The increase in emotional symptoms of novice clinical psychology trainees compared with a control cohort / El incremento en síntomas emocionales en practicantes de psicología clínica en comparación con una cohorte control

Abstract Cross-sectional research has shown that clinical psychology trainees usually face a wide range of stressors related to the clinical practice and tend to present higher distress than other psychology students. However, to our knowledge, no longitudinal study has been conducted analyzing this fact. Specifically, this study analyses the evolution of emotional symptoms among a group of novice clinical psychology trainees compared with a control cohort. We recruited 575 Colombian Psychology undergraduates: 52.9% were in the semester in which they began their clinical practice, and 47.1% were attending a regular semester. At the beginning of the semester (T1), participants responded to measures of emotional symptoms (Depression, Anxiety, and Stress Scale - 21, DASS-21; General Health Questionnaire - 12, GHQ-12). Approximately two months later (T2), participants responded to the DASS-21 and GHQ-12. The two groups did not differ in their scores on the DASS-21 and the GHQ-12 at T1. Bayesian repeated-measures ANOVA showed that clinical psychology trainees showed higher increases in scores on the DASS-Total, DASS-Depression, and DASS-Stress than participants attending a regular semester. This is the first study that shows clinical psychology trainees experiencing a higher increase in emotional symptoms compared with a control cohort.

Resumen La investigación transversal ha mostrado que los practicantes de psicología clínica suelen enfrentar un amplio rango de estresores relacionados con la práctica clínica y tienden a presentar mayor grado de malestar emocional que otros estudiantes de psicología. Sin embargo, ningún estudio longitudinal ha analizado este hecho. Este artículo analiza la evolución de los síntomas emocionales entre un grupo de practicantes en psicología clínica novatos comparados con una cohorte control. Se reclutaron 575 estudiantes de Psicología colombianos: 52.9% comenzaban su práctica clínica y 47.1% cursaban un semestre normal. Al inicio del semestre (T1), los participantes respondieron a medidas de síntomas emocionales (Depression, Anxiety, and Stress Scale-21, DASS-21; General Health Questionnaire-12, GHQ-12). Aproximadamente dos meses después (T2), respondieron al DASS-21 y GHQ-12. Los dos grupos no difirieron en las puntuaciones del DASS-21 y GHQ-12 en el T1. Los ANOVA de medidas repetidas Bayesianos mostraron que los practicantes incrementaron sus puntuaciones en el DASS-Total, DASS-Depresión y DASS-Estrés más que los participantes que asistían a un semestre normal. Este es el primer estudio que muestra que los practicantes de psicología clínica experimentan un mayor incremento de síntomas emocionales que los de una cohorte control.

A Systematic Review and Meta-Analysis of Third-Wave Online Interventions for Depression / Revisión sistemática y meta-análisis de las intervenciones de tercera generación online para depresión

Abstract Online psychological interventions for the treatment of depression are increasing as an alternative to traditional face-to-face psychotherapy. Adaptations of cognitive behavioral therapy for the treatment of depression have been tested, with meta-analyses showing weighted effect sizes ranging from d = 0.40 to 0.56. However, there is less evidence on the effect of adaptations of third-wave behavioral therapies for depression. Accordingly, this study reviews the evidence of online applications of third-wave behavioral therapies for depression. Nine randomized clinical trials were found with a total of 1910 participants. Most of these trials implemented online versions of behavioral activation (BA) and acceptance and commitment therapy (ACT). All studies reported positive effects of third-wave therapies. A meta-analysis was conducted with the 6 studies (N = 1744) that compared an online intervention versus wait-list or treatment as usual conditions. Medium to large effect sizes were found with a weighted effect size of d = 0.61. In conclusion, online adaptations of third-wave therapies seem to be legitimate options for the treatment of depression.

Resumen Las intervenciones psicológicas online para el tratamiento de la depresión están creciendo como una alternativa a la psicoterapia tradicional vis a vis. Se han evaluado adaptaciones de la terapia cognitivo conductual para el tratamiento de la depresión, señalando los meta-análisis tamaños del efecto promedio entre d = 0.40 y 0.56. Sin embargo, existe menor evidencia acerca de los efectos de adaptaciones de las terapias conductuales de tercera generación para la depresión. Consecuentemente, este estudio revisa la evidencia de las aplicaciones online de terapias conductuales de tercera generación para la depresión. Se encontraron 9 estudios clínicos aleatorizados con un total de 1910 participantes. La mayor parte de los estudios aplicaron versiones de la activación conductual y la terapia de aceptación y compromiso. Todos los estudios reportaron efectos positivos de las terapias de tercera generación. Se realizó un meta-análisis con los 6 estudios (N = 1744) que compararon una intervención online versus un control en lista de espera o tratamiento habitual. Se encontraron tamaños del efecto entre medianos y grandes, con un tamaño del efecto promedio de d = 0.61. En conclusión, las adaptaciones online de terapias de tercera generación parecen ser una opción legítima para el tratamiento de la depresión.

Psychometric properties and factor structure of the Ruminative Responses Scale-Short Form in Colombia

The Ruminative Response Scale (RRS) is the most used measure of rumination in response to depressive mood. The RRS consists of 22 items that are responded on a 4-point Likert-type scale. A 10-item version of the RRS (RRS-SF) has been developed by removing the items that overlap with items of depression measures. The RRS-SF contains two subscales (Brooding and Reflection) that showed acceptable psychometric properties in the original and Spanish version. However, the psychometric properties and factor structure of the RRS-SF have not been tested in Colombia. After warranting validity content of the Spanish version of the RRS-SF, it was administered to a total of 604 participants including a nonclinical and clinical sample. The internal consistency of both subscales was acceptable and similar to the original version. The two-factor model showed a good fit to the data and measurement invariance across samples. The clinical sample’s mean scores on the RRS-SF subscales were significantly higher than scores of the nonclinical sample. Brooding and Reflection scores were significantly related to measures of pathological worry, emotional symptoms, psychological distress, experiential avoidance, and cognitive fusion. The Spanish version of the RRS-SF showed good psychometric properties in Colombia (AU)

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The role of common physical properties and augmental functions in metaphor effect

Metaphor is a tool frequently used in psychotherapy such as Acceptance and Commitment Therapy (ACT), a contextual behavioral model of psychological intervention rooted in an approach to human language and cognition known as Relational Frame Theory (RFT). This experimental analogue study aimed to analyze the effect of two variables in the metaphor effect on promoting psychological flexibility according to RFT: (a) the presence of common physical properties between the individual’s experience and the metaphor, and (b) the specification of appetitive augmental functions in the metaphor content. A 2x2 factorial design was implemented where the presence/absence of the above-mentioned variables was manipulated. Eighty-three participants first responded to measures of experiential avoidance, cognitive fusion, and generalized pliance. Subsequently, they were exposed to a cold-pressor task at pretest. Afterwards, participants were randomly assigned to four experimental protocols consisting of a metaphor that included: (a) common physical properties and augmental functions, (b) only common physical properties, (c) only augmental functions, and (d) none of these variables. Then, participants were re-exposed to the cold-pressor task (posttest). The results showed that both variables had a statistically significant effect on the pain tolerance induced by the cold-pressor task (AU)

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