Clinica Y Salud最新文献

Clinical symptoms of anxiety and depression as well as cognitive impairment determine the quality of life of patients with brain tumors (Liu, Page, Solheim, Fox, & Chang, 2009). The aim of this paper is to analyze the quality of life and its relationship to psychological variables in individuals diagnosed with glioma six months earlier. The sample consisted of 28 patients (58.6% male) with a mean age of 54.38 and 89.2% of them receiving adjuvant therapy (chemotherapy). All subjects were administered a neuropsychological battery assessing quaility of life, anxiety and depression, attention, memory, language, visuoconstructive skills, visual organization, language, and executive functions. These patients have a worse quality of life in certain dimensions (physical, functional, family) and overall perception of well-being. All areas of quality of life are associated with mood and the presence of clinical manifestations of depression accounts for a lower quality of life. On the other hand, improved cognitive performance in object recognition processes, memory, and planning indicates a higher overall quality of life of these patients.

Looking after an elderly relative with dementia is associated with negative emotional consequences for caregivers. The present paper describes a cognitive-behavioral therapy (CBT) and an acceptance and commitment therapy (ACT) that were designed to reduce emotional distress in the caregiver. The objective of CBT is to modify dysfunctional beliefs and thoughts related to caregiving and to train caregivers to increase the frequency of gratifying activities; it also includes training in relaxation and in skills for seeking help. ACT involves working in particular on three aspects: on the identification of the caregiver's personal pattern of experiential avoidance and the alternative of acceptance of emotions, thoughts and feelings; on helping caregivers to identify their values and the barriers to acting in coherence with them; and on increasing caregivers’ motivation to commit themselves to their values and perform actions and activities coherent with those values.

Unpleasant irrelevant events are known to negatively affect our capacity to maintain neutral but task- relevant information in working memory (WM). In parallel, anxiety biases our attentional responses to those stimuli that may be potentially threatening in order to adaptively enhance their detection and assessment. In this study, we investigated differences between healthy anxious and non-anxious volunteers while they performed a WM task in which neutral and unpleasant pictures were presented as distractors. Our results revealed that state anxiety could increase the interfering effect of neutral but not unpleasant distractors. These findings are discussed in regard to previous studies suggesting that anxiety and acute stress can decrease the level of specificity in the vigilance mechanism that serves to optimize the detection and evaluation of threats.

In recent years, the addictive processes and more specifically Alcohol Use Disorders (AUD) have been studied using different neuropsychological and neurophysiological approaches, including the Startle Response (SR) and the Prepulse Inhibition (PPI). In this article we present the results of three studies carried out by our group. The first study included 19 male patients who had alcohol dependence and were detoxified for a period of 10-14 days, undergoing testing for SR and PPI at baseline and after the detoxification treatment. The second study included 60 abstinent alcoholic men who had been abstinent for more than a month and who were compared with healthy controls. The sample of the third studied included 40 alcohol dependent men, who proceeded from study 2, and who were assessed with laboratory impulsivity paradigms after having been tested on SR and PPI. Our studies have found that alcohol dependent patients exhibit a reduced magnitude of the SR and impairments in the PPI compared to healthy controls. Impairments in the PPI are even more evident when the subject is actively consuming alcohol and during early detoxification, and tend to partially improve after the detoxification process is successfully completed, although percentages of PPI do not reach the levels of healthy controls. Finally, we found that variables of the SR and variables of impulsivity were correlated in abstinent alcohol dependent patients, but not in controls. In conclusion, SR and PPI could be useful tools for the assessment of patients with alcohol dependence. They could either be considered as vulnerability markers for the development of alcohol or be an index of alcohol neurotoxicity in the central nervous system.

