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© 2020 John Wiley & Sons, Ltd.Evidence of self-help interventions for adjustment disorder (AjD) is limited. This study aims at testing in a randomized controlled trial (RCT) the effectiveness of a disorder-specific, Internet-delivered cognitive–behavioural therapy (ICBT) intervention for AjD. Participants were randomly allocated to either an ICBT with brief weekly telephone support (n = 34) or a waiting list group (n = 34). Beck's inventories for depression and anxiety were used as primary outcomes. The secondary outcomes were AjD symptoms, post-traumatic growth, positive and negative affect, and quality of life. In all, 76.5% of the participants completed the intervention. Compared with the control group, participants in the intervention condition showed significantly greater improvement in all outcomes (Cohen's d ranged from 0.54 to 1.21) except in anxiety symptoms measured by Beck Anxiety Inventory (d = 0.27). Only ICBT group showed a significant improvement in post-traumatic growth, positive and negative affect, and quality of life. The number of cases that achieved clinically meaningful change in all outcome measures was also higher in the ICBT group. All therapeutic gains were maintained at 3-, 6- and 12-month follow-ups. The current study provides evidence on the effectiveness of ICBT interventions to reduce the impact of AjD. Results suggest that brief self-help intervention with minimal therapist support is more effective than the mere passage of time in reducing the distress symptoms associated to the disorder and also can confer additional benefits.

Introduction Positive psychological variables, such as meaning in life and the capacity for enjoyment, are important resilience factors against negative behaviors and symptoms. These constructs are related to better emotional regulation strategies, a greater perception of control over one’s life, and better mental health in general. Adjustment disorder (AjD) is a prevalent condition defined as the failure to adapt to a stressful event. Objective This study presents secondary analysis data on the effect of an Internet-delivered cognitive-behavioral therapy intervention (iCBT) for AjD on meaning in life and capacity for enjoyment, compared to a control group. Method The sample consisted of 68 participants with AjD. 34 in the iCBT condition and 34 in the control group). Meaning in life was assessed by the Purpose-in-Life Test-10, and the Environmental Rewards Observation Scale was used to assess the capacity for enjoyment. The iCBT intervention focused on acceptance and processing of the stressful event. Intent-to-treat mixed-model analyses without any ad hoc imputations and using Cohen’s d effect comparisons were conducted. Results The results revealed a significant main effect of time and a significant group x time interaction in all the measures. Significantly higher pre-post score differences were found in the treatment condition. Discussion Meaning in life and capacity for enjoyment can change after an iCBT intervention for AjD. Therapeutic implications of the results and future lines of research about the role of meaning in life in AjD are discussed.

III Jornades d’Investigació per a l’Alumnat de la Facultat de Ciències de la Salut Introducción: Se ha encontrado que en el contexto de afecciones médicas el afrontamiento activo se relaciona con una mejor respuesta al tratamiento. Sin embargo, no se ha analizado su influencia en el tratamiento de los Trastornos Adaptativos (TA). Objetivo: Analizar la capacidad predictiva de los estilos de afrontamiento en la intensidad sintomática y en el cambio clínico en pacientes con TA. Método: La muestra incluyó 44 pacientes que recibieron un TCC de 6-8 sesiones para los TA. El cuestionario Brief COPE (Carver, 1997) se utilizó para medir las estrategias de afrontamiento. La sintomatología depresiva y de estrés y pérdida fue evaluada en el post-tratamiento y seguimientos de los 3, 6 y 12 meses. Resultados: Las estrategias de afrontamiento no predijeron la intensidad sintomatológica depresiva pero sí la asociada al estