Emotional Regulation as a Transdiagnostic Process of Emotional Disorders in Therapy: A Systematic Review and Meta-Analysis.

CONTEXT: Several studies have shown that emotional regulation (ER) is a transdiagnostic construct of emotional disorders. Therefore, if therapy improves ER, it would improve psychological distress. OBJECTIVE: This review assesses and compares the changes in ER due to psychological treatment in different therapies. METHODS: A systematic review and meta-analysis of RCTs published in the databases PubMed, PsycINFO and Web of Science was performed. It was registered in PROSPERO under the number CRD42023387317. Two independent experts in the field reviewed the articles. RESULTS: A total of 18 articles met the criteria for inclusion in the review. Analysis of these studies suggests that in unified protocol (UP), cognitive behaviour therapy, dialectical behaviour therapy (DBT) and mindfulness, there is evidence to support that a moderate effect occurs during treatment. Furthermore, in mindfulness and DBT, the effect was moderate in the follow-up period, while in UP, it was high. LIMITATIONS: Given the heterogeneity of the applied interventions and the methodological limitations found in the reviewed trials, the results should be interpreted with caution. CONCLUSIONS: UP, cognitive behaviour therapy, DBT and mindfulness can improve ER after therapy, while UP, DBT and mindfulness in the follow-up period. Other therapies, such as SKY or Flotation REST, require more research.

INTRODUCCIÓN: Varios estudios han demostrado que la regulación emocional es un constructo transdiagnóstico de los trastornos emocionales. Por lo tanto, si la terapia mejora la regulación emocional, también mejorará el malestar psicológico. OBJETIVO: Evaluar y comparar el cambio en la regulación emocional debido al tratamiento psicológico en diferentes terapias. MÉTODO: Se realizó una revisión sistemática y metaanálisis de ECA publicados en las bases de datos PubMed, PsycINFO y Web of Science. Se registró en PROSPERO con el número CRD42023387317. Dos expertos independientes en la materia revisaron los artículos. RESULTADOS: Un total de 18 artículos cumplieron los criterios de inclusión en la revisión. El análisis de estos estudios sugiere que en el Protocolo Unificado, la Terapia Cognitivo Conductual, la Terapia Dialéctica Conductual y terapias basadas en mindfulness existen evidencias que apoyan que se produce un efecto moderado durante el tratamiento. Además, en las terapias basadas en mindfulness y en la Terapia Dialéctica Conductual, el efecto se moduló en el periodo de seguimiento, mientras que en el Protocolo Unificado fue mayor. LIMITACIONES: Dada la heterogeneidad de las intervenciones aplicadas y las limitaciones metodológicas encontradas en los ensayos revisados, los resultados podrán interpretarse con cautela. CONCLUSIONES: UP, CBT, DBT y mindfulness pueden mejorar la ER tras la terapia, mientras que UP, DBT y mindfulness pueden mejorar la recuperación tras un tiempo de seguimiento. Otras terapias, como SKY o Flotation REST, requieren más investigación.

Longitudinal mental health state during the COVID-19 pandemic. Longitudinal change of mental symptoms and its predictors during the COVID-19 pandemic: A prospective longitudinal study on Spanish population.

OBJECTIVE: The general objective of this study is to analyze the change in mental health and post-traumatic symptoms over 6 months during the COVID-19 pandemic in a Spanish community sample, with a particular focus on individual differences in longitudinal change in symptoms and its predictors. METHOD: This longitudinal prospective study surveyed a Spanish community sample three times (T1: during the initial outbreak, T2: after 4 weeks and T3: after 6 months). Four thousand one hundred and thirty-nine participants from all the Spanish regions completed the questionnaires. However, the longitudinal analysis was performed only with participants which responded at least two times (1,423 participants). Mental health assessments included depression, anxiety, and stress (measured by the Depression, Anxiety and Stress Scale (DASS-21) and post-traumatic symptoms were assessed by the Impact of Event Scale-Revised (IES-R). RESULTS: All the mental health variables achieved worse results at T2. Depression, stress, and posttraumatic symptoms did not recover at T3 when compared with the initial measure, while anxiety was practically stable across the timeline. Women, younger age, having a previous mental health diagnosis and contact with individuals with COVID-19 were linked to worse psychological evolution during the 6-months period. A good perception of one's physical health may be a protective factor. CONCLUSIONS: After 6 months of the pandemic, the general population's mental health was still worse than at the initial outbreak for most of the variables analyzed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trauma infantil en esquizofrenia. Implicaciones en los síntomas psicóticos positivos y negativos / Childhood trauma and schizophrenia. Implications for positive and negative psychotic symptomsresumen

