Mental Health in Doctoral Students: Individual, Academic, and Organizational Predictors.

BACKGROUND: The mental health of doctoral students is a matter of concern, and several variables appear to be associated with the state of their mental health. However, there have been no studies on the population of doctoral students in Spain to date using validated instruments. METHOD: A cross-sectional observational study was conducted to assess mental health in 1,018 doctoral students. The impact of personal, academic, psychological, and social/organisational variables on their mental health was assessed. RESULTS: Between 50% and 60% of the sample might be experiencing a common psychological disorder, while 18.8% of the sample might be experiencing passive suicidal ideation. In addition, using binary logistic regression, significant predictors of negative mental health were identified, including: sociodemographic variables (being female); academic variables (longer time spent in a doctoral programme); psychological variables (lower life satisfaction; greater interference and less clarity about negative emotions); and social and organisational variables (greater fear of losing tuition rights, lower social support, and greater interference of academic work with personal life). CONCLUSIONS: Doctoral students need measures to remedy and prevent mental health issues based on improving self-care and emotion regulation, promoting social support at university, and reducing the pressure of losing tuition rights among final-year students.

Video Game Playing and Internet Gaming Disorder: A Profile of Young Adolescents.

In recent times, growing concern has arisen regarding the utilization of technology, video games, and the emergence of internet gaming disorder (IGD), particularly among young adolescents. This worry arises from the ambiguity in distinguishing between "normal" and "problematic" video game behavior, despite efforts to establish clear criteria for defining both. The goal of this study is to outline distinct profiles of adolescent video game players and identify variables associated with their gaming practices that correlate with problematic gaming. The study utilizes a substantial sample of adolescents drawn from a representative cross-section of educational institutions in the city of Madrid, ranging in age from 12 to 16 years. In total, 1516 participants (75%) acknowledged engaging in video game activities. The research delves into characterizing prevailing profiles of video game participants within this cohort and scrutinizes the profile that aligns with issues of IGD. In summary, approximately three-quarters of young adolescents participate in video gaming, with males constituting the majority. Typically, participants immerse themselves in action genre games for over three days per week, with males exhibiting a higher frequency than their female counterparts. Elevated gaming frequency correlates with heightened IGD scores, particularly among females. Young adolescents show a preference for game consoles (males) and mobile phones (females) and often play alone at home. Specific factors such as the device used, online mode, company, and gaming location impact the IGD scores. These profiles aim to assist families and educators in recognizing potential risk behaviors and IGD concerns; however, it is crucial to emphasize the necessity for case-specific screening and evaluation before deliberating on such behaviors.

Cognitive Patterns and Problematic Use of Video Games in Adolescents: A Cluster Analysis.

BACKGROUND: Video game playing (VGP) is an increasingly common leisure activity among children and adolescents, although in some cases, it is accompanied by problems due to misuse. METHOD: A sample of 2884 children and adolescents aged between 12 and 20, representative of the Community of Madrid (Spain), were studied using a cluster analysis to explore the existence of cognitive patterns associated with engagement, attitudes, and concurrent cognitions. We also explored the relationship between these patterns and problematic VGP, using the 2173 gamers as a reference. RESULTS: The concurrent cognitions were not qualitatively different between the problematic users and the others. High engagement and high activation of concurrent cognitions (intensity and frequency) showed the greatest relationship with problematic VGP. CONCLUSIONS: The results suggest the existence of different groups of gamers and the relevance to include psycho-educational aspects in intervention programs, as well as the training of specific skills, especially those related with the control of activation. Limitations related to the sample size and potential supplementary analyses are acknowledged.

Risk Factors Associated with Relapse in Major Depressive Disorder in Primary Care Patients: A Systematic Review.

