F. J. Labrador

Stress-management training for essential hypertension: a controlled study.

Forty three patients with essential hypertension participated in a study on the effectiveness of stress-management training for essential hypertension. After 6–9 clinic and 48 self-measured readings of systolic and diastolic blood pressures (SBP and DBP), 22 patients were treated with a program based on education, relaxation, and problem-solving training; and another 21 patients were assigned to a waiting list control group. At post-treatment, mean reductions of clinic BP (17/13 mm Hg vs. 6.9/4.7 mm Hg for SBP/DBP), percentages of subjects who achieved at least a 5 mm Hg reduction (86/86% vs. 48/48% for SBP/DBP) and percentages of subjects who in addition achieved a normotensive level (59/68% vs. 29/14% for SBP/DBP) were significantly higher in the treated group than in the control group. Concerning self-measured BP, the effectiveness of the stress-management training was not so considerable (mean reductions of 3.6/2.4 mm Hg and percentages of subjects who achieved a 5 mm Hg reduction of 52/38% for SBP/DBP), but it was significant and maintained in a 4-month follow-up assessment (mean reductions of 4/2 mm Hg and percentages of subjects who achieved a 5 mm Hg reduction of 48/33% for SBP/DBP). It is suggested that stress-management training can be beneficial for treatment of essential hypertension.

Blood pressure variability and stress management training for essential hypertension.

The purpose of this study was to determine whether stress management training reduces blood pressure (BP) variability in hypertensive patients. Previous literature suggests that cardiovascular risk is not only a function of BP levels, but also of BP variability, and this partially depends on changes induced by the stress of everyday life. The authors reanalyzed data from a previous study of 43 male patients with essential hypertension who were randomly assigned to 2 groups (stress management training and waiting list). Patients in the stress management group lowered their self-measured BP variability significantly from pretreatment to the 4-month follow-up examination, showing a mean reduction of 2.6/1.5 mm Hg in the standard deviation of systolic/diastolic BP (SBP/DBP), and a mean decrease of 1.84/1.59% in the coefficient of variation of SBP/DBP. For SBP, these reductions were significantly greater than those showed by the control group. These results suggest that stress management training is effective in reducing day-to-day BP variability, providing an additional reduction in cardiovascular risk for hypertensive patients.

Norms for the Spanish version of the Eating Disorders Examination Questionnaire (S-EDE-Q)

BACKGROUND This study presents normative data on the Spanish Version of the Eating Disorders Examination Questionnaire (S-EDE-Q) for adolescents and young adults in Spain. METHOD A sample of 1,543 men and women, aged 12 - 21 years, completed the S-EDE-Q as part of a larger assessment battery. RESULTS Means, standard deviations, clinical significance and percentile ranks for the raw Restraint, Eating Concern, Shape Concern, and Weight Concern subscales and the Global Score by age group and gender are presented. Data on any and regular occurrences of dieting, bingeing and compensatory behaviors by age group and gender are reported. Compared with men, women scored higher on all the subscales and reported more key eating disorders (ED) and compensatory behavior. Compared with adolescents, young adults scored higher on the Restraint and Shape Concern subscales and reported more dietary restraint (DR), objective binge episodes (OBE) and diuretic misuse (DIUR). CONCLUSIONS These results can help researchers and clinicians interpret the S-EDE-Q scores of adolescents and young adults in Spanish-speaking countries.

Evaluation of a Group Cue-Exposure Treatment for Opiate Addicts

Twenty-four detoxified opiate addicts were randomized to an experimental group and a control group to evaluate efficacy of a group cue-exposure treatment to reduce or extinguish classically conditioned responses to drug-related stimuli. Assessment included psychophysiological responses (skin temperature, skin conductance level--SCL--, and heart rate) to a videotape and subjective measures (subjective craving, positive and negative affect) before and after the videotape. The experimental group received a group cue-exposure program to drug-related stimuli that comprised twelve treatment sessions administered three times weekly. The treatment program significantly reduced conditioned responses to drug-related stimuli, as measured by SCL and positive affect.

Sociodemographic, Psychopathological and Clinical Characteristics of Pathological Slot-Machine Gamblers in Treatment: A Descriptive Study of Spanish Male Gamblers

The purpose of this study is to describe the sociodemographic, psychopathological, and clinical characteristics of a sample of Spanish male pathological slot-machine gamblers in treatment. The sample was made up of 80 men who met the criteria of the DSM-IV for pathological gambling. The mean age was 29 years, and the mean age at which they had started slot-machine gambling was 20 years, with a mean problem duration of three years before they sought treatment. Regarding employment status, service sector workers were the most frequently represented (36.3%), followed by students (20%) and the unemployed (15%). The most influential psychopathological variables noted were the prevalence of affective disorders (36.2%), past abuse of alcohol (12.5%), and regular use of illegal substances (26.3%), either in the past or at the time of seeking treatment. Also discussed is the low age of the men seeking treatment for gambling problems, the way they finance their gambling and explanations for their gambling behaviour.

Validación del Eating Attitudes Test como instrumento de cribado de trastornos de la conducta alimentaria en población general

BACKGROUND AND OBJECTIVE To validate the best cut-off point of the Eating Attitudes Test (EAT-40), Spanish version, for the screening of eating disorders (ED) in the general population. MATERIAL AND METHOD This was a transversal cross-sectional study. The EAT-40 Spanish version was administered to a representative sample of 1.543 students, age range 12 to 21 years, in the Region of Madrid. Six hundred and two participants (probable cases and a random sample of controls) were interviewed. RESULTS The best diagnostic prediction was obtained with a cut-off point of 21, with sensitivity: 88.2%; specificity: 62.1%; positive predictive value: 17.7%; negative predictive value: 62.1%. CONCLUSIONS Use of a cut-off point of 21 is recommended in epidemiological studies of eating disorders in the Spanish general population.

Evaluación de la eficacia de un tratamiento individual para mujeres víctimas de violencia de pareja con trastorno de estrés postraumático

The aim of this research is to evaluate the effectiveness of a brief and specific treatment of the Posttraumatic Stress Disorder (PSD) in women victims of domestic violence. The participants were 20 battered women, all of whom fulfilled the PSD diagnosis (DSM-IV-TR). The treatment, individually applied, consists of eight sessions and it includes psycho-education, training for the activation control, cognitive therapy and exposure therapy. A quasi-experimental design of repeated measures was used (pre-treatment, post-treatment and 6 month follow-up). The results at the post-treatment stage showed a significant improvement for the PSD symptoms (80% of the women no longer fulfilled the PSD criteria). Also, they presented significant improvements in other symptoms: depression, self-esteem, social adaptation problems, and posttraumatic beliefs. At the six month follow-up these improvements remained constant, and even increased.

Violencia laboral en urgencias extrahospitalarias: una revisión sistemática y líneas de intervención psicológica

La violencia laboral en el ambito sanitario ha experimentado un crecimiento exponencial en los ultimos anos. El objetivo de este trabajo es hacer una revision sistematica de la literatura y senalar algunas lineas de intervencion psicologica. En general se observan elevadas tasas de violencia fisica y verbal; sin embargo se observan mayores diferencias en las variables asociadas a la agresion, como las caracteristicas de los profesionales agredidos, causas y lugar de la agresion, probablemente unidas a la organizacion del sistema sanitario de cada pais. Se recomienda: a) priorizar la formacion especializada de los profesionales que trabajan en servicios de emergencia, b) programas de prevencion dirigidos al entrenamiento en habilidades de comunicacion con los pacientes y/o acompanantes, la identificacion de situaciones de riesgo y la puesta en marcha de estrategias de afrontamiento adecuadas y medidas de seguridad, y c) la atencion psicologica de los profesionales que ya han sufrido alguna agresion.

Distorsiones cognitivas durante el juego en máquinas recreativas con premio en jugadores patológicos y no jugadores

Se analisam as distorcoes cognitivas referidas ao acaso em jogadores patologicos, antes do tratamento, versus um grupo de nao-jogadores ou jogadores sem problema. A mostra esta composta por 160 varoes, 80 jogadores patologicos (DSM-IVTR), cuja atividade principal de jogo eram as maquinas recreativas e 80 varoes sem problemas de jogo. O objetivo e constatar se os sesgos cognitivos respeito ao jogo diferem em frequencia e intensidade entre ambas amostras. Se avaliaram os sesgos cognitivos mediante: (a) observacao sistematica em laboratorio (metodo de pensar em voz alta durante o jogo) e (b) autoinforme (escala Likert de estimativa de probabilidades de ganhar e atribuicao dos resultados). Existem diferencas significativas entre os jogadores patologicos e os nao jogadores nas medidas mais relevantes: (a) porcentagem de frases irracionais (30.31% versus. 8.28%); (b) taxa de irracionalidade em frases sobre estrategias (97% versus 82%), (c) estimativa de possibilidades de ganhar (38.46% vs. 26.92%) e (d) a porcentagem dos resultados atribuido a sorte (44.30% vs. 19.74%). Os elevados valores de distorcoes cognitivas nos jogadores parecem um fator etiologico destacado no desenvolvimento das condutas de jogo patologico. Em consequencia, pelo menos uma parte do tratamento deve dirigirse a modificar estas distorcoes

Treatment of Anxiety Disorders in a Psychology Clinic.

People with anxiety disorders demand psychological attention most often. Therefore, it seems important to identify both the characteristics of the patients who demand help and the clinical variables related to that demand and its treatment. A cohort of 292 patients who requested help at a university clinical facility was studied. The typical profile of the patient was: being female, young, unmarried, with some college education, and having previously received treatment, especially pharmacological one. The three most frequent diagnoses of anxiety, which include 50% of the cases, were: Anxiety Disorder not otherwise specified, Social Phobia, and Panic Disorder with Agoraphobia. Regarding the characteristics of the intervention, the average duration of the assessment was 3.5 sessions (SD = 1.2), and the duration of the treatment was 14 sessions (SD = 11.2). The percentage of discharges was 70.2%. The average cost of treatment was around €840. The results are discussed, underlining the value of empirically supported treatments for anxiety disorders.