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Clinical and epidemiological research suggests that behavioral addictions (BA) are associated with a wide range of psychiatric disorders. However, the relationship between BA and bipolar disorders (BD) has not been thoroughly explored. The aim of this systematic review was to critically summarize and evaluate the current available evidence regarding a possible association between BA and BD. A systematic review of major electronic databases according to PRISMA guidelines was conducted from inception to 31st December 2017. We sought quantitative studies data concerning prevalence of comorbidity, features and treatment related to BA-BD comorbidity. Data were narratively synthesized. Of the 1250 studies returned from the search, a total of 28 articles were included in this review. BA may be overrepresented in BD samples, and the other way around. Pathological gambling and kleptomania were the most prevalent conditions followed by compulsive buying, compulsive sexual behavior and internet addiction. BA was also associated with other mood disorders, anxiety disorders and substance use disorder. BD-BA comorbidity was related with more severe course of illness. Studies on treatment strategies for BD-BA comorbidity are rather limited; only one randomized controlled trial that fulfilled inclusion criteria was identified. Methodological heterogeneity in terms of design and results among studies was found. BD-BA commonly co-occurs although there is a need for rigorous studies. Routine screening and adequate assessment may be helpful in BD patients to identify individuals at risk for BA and to effectively manage the complex consequences associated with BA-BD comorbidity., (Copyright © 2018 Elsevier B.V. and ECNP. All rights reserved.)

Introduction: There are no studies which address the relationship between mindfulness and cognitive flexibility in interventions carried out online. This is the first study to examine the effect of two online mindfulness-based interventions on this cognitive function. Objectives: To assess changes on cognitive flexibility after two online mindfulness-based group interventions in adult patients with anxiety disorders. Methods: This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Thirteen adult patients (age mean = 51.69 years, ranging from 33 to 69 years, S.D. = 11.56) with anxiety disorders completed the interventions. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. Both interventions were carried out online. The dependent variable was the score on the TMT-B (seconds). A comparison of paired-means was conducted. Statistical significance was set at p < .05. Results: The normality assumption was met. Statistical power observed = 70.0%. The paired t-test showed statistically significant change between pre-treatment and post-treatment (p = 0.019; Cohen's d = 0.75), indicating improvement on cognitive flexibility. Conclusions: These results show a statistically significant and medium/large effect-size change in cognitive flexibility after the two online interventions based on mindfulness. A larger sample size is required to confirm these results. Moreover, other studies need to examine the reliable change on this neuropsychological outcome. [ABSTRACT FROM AUTHOR]

Introduction: Research is needed to explore whether cognitive flexibility may account for potential gender differences after mindfulness-based interventions. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on cognitive flexibility according to gender. Methods: This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Firstly, 80 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 64 patients decided to participate (mean age = 40.66, S.D. = 11.43; 40 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2x2 mixed ANOVA (pre-post change x intervention type x gender) was conducted, with Sidak-correction post hoc tests. The dependent variable was the score on TMT-B. Results: A natural logarithmic transformation was conducted to correct violation of normality and homoscedasticity assumptions. No statistically significant differences were observed on age or gender between interventions. No statistically significant interaction effect was observed between pre-post change x intervention x gender [F(1, 52) = .014, p = .907]. An interaction effect was observed between pre-post change x intervention [F(1, 52) = 4.180, p = .046; statistical power observed = 52%]: while TMT-B improved after ACT (p = .001; Cohen's d = 0.607), there were no changes after MER (p = .367; Cohen's d = 0.097). Conclusions: These medium effect-size results confirm previous findings of our research team indicating cognitive flexibility improves after ACT but not after MER. [ABSTRACT FROM AUTHOR]

Introduction: There are no studies addressing the effect of training mindfulness on the executive function of inhibition in patients with anxiety disorders. Objectives: To assess changes on inhibitory control and visual processing speed after mindfulness-based group interventions in patients with anxiety disorders. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). 39 adult patients (age range: 21-63) started this study and 17 completed the follow-up measures so far. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. A repeated measures ANOVA was conducted (pre-treatment, posttreatment and 6-month follow-up), with Sidak-correction parametric post hoc tests. Also, the Wilcoxon signed ranks test with Bonferroni-correction was used for non-parametric pairwise comparisons at p < 0.017. The dependent variables were the three scores on the Stroop test: Word, Color and Interference. Results: Normality assumptions were met for Color and Interference, but not for Word. A statistically significant change in Interference was observed [F(2, 32) = 5.190, p = 0.011, partial eta-squared = 0.245, statistical power observed = 79.1%], specifically between pre-treatment and follow-up (p = 0.034). The Wilcoxon test showed statistically significant change in Word between pre-treatment and follow-up (p = 0.011; Cohen's d = 0.633) and in Color between pre-treatment and post-treatment (p = 0.015; Cohen's d = 0.143). Conclusions: These preliminary results show moderate improvement in visual processing speed and large increase in inhibitory control at the 6-month follow-up in comparison to the pretreatment after both mindfulness-based interventions. [ABSTRACT FROM AUTHOR]