BACKGROUND: Major Depressive Disorder (MDD) is highly recurrent. Most patients with MDD are treated in the Primary Care (PC) setting. The purpose of this systematic review was to identify risk factors associated with relapse of MDD in PC. METHOD: A systematic review of PsycINFO, PubMed, Web of Science and ScienceDirect, from 1978 to 2019, following PRISMA guidelines was conducted. RESULTS: Eight studies fulfilling the eligibility criteria and 12 risk factors associated with relapse of MDD were found. Patients who showed a higher frequency of relapse were: 1) those with higher scores in neuroticism, disability, current MDD episode severity, and childhood abuse; 2) lower scores on extraversion, self-esteem, emotional role, physical functioning; 3) history of MDD relapse; 4) comorbidity; and 5) poorer adherence to antidepressant medication (ADM). In terms of treatment, ADM combined with cognitive behavioural therapy and psychoeducation was reported to produce fewer relapses, as was mindfulness-based cognitive therapy for patients with a higher score in childhood abuse. CONCLUSIONS: Despite the very varied nature of the studies, different risk factors associated with relapse were identified. However, more research is needed on this important problem, with randomized controlled trials.

Exposición de jóvenes y adolescentes a la publicidad de los juegos de azar: una revisión sistemática / Exposure of adolescents and youth to Gambling advertising: a sys-tematic review

Los posibles efectos negativos de la publicidad de juegos de azar (JdA), sobre todo en Adolescentes y Jóvenes (AyJ), generan alarma social. Se realizó una revisión sistemática de las investigaciones sobre publicidad y juego en AyJ, en los últimos 10 años, siguiendo las directrices PRISMA, seleccionándose 31 trabajos. Los resultados destacan que AyJ, en contra de la legislación, participan con frecuencia en JdA, presentando problemas de juego. La publicidad de JdA es variada e intensa en especial en TV, eventos deportivos y redes sociales, estando dirigida a JyA, aunque suelen ser críticos con ella. Afecta más a varones jóvenes y con conductas de juego inadecuadas, consolidándolas. Los contenidos principales tratan de normalizar el juego y resaltar ganancias (sociales o económicas). El nivel de recuerdo y las actitudes sobre la publicidad del juego se asocian a incrementos en la intención de jugar, comportamientos de juego, y problemas de juego. Los incentivos más eficaces para jugar incluyen promociones económicas. La publicidad parece tener efecto, aunque reducido, para mejorar la actitud hacia los JdA e incrementar la participación en éstos, pero es difícil identificar sus efectos a medio y largo plazo. Son necesarios más estudios sobre JdA y publicidad, en especial en España

The possible negative effects of gambling Advertising (GA), especially in Adolescents and Youth (A&Y), generate social alarm. A systematic review of the research on advertising and gambling in A&Y in the last 10 years was carried out, following the PRISMA guidelines, including 31 studies. The results highlight that A&Y, against the law, frequently participate in gambling, with some having gambling problems. GA is varied and intense, especially on TV, sporting events and social networks, also targeting A&Y, although they are often critical of it. It affects more young men and people with inappropriate gambling behaviours, consolidating those behaviours. The main messages try to normalise gambling and highlight profits (social or economic). The levels of recall, as well as the attitudes about GA are associated with an increase in gambling intentions, behaviours, and problems. The most effective incentives to gamble include economic promotions. Advertising seems to have an effect, albeit reduced, to improve the attitude towards gambling and increase participation, but it is difficult to identify its effects in the medium and long term. More studies on gambling and advertising are necessary, especially in Spain

Factores que interfieren en el curso del tratamiento de los problemas de ansiedad: La prolongación y la terminación prematura del tratamiento / Factors interfering with the course of treatment for anxiety disorders: Prolongation and premature termination of treatment

El tratamiento de los trastornos de ansiedad ha demostrado su eficacia y efectividad. Sin embargo, no siempre se consiguen los resultados deseados. Estudiar aquellos factores que interfieren en el curso natural del tratamiento contribuirá a tomar medidas oportunas. Dos de estos factores son la prolongación innecesaria de los tratamientos y el fenómeno de la terminación prematura. Como es esperable, la duración del tratamiento depende de la naturaleza del problema y de la existencia de problemas comórbidos, pero también de planificaciones demasiado ambiciosas (exceso de técnicas) o la combinación con psicofármacos (con incrementos de hasta un 21% de sesiones). La terminación prematura se sitúa entorno al 30-35% y los pacientes "anuncian el desenlace" con peor ejecución de tareas y asistencias más irregulares desde el principio. Aproximadamente 50% de los abandonos ocurren antes de la sesión 8 y entorno al 80% de los tratamientos completados exitosamente concluyen antes de la sesión 20

