The Effect of Daily Meditative Practices Based on Mindfulness and Self-Compassion on Emotional Distress under Stressful Conditions: A Randomized Controlled Trial.

Intervention programs based on self-compassion have demonstrated their efficacy both in reducing psychological distress and increasing well-being. The goal of this study was to test the efficacy of an online intervention to increase mindfulness and self-compassion levels in a non-clinical sample in a highly stressful context: the ten weeks of lockdown imposed in the early stages of the COVID-19 pandemic. The intervention sessions consisted of thirty-minute guided meditations followed by thirty minutes of inquiry. Sixty-one participants completed two thirds of the sessions or more, and 65 individuals participated in a waiting-list (WL) control group. Self-compassion, anxiety, depression and stress levels were assessed. The analysis of pre-post results suggests that the interventions increased self-compassion levels and decreased anxiety, depression and stress levels, whereas the WL group did not show any significant changes. The emotional changes in the intervention group were associated with the increase in self-compassion. However, at follow-up, the scores of emotional distress variables returned to the initial pre-intervention scores. These data can be interpreted in line with previous results that have shown the efficacy of self-compassion-based intervention programs. Given that this efficacy was not maintained at follow-up, data are discussed according to the pervasive role of a highly stressful context and-as described in other studies-the need for regular practice to maintain the benefits obtained.

Validación cognitiva de un protocolo instruccional de reexperimentación emocional en adultos víctimas de violencia política en Colombia / Cognitive validation of an instructional protocol for emotional disclosure in adult victims of political violence in Colombia

Resumen La re experimentación emocional (RE) permite dar sentido a hechos traumáticos o estresantes mediante un proceso dirigido por instrucciones verbales o escritas, y por ello puede generar beneficios en el bienestar psicológico y la salud física autoinformada. El objetivo del presente estudio fue evaluar la comprensión de tres tipos de instrucciones experimentales (RE tradicional, RE con claves de aceptación y compromiso, y RE psicosocial) y una instrucción para el grupo control (RE trivial), mediante técnicas de validación cognitiva (pruebas centradas en el significado y verbalización de pensamiento) en personas expuestas a hechos de violencia política en Colombia. Para ello, se desarrolló un estudio de tipo cualitativo con corte instrumental, en el que se entrevistó a 42 colombianos víctimas de violencia política, en su mayoría mujeres, elegidos con un muestro por conveniencia. Las entrevistas fueron transcritas y codificadas mediante un análisis categorial mixto que tomó como referente procedimientos del Movimiento de Aspectos Cognitivos de la Metodología de Encuestas. Como resultado, los participantes comprendieron de manera diferencial las instrucciones dadas en cada protocolo, enfocándose en aspectos como el contexto sociopolítico en el caso del protocolo psicosocial, y en respuestas asociadas a la aceptación en el protocolo con claves de aceptación y compromiso. Se identificaron dificultades en la comprensión de algunas secciones de los protocolos, las cuales fueron ajustadas. Finalmente, se enfatiza la importancia de implementar técnicas de validación cognitiva para verificar la comprensión de instrucciones, protocolos o instrumentos, dado que el desempeño de los participantes y la calidad de las medidas de las intervenciones pueden verse afectados por la comprensión e interpretación de las instrucciones propuestas.

Abstract Emotional disclosure (ED) allows making sense of traumatic or stressful events through a process guided by verbal or written instructions, and thus may generate benefits in psychological well-being and self-reported physical health. The aim of the present study was to evaluate the understanding of three types of experimental instructions (traditional ED, ED with acceptance and commitment cues, and psychosocial ED) and one instruction for the control group (trivial ED), trough cognitive validation techniques (tests focused on meaning and verbalización of thought), in people exposed to events of political violence in Colombia. For this purpose, a qualitative study with an instrumental approach was developed, in which 42 Colombian victims of political violence, mostly women, were interviewed, chosen through convenience sampling. The interviews were transcribed and analyzed by means of a mixed categorical analysis that used as a reference procedures from the Cognitive Aspects of the Survey Methodology Movement. As a result, participants differentially understood the instructions given in each protocol, focusing on aspects such as the sociopolitical context in the case of the psychosocial protocol, and on responses associated with acceptance in the protocol with acceptance and commitment cues. Difficulties were identified in the understanding of some sections of the protocols, which were adjusted. Finally, the importance of implementing cognitive validation techniques to verify the understanding of instructions, protocols or instruments is emphasized, given that the performance of the participant and the quality of the measures of the experiments may be affected by the understanding and interpretation of the proposed instructions.

Decision aids linked to the recommendations in clinical practice guidelines: results of the acceptability of a decision aid for patients with generalized anxiety disorder.

