Mindfulness trait and the potential mediating role of emotional regulation strategies in bipolar disorder / Mindfulness rasgo y el potencial papel mediador de las estrategias de regulación emocional en el trastorno bipolar

En este estudio transversal se investiga la asociación entre los principales síntomas del Trastorno bipolar (TB) y las dificultades asociadas a las estrategias de regulación emocional (ERE) adaptativas y desadaptativas. Además, este estudio examina los efectos mediadores de las ERE con el mindfulness rasgo y el TB. Método. Veinticuatro adultos con TB completaron la Escala de Conciencia de Atención Plena (MAAS), el Inventario de Depresión de Beck (BDI-II), la Escala de Autoevaluación de Manía de Altman (ARSM), el Inventario de Ansiedad Rasgo (STAI-R), y el Cuestionario de Regulación Emocional Cognitiva (CERQ). Resultados. El análisis de regresión múltiple mostró cómo la depresión se relacionaba significativa y positivamente con la autoculpabilización, mientras que la ansiedad rasgo estaba positivamente asociada con la autoculpabilización y el catastrofismo. En segundo lugar, el análisis de mediación mostró un efecto de mediación significativo para la autoculpabilidad en la relación entre mindfulness y depresión (a*b = -.15; ICB 95% [-.36, -.03]) y entre mindfulness y ansiedad rasgo (a*b = -.09; ICB 95% [-.27, -.01]). Conclusiones. Nuestros resultados informan del papel de la auto-culpabilidad y el catastrofismo en el TB y de cómo éstas podrían mediar significativamente entre el mindfulness rasgo y el TB. Estos resultados sugieren que una práctica de meditación enfocada en el catastrofismo y la autoculpabilidad puede ser especialmente útil para reducir los síntomas en los pacientes bipolares.(AU)

This cross-sectional study investigates the association between the main symptoms of Bipolar disorder (BD) and emotional regulation dif-ficulties in adaptive and maladaptive emotional regulation strategies (ERS). In addition, this study examines the possible mediating effects of ERS with dispositional mindfulnessand bipolar symptoms. Method.Twenty-four adults diagnosed with BD completed the Mindful Attention Awareness Scale (MAAS), the Beck Depression Inventory (BDI-II), the Altman Mania Self-Assessment Scale (ARSM), the Trait Anxiety Inventory (STAI-R), and the Cognitive Emotional Regulation Questionnaire (CERQ). Results. First, mul-tiple regression analysis showed how depression was significantly positively related to self-blame, whereas trait anxietywas positively associated with self-blame and catastrophizing. Second, the results of the mediation analy-sis have shown a significant mediation effect for the self-blamein the rela-tionship between mindfulnessand depression (a*b = -.15; BCI 95% [-.36, -.03]) and between mindfulnessand trait anxiety (a*b = -.09; BCI 95% [-.27, -.01]). Conclusions. Our results report the role of self-blame and catastrophiz-ing in BD and how these might significantly mediate between dispositional mindfulness and symptoms of depression and anxiety. These results suggest that a meditation practice focused on reducing catastrophizing and self-blame may be especially helpful for symptoms of depression and anxiety in bipolar patients.(AU)

Preventive interventions for children and adolescents of parents with mental illness: A systematic review.

BACKGROUND: Children of parents with mental disorders have a relatively high risk of developing a mental illness or behavioural disorder. OBJECTIVE: The aim of this systematic review was to evaluate the efficacy of preventive psychotherapeutic interventions in children of parents with mental illness. In particular, the development of mental illness and/or psychological symptomatology in this population was assessed. METHOD: This qualitative systematic review looked at interventions targeting children aged 4-18 years without a diagnosed mental disorder, alone or with their families, with a parent with a diagnosed mental disorder. The protocol was pre-registered in Open Science Framework. A total of 1255 references were retrieved from MEDLINE, PsychArticles, PsycINFO, Springer Link, Science Direct, Scopus and WOS databases, and 12 references from grey literature. This search was replicated by an external reviewer. RESULTS: Fifteen studies involving 1941 children and 1328 parents were included. Interventions were based on cognitive-behavioural and/or psychoeducational components, including six randomized controlled trials. Internalizing symptomatology was assessed in 80% of the studies, externalizing and prosocial behaviour in 47%, and coping style in 33%. Only two studies measured the future risk of developing a mental disorder (ORs of 2.37 and 6.6). There was variability in the format of the intervention (group; family) as well as in the type of intervention and its duration (from one session to 12 sessions). CONCLUSIONS: Interventions for children of parents with mental disorder were clinically and statistically significant, especially in preventing internalizing symptomatology at one-year follow-up, with effect sizes ranging from d = -0.28 to 0.57 (95% CI).

Effectiveness of mindfulness-based interventions on anxiety for children and adolescents: A systematic review and meta-analysis.

AIM: This paper aims to investigate the extent to which mindfulness-based interventions serve to reduce anxiety in children and adolescents. A heterogeneous sample was used, including clinical and non-clinical population. METHODS: A literature search of controlled intervention studies published up to December 31, 2016, was carried out in PubMed, Lilacs, Cochrane, Embase, PsycInfo, Opengrey and Teseo databases. The effect size was calculated by Cohen's d. The Cochran Q statistic and the I2 index were used for the study of heterogeneity. An analysis was conducted using the random effects model. RESULTS: 829 articles were identified, of which 18 were finally selected. Of these, only three had statistically significant effect sizes. The overall combined result obtained was .013, but it did not result statistically significant (CI95% [-.102, .128].) The Q statistic was statistically significant (Q [18] = 28.497, P = . 39) and the I2 index was 40.34%, indicating a moderate heterogeneity. CONCLUSIONS: This meta-analysis did not obtain statistically significant results that could provide conclusions. In general, the studies analysed are small, of low power and have a marked heterogeneity, which implies that the findings are provisional and need to be supported by more robust studies. Although it cannot be ruled out that mindfulness-based interventions are not effective in the infant-juvenile population, it is also possible that this effect could not be detected due to the limited number of available studies. Larger investigations are needed, with sufficient statistical power and designs that control the variables potentially moderating, to establish clear conclusions.

