Rosa María Baños Rivera

Advancing psychotherapy and evidence-based psychological interventions

Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom‐based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state‐of‐the‐art in psychotherapy treatment research, “component analyses” aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large‐scale public health strategies and treatments that can be applied to more patients in a simpler and cost‐effective way. Increased research on efficacy and moderators of Internet‐based treatments and e‐mental health tools (e.g. to support “real time” clinical decision‐making to prevent treatment failure or relapse) might be one promising way forward. Copyright

Attentional biases and vulnerability to depression

This study was designed to examine selective processing of emotional information in depression. It focuses on possible attentional biases in depression, and whether such biases constitute a cognitive vulnerability factor to suffer from the disorder or, on the contrary, they reflect a feature associated exclusively with the clinical level of depression. 81 participants were included in the study: 15 with a diagnosis of Major Depression; 17 were diagnosed as Dysthymia; 11 participants scored over 18 in the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979); 15 participants, in whom a sad mood state was induced by an experimental mood induction (Velten technique + music, or biographical recall + music); and 23 participants as a normal-control group. All participants were presented with the emotional Stroop task. The data indicated that attentional bias was only present in the group of patients with Major Depression, so it does not seem to be a cognitive vulnerability factor for this disorder.

The need for a behavioural science focus in research on mental health and mental disorders.

Psychology as a science offers an enormous diversity of theories, principles, and methodological approaches to understand mental health, abnormal functions and behaviours and mental disorders. A selected overview of the scope, current topics as well as strength and gaps in Psychological Science may help to depict the advances needed to inform future research agendas specifically on mental health and mental disorders. From an integrative psychological perspective, most maladaptive health behaviours and mental disorders can be conceptualized as the result of developmental dysfunctions of psychological functions and processes as well as neurobiological and genetic processes that interact with the environment. The paper presents and discusses an integrative translational model, linking basic and experimental research with clinical research as well as population‐based prospective‐longitudinal studies. This model provides a conceptual framework to identify how individual vulnerabilities interact with environment over time, and promote critical behaviours that might act as proximal risk factors for ill‐health and mental disorders. Within the models framework, such improved knowledge is also expected to better delineate targeted preventive and therapeutic interventions that prevent further escalation in early stages before the full disorder and further complications thereof develop. In contrast to conventional “personalized medicine” that typically targets individual (genetic) variation of patients who already have developed a disease to improve medical treatment, the proposed framework model, linked to a concerted funding programme of the “Science of Behaviour Change”, carries the promise of improved diagnosis, treatment and prevention of health‐risk behaviour constellations as well as mental disorders. Copyright

Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review

This review is designed to systematically examine the available evidence about virtual reality exposure therapy’s (VRET) efficacy for phobias, critically describe some of the most important challenges in the field and discuss possible directions. Evidence reveals that virtual reality (VR) is an effective treatment for phobias and useful for studying specific issues, such as pharmacological compounds and behavioral manipulations, that can enhance treatment outcomes. In addition, some variables, such as sense of presence in virtual environments, have a significant influence on outcomes, but further research is needed to better understand their role in therapeutic outcomes. We conclude that VR is a useful tool to improve exposure therapy and it can be a good option to analyze the processes and mechanisms involved in exposure therapy and the ways this strategy can be enhanced. In the coming years, there will be a significant expansion of VR in routine practice in clinical contexts.

Alternative options for prescribing physical activity among obese children and adolescents: brisk walking supported by an exergaming platform

BACKGROUND Physical inactivity has been identified as an important public health concern for children. An increasing sedentary way of life is directly related to obesity; hence, prevention and management of childhood obesity are commonly based on lifestyle interventions wherein increasing physical activity is one of the main targets. The use of exergames can be useful in promoting physical activity, but it is necessary more research. This study analyzes the effects of an exergaming platform that involves brisk walking, on perceived exertion, self-efficacy, positive expectations and satisfaction in a sample of clinically obese children, as compared with normal weight children. Physiological variables like heart rate, oxygen consumption and energy expenditure were also measured. METHOD A total sample of 42 children was recruited. Children were randomized into those walking on a treadmill and those using a treadmill with the support of the exergaming platform (Wii-Fit). RESULTS The obese children scored significantly higher in expectations and satisfaction in the exergame condition but not in self-efficacy, perceived exertion or physiological measures. CONCLUSIONS These results suggest that this exergaming platform could be a tool to assist obese children in the practice of brisk walking as part of a programme designed to treat obesity.

Trastornos de conducta alimentaria y atención primaria: el desafío de las nuevas tecnologías

a Servicio de Psiquiatria, Hospital Miguel Servet, Universidad de Zaragoza, Instituto Aragones de Ciencias de la Salud, Zaragoza, Espana b Departamento de Psicologia Basica, Clinica y Psicobiologia, Universitat Jaume I, Castellon, Espana c Departamento de Personalidad, Evaluacion y Tratamientos Psicologicos, Universitat de Valencia, Valencia, Espana d Red de Investigacion en Atencion Primaria (RD12/0007), Instituto Carlos III, Espana e CIBER Fisiopatologia, Obesidad y Nutricion (CB06/03), Instituto Carlos III, Espana