BACKGROUND: Generalized anxiety disorder (GAD) is one of the most prevalent mental health problems. Patients with GAD have unmet needs related to the information received about their disorder, its treatments and their participation in the decision-making process. The aim of this study is to develop and assess the acceptability of a patient decision aid (PtDA) for patients with GAD. METHOD: The PtDA was developed following the International Patient Decision Aid Standards. The recommendations of the Spanish clinical practice guideline (CPG) for patients with GAD were used as the basis. The first prototype was developed by an expert committee, further improvements were made with patients (n = 2), clinical experts (n = 13) and the project management group (n = 7). The acceptability of this second draft was assessed by patients non-involved in the previous phases (n = 11). RESULTS: The final PtDA version included a brief description of GAD and its treatments. Most participants agreed that the PtDA was easy to use, visually appealing and useful. At least half of the participants learned new things about treatments and adverse effects. CONCLUSIONS: A PtDA was developed for patients with GAD based on recommendations from the Spanish CPG. It was improved and accepted by patients and clinical experts involved. An evaluation of its effectiveness on the shared decision-making process during the clinical encounter is planned.

Shared Decision-Making and Information Needs among People with Generalized Anxiety Disorder.

Shared decision making (SDM) aims to involve patients in the decisions about their care, considering their preferences, values and concerns about the different treatment options. However, research shows that people with mental health problems have considerable unmet information needs about their condition. This community-based cross-sectional study explores the SDM process and information needs among people with Generalized Anxiety Disorder (GAD), as an initial step in the design and development of a Patient Decision Aid for this population. Seventy participants completed an online survey with the Control Preference Scale, and questions about the perceived difficulty of past treatment decisions and the use of the Internet for searching for GAD-related information. Most participants preferred an active (42.9%) or collaborative role (41.4%) in the SDM process, and 53% did not perceive their preferred role. Information provided by healthcare professionals was considered insufficient by 28% of the sample, and over 30% reported using the Internet to look for GAD-related information at least once a week or more. The most relevant GAD-related information needs were general information (71.4%), information on self-help groups (65.7%), recommendations on how to face this disorder (61.4%) and information on treatment options (50%). Exploratory analyses showed that patients who perceived an active participation were more likely to search for information frequently (p = 0.038), and those who felt more involved than desired tended to search for more themes (p = 0.049). In summary, the study showed that a considerable percentage of GAD patients have unmet needs related to decision-making participation and information.

Effects of a Mindfulness and Acceptance-Based Program on Intimate Relationships in a Youth Sample: A Randomized Controlled Trial.

Intimate relationship conflicts in young people are crucial experiences for change. They can lead to more or less satisfactory relationships, depending on individuals' skills to cope with these conflicts. This may or may not lead to violence in couples. Acceptance and self-regulation processes are an effective strategy to address individual factors such as avoidance and anxiety in intimate relationships of people in these age groups, thus preventing violence. The aim of this study was to assess the effects of an eight-session mindfulness and acceptance-based program (MAP). Participants (n = 40), who were aged from 18 to 25 years old, were randomly assigned to a group receiving the MAP or an active control group. Outcome measures were anxiety about abandonment, intimacy avoidance (Experiences in Close Relationships scale), well-being (Psychological Well-being Scale), dispositional mindfulness (Five Facet Mindfulness Questionnaire) and flexibility (Acceptance and Action Questionnaire-II). Measures were taken at pre-intervention, post-intervention and follow-up. Results showed that the MAP decreased anxiety (p = 0.025) and avoidance (p = 0.01) and increased mindfulness (p < 0.001) and flexibility (p = 0.001). In general, these improvements persisted at follow-up. Results are discussed in relation to the usefulness of mindfulness-acceptance strategies to cope with non-pathological intimate relationship conflicts.

Reduciendo la ideación suicida en adolescentes con terapia de perspectiva temporal. Un estudio experimental / Reducing suicidal ideation in adolescents with time perspective therapy. An experimental study