Introduction: Alexithymia is a personality construct that encompasses difficulties in identifying feelings and differentiating between feelings and the somatic sensations associated with emotional arousal. Mindfulness-based interventions could improve this disturbance in processing affective information. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on alexithymia in patients with anxiety disorders. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). Firstly, 52 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 39 patients decided to participate (age range: 21-63; 26 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2 mixed ANOVA (pre-post change x intervention type) was conducted, with Sidak-correction post hoc tests. The dependent variable was the total score on the Toronto Alexithymia Scale 20-item (TAS-20). Results: Normality and homoscedasticity assumptions were met. No statistically significant differences between interventions were observed on the pre-treatment score (t(36.70) = 0.68, p = 0.50). No statistically significant interaction effect was observed. A main effect pre-post change was statistically significant [F(1, 30) = 23.45, p = 0.00, partial eta-squared = 0.44, statistical power observed = 99.7%]. Both interventions reduced similarly, with a large effect size, the alexithymia level after treatment. Conclusions: These preliminary results show a relevant improvement in processing affective information in patients with anxiety disorders after both mindfulness-based interventions. A larger sample size is required to confirm these results. [ABSTRACT FROM AUTHOR]

Introduction: Promising results are being observed regarding working memory capacity after training in mindfulness. However, there are no randomized controlled trials measuring its change after mindfulness-based interventions in patients with anxiety disorders. Objectives: To assess changes on auditive working memory after two mindfulness-based group interventions in patients with anxiety disorders. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). 39 adult patients (age range: 21-63) started this study and 17 completed the follow-up measures so far. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. A repeated measures ANOVA was conducted (pre-treatment, post-treatment and 6-month follow-up), with Sidak-correction parametric post hoc tests. Also, the Friedman test and Wilcoxon signed ranks test with Bonferroni-correction was used for non-parametric pairwise comparisons at p < 0.017. The dependent variables were the scores on Digit span backward and the Digit span sequence (WAIS-IV). Results: Normality assumptions were not met for Digit span backward or Digit span sequence. Friedman tests showed no statistically significant change in Digit span backward (p = 0.270; partial etasquared = 0.005; statistical power observed = 6.2%) or in Digit span sequence (p = 0.612; partial eta-squared = 0.011; statistical power observed = 7.5%). Conclusions: These preliminary results show no changes on auditive working memory after participating in both mindfulness-based interventions. A larger sample size is required to confirm this trend and to analyze if the measures used present lack of sensitivity to change. [ABSTRACT FROM AUTHOR]

Introduction: The third wave of behavioral and cognitive therapies use different techniques to promote lasting changes regarding mindfulness as a trait. However, there are very few studies comparing various mindfulness-based interventions. This is the first study to compare two mindfulness-based interventions on this trait in patients with mixed anxiety disorders. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on mindfulness trait. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). Firstly, 52 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 39 patients decided to participate (Mean age = 42.38; S.D. = 11.71; 21-63 years). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2 mixed ANOVA (pre-post change x intervention type) was conducted, with Sidakcorrection post hoc tests. The dependent variable was the total score on the Five Facet Mindfulness Questionnaire. Results: Normality and homoscedasticity assumptions were verified. No statistically significant interaction effect was observed. A main effect pre-post change was statistically significant [F(1, 30) = 22.84, p = 0.00, partial eta-squared = 0.43, statistical power observed = 99.6%]. Both interventions increased similarly, with a large effect size, mindfulness trait after treatment. Conclusions: These preliminary results show that mindfulness dispositional improves similarly and greatly after both interventions. Therefore, these findings indicate that mindfulness can be cultivated with different techniques beyond the meditation practice. [ABSTRACT FROM AUTHOR]

