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The efficacy of cognitive-behavioral therapy for panic disorder and agoraphobia (PDA) has been widely demonstrated. The exposure technique is the main component of these programs; interoceptive exposure also plays an important role. The... more
The efficacy of cognitive-behavioral therapy for panic disorder and agoraphobia (PDA) has been widely demonstrated. The exposure technique is the main component of these programs; interoceptive exposure also plays an important role. The virtual reality (VR) program for treating PDA developed by Botella's group can simulate physical sensations in a controlled manner while the user is immersed in the VR environments in the consultation room. These include audible effects, such as rapid heartbeat and panting, as well as visual effects, such as blurry vision, double vision and tunnel vision. This work examines the efficacy of the interoceptive exposure (IE) component in two treatment conditions: 1) VR Interoceptive Exposure Simultaneous Condition (VRIE-sim; N=14), and 2) Interoceptive Exposure Traditional Condition (IET; N=15). Results obtained showed that both treatment conditions significantly reduced the main clinical variables at post-treatment; these results were maintained or even improved at three month follow-up. Simultaneous VR interoceptive and VR external stimuli exposure is a new and effective way to apply PDA treatment.
Research Interests: Medicine, Interoception, Agoraphobia, Virtual Reality, Library and Information Studies, and 15 moreHumans, Computer Simulation, Female, Pubmed, Cognitive Therapy, Male, Panic Disorder, Young Adult, Exposure Therapy, Computer User Interface Design, Middle Aged, Panic, Adult, Public health systems and services research, and HeartBeat
Research Interests: Clinical Psychology, Cognitive Science, Developmental Psychopathology, Eating Disorders, Chronic Pain, and 15 moreAttention, Emotion Regulation, Medicine, Comorbidity, Anxiety, Emotions, Humans, Defense Mechanisms, Mental Disorders, Psychological Trauma, Emotional Regulation, Behavioral Addictions, ANXIETY, Opioid, and Externalization
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Background: Eating disorders (EDs) are serious disorders that significantly affect not only the lives of patients, but also those of their family members who often experience high levels of burden, suffering and helplessness. If, in... more
Background: Eating disorders (EDs) are serious disorders that significantly affect not only the lives of patients, but also those of their family members who often experience high levels of burden, suffering and helplessness. If, in addition to ED, the patient has a personality disorder (PD), the psychological distress experienced by family members can be devastating. However, few treatments have been developed for family members of people with ED and PD. Family Connections (FC) is a programme that has been shown to be effective for family members of people with borderline personality disorder. The overall aims of this work are: (a) to adapt FC for application to family members of patients with BPD-PD (FC: ED-PD); (b) to analyse, in a randomised controlled clinical trial, the efficacy of this programme in a Spanish population, compared to a control condition consisting of treatment as usual optimised treatment (TAU-O); (c) to analyse the feasibility of the intervention protocol; (d)...
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Background Students beginning university are at a heightened risk for developing mental health disorders. Online prevention and early intervention programmes targeting mental health have the potential to reduce this risk, however,... more
Background Students beginning university are at a heightened risk for developing mental health disorders. Online prevention and early intervention programmes targeting mental health have the potential to reduce this risk, however, previous research has shown uptake to be rather poor. Understanding university stakeholders’ (e.g. governing level and delivery staff [DS] and students) views and attitudes towards such online prevention programmes could help with their development, implementation and dissemination within university settings. Methods Semi-structured interviews, focus groups and online surveys were completed with staff at a governing level, university students and DS (i.e. student health or teaching staff) from six European countries. They were asked about their experiences with, and needs and attitudes towards, online prevention programmes, as well as the factors that influence the translation of these programmes into real-world settings. Results were analyzed using themat...
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Introduction Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and... more
Introduction Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD). Aim The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified. Method This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention. Results There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (μ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134);depression, anxiety, and stress (η 2 = 0.087);family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219);and quality of life (η 2 = 0.006), respectively). Conclusions This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.
