Telepsychological Mobile Applications in the Spanish Android Market.

BACKGROUND: The use of Android mobile applications aimed at addressing users' psychological health is increasing. However, no review has been conducted on public Android commercial telepsychological applications in Spain. METHOD: A systematic search was carried out in the general applications section of Google Play Store based on 20 keywords in Spanish. Applications in Spanish or English that were relevant from the perspective of the search terms were included in the analysis. RESULTS: Of the 1,000 applications retrieved, only 43.59% (337/773) met the inclusion criteria, of which 49.26% (171/337) were Spanish. Most of them were Self-applied treatment applications (52.96%, 29.59%, Spanish; 23.37%, English). A total of 69.44% (37.38% Spanish; 31.95% English) did not indicate the origin of the information and the academic link was anecdotal (3.25%). CONCLUSIONS: The low percentage of relevant applications, high prevalence of self-help applications, absence of references on the origin of the information, absence of academic support, and lack of certifications encouraged us to recommend caution to consumers and professionals in their adoption of these applications for the treatment of any psychological disorder.

Obsessive beliefs and uncertainty in obsessive compulsive and related patients

Background/objective: The aim of the present study was to examine obsessive beliefs and intolerance of uncertainty differences among patients Obsessive compulsive disoreder (OCD), trichotillomania, excoriation, generalized anxiety disorder (GAD) and a control group healthy.Method: 130 participants between the ages of 17 and 62 years (Mean = 29.56, SD = 11.81) diagnosed with OCD (n = 36), trichotillomania (n = 18), excoriation (n = 17), GAD (n = 31) and a healthy control group (n = 28) were evaluated by Obsessive Beliefs Spanish Inventory-Revised and Intolerance of Uncertainty Scale.Results: The trichotillomania group presented one of the highest obsessive beliefs highlighting over-importance of thoughts, thought action fusion-moral, importance of controlling one's thoughts. The OCD group also had higher scores in inflated responsibility and thought action fusion-likelihood. The GAD group excelled in inhibitory and prospective uncertainty. The level of depression influenced obsessive beliefs while anxiety affected inhibitory and prospective uncertainty.Conclusions: Cognitive variables such as obsessive beliefs and Intolerance of Uncertainty should be considered in the prevention and intervention of obsessive and anxiety disorders. (AU)

Obsessive beliefs and uncertainty in obsessive compulsive and related patients creencias obsesivas e incertidumbre en pacientes con trastorno obsesivo compulsivo y afines.

Background/objective: The aim of the present study was to examine obsessive beliefs and intolerance of uncertainty differences among patients Obsessive compulsive disoreder (OCD), trichotillomania, excoriation, generalized anxiety disorder (GAD) and a control group healthy. Method: 130 participants between the ages of 17 and 62 years (Mean = 29.56, SD = 11.81) diagnosed with OCD (n = 36), trichotillomania (n = 18), excoriation (n = 17), GAD (n = 31) and a healthy control group (n = 28) were evaluated by Obsessive Beliefs Spanish Inventory-Revised and Intolerance of Uncertainty Scale. Results: The trichotillomania group presented one of the highest obsessive beliefs highlighting over-importance of thoughts, thought action fusion-moral, importance of controlling one's thoughts. The OCD group also had higher scores in inflated responsibility and thought action fusion-likelihood. The GAD group excelled in inhibitory and prospective uncertainty. The level of depression influenced obsessive beliefs while anxiety affected inhibitory and prospective uncertainty. Conclusions: Cognitive variables such as obsessive beliefs and Intolerance of Uncertainty should be considered in the prevention and intervention of obsessive and anxiety disorders.

Telepsychological Mobile Applications in the Spanish Android Market / Aplicaciones Móviles Telepsicológicas en el Mercado Android Español

Background: The use of Android mobile applications aimed at addressing users’ psychological health is increasing. However, no review has been conducted on public Android commercial telepsychological applications in Spain. Method: A systematic search was carried out in the general applications section of Google Play Store based on 20 keywords in Spanish. Applications in Spanish or English that were relevant from the perspective of the search terms were included in the analysis. Results: Of the 1,000 applications retrieved, only 43.59% (337/773) met the inclusion criteria, of which 49.26% (171/337) were Spanish. Most of them were Self-applied treatment applications (52.96%, 29.59%, Spanish; 23.37%, English). A total of 69.44% (37.38% Spanish; 31.95% English) did not indicate the origin of the information and the academic link was anecdotal (3.25%). Conclusions: The low percentage of relevant applications, high prevalence of self-help applications, absence of references on the origin of the information, absence of academic support, and lack of certifications encouraged us to recommend caution to consumers and professionals in their adoption of these applications for the treatment of any psychological disorder.(AU)

Antecedentes: La oferta de aplicaciones móviles dirigidas a abordar la salud psicológica de los usuarios es cada vez mayor. Sin embargo, no se ha realizado ninguna revisión amplia de la oferta comercial de aplicaciones telepsicológicas en España. Método: Se llevó a cabo una búsqueda sistemática en la sección general de aplicaciones de la Google Play Store en base a 20 palabras clave en castellano. Se incluyeron en el análisis las aplicaciones en castellano o inglés que fueran relevantes desde el punto de vista del término empleado en la búsqueda. Resultados: De las 1.000 aplicaciones recuperadas, solo el 43,59% (337/773) cumplía los criterios de inclusión, entre las cuales solo el 49,26% (171/337) estaban en castellano. Las aplicaciones de tratamiento auto-aplicado (52,96%; 29,59% castellano; 23,37% inglés) fueron las más numerosas. El 69,44% (37,38% castellano; 31,95% inglés) no indicaban la procedencia de la información, y la vinculación académica fue anecdótica (3,25%). Conclusiones: El bajo porcentaje de aplicaciones relevantes, la alta prevalencia de aplicaciones de autoayuda, la ausencia de referencias sobre el origen de la información, la ausencia de respaldo académico, o la falta de certificaciones, invita a recomendar cautela a consumidores y profesionales en su adopción en el tratamiento de cualquier trastorno psicológico.(AU)

Predictors of Parental Accommodation and Response Treatment in Young Children With Obsessive-Compulsive Disorder.

Background: Cognitive-behavioral family-based treatment (CBFT) is the treatment standard in very young children with obsessive-compulsive disorder (OCD), which includes the same core components of cognitive-behavioral therapy (CBT) with significant family involvement. Although the latter reports high rates of remission, some children do not improve with treatments. Therefore, it is necessary to identify possible moderating variables such as comorbidity, severity of disorder, years of onset, parental anxiety, and parental accommodation. This study has two main aims: (1) to propose a predictive model on family accommodation (father and mother), taking into account variables related to the children (severity of obsessive-compulsive responses, internalizing and externalizing symptoms, and comorbidity) and with the parents before intervention (worry, accommodation of one parental member over the other) and (2) to examine the mediating role of externalizing symptoms and mother's accommodation in the relation between initial severity and improvement of severity of obsessive-compulsive responses in children aged 5-8 years. Methods: Participants comprised 56 children with OCD [mean = 6.61 (SD = 0.76)] and their parents; 79% of the sample was men. Treatment was implemented by two clinicians specialized in OCD (>15 years of experience). Clinicians were trained to administer CBT protocol in the same way. They were doctors of clinical psychology and researchers at the OCD. Results: Mother's accommodation was associated with child variables (Child Behavior Checklist-Externalizing and Initial Severity, Children's Yale-Brown Obsessive-Compulsive Scale). Father's accommodation could be explained by parent variables (mother's accommodation and worry). Simple mediation model tested using the SPSS macro PROCESS supported the relation of the initial severity of symptoms with that following intervention, through the simple indirect effect of externalizing symptoms of the child. Conclusions: Comorbidities with externalizing symptoms, father's worry, and mother's accommodation were variables that should be controlled in treatment of pediatric OCD.

Coping Strategies, Anxiety and Depression in OCD and Schizophrenia: Changes during COVID-19.

BACKGROUND: The main aim was to examine changes in coping strategies, anxiety and depression in obsessive-compulsive and schizophrenia patients during COVID-19, in addition to controlling the influence of intolerance to uncertainty and experiential avoidance. METHOD: The first time, the study comprised (15-30 April 2020) 293 patients, 113 of whom were diagnosed with obsessive-compulsive disorder, 61 with schizophrenia and 119 healthy controls, aged 13-77 years (M = 37.89, SD = 12.65). The second time (15-30 November), the study comprised 195 participants (85 obsessive-compulsive patients, 42 schizophrenic patiens and 77 healthy controls participants). The evaluation was carried out through an online survey. RESULTS: The clinical groups worsened over time in cognitive coping, anxiety and depression, while the control group only worsened in depression. Intergroup differences in anxiety, depression and coping strategies were maintained, highlighting the use of some maladaptive strategies (avoidance, spiritual) in clinical groups. Experiential avoidance and tolerance for uncertainty mainly affected coping. CONCLUSIONS: The duration of COVID-19 not only produced changes in anxiety and depression in clinical groups but also in coping strategies to face this pandemic and its consequences.

