The patients of these two groups received incentives contingent on cocaine abstinence with two different magnitudes. Retention rate at six months was 35% in the standard treatment, 78.6% in the treatment with incentives I, and 53.3% in the treatment with incentives II. The global prognostic capacity of the individual variables (sociodemographic, history and consumption pattern, psychopathological variables, and EuropASI scores) was 85.7%, with the psychopathological variables being more closely related to retention. These results suggest that the use of incentives may be an effective strategy to improve retention in outpatient treatments for cocaine addiction

Comparación de pacientes cocainómanos y heroinómanos en el EuropASI / EUROPASI comparisons of cocaine and heroin addicts

El objetivo de este estudio es analizar las diferencias entre heroinómanos y cocainómanos en las áreas que mide el EuropASI. Se pretende, a su vez, elaborar un perfil de usuario para cada uno de los grupos con las características psicosociales de estos pacientes. La muestra se compuso de 373 pacientes extraídos de forma aleatoria de entre todas las personas que solicitaron tratamiento por su adicción a la cocaína o a la heroína durante el año 2003 en los centros de Proyecto Hombre en España. Los resultados muestran que, en general, los usuarios del programa de heroína presentan mayor gravedad en su patrón de consumo y padecen más problemas asociados que los usuarios del programa de cocaína. Esta tendencia se ve reflejada prácticamente en todas las áreas que mide el EuropASI: estado de salud, educación y empleo, situación legal y relaciones sociales/familiares. El estado psiquiátrico es el único área en el que no se encuentran diferencias entre ambos grupos. Se discuten los resultados y se analizan las implicaciones clínicas de los mismos

The objective of this study is to analyse the differences between heroin addicts and cocaine addicts in the areas measured by the EuropASI. It is also aimed to draw up a user profile for each of the groups, with the psychosocial characteristics of these patients. The sample was made up of 373 patients, taken at random from those requesting treatment for addiction to cocaine or heroin during 2003 at the Proyecto Hombre centres in Spain. The results show that, in general, the heroin programme users present greater severity in their consumption pattern and have more associated problems than the cocaine programme users. This tendency is reflected in practically all the areas measured by the EuropASI: state of health, education and employment, legal situation and social/ family relationships. Psychiatric state is the only area in which there are no differences between the two groups. The results are discussed and their clinical implications analysed

Construcción y validación de un cuestionario de factores de riesgo interpersonales para el consumo de drogas en la adolescencia / Construction and validation of a questionnaire on interpersonal risk factor for drug use in adolescence

La identificación de factores de riesgo y de protección del consumo de drogas resulta fundamental de cara a implementar programas de prevención eficaces. En este estudio se presenta un cuestionario para la identificación de factores de riesgo interpersonales del consumo de drogas en adolescentes. El instrumento fue aplicado a una muestra de 2.126 alumnos de la ESO de distintas partes de la geografía española. Los resultados muestran que la fiabilidad del instrumento es elevada. La estructura factorial indica la existencia de siete factores: reacción de los familiares ante el consumo de drogas, grupo de amigos, acceso a las drogas, situaciones de riesgo de la familia, educación familiar en drogas, estilo educativo y actividades protectoras. Estos factores se muestran buenos predictores del uso de drogas. En conclusión, se trata de un instrumento útil para la evaluación de factores de riesgo del consumo de sustancias en la adolescencia (AU)

The identification of risk factors and protection factors in relation to drug consumption is fundamental to the implementation of effective prevention programmes. This study presents a questionnaire for the identification of interpersonal risk factors in drug use among adolescents. The instrument was applied to a sample of 2,126 school pupils aged 12-16 from different parts of Spain. The results show high reliability of the instrument. The factor structure indicates seven factors: reaction of family to drug consumption, peer group, access to drugs, family risk situations, family education in drugs, parental style, and protective activities. These factors show themselves to be good predictors of drug use. In conclusion, this is a useful instrument for the assessment of risk factors in relation to substance use among adolescents (AU)

Evaluation of what parents know about their children's drug use and how they perceive the most common family risk factors.

Research on family risk factors for addictive behaviors in young people has not paid a great deal of attention to parents' knowledge of their children's addictive behaviors and of the family risk factors that affect such behaviors. The aim of this work is to compare knowledge about these two aspects in two groups of parents that differ regarding their children's declared drug use. The research was carried out with a sample of 309 schoolchildren and their families, divided into two groups: one of 154 families with children defined as non-Drug Users and another of 155 families with children defined as Drug Users. The results show that parents with children who consume drugs tend to strongly underestimate their children's use. Moreover, they overestimate the control they exercise over them and appear to be more familiarized with the use of drugs, if we compare them with parents of non-Drug Users. It is suggested that these results may be relevant for the planning of strategies that increase motivation in families with drug-risk children to participate in prevention programs.

