Unified Protocol for the transdiagnostic treatment of emotional disorders in people with post COVID-19 condition: study protocol for a multiple baseline n-of-1 trial.

Background: Post COVID-19 syndrome, defined as the persistence of COVID-19 symptoms beyond 3 months, is associated with a high emotional burden. Post COVID-19 patients frequently present comorbid anxiety, depressive and related disorders (emotional disorders, EDs) which have an important impact on their quality of life. Unfortunately, psychological interventions to manage these EDs are rarely provided to post COVID-19 patients. Also importantly, most psychological interventions do not address comorbidity, namely simultaneous EDs present in COVID-19 patients. This study will explore the clinical utility and acceptability of a protocol-based cognitive-behavioral therapy called the Unified Protocol for the transdiagnostic treatment of EDs in patients suffering post COVID-19 condition. Methods: A multiple baseline n-of-1 trial will be used, as it allows participants to be their own comparison control. Sample will be composed of 60 patients diagnosed with post COVID-19 conditions and comorbid EDs from three Spanish hospitals. After meeting the eligibility criteria, participants will answer the pre-assessment protocol and then they will be randomly assigned to three different baseline conditions (6, 8, or 10 days of assessments before the intervention). Participants and professionals will be unblinded to participants' allocation. Once the baseline assessment has been completed, participants will receive the online psychological individual intervention through video-calls. The Unified Protocol intervention will comprise 8 sessions of a 1 h duration each. After the intervention, participants will answer the post-assessment protocol. Additional follow-up assessments will be conducted at one, three, six, and twelve months after the intervention. Primary outcomes will be anxiety and depressive symptoms. Secondary outcomes include quality of life, emotion dysregulation, distress tolerance, and satisfaction with the programme. Data analyses will include between-group and within-group differences and visual analysis of patients' progress. Discussion: Results from this study will be disseminated in scientific journals. These findings may help to provide valuable information in the implementation of psychological interventions for patients suffering post COVID-19 conditions. Clinical trial registration: https://clinicaltrials.gov, identifier (NCT05581277).

Female students' personality and stress response to an academic examination.

BACKGROUND: Women are vulnerable to stress-related disorders. Examinations are a source of stress, triggering emotional, cognitive, and hormonal responses. We examined women's psychological and hormonal stress responses and academic performance according to personality during a real-life examination. METHODS: Female students (N = 66) were divided into two groups based on hierarchical cluster analysis: one cluster characterized by high neuroticism and moderate extraversion (HN-ME; n = 42) and the other by low neuroticism and high extraversion (LN-HE; n = 24). Academic performance, perceived stress, and emotional dysregulation were analyzed. State anxiety, affect, and cortisol release were measured before and on the examination day. RESULTS: The HN-ME cluster was high in perceived stress, emotional dysregulation, and negative affect. This cluster also had higher state anxiety levels two days before and shortly after the examination compared to the LN-HE cluster. Students' cortisol levels were higher on the examination day, and there was a marginal significance of the Cluster factor in the cortisol release regardless of the day of measurement. CONCLUSIONS: Women with high neuroticism and moderate extraversion may be more vulnerable to psychological stress in academic settings but similar to other women in their cortisol response.

Brief transdiagnostic group intervention for people living with HIV and emotional disorders: feasibility and clinical utility.

Emotional regulation-based transdiagnostic interventions provide positive but limited evidence regarding efficacy with people living with human immunodeficiency virus (HIV). In the present study, 10 participants living with HIV with emotional disorders completed a five-session transdiagnostic group intervention to improve their emotional regulation skills (Unified Protocol). Changes at pre-treatment, post-treatment and three-month follow-up were explored at the population (mean-rank) and the individual level (reliable change index). Compared to pre-treatment, participants improved significantly in anxiety, depression, negative affect and quality of life. Changes were maintained at the three-month follow-up. Emotion regulation, particularly the confusion factor, improved when comparing pre-treatment with the three-month follow-up. At the three-month follow-up, the percentage of normalized scores was the largest in maladjustment (70%), followed by depression, negative affect, and lack of control (50%). All participants indicated high treatment satisfaction and perceived benefits. These promising results suggest that brief emotion regulation interventions might be feasible and effective in the public health settings for people living with HIV suffering emotional disorders.

Guiding future research on psychological interventions in people with COVID-19 and post COVID syndrome and comorbid emotional disorders based on a systematic review.

