Juan Manuel Bethencourt

Structural gender differences in perceived social support

Abstract Gender is an important influence on support-relevant social interactions, however findings of studies on gender differences in social support are not definitive. Although differences between men and women in the various social support measures have been found in numerous studies, neither the cause nor the explanatory process is known. This study examines gender differences in the dimensionality of social support. A large sample ( N =3210) from the general population of women (60%) and men aged between 18 and 65 years old (Mean age=34.1) responded to a brief scale with items assessing the distinct functions of the perceived availability of social support. Confirmatory factor analyses yielded one factor in the womens sample that measures global social support perceived, and two in the mens. The first factor in the mens sample measures emotional support (providing empathy, caring, validation of self-worth), and the second measures instrumental support (e.g. practical assistance or financial aid). We concluded that there are gender differences in the structure of perceived social support and that these differences can be explained by socialization experiences and social roles associated with gender.

Cognitive-behavioral treatment and antidepressants combined with virtual reality exposure for patients with chronic agoraphobia

In this study we compared the efficacy of virtual reality exposure combined with cognitive-behavioral therapy (VRET) to that of traditional cognitive-behavioral therapy (CBT) alone in reducing phobic symptoms in a sample of patients with long-term agoraphobia. The study was a between-subject design with three experimental conditions (VRET group, N = 30; CBT group, N = 30; and medication only group, N = 20) and repeated measures (pre-treatment, post-treatment, and six-month follow-up). All patients were receiving antidepressant medication. Results showed that all therapies were statistically effective both at post-treatment and six-month follow-up. The VRET group showed clinical improvement in most variables measured at follow-up. The CBT group showed the highest dropout rates. These results are discussed pointing out that VRET probably serves as an intermediate procedure for an efficient exposure to phobic stimuli. Besides describing the advantages of VRET for the treatment of agoraphobia symptoms in cost-benefit terms, the study also considered issues related to higher treatment adherence and motivation.

Gender differences in psychological distress in Spain

Background and aims: Epidemiological and community-based surveys consistently report gender differences in mental health. This study examines gender differences in psychological distress by analyzing the relevance of stress, coping styles, social support and the time use. Methods: Psychological tests were administered to a convenience sample of 1,337 men and 1,251 women from the Spanish general population, aged between 18 and 65 and with different socio-demographic characteristics, although both the women and men groups had similar age and educational levels. Results: Women had more psychological distress than men. Although psychological distress in the women and men groups have some common correlates such as more stress, more emotional and less rational coping and less social support, we find some gender differences. Work role dissatisfaction was more associated with distress in the men than in the women group. In addition, women’s distress was associated with more daily time devoted to childcare and less to activities they enjoy, and men’s distress was associated with more time devoted to housework and less to physical exercise. Conclusions: Social roles traditionally attributed to women and men – and the differences in the use of time that such roles entail – are relevant in gender differences in psychological distress.

Anxiety and Depression in Drug-Dependent Patients with Cluster C Personality Disorders

Objective Comorbidity between personality disorders (PD) and substance-use disorders (SUD) is one of the most common findings in the psychiatric field. The patients with Cluster C disorders present maladjustment traits often characterized by high levels of anxiety. The main aim of this study was to find evidences about higher anxiety and depression prevalence on Cluster C than others Clusters, analyzing similarities and differences within, with other Cluster A and B PD patients and patients without PD. Method A total of 822 substance dependent patients (ages18–78; Mean = 38.35, SD = 10.14) completed the structured clinical interview for DSM-IV Axis I and Axis II disorders, Beck Depression Inventory, and State-Trait Anxiety Inventory. Results Results supported poly-consumption in Cluster C patients, being greater alcohol consumption as well as abuse of both stimulants and depressants. Anxiety and depression did not show just one pattern for all patients with SUD-Cluster C PD. There was a relation between anxiety and depression for all the groups except for the Dependent-PD. Conclusion Interventions should focus on aspects like depression and anxiety more than on the substance consumed.