The efficacy and the effectiveness of anxiety disorder treatments have been proven. However, the desired results are not always achieved. Studying the factors that interfere with the natural course of the treatments could help to correct and to adapt them. Two of these factors are the unnecessary prolongation of treatments and premature termination. As expected, the duration of the treatment depends on the nature of the problem and the existence of comorbid problems, however also treatments that are too ambitious (an excess of techniques) or combined with pharmacological treatments (increasing sessions by up to 21%) have a longer duration. Premature termination was around 30-35% and patients "announce" their drop-out by displaying poorer task performance and more irregular attendance from the beginning. More than 50% of the therapeutic dropout occurs before the eighth session and 80% of successful treatments were completed before the 20th session

Treatment of Anxiety Disorders in a Psychology Clinic.

People with anxiety disorders demand psychological attention most often. Therefore, it seems important to identify both the characteristics of the patients who demand help and the clinical variables related to that demand and its treatment. A cohort of 292 patients who requested help at a university clinical facility was studied. The typical profile of the patient was: being female, young, unmarried, with some college education, and having previously received treatment, especially pharmacological one. The three most frequent diagnoses of anxiety, which include 50% of the cases, were: Anxiety Disorder not otherwise specified, Social Phobia, and Panic Disorder with Agoraphobia. Regarding the characteristics of the intervention, the average duration of the assessment was 3.5 sessions (SD = 1.2), and the duration of the treatment was 14 sessions (SD = 11.2). The percentage of discharges was 70.2%. The average cost of treatment was around €840. The results are discussed, underlining the value of empirically supported treatments for anxiety disorders.

Treatment of anxiety disorders in a psychology clinic

People with anxiety disorders demand psychological attention most often. Therefore, it seems important to identify both the characteristics of the patients who demand help and the clinical variables related to that demand and its treatment. A cohort of 292 patients who requested help at a university clinical facility was studied. The typical profile of the patient was: being female, young, unmarried, with some college education, and having previously received treatment, especially pharmacological one. The three most frequent diagnoses of anxiety, which include 50% of the cases, were: Anxiety Disorder not otherwise specified, Social Phobia, and Panic Disorder with Agoraphobia. Regarding the characteristics of the intervention, the average duration of the assessment was 3.5 sessions (SD = 1.2), and the duration of the treatment was 14 sessions (SD = 11.2). The percentage of discharges was 70.2%. The average cost of treatment was around 840 Euros. The results are discussed, underlining the value of empirically supported treatments for anxiety disorders (AU)

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Uso de técnicas de exposición en una clínica de psicología / Use of Exposure Techniques in a Psychology Clinic

El objetivo del artículo es indagar el uso de las técnicas de exposición en la práctica de la psicología clínica asistencial. Se analiza el tipo de técnicas de exposición, su frecuencia de uso, tanto en general como en función del diagnóstico, y su relación con los resultados del tratamiento. De los 880 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense, con todo tipo de diagnóstico, el 67.2% son mujeres y su edad media es de 32.79 años. Los resultados señalan que el 39.5% de los casos ha utilizado alguna técnica de exposición, siendo la Exposición Gradual la más frecuente (31.6%). Predomina el uso de las técnicas de exposición en trastornos de ansiedad (70.8%), somatomorfos (47.4%) y sexuales (47.1%). Se observa un incremento en el uso de técnicas de exposición en los casos con comorbilidad (55.4% frente a 36.3%). De los casos que han recibido alguna técnica de exposición, el 74.1% ha finalizado con éxito el tratamiento, frente al 61.9% de los que no han utilizado ninguna técnica de exposición. Se discuten los resultados, destacando el valor de usar técnicas de exposición para reducir la evitación o las respuestas de miedo con independencia del diagnóstico.

