Uso de la Teleterapia para el Tratamiento de los Trastornos de Ansiedad, TOC y TEPT, Durante la Pandemia por COVID-19 en España / Use of Teletherapy for the Treatment of Anxiety Disorders, OCD and PTSD, During the COVID-19 Pandemic in Spain

La proporción de teletratamiento llevada a cabo por psicólogos durante la pandemia por COVID-19 para el TAG, fobia específica, agorafobia, ansiedad social, pánico, TOC y TEPT, así como si la experiencia en teleterapia tiene un efecto significativo en la demanda no han sido estudiadas. Los resultados indican que el TAG con un 69.2%, es el trastorno que más teletratamiento ha recibido y la fobia con un 60.5%, el que menos. El pánico, la ansiedad social, TEPT, TOC y agorafobia tuvieron una demanda media del 67.2%, 66.8%, 64.0%, 63.5% y 62.2%, respectivamente. La experiencia en teleterapia resultó significativa. El teletratamiento para psicólogos con experiencia aumentó una media del 93.9% respecto al 35.7% de aquellos sin experiencia. Un 22.8% de psicólogos no realizó teletramiento de la ansiedad. Estos resultados puede ser útiles para desarrollar programas específicos de prevención e intervención telemática para los trastornos de ansiedad ante futuras pandemias por coronavirus.

The distribution of teletreatment carried out by psychologists during the COVID-19 pandemic for GAD, specific phobia, agoraphobia, social anxiety, panic, OCD and PTSD, and whether experience in teletherapy has an significant effect on demand have not been studied. The results indicate that GAD with 69.2% has been the disorder that has received the most teletherapy and phobia with 60.5%, the least. Panic, social anxiety, PTSD, OCD, and agoraphobia had a demand of 67.2%, 66.8%, 64.0%, 63.5%, and 62.2%, respectively. The experience in teletherapy was significant. Tele-treatment for experienced psychologists increased an average of 93.9% compared to 35.7% for those without experience. 22.8% of psychologists did not carry out anxiety teletherapy. These results may be useful to develop specific prevention and telematic intervention programs for anxiety disorders in the face of future coronavirus pandemics

Quality of Life in Hidradenitis Suppurativa: validation of the HSQoL-24.

To date, there are no disease-specific instruments in Spanish to assess quality of life of patients with hidradenitis suppurativa. A multicentre study was previously carried out in Spain between 2016 and 2017 to develop the Hidradenitis Suppurativa Quality of Life-24 (HSQoL-24), a disease-specific questionnaire to assess quality of life in patients with hidradenitis suppurativa. The objectiv-es of this study are to revalidate the HSQoL-24 in Spanish with a larger sample of patients, and to present the English version. In this multi-centre study in Spain, patients with hidradenitis suppurativa completed the HSQoL-24, the Dermatology Life Quality Index and the Skindex-29. The Hurley staging system was used to assess the severity of the disease. Validation of the questionnaire was carried out in 130 patients, of whom 75 (57.7%) were women. This study demonstrates adequate values of reliability and validity of the HSQoL-24, confirming the previous test re-test validation and making this questionnaire one of wide clinical validity in terms of results perceiv-ed by patients.

Concurrent and longitudinal effects of maternal and paternal warmth on depression symptoms in children and adolescents.

The main aim of this study is to examine the concurrent and longitudinal effects of perceived affection of mothers and fathers separately on the self-reported symptoms of children's depression. Data were obtained from a 3-wave study of 535 families with children (41.3% boys) aged 9-15 years of age. Structural equation models were performed to test different models. Significant effects of mothers' and fathers' affection on depression symptomatology over the three years were found. The longitudinal effects of parental warmth on the child's depression symptoms were mediated over time by the previous levels of the mother's and father's warmth. The presence of parental warmth can lessen the severity of depression symptoms, especially when paternal and maternal warmth are applied consistently over a long period of time. These results were invariant across the child's sex. Treatments for childhood depression should take place over extended periods of time including both fathers and mothers.

