Fostering Self-Compassion and Loving-Kindness in Patients With Borderline Personality Disorder: A Randomized Pilot Study.

The aim of this randomized pilot study is to investigate the effects of a short training programme in loving-kindness and compassion meditation (LKM/CM) in patients with borderline personality disorder. Patients were allocated to LKM/CM or mindfulness continuation training (control group). Patients in the LKM/CM group showed greater changes in Acceptance compared with the control group. Remarkable changes in borderline symptomatology, self-criticism and self-kindness were also observed in the LKM/CM group. Mechanistic explanations and therapeutic implications of the findings are discussed. HIGHLIGHTS: Three weeks of loving-kindness and compassion meditations increased acceptance of the present-moment experience in patients with borderline personality disorder. Significant improvements in the severity of borderline symptoms, self-criticism, mindfulness, acceptance and self-kindness were observed after the LKM/CM intervention. LKM/CM is a promising complementary strategy for inclusion in mindfulness-based interventions and Dialectical Behavioural Therapy for treating core symptoms in borderline personality disorder. Copyright © 2016 John Wiley & Sons, Ltd.

Cybersickness. A systematic literature review of adverse effects related to virtual reality.

BACKGROUND: Virtual Reality (VR) uses computer technology to create a simulated environment. VR is a growing technology with promising extensive applications in different areas such as Medicine, entertainment, sports, gaming, and simulation. However, information about VR side effects is still limited. We aimed to identify the most frequent physical side effects caused by VR therapeutic applications. METHODOLOGY: All available full-text articles evaluating VR as a therapeutic intervention and side effects using the Simulator Sickness Questionnaire (SSQ) between 2016 and 2021 were consulted across 4 electronic (Entrez Pubmed, Scopus, Science Direct, and Wiley databases). The methodological quality was assessed using the PEDro scale. RESULTS: Ten out of 55 reviewed articles (18%) met inclusion/exclusion criteria, including a sample of 416 patients, mean age of 24.54 (15-52.6)years old. According to the PEDro scale, two articles (20%) were considered good or excellent. Side effects were reported more frequently with head-mounted displays compared to desktop systems, especially disorientation, followed by nausea and oculomotor disturbances. CONCLUSIONS: Although VR might have positive effects as a therapeutic tool, VR can also cause side events. As in any other therapeutic intervention, it is important to understand the effectiveness and safety before planning a VR intervention using a well-designed scientific methodology.

How to estimate body composition in Huntington's disease. A cross-sectional, observational study using multiple frequencies bioimpedance. / Cómo estimar la composición corporal en la enfermedad de Huntington. Estudio transversal y observacional con bioimpedancia de múltiples frecuencias.

INTRODUCTION: Huntington´s disease (HD) is a rare neurodegenerative disorder. Reliable information about nutritional status, especially body composition from individuals with HD is critical for clinical care and research. The ease of application and portability of multiple frequencies bioelectrical impedance analysis (mfBIA) make it an attractive tool for measuring body composition, but its accuracy in HD is unknown. AIM: To evaluate the accuracy of mfBIA vs. Dual X-ray absorptiometry (DEXA) in HD. PATIENTS AND METHODS: Cross-sectional, observational, and single-center study. HD severity was measured using motor subscale of the unified Huntington´s disease rating scale (m-UHDRS) and the total functional capacity (TFC). Body composition was measured in terms of fat-free mass (FFM), fat mass (FM), fat-free mass index (FFMI), and fat mass index (FMI). Using Bland-Altman plots, we analyzed reliability between DEXA and mfBIA using the Intraclass Correlation Coefficient with 95% confidence intervals (CI) and bias estimates for all. RESULTS: We included 16 patients with HD, 7 men, and 9 women, median age of 58.5 (32;68) years, TFC: 10 (3;13), and m-UHDRS: 31 (7;85). The reliability between mfBIA and DEXA were high for FFMI in men: 0.88 (95% CI 0.17-0.98), and women: 0.90 (95% CI 0.61- 0.98); for FMI, men: 0.97 (95% CI 0.83-0.99), and women: 0.91 (95% CI 0.68-0.98). Compared to DEXA, mfBIA slightly overestimated FFM, FM, FMI and FFMI in men and underestimated FFMI in women. CONCLUSIONS: mfBIA is an easy-to-use, safe, non-invasive, accurate method for measuring body composition and nutritional status in patients with mild-moderate HD.

TITLE: Cómo estimar la composición corporal en la enfermedad de Huntington. Estudio transversal y observacional con bioimpedancia de múltiples frecuencias.Introducción. La enfermedad de Huntington (EH) es un trastorno raro neurodegenerativo. La información fiable del estado nutricional, especialmente de la composición corporal, es crítica en clínica y en investigación. La facilidad de aplicación y portabilidad del análisis de la bioimpedancia de múltiples frecuencias (mfBIA) la convierten en una herramienta atractiva para medirla, pero se desconoce su precisión en la EH. Objetivo. Evaluar la precisión del mfBIA frente a la absorciometría dual de rayos X (DEXA) en la EH. Pacientes y métodos. Estudio transversal, observacional y unicéntrico. La EH se midió con la subescala motora de la escala unificada de valoración de la EH y con la capacidad funcional total. La composición corporal se valoró según la masa libre de grasa (MLG), la masa grasa (MG), el índice de masa libre de grasa (IMLG) y el índice de masa grasa (IMG). Se utilizó el coeficiente de correlación intraclase con intervalos de confianza al 95% y estimaciones de sesgo mediante gráficos de Bland-Altman. Resultados. Se incluyó a 16 pacientes, siete hombres y nueve mujeres, con edad media de 58,5 (32-68) años, capacidad funcional total de 10 (3-13) y escala unificada de valoración de la EH de 31 (7-85). La fiabilidad era alta entre el mfBIA y la DEXA para el IMLG en hombres, 0,88 (intervalo de confianza al 95%: 0,17-0,98), y mujeres, 0,9 (intervalo de confianza al 95%: 0,61-0,98); y para el IMG en hombres, 0,97 (intervalo de confianza al 95%: 0,83-0,99), y mujeres, 0,91 (intervalo de confianza al 95%: 0,68-0,98). El mfBIA sobreestimó ligeramente la MLG, la MG, el IMG y el IMLG en los hombres, pero subestimó el IMLG en las mujeres. Conclusiones. El mfBIA es un método fácil de usar, seguro, no invasivo y preciso para medir la composición corporal y el estado nutricional en pacientes con EH leve-moderada.

Validation of ActiGraph and Fitbit in the assessment of energy expenditure in Huntington's disease.

BACKGROUND: Consumer and research activity monitors have become popular because of their ability to quantify energy expenditure (EE) in free-living conditions. However, the accuracy of activity trackers in determining EE in people with Huntington's Disease (HD) is unknown. RESEARCH QUESTION: Can the ActiGraph wGT3X-B or the Fitbit Charge 4 accurately measure energy expenditure during physical activity, in people with HD compared to Indirect Calorimetry (IC) (Medisoft Ergo Card)? METHODS: We conducted a cross-sectional, observational study with fourteen participants with mild-moderate HD (mean age 55.7 ± 11.4 years). All participants wore an ActiGraph and Fitbit during an incremental test, running on a treadmill at 3.2 km/h and 5.2 km/h for three minutes at each speed. We analysed and compared the accuracy of EE estimates obtained by Fitbit and ActiGraph against the EE estimates obtained by a metabolic cart, using with Intra-class correlation (ICC), Bland-Altman analysis and correlation tests. RESULTS: A significant correlation and a moderate reliability was found between ActiGraph and IC for the incremental test (r = 0.667)(ICC=0.633). There was a significant correlation between Fitbit and IC during the incremental test (r = 0.701), but the reliability was poor at all tested speeds in the treadmill walk. Fitbit significantly overestimated EE, and ActiGraph underestimated EE compared to IC, but ActiGraph estimates were more accurate than Fitbit in all tests. SIGNIFICANCE: Compared to IC, Fitbit Charge 4 and ActiGraph wGT3X-BT have reduced accuracy in estimating EE at slower walking speeds. These findings highlight the need for population-specific algorithms and validation of activity trackers.

Pharmacogenetics in the Treatment of Huntington's Disease: Review and Future Perspectives.