The aim of this work is to explore the use of exposure techniques at the health care context of a clinical psychology facility. Different modalities of exposure techniques, their frequency of usage - both across the entire sample and considering different diagnostic groups - and their relationship to the treatment results, were analysed. From the 880 patients with diverse diagnosis treated at the University Psychology Clinic of the Universidad Complutense of Madrid, 67.2% were women, with a mean of32.79 years. Results show that exposure techniques were used in 39.5% of total cases, being gradual exposure the most frequent (31.6%). Exposure techniques were employed foremost on anxiety disorders (70.8%), somatoform disorders (47.4%), and sexual disorders (47.1%). Also, it was observed that exposure techniques were used more often in cases with one or more comorbid diagnosis (55.4 vs. 36.3%). 74.1% of the patients treated with exposure techniques received therapeutic discharge, while 61.9% of patients not treated with exposure techniques were discharged. The results are discussed, emphasizing the utility of exposure techniques to treat avoidant or fearful behaviour regardless of the diagnosis.

El uso de las técnicas de relajación en la práctica de una clínica de psicología / The use of relaxation techniques in a psychology clinic practice

El objetivo del artículo es identificar el uso de las técnicas de relajación (TR) en la práctica de la Psicología Clínica asistencial. Se analiza el tipo de técnicas de relajación, su frecuencia de uso, tanto en general como en función del diagnóstico, y su relación con los resultados del tratamiento. De los 880 pacientes en una clínica universitaria asistencial, con todo tipo de diagnóstico, el 67.2% son mujeres y su edad media es de 32.79 años. Los resultados señalan que el 70.5% de los casos ha utilizado alguna TR, siendo el Control de la Respiración la más frecuente (72.3%). Predomina su uso en trastornos de ansiedad (87.8%), somatomorfos (84.2%) y control de impulsos (77.8%). Hay un incremento importante en el uso de TR en los casos con comorbilidad (82.4% frente a 68%). Y el uso de técnicas de control de respiración o relajación progresiva entre los pacientes que obtienen el alta es de alrededor del 69%. Se discuten los resultados destacando el valor de usar TR, incluso con independencia del diagnóstico

The aim of this article is to describe the use of relaxation techniques (RT) in the practice of clinic psychology care. Relaxation techniques are analyzed considering what type of technique they are and their use, going from a general overview to a specific diagnosis context and treatment results. 67.2 % of 880 clinic patients with all types of diagnosis are women and the average age is 32.79 years old. The results show that some RT has been used in 70.5 % of the cases being breath control the most frequent one (72.3 %). It is mainly used for anxiety disorders (87.8%), somatoform disorder (84.2%) and impulse control disorder (77.8%). The use of these techniques is more frequent in cases of comorbid disorder (82.4% versus 68%). Breathe control and progressive muscular relaxation techniques are used in about 69 per cent of discharged patients. The discussion of this paper focuses on the results of using RT regardless of the diagnosis

Does adding pharmaceutical medication contribute to empirically supported psychological treatment for anxiety disorders? / ¿Aporta algo añadir fármacos al tratamiento psicológico empíricamente apoyado para los trastornos de ansiedad?

Background: The goal of this work is to determine whether the combined use of empirically supported psychological treatments (ESTs) and pharmacological therapy (PT) achieves better results than the isolated use of ESTs in the treatment of Anxiety Disorders (AD) in a welfare clinical setting. Method: A quasi-experimental study was designed, with a sample of 287 patients with primary diagnosis of AD. Of the patients, 25.1% (n = 72) received ESTs+PT and 74.9% (n = 216), only ESTs. At pretreatment, no intergroup differences were observed in anxiety and depressive symptoms, duration of the problem and comorbidity, but there were differences for previous treatments (they were fewer in the EST group). Results: After the intervention, both groups showed similar degree of completion, compliance with treatment, task performance and similar effectiveness at post treatment but EST+PT was significantly longer (16.58 sessions vs. 13.04 sessions). Conclusions: It is concluded that adding PT to EST does not improve the results but it does increase the cost and duration of treatment, thereby reducing the efficiency of the intervention (AU)