The present article presents the data from an experimental research with the primary goal of exploring the presence of memory bias in participants with high levels of evaluation anxiety in comparison with a group with low evaluation anxiety, as measured by the F1 factor of the Anxiety Situations and Responses Inventory (Miguel-Tobal & Cano-Vindel, 2002). For this purpose, an experimental task based on the conception of explicit memory was carried out, specifically a free recall test, cuing the beginning of words, using words with evaluation anxiety content versus neutral words. The results and their clinical implications, as well as the limitations in the experimental study concerning the processing of threatening information, are discussed.

Some psychological theories about persecutory delusions emphasize the importance of the concepts of self and others (Bentall, Corcoran, Howard, Blackwood, & Kinderman, 2001). However, results are inconsistent, in part due to an almost exclusive usage of explicit measures focusing on self-esteem. Freeman (2007) has proposed that evaluative beliefs about self and others are a more stable indicator and a better predictor than self-esteem. Then, this study explored the differences in the explicit and implicit conception of self and others between patients with paranoia (n = 79), depression (n = 38), and a healthy control group (n = 52). The results showed that at the explicit level clinical groups had more negative evaluative beliefs about the self than controls, but there were no differences in evaluative beliefs about others between groups. Only the depression group showed a significantly more negative self than others. At implicit level, although patients had a more negative self than controls, these differences were not significant. There were no differences between groups in implicit indexes of others either. However, the control group presented an implicit pattern opposite to the explicit one, in which the index of others was significantly more negative than the index self. This study highlights the importance of exploring self together with the concept of others at different dimensions of processing.

The aim of this research is to study sensitivity to reward and punishment patterns in a learning and their relation to different personality dimensions in a sample of 81 female victims of intimate partner violence. Sensitivity to reward and punishment, positive and negative affection, impulsivity and personality of the participants are all evaluated through self-report evidence. In order to assess the impact upon learning, an emotional reversal learning task is performed. The ANOVA (analysis of variance) tests that were run show little relationship between self-report measures and what their behavioral correlates should be in the affective reversal learning paradigm, discussing both theoretical and applied implications.

Onset and pathologization of gambling are attributable to the interaction between many individual and contextual factors. Among these, learning processes play a key role. The Neuroscience of Learning has provided evidence at the behavioral, cognitive, and neurobiological levels suggesting that (1) reward sensitivity and gamblers’ vulnerability to the addictive effects of certain reinforcement schedules are linked to anomalies in the functioning of the mesolimbic reward system; (2) feedback-tracking networks implemented in the orbitofrontal cortex and connected structures are involved in decision making anomalies, hyposensitivity to losses, and learning inflexibility, as frequently reported in studies with pathological gamblers; and (3), as it happens in other addictive disorders, anomalies in dorsolateral and dorsomedial structures of cognitive control could be linked to poor planning of alternative behaviors and weakening of the ability to regulate impulses and motivational states, including craving. This evidence justifies a treatment framework based on the rehabilitation of altered functions. With that aim in mind, we propose the integration of customary cognitive- behavioral therapy (CBT) techniques for reduction of incentive salience, craving reduction and control, and improvement of planning and inhibition functions. In addition, behavioral economics’ techniques are proposed to boost reward sources beyond monetary and gambling-related rewards, and implementation of simulated gambling to train the individual in rational win/loss accounting. The use of these techniques should be guided by an adequate characterization of patient's idiosyncratic vulnerabilities.

The goal of the present study is to explore the relation between parents’ anxiety and cognitive representations of medication in pediatric treatment of their children, seeking possible differences as a function of gender and age. A total of 1,772 parents of children attended in primary pediatric health care centers of the public health care system of Andalusia, Spain participated in this study. Of the sample, 25.1% were men and 74.9% were women. Negative beliefs about medicines were found to be associated with higher levels of anxiety in parents during primary pediatric health care. Among the variables studied, the beliefs in medication abuse predicted higher levels of anxiety. Intervention initiatives could substantially improve patients and their relatives’ well-being during pediatric consultation, adherence to treatment, and lastly general satisfaction. Findings are discussed with reference to other authors, clinical implications, and the need of future research.