Objective: The COVID-19 pandemic has been emotionally challenging for the entire population and especially for people who contracted the illness. This systematic review summarizes psychological interventions implemented in COVID-19 and long COVID-19 patients who presented comorbid emotional disorders. Methods and measures: 3,839 articles were identified in 6 databases and 43 of them were included in this work. Two independent researchers selected the articles and assessed their quality. Results: 2,359 adults were included in this review. Severity of COVID-19 symptoms ranged from asymptomatic to hospitalized patients; only 3 studies included long COVID-19 populations. Similar number of randomized controlled studies (n = 15) and case studies (n = 14) were found. Emotional disorders were anxiety and/or depressive symptoms (n = 39) and the psychological intervention most represented had a cognitive behavioral approach (n = 10). Length of psychological programs ranged from 1-5 sessions (n = 6) to 16 appointments (n = 2). Some programs were distributed on a daily (n = 4) or weekly basis (n = 2), but other proposed several sessions a week (n = 4). Short (5-10 min, n = 4) and long sessions (60-90 min, n = 3) are proposed. Most interventions were supported by the use of technologies (n = 18). Important risk of bias was present in several studies. Conclusion: Promising results in the reduction of depressive, anxiety and related disorders have been found. However, important limitations in current psychological interventions were detected (i.e., duration, format, length, and efficacy of interventions were not consistently established across investigations). The results derived from our work may help to understand clinical practices in the context of pandemics and could guide future efforts to manage emotional suffering in COVID-19 patients. A stepped model of care could help to determine the dosage, length and format of delivery for each patient.Systematic review registration: PROSPERO 2022 CRD42022367227. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022367227.

Evaluando las creencias irracionales de forma fiable y rápida: refinando y acortando la versión en español de la “Escala de actitudes y creencias” / Assessing irrational beliefs reliably and quickly: refining and shortening the Spanish version of the "Attitudes and Beliefs Scale"

La “Escala de actitudes y creencias” (EAC) es una medida de creencias irracionales (CI) muy utilizada, pero con problemas psicométricos. Nuestro objetivo fue mejorar la calidad psicométrica de la versión española de la EAC. Se combinó la teoría clásica de los tests, teoría de respuesta al ítem y análisis factorial confirmatorio para obtener una versión corta de la escala utilizando dos muestras, una general (n= 565) y otra con dolor crónico (n= 514). Se realizaron correlaciones de Pearson con CI, personalidad y medidas de salud para investigar las fuentes de validez de constructo. Tras eliminar la mitad de los ítems (12), el ajuste factorial de la escala fue bueno (RMSEA< 0,08; CFI y TLI> 0,95). Las CI se asociaron con más neuroticismo (0,21≤ r≤0,61; p≤ 0,001), peor salud mental (-0,17≤ r≤ -0,56; p≤ 0,001), menor extraversión y responsabilidad (-0,14≤ r≤ -0,41; p≤ 0,01). Estos resultados se replicaron en ambas muestras, pero las CI sólo se asociaron con una peor salud física en la muestra general. La versión española abreviada de la EAC es válida, fiable y puede administrarse rápidamente en entornos clínicos. (AU)

The Attitudes and Beliefs Scale (ABS) is a widely used measure of irrational beliefs (IBs) but has important psychometric problems. Our objective is to improve the psychometric quality of a Spanish version of the scale. Classical test theory, item response theory, and confirmatory factor analyses were combined to obtain a shorter version of the scale using 2 samples: one from the general population (n= 565) and another with chronic pain (n= 514). Pearson correlations were performed with IBs, personality and health measures to investigate sources of construct validity. After eliminating half of the items (12), the factorial fit of the scale became very good (RMSEA< .08; CFI and TLI> .95). IBs were associated with more neuroticism (.21≤ r≤ .61, p≤ .001) and poorer mental health (-.17≤ r≤ -.56, p≤ .001), as well as a less extraversion and conscientiousness (-.14≤ r≤ -.41, p≤ .01). These results were replicated in both samples, but IBs were only associated with poorer physical health in the general population sample. The shortened Spanish version of the ABS is a valid and reliable instrument that can be rapidly administered in clinical settings. (AU)

Developing a smartphone App based on the Unified Protocol for the transdiagnostic treatment of emotional disorders: A qualitative analysis of users and professionals' perspectives.