Resumen El suicidio es una de las principales causas de muerte en el mundo, problema que en los últimos años ha venido en aumento sostenido para la población adolescente. En particular, la ideación suicida se ha relacionado fuertemente con el intento suicida, un predictor directo del suicidio; sin embargo, se encuentran escasas estrategias para disminuir la ideación suicida diseñadas principalmente para la depresión. Considerando las posibilidades terapéuticas de la teoría de Zimbardo sobre la perspectiva temporal equilibrada, en el presente estudio se diseñó una intervención breve basada en la perspectiva del tiempo para adolescentes con el objetivo de evaluar el efecto de una intervención de perspectiva temporal en la modificación de indicadores de ideación y conducta suicida en adolescentes. De este modo, se realizó un estudio experimental, donde 82 participantes de 15 a 19 años fueron asignados a una intervención experimental o a un grupo control. Los participantes del grupo experimental (n = 43) participaron durante 8 sesiones del programa de intervención de perspectiva del tiempo denominado "Serenamente". Las mediciones pre-post se realizaron sobre las variables de ideación suicida (Okasha), el perfil temporal (ZTPI) y la calidad de vida (SF-36). Como resultados, se encontró que la intervención reduce la ideación suicida en un 41 %; y que, posiblemente, mejora la salud física de quienes reciben este tipo de tratamiento. Los resultados son un avance promisorio con fines preventivos en contextos educativos y de salud.

Abstract Suicide is one of the leading causes of death in the world, a problem that has been steadily increasing in recent years for the adolescent population. In particular, suicidal ideation has been strongly associated with suicide attempt, a direct predictor of suicide; however, few strategies to decrease suicidal ideation designed primarily for depression are found. Considering the therapeutic possibilities of Zimbardo's theory on balanced time perspective, in the present study a brief intervention for adolescents based on that theory was designed with the aim of evaluating the effect of a time perspective intervention on the modification of indicators of suicidal ideation and behavior in adolescents. Thus, an experimental study was conducted, where 82 participants aged 15 to 19 were assigned to either an experimental intervention or a control group. The participants of the experimental group (n = 43) engaged in eight sessions of the time perspective intervention program called "Serenity". Pre-post measurements were made on the variables of suicidal ideation (Okasha), time profile (ZTPI) and quality of life (SF-36). Results show that the intervention reduces suicidal ideation by 41%; and that, possibly, it improves the physical health of those who receive this type of treatment. The results are a promising advance for preventive purposes in educational and health contexts.

Framing the process in the implementation of care for people with generalized anxiety disorder in primary care: a qualitative evidence synthesis.

BACKGROUND: Generalized anxiety disorder (GAD) is one of the most common mental disorders in primary care (PC). GAD has low remission and high relapse rates over long follow-up periods. Qualitative evidence was synthesized to understand the implementation of care and treatment options for people with GAD in PC. METHODS: Research published from 2008 to September 2020 was searched in five databases (MEDLINE, EMBASE, CINAHL, WOS and PsycArticles). Studies that used qualitative methods for data collection and analysis to investigate the implementation of care and treatment options for people with GAD in PC and outpatient settings were included. Non-qualitative studies, mixed methods studies that did not separately report qualitative findings and studies in languages other than English or Spanish were excluded. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to assess the overall confidence in the findings. RESULTS: The results with a moderate level of confidence showed that the trajectory of care for people with GAD in PC and outpatient settings is long and fluctuates over time, involving multiple difficulties in accessing and maintaining initial treatment or successive treatment options. In addition, there are wide variations in the preferences for and acceptability of different treatment options. The results with a high level of confidence indicated that more information on GAD and its treatment options is needed for PC practitioners, GAD patients and their carers. The results with a low level of confidence suggested that patients use antidepressants for longer than recommended and that the interruption of treatment is not usually planned. CONCLUSIONS: Initial resistance to new treatments among people with GAD can make access and adherence to treatment difficult. Improving care may require patients to be informed of possible trajectories in stepped care pathways before the initiation of treatment so they are aware that they may need to try a number of options until the most effective treatment for them is found. Increased awareness of and information materials on GAD may facilitate both appropriate diagnosis and long-term care.

[Progression of symptoms in children with attention deficit and hyperactivity disorder in treatment with methylphenidate]. / Progresión de los síntomas en niños con trastorno por déficit de atención e hiperactividad en tratamiento con metilfenidato.

Attention deficit and hyperactivity disorder (ADHD) is a neurobiological disorder frequent in childhood. The main symptoms are attention disorder and/or impulsivity and/or hyperactivity. There are different subtypes of ADHD according to the degree of presence of these three symptoms. There are different therapeutic approaches with high proved effectiveness. Methylphenidate, a stimulant that acts through the dopaminergic and adrenergic pathways, is commonly used for the treatment of ADHD. The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening instrument internationally used for the screening of mental health problems in children and adolescents. It consists in a 25 items questionnaire with 5 different scales: emotional symptoms, conduct problems, hyperactivity / inattention, peer relationship problems and prosocial behaviours. The SDQ score was collected in a sample of ADHD patients with an age between 7 and 12 years. The score obtained before starting treatment with methylphenidate was compared before and after starting treatment, every 3-6 months and up to a period of 2 years. Statistical processing was performed using R, which is a free program for statistical and graphical analysis, that allows temporary analysis. The results indicate that hyperactivity improves throughout the first year of treatment, emotional symptoms and behavioral problems improve during the first 6 months of treatment, pro-social symptoms slowly improve over 2 years. Problems with partners do not improve in the analyzed time.