Coping strategies in obsessive-compulsive patients during Covid-19 lockdown / Estrategias de afrontamiento en pacientes con Trastorno obsesivo-compulsivo durante el confinamiento por COVID-19

Background/Objective: The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels. (AU)

Antecedentes/Objetivo: El objetivo de este estudio fue comparar las estrategias de afrontamiento utilizadas por pacientes con Trastorno obsesivo-compulsivo (TOC) durante el confinamiento debido a la COVID-19 frente a controles sanos y analizar su relación con algunas variables que pueden influir en los resultados (ansiedad, depresión, comorbilidad, tipo de obsesiones-compulsiones). Método: Los participantes fueron 237, 122 diagnosticados de Trastorno obsesivo-compulsivo y 115 controles sanos, con edades comprendidas entre 13 y 58 años (M = 34,60, DT = 10,41). Resultados: Los grupos presentaron diferencias en el uso de algunas estrategias adaptativas (reinterpretación positiva, aceptación, humor) y desadaptativas (negación, autoculpa). Dentro del grupo TOC, la comorbilidad afectó para el mayor uso de estrategias inadecuadas (negación, abuso de sustancias y autoculpa), mientras que el tipo de obsesiones-compulsiones no influyó en el uso de las mismas. Los niveles de ansiedad y depresión estaban relacionadas con el uso de estrategias menos adaptativas. Conclusiones: Estos hallazgos refuerzan la necesidad de entrenar en la utilización de estrategias de afrontamiento eficaces y adaptativas, siendo necesario mejorar el seguimiento clínico de estos pacientes. Es importante estar en contacto con profesionales de la salud, revisar la medicación y observar los niveles de ansiedad y depresión. (AU)

Response Inhibition, Cognitive Flexibility and Working Memory in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder.

This study analyzed response inhibition, cognitive flexibility and working memory in three groups of patients diagnosed with obsessive-compulsive disorder, social anxiety disorder and generalized anxiety disorder, considering some variables that may influence results (nonverbal reasoning, comorbidity, use of pharmacotherapy). Neuropsychological measures were completed using a computerized Wisconsin card sorting test, Stroop color word test, go/no-go task, digits and Corsi. Significant differences were obtained among groups in cognitive flexibility and working memory variables. The obsessive-compulsive disorder (OCD) group showed the worst results. The social anxiety disorder group obtained greater effect sizes in visuospatial memory. However, significant differences between groups in visuospatial memory were no longer present when nonverbal reasoning was controlled. Comorbidity influenced interference in the OCD and generalized anxiety disorder (GAD) groups. In addition, the executive functions were differently influenced by the level of obsessions and anxiety, and the use of pharmacotherapy. Study limitations include a non-random selection of participants, modest sample size and design type (cross-sectional). The OCD group showed the worst results in flexibility cognitive and verbal working memory. Comorbidity, use of pharmacotherapy and level anxiety and obsessions were variables influencing the performance of executive functions.

Executive Functioning and Clinical Variables in Patients with Obsessive-Compulsive Disorder.

BACKGROUND: Cognitive flexibility, response inhibition, and working memory are considered the main mechanisms responsible for executive control. This study examined differences in cognitive flexibility, inhibition, and working memory in patients with obsessive-compulsive disorder (OCD) relative to a control group. METHOD: A total of 62 obsessive-compulsive participants (OCD = 32; healthy control = 32) aged between 17 and 56 years old (M = 33.16, SD = 9.23) were administered the computerized Wisconsin Card Sorting Test, Stroop Color-Word Test, Go/No-Go Task, Digit Test, and Corsi Block Test. Clinician-rated and self-reported obsessive-compulsive symptom severity, and anxiety, depression, and obsessive beliefs were evaluated. RESULTS: The control group performed better than the OCD group in tasks involving cognitive flexibility, inhibition, and visuospatial working memory. Anxiety and obsessive beliefs influenced the participants' performance on inhibition and working memory tasks. Similarly, comorbidity also influenced inhibition and working memory. In addition, the use of pharmacotherapy and the degree of OCD symptom severity influenced verbal working memory. CONCLUSIONS: Cognitive flexibility, inhibition, and visuospatial working memory deficits may be endophenotypes of OCD but require further examination for specificity. OCD severity, comorbidity patterns, anxiety, and obsessive beliefs may influence performance.

Coping strategies in obsessive-compulsive patients during Covid-19 lockdown.

The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). METHOD: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). RESULTS: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. CONCLUSIONS: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.

El objetivo de este estudio fue comparar las estrategias de afrontamiento utilizadas por pacientes con Trastorno obsesivo-compulsivo (TOC) durante el confinamiento debido a la COVID-19 frente a controles sanos y analizar su relación con algunas variables que pueden influir en los resultados (ansiedad, depresión, comorbilidad, tipo de obsesiones-compulsiones). Método: Los participantes fueron 237, 122 diagnosticados de Trastorno obsesivo-compulsivo y 115 controles sanos, con edades comprendidas entre 13 y 58 años (M = 34,60, DT = 10,41). Resultados: Los grupos presentaron diferencias en el uso de algunas estrategias adaptativas (reinterpretación positiva, aceptación, humor) y desadaptativas (negación, autoculpa). Dentro del grupo TOC, la comorbilidad afectó para el mayor uso de estrategias inadecuadas (negación, abuso de sustancias y autoculpa), mientras que el tipo de obsesiones-compulsiones no influyó en el uso de las mismas. Los niveles de ansiedad y depresión estaban relacionadas con el uso de estrategias menos adaptativas. Conclusiones: Estos hallazgos refuerzan la necesidad de entrenar en la utilización de estrategias de afrontamiento eficaces y adaptativas, siendo necesario mejorar el seguimiento clínico de estos pacientes. Es importante estar en contacto con profesionales de la salud, revisar la medicación y observar los niveles de ansiedad y depresión.

Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder / Flexibilidad cognitiva e inhibición de respuestas en pacientes con Trastorno obsesivo-compulsivo y Trastorno de ansiedad generalizada

BACKGROUND/OBJECTIVE: The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption). METHOD: The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. RESULTS: Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. CONCLUSIONS: Cognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las diferencias en flexibilidad cognitiva e inhibición de respuestas teniendo en cuenta algunas variables que pueden influir en los resultados (razonamiento no verbal, depresión, ansiedad, intolerancia a la incertidumbre, comorbilidad, consumo de fármacos). MÉTODO: Los participantes fueron 95 adultos de edades comprendidas entre 17-61 años (M = 33,48; DT = 11,13), diagnosticados de Trastorno obsesivo-compulsivo, Trastorno de ansiedad generalizada y un grupo de control sano. Las variables neuropsicológicas fueron evaluadas con el Test de Clasificación de Tarjetas de Wisconsin, Test Stroop de Colores y Palabras y Tareas Go/NoGo. RESULTADOS: Los grupos clínicos presentaron peores resultados en flexibilidad cognitiva frente al grupo control. El grupo obsesivo-compulsivo alcanzó peores puntuaciones en flexibilidad que el grupo con ansiedad generalizada, una vez controlado el razonamiento no verbal y la tolerancia a la incertidumbre. La comorbilidad y el consumo de fármacos no afectaron a los resultados en el grupo obsesivo-compulsivo. Sin embargo, ambas variables influyeron en el grupo con ansiedad generalizada. CONCLUSIONES: La flexibilidad cognitiva podría ser incluida en los paquetes de tratamiento del Trastorno obsesivo-compulsivo y del Trastorno de ansiedad generalizada

Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder.

BACKGROUND/OBJECTIVE: The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption). METHOD: The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. RESULTS: Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. CONCLUSIONS: Cognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder.

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las diferencias en flexibilidad cognitiva e inhibición de respuestas teniendo en cuenta algunas variables que pueden influir en los resultados (razonamiento no verbal, depresión, ansiedad, intolerancia a la incertidumbre, comorbilidad, consumo de fármacos). MÉTODO: Los participantes fueron 95 adultos de edades comprendidas entre 17-61 años (M = 33,48; DT = 11,13), diagnosticados de Trastorno obsesivo-compulsivo, Trastorno de ansiedad generalizada y un grupo de control sano. Las variables neuropsicológicas fueron evaluadas con el Test de Clasificación de Tarjetas de Wisconsin, Test Stroop de Colores y Palabras y Tareas Go/NoGo. RESULTADOS: Los grupos clínicos presentaron peores resultados en flexibilidad cognitiva frente al grupo control. El grupo obsesivo-compulsivo alcanzó peores puntuaciones en flexibilidad que el grupo con ansiedad generalizada, una vez controlado el razonamiento no verbal y la tolerancia a la incertidumbre. La comorbilidad y el consumo de fármacos no afectaron a los resultados en el grupo obsesivo-compulsivo. Sin embargo, ambas variables influyeron en el grupo con ansiedad generalizada. CONCLUSIONES: La flexibilidad cognitiva podría ser incluida en los paquetes de tratamiento del Trastorno obsesivo-compulsivo y del Trastorno de ansiedad generalizada.