Efficacy of an internet-based psychological treatment for agoraphobia with minimal therapist contact

This study deals with the efficacy of an Internet-based computer therapy compared with an in-person cognitive-behavioral therapy, in the treatment of agoraphobia. Patients in the Internet group only had minimal initial contact with a therapist. The sample was composed of 44 adult patients with a diagnosis of agoraphobia. The Internet group and in-person groups underwent an 11-session intervention program. Agoraphobic cognitions, body sensations, social fear (as mobility test), and depression level were used as outcome measures. Results showed higher attrition rates in the Internet group. The in-person group exhibited improvements in all dependent measures, with moderate effect sizes (0.63 to 0.77 cohen’s d). The Internet group showed improvements in body sensations and depression level (moderate effect sizes). Intergroup comparisons showed a higher efficacy of in-person therapy, with moderate to large effect sizes ( 2 = 0.15 to 0.40). After the intervention, the Internet group exhibited better results than the control group and comparable results to the in-person group in body sensations, social fears/mobility, and depression level. These results are discussed considering the limited extent of internet-based therapy.

Verbal Emotional Disclosure of Traumatic Experiences in Adolescents: The Role of Social Risk Factors

It is well-known that traumatic events and adverse life situations are very important in both physical and psychological health. Prevalence studies suggested that adolescents experience at least one potentially traumatic event before reaching age 18. The paradigm of research centered on expressive writing has evidenced the beneficial effects that the emotional disclosure of previous traumas produces on physical health and psychological adjustment. The aims of the study are threefold: determining the prevalence of adverse or traumatic events; examining the extent to which psychopathological symptoms developed in those exposed to traumatic events; and exploring an verbal emotional disclosure (VED) paradigm in which variations on time spent talking about traumatic experiences to others resulted in a reduction of the psychological impact of trauma in a sample of Spanish adolescents. 422 volunteer adolescents participated, 226 boys and 192 girls, from 10 to 19 years old, all of them living in Tenerife. The mean age was 14.8 years (SD = 1.83). All of them completed the instruments used to assess the psychological impact of traumatic experiences and VED. The main results indicated that 77% of the participants had suffered a traumatic situation. The participants who have been exposed to traumatic events scored significantly higher in measures of post-traumatic stress, disorder, intrusive thoughts, avoidance behaviors, anxiety and depression, compared to those without trauma. Furthermore, results show a decrease in symptomatology scores as a function of time spent disclosing emotional experiences to others, particularly when disclosure occurred several times. In conclusion, stressful events or traumatic experiences and their concomitant emotional effects are highly prevalent in adolescents, and repeated VED to others appears to ameliorate their impact. VED shows greater therapeutic benefits when adolescents narrate the experience on several occasions and in an extensive way.

Anxiety and Depression in Drug-dependents Patients with Cluster C Personality Disorders

Introduction Substance-dependent patients(SDP) have more personality disorders(PD) than general population; and they present more frequent and severe levels of depression and anxiety. Objectives To study cluster C personality disorders in SDP. Methods We included a clinical sample of 822(621 males) SDP according to the DSM-IV-TR criteria seeking treatment in the Outpatient Drug Clinic Vall d’Hebron in Barcelona, Spain. The assessment process consisted of three interview sessions conducted by trained psychiatrists and psychologists using SCID I and II, BDI, STAI-R/S. Exclusion criteria were:intoxication at baseline examination, severe somatic disease at baseline examination and low language proficiency. Results 39.2% of the sample presented at least one PD and 9.55% presented a cluster C PD. Of them the found prevalence were Avoidant(44.9%), Dependt(11.5%), Obssessive-compulsive(37.2%), comorbidity (6.4%). The addiction prevalences that Cluster C PD patients show were: dependent of alcohol 9.4%, benzodiazepines 18.5%, opioids 6.1%, cocaine 9.7 and cannabis 12.3%. 70.5% of the PD cluster C group were men, however differences according to the cluster C PD were found, being higher the proportion of men in Obsessive-compulsive PD (85.7%) and fewer in Dependent PD patients (33.7%)(χ2 =12.19, p = .007). Cluster C PD patients presented more depressive symptoms and showed higher scores in anxiety-trait than patient with Cluster A or B PD, being this difference statistically significant. Conclusion There is a high rate of cluster C personality disorders among addicted patients. Higher levels of anxiety depression are detected in these patients. Clinicians should be check systematically this symptoms and traits in addicted patients.