Huntington's disease (HD) is an autosomal dominant progressive brain disorder, caused by a pathological expansion of a CAG repeat that encodes the huntingtin gene. This genetic neurodegenerative rare disease is characterized by cognitive, motor, and neuropsychiatric manifestations. The aim of the treatment is symptomatic and addresses the hyperkinetic disorders (chorea, dystonia, myoclonus, tics, etc.) and the behavioural and cognitive disturbances (depression, anxiety, psychosis, etc.) associated with the disease. HD is still a complex condition in need of innovative and efficient treatment. The long-term goal of pharmacogenetic studies is to use genotype data to predict the effective treatment response to a specific drug and, in turn, prevent potential undesirable effects of its administration. Chorea, depression, and psychotic symptoms have a substantial impact on HD patients' quality of life and could be better controlled with the help of pharmacogenetic knowledge. We aimed to carry out a review of the available publications and evidence related to the pharmacogenetics of HD, with the objective of compiling all information that may be useful in optimizing drug administration. The impact of pharmacogenetic information on the response to antidepressants and antipsychotics is well documented in psychiatric patients, but this approach has not been investigated in HD patients. Future research should address several issues to ensure that pharmacogenetic clinical use is appropriately supported, feasible, and applicable.

Clinical and Epidemiological Profiles of Primary Healthcare Professionals with COVID-19 Infection and Long COVID: An Observational Study.

Health professionals have been one of the groups most affected by the SARS-CoV-2 virus. Currently, there is little scientific evidence on the similarities and differences between COVID-19 infection and the development of long COVID in primary care (PC) workers. Therefore, it is necessary to analyse their clinical and epidemiological profiles in depth. This study was observational and descriptive, including PC professionals who were divided into three comparison groups based on the diagnostic test for acute SARS-CoV-2 infection. The responses were analysed using descriptive and bivariate analysis to examinate the relationship between independent variables and the presence or not of long COVID. Binary logistic regression analysis was also conducted, with each symptom as the dependent variable and each group as the independent variable. The results describe the sociodemographic characteristics of these population groups, revealing that women in the health sector are the most affected by long COVID and that being in this group is associated with its development. Furthermore, individuals with long COVID exhibited the highest number of symptoms and pathologies. Certain symptoms were found to be associated with long COVID development in this population, including an altered sense of smell, pneumonia, fever, and sore throat, among others. Similarly, altered senses of smell and taste, chest tightness, and joint pain, among others, were found to be associated with acute COVID-19 infection. Additionally, patients with pre-existing overweight or obesity were more likely to experience acute COVID-19 and develop long COVID. The data obtained can be crucial for improving the detection, diagnosis, and treatment of long COVID patients, ultimately leading to an enhancement in their quality of life.

Long COVID Symptomatology and Associated Factors in Primary Care Patients: The EPICOVID-AP21 Study.

Persistent COVID-19 condition includes a wide variety of symptoms and health problems of indeterminate duration. The present study examined the sociodemographic and clinical characteristics of the population with Long COVID seen in Primary Care using a questionnaire based on the existing scientific literature. It was an observational and descriptive study of the characteristics of the Spanish population with Long COVID over 14 years of age. The responses were analysed by means of a descriptive analysis of the variables recorded, in addition to a bivariate analysis to determine the existence of a relationship between persistent COVID-19 and variables such as gender, age, vaccination status or concomitant pathology. The results obtained clearly describe the sociodemographic characteristics of the population, highlighting the predominance of female gender and the prevalence of tiredness and fatigue. Furthermore, relevant information was obtained on the differences in symptomatology according to gender, age, previous pathologies and alterations derived from infection and/or vaccination. These data are important for better detection, diagnosis and treatment of Long COVID and the improvement of the quality of life of this population.

How can I assess my patients with Parkinson's disease during a busy clinic day?

BACKGROUND: The evaluation of motor impairment in Parkinson's disease (PD) is mainly assessed with the motor subdomain of the Unified Parkinson's Disease Rating scale (UPDRS part III) and, lately, with the MDS-UPDRS part III. To optimize efforts and special needs during specific circumstances in clinical practice, we sought to identify the most sensitive items to assess motor impairment in PD. METHODS: We included the COPPADIS-PD cohort and collected the UPDRS part III at baseline (V0), 12 months (V1), and 24 months (V2). Factor analysis and effect size using Cohen's d formula were performed in the Off and On states at V0, V1, and V2. RESULTS: We included 667 patients with PD, mean age of 62.59 ± 8.91 years, 410 (60.2%) males, with a median HY stage of 2.00 (1.00; 4.00) at baseline. Over time, the most discriminating items were postural stability and body bradykinesia ("arise from chair" and "gait") in the Off state, right and left upper extremity bradykinesia ("finger tap", "hand movements" and "prono/supination") in the On state. Body bradykinesia and right-left finger tapping were the items with the largest effect size (0.93, 0.84, 0.83, respectively) to assess motor improvement after receiving antiparkinsonian medications over time. CONCLUSION: Under specific circumstances, selecting a few items of the UPDRS part III, including postural stability, body bradykinesia, and upper extremity bradykinesia, could be used to create a quick clinical judgment of motor status and improvement in PD.