Estilos educativos parentales y emociones como predictores de respuestas obsesivo-compulsivas en población adolescente / Parental educational styles and emotions as predictors of obsessive-compulsive responses in adolescent population

Resumen Las variables familiares y emocionales están relacionadas con el desarrollo y mantenimiento de distintos trastornos psicopatológicos. El objetivo de este estudio fue analizar la relación entre variables emocionales (regulación de emociones, optimismo y tolerancia a la frustración) y familiares (estilos parentales percibidos) con respuestas obsesivo-compulsivas. En cuanto al método, los participantes fueron 473 adolescentes (249 chicos y 224 chicas) con edades comprendidas entre los 12 y 18 años (M = 14.84, DT = 1.83) que cursaban estudios de Educación Secundaria y Bachillerato. En resultados, la variable optimismo alcanzó el mayor peso explicativo de obsesión-compulsión, seguida de la atención a los síntomas, revelación del padre y tolerancia a la frustración. Las puntuaciones en ansiedad y depresión presentaron un alto porcentaje de varianza explicada. Se concluye que el optimismo, la atención adecuada a los síntomas, la tolerancia a la frustración y las relaciones de confianza entre padres e hijos podrían ser factores protectores en la aparición de pensamientos obsesivo-compulsivos.

Abstract Family and emotional variables are related to the development and maintenance of different psychopathological disorders. The aim of this study was to analyze differences between emotional variables (emotion regulation, optimism and tolerance to frustration) and family variables (perceived educational styles) with obsessive-compulsive responses. Method: Participants were 473 adolescents (249 boys and 224 girls) aged between 12 and 18 years old (M = 14.84, SD = 1.83) who were studying Secondary Education. Results: The optimism variable reached the highest explanatory weight of obsession-compulsion, followed by attention to symptoms, sharing of feeling with father and tolerance to frustration. The scores in anxiety and depression showed a high percentage of variance explained. Conclusions: Optimism, adequate attention to symptoms, tolerance to frustration and relationships of trust between parents and children could be protective factors of obsessive-compulsive thoughts.

Family involvement and treatment for young children with Obsessive-Compulsive Disorder: Randomized control study.

BACKGROUND/OBJECTIVE: The aim of this paper was to evaluate the diferential efficacy of cognitive behavioral family treatment in children under 8 years of age with Obsessive-Compulsive Disorder (OCD) in the reduction of obsessive-compulsive responses and secondary outcomes in three treatment conditions: (a) Treatment of parents and child, (b) Treatment of mother and child, and (c) Treatment of mother. METHOD: Forty-four children with obsessive-compulsive disorder, aged 5.2-7.9 years old and their parents, were randomized to one of three groups in a 1:1:1 ratio. Seventy-five percent was male and 100% Caucasian (White-European). Treatment involved 12 individual sessions of is Cognitive-Behavioral Family-Based Treatment delivered. RESULTS: The three conditions produced clinical improvements in post-test and follow-up in the primary (symptom severity OCD) and secondary outcomes. The results showed no intergroup differences in variables related to OCD symptom severity, although statistically significant differences were found in groups in Internalizing and Externalizing problem, mother and fathers accomodation. CONCLUSIONS: The most efficient condition was that including a greater number of family members even when there was high family accommodation. The direct involvement of the child in the psychological treatment was important in achieving better results.