Introduction: Meta-analysis show significant improvement regarding working memory capacity after training in mindfulness, but further research is needed to clarify these results. This is the first study to compare two mindfulness-based interventions on this cognitive function in patients with anxiety disorders. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on auditive working memory. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). Firstly, 52 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 39 patients decided to participate. Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2 mixed ANOVA (pre-post change x intervention type) was conducted, with Sidak-correction post hoc tests. The dependent variables were the scores on the Digit span backward and the Digit span sequence (WAIS-IV). Results: Normality violation was observed in both measures. Homoscedasticity assumption was met. No statistically significant main or interaction effect was observed (partial eta-squared between 0.00 and 0.07; statistical power observed between 5.10% and 32.6%). The Wilcoxon signed ranks tests confirmed this nonstatistically significant change on Digit span backward (p = 0.91) or Digit span sequence (p = 0.17) after treatments. Conclusions: Auditive working memory was not improved after any of the two mindfulness-based interventions. The ceiling effect of both measures may contribute to the lack of sensitivity to change. A larger sample size is required to confirm these results. [ABSTRACT FROM AUTHOR]

Introduction: Results about the effects of training in mindfulness on the executive function of inhibition are mixed. This is the first study to compare two mindfulness-based interventions on inhibitory control and visual processing speed. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on inhibitory control and visual processing speed. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). Firstly, 52 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 39 patients decided to participate. Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2 mixed ANOVA (pre-post change x intervention type) was conducted, with Sidak-correction post hoc tests. The dependent variables were the three scores on the Stroop test: Word, Color and Interference. Results: Normality and homoscedasticity assumptions were met, except for normality in Word. No statistically significant interaction effect was observed. Two main effects pre-post change were statistically significant for Color [F(1, 33) = 6.22, p = 0.02, partial eta-squared = 0.16, statistical power observed = 67.8%] and Interference [F(1, 33) = 5.54, p = 0.00, partial eta-squared = 0.14, statistical power observed = 62.7%]. The Wilcoxon signed ranks test showed statistically significant change in Word (p = 0.02, partial eta-squared = 0.16, statistical power observed = 66.8%). Conclusions: These results show both mindfulness-based interventions improved similarly, with large effect sizes, visual processing speed and inhibitory control. [ABSTRACT FROM AUTHOR]

Introduction: There is paucity of empirical studies which compare various mindfulness-based interventions on speed of visuomotor tracking and also analyse the differential effect of gender. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on speed of visuomotor tracking according to gender. Methods: This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Firstly, 80 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 64 patients decided to participate (mean age = 40.66, S.D. = 11.43; 40 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2x2 mixed ANOVA (pre-post change x intervention type x gender) was conducted, with Sidak-correction post-hoc tests. The dependent variable was the score on TMT-A. Results: Normality and homoscedasticity assumptions were met. No statistically significant differences were observed on age or gender between interventions. No statistically significant interaction effect was observed between pre-post change x intervention x gender on TMT-A [F(1, 52) = 2.867, p = .096, statistical power observed = 38.3%]. However, simple effects were statistically significant: whilemales improved onTMT-AafterMER(p = .000;Cohen's d = 1.092), females did so after ACT (p = .000; Cohen's d = 1.506). Conclusions: These results show that gender moderates the improvement of the two mindfulness-based interventions examined on the speed of visuomotor tracking. More research is needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Introduction: Results about the effects of mindfulness training on the executive function of inhibition are mixed. Research about interventions in anxiety disorders is needed to exam the differential efficacy among men and women, and the factors involved in those potential gender differences. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on inhibitory control according to gender. Methods: This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Firstly, 80 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 64 patients decided to participate (mean age = 40.66, S.D. = 11.43; 40 females). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2x2 mixed ANOVA (pre-post change x intervention type x gender) was conducted, with Sidak-correction post-hoc tests. The dependent variable was the Interference score of the Stroop test. Results: Normality and homoscedasticity assumptions were met. No statistically significant differences were observed on age or gender between interventions. A statistically significant interaction effect was observed between pre-post change x intervention x gender on Interference [F(1, 52) = 5.004, p = .030; statistical power observed = 59.3%]. Improvement in interference was larger for women after ACT (p = .000) and for men after MER (p = .002). Conclusions: These preliminary results show improvements in inhibition after the two interventions examined. However, each treatment maximizes improvement in different ways according to gender. Further research is required. [ABSTRACT FROM AUTHOR]