Antecedentes: el objetivo de este trabajo es determinar si, en el tratamiento de los Trastornos de Ansiedad en un contexto asistencial, el uso conjunto de Tratamientos Psicológicos Empíricamente Apoyados (TEAs) y Tratamiento Farmacológico (TF) consigue mejores resultados que el uso solo de TEAs. Método: se diseñó un estudio cuasiexperimental, con una muestra de 287 pacientes con diagnóstico primario de Trastorno de Ansiedad. El 25,1% de los pacientes (n= 72) recibió TEAs+TF y el 74,9% (n= 216) solo TEAs. En el pretratamiento no aparecieron diferencias intergrupo en el nivel de ansiedad y sintomatología depresiva, duración del problema y comorbilidad, pero sí en tratamientos previos (menos en el grupo de TEA). Resultados: tras la intervención ambos grupos mostraron valores similares en el porcentaje de éxito y efectividad, nivel de ejecución de tareas, puntualidad y asistencia, sin embargo hubo diferencias significativas en la duración del tratamiento, que fue significativamente más largo en el grupo de TEA+TF (16,58 sesiones frente 13,04 sesiones). Conclusiones: se concluye que añadir TF al TEA no mejora los resultados pero incrementa los costos y duración del tratamiento, reduciendo la eficiencia de la intervención (AU)

Does adding pharmaceutical medication contribute to empirically supported psychological treatment for anxiety disorders?

BACKGROUND: The goal of this work is to determine whether the combined use of empirically supported psychological treatments (ESTs) and pharmacological therapy (PT) achieves better results than the isolated use of ESTs in the treatment of Anxiety Disorders (AD) in a welfare clinical setting. METHOD: A quasi-experimental study was designed, with a sample of 287 patients with primary diagnosis of AD. Of the patients, 25.1% (n = 72) received ESTs+PT and 74.9% (n = 216), only ESTs. At pretreatment, no intergroup differences were observed in anxiety and depressive symptoms, duration of the problem and comorbidity, but there were differences for previous treatments (they were fewer in the EST group). RESULTS: After the intervention, both groups showed similar degree of completion, compliance with treatment, task performance and similar effectiveness at post treatment but EST+PT was significantly longer (16.58 sessions vs. 13.04 sessions). CONCLUSIONS: It is concluded that adding PT to EST does not improve the results but it does increase the cost and duration of treatment, thereby reducing the efficiency of the intervention.

Diferencias sociodemográficas, clínicas y de resultados del tratamiento entre los trastornos de ansiedad / Sociodemographic, clinical and outcome differences among anxiety disorders

Los objetivos del artículo son analizar las características sociodemográficas y clínicas de los pacientes con trastornos de ansiedad, tratados en una clínica de psicología, y los resultados del tratamiento en cada uno de los trastornos de ansiedad. Se analizan los datos de 282 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense de Madrid que presentaban al menos un diagnóstico de ansiedad según criterios DSM-IV-TR. Los trastornos de ansiedad más frecuentes son el trastorno de ansiedad no especificado (19,1%) y la fobia social (18,8%). Se observan diferencias significativas en función del sexo, siendo el porcentaje de mujeres significativamente superior al de hombres en todos los problemas excepto en el trastorno obsesivo-compulsivo. El trastorno de ansiedad no especificado requirió un menor número de sesiones de evaluación y tratamiento, mientras que el trastorno obsesivo compulsivo requirió un mayor número de sesiones. No aparecieron diferencias significativas en porcentajes de altas y abandonos en fobia específica, trastorno de ansiedad generalizada y trastorno obsesivo-compulsivo. Se discuten las diferencias entre los datos epidemiológicos y clínicos y sus implicaciones para el tratamiento (AU)

The aims of this paper are to analyze differences in sociodemographic and clinical characteristics among the various anxiety disorders treated in a Psychology Clinic, and the results of treatment in each anxiety disorder. Data from 282 patients of University Psychology Clinic at the Complutense University of Madrid, who had at least one diagnosis of anxiety according to DMS-IV-TR criteria, were analyzed. The most frequent anxiety disorders were nonspecific anxiety disorder (19.1%) and social phobia (18.8%). Significant differences were observed according to sex (in all disorders, the percentage of women was significantly higher than that of men, except for obsessive-compulsive disorder). Unspecific anxiety disorder required a smaller number of assessment and treatment sessions, whereas obsessive-compulsive disorder required a greater number of sessions. There were no significant differences between the percentage of patients who completed treatment and dropout rates in specific phobia, general anxiety disorder and obsessive compulsive disorder. Differences between epidemiological and clinical data are discussed (AU)

[Sociodemographic, clinical and outcome differences among anxiety disorders]. / Diferencias sociodemográfi cas, clínicas y de resultados del tratamientoentre los trastornos de ansiedad.