ANTECEDENTES/OBJETIVO: El objetivo fue analizar la eficacia diferencial de un tratamiento cognitivo-conductual para la reducción de obsesiones y compulsions y otras medidas secundarias en niños menores de 8 años con Trastorno Obsesivo-Compulsivo (TOC). Las tres condiciones de tratamiento fueron: (a) Tratamiento a los padres y al niño, (b) Tratamiento a la madre y al niño, (3) Tratamiento a la madre. MÉTODO: Cuarenta y cuatro niños, con edades comprendidas entre 5,2­7,9 años, y sus padres fueron asignados al azar a uno de los tres grupos, ratio de 1:1:1. El 75% eran varones y el 100% españoles. El tratamiento consistió en 12 sesiones individuales de Terapia familiar cognitivo-conductual. RESULTADOS: Las tres condiciones de tratamiento produjeron mejorías clínicas en el postest y seguimiento en las medidas primarias (severidad TOC) y secundarias. Los resultados mostraron que no existían diferencias entre los grupos en las variables relacionadas con síntomas de severidad, mientras que sí se hallaron en problemas internalizantes y externalizantes, y acomodación de la madre y del padre. CONCLUSIONES: La condición más eficiente fue la que incluía mayor número de miembros familiares, sobre todo cuando había una mayor acomodación familiar. La participación directa del niño en el tratamiento psicológico fue importante para lograr mejores resultados.

Family involvement and treatment for young children with Obsessive-Compulsive Disorder: Randomized control study / Implicacion familiar y tratamiento de niños pequeños con Tastorno Obsesivo-Compulsivo: un estudio aleatorizado

Background/Objective: The aim of this paper was to evaluate the diferential efficacy of cognitive behavioral family treatment in children under 8 years of age with Obsessive-Compulsive Disorder (OCD) in the reduction of obsessive-compulsive responses and secondary outcomes in three treatment conditions: (a) Treatment of parents and child, (b) Treatment of mother and child, and (c) Treatment of mother. Method: Forty-four children with obsessive-compulsive disorder, aged 5.2-7.9 years old and their parents, were randomized to one of three groups in a 1:1:1 ratio. Seventy-five percent was male and 100% Caucasian (White-European). Treatment involved 12 individual sessions of is Cognitive-Behavioral Family-Based Treatment delivered. Results: The three conditions produced clinical improvements in post-test and follow-up in the primary (symptom severity OCD) and secondary outcomes. The results showed no intergroup differences in variables related to OCD symptom severity, although statistically significant differences were found in groups in Internalizing and Externalizing problem, mother and fathers accomodation. Conclusions: The most efficient condition was that including a greater number of family members even when there was high family accommodation. The direct involvement of the child in the psychological treatment was important in achieving better results

Antecedentes/Objetivo: El objetivo fue analizar la eficacia diferencial de un tratamiento cognitivo-conductual para la reducción de obsesiones y compulsions y otras medidas secundarias en niños menores de 8 años con Trastorno Obsesivo-Compulsivo (TOC). Las tres condiciones de tratamiento fueron: (a) Tratamiento a los padres y al niño, (b) Tratamiento a la madre y al niño, (3) Tratamiento a la madre. Método: Cuarenta y cuatro niños, con edades comprendidas entre 5,2-7,9 años, y sus padres fueron asignados al azar a uno de los tres grupos, ratio de 1:1:1. El 75% eran varones y el 100% españoles. El tratamiento consistió en 12 sesiones individuales de Terapia familiar cognitivo-conductual. Resultados: Las tres condiciones de tratamiento produjeron mejorías clínicas en el postest y seguimiento en las medidas primarias (severidad TOC) y secundarias. Los resultados mostraron que no existían diferencias entre los grupos en las variables relacionadas con síntomas de severidad, mientras que sí se hallaron en problemas internalizantes y externalizantes, y acomodación de la madre y del padre. Conclusiones: La condición más eficiente fue la que incluía mayor número de miembros familiares, sobre todo cuando había una mayor acomodación familiar. La participación directa del niño en el tratamiento psicológico fue importante para lograr mejores resultados

Efectividad del tratamiento temprano de niños con mutismo selectivo en los centros educativos / Effectiveness of early treatment of children with selective mutism in educational centers

Resumen El mutismo selectivo (MS) es un trastorno de ansiedad de baja prevalencia, lo que dificulta su investigación. Pese a su inicio temprano su diagnóstico no suele hacerse antes del acceso a la escolaridad obligatoria. El objetivo de este estudio fue valorar la eficiencia de un protocolo cognitivo-conductual para la intervención psicológica en el contexto educativo (ipmsce), siguiendo los criterios de la Task Force in Promotion and Dissemination of Psychological Procedures. Participaron 10 niños que presentaban una demora inferior a dos años entre el inicio del MS y su diagnóstico (1.00 ± 0.54). La edad media fue de 4.94 años y el 80% fueron niñas. Se utilizó un diseño de acumulación de casos, con medidas del tratamiento antes de su aplicación, al finalizar y en un seguimiento a los 12 meses, obtenidas a través de los padres, los profesores y un test situacional. Los resultados muestran la efectividad de la intervención.