Introduction: The relationship between attentional functioning and mindfulness is an intensive field of study, mainly in face-to-face interventions. However, no neuropsychological study addressed the effect of online mindfulness-based interventions on this cognitive function. Objectives: To assess changes on attentional functioning after two online mindfulness-based group interventions in adult patients with anxiety disorders. Methods: This study was carried out in a Mental Health Unit in Spain (Colmenar Viejo, Madrid). Thirteen adult patients (age mean = 51.69 years, ranging from 33 to 69 years, S.D. = 11.56) with anxiety disorders completed the interventions. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. Both interventions were carried out online. The dependent variables were the scores on the TMT-A (seconds), Digit span forward and Longest digit span forward (WAIS-IV). A comparison of paired-means was conducted. Statistical significance was set at p < .05. Results: The normality assumption was met except for Longest digit span forward. The paired t-test showed statistically significant change between pre-treatment and post-treatment on TMT-A [t(12)= 3.81; p = 0.002; Cohen's d = 1.056; statistical power observed = 94.0%], but not on Digit span forward (p = .45). Wilcoxon signed ranks test showed no statistically significant change on Longest digit span forward (p = .56). Conclusions: These results show a large improvement on visual attention and speed of visuomotor tracking, but not on auditive attention, after both online mindfulness-based group interventions. [ABSTRACT FROM AUTHOR]

Introduction: Cognitive flexibility is a key construct related to mindfulness. However, there are no randomized controlled trials about mindfulness-based interventions addressing it as an endpoint in patients with anxiety disorders. Objectives: To assess changes on cognitive flexibility after two mindfulness-based group interventions in patients with anxiety disorders. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). 39 adult patients (age range: 21-63) started this study and 17 completed the follow-up measures so far. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. A repeated measures ANOVA was conducted (pre-treatment, posttreatment and 6-month follow-up), with Sidak-correction parametric post hoc tests. Also, the Friedman test and Wilcoxon signed ranks test with Bonferroni-correction was used for non-parametric pairwise comparisons at p < 0.017. The dependent variable was the score on the TMT-B (seconds). Results: The normality assumption was not met. Statistical power observed = 23.0%. The Wilcoxon test showed statistically significant change between pre-treatment and post-treatment (p = 0.013; Cohen's d = 0.003), and between pre-treatment and follow-up (p = 0.010; Cohen's d = 0.610). No statistically significant change was observed between post-treatment and follow-up (p = 0.192; Cohen's d = 0.345). Conclusions: These preliminary results show null change immediately after treatment completion of both mindfulness-based interventions, but moderate improvement in cognitive flexibility at the 6-month follow-up in comparison to the pre-treatment. However, a larger sample size is required to confirm these results. [ABSTRACT FROM AUTHOR]

Introduction: Most neuropsychological studies show a dissociation between the subjective complaints of attention and the results from the objective tests. Objectives: To determine the relationship between subjective complaints and objective neuropsychological test results of attention in patients with anxiety disorders referred to mindfulness-based group interventions. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). 46 adult patients (age range from 21 to 63) with anxiety disorders completed the pre-treatment measures and 33 out of them completed the post-treatment measures. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. The outcomes were Digit span forward and Longest digit span forward (WAIS-IV), TMT, Stroop and a self-reported item about attention from the WHOQOL-BREF (the higher score, the better self-perceived attention). Pearson correlations were computed and interpreted at p < 0.05. Results: Before treatments, the self-reported measure of attention significantly correlated with the Longest digit span forward (r = .307; p = .038), Stroop Word (r = .337; p = .022), Stroop Interference (r = .320; p = .032) and TMT-A (r = -.399; p = .006). At the posttreatments, the self-reported measure of attention only significantly correlated with TMT-A (r = -.345; p = .049). These results show that the better self-perceived attention, the better performance in such objective tests. Conclusions: In patients with anxiety disorders the self-reported complaints of attention converge with objective results of the neuropsychological tests. However, after both mindfulness-based interventions this association is weaker. [ABSTRACT FROM AUTHOR]