Applied Psychology. The Case of the Baer, Wolf and Risley Prescriptions for Applied Behavior Analysis / Psicologia aplicada. El caso de las prescripciones de Baer, Wolf y Riesley para el análisis aplicado de la conducta

Baer, Wolf and Risley, members of the group that promoted the creation of the Journal of Applied Behavior Analysis, offered in its first issue a detailed series of 'prescriptions' that characterized the way research and research articles would be conceived as adequate to the applied field by the journal editors. Their 'prescriptions' have been largely cited, becoming a sign of authors' identification with the journal policy, and widely influencing the structure and topics of this specialized literature.

El "Journal of Applied of Behavior Analysis" publicó en su primer número, en 1967, unas reglas o prescripciones , elaboradas por tres miembros del grupo editorial (Baer, Wolf y Riesley) , que han servido eficazmente para orientar a los futuros autores acerca del modo como construir los articulos que podrían ser publicados en la revista. Esas prescripciones reunen las principales características propias de la investigación aplicada en el campo del análisis conductual.

Análisis longitudinal de la comorbilidad entre depresión y agresión: Cronicidad y severidad en sujetos de 11 a 13 años / Longitudinal analysis of comorbidity between depression and aggression: Chronicity and severity in individuals 11 to 13 years

La comorbilidad entre depresión y agresión infanto-adolescente ha sido contrastada básicamente a un nivel estadístico. Sin embargo, pocos estudios han comprobado de manera longitudinal otra de las premisas fundamentales que permite establecer la comorbilidad: la sinergia, es decir, la acción conjunta de dos o más trastornos que se traduce en una severidad y cronicidad superior a las generadas por la suma de los efectos individuales. Mediante un diseño longitudinal a lo largo de 3 años se examinó la severidad y cronicidad de un grupo de sujetos comórbidos depresivos - agresivos. Se analizaron los niveles de depresión y agresión, así como el papel del sexo en estas relaciones. La evaluación se realizó a través de autoinformes en una muestra de 525 sujetos de edades comprendidas entre los 11 y 13 años. La muestra fue aleatoriamente seleccionada de diferentes colegios de la Comunidad de Madrid (España). Los resultados muestran que la depresión y agresión se relacionan de manera estadísticamente significativa. Los sujetos comórbidos exhiben una cronicidad de mayor duración en las respuestas agresivas que en las depresivas. La severidad en los sujetos comórbidos es mayor en las respuestas agresivas de tipo total y verbal, así como en las depresivas. El sexo no ejerce ningún efecto significativo. Se concluye que los datos indican la importancia de explorar la comorbilidad con diferentes tipos de agresión, especialmente la verbal, y en diferentes grupos de edad. Se discute la necesidad de atender a los síntomas subyacentes al trastorno principal en afectados de larga duración, ya que a la expresión de uno de los trastornos puede subyacer la cronicidad asociada a la comorbilidad con importantes repercusiones para su diagnóstico y tratamiento.