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Según estudios previos el sentido en la vida está asociado negativamente con la psicopatología, el riesgo de suicido y la inestabilidad emocional en personas con trastornos alimentarios (TA). El objetivo de este estudio fue analizar el... more
Según estudios previos el sentido en la vida está asociado negativamente con la psicopatología, el riesgo de suicido y la inestabilidad emocional en personas con trastornos alimentarios (TA). El objetivo de este estudio fue analizar el papel mediador del sentido de la vida y sus dimensiones en la relación entre la insatisfacción corporal y la sintomatología del TA y aportar pruebas que apoyen un modelo de elaboración del sentido de los trastornos alimentarios (MESTA). 292 personas diagnosticadas con TA (93,5% mujeres) contestaron el “Test de propósito en la vida” (PIL), el “Test de actitudes hacia la comida” (EAT) y el “Cuestionario multidimensional de relaciones entre el cuerpo y el yo” (MBSRQ-AS). Se realizaron análisis de mediación múltiple. El sentido en la vida medió la asociación entre la insatisfacción corporal y la psicopatología del TA. La dimensión de Satisfacción y sentido tuvo un papel mediador mayor. El sentido en la vida podría ser una variable importante en el manteni...
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espanolLas tecnologias de la informacion y la comunicacion (TICs) han supuesto un cambio radical en una diversidad de disciplinas, entre ellas esta la Psicologia Clinica y de la Salud. En la infancia y adolescencia la interaccion con las... more
espanolLas tecnologias de la informacion y la comunicacion (TICs) han supuesto un cambio radical en una diversidad de disciplinas, entre ellas esta la Psicologia Clinica y de la Salud. En la infancia y adolescencia la interaccion con las TICs es frecuente y habitual y se ve facilitada porque son nativos digitales que se identifican de forma natural con los avances tecnologicos. La ultima decada ha supuesto una clara revolucion respecto a la utilizacion de diferentes tecnologias para la aplicacion de tratamientos psicologicos y la promocion de la salud, de manera que se facilite y mejore el aprendizaje de una diversidad de competencias emocionales y conductas saludables en estas poblaciones que estan en continuo proceso de desarrollo y cambio. La orientacion cognitivo-comportamental y los tratamientos psicologicos basados en la evidencia han sido transferidos con exito a las TICs y existen numerosos estudios que lo ponen de manifiesto. El presente articulo aborda una revision de las ...
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Background: Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of... more
Background: Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Treatment at Usual (CBT-TAU) in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether resilience is a predictor of QoL at pre...
Research Interests: Psychology, Clinical Psychology, Resilience, Quality of life, Borderline Personality Disorder, and 10 moreMedicine, Psychological Treatment, Population, Personality Disorder, Root-Mean Square Error, Beck Depression Inventory, Clinical Sciences, Psychological Resilience, Dialectical Behavior Therapy, and Square
Dialectical behavior therapy (DBT) and systems training for emotional predictability and problem solving (STEPPS) are two treatment protocols for people with borderline personality disorder (BPD) that have received important empirical... more
Dialectical behavior therapy (DBT) and systems training for emotional predictability and problem solving (STEPPS) are two treatment protocols for people with borderline personality disorder (BPD) that have received important empirical support. However, their possible differential effectiveness has not yet been studied. The objective of this study is to explore the effectiveness of these two treatment programs. A nonrandomized clinical trial was carried out in which both treatments were applied for six months. The sample consisted of 72 patients diagnosed with BPD. The results indicate that both groups experienced a statistically significant reduction in BPD symptom, emotional regulation, impulsiveness, dissociative experiences, suicidal risk, depression, or anger. However, the DBT condition obtained statistically significant differences in BPD behavioral symptoms and fear of suicide. DBT and STEPPS treatment are effective treatments for participants with BPD, and DBT was more effect...