Related Factors with Depression and Anxiety in Mastectomized Women Breast Cancer Survivors.

Breast cancer (BC) is the most common cancer diagnosis with the highest mortality rate worldwide. The aim of this study was to identify factors related to depression and anxiety in mastectomized women BC survivors. A cross-sectional study was conducted with a sample of 198 women diagnosed with BC aged 30-80 years in Mexico. Depression and anxiety were assessed using the 14-item Hospital Anxiety and Depression Scale (HADS). The results showed that 94.44% and 69.18% of the women scored more than eight points on HADS in the anxiety and depression subscales, respectively; 70.20% and 10.60% were identified as pathological. The following variables were analyzed: age, time elapsed since the start of treatment, received treatment at the time of the evaluation, type of surgery, family history, marital status and employment status. Time elapsed since surgery, having a partner, and employment showed significant results as factors associated to levels of depression and anxiety in these patients. In conclusion, it has been shown that BCSs under 50 years of age receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis could have higher rates of clinical depression. On the other hand, BCSs older than 50 years receiving some kind of treatment, without family history, without a partner, with a job, with more than secondary education and with more than 5 years since diagnosis, could have higher rates of clinical anxiety. In conclusion, the variables studied provide valuable information for the implementation of psychotherapy plans in healthcare systems to reduce the risk of depression and/or anxiety in women with BC who have undergone mastectomy.

Quality of Life in Breast Cancer Survivors in Relation to Age, Type of Surgery and Length of Time since First Treatment.

(1) Background: Quality of life assessment is a critical aspect of breast cancer patient outcomes, as diagnosis, prognosis and treatment can have a major impact on quality of life. The aim of this study was to describe the characteristics of the sample and to verify the relationship between quality of life (QOL) in women diagnosed with breast cancer (BC) and their age, type or surgery and time since treatment; (2) Methods: a cross-sectional, descriptive study was conducted with 183 women diagnosed with BC, aged 30−80 years in Mexico. Women's QOL was assessed using two questionnaires, The European Organization for Research and Treatment of Cancer-Quality of Life Core Questionnaire (EORTC QLQ-C30) and The Breast Cancer Module (EORTC QLQ-BR23). (3) Results: the results show significant differences in several items when the variable age is taken into account, indicating that younger women have poorer social and sexual function, as well as poorer sexual enjoyment and lower expectations of the future. The type of surgery also indicates a significantly better QOL in those women who receive conservative treatment versus a mastectomy; the time elapsed since surgery does not show any significant results, except for sexual functioning and breast-related symptoms where >5 years implies better scores on the items. (4) Conclusions: in conclusion, it is important to take into account the characteristics of women with BC, particularly at the time of treatment, in order to mitigate the impact of the disease on their QOL with the help of a multidisciplinary team.

Accelerometer Cut-Points for Physical Activity Assessment in Adults with Mild to Moderate Huntington's Disease: A Cross-Sectional Multicentre Study.

Accelerometers can estimate the intensity, frequency, and duration of physical activity in healthy adults. Although thresholds to distinguish varying levels of activity intensity using the Actigraph wGT3X-B have been established for the general population, their accuracy for Huntington's disease (HD) is unknown. We aimed to define and cross-validate accelerometer cut-points for different walking speeds in adults with mild to moderate HD. A cross-sectional, multicentre, case-control, observational study was conducted with a convenience sample of 13 symptomatic ambulatory HD participants. The accelerometer was placed around the right hip, and a heart monitor was fitted around the chest to monitor heart rate variability. Participants walked on a treadmill at three speeds with light, moderate and vigorous intensities. Correlation and receiver operation curve analyses were performed between the accelerometer magnitude vector with relative oxygen and heart rate. Optimal cut-points for walking speeds of 3.2 km/h were ≤2852; 5.2 km/h: >2852 to ≤4117, and in increments until their maximum velocity: >4117. Our results support the application of the disease-specific cut-points for quantifying physical activity in patients with mild to moderate HD and promoting healthy lifestyle interventions.