Emotional Disorders have become the most prevalent mental disorders in the world. In relation to their high prevalence, mental health care from public health services faces major challenges. Consequently, finding solutions to deliver cost-effective evidence-based treatments has become a main goal of today's clinical psychology. Smartphone apps for mental health have emerged as a potential tool to deal with it. However, despite their effectiveness and advantages, several studies suggest the need to involve patients and professionals in the design of these apps from the first stage of the development process. Thus, this study aimed to identify, from both a group of users and professionals, the needs, opinions, expectations and design aspects of a future smartphone app based in the Unified Protocol (UP), that will allow to develop the subsequent technical work of the app engineers. Two focus groups were conducted, one with 7 professionals and the other with 9 users, both groups familiar with the UP. A thematic content analysis based in grounded theory was performed in order to define emergent categories of analysis derived from the interview data. The results revealed 8 common topics in both focus groups and 5 specific key topics were identified in the professionals' focus group. Of the total proposals, 93 % of the professionals' and 78 % of the users' are implemented in the preliminary version of the app.

Study on the use, acceptability and implementation of the Unified Protocolin general health psychologists in Spain / Estudio sobre el uso, aceptabilidad e implementación del Protocolo Unificado en psicólogos generales sanitarios en España

The dissemination of evidence-based psychological treatments (EBPT) is a pending task for Clinical Psychology. Through an online sur-vey and following the Theoretical Framework of Acceptability, we ana-lyzed the opinions about use, acceptability and intention to use in the fu-ture of the Unified Protocol for the transdiagnostic treatment of emotional disorders (UP) in a sample of 153 professionals of General Health Psy-chology (GHPs). All participants took a training course in the UP and were grouped depending on their previous experience in the UP application. The results showed high scores in acceptability and intention to use in the future in GHPs regardless of the group. Finally, statistically significant cor-relations were found between intention to use in the future and affective attitude, consistency of the intervention and perceived efficacy (in both groups) and self-efficacy (in the group of GHPs without experience in the use of UP). The UP is an EBPT that presents high levels of acceptance and intention to use by the GHPs who received training in this interven-tion, this will facilitate its dissemination and implementation and will allow a greater number of people to benefit from this treatme.(AU)

La diseminación de tratamientos psicológicos basados en la evidencia (TPBE) es una tarea pendiente para la Psicología Clínica. A través de una encuesta online y siguiendo el Modelo Teórico sobre Aceptabilidad, analizamos las opiniones sobre el uso, aceptabilidad e intención de uso en el futuro del Protocolo Unificado para el tratamiento transdiagnóstico de los trastornos emocionales (PU) en una muestra de 153 profesionales de la Psicología General Sanitaria (PGS). Todos los participantes habían realizado un curso de formación sobre el PU y se agruparon según su experiencia previa con la aplicación del PU. Los resultados mostraron altas puntuaciones en aceptabilidad e intención de uso en los PGS con independencia del grupo. Se encontraron correlaciones estadísticamente significativas entre la intención de uso en el futuro y la actitud afectiva, coherencia de la intervención y eficacia percibida (en ambos grupos) y autoeficacia (en el grupo de PGS sin experiencia en el uso del PU). El PU es un TPBE que presenta altos niveles de aceptación e intención de uso por parte de los PGS que recibieron formación en esta intervención, esto facilitará su diseminación e implementación y permitirá que un mayor número de personas puedan beneficiarse de este tratamiento.(AU)

Application of the unified protocol for the transdiagnostic treatment of comorbid emotional disorders in patients with ultra-high risk of developing psychosis: A randomized trial study protocol.

Background: Cognitive Behavioral Therapy is delivered in most of the early intervention services for psychosis in different countries around the world. This approach has been demonstrated to be effective in decreasing or at least delaying the onset of psychosis. However, none of them directly affect the comorbidity of these types of patients that is often the main cause of distress and dysfunctionality. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is a psychological intervention that combines cognitive-behavioral and third-generation techniques that address emotional dysregulation as an underlying mechanism that these disorders have in common. The application of this intervention could improve the comorbid emotional symptoms of these patients. Materials and methods: The study is a randomized controlled trial in which one group receives immediate UP plus standard intervention and the other is placed on a waiting list to receive UP 7 months later, in addition to standard care in one of our early psychosis programs. The sample will be 42 patients with UHR for psychosis with comorbid emotional symptoms. The assessment is performed at baseline, at the end of treatment, and at 3-months' follow-up, and includes: general psychopathology, anxiety and depression, positive and negative emotions, emotional dysregulation, personality, functionality, quality of life, cognitive distortions, insight, and satisfaction with the UP intervention. Discussion: This will be the first study of the efficacy, acceptability, and viability of the UP in a sample of young adults with UHR. The results of this study may have clinical implications, contributing to improving the model of care for young people who consult for underlying psychotic, anxiety, and/or depressive symptoms that can lead to high distress and dysfunctionality. Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT04929938].