Introduction: There are no randomized controlled trials measuring the effect on attention after mindfulness-based interventions in patients with anxiety disorders. Objectives: To assess changes on auditive and visual attention after two mindfulness-based group interventions in patients with anxiety disorders. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). 39 adult patients (age range: 21-63) started this study and 17 completed the follow-up measures so far. The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. A repeated measures ANOVA was conducted (pre-treatment, posttreatment and 6-month follow-up), with Sidak-correction parametric post hoc tests. Also, the Friedman test and Wilcoxon signed ranks test with Bonferroni-correction was used for non-parametric pairwise comparisons at p < 0.017. The dependent variables were the scores on TMT-A, Digit span forward and Longest digit span forward (WAIS-IV). Results: Normality assumptions were met for TMT-A, but not for Digit span forward or Longest digit span forward. A statistically significant change in TMT-A was observed [F(2, 32) = 14.496, p = 0.000, partial eta-squared = 0.475, statistical power observed = 99.8%], specifically in pre-versus post-treatment (p = 0.023), and pre-treatment versus follow-up (p = 0.000). Friedman tests showed no statistically significant change in Digit span forward (p = 0.787) or Longest digit span forward (p = 0.433). Conclusions: These preliminary results show large improvement in visual attention and visuomotor tracking speed, but not in auditive attention, at the 6-month follow-up in comparison to the pretreatment. [ABSTRACT FROM AUTHOR]

Introduction: The third wave of behavioral and cognitive therapies have been successfully applied to patients with anxiety disorders. However, there are very few studies comparing the effectiveness between different mindfulness-based interventions. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on anxiety sensitivity. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). Firstly, 52 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 39 patients decided to participate. Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2 mixed ANOVA (pre-post change x intervention type) was conducted, with Sidak-correction post hoc tests. The dependent variables were four scores of the Anxiety Sensitivity Index-3 (total score, physical, cognitive and social subscales). Results: Normality and homoscedasticity assumptions were verified, except for normality and homoscedasticity in cognitive and social subscales. No statistically significant interaction effect was observed. Main effects pre-post change were statistically significant for the total score (partial eta-squared = 0.27, statistical power = 89.7%) and physical subscale (partial eta-squared = 0.15, statistical power = 60%), showing reduction in such measures after both treatments. Wilcoxon signed ranks tests showed also a statistically significant decrease for cognitive (p = 0.00) and social subscales (p = 0.02) after both treatments. Conclusions: These preliminary results show that all the domains of anxiety sensitivity (physical, cognitive and social) decreased significantly after both interventions. [ABSTRACT FROM AUTHOR]

Introduction: The third wave of behavioral and cognitive therapies promote a new relationship with negative internal events, based on acceptance, as opposed to their control. This is the first study to compare two mindfulness-based interventions on this psychological construct. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on experiential avoidance. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). Firstly, 52 patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 39 patients decided to participate. Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2 mixed ANOVA (pre-post change x intervention type) was conducted, with Sidak-correction post hoc tests. The dependent variable was the score on the Acceptance and Action Questionnaire-II. Results: Normality and homoscedasticity assumptions were met. No statistically significant differences between interventions were observed on the pre-treatment score (t(37) = 0.98, p = 0.34). A statistically significant interaction effect was observed [F(1, 30) = 6.92, p = 0.01, partial eta-squared = 18.7, statistical power observed = 72.1%]. MER reduced experiential avoidance after treatment (p = 0.00), with a large effect size, but not ACT (p = 0.30). Conclusions: These preliminary results show a Mindfulness-based Emotional Regulation intervention reduced the perceived experiential avoidance but not Acceptance and Commitment Therapy, although both promote the acceptance as a core process. A larger sample size is required to confirm these results. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of studies which address the relationship between mindfulness and cognitive flexibility. This is the first study to compare two mindfulness-based interventions on this cognitive function. Objectives: To compare the effectiveness of Acceptance and Commitment Therapy (ACT) versus a Mindfulness-based Emotional Regulation (MER) intervention on cognitive flexibility. Methods: This study was carried out in a Mental Health Unit (Colmenar Viejo, Madrid). Firstly, 52 adult patients with anxiety disorders were randomized according to the score on the Acceptance and Action Questionnaire-II (blocking factor), of whom, 39 patients decided to participate (age range: 21-63 years). Each intervention was weekly, during 8 weeks, guided by two Clinical Psychology residents. A 2x2 mixed ANOVA (pre-post change x intervention type) was conducted, with Sidak-correction post hoc tests. The dependent variable was the score on the TMT-B (seconds). Results: A transformation according to the natural logarithmic function was conducted due to normality violation regarding the post-intervention measure. Homoscedasticity assumption was met. No statistically significant differences between interventions were observed on the pre-treatment score (t(36) = -0.28, p = 0.78). A statistically significant interaction effect was observed [F(1, 33) = 8.00, p = 0.01, partial eta-squared = 0.20, statistical power observed = 78.4%], showing significant improvement after ACT but not after MER. The Mann-Whitney test, on the difference pre-post scores, confirmed such improvement after ACT (p = 0.02). Conclusions: These results show a differential change pattern between both mindfulness-based interventions regarding cognitive flexibility. A larger sample size is required to confirm these results. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We aimed to determine whether there were differences with regard to anxiety and depressive symptomatology between liver transplant recipients with better (G1) versus worse (G2) self-perceptions of general health compared with pre–liver transplantation cirrhotic patients (G3). Methods: The groups of patients included 168 recipients including 85 and 83 with better or worse self-perceptions of general health, respectively, and 75 cirrhotic pre–liver transplantation patients. For the psychological assessment we used the Hospital Anxiety and Depression Scale and the general health dimension of the SF-36 Health Questionnaire. The following analyses were used: Analysis of variance (ANOVA) with post hoc pairwise comparisons by means of Tukey''s test and Cohen''s d, an effect size index. Results: Significant differences were observed among the three groups for the variables of anxiety (P = .000) and depression (P = .000). Specifically, liver transplant recipients with better self-perceptions of general health displayed lower scores (better mental health) compared with those showing worse self-perceptions or cirrhotic patients. There were no differences between the latter two groups. The differences in these variables were relevant (large effect sizes) for anxiety (Cohen''s d 1–2 = −1.075, Cohen''s d 1–3 = −1.155) and for depression (Cohen''s d 1–2 = −1.145, Cohen''s d 1–3 = −1.158). Conclusion: The anxious-depressive status was not necessarily better among liver transplant recipients. There was great variability among them as a function of self-perceived general health. Transplant recipients with worse self-perception of general health presented the same anxiety-depressive levels as patients with severe liver disease in the pretransplantation phase; the latter groups reach the clinical threshold on the depression scale. [Copyright &y& Elsevier]