The comorbidity between depression and aggression in children and adolescents is an issue that has sparked controversy as its existence has important implications for the validity of the classification systems, for the establishment of explanatory models, the design of new treatments as well as in the final outcome which the comorbid person presents in these in comparison with conventional treatments. In addition, the prevalence rates in depressive-aggressive comorbidity are significant, oscillating between 7.97 and 10.91%. Therefore, the study of comorbidity becomes necessary and the lack of studies focusing on the subject comes as a surprise. Perhaps one of the main problems concerning the research of comorbidity lies in the fact that most of the studies do not validate the clinical criteria that focuses on the principle of synergy, as Clark and Watson had established in Tripartite model, since doing so would require longitudinal studies measuring the effects of a commorbid disorder in contrast to those where there is no comorbidity to be found. In addition to clinical judgment, the Tripartite model demands a further statistic indicating the existence of a significant correlation between those synergistic disorders, which is the one on which most studies have been focusing. This type of results, based solely on clinical judgment, mainly through cross-sectional studies, has not allowed to implement another type of results, as suggested by the Tripartite model, that would have helped to establish clinical and diagnostic criteria through dimensional self-assessment tools which are closer to a reality in child and adolescent assessment where comorbidity is rather the rule than the exception. Therefore, that kind of study, using a longitudinal design over a period of three years, will help expand those cross-sectional ones, which will allow for examining whether there is a significant association, as well as a synergy that attests to the existence of an aggressive-depressive comorbidity on both, statistical and clinical level. In order to do so this study examined the severity and chronicity of a group of comorbid depressive-aggressive persons. In addition, the levels of depression and aggression and the role of sex within these relationships were analyzed. The sample, randomly selected from different schools in the Community of Madrid (Spain), comprised 525 individuals ranging from 11 to 13 years old, 58.9% female, the family structure was mostly biparental (92%) and the vast majority belonged to a middle class environment (85%). Depression and aggression were assessed through specific types of self-report questionnaires for children and adolescents, both in their Spanish version. The results support the statistical basis, since depression and aggression exhibit a significant positive and moderate association ranging between .11 and .24, in which the fact that the found association was higher within verbal aggression than in the physical one among all ages with the exception of the group of subjects to testing aged 12 needs to be stressed. With regards to the clinical criteria, the results provide partial support, as comorbid subjects exhibit a longer duration in chronic aggressive symptoms than those other groups affected only by depression or aggression, while they are similar to those of merely depressive subjects in the symptoms indicating a depression. Regarding severity, comorbid subjects show a higher level within the field of totally and verbally aggressive symptoms, as well as in the depressive ones which makes their physical aggression comparable to the one found in the test group of total aggression, hence, the data partially support the clinical standard. The tested person's sex, however, is of no significant meaning for the outcome. In conclusion, the data indicates the importance of exploring the comorbidity of different types of aggression, particularly the verbal one, and within different age groups. The need for addressing the underlying primary disorder symptoms in long-term affected patients is discussed, since chronic comorbidity may underlie the expression of one of the disorders and entail important implications for diagnosis and treatment.

Análisis longitudinal de la comorbilidad entre depresión y agresión: Cronicidad y severidad en sujetos de 11 a 13 años / Longitudinal analysis of comorbidity between depression and aggression: Chronicity and severity in individuals 11 to 13 years

La comorbilidad entre depresión y agresión infanto-adolescente ha sido contrastada básicamente a un nivel estadístico. Sin embargo, pocos estudios han comprobado de manera longitudinal otra de las premisas fundamentales que permite establecer la comorbilidad: la sinergia, es decir, la acción conjunta de dos o más trastornos que se traduce en una severidad y cronicidad superior a las generadas por la suma de los efectos individuales. Mediante un diseño longitudinal a lo largo de 3 años se examinó la severidad y cronicidad de un grupo de sujetos comórbidos depresivos - agresivos. Se analizaron los niveles de depresión y agresión, así como el papel del sexo en estas relaciones. La evaluación se realizó a través de autoinformes en una muestra de 525 sujetos de edades comprendidas entre los 11 y 13 años. La muestra fue aleatoriamente seleccionada de diferentes colegios de la Comunidad de Madrid (España). Los resultados muestran que la depresión y agresión se relacionan de manera estadísticamente significativa. Los sujetos comórbidos exhiben una cronicidad de mayor duración en las respuestas agresivas que en las depresivas. La severidad en los sujetos comórbidos es mayor en las respuestas agresivas de tipo total y verbal, así como en las depresivas. El sexo no ejerce ningún efecto significativo. Se concluye que los datos indican la importancia de explorar la comorbilidad con diferentes tipos de agresión, especialmente la verbal, y en diferentes grupos de edad. Se discute la necesidad de atender a los síntomas subyacentes al trastorno principal en afectados de larga duración, ya que a la expresión de uno de los trastornos puede subyacer la cronicidad asociada a la comorbilidad con importantes repercusiones para su diagnóstico y tratamiento.(AU)