El trastorno por déficit de atención e hiperactividad (TDAH) es un trastorno neurobiológico frecuente en la infancia. Sus síntomas cardinales involucran a la atención y/o la impulsividad y/o la hiperactividad. Hay diferentes subtipos de TDAH según la expresividad clínica de esos tres síntomas. Hay distintas estrategias terapéuticas de alta efectividad. El metilfenidato, un estimulante que actúa en las vías dopaminérgicas y adrenérgicas, se utiliza con frecuencia en su tratamiento. El Cuestionario de Cualidades y Dificultades (SDQ) es un cuestionario de despistaje breve utilizado para la detección de problemas de salud mental en niños y adolescentes. Consta de 25 preguntas que se distribuyen en 5 escalas: sintomatología emocional, problemas de conducta, hiperactividad/inatención, problemas con los compañeros y conducta prosocial. Se recogió la puntuación del SDQ en una muestra de pacientes con TDAH con una edad situada entre los 7 y 12 años. Se comparó la puntuación obtenida antes de comenzar el tratamiento con metilfenidato y después de comenzar tratamiento, cada 3-6 meses y hasta un periodo de 2 años. Se realizó el procesamiento estadístico mediante R, que es un programa gratuito para análisis estadísticos y gráficos, y permite análisis temporales. Los resultados indican que la hiperactividad mejora a lo largo del primer año de tratamiento, la sintomatología emocional y los problemas de comportamiento mejoran durante los primeros 6 meses de tratamiento, la sintomatología prosocial mejora lentamente a lo largo de los 2 años y los problemas con compañeros no mejoran en el tiempo analizado.

Progresión de los síntomas en niños con trastorno por déficit de atención e hiperactividad en tratamiento con metilfenidato / Progression of symptoms in children with attention deficit and hyperactivity disorder in treatment with methylphenidate

El trastorno por déficit de atención e hiperactividad (TDAH) es un trastorno neurobiológico frecuente en la infancia. Sus síntomas cardinales involucran a la atención y/o la impulsividad y/o la hiperactividad. Hay diferentes subtipos de TDAH según la expresividad clínica de esos tres síntomas. Hay distintas estrategias terapéuticas de alta efectividad. El metilfenidato, un estimulante que actúa en las vías dopaminérgicas y adrenérgicas, se utiliza con frecuencia en su tratamiento. El Cuestionario de Cualidades y Dificultades (SDQ) es un cuestionario de despistaje breve utilizado para la detección de problemas de salud mental en niños y adolescentes. Consta de 25 preguntas que se distribuyen en 5 escalas: sintomatología emocional, problemas de conducta, hiperactividad/inatención, problemas con los compañeros y conducta prosocial. Se recogió la puntuación del SDQ en una muestra de pacientes con TDAH con una edad situada entre los 7 y 12 años. Se comparó la puntuación obtenida antes de comenzar el tratamiento con metilfenidato y después de comenzar tratamiento, cada 3-6 meses y hasta un periodo de 2 años. Se realizó el procesamiento estadístico mediante R, que es un programa gratuito para análisis estadísticos y gráficos, y permite análisis temporales. Los resultados indican que la hiperactividad mejora a lo largo del primer año de tratamiento, la sintomatología emocional y los problemas de comportamiento mejoran durante los primeros 6 meses de tratamiento, la sintomatología prosocial mejora lentamente a lo largo de los 2 años y los problemas con compañeros no mejoran en el tiempo analizado.

Attention deficit and hyperactivity disorder (ADHD) is a neurobiological disorder frequent in childhood. The main symptoms are attention disorder and/or impulsivity and/or hyperactivity. There are different subtypes of ADHD according to the degree of presence of these three symptoms. There are different therapeutic approaches with high proved effectiveness. Methylphenidate, a stimulant that acts through the dopaminergic and adrenergic pathways, is commonly used for the treatment of ADHD. The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening instrument internationally used for the screening of mental health problems in children and adolescents. It consists in a 25 items questionnaire with 5 different scales: emotional symptoms, conduct problems, hyperactivity / inattention, peer relationship problems and prosocial behaviours. The SDQ score was collected in a sample of ADHD patients with an age between 7 and 12 years. The score obtained before starting treatment with methylphenidate was compared before and after starting treatment, every 3-6 months and up to a period of 2 years. Statistical processing was performed using R, which is a free program for statistical and graphical analysis, that allows temporary analysis. The results indicate that hyperactivity improves throughout the first year of treatment, emotional symptoms and behavioral problems improve during the first 6 months of treatment, pro-social symptoms slowly improve over 2 years. Problems with partners do not improve in the analyzed time.