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Research Interests: Psychology, Clinical Psychology, Brief Psychotherapy, Cognitive Behavioral Therapy, Research Design, and 15 moreDepression, Cognition, Medicine, Behavioral Activation, Humans, Major Depressive Disorder, Female, Cognitive Therapy, Male, Psychological Intervention, Caregivers, Clinical Sciences, Randomized Controlled Trial, Remote Consultation, and indicated prevention
Research Interests: Information Systems, Psychology, Cognitive Psychology, Cognitive Science, Computer Science, and 15 moreHuman Computer Interaction, Web Design, Usability, Accessibility, Web Applications, Usability and user experience, HCI, The Internet, Cognitive Ergonomics, Accesibilidad, Elderly, Usabilidade, Usabilidad, Human centered design, and Computers In Human Behavior
The question of how to quantify insufficient coping behavior under chronic stress is of major clinical relevance. In fact, chronic stress increasingly dominates modern work conditions and can affect nearly every system of the human body,... more
The question of how to quantify insufficient coping behavior under chronic stress is of major clinical relevance. In fact, chronic stress increasingly dominates modern work conditions and can affect nearly every system of the human body, as suggested by physical, cognitive, affective and behavioral symptoms. Since freshmen students experience constantly high levels of stress due to tight schedules and frequent examinations, we carried out a 3-center study of 1,303 students from Italy, Spain and Argentina in order to develop socioculturally independent means for quantifying coping behavior. The data analysis relied on 2 self-report questionnaires: the Coping Strategies Inventory (COPE) for the assessment of coping behavior and the Zurich Health Questionnaire which assesses consumption behavior and general health dimensions. A neural network approach was used to determine the structural properties inherent in the COPE instrument. Our analyses revealed 2 highly stable, socioculturally ...
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... Palacios et al./Treatment ofMental Disorders with Virtual Reality 173 automatic virtual environment (CAVE), that is, high presence (Krijn et al ... ie Gershon, Zimand, Lemos, Rothbaum & Hodges, 2003;... more
... Palacios et al./Treatment ofMental Disorders with Virtual Reality 173 automatic virtual environment (CAVE), that is, high presence (Krijn et al ... ie Gershon, Zimand, Lemos, Rothbaum & Hodges, 2003; Gershon, Zimand, Pickering, Rothbaum & Hodges, 2004; Schneider & Workman ...
Research Interests: Virtual Reality and iOS
Research Interests: Virtual Reality and iOS
The emergence of new shared media, such as the Internet and virtual reality are changing the ways in which people relate, communicate, and live. Health care, and in particular clinical psychology, is one of the areas that could be most... more
The emergence of new shared media, such as the Internet and virtual reality are changing the ways in which people relate, communicate, and live. Health care, and in particular clinical psychology, is one of the areas that could be most dramatically reshaped by these new technologies. To exploit and understand this potential is the overall goal of the "Telemedicine and Portable Virtual Environment in Clinical Psychology"--VEPSY UPDATED--an European Community funded research project (IST-2000-25323, http://www.vepsy.com) whose specific goal is the development of different PC based virtual reality modules to be used in clinical assessment and treatment. In particular the developed modules have been using to address the following pathologies: anxiety disorders; male impotence and premature ejaculation; obesity, bulimia and binge-eating disorders. The chapter details the general technical and clinical characteristics of the developed modules.
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Anxiety as a symptom or disorder is affected by multiple variables such as antecedent events, interpretation of the events, psychological vulnerability, and individual differences in the reaction towards an event. Nowadays,... more
Anxiety as a symptom or disorder is affected by multiple variables such as antecedent events, interpretation of the events, psychological vulnerability, and individual differences in the reaction towards an event. Nowadays, virtual-reality therapy is used as therapeutic tool for patients suffering from some kind of anxiety disorder. In Mexico, the National Survey on Psychiatric Epidemiology [1] informed that anxiety disorders are the most common disorders followed by affective disorders, which are more prevalent in women than in men. Among the different anxiety disorders, the category of specific phobias (7.1%) was the most common. Based on this demand, a collaborative effort between research groups from the University Jaume I in Spain and the National Autonomous University of Mexico (UNAM), initiated a project which purpose was the technological transfer of systems based on virtual reality for the treatment of Fear of Flying to be implemented and evaluated in the Mexican population...