The comorbidity between depression and aggression in children and adolescents is an issue that has sparked controversy as its existence has important implications for the validity of the classification systems, for the establishment of explanatory models, the design of new treatments as well as in the final outcome which the comorbid person presents in these in comparison with conventional treatments. In addition, the prevalence rates in depressive-aggressive comorbidity are significant, oscillating between 7.97 and 10.91%. Therefore, the study of comorbidity becomes necessary and the lack of studies focusing on the subject comes as a surprise. Perhaps one of the main problems concerning the research of comorbidity lies in the fact that most of the studies do not validate the clinical criteria that focuses on the principle of synergy, as Clark and Watson had established in Tripartite model, since doing so would require longitudinal studies measuring the effects of a commorbid disorder in contrast to those where there is no comorbidity to be found. In addition to clinical judgment, the Tripartite model demands a further statistic indicating the existence of a significant correlation between those synergistic disorders, which is the one on which most studies have been focusing. This type of results, based solely on clinical judgment, mainly through cross-sectional studies, has not allowed to implement another type of results, as suggested by the Tripartite model, that would have helped to establish clinical and diagnostic criteria through dimensional self-assessment tools which are closer to a reality in child and adolescent assessment where comorbidity is rather the rule than the exception. Therefore, that kind of study, using a longitudinal design over a period of three years, will help expand those cross-sectional ones, which will allow for examining whether there is a significant association, as well as a synergy that attests to the existence of an aggressive-depressive comorbidity on both, statistical and clinical level. In order to do so this study examined the severity and chronicity of a group of comorbid depressive-aggressive persons. In addition, the levels of depression and aggression and the role of sex within these relationships were analyzed. The sample, randomly selected from different schools in the Community of Madrid (Spain), comprised 525 individuals ranging from 11 to 13 years old, 58.9% female, the family structure was mostly biparental (92%) and the vast majority belonged to a middle class environment (85%). Depression and aggression were assessed through specific types of self-report questionnaires for children and adolescents, both in their Spanish version. The results support the statistical basis, since depression and aggression exhibit a significant positive and moderate association ranging between .11 and .24, in which the fact that the found association was higher within verbal aggression than in the physical one among all ages with the exception of the group of subjects to testing aged 12 needs to be stressed. With regards to the clinical criteria, the results provide partial support, as comorbid subjects exhibit a longer duration in chronic aggressive symptoms than those other groups affected only by depression or aggression, while they are similar to those of merely depressive subjects in the symptoms indicating a depression. Regarding severity, comorbid subjects show a higher level within the field of totally and verbally aggressive symptoms, as well as in the depressive ones which makes their physical aggression comparable to the one found in the test group of total aggression, hence, the data partially support the clinical standard. The tested persons sex, however, is of no significant meaning for the outcome. In conclusion, the data indicates the importance of exploring the comorbidity of different types of aggression, particularly the verbal one, and within different age groups. The need for addressing the underlying primary disorder symptoms in long-term affected patients is discussed, since chronic comorbidity may underlie the expression of one of the disorders and entail important implications for diagnosis and treatment.(AU)

Presentación inusual de un penfigoide gestacional / Atypical presentation of pemphigoid gestationis

El penfigoide gestacional (PG) es una dermatosis ampollosa autoinmunitaria que generalmente aparece en el segundo y el tercer trimestres de la gestación, aunque no es infrecuente su debut en el puerperio inmediato. Clínicamente, consiste en la aparición de lesiones pruriginosas urticariformes y vesículo-ampollosas que comienzan, preferentemente, en el área periumbilical, con extensión centrífuga al resto de la superficie corporal. El PG está asociado a prematuridad y bajo peso. En el 5% de los casos los recién nacidos con madre con PG pueden presentar una erupción vesículo-ampollosa moderada debido al paso transplacentario de autoanticuerpos frente a inmunoglobulina G (IgG) maternos y que suele resolverse en poco tiempo. Presentamos el caso de una paciente puérpera con lesiones inicialmente acrales, con morfología similar a las del eritema exudativo multiforme, que posteriormente se extendieron a los brazos y las piernas y dieron lugar a grandes ampollas. El estudio histológico y la inmunofluorescencia directa fueron claves para el diagnóstico correcto y el posterior manejo terapéutico (AU)

Pemphigoid gestationis (PG) is an autoimmune blistering dermatosis that usually occurs in the second and third trimesters of pregnancy, although onset in the early puerperium is not infrequent. Clinically, this entity consists of pruritic urticarial blisters and vesicles that usually start in the periumbilical area and spread peripherally. PG is associated with prematurity and low birth weight. In 5% of cases, the neonates of mothers with PG may show moderate blistering-vesicular eruptions induced by autoantibodies transferred across the placenta, which usually resolve in a short time. We report the case of a puerperal patient who initially showed acral lesions with a morphology similar to those of exudative erythema multiforme, which subsequently spread to her arms, legs and face resulting in large blisters. Histological studies and direct immunofluorescence were essential to proper diagnosis and subsequent therapeutic management (AU)

Sarcoidosis aguda. Síndrome de Löfgre / Acute Sarcoidosis. Löfgren síndrome

El Síndrome de Löfgren es una variante de presentación aguda de la sarcoidosis, de carácter benigno, caracterizada por la presencia de eritema nodoso, adenopatías hiliares bilaterales y poliartralgias o poliartritis. Presentamos un caso de Síndrome de Löfgren cuyo interés reside en el diagnóstico de una enfermedad sistémica como es la sarcoidosis a través de las lesiones cutáneas (AU)

Löfgren syndrome is an acute form sarcoidosis that is caracterized by erythema nodosum, bilateral hilar lymphadenopathy, and polyarthralgia or polyarthitis. We report a case of Löfgren syndrome whose interest lies in the diagnosis of a systemic disease like sarcoidosis throught cutaneous manifestation (AU)

Síndrome de Sweet asociado a Carcinoma de Colon / Sweet´s Syndrome associated with Colon Carcinoma

Los síndromes paraneoplásticos son cuadros clínicos infrecuentes que se asocian a neoplasias, siendo a menudo precursores de éstas. La asociación de Síndrome de Sweet (SS) con procesos malignos está presente en el 20% de los casos, siendo las neoplasias de origen hematológico el 85% y el 15% los tumores sólidos. De entre los tumores sólidos asociados a SS, el adenocarcinoma de colon es muy infrecuente. Presentamos un caso clínico de SS con gran expresividad clínica, que nos llevó al diagnóstico de un adenocarcinoma de colon hasta ese momento desconocido (AU)

The paraneoplastic syndromes are a rare clinical conditions that are associated with malignancies, often being forerunners of these. Sweet´s syndrome (SS) associated with malignant process is present in 20% of cases, being hemalogic disorders 85% and solid tumors 15%. Among solid tumors associated with Sweet´s syndrome, adenocarcinoma of colon is infrequent. We report a case of SS with great clinical expressiveness, that led us to the diagnosis of colon adenocarcinoma which it had been unknown until then (AU)

Linfoma primario cutáneo de células grandes B difuso de las piernas / Primary cutaneous diffuse large B- cell lymphoma, legtype

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Testing the hierarchical structure of the Children's Depression Inventory: a multigroup analysis.

Using exploratory and confirmatory factor analyses, the aims were (a) to obtain, describe, and compare different solutions of three, five, and six first-order factors raised in the previous literature about the Children's Depression Inventory (CDI); (b) analyze the number and nature of the second-order factors; (c) test which model best reproduces the CDI structure; and (d) test possible developmental differences between child and adolescent samples. The CDI was applied to 4,707 Spanish children and adolescents with an age range between 7 and 16 years. Results show that best models considered five or six factors, including Social Problems (Anhedonia), Negative Affect, Externalizing, School Problems, and Negative Self-Esteem (Self-Deprecation). Also, a factor of Biological Dysregulation obtained some support. Higher-order factors do not reproduce the classical distinction between internalizing and externalizing symptoms. Finally, no large developmental differences in the CDI structure were found between children and adolescents samples.

Do parents and adolescents differ in their perceptions of rearing styles? Analysis of the EMBU versions for parents and adolescents.

In the present study, memories of rearing styles between parents, mother and father, and their son/daughters were explored through the EMBU versions for parents (EMBU-P) and adolescents (EMBU-A). Results show that parents differ in three of the four scales of the EMBU: Emotional Warmth, Control Attempts, and Favoring Subject. Also, mothers score higher on Emotional Warmth, and Control Attempts, but less on Favoring Subject. When parents and adolescents were compared in the common items to both versions, no substantial differences were found, except for the Favoring Subject scale. The sex of the adolescent seems not to play a relevant role in the observed differences. A revision of specialized literature suggested that differences in the fathers' and mothers' perceptions of their rearing styles could be related to differences in personality and marital satisfaction. These hypothetical relationships should be investigated in a parallel study.