La relación entre trauma infantil (TI) y la psicosis está bien establecida y son diversas las teorías sobre los factores que median en esta relación. También son muchos los estudios que exploran la influencia del TI en el curso de la psicosis en distintas áreas. El objetivo de este estudio fue explorar la influencia del TI en la presencia e intensidad de los síntomas psicóticos positivos (SPP) y negativos (SPN) en pacientes con trastornos del espectro esquizofrénico. Se incluyeron un total de 45 pacientes con diagnóstico de esquizofrenia o trastorno esquizoafectivo. Se valoraron datos sociodemográficos, los antecedentes de TI mediante el Childhood Trauma Questionnaire, Short Form (CTQ-SF), así como la intensidad de los síntomas psicóticos positivos y negativos mediante la Positive and Negative Syndrome Scale (PANSS+ y -).De la totalidad de la muestra, 35 pacientes, el 77,8 %, habían padecido algún tipo trauma infantil; el 55,6%, negligencia emocional; el 48,9%, abuso emocional: el 46,7%, negligencia física y el 40,0%, abuso sexual. No encontramos correlación entre CTQ-SF y PANSS+ y sí una relación inversa ente CTQ-SF v PANSS- (Rho -0.300, p=0.045). A diferencia de otros estudios no encontramos una correlación entre el TI y los SPP, a excepción del abuso físico con el ítem de excitación, tal vez debido a la cronicidad de los pacientes de nuestra muestra. La correlación moderada e inversa entre el TI y los SPN sugerimos que podría deberse a que los síntomas psicóticos positivos y negativos surgirían de diátesis distintas. Los síntomas negativos estarían en relación con déficits de neurodesarrollo y no relacionados con el estrés, como se ha sugerido en los síntomas psicóticos positivos. Sin embargo, dado que es trata de un hallazgo poco replicado, es difícil establecer conclusiones claras.(AU)

The relationship between childhood trauma (CT) and psychosis is well established and theories about the factors mediating this relationship are diverse. CT is associated with a worse prognosis of psychosis The aim of this study was to explore the influence of childhood trauma on the presence and intensity of positive (PPS) and negative psychotic symptoms (NPS) in patients with schizophrenic spectrum disorders. Forty-five patients with a diagnosis of schizophrenia or schizo affective disorder were included. Sociodemographic data, childhood trauma history using the Childhood Trauma Questionnaire Short Form (CTQ-SF) and the intensity of positive and negative psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS + and -), were valued. Of the total sample, 35 patients, 77.8%, had suffered some type of childhood trauma; 55.6%, emotional neglect; 48.9%, emotional abuse: 46.7%, physical neglect and 40.0%, sexual abuse. We did not find a correlation between CTQ-SF and PANSS+ and an inverse relationship between CTQ-SF v PANSS- (Rho -0.300, p=0.045). Unlike other studies, we did not find a correlation between CT and PPS, except for physical abuse with the excitation item, perhaps due to the chronicity of patients in our sample. The inverse corre lation between CT and NPS may be due to positive and negative psychotic symptoms arising from different diameters. NPS could be related to neurological development deficits and not related to stress, as suggested in PPS. However, since it is a finding with little replication, it is difficult to draw clear conclusions.(AU

Immediate Psychological Response during the Very Early Stage of the Coronavirus Pandemic (COVID-19) in a Spanish Community Sample.

The World Health Organization declared a pandemic due to COVID-19 on 11 March 2020 and remarked on the relevance of studying its consequences on mental health. A cross-sectional study was conducted to evaluate the immediate psychological response to the pandemic and quarantine in Spain.