Abstract Selective mutism (SM) is an anxiety disorder of low prevalence, which makes its investigation difficult. Despite its early start, its diagnosis is not usually made before access to compulsory schooling. The objective of this study was to assess the efficiency of a cognitive-behavioral protocol for psychological intervention in the educational context (ipmsce), following the criteria of the Task Force in Promotion and Dissemination of Psychological Procedures. Ten children with a delay of less than two years between the onset of SM and its diagnosis (1.00 ± 0.54) participated. The average age was 4.94 years and 80 % were girls. A case accumulation design was used, with measures of treatment before its application, at the end and in a followup at 12 months, obtained through parents, teachers and a situational test. The results show the effectiveness of the intervention.

Tratamiento del mutismo selectivo en dos hermanas políglotas / Treatment of selective mutism in two polyglot sisters

Presentamos el proceso de evaluación y tratamiento de dos niñas políglotas, de cinco y siete años. Ambas cumplieron los criterios para el diagnóstico del mutismo selectivo (APA, 2013). La intervención se realizó con la participación de la familia y la escuela. Se diseñó un tratamiento cognitivo conductual que se aplicó diferenciadamente a los adultos y a las niñas. El entrenamiento de los adultos incluyó transmisión de información, instrucciones, reestructuración cognitiva y modelado; el de las niñas, desvanecimiento estimular, economía de fichas, coste de respuesta y exposición a ser vistas y oídas hablando a otros compañeros de sus respectivas clases. Los resultados muestran la normalización del habla audible en respuesta a solicitudes externas en clase y en el patio de recreo, la aparición del habla espontánea, el incremento del juego y la eliminación del aislamiento social. Estos resultados se mantuvieron en las medidas de seguimiento a 3, 6 y 12 meses. El tratamiento ha mostrado su eficacia en la remisión completa del trastorno en los dos casos

We present the process of evaluation and treatment of two polyglot girls of five and seven years of age. Both met the criteria for the diagnosis of selective mutism (APA, 2013). The intervention was carried out with the participation of the family and the school. A cognitive behavioral treatment was designed and later applied in a differentiated manner to adults and girls. Adult training included transmission of information, instructions, cognitive restructuring and modeling; treatment for the girls included stimulation fading, economy of cards, response cost, and exposure to be seen and heard talking to other classmates in their respective classrooms. The results show a normalization of audible speech in response to external requests in class and on the playground, the appearance of spontaneous speech, the increase in play and the elimination of social isolation. These results were maintained in the follow-up measures at 3, 6 and 12 months. The treatment has shown its efficacy in the complete remission of the disorder in both cases

Relaciones entre depresión, estrés y esquemas disfuncionales tempranos en adolescentes / Relationships between depression, stress, and early maladaptive schemas in adolescents

La depresión en adolescentes es un problema clínico y social importante. El presente estudio examina las relaciones bidireccionales que se producen entre los esquemas disfuncionales tempranos, los eventos estresantes y la depresión. Se formaron dos grupos de adolescentes, uno con sintomatología alta en depresión (N= 110, 76 mujeres, edad media de 15,45; DT= 1,69) y otro con sintomatología baja en depresión (N= 115, 76 mujeres, edad media de 15,65; DT= 1,05). Ambos grupos completaron medidas de depresión, eventos estresantes y de tres dominios de esquemas disfuncionales tempranos (desconexión y rechazo, foco en los demás y autonomía dañada) en dos intervalos con una separación de cuatro meses. Los resultados muestran la importancia de los esquemas de desconexión y rechazo en la depresión. Además, los eventos estresantes predijeron un aumento de todos los dominios de esquemas y los síntomas de depresión predijeron un aumento de esquemas de autonomía dañada. Estos resultados son valiosos para comprender los mecanismos a través los cuales el estrés y la depresión funcionan en los adolescentes

The prevalence of depression in adolescents is an important clinical and social problem. The present study examines the bidirectional relationships that occur between the level of cognition of early maladaptive schemas, stressors and depression. Two groups of adolescents were formed, one comprised adolescents with high symptomatology in depression (n= 110, 76 women, Mage= 15.45, SD= 1.69), and the other adolescents with low symptomatology in depression (n= 115, 76 women, Mage= 15.65, SD= 1.05). Both groups completed measures of depression, stressors and three domains of early maladaptive schemas (disconnection and rejection, focus on others and impaired autonomy) at two different points in time spaced four months apart. The results show the importance of the disconnection and rejection schemas in depression. Moreover, the stressors predicted an increase in all the schema domains and depressive symptoms predicted an increase in the impaired autonomy schema domain. These results are very valuable to understand the mechanisms through which stress and depression work in adolescents