Validity and reliability of the Spanish version of the Somatoform Dissociation Questionnaire (SDQ-20).

BACKGROUND: The Somatoform Dissociation Questionnaire (SDQ-20) is a self-reported questionnaire measuring somatoform dissociation. The aim of this study is to analyze the psychometric properties of the Spanish version of the SDQ-20 and its short version (SDQ-5). METHODS: Validity and reliability were examined in a sample of 360 psychiatric outpatients: 38 dissociative (conversion) disorders, 30 dissociative (psychoform) disorders, and 292 patients suffering from other disorders. Dissociative disorders were diagnosed using the SCID-D and a specific interview for conversion disorders. RESULTS: Subjects meeting criteria for any dissociative or conversion disorder scored significantly higher in the SDQ-20 (criterion validity). Somatoform dissociation, psychoform dissociation and early trauma were significantly correlated (construct validity). An alpha coefficient of .866 (reliability) and a test-retest correlation of 0.91 were obtained. The cut-off score maximizing sensitivity and specificity was 27.5 for psychoform dissociative disorders (sensitivity of 81.6% and specificity of 71.0%) and 29.5 for conversion disorders (81.6% and 71.0%). For the SDQ-5, the coefficient alpha was 0.561 and the selected cut-off score was 5.5 (sensitivity of 73.33% and specificity of 70.41%). CONCLUSIONS: The Spanish version of the SDQ-20 presents good psychometric properties while the SDQ-5 shows worse characteristics and its use with Spanish samples is not recommended.

The Progressive Approach to EMDR Group Therapy for Complex Trauma and Dissociation: A Case-Control Study.

Eye Movement Desensitization and Reprocessing is a psychotherapeutic approach with recognized efficiency in treating post-traumatic stress disorder (PTSD), which is being used and studied in other psychiatric diagnoses partially based on adverse and traumatic life experiences. Nevertheless, there is not enough empirical evidence at the moment to support its usefulness in a diagnosis other than PTSD. It is commonly accepted that the use of EMDR in severely traumatized patients requires an extended stabilization phase. Some authors have proposed integrating both the theory of structural dissociation of the personality and the adaptive information processing model guiding EMDR therapy. One of these proposals is the Progressive Approach. Some of these EMDR procedures will be evaluated in a group therapy format, integrating them along with emotional regulation, dissociation, and trauma-oriented psychoeducational interventions. Patients presenting a history of severe traumatization, mostly early severe and interpersonal trauma, combined with additional significant traumatizing events in adulthood were included. In order to discriminate the specific effect of EMDR procedures, two types of groups were compared: TAU (treatment as usual: psychoeducational intervention only) vs. TAU+EMDR (the same psychoeducational intervention plus EMDR specific procedures). In pre-post comparison, more variables presented positive changes in the group including EMDR procedures. In the TAU+EMDR group, 4 of the 5 measured variables presented significant and positive changes: general health (GHQ), general satisfaction (Schwartz), subjective well-being, and therapy session usefulness assessment. On the contrary, only 2 of the 5 variables in the TAU group showed statistically significant changes: general health (GHQ), and general satisfaction (Schwartz). Regarding post-test inter-group comparison, improvement in subjective well-being was related to belonging to the group that included EMDR procedures, with differences between TAU and TAU+EMDR groups being statistically significant [χ2(1) = 14.226; p < 0.0001]. In the TAU+EMDR group there was not one patient who got worse or did not improve; 100% experienced some improvement. In the TAU group, 70.6% referred some improvement, and 29.4% said to have gotten worse or not improved.

[Spanish adaptation of Hobfoll's Strategic Approach to Coping Scale (SACS)]. / Adaptación española de la Escala Multiaxial de Afrontamiento Estratégico (SACS) de Hobfoll.

The present research adapted the Strategic Approach to Coping Scale (SACS), developed by Hobfoll and colleagues, to the Spanish population. SACS is an instrument derived from Hobfoll's Conservation of Resources Theory, which emphasises the contribution of social factors to coping processes. This instrument assesses coping strategies in 9-subscales, organised in three dimensions: orientation to the problem (active/passive), use of social resources (prosocial/antisocial), and orientation to others involved (direct/indirect). The Spanish version, administered to a non-clinical sample (N= 767), found 7-subscales structured in prosocial/antisocial, active/passive and reflexive/intuitive dimensions, with adequate reliability and construct validity. To conclude, the Spanish SACS is a potentially useful and reliable instrument for research and clinical purposes, mainly in areas in which social components need to be explicitly considered.

Predicción de la sintomatología somática a partir del estrés diario y de los sintomas previos: un estudio prospectivo / Daily stress and symptoms predicting current somatic symptomatology levels: A prospective study

Este es un estudio prospectivo, realizado durante siete días consecutivos, en el que se analiza el poder predictivo del estrés diario y de la sintomatología somática iniciales, sobre la sintomatología somática posterior. Los resultados indican que el mejor predictor de la sintomatología somática fue el nivel previo de síntomas, pero el estrés diario también fue un predictor significativo aun después de controlar estadísticamente el nivel inicial de síntomas (AU)