Deterioration rates in Virtual Reality Therapy: An individual patient data level meta-analysis.

Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31-1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.

Síntomas de depresión en hombres / Depression Men's Symptoms

Resumen El objetivo de este estudio era el objetivo de la presente investigación comparativa es identificar los síntomas específicos de depresión en hombres y determinar si existe un sesgo diagnóstico en los criterios incluidos en el sistema DSM y CIE. Para ello se estudia una muestra clínica conformada por 156 hombres y 174 mujeres entre los 18 y los 65 años, con diagnóstico previo de depresión, y un grupo control compuesto por 149 hombres y 151 mujeres sin depresión. Para evaluar depresión se usó Cuestionario de Depresión en Hombres (CDH) y la Entrevista MINI (Mini International Neuropsychiatric Interview). Para los análisis psicométricos se empleó el Modelo de Rasch desde la Teoría de Respuesta al Ítem y análisis comparativos multivariados. Se concluye que los hombres se deprimen de forma significativamente diferente de las mujeres y que parte de los síntomas identificados no son considerados en los sistemas nosológicos vigentes.

Abstract The aim of this study was to identify if there are symptoms of depression in men who are not described in diagnostic manuals available. This clinical sample comprised 156 men and 174 women between 18 and 65 years prior to diagnosis of depression, and 149 men and 151 women without depression used as controls is studied. To evaluate Depression Questionnaire Depression in Men (CDH) and Interview MINI (Mini International Neuropsychiatric Interview) was used. For psychometric analyzes the Rasch model was used from the Item Response Theory and multivariate comparative analysis. We conclude that men are depressed significantly different from women and that some of the symptoms identified are not considered in the current nosological systems.

Prenatal Cocaine and Cocaine Consumption in Young Adult Mice / Cocaína prenatal y consumo de cocaína de ratones adultos jovenes

Resumen Con el propósito de evaluar los efectos de la Exposición Prenatal de Cocaína -EPC- (25 y 50 mg/kg/día) desde el 8 hasta el 21 día de gestación, en el consumo de cocaína oral en ratones hembras y machos en la adultez temprana (7ª semana de edad), se realizó un estudio experimental factorial mediante el modelo de "elección libre de dos botellas" que mide el consumo en mililitros. Se evaluó el consumo durante 14 días consecutivos a partir de la 7ª semana de edad. Para el análisis del consumo se utilizó el MANOVA de medidas repetidas y se encontró que la EPC 50mg/kg/día incrementó el consumo de cocaína oral en ratones hembras y machos adultos-jóvenes tanto en la fase de adquisición como la de mantenimiento. Y la EPC 25mg/kg/día aumentó el consumo únicamente en los machos en la fase de mantenimiento, mostrando la mayor susceptibilidad de estos a la EPC, en cambio el alto consumo de cocaína observado en las hembras no fue dosis-relacionado, por lo que se puede atribuir a factores situacionales. De esta forma se ve como la EPC en las dos dosis evaluadas incrementa el consumo de cocaína oral en la adultez temprana en los ratones; la dosis alta (50mg/kg) el consumo de hembras y machos y la dosis baja (25mg/kg) incrementa el consumo únicamente en los machos. Se observa que los efectos están relacionados a la dosis y que los machos son más vulnerables a los efectos de la EPC.

Abstract To evaluate the effects of Prenatal Exposure of Cocaine-EPC- (25 or 50 mg / kg / day) from 8-21 day of gestation, on oral cocaine use in female and male mice in early adulthood, was used the test of "free choice of two bottles" that measures the oral cocaine consumption in milliliters. This was evaluated for 14 consecutive days from the 7th week of age. Repeated measures MANOVA was used for the analysis of consumption. It was found that EPC 50mg/kg/day increased oral cocaine consumption in female and young adult male mice both in the acquisition and maintenance phases. And the EPC 25mg/kg/day increased the consumption only in the males in the maintenance phase, showing the greater susceptibility of these to the EPC, whereas the high cocaine consumption observed in the females was not dose-related, which can be attributed to situational factors. In this way, it is seen how the EPC in the two doses evaluated increases oral cocaine consumption in early adulthood in mice; the high dose (50mg / kg) the consumption of females and males and the low dose (25mg / kg) increases the consumption only in males. It is observed that the effects are related to the dose, and that males are more vulnerable to the EPC effects.

