The Usefulness of a Massive Open Online Course about Postural and Technological Adaptations to Enhance Academic Performance and Empathy in Health Sciences Undergraduates.

Massive open online courses (MOOCs) provide accessible and engaging information for Physical Therapy and Occupational Therapy students. The objective of this research was to determine the usefulness in improving academic performance and empathy in health sciences undergraduates, and to test a hypothetical model through structural equation analysis. This research was carried out using a descriptive and quasi-experimental design. It was conducted in a sample of 381 participants: 176 used a MOOC and 205 did not. The results of the Student's t-test showed statistically significant differences in academic performance between the groups in favor of those students who had realized the MOOC. Participants carried out an evaluation rubric after taking MOOC. Statistically significant differences in empathy were also obtained between the pre (X = 62.06; SD = 4.41) and post (X = 73.77; SD = 9.93) tests. The hypothetical model tested via structural equation modeling was supported by the results. Motivation for the MOOC explained 50% of the variance. The MOOC (participation and realization) explained 58% of academic performance, 35% of cognitive empathy and 48% of affective empathy. The results suggest an association between higher realization and participation in a MOOC and higher levels of academic performance, and cognitive and affective empathy.

Pain Acceptance and Pain-Related Disability Predict Healthcare Utilization and Medication Intake in Patients with Non-Specific Chronic Spinal Pain.

Longitudinal research is needed to determine predictive factors of healthcare utilization and medication intake in people with non-specific spinal pain. This study aims to prospectively examine the predictive value of sex, age, work status, pain intensity, pain acceptance, disability, depression, pain anxiety, and catastrophizing in relation to healthcare utilization and medication intake in people with non-specific spinal pain. Participants were 79 patients with non-specific spinal pain of 6 to 9 months' duration. They were followed-up at 6 months and 12 months. At enrolment they were administered a battery of questionnaires assessing the predictive variables. Healthcare utilization and medication intake were assessed at follow-ups 1 and 2. At follow-up 1, higher pain acceptance was associated with less healthcare utilization and less medication intake, while male sex was associated with less medication intake. At follow-up 2, higher pain-related disability was associated with higher healthcare use, and pain intensity was associated with higher medication intake. These results suggest that during the early stages of non-specific spinal pain chronification, pain acceptance and the avoidance of pain-related disability-understood as giving up normal activities-can lead to reductions in healthcare utilization and medication intake.

Exploring Changes in Activity Patterns in Individuals with Chronic Pain.

This longitudinal study explored whether activity patterns change over time in a sample of 56 individuals with chronic musculoskeletal pain over a 15-day period. Once a day, the participants recorded their level of pain intensity and the degree to which they had engaged in several specific activity patterns. Linear mixed models with random coefficients were used to investigate the rate of change in the activity patterns. Age, sex, pain intensity, and pain duration were controlled. The results show that excessive persistence was the only self-reported activity pattern to show a linear change over the 15-day period. There was a decrease in excessive persistence, and this decrease was slower with higher levels of activity avoidance. However, no significant association was found between sex, age, pain intensity, and pain duration and excessive persistence at baseline or change over time. At baseline, a positive association was found between excessive persistence and pain avoidance, pain-related persistence, and pacing to reduce pain, and a negative association was found between excessive persistence and pacing to save energy for valued activities. This result suggests a profile characterized by alternate periods of high and low activity that, in this study, were unrelated to longitudinal changes in pain intensity.

El papel mediador de la gestión de las metas vitales entre el optimismo y el bienestar en mujeres con fibromialgia / The mediating role of goal adjustment strategies between optimism and well-being in women with fibromyalgia

El optimismo disposicional se ha mostrado como una variable predictora del bienestar de los individuos que padecen dolor crónico. Este estudio tiene como objetivo analizar el papel mediador de la tenacidad y la flexibilidad, como estrategias de regulación de metas, entre el optimismo disposicional y la adaptación en una muestra de 99 mujeres con fibromialgia. Los análisis de regresión señalan al optimismo y la tenacidad como las únicas variables que se asocian con el propósito vital y el bienestar, teniendo la intensidad de dolor un efecto sobre el afecto positivo. La interacción entre la tenacidad y la flexibilidad surge como variable predictora del bienestar y mediadora en la relación del optimismo con el propósito vital, afecto positivo y el bienestar psicológico de las mujeres. La interacción entre la persecución tenaz de las metas y el ajuste flexible de las mismas es una estrategia eficaz que media entre el optimismo y el bienestar de las mujeres con fibromialgia

Dispositional optimism has been shown as a predictor of the well-being of individuals suffering from chronic pain. The present study aims to analyze the mediating role of tenacity and flexibility, as goal-setting strategies, between dispositional optimism and adaptation in a sample of 99 women with fibromyalgia. The regression analyses point to optimism and tenacity as the only variables that are associated with vital purpose and well-being, with the intensity of pain having an effect on positive affect. The interaction between tenacity and flexibility emerges as a predictor of well-being and a mediator in the relationship of optimism with vital purpose, positive affect and psychological well-being of the women. The interaction between the tenacious pursuit of goals and the flexible adjustment is an effective strategy that mediates between optimism and wellbeing of women with fibromyalgia

El malestar emocional como síntoma de estrés postraumático / Emotional distress as a symptom of post-traumatic stress