Comparison of several shortened versions of the EMBU: exploratory and confirmatory factor analyses.

The aim of the present study was to analyze the psychometric properties of different versions of the EMBU (Egna Minnen av Barndoms Uppfostran - My memories of upbringing) in a non-clinical sample of adolescents. The factor structure of the questionnaire was studied by means of more adequate exploratory and confirmatory factor procedures in order to ascertain which version achieves a better fit to data. The 64-item version of the EMBU was administered to a non-clinical sample of 832 adolescents. Exploratory and Confirmatory factor analyses were carried out for successive versions of 64, 37, 24 and 23 items. The theoretical four-factor structure of the 64-item version is not replicated in a factor analysis through principal axis extraction with direct oblimin rotation. The "Favoring Subject" factor was not found. 37 items present loadings equal to or larger than 0.30 for the "Rejection", "Emotional Warmth" and "Overprotection" factors. A re-analysis of these items shows a clear three-factor structure. When Arrindell et al.'s (1999) 23-item version was analysed, the three expected factors were also found. Confirmatory factor analyses allow us to reduce the 36-item version to a shorter one of 24 items. This last version achieves the best fit to data, including the 23-item version. The new 24-item version improves the construct validity of the EMBU and presents similar reliability coefficients.

Bryant's Empathy Index for children and adolescents: psychometric properties in the Spanish language.

The present study investigated the following issues: (1) the structure of Bryant's Empathy Index for children and adolescents in a Spanish sample of 408 boys and 424 girls (M age=14.4 yr.), and (2) sex differences, including effect sizes and internal consistency of the scale. A principal components factor analysis with oblimin rotation showed that 20 of the index's 22 items load on three robust factors, related to Feelings of Sadness, Understanding Feelings, and Tearful Reaction with regard to the emotions of others. The 3-factor structure obtained an adequate fit to the data in the confirmatory factor analysis. Coefficients alpha ranged between .72 and .78. The 3 factors accounted for 42% of variance. As expected, girls scored higher than boys. It was concluded that the Spanish version of Bryant's Empathy Index has an acceptable reliability and construct validity, making it useful for research.

Clinical psychology in Spain.

A general view of the field of clinical psychology in present-day Spain is offered here. The field has experienced an enormous development over the past two decades. Many journals and specialized societies have been established, and a large number of professionals now are working in the field, most of them in private practice, but some in medical centers belonging to the Spanish national health service. This great expansion seems due mainly to the creation of a degree in psychology(1968) and the continuous flow of students demanding training in clinical subjects. A theoretical orientation toward a cognitive-behavioral approach seems to dominate, closely followed by those choosing a dynamic orientation. A large group of professionals dealing with health problems are reinforcing their idiosyncratic profile among the clinical psychology. A new study program to become a specialist in our field recently has been implemented and is just entering its initial stages (Internship in Psychology-PIR); it represents a significant improvement in the curriculum of the clinical psychology. All of these facts seem to prove the great vitality of this field in present-day Spain.

Adaptacion del cuestionario de crianza parental (PCRI-M) a poblacion española / Adaptation of teh parent-child Relationship Inventory (PCRI) to Spanish population

Se presenta la adaptación española del Cuestionario de Crianza Parental (PCRI; Gerard, 1994), incluyendo sus propiedades psicométricas. El instrumento mide las actitudes de los padres hacia la crianza de los hijos. El PCRI-M consta de 78 ítems distribuidos en 8 escalas: apoyo, satisfacción con la crianza, compromiso, comunicación, disciplina, autonomía, distribución del rol, y deseabilidad social. Después de traducir el instrumento al español y de adaptarlo en una muestra piloto, se aplicó a 547 madres cuyas edades oscilaban entre 26 y 53 años (edad promedio: 36.37). Los resultados indican que las características del cuestionario son adecuadas. Por lo tanto puede utilizarse con este tipo de población