Cocaine exposure during pregnancy and postpartum maternal behavior in mice / Cocaína durante a Gestação e Comportamento Materno Pós-parto em Ratos / Cocaína durante la gestación y conducta materna postparto en ratones

Abstract Maternal cocaine abuse during pregnancy is associated to neglect, abuse, and mother-child bond disruption, which directly affects infant development; therefore, various neurobehavioral problems of children of drug-dependent parents could be attributed to inadequate maternal behavior or prenatal exposure to drugs. Thus, the aim of this research was to analyze the effects of chronic cocaine administration during pregnancy on postpartum maternal behavior. To do this, 21 CD1 pregnant female mice were randomly assigned for administration of saline solution and cocaine (25 mg/kg/day and 50 mg/kg/day), from day 8 to 21 of gestation. After delivery, for 15 minutes a day, during 20 days, the frequency of occurrence of 16 behavioral patterns of maternal behavior was individually recorded, using an ethogram. Cocaine slightly affected maternal behavior frequency, although it may have affected other parameters, such as latency, duration, and sequence of this behavior.

Resumo O abuso materno de cocaína durante a gestação está relacionado com negligência, maltrato, perturbação do vínculo mãe-filho, o que incide diretamente no desenvolvimento das crianças. Por isso, as diversas problemáticas neurocomportamentais dos filhos de pais drogodependentes poderiam ser atribuídas ao inadequado comportamento materno ou à exposição prénatal à droga. O objetivo desta pesquisa foi analisar os efeitos da administração crônica de cocaína durante a gestação no comportamento materno pós-parto de ratos. Para isso, designaram-se aleatoriamente 21 ratos CD1 fêmeas gestantes para a administração de solução salina e cocaína (25 mg/kg/dia e 50 mg/kg/dia), desde o oitavo até o 21° dia de gestação. Após o parto, durante 20 dias (15 minutos diários), registrou-se individualmente a frequência de apresentação de 16 índices de comportamento materno mediante um etograma. Constatou-se que a cocaína afetou levemente a frequência do comportamento materno, embora possivelmente afete outros parâmetros como latência, duração e sequência desse comportamento.

Resumen El abuso materno de cocaína durante la gestación se relaciona con negligencia, maltrato y perturbación del vínculo madre-hijo, lo que incide directamente en el desarrollo de los infantes; por esto, las diversas problemáticas neuroconductuales de los hijos de padres drogodependientes podrían atribuirse a la inadecuada conducta materna o a la exposición prenatal a la droga. El objetivo de esta investigación fue analizar los efectos de la administración crónica de cocaína durante la gestación en la conducta materna postparto de ratones. Para esto se asignaron aleatoriamente 21 ratones CD1 hembras gestantes para la administración de solución salina y cocaína (25 mg/kg/día y 50 mg/kg/día), desde el octavo hasta el día veintiuno de gestación. Después del parto, durante 20 días (15 minutos diarios), se registró individualmente la frecuencia de presentación de 16 índices de conducta materna mediante un etograma. Se encontró que la cocaína afectó levemente la frecuencia de la conducta materna, aunque posiblemente afecte otros parámetros como la latencia, duración y secuencia de esta conducta.

Efectos de la exposición prenatal a cocaína en la conducta emocional en ratones / Effects of prenatal cocaine administration on emotional behavior in mice

El objetivo de este estudio fue analizar los efectos de la Exposición Prenatal a Cocaína (EPC) (0,25 o 50 mg/kg/día) en la conducta emocional de ratones hembras y machos en la adolescencia y la adultez temprana. Se asignaron 27 ratones CD1 hembras gestantes a 3 condiciones experimentales: un grupo control que se le administró solución salina y 2 experimentales a los que se le administró cocaína 25 mg/ kg/día y 50 mg/kg/día, desde el día octavo al veintiunavo de gestación. La conducta emocional de los hijos de estas madres se evaluó en la adolescencia y en la adultez temprana (5.ª y 7.ª semana de edad, respetivamente) por medio del tablero de agujeros y el laberinto en cruz a través de diferentes índices de actividad exploratoria. Los datos se analizaron por medio de MANOVAS y ANOVAS con un valor a de 0.05. La EPC alteró de forma dosis-relacionada la conducta emocional; los sujetos sometidos a EPC 50 mg/kg/día exhibieron mayor ansiedad y temor, en cambio los tratados con EPC 25 mg/kg/día exploraron más, mostrando conductas de alto riesgo, características de la impulsividad e hiperactividad. Los efectos encontrados se mantuvieron en el tiempo, por lo que se concluye que la EPC perturbó permanente y significativamente la emoción.