El trastorno por estrés postraumático (TEPT) tiene una importante prevalencia en la población, por lo que conocer los mecanismos psicológicos para la vulnerabilidad y el mantenimiento del trastorno es claramente relevante. Entre dichos mecanismos, se ha postulado el constructo de malestar emocional como transdiagnóstico a diversos trastornos mentales. El objetivo del presente estudio fue poner a prueba un modelo hipotético que analizaba la asociación entre tres variables pertenecientes a dicho constructo (evitación experiencial, tolerancia al malestar e intolerancia a la incertidumbre inhibitoria) y el TEPT. Participaron 328 estudiantes universitarios (74.7% mujeres y 25.3% hombres, con una media de edad de 21 años) que habían experimentado al menos un acontecimiento traumático de acuerdo con los criterios del DSM-5, quienes completaron una batería de cuestionarios. Se efectuó un análisis de ecuaciones estructurales cuyos resultados apoyaron parcialmente el modelo hipotético. La evitación experiencial mostró asociarse positiva y significativamente con la tolerancia al malestar, la intolerancia a la incertidumbre inhibitoria y los síntomas del TEPT. La tolerancia al malestar también se vinculó de forma positiva y significativa con dichos síntomas. Sin embargo, la intolerancia a la incertidumbre inhibitoria no mostró relación con esta sintomatología. En apoyo a la evidencia empírica precedente, los hallazgos de este estudio inciden en el papel de la evitación experiencial y la tolerancia al malestar como variables moderadoras de la sintomatología postraumática. Asimismo, apuntan hacia la necesidad de considerar estas variables en las intervenciones psicológicas para el tratamiento del TEPT

Post-traumatic stress disorder or PTSD has an important prevalence in the population, so knowing the psychological mechanisms of vulnerability and maintenance of this disorder is clearly relevant. Among those mechanisms, the emotional distress construct has been postulated as a trans-diagnostic tool related to different mental disorders. The objective of the present study was to test a hypothetical model for the analysis of the association between three variables of this construct (experiential avoidance, distress tolerance, and inhibitory uncertainty intolerance) and PTSD. The subjects of study amounted to 328 university students (74.7% women and 25.3% men, with a median age of 21) who had experienced at least one traumatic event according to the DSM-5 criteria. They were made to complete a set of questionnaires. A structural equation analysis was carried out, with results partially coincident with the hypothetical model. Exponential avoidance showed a positive and significant association with distress tolerance, inhibitory uncertainty intolerance and PTSD symptoms. Distress tolerance was also associated with these symptoms in a positive and significant way. However, inhibitory uncertainty intolerance was not associated with this symptomatology. Following the preexisting empirical evidence, the findings of this study have an impact on the role of experiential avoidance and distress tolerance, as variables that moderate post-traumatic symptomatology. Furthermore, the findings point to the need to consider these variables in psychological interventions for the treatment of PTSD

Effective therapies for the treatment of complex posttraumatic stress disorder: A qualitative systematic review / Terapias eficaces para el tratamiento de estrés postraumático complejo: Una revisión sistemática cualitativa

Abstract: Background: Current literature shows that posttraumatic stress disorder and complex posttraumatic stress disorder symptoms differ. Although the psychological treatments available for posttraumatic disorder are well established, little is known about the effectiveness of those aimed at the treatment of complex posttraumatic stress. Objective: To evaluate the efficacy of psychological treatments for complex posttraumatic stress disorder. Method: A systematic qualitative search was conducted according to PRISMA guidelines, searching four psychological and health electronic databases: Medline, Pilots, PsycINFO, and Pubmed. Three reviewers independently selected the studies in two phases: preselection (criteria for complex posttraumatic stress disorder, replicable psychological treatment, and treatment effect) and selection (additional criteria: type of study, participants, and treatment). Results: Of the 615 studies reviewed, 25 were preselected, eight of which met the inclusion and methodological quality criteria. Five studies explored adult populations (with one exception, all were randomized clinical trials) and three child populations (clinical studies with pre- post-treatment design, with and without control group). Most studies with adult populations included psychoeducation, cognitive restructuration, and exposure therapy. The studies with child samples included EMDR and mindfulness as the most frequent treatment components. Discussion and conclusion: The evidence was insufficient to determine the most effective treatment. More research on this issue is required.

Resumen: Antecedentes: La literatura actual muestra una diferenciación entre los síntomas de trastorno por estrés postraumático y estrés postraumático complejo (TEPTC). Si bien los tratamientos psicológicos para el primer tipo de sintomatología están claramente establecidos, son menos conocidas las intervenciones para el TEPTC. Objetivo. Evaluar la eficacia de las terapias psicológicas para reducir los síntomas del TEPTC. Método: Se realizó una revisión sistemática cualitativa basada en la guía de publicación PRISMA. Se usaron cuatro bases de datos: Medline, Pilots, Psycinfo y Pubmed. Con base en criterios previamente definidos, tres revisores independientes eligieron los trabajos en dos fases: preselección (criterios para TEPTC, tratamiento psicológico replicable, datos sobre efectos) y selección (considerando tres criterios adicionales: tipo de estudio, de participantes y de intervención). Resultados: De los 615 encontrados, se preseleccionó un total de 25 artículos para revisión de texto completo, de los cuales se seleccionaron un total de ocho. Cinco trabajos incluyeron población adulta (a excepción de un estudio, todos eran ensayos clínicos controlados aleatorizados) y el resto infantil (diseño pre-post-tratamiento, con o sin grupo control). Mayoritariamente, los componentes de los tratamientos para adultos fueron: psicoeducación, reestructuración cognitiva y exposición. Los estudios con muestras infantiles incluyeron técnicas más heterogéneas, si bien el uso del EMDR y mindfulness fueron comunes a dos de las intervenciones. Discusión y conclusión: Dada la escasez de estudios encontrados y los problemas de control metodológico, no es posible destacar un tratamiento de elección para el TEPCT con eficacia superior al resto. Se requiere de más investigación en este ámbito.