Cómo estimar la composición corporal en la enfermedad de Huntington. Estudio transversal y observacional con bioimpedancia de múltiples frecuencias / How to estimate body composition in Huntington’s disease. A cross-sectional, observational study using multiple frequencies bioimpedance

Introducción La enfermedad de Huntington (EH) es un trastorno raro neurodegenerativo. La información fiable del estado nutricional, especialmente de la composición corporal, es crítica en clínica y en investigación. La facilidad de aplicación y portabilidad del análisis de la bioimpedancia de múltiples frecuencias (mfBIA) la convierten en una herramienta atractiva para medirla, pero se desconoce su precisión en la EH. Objetivo Evaluar la precisión del mfBIA frente a la absorciometría dual de rayos X (DEXA) en la EH. Pacientes y métodos Estudio transversal, observacional y unicéntrico. La EH se midió con la subescala motora de la escala unificada de valoración de la EH y con la capacidad funcional total. La composición corporal se valoró según la masa libre de grasa (MLG), la masa grasa (MG), el índice de masa libre de grasa (IMLG) y el índice de masa grasa (IMG). Se utilizó el coeficiente de correlación intraclase con intervalos de confianza al 95% y estimaciones de sesgo mediante gráficos de Bland-Altman. Resultados Se incluyó a 16 pacientes, siete hombres y nueve mujeres, con edad media de 58,5 (32-68) años, capacidad funcional total de 10 (3-13) y escala unificada de valoración de la EH de 31 (7-85). La fiabilidad era alta entre el mfBIA y la DEXA para el IMLG en hombres, 0,88 (intervalo de confianza al 95%: 0,17-0,98), y mujeres, 0,9 (intervalo de confianza al 95%: 0,61-0,98); y para el IMG en hombres, 0,97 (intervalo de confianza al 95%: 0,83-0,99), y mujeres, 0,91 (intervalo de confianza al 95%: 0,68-0,98). El mfBIA sobreestimó ligeramente la MLG, la MG, el IMG y el IMLG en los hombres, pero subestimó el IMLG en las mujeres. Conclusiones El mfBIA es un método fácil de usar, seguro, no invasivo y preciso para medir la composición corporal y el estado nutricional en pacientes con EH leve-moderada. (AU)

INTRODUCTION Huntington´s disease (HD) is a rare neurodegenerative disorder. Reliable information about nutritional status, especially body composition from individuals with HD is critical for clinical care and research. The ease of application and portability of multiple frequencies bioelectrical impedance analysis (mfBIA) make it an attractive tool for measuring body composition, but its accuracy in HD is unknown. AIM To evaluate the accuracy of mfBIA vs. Dual X-ray absorptiometry (DEXA) in HD. PATIENTS AND METHODS Cross-sectional, observational, and single-center study. HD severity was measured using motor subscale of the unified Huntington´s disease rating scale (m-UHDRS) and the total functional capacity (TFC). Body composition was measured in terms of fat-free mass (FFM), fat mass (FM), fat-free mass index (FFMI), and fat mass index (FMI). Using Bland-Altman plots, we analyzed reliability between DEXA and mfBIA using the Intraclass Correlation Coefficient with 95% confidence intervals (CI) and bias estimates for all. RESULTS We included 16 patients with HD, 7 men, and 9 women, median age of 58.5 (32;68) years, TFC: 10 (3;13), and m-UHDRS: 31 (7;85). The reliability between mfBIA and DEXA were high for FFMI in men: 0.88 (95% CI 0.17-0.98), and women: 0.90 (95% CI 0.61- 0.98); for FMI, men: 0.97 (95% CI 0.83-0.99), and women: 0.91 (95% CI 0.68-0.98). Compared to DEXA, mfBIA slightly overestimated FFM, FM, FMI and FFMI in men and underestimated FFMI in women. CONCLUSIONS mfBIA is an easy-to-use, safe, non-invasive, accurate method for measuring body composition and nutritional status in patients with mild-moderate HD. (AU)

Morphine potentiates the impairing effects of neuroleptics on two-way active conditioned avoidance response in male mice.