Efectos del tratamiento de adolescentes con fobia social en el neuroticismo y la extraversión / The effects of treatment of adolescents with social phobia on neuroticism and extraversion

El objetivo de este estudio es presentar los efectos de la aplicación de un protocolo de tratamiento manualizado, en una muestra comunitaria de 67 adolescentes españoles (62,68% mujeres), en la fobia social generalizada (FSG) y en el neuroticismo (N) y la extraversion (E). Los participantes fueron asignados al azar a un grupo de control (n = 33; M = 15,21 años; DT = 1,04) y otro de tratamiento (n = 34; M = 15,29 años; DT = 1,10). Todos cumplieron los criterios requeridos para el diagnóstico de fobia social (subtipo generalizado; APA, 1994) y rellenaron el "Inventario de ansiedad y fobia social" (SPAI), el "Cuestionario Eysenck de personalidad" para niños (EPQ-J) y para adultos (EPQ-A), según su edad cronológica. También se cuantifico el tiempo mirando en la dirección del interlocutor durante un test situacional. Los resultados muestran que: (I) el tratamiento es eficaz para eliminar/reducir la FSG; y (II) N y E muestran cambios significativos entre el prestest y el postest que se prolongan en el seguimiento. Se discuten las implicaciones de estos hallazgos y la estabilidad de N y E

The aim of this study is to present the effects of the application of a manualized treatment protocol in a community sample of 67 Spanish adolescents (62.68% women) in generalized social phobia (GSP), in neuroticism (N), and extraversion (E). The participants were randomly assigned to a control group (n = 33; M = 15.21 years old, SD = 1.04) and a treatment group (n = 34; M = 15.29 years old, SD = 1.10). All met the criteria required for the diagnosis of social phobia (generalized subtype, APA, 1994) and completed the Inventory of Anxiety and Social Phobia (SPAI), and the Eysenck Personality Questionnaire for children (EPQ-J) or for adults (EPQ-A) according to their age. The time looking at the conversation partner during a situational test was also quantified. The results show that: (I) the treatment is effective to eliminate / reduce GSP; and (II) N and E show significant changes between the pretest and the posttest that are prolonged in the follow-up. The implications of these findings and the stability of N and E are discussed

Actualización de un modelo tentativo del mutismo selectivo / Update of a tentative model of selective mutism

El mutismo selectivo es un trastorno del comportamiento infanto-juvenil de inicio temprano (generalmente entre los 3 y los 5 años) que consiste en la resistencia al habla o su inhibición en situaciones sociales concretas, caracterizadas por la presencia de extraños, personas a las que no se habla o a las que se ha dejado de hablar, lugares en los que no se habla o donde el niño piensa que puede ser escuchado por quien no quiere, etc. Su escasa prevalencia lo convierte en un trastorno de la conducta raro y la revisión de la literatura confirma que la ansiedad es la alteración prominente en quienes lo presentan, lo que ha llevado a que en la última edición del Manual diagnóstico y estadístico de los trastornos mentales (Asociación Americana de Psiquiatría, DSM-5; APA, 2013) haya sido reclasificado como un trastorno de ansiedad. Este hecho, así como los avances en su investigación y los retos que estos plantean respecto de su evaluación y tratamiento hacen necesaria una revisión y actualización de las propuestas explicativas existentes. Este es el marco en el que se inserta el trabajo que presentamos

Selective mutism is a disorder of early-onset behavior (usually between 3 and 5 years) consisting in a resistance to speech or its inhibition in specific social situations, characterized by the presence of strangers, people who are not spoken to or to whom the child has stopped talking, places where the child doesn't speak or where the child thinks he/she can be heard by unwanted people, etc. Its low prevalence makes it a rare behavior disorder and the review of the literature confirms that anxiety is the prominent alteration in those who present it, which has led to the result that in the last edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, DSM-5; APA, 2013) the behavior has been reclassified as an anxiety disorder. This fact, as well as the advances in its research and the challenges that it poses regarding its evaluation and treatment, make it necessary to review and update the existing explanatory proposals. This is the framework of the work presented here