In order to study the effects of prenatal cocaine exposure (0, 25 or 50 mg/kg/day), on the emotional behavior of young and adult mice of both sexes, 27 CD1 pregnant female mice were assigned to one of three experimental conditions: a control group was given saline solution, a first experimental group that was given 25 mg/kg/day of cocaine and another experimental group with 50 mg/kg/day of cocaine, all between gestational days 8-21. Emotional behavior was evaluated in the offspring (both males and females) of the females at five and seven weeks of age, via the hole board followed by the plus maze with different rates of exploratory activity. Data were analyzed with MANOVAS and ANOVAS with and a of 0.05. Prenatal Cocaine Exposure (PCE) altered dose-related emotional behavior; subjects with PCE of 50 mg/kg/day exhibited more anxiety and fear, in contrast to the 25 mg/kg/day group that explored more and showed greater high-risk behaviors, which are features of impulsivity and hyperactivity. The effects found were maintained over time, so it is concluded that PCE permanently and significantly perturbed emotion.

Preferencias por las decisiones compartidas en pacientes con depresión / Depressive patients' preferences in shared decision-making / Preferências pelas decisões compartilhadas em pacientes com depressão

This study analyzed the role of psychological processes predicting depressed patients' preferences in clinical decision-making about psychiatric treatment. 462 patients diagnosed with depressive disorders, acute or recurrent, participated in a crosssectional survey. Most participants preferred collaborative-passive or totally passive roles. Results showed no significant differences between acute and recurrent patients in their preference of participation in decision-making, but longer treatment duration was associated with a more passive style. MANCOVA, controlling age, educational level and treatment duration variables, showed that collaborative and passive patients had a greater locus of control focused on their psychiatrist than active patients. Gender differences were found. Men showed greater internal locus of control and psychological reactance, while women showed greater external locus of control focused on chance. Regression analysis indicated that, for men, passive preferred role was explained by external locus centered on their psychiatrist. However, age registered the highest weight for women' passive decision-making, followed by the locus focused on chance, locus focused on the psychiatrist and lower self-efficacy. Our findings suggest the need to study shared decision-making from a differential perspective that involves psychological processes and the impact of these processes in adherence to medical treatments.

En el presente estudio se analizaron los procesos psicológicos asociados con las preferencias de los pacientes con depresión en la toma de decisión sobre su tratamiento psiquiátrico. Participaron 462 pacientes diagnosticados con un trastorno depresivo agudo o recurrente. La mayor parte prefirió asumir un rol colaborativo-pasivo o totalmente pasivo. Los resultados no mostraron diferencias significativas entre pacientes en función de su cronicidad en la preferencia por la toma de decisiones, aunque un mayor tiempo de tratamiento se asoció con un estilo más pasivo. El MANCOVA aplicado al total de participantes, controlando la edad, el nivel educativo y el tiempo de tratamiento, indicó que los pacientes colaborativos y pasivos mostraron mayor locus de control centrado en la confianza en el psiquiatra que los activos. Se encontraron diferencias de género mostrando en los hombres mayor locus de control interno y reactancia psicológica, y en las mujeres, mayor locus centrado en el azar. Los análisis de regresión indicaron que en el caso de los hombres, la preferencia pasiva por la toma de decisión es explicada por el locus centrado en el psiquiatra. Sin embargo, en las mujeres tuvo mayor peso la edad, seguida del locus centrado en el azar, el locus centrado en el psiquiatra y una percepción de menor autoeficacia. Los hallazgos señalan la necesidad de estudiar desde una perspectiva diferencial la participación de los pacientes en la toma de decisión de acuerdo con los procesos psicológicos, así como la repercusión que esta tiene en la adherencia al tratamiento médico.

Neste estudo, analisaram-se os processos psicológicos associados com as preferências dos pacientes com depressão na tomada de decisão sobre seu tratamento psiquiátrico. Participaram 462 pacientes diagnosticados com um transtorno depressivo agudo ou recorrente. A maior parte preferiu assumir um papel colaborativo-passivo ou totalmente passivo. Os resultados não mostraram diferenças significativas entre pacientes em função de sua cronicidade na preferência por tomada de decisões, embora um maior tempo de tratamento tenha sido associado com um estilo mais passivo. O MANCOVA aplicado ao total de participantes, controlando a idade, o nível educativo e o tempo de tratamento, indicou que os pacientes colaborativos e passivos mostraram maior lócus de controle centralizado na confiança no psiquiatra do que os ativos. Constataram-se diferenças de gênero que mostraram nos homens maior lócus de controle interno e reatância psicológica, e, nas mulheres, maior lócus centralizado no aleatório, o lócus centralizado no psiquiatra e uma percepção de menor autoeficácia. Os achados indicam a necessidade de estudar, sob uma perspectiva diferencial, a participação dos pacientes na tomada de decisão de acordo com os processos psicológicos e a repercussão que esta tem na aderência ao tratamento médico.