The dopaminergic and opioid systems have effects on the conditioned avoidance response (CAR), although the possible interaction between these systems on this behaviour has not been studied. The effects of morphine (12.6 mg/kg), haloperidol (0.075 mg/kg), sulpiride (20 mg/kg) and risperidone (0.1 mg/kg) alone as well as morphine combined with these dopamine (DA) antagonists on the acquisition and performance of the CAR were explored in mice. Morphine increased avoidances but this seemed secondary to a rise in activity levels. All DA antagonists impaired CAR in the acquisition phase but only haloperidol disrupted performance. The combination of morphine plus neuroleptics impaired acquisition and performance of CAR. These results suggest that morphine disrupts the learning of CAR and that the classical neuroleptic haloperidol profoundly impairs acquisition and performance of CAR to a greater degree than atypical neuroleptics such as sulpiride and risperidone. Finally, it is concluded that morphine potentiates the impairing effects of DA antagonists on CAR.

La conciencia humana: integración y complejidad / Human consciousness: Integration and Complexity

El propósito de este trabajo es contribuir a la confección de modelos de la conciencia que sean compatibles tanto con los conocimientos psicológicos como con los datos neurofisiológicos disponibles. Comenzamos describiendo el modelo de Edelman, en el que se postula la existencia de dos tipos de conciencia: la conciencia primaria, que sería común a muchas especies animales y que permite la creación de una "escena" representativa del momento presente; y la conciencia de orden superior, privativa de los seres humanos y en la que aparece la noción del yo y la memoria simbólica en forma de lenguaje. Se describe, asimismo, la maquinaria neurológica propuesta para sustentar ambos tipos de conciencia y se tratan algunos de los dilemas que surgen al considerar la relación entre ambas, especialmente entre el lenguaje y la conciencia primaria. Tomando como base el modelo de Edelman, se analizan aspectos clave de la conciencia humana como son nuestra potente capacidad modeladora de la realidad, tanto espacial como temporal, y los procesos implicados en la toma de decisiones, así como su posible sustrato neurofisiológico. Por último, se recoge la nueva hipótesis de Tononi y Edelman (hipótesis del núcleo dinámico) en la que se plantea una explicación de la conciencia en términos de integración y de diferenciación, hipótesis que es capaz de sustentar, a nivel neurofisiológico, la complejidad fenomenológica de las funciones estudiadas. (AU)

Human Consciousness: Integration and Complexity. The purpose of this paper is to contribute to developing models of consciousness that integrate both psychological and neurophysiological data in the field of conscious experience. It begins by introducing the model of Edelman, which postulates two kinds of consciousnes: «Primary consciousness», common to several animal species, allows us to create a «scene» of things of the world which is limited to the present moment; and «Higher-order consciousness», existing only in humans, involves the notion of self and the phylogenetic appearance of language as a symbolic memory. The neurological outfit postulated for these types of consciousness is described succintly and some questions arising when considering the relationship between the two are dealt with, specially between language and primary consciousness. Taking Edelman’s model as a starting point, some key aspects of human consciousness are commented upon, such as its powerful ability to build spatial as well as temporal models of reality and the process of decision making, with their presumed neurophysiological substrates. Finally, the recent hypothesis of the «dynamic core» (by Tononi and Edelman) is presented. It tries to explain consciousness in terms of integration and differentiation in the nervous system, a hypothesis which seems, at the neurophysiological level, to be able to account for the phenomenological complexity of the functions that have been previously specified (AU)

La deuda emocional / Emotional debt

El cerebro humano es capaz de generar respuestas emocionales no sólo ante estímulos sensoriales del mundo externo, sino también ante imágenes producidas por la fantasía. Estas imágenes virtuales evocan emociones perfectamente reales y con efectos fisiológicos en el organismo que, además, incitan al sujeto a comprometerse consigo mismo en obtener (o en rehuir), en el futuro, aquel objeto que suscita la emoción. Este compromiso se denomina aquí "deuda emocional". La deuda emocional suele entrañar una sobrevaloración afectiva del objeto imaginado, susceptible de provocar comportamientos inadecuados en el presente y de convertirse, a largo plazo, en fuente de sufrimiento y de estrés crónico. Las deudas emocionales, sin embargo, también pueden ser saldadas definitivamente, proceso que conlleva importantes efectos terapéuticos, como sucede en el perdón. Incluso, es posible no asumir deuda emocional alguna, lo que implica un importante cambio cualitativo (y un estadio posiblemente más avanzado) en el funcionamiento de la mente humana (AU)