Abstract: Objective: To determine whether differences in the coping strategies used by liver patients during the pretransplantation phase were a function of their relatives'' level of anxiety. Materials and Methods: We assessed 75 pre–liver transplantation patients and 75 relatives (one per patient). To assess relatives'' anxiety status, we used the Hospital Anxiety and Depression Scale (HADS), and the Questionnaire of Coping with Stress in Cancer Patients (CAEPO) to study patients'' coping strategies. Three subgroups of relatives were established as a function of their scores on the HADS anxiety subscale: normal anxiety (G1), dubious anxiety (G2), and clinical anxiety (G3). To verify intergroup differences in the coping strategies used by the patients, we used the nonparametric Kruskal-Wallis H test. We also performed pairwise comparisons with nonparametric Mann-Whitney U test (with Bonferroni''s correction) and Cohen''s d as an effect size index. Results: Focusing on the most relevant effect sizes, the pairwise contrasts indicated the following differences: a) normal anxiety (G1) and dubious anxiety (G2): seeking social support (d = 0.502); b) normal anxiety (G1) and clinical anxiety (G3): coping and active fighting (d = 0.607), self-control and emotional control (d = 0.658), and seeking social support (d = 0.944); and c) dubious anxiety (G2) and clinical anxiety (G3): coping and active fighting (d = 0.743), self-control and emotional control (d = 0.722), and seeking social support (d = 0.515). Conclusion: In general, during the pre–liver transplantation study, the liver patients whose relatives showed clinical levels of anxiety used these three healthy coping strategies to a lesser extent: coping and active fighting, self-control and emotional control, and seeking social support. [Copyright &y& Elsevier]

Abstract: Objective: To compare the mental health of relatives of liver transplant patients during the three phases: pretransplantation, waiting list, and posttransplantation. Materials and methods: This follow-up study used the Hospital Anxiety and Depression Scale (HADS) to assess the relatives of 35 liver transplant patients (one relative for each patient). The anxiety-depression status was compared across the three liver transplant phases: pretransplant study (G1), from the first to the third month after admission to the waiting list (G2), and the 3 months after liver transplantation (G3). Student t test for paired samples was used for statistical analysis, and Cohen d calculated as an effect size index. Results: Significant differences were observed (P = .000) among the three phases in anxiety and depression variables. In both, the greatest affective symptomatology corresponded to the phases prior to the liver transplantation (G1 and G2) and the lowest in the post–liver transplant stage (G3). Relevant differences (large effect size) were noted between pre- and posttransplant phases in both HADS subscales: anxiety (Cohen d 1–3 = 1.197; Cohen d 2–3 = 0.817) and depression (Cohen d 1–3 = 1.228; Cohen'' d 2–3 = 1.239). Conclusion: Relatives show poorer mental health during the phases prior to liver transplantation compared with the posttransplantation. [Copyright &y& Elsevier]