Clinica Y Salud最新文献

In the past, the practice of symptom validity assessment (SVA) in European countries was considerably lagging behind developments in North America, with the topic of malingering being largely taboo for psychological and medical professionals. This was being changed in the course of the past decade with a growing interest in methods for the assessment of negative response bias. European estimates of suboptimal test performance in civil and social forensic contexts point at base rates similar to those obtained in North America. Symptom over-reporting and underperformance in neuropsychological examinations appear to occur in a sizable proportion of patients. Although there is considerable progress in establishing SVA as an integral and indispensable part of psychological and neuropsychological assessment in some countries, others appear to lag behind. In some countries there is still enormous resistance against SVA from part of the neuropsychological and psychiatric communities.

Introduction

Although international literature has demonstrated the usefulness of different traditional neuropsychological verbal memory indexes to detect malingered cognitive deficits, no study has been conducted in Spain with such a purpose yet.

Methodology

The present study included 84 patients divided into four groups: three groups of mild traumatic brain injury patients (30 patients who do not request an economic compensation, 14 participants who requested an economic compensation but are not suspected of malingering, and 10 participants suspected of malingering according to different malingering tests), and a group of 30 analogues. All participants completed an extensive neuropsychological battery including the Test de Aprendizaje Verbal España Complutense (Spanish version of the California Verbal Learning Test) and several malingering tests (Victoria Symptom Validity Test, Test of Memory Malingering, Dot Counting Test, the b Test and the Rey 15-item Test).

Results

Significant differences were found between the groups of the study for all indexes, with large effect sizes. With a specificity of at least 90%, some of the indexes from the TAVEC showed adequate sensitivity to detect malingering: total number of words recalled in the five trials, short-term memory, and recognition, which obtained a sensitivity of 50%, long-term memory (40%), and discriminability index (60%).

Conclusions

Some of the TAVEC indexes demonstrated efficacy in detecting malingering. However, they should never be employed or interpreted in isolation.

This study was aimed at analyzing the psychological profile of essential hypertension (EHT) concerning the following emotional constructs: trait anger, anger expression and control, anxiety, depression, stress, and, as a novelty in comparison with previous scientific literature, automatic thoughts and dysfunctional attitudes related to anger-hostility. To do that, a group of 57 adults with sustained EHT was compared with a group of 37 adults with normotension on a variety of psychometric measures of those emotional and cognitive constructs. Results suggest that people with EHT, in comparison with normotensive, show significantly higher levels of anxiety and anger-hostility coping thoughts as well as an almost significant trend toward a higher frequency of hostile and physically aggressive thoughts. Implications of these findings for psychological models of EHT and for the design and improvement of psychological interventions in EHT are discussed.

This paper presents a first descriptive approach to the study of instructions in therapy as a previous step to a more comprehensive research about the influence of instructions on therapeutic adherence. Two cases treated by two behavioral therapists were analyzed throughout the treatment –one of them was an experienced therapist and the other was inexperienced one. The sessions were observed and registered with a specific coding system and The Observer XT software. Data highlight the differences in frequency and type of instructions depending on the tasks carried out by the therapists, as well as on their experience. Results provide some first hypotheses (to be proved) about the existence of different patterns of therapist instructions during the psychological treatment and allow us to establish some bases for the study of the influence of instructions on therapeutic adherence which may improve the effectiveness of psychological interventions.

The practice of relaxation may be an effective strategy for coping with stress during the pregnancy period, a stage of physical and emotional changes that requires adaptations. The objective was to evaluate the effects of the regular practice of a relaxation technique in pregnant women on emotional and physical variables: stress, anxiety, depression, heart rate (HR), and blood pressure (BP). Sample: 46 pregnant women, aged between 18 and 38 years, and living in Portugal. Method: These women were divided into two groups, experimental and control. The experimental group received, between the 2nd and the 8th month of pregnancy a total of twenty to twenty five individual sessions of visualization and progressive relaxation. To evaluate the effectiveness of the intervention, HR and BP was measured pre-and posttreatment, as well as anxiety, depression, and stress, using EADS-21. The results demonstrate the effectiveness of the intervention on the variables assessed.

Since the 60's, pupil reactivity has been used in Psychology as a psychophysiological index of cognitive and emotional processing. In this paper, we provide a brief review from early and controversial studies focused on studying the effect of different types of stimuli on pupil size to the latest research that has used this index as a measure of affective processing in different psychological disorders. We also review studies that link mental activity or cognitive load with pupil dilations. We discuss the clinical implications of the use of this simple psychophysiological index.

The present study evaluates the effects of the estrous cycle on activity-based anorexia by identifying the successive phases of the estrous cycle of female rats before, during, and after exposure to the experimental conditions. Activity-based anorexia is established when rats are exposed to a restricted-feeding schedule (1 hour) while having free access to a running wheel (23 hours). Under these conditions rats quickly lose bodyweight, reduce food consumption, and gradually increase their levels of activity on the running wheel. Recent data show that food restriction and the increase of activity interrupt the estrous cycle and that hormonal factors affect the activity level and food consumption of female rats during some phases of the estrous cycle. Results showed increased activity and greater weight loss in females compared to males though during feeding time there were no differences in food and water consumption. Males and females recovered their initial bodyweight after the procedure. Females showed anticipatory activity before eating and their estrous cycles were disturbed during the experimental phase.

Dependent care tasks deser ve a special study and attention because of being a health risk factor. That is the reason why we analyzed the effects of working as a family caregiver and of attending a stress management workshop and the impact of two relevant covariables, i.e., dysfunctional thoughts and the time spent providing care. We analyzed a sample of 219 participants attending psychoeducational workshops. Three instruments were applied: A socio-demographic questionnaire, the General Health Questionnaire (GHQ28), and the Dysfunctional Thoughts Questionnaire (CPD). Univariate analysis showed that working as a family caregiver has a negative impact (p < .001) on all GHQ scales and that attending a stress management workshop has a positive effect (p < .05) on general health, somatization and social function. Furthermore, covariance analysis showed that the effects of working as a caregiver and attending a stress management workshop remained significant even when the two covariables (dysfunctional thoughts and time providing care) were considered.

This article reviews what information needs to be gathered to carry out the functional analysis of a clinical case, what the scientific characteristics of this information are, how to integrate available information, and how to graphically represent clinical judgments to make treatment decisions. Functional analysis is the integration of important, modifiable, causal variables and causal relations associated with a client's behavior problems and intervention goals. We present a clinical case to illustrate the applications of behavioral assessment methods and to show how data obtained in the assessment process can be integrated into a functional analysis. Functional Analytic Clinical Case Diagrams (FACCD), which are causal diagrams of a functional analysis, are also introduced. The functional analysis and FACCD are designed to efficiently communicate the functional analysis to others, as an aid in teaching case formulations, and to assist in selecting the most beneficial intervention focus with a client. The functional analysis is a dynamic, hypothesized, idiographic clinical case formulation. The validity of a functional analysis can be confined to particular settings or contexts.

Two male children with Fragile X Syndrome with full mutation received treatment at CADIT: the Children's Center for Early Intervention and Development in Spain. The study's main objective was to examine a comprehensive description of two FXS cases that serve to increase the knowledge about the syndrome characteristics and to recognize the importance of an individualized evaluation of children with this kind of syndrome, given the heterogeneity that exists within this syndrome; secondly, to evaluate the effectiveness of the work done in these centers, in particular in the language and cognitive areas, we discovered that although it is important to intervene in these areas, most of the needs are centered on the motor and autonomy areas.