The human brain is capable of reacting with emotional responses to stimuli coming both from the external world and from internal representations produced by imagination. These virtual images can elicit perfectly real emotions with physiological effects in the organism. A typical result of these emotions is that the subject commits him/herself to obtain or avoid the object that evoked the emotion. Such commitment is described here as ‘emotional debt’. Emotional debt involves the overestimation of an illusory reality, bringing about maladjusted behaviors in the present and giving rise in the long term to moral suffering and chronic stress. Canceling an emotional debt is a real possibility that produces therapeutic effects (as is the case in forgiveness). It is even possible to avoid any emotional debt at all, which implies an important change (and a further developmental stage) in the functioning of the human mind (AU)

Las trampas de la imaginación / The snares of Imagination

La existencia de una imaginación exuberante en la especie humana (es decir, la potente capacidad cerebral una realidad virtual) plantea al menos dos cuestiones básicas. Por un lado, la necesidad de que el sistema nervioso disponga de mecanismos que le permitan distinguir entre realidad y fantasía. Por otro, la aparición relativamente reciente, en términos evolutivos, de esta capacidad imaginativa supone un reto para el funcionamiento de unos mecanismos emocionales que son de origen mucho más antiguo. Éstos se encuentran ante el dilema de cómo reaccionar frente a una serie de imágenes que, aunque originadas en el cerebro al igual que las que reproducen los objetos del mundo externo, no se corresponden con la realidad del mundo externo. En este artículo se exponen dos mecanismos implicados en la solución de este dilema: el mecanismo de los qualia y la conciencia de la propia actividad mental. El autor desarrolla especialmente este segundo mecanismo y presenta el funcionamiento diferenciado de la conciencia en dos formas distintas: la conciencia ligada y la conciencia desligada del acontecer. La diferencia fundamental entre ellas estriba precisamente en si las emociones se orientan hacia estímulos imaginados. El ser humano puede elegir entre uno y otro funcionamiento de su conciencia y de esa elección se siguen consecuencias de largo alcance para la vida humana (AU)

Two basic problems are posed by the existence of a powerful imagination (the mental capacity to create virtual realities) in human beings: The nervous system needs a mechanism to differentiate the real from the virtual reality and on the other hand, the relatively recent evolutionary appearance of imagination may interfere with the function of the much older emotional mechanisms. These face the challenge of how to react to images produced by the brain, like those of external reality, but which are not external reality at all. This paper discusses two mechanisms by which these problems may be (partially) solved: the qualia and the consciousness of our own mental activity. The author focuses on the second mechanism and introduces two distinct forms of consciousness: reality-bound and reality-unbound consciousness. Their fundamental difference is that emotions, in the first case, are directed towards «real» reality, whereas in the second, are driven by virtual reality. Humans can choose between these two operating modes and this choice has far-reaching consequences for their lives (AU)

El ego, la conciencia y las emociones: un modelo interactivo / Ego, consciousness and emotions: an interactive model

En este artículo se presenta un modelo de funcionamiento mental utilizando como protagonistas a tres de las instancias mentales clásicas: el ego, a conciencia y las emociones. Tras exponer brevemente cómo concibe el autor cada uno de estos tres constructos, se exponen dos versiones distintas de cómo posiblemente interactúan entre sí. La primera responde a la forma de funcionamiento más habitual en nuestro entorno social occidental. La segunda tiene su máxima representación en la tradición meditativa oriental, aunque también se encuentra presente en las tradiciones místicas de todo tipo, incluidas las occidentales. La esencia de esta forma alternativa de funcionamiento mental consistiría en que la primera forma de funcionamiento, se truncaría en esta segunda modalidad. Surge así una nueva forma de relación de la conciencia con el complejo emociones-ego, en virtud de la cual la conciencia queda liberada de su habitual y estricta dependencia de este complejo, abriendo así las puertas de la experiencia humana a todo un universo de vivencias inexploradas (AU)

In this paper, a model of mental processing is presented using as protagonists three of the classic mental instances: ego, consciousness and emotions. After briefly expounding the author’s conception of each of these three constructs, two different versions of their possible interaction are outlined. The first corresponds to the most usual working mode in our western cultural setting. The second finds its maximum representation in the oriental tradition of meditation, though it is also present in mystical traditions of all types, including those of the West. The essence of this alternative form of mental functioning consists of breaking the habitual identification of consciousness with ego and emotions, which is characteristic of the first mode. In this way, a new form of relationship between consciousness and the ego-emotions complex arises, by virtue of which consciousness is freed from its habitual strict dependence on this complex, so opening up a whole universe of unexplored human experience (AU)