Luciana Sofía Moretti

Adaptación del cuestionario de alianza de ayuda revisado versión paciente (HAQ-II-P) para la población de cordobeses

Evidence-Based Psychology would be incomplete if the role of the therapeutic relationship was not investigated. However, the absence of adapted instruments impedes the development of empirical studies in the local context. The principal objective of this work was to adapt the patient version of the Revised Helping Alliance Questionnaire (HAq-II). As an additional objective a comparison of three theoretical models of therapeutic alliance was carried out. After translating the items and evaluating their equivalency via a panel of experts, the HAq-II was administered to a sample of 119 participants undergoing brief psychotherapy. The results of the confirmatory factorial analysis suggest an underlying model of two dimensions: positive bond with the therapist (α = .70) and goal and task agreement (α = .71). It should be noted that this model fits coherently with the theories proposed by Luborsky and Bordin.

Cost-Effectiveness and Cost-Utility Analysis of the Treatment of Emotional Disorders in Primary Care: PsicAP Clinical Trial. Description of the Sub-study Design

Introduction: In the primary care (PC) setting in Spain, the prevalence of emotional disorders (EDs) such as anxiety, depression and somatoform disorder is high. In PC patients, these disorders are not always managed in accordance with the recommendations provided by clinical practice guidelines, resulting in major direct and indirect economic costs and suboptimal treatment outcomes. The aim is to analyze and compare the cost-effectiveness and cost-utility of group-based psychological therapy versus treatment as usual (TAU). Methods: Multicenter, randomized controlled trial involving 300 patients recruited from PC centers in Madrid, Spain, with symptoms or possible diagnosis of anxiety, mood (mild or moderate), or somatoform disorders. Patients will be randomized to one of two groups: an experimental group, which will receive group-based transdiagnostic cognitive-behavioral therapy (TD-CBT); and a control group, which will receive TAU (mainly pharmacological interventions) prescribed by their general practitioner (GP). Clinical assessment will be performed with the Patient Health Questionnaire (PHQ). Direct and indirect costs will be calculated and relevant socio-demographic variables will be registered. The Spanish version of the EuroQol 5D-5L will be administered. Patients will be assessed at baseline, immediately after treatment finalization, and at 6 and 12 months post-treatment. Discussion: To our knowledge, this is the first study to compare TD-CBT to TAU in the PC setting in Spain. This is the first comparative economic evaluation of these two treatment approaches in PC. The strength of the study is that it is a multicenter, randomized, controlled trial of psychotherapy and TAU for EDs in PC. Trial registration: Protocol code: ISCRCTN58437086; 20/05/2013. EUDRACT: 2013-001955-11. Protocol Version: 6, 11/01/2014.

Validación del Cuestionario de Lugar de Control del Dolor en estudiantes argentinos con cefaleas recurrentes

Objetivo. Validar el Cuestionario de Lugar de Control del Dolor (CLCD) en una muestra de estudiantesuniversitarios argentinos con cefaleas recurrentes. Metodo. Se empleo un muestreo no probabilistico intencional de 382 estudiantes universitarios de la ciudad de Cordoba (Argentina), que en los ultimos seis meses habian sufrido de cefaleas. El 77.7% de la muestra fueron mujeres y el 22.3% varones, con una media de edad de 22.4 anos ( DE = 4.2). Se realizaron estudios para evaluar la estructura interna, consistencia interna y la validez externa del cuestionario. Resultados. El analisis factorial exploratorio mostro tres factores que explicaban un 39.79% de la varianza: (1) locus de control externo por profesionales de la salud, (2) locus de control externo por azar y (3) locus de control interno. Asimismo, los valores alfa de Cronbach para evaluar la consistencia interna de los factores resultaron optimos (valores α comprendidos entre 0.80 y 0.86).Los analisis realizados para evaluar la validez externa del cuestionario, mediante el coeficiente de correlacion de Pearson, revelaron que los factores locus de control externo por profesionales de la salud y los factores locus de control externo por azar correlacionaron positivamente con la intensidad del dolor ( r = 0.15, p < 0.01; r = 0.23, p < 0.01, respectivamente), no obstante los valores obtenidos fueron bajos. Conclusion. Aunque presenta limitaciones en su validez externa, los estudios psicometricos realizados permiten concluir que el CLCD es un instrumento confiable y valido para evaluar locus de control en poblacion universitaria argentina con dolor cronico ocasionado por cefaleas.