Development and psychometric properties of the maternal ambivalence scale in spanish women.

BACKGROUND: maternal ambivalence, which refers to experiencing mixed emotions about motherhood, like happiness and sadness, is frequent during the perinatal period. AIM: Due to the relevance of this topic and the lack of psychometrically-sound instruments to measure it, this study aims to develop and test a measure of maternal ambivalence called the Maternal Ambivalence Scale (MAS). METHODS: in this cross-sectional, observational study, participants were 1424 Spanish women recruited online who were either pregnant (33%) or recent mothers of children under 2 years (67%). They responded to the MAS and measures of anxiety and depressive symptoms and life satisfaction. Analyses included exploratory and confirmatory factor solutions for the MAS, internal consistency estimates (Cronbach's α) for all scales, as well as bivariate correlations to investigate sources of validity evidence. Comparisons between pregnant and postpartum women were also examined. RESULTS: The assumptions for factor analysis about the relationship between items were met (Kaiser-Meyer-Olkin's [KMO] test = 0.90; Barlett's Chi-square sphericity test = 5853.89, p < .001). A three-factor solution (Doubts, Rejection, and Suppression) for the MAS showed a good model fit both in exploratory (Chi-square = 274.6, p < .001, Root Mean Square Error of Approximation [RMSEA] = 0.059, RMSEA 90% Confidence Interval [CI]=[0.052, 0.066], Comparative Fit Index [CFI] = 0.985, Tucker Lewis Index [TLI] = 0.974) and confirmatory analyses (Chi-square = 428.0, p < .001, RMSEA = 0.062, RMSEA 90% CI=[0.056, 0.068], CFI = 0.977, TLI = 0.971). Doubts (α = 0.83), Rejection (α = 0.70), and Suppression (α = 80) were associated with higher anxiety and depressive symptoms, as well as lower life satisfaction (all p < .001). Pregnant women presented greater Rejection (mean difference = 0.30, p = .037, 95% CI=[0.02, 0.58]) and less Suppression (mean difference=-0.47, p = .002, 95% CI=[-0.77,-0.17]) than mothers. CONCLUSION: with this study, we provide clinicians and researchers with a novel tool that successfully captures the complex nature of maternal ambivalence. Given the associations of maternal ambivalence with important outcomes in perinatal women, this tool could be important for the prevention of distress associated with chronic ambivalence and to evaluate the effectiveness of interventions addressing ambivalence.

Assessment of Acceptability and Initial Effectiveness of a Unified Protocol Prevention Program to Train Emotional Regulation Skills in Female Nursing Professionals during the COVID-19 Pandemic.

Healthcare professionals, especially women, have shown increases in anxious-depressive symptoms as a consequence of the COVID-19 pandemic. The aim of this pilot study was to evaluate the acceptability and preliminary effectiveness of a Unified Protocol (UP) prevention program to provide emotional regulation skills to cope with stressful situations. The sample consisted of 27 nursing professionals (100% women; mean age: 45.67; SD = 7.71) working in a Spanish public hospital during COVID-19, who were randomized to an immediate treatment group (ITG, n = 13) or to a delayed treatment group (DTG, n = 14, which served as the waiting list control group and received the program 5 weeks after the ITG had received it). The program consisted of five-weekly, two-hour, UP-based group sessions. Variables related to emotional symptomatology, emotional regulation, personality, burnout, and perceived quality of life were evaluated at the following time points: pre- and post-intervention and at 1-, 3-, and 6-month follow-ups. Statistically significant between-group differences showed lower emotional exhaustion and personal accomplishment in favor of the ITG after the intervention. Regarding the effect over time for all participants who received the UP (n = 27), statistically significant reductions were observed in neuroticism, personal accomplishment, and subjective distress caused by traumatic events (-0.23 ≤ d ≤ -0.73). A statistically significant interaction "Time*Condition" was found in anxiety, with increases in the DTG. Participants showed high satisfaction with the UP. These findings show good acceptability and preliminary effectiveness of the UP to reduce the emotional impact of the pandemic in female nursing workers.

Application of the unified protocol for transdiagnostic treatment of emotional disorders in post-bariatric surgery patients: an effectiveness and feasibility study in group format

La obesidad es un grave problema de salud con implicaciones globales. La cirugía bariátrica (CB) es el tratamiento más utilizado y eficaz, pero hay pacientes que no pierden una cantidad sustancial de peso, hecho que se ha relacionado con la presencia de síntomas de alimentación emocional, ansiedad y depresión. El objetivo de este estudio es analizar la viabilidad y efectividad de una intervención basada en la regulación de las emociones denominada Protocolo Unificado (PU), aplicada en formato grupal a 6 pacientes post-CB que presentan trastornos/síntomas emocionales. Los resultados tras el tratamiento mostraron altas tasas de asistencia y satisfacción con el PU, y mejorías estadísticamente significativas para el neuroticismo, los síntomas de los trastornos alimentarios y la alimentación emocional. En el seguimiento a los 6 meses, se muestran reducciones significativas en los síntomas de ansiedad, neuroticismo, inadaptación y disregulación (d = 0.83-1.46) y el índice de masa corporal se mantuvo estable a lo largo del tiempo. Estos resultados preliminares son esperanzadores sobre la viabilidad y efectividad del PU para tratar la disregulación emocional en pacientes después de la CB.(AU)

Obesity is a serious health problem with global implications. Bariatric surgery (BS) is the most used and effective treatment, but there are patients who do not lose a substantial amount of weight, a fact that has been related with the presence of emotional eating, anxiety and depression symptoms. The aim of this study is to analyze the effectiveness and feasibility of an emotion regulation-based intervention called Unified Protocol (UP), applied in group format to 6 post-BS patients presenting emotional disorders/symptoms. Results at post-treatment shown high attendance rates and satisfaction with the UP scores and significant improvements on neuroticism, eating disorders symptoms and emotional eating. At 6-month follow-up we found significant reductions on anxiety symptoms, neuroticism, maladjustment and dysregulation (d = 0.83-1.46) and the body mass index remained stable over time. These preliminary results are encouraging about the effectiveness and feasibility of the UP to treat emotional dysregulation in patients after BS.(AU)

Unified Protocol in a Group Format for Improving Specific Symptoms of Emotional Disorders in the Spanish Public Health System.

BACKGROUND: The Unified Protocol (UP) for the transdiagnostic treatment of emotional disorders (EDs) has demonstrated its efficacy in improving dimensions shared by EDs, but there is insufficient evidence regarding the specific symptoms of each ED. The main objective of the study was to evaluate the efficacy of the UP applied in a group format compared with individual Treatment as Usual (TAU), in improving specific ED symptoms. METHODS: The study sample (n=243) was a subset of participants of a randomized controlled trial conducted in the Spanish public health system. Specific symptoms assessed from pre-treatment to the six-month follow-up were: depressive, agoraphobic, generalized anxiety, panic, and obsessive-compulsive symptoms. Personality dimensions and quality of life were also measured. RESULTS: There were statistically significant changes after the UP in all the study variables (0.44 = d = 1.35). Changes in depressive symptoms, obsessive-compulsive disorder, and perceived quality of life were superior in the UP. CONCLUSIONS: The results support the efficacy of group UP for improving both transdiagnostic dimensions and specific ED symptoms, as well as quality of life, through the public health-care system.

Unifi ed Protocol in a Group Format for Improving Specifi c Symptoms of Emotional Disorders in the Spanish Public Health System / Protocolo Unifi cado en Formato Grupal Para la Mejora de losSíntomas de los Trastornos Emocionales en el Sistema de Salud Público

Background: The Unifi ed Protocol (UP) for the transdiagnostic treatment of emotional disorders (EDs) has demonstrated its effi cacy in improvingdimensions shared by EDs, but there is insuffi cient evidence regarding thespecifi c symptoms of each ED. The main objective of the study was toevaluate the effi cacy of the UP applied in a group format compared withindividual Treatment as Usual (TAU), in improving specifi c ED symptoms.Methods: The study sample (n=243) was a subset of participants of arandomized controlled trial conducted in the Spanish public health system.Specifi c symptoms assessed from pre-treatment to the six-month follow-upwere: depressive, agoraphobic, generalized anxiety, panic, and obsessivecompulsive symptoms. Personality dimensions and quality of life werealso measured. Results: There were statistically signifi cant changes afterthe UP in all the study variables (0.44 = d = 1.35). Changes in depressivesymptoms, obsessive-compulsive disorder, and perceived quality of lifewere superior in the UP. Conclusions: The results support the effi cacyof group UP for improving both transdiagnostic dimensions and specifi cED symptoms, as well as quality of life, through the public health-caresystem.

Antecedentes: el Protocolo Unifi cado (PU) para el tratamiento transdiagnóstico de los trastornos emocionales (TEs) ha demostradoefi cacia en la mejora de las dimensiones compartidas por los TEs, perono hay sufi ciente evidencia respecto a los síntomas específi cos de cadauno de los TEs. El objetivo principal de este estudio fue evaluar la efi caciadel PU aplicado en formato grupal, en comparación con un Tratamiento Habitual (TH) individual, para mejorar los síntomas específi cos de losTEs. Método: la muestra del estudio (n=243) fueron un subgrupo departicipantes de un ensayo controlado aleatorizado en el sistema desalud público español. Los síntomas evaluados antes y hasta los 6 mesesde seguimiento fueron: depresión, agorafobia, ansiedad generalizada,pánico y obsesivo-compulsivo. También se midieron dimensiones de lapersonalidad y la calidad de vida. Resultados: se produjeron cambiosestadísticamente signifi cativos tras el PU en todas las variables (0.44 =d = 1.35). Los cambios en síntomas de depresión, trastorno obsesivocompulsivo y calidad de vida fueron superiores en el PU. Conclusiones: los resultados apoyan la efi cacia del PU en grupo para mejorar tanto lasdimensiones transdiagnósticas, como los síntomas específi cos de los TEs,así como la calidad de vida en nuestro sistema público de salud.

Prevention of Emotional Disorders and Symptoms Under Health Conditions: A Pilot Study using the Unified Protocol in a Fertility Unit

Los trastornos emocionales (TE) son frecuentes durante los tratamientos de fertilidad. El Protocolo Unificado (PU) es una intervención transdiagnóstica que ha demostrado su eficacia en la prevención de TE en condiciones médicas. El objetivo de este estudio piloto es:1) mejorar la disregulación emocional para prevenir síntomas ansiosos y depresivos en mujeres en tratamiento de inseminación artificial (IA); 2) evaluar la acepta-bilidad (satisfacción y adherencia). Método: 5 mujeres en tratamiento de IA, sin diagnóstico clínico, respondieron a medidas de estado de ánimo (ansiedad y depresión),afecto,calidad de vida y regulación emocional en el pre-y post-evaluación, y en los seguimientos a los 1, 3 y 6 meses. La adap-tación preventiva del PU se basó en la aplicación de 6 sesiones presenciales grupales de 2 horas de duración. La situación generada por la COVID-19 provocó el cambio al formato online para finalizar el programa. Resultados: las mujeres no desarrollaron TE, no se encontraron diferencias pre-post y pre-seguimientos estadísticamente significativas en ansiedad, depresión, ca-lidad de vida y disregulación emocional (p>.050). Se observa una tenden-cia a la mejoría en la evaluación post-programa. Conclusiones: Parece que programas como el PU, centrado en factores terapéuticos compartidos, ha tenido un efecto emocional preventivo durante IA.(AU)

Emotional Disorders (EDs) are common in women who under-go fertility treatments. The Unified Protocol (UP) is a transdiagnostic in-tervention that has demonstrated efficacy in preventing EDs under differ-ent health conditions. The aim of this pilot study is to: 1) improve emo-tional dysregulation for the prevention of anxiety and depressive symp-toms in women undergoing intrauterine inseminations (IUI); 2) assess their acceptability (e.g., satisfaction and adherence rates). Method: Five women undergoing IUI, with no clinical diagnoses, responded to measures of mood (anxiety and depression), affect, quality of life and emotional dysregulation in the pre-and post-assessments, and at the 1-, 3-and 6-month follow-ups. The UP was adapted to be applied during six face-to-face group sessions lasting 2 h. The COVID-19 pandemic situation im-plied changing to an online format to end the program. Results: The re-sults showed that women did not develop EDs, and no statistically signifi-cant pre-post and pre-follow-up differences werefound for anxiety, de-pression,quality of life and emotional dysregulation (all p>.050). A ten-dency towards improvement in the post-assessment evaluation was noted. Satisfaction with the format and UP program was high. Conclusions: It would seem that programs focusing on therapeutic common factors like the UP could have an emotional preventive effect during IUI.(AU)

Mother-infant bonding screening in a sample of postpartum women: comparison between online vs offline format.