Respuesta psicológica inmediata durante una etapa muy temprana de la pandemia por coronavirus (COVID-19) en una muestracomunitaria española / Immediate Psychological Response during the Very Early Stage of the Coronavirus Pandemic (COVID-19) in a Spanish Community Sample

Introducción: La Organización Mundial de la Salud declaró la pandemia por COVID-19 el 11 de marzo de 2020 ysubrayó la importancia de estudiar sus consecuencias en lasalud mental de la población. Se presenta un estudio transversal evaluando las respuestas psicológicas a la primera olade la pandemia en España.Metodología. Entre el 23 y 28 de marzo, se realizó unaencuesta online en una muestra española seleccionada trasun muestreo en bola de nieve. Se recogieron variables sociodemográficas, de salud y comportamentales. Se evaluaron laansiedad y depresión a través de la Escala de Depresión, Ansiedad y Estrés (DASS-21), los síntomas postraumáticos a través de la Escala de Impacto del Evento Revisada (IES-R) y lospatrones de autocuidado con la Escala de Autocuidado (SCS).Resultados. Se incluyeron 3524 participantes, 24,1 %mostraron síntomas postraumáticos moderados o severos,21,9 % refirieron síntomas depresivos moderados, severos o extremadamente severos y 32 % síntomas ansiososmoderados, severos o extremadamente severos. El génerofemenino, la menor edad, menor nivel educativo, diagnóstico psiquiátrico previo, peor salud física, contacto con COVID-19, falta de rutinas y algunos síntomas psicológicos serelacionaron con peores respuestas psicológicas.Conclusiones. Se confirma el impacto sobre la saludmental que la primera ola de la pandemia tuvo en España yse identifican algunas variables relacionadas con peor respuesta que pueden resultar útiles en la prevención en salud mental en futuras situaciones equivalentes. (AU)

Introduction: The World Health Organization declared apandemic due to COVID-19 on 11 March 2020 and remarkedon the relevance of studying its consequences on mentalhealth. A cross-sectional study was conducted to evaluatethe immediate psychological response to the pandemic andquarantine in Spain.Methods. From March 23 to 28, an online survey wasconducted in a Spanish community sample. Sociodemographic,health and behavioral variables were surveyed. Depressionand anxiety sypmtoms were measured by the Depressión,Anxiety and Stress Scale (DASS-21), posttraumatic symptomsby the Impact of Event Scale-Revised (IES-R) and self-carepatterns by the Self-Care Scale (SCS).Results. 3524 respondents were included, 24.1%showed moderate or severe psychological impact, 21.9%reported moderate, severe or extremely severe depressionand 32% moderate, severe or extremely severe anxiety.Female gender, younger age, low education, psychiatricdiagnosis, worse physical health, contact history, lack ofroutines, and some psychological symptoms were related toworse psychological responses.Conclusions. This study provides evidence for a negativemental health impact of the pandemic in the Spanishcommunity that started at the early stages and identifiessome variables linked to worse psychological response. (AU)

Psychological Responses According to Gender during the Early Stage of COVID-19 in Spain.

BACKGROUND: Current research has pointed out an increased risk of mental health problems during the COVID-19 pandemic in women compared to men, however the reason for this difference remains unclear. The aim of this research is to study early psychological responses to the pandemic in the Spanish general population, focusing on gender differences. METHODS: Nine to 14 days after the declaration of a state of emergency an online survey was conducted assessing sociodemographic, health, behavioral and COVID-19-related variables. Mental health status was evaluated by the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the Self-Care Scale (SCS). RESULTS: The study included 3520 respondents: 2611 women and 909 men. Women scored significantly higher in DASS-21 and IES-R (p < 0.05) and were more likely to somatize, suffer from hypochondriasis, sleeping disturbances and claustrophobia (p < 0.05). Being a woman can be considered a risk factor for intrusive thoughts, avoidance mechanisms, stress and anxiety (Odd Ratio = 2.7/2.3/2.3/1.6). The risk of presenting posttraumatic symptoms and emotional distress was greater in women (Odd Ratio = 6.77/4.59). General linear models to predict IES-R and DASS-21 scores clarified which variables were gender specific, such as main concerns. CONCLUSIONS: This study provides evidence that at early stages of the pandemic, women mental health was more impacted and that both genders show different concerns. Gender perspective in secondary and tertiary prevention strategies must be taken into account when facing the distress associated with the pandemic.

[Borderline Personality Disorder, trauma and EMDR]. / Disturbo borderline di personalità, trauma e EMDR.

The authors step by the diagnostic criteria for Borderline Personality Disorder, viewing them from the perspective of the Adaptive Information Processing e pointing them as a guide for exploration and search of traumatic interpersonal events connected to attachment story and which can be addressed by the therapeutic work with EMDR.