The aims of this paper are to analyze differences in sociodemographic and clinical characteristics among the various anxiety disorders treated in a Psychology Clinic, and the results of treatment in each anxiety disorder. Data from 282 patients of University Psychology Clinic at the Complutense University of Madrid, who had at least one diagnosis of anxiety according to DMS-IV-TR criteria, were analyzed. The most frequent anxiety disorders were nonspecific anxiety disorder (19.1%) and social phobia (18.8%). Significant differences were observed according to sex (in all disorders, the percentage of women was significantly higher than that of men, except for obsessive-compulsive disorder). Unspecific anxiety disorder required a smaller number of assessment and treatment sessions, whereas obsessive-compulsive disorder required a greater number of sessions. There were no significant differences between the percentage of patients who completed treatment and dropout rates in specific phobia, general anxiety disorder and obsessive-compulsive disorder. Differences between epidemiological and clinical data are discussed.

¿Por qué se alargan los tratamientos psicológicos? Predictores de una mayor duración del tratamiento y diferencias entre los casos de corta y larga duración / Why are psychological treatments prolonged? Predictors of a longer duration of treatment and analysis of the differences between long- and short-term cases

El objetivo del estudio es identificar qué variables pueden explicar una mayor duración de los tratamientos psicológicos y analizar las diferencias entre casos extremos de corta y larga duración. Se analizaron los datos de 419 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense de Madrid. Los factores que mejor explicaban la duración del tratamiento eran: número de técnicas aplicadas, presencia de comorbilidad, haber recibido algún tratamiento anterior y presentar un diagnóstico principal de trastorno del estado de ánimo o trastorno de la conducta alimentaria. Se obtuvieron diferencias significativas entre los casos de corta y larga duración en el número de técnicas aplicadas y el número de objetivos terapéuticos establecidos al comienzo del tratamiento, también en variables clínicas (grupo diagnóstico, comorbilidad y haber recibido algún tratamiento anterior) y sociodemográficas (edad y nivel educativo). Se discuten los resultados y se proponen líneas de actuación y/o reflexión (AU)

The purpose of this study was to identify variables that may explain a longer psychological treatment and to analyze differences between shortand long-term cases. Data from 419 patients of the University Clinic of Psychology at the Complutense University of Madrid were analyzed. Number of intervention techniques, comorbidity, previous treatments, and a primary diagnosis of mood disorder or eating disorder were the factors that explained longer treatment duration. Significant differences were observed between short- and long-term cases in number of intervention techniques, number of therapeutic objectives, and also in some clinical variables (diagnostic group, comorbidity, previous treatment) and demographics (age and educational level). Results are discussed and some lines of intervention and/ or reflection are proposed (AU)

[Why are psychological treatments prolonged? Predictors of a longer duration of treatment and analysis of the differences between long- and short-term cases]. / Por qué se alargan los tratamientos psicológicos? Predictores de una mayor duración del tratamiento y diferencias entre los casos de corta y larga duración.

The purpose of this study was to identify variables that may explain a longer psychological treatment and to analyze differences between short- and long-term cases. Data from 419 patients of the University Clinic of Psychology at the Complutense University of Madrid were analyzed. Number of intervention techniques, comorbidity, previous treatments, and a primary diagnosis of mood disorder or eating disorder were the factors that explained longer treatment duration. Significant differences were observed between short- and long-term cases in number of intervention techniques, number of therapeutic objectives, and also in some clinical variables (diagnostic group, comorbidity, previous treatment) and demographics (age and educational level). Results are discussed and some lines of intervention and/ or reflection are proposed.