AIMS: We aim to study the the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ)administered through two different formats, offline (paper-and-pencil) and online. We also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor mother infant bonding (MIB). METHODS: A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and other clinical and sociodemographic variables. RESULTS: The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both samples. Online participants reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. No differences were found in both samples regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes. CONCLUSION: Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method.

Validity Evidence of the Multidimensional Emotional Disorders Inventory among Non-Clinical Spanish University Students.

The current diagnostic systems for mental health disorders are categorical, which, it has been argued, poorly reflect the reality of mental health problems. This is especially relevant in emotional disorders (EDs), especially due to the existing comorbidity between supposedly different disorders. To address this, Brown and Barlow developed a hybrid dimensional-categorical approach to EDs that can be evaluated with the Multidimensional Emotional Disorder Inventory (MEDI), a transdiagnostic self-report questionnaire. This study aims to adapt and explore the sources of validity evidence of the MEDI in a non-clinical sample of Spanish university students (n = 455). Two confirmatory analyses were performed: one with a four-dimensional structure obtained with an exploratory analysis and another with the original nine-dimensional structure of the MEDI. The latter obtained a better fit. The descriptive data, including percentiles, T-scores, and sex differences in total scores are also provided, together with sources of validity evidence. These revealed significant moderate interrelations between factors and with related measures (e.g., personality, depression, and anxiety). This study adapted the MEDI for use in Spanish, provides further support about its factor structure, and offers novel data about its validity sources. The MEDI makes the evaluation of dimensional and transdiagnostic models easier, which might be fundamental in present and future research and clinical practice.

Effectiveness of psychological interventions in the treatment of perinatal depression: A systematic review of systematic reviews and meta-analyses.

BACKGROUND: Perinatal depression is a high prevalent mental health problem with serious consequences. Evidence about effective psychological interventions in treating perinatal depression has been increasing, but it lacks a comprehensive synthesis of findings. METHODS: A systematic review of systematic reviews and meta-analyses concerning the effectiveness of psychological interventions in treating perinatal depression (depression during pregnancy and the first 12 months postpartum) in adult women was conducted. The electronic databases MEDLINE (PubMed), PsycINFO, The Cochrane Library, Web of Science and Prospero were searched, on May 2020, using a combination of keywords. Data were independently extracted by two authors and a synthesis of the results was presented. Methodological quality was independently assessed by two authors, using AMSTAR-2. RESULTS: Seven systematic reviews were included and reported, overall, the effectiveness of psychological interventions in decreasing depressive symptoms in women in the perinatal period, both short and long-term. CBT was found to be the most effective intervention, regardless of the treatment format. LIMITATIONS: Grey literature was not searched, and some studies may overlap among the included systematic reviews. These (the included reviews) were rated with low methodological quality, which weakens the evidence of the reported results. CONCLUSIONS: CBT is currently the most evidence-based psychological intervention, provided in different delivery formats (individual, group, face-to-face or Internet-based). Further studies, including systematic reviews, with other types of psychological interventions (e.g., third-wave CBT) and with higher quality are needed.

Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Medical Conditions: A Systematic Review.

Emotional disorders are those that most commonly present comorbidly with medical conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral emotion-based intervention, has proven efficacy and versatility. The aim of this systematic review is to know the current (research studies) and future research interest (study protocols) in using the UP for the transdiagnostic treatment of emotional symptoms or disorders (EDs) in people with a medical condition. Using the PRISMA guidelines, a literature search was conducted in Web of Science, PubMed, Medline, and Dialnet. The nine research studies included in this review indicated that the UP is effective in treating emotional symptomatology in a population with a medical condition (effect sizes ranging from d = -3.34 to d = 2.16). The three included study protocols suggest interest in the future UP application to different medical conditions, and also in distinct application formats. Our review results are encouraging, and conducting more controlled studies is advised to recommend the UP to treat and/or prevent EDs in medical conditions, especially in children and youths.

[Evidence-Based Psychological Treatments for Adults: A Selective Review]

Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.