Tratamientos psicológicos eficaces para los trastornos de personalidad / Efficacious psychological treatments for personality disorders

Se han procesado muchos tratamientos psicológicos para los trastornos de la personalidad, pero son escasos los estudios sobre su eficacia clínica. Tras la revisión efectuada, parece que al día de hoy no existe ninguna terapia psicológica eficaz, ni para los trastornos de la personalidad en general, ni para los distintos trastornos de la personalidad en particular. No obstante, para el trastorno límite de la personalidad, la terapia dialéctica cognitivo-conductual y la terapia de conducta clásica cuentan con avales empíricos suficientes como para ser consideradas como tratamientos psicológicos probablemente eficaces. Con todo, parece que los clínicos tratan globalmente los trastornos de la personalidad con terapias concretas predefinidas, cuando según Milon, por el contrario, la propia personalidad es la que debe guiar la terapia mediante la combinación de las diversas terapias existentes según las diversas características problemáticas de la personalidad del paciente (AU)

There are many proposed psychological treatments for personality disorders, but there are few studies about its clinical efficacy. After our review, it seems that nowadays there is no «efficacious psychological therapy», neither for personality disorders in general, nor for the different personality disorders in particular. Nevertheless, for borderline personality disorder, the cognitive-behavioral dialectic therapy and the classical behavior therapy have enough empirical endorsement to be considered «probably efficacious psychological treatments». Even so, it seems that clinicians treat globally personality disorders with predefined concrete therapies, ignoring that Millon, on the contrary, proposed that personality itself must be the guide to the therapy through the combination of the diverse existing therapies according to the patient’s problematical personality characteristics (AU)

Perfil psicológico y calidad de vida pacientes con enfermedades dermatológicas / Psychological profile and quality of life in skin diseases

Al igual que ha ocurrido respecto a otras patologías (problemas cardiovasculares, cáncer, asma, enfermedad de Crohn, hipertensión, etc.) la Psicología de la Salud se ha interesado desde la década de los 80, por descubrir aspectos psicológicos identificativos de los pacientes aquejados de enfermedades de la piel. Las impresiones clínicas de los dermatólogos acentúan con frecuencia el papel que los componentes psicológicos desempeñan en la génesis, mantenimiento y las consecuencias de las patologías cutáneas, pero los resultados no son concluyentes. El objetivo de este estudio es indagar características de personalidad y calidad de vida de los enfermos dermatológicos. Con tal finalidad, se tomó una muestra de 202 pacientes, aquejados de diversas enfermedades de la piel: dermatitis, alopecia, urticaria, acné, psoriasis, verrugas, liquen, rosácea y herpes; a los cuales se les aplicó diferentes instrumentos de evaluación psicológica: EPQ-A, STAI, SKINDEX, ZUNG DEPRESSION INVENTORY. Los resultados muestran que no existe un perfil psicológico homogéneo ni diferenciado de estos pacientes con respecto a la población normal, si bien ciertas patologías sí han presentado perfiles peculiares en algunas escalas. Se observan marcadores de depresión muy elevados en la mayoría de las alteraciones cutáneas y una valoración negativa de la calidad de vida en un porcentaje elevado de los sujetos (AU)

Just like it has happened with another pathologies (cardiovascular disorders, cancer, asthma, human hypertension, Chron disorder) Health Psichology has been interested in discover psychological aspects characteristic of dermatology patients from eighties. Dermatology clinical impressions stress frequently that psychological aspects perform an important role on the genesis, maintenance and consequences of dermatological disorder, but results aren ’t conclusive. The aim of this study is to know the quality of life and psychological pro file related to skin disorders. For this purpose, we took a sample of 200 patients with different diagnosis: dermatitis, psoriasis, alopecia, acne, urticaria, rosacea, lichen and herpes). We applied to this sample different instruments of psychological evaluation, line EPQ-A, STAI, SKINDEX, ZUNG DEPRESSION INVENTORY. The results showed that men have a poor quality of life during the first and second year of their skin disorder development. We can conclude that dermatology patients have n ’t showed a specific psychological profile, but some skin disorders have a characteristic profile in some questionnaire (AU)