Research Interests: Psychology, Computer Science, Anxiety Disorders, Fear, Medicine, and 15 moreStudies, Anxiety, Virtual Reality, Cross-Cultural Comparison, Library and Information Studies, Population, Humans, Phobias, Pubmed, Cognitive Behavioral Treatment Method, Fear of Flying, Public health systems and services research, ANXIETY, Virtual Reality Exposure Therapy, and Phobic disorders
According to the recent reports presented by IST Advisory Group (ISTAG) the evolutionary technology scenarios in support of the Knowledge Society of the 2010s will be rooted within three dominant trends: (a) Ambient Intelligence, the... more
According to the recent reports presented by IST Advisory Group (ISTAG) the evolutionary technology scenarios in support of the Knowledge Society of the 2010s will be rooted within three dominant trends: (a) Ambient Intelligence, the pervasive diffusion of intelligence in the space around us; (b) B3G, "Beyond 3rd Generation" mobile communication system; (c) Shared Virtual Reality, with the increase of the range, accessibility and comprehensiveness of communications. The convergence of these trends manifests itself as the next frontier of Information and Communication Technologies. This convergence stimulates a change in the way health care is carried out, making it an embodied experiential process in which communication and collaboration of geographically dispersed users may also play a key role. In this special issue we will try to outline this process and its potential for the future of cybertherapy. We suggest that a key role will be played by the attainment of "Im...
Virtual Reality (VR) is a new technology that is having a great impact on various areas of health science. The use of VR is of special interest in the treatment of psychological disorders. Reasonable data exist on the effectiveness of... more
Virtual Reality (VR) is a new technology that is having a great impact on various areas of health science. The use of VR is of special interest in the treatment of psychological disorders. Reasonable data exist on the effectiveness of this technology in the treatment of different anxiety disorders. The present paper explains in detail a psychological program for the treatment of claustrophobia using VR, whose effectiveness has already been demonstrated. (Botella et al.,1998). In addition, we describe the technical aspects of the software and point out several limitations VR still presents in the area of psychological treatment. Color images and video clips are included with the CDROM version.
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This study aggregated data from three randomized control trials to explore the differential efficacy of three forms of exposure therapy, namely, in vivo (iVET), virtual reality (VRET), and augmented reality (ARET), in the treatment of... more
This study aggregated data from three randomized control trials to explore the differential efficacy of three forms of exposure therapy, namely, in vivo (iVET), virtual reality (VRET), and augmented reality (ARET), in the treatment of small animal phobia. Additionally, baseline patient characteristics were used to detect subgroups of patients who showed a differential response to certain treatment modalities. Primary measures were distance covered, anxiety during the behavioral avoidance test (BAT), and overall fear of small animals. A repeated-measures analysis of variance was used to explore the overall treatment effect across the exposure modalities. A cluster analysis and an analysis of moderation were conducted to explore differential response to treatments. The main study finding was that the three treatment conditions were similarly efficacious in the treatment of small animal phobia for all study outcomes. Only for distance covered, our results revealed a tendency for iVET t...
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Individuals with eating disorders might be characterized by lower levels of direct engagement with the eating experience. This study aims to explore similarities and differences in direct experience while eating in four different weight... more
Individuals with eating disorders might be characterized by lower levels of direct engagement with the eating experience. This study aims to explore similarities and differences in direct experience while eating in four different weight conditions and healthy controls (HCs): anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and obesity (OB). : A total sample of 143 women were recruited. Participants were asked to eat an orange slice and write down 10 things about the experience of eating, classifying the focus of these thoughts as either experiential ("direct experience") or analytical ("thinking about"). A direct experience index (DEI) was calculated by dividing the number of times a participant classified an experience as a "direct experience" (the numerator) by the total number of observations. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ) and rated their level of anxiety after the...
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Adjustment Disorder (AjD) is a common and disabling mental health problem. The lack of research on this disorder has led to the absence of evidence-based interventions for its treatment. Moreover, because the available data indicate that... more
Adjustment Disorder (AjD) is a common and disabling mental health problem. The lack of research on this disorder has led to the absence of evidence-based interventions for its treatment. Moreover, because the available data indicate that a high percentage of people with mental illness are not treated, it is necessary to develop new ways to provide psychological assistance. The present study describes a Randomized Controlled Trial (RCT) aimed at assessing the effectiveness and acceptance of a linear internet-delivered cognitive-behavioral therapy (ICBT) intervention for AjD. A two-armed RCT was designed to compare an intervention group to a waiting list control group. Participants from the intervention group will receive TAO, an internet-based program for AjD composed of seven modules. TAO combines CBT and Positive Psychology strategies in order to provide patients with complete support, reducing their clinical symptoms and enhancing their capacity to overcome everyday adversity. Par...