Los nuevos desarrollos tecnológicos aplicados al tratamiento psicológico / New technological developments applied to psychological treatment / Os novos desenvolvimentos tecnológicos aplicados ao tratamento psicológico

El desarrollo de nuevas tecnologías ha alcanzado prácticamente a todo el desarrollo humano. En el caso de la psicología clínica, ha significado nuevos avances en el conocimiento, evaluación y tratamientos psicológicos de diferentes problemas y trastornos. En este trabajo se revisan cuatro desarrollos que han tenido una expansión importante: el uso de internet para el tratamiento psicológico, el uso de la realidad virtual, el neurofeedback y la estimulación magnética transcraneal. Se presenta brevemente cada técnica o procedimiento, su aplicación a problemas concretos, sus ventajas y sus inconvenientes. Finalmente se discute el desarrollo de estos recursos y la necesidad de seguir aportando conocimientos que vayan mejorando su eficacia y su eficiencia, de acuerdo con tipos de pacientes, patologías, procedimiento específico, así como evitar efectos indeseables.

The impact of new technologies has reached almost all human development. In the case of clinical psychology, has meant new advances in the understanding, assessment and treatment of various psychological problems and disorders. In this paper, four developments that have had a major expansion are reviewed: Internet-based psychological treatment, the use of virtual reality, neurofeedback, and transcranial magnetic stimulation. First, each technique or procedure is briefly presented. Then, its application to specific problems, its advantages and disadvantages are described. Finally, the development of these resources and the need to continue providing knowledge is discussed. These advances will improve their effectiveness and efficiency, according to types of patients, specific disorders, and to avoid side-effects.

O desenvolvimento de novas tecnologias alcançou praticamente a todo o desenvolvimento humano. No caso da psicologia clínica, significou novos avanços no conhecimento, avaliação e tratamentos psicológicos de diferentes problemas e transtornos. Neste trabalho são revisados quatro desenvolvimentos que tiveram uma expansão importante: o uso da internet para o tratamento psicológico, o uso da realidade virtual, ou neurofeedback e a estimulação magnética transcraniana. Cada técnica ou procedimento é brevemente apresentado, sua aplicação a problemas concretos, suas vantagens e seus inconvenientes. Finalmente discute-se o desenvolvimento destes recursos e a necessidade de seguir contribuindo com conhecimentos que possam melhorar sua eficácia e sua eficiência, de acordo com tipos de pacientes, patologias, procedimento específico, assim como evitar efeitos indesejáveis.

Prevalencia de los trastornos mentales en la Isla de Tenerife / The prevalence of mental disorders on the Island of Tenerife

Se pretende con este estudio llevar a cabo una estimación de la prevalencia de los trastornos mentales agrupados tanto en categorías generales como en categorías diagnósticas específicas. Se utilizó un diseño por conglomerados bietápico, llevando a cabo una selección aleatoria de la muestra en dos fases. La muestra en 1ª fase estuvo constituida por 800 personas, mayores de 18 años. En 2ª fase se trabajó con 114 personas. Como instrumentos de evaluación se administraron el GHQ-28 y la entrevista estructurada CIDI. Los resultados indican una prevalencia estimada del 18,42% para el total de la muestra. Se obtiene una mayor prevalencia de trastornos en las mujeres. Por categorías específicas, los trastornos de ansiedad son los más prevalentes, seguidos por los trastornos relacionados con sustancias y de los trastornos del estado de ánimo. Se destaca que los trastornos relacionados con el uso de sustancias ocupan un segundo lugar, desplazando a los trastornos del estado de ánimo, lo que concuerda con otros estudios realizados con metodología similar (AU)

In this study it is described the results of an epidemiological community study on the prevalence of both general and specific mental disorders. A two stage design was use according a random sample distribution by conglomerates. In the first stage 800 adult persons was the final sample; second stage, 114 adults were assessed. The assessment instruments were GHQ-28 and the CIDI structured interview. The results indicate an estimated prevalence rate of 18,42% of general mental disorders. These rates are highest in women. According to specific disorders, the anxiety disorders was most prevalent disorder, followed by substance abuse and affective disorders. It is outlined that substance abuse disorders occupy the second position, displeasing the affective disorders, which agrees with other studies realized with similar methodology (AU)