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Transdiagnostic cognitive-behavioral therapy for emotional disorders (ED) has proven to be effective. However, current transdiagnostic treatment protocols address only the regulation of negative affectivity, and they do not include... more
Transdiagnostic cognitive-behavioral therapy for emotional disorders (ED) has proven to be effective. However, current transdiagnostic treatment protocols address only the regulation of negative affectivity, and they do not include treatment components to more directly target the regulation of positive affectivity. In this study, we propose to evaluate the preliminary efficacy and acceptability of a transdiagnostic treatment protocol for ED that includes, as an innovative feature, a specific treatment component to directly upregulate positive affectivity based on positive psychology interventions. A total of 24 participants were randomized to either a transdiagnostic treatment protocol ( n = 12) or a transdiagnostic treatment protocol with an additional component designed to regulate positive affectivity ( n = 12). Participants completed measures of anxiety, depression, positive and negative affectivity, and quality of life, as well as treatment acceptability at pre- and posttreatme...
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Emotional disorders (ED) are among the most prevalent mental disorders. However, less than 50% of people suffering from ED receive the appropriate treatment. This situation has led to the development of new intervention proposals based on... more
Emotional disorders (ED) are among the most prevalent mental disorders. However, less than 50% of people suffering from ED receive the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which tries to address the underlying processes common to ED. Most of these programs focus primarily on down-regulating negative affectivity, rather than increasing strengths and up-regulating positive affectivity. The data suggest the existence of disturbances in positive affectivity in these disorders, and so new interventions focusing on these problems are greatly needed. It is also essential to provide assistance to all the people in need. Information and Communication Technologies can be very useful. This study aims to evaluate the efficacy of a transdiagnostic Internet-based treatment for ED in a community sample. The protocol includes traditional CBT components, as well as a specific component to address posi...
Research Interests: Psychology, Clinical Psychology, Depression, Treatment Outcome, Emotion Regulation, and 15 moreMedicine, Anxiety, Humans, Female, Cognitive Therapy, Male, Emotional Disorders, Psychological Intervention, Clinical Sciences, Mood Disorders, Randomized Controlled Trial, ANXIETY, Clinical Protocols, Internet, and Transdiagnostic
Self-guided internet-based cognitive behavioral therapy (iCBT) has the potential to increase access and availability of evidence-based therapy and reduce the cost of depression treatment. To estimate the effect of self-guided iCBT in... more
Self-guided internet-based cognitive behavioral therapy (iCBT) has the potential to increase access and availability of evidence-based therapy and reduce the cost of depression treatment. To estimate the effect of self-guided iCBT in treating adults with depressive symptoms compared with controls and evaluate the moderating effects of treatment outcome and response. A total of 13 384 abstracts were retrieved through a systematic literature search in PubMed, Embase, PsycINFO, and Cochrane Library from database inception to January 1, 2016. Randomized clinical trials in which self-guided iCBT was compared with a control (usual care, waiting list, or attention control) in individuals with symptoms of depression. Primary authors provided individual participant data from 3876 participants from 13 of 16 eligible studies. Missing data were handled using multiple imputations. Mixed-effects models with participants nested within studies were used to examine treatment outcomes and moderators....
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During life, many personal changes occur. These include changing house, school, work, and even friends and partners. However, the daily experience shows clearly that, in some situations, subjects are unable to change even if they want to.... more
During life, many personal changes occur. These include changing house, school, work, and even friends and partners. However, the daily experience shows clearly that, in some situations, subjects are unable to change even if they want to. The recent advances in psychology and neuroscience are now providing a better view of personal change, the change affecting our assumptive world: (a) the focus of personal change is reducing the distance between self and reality (conflict); (b) this reduction is achieved through (1) an intense focus on the particular experience creating the conflict or (2) an internal or external reorganization of this experience; (c) personal change requires a progression through a series of different stages that however happen in discontinuous and non-linear ways; and (d) clinical psychology is often used to facilitate personal change when subjects are unable to move forward. Starting from these premises, the aim of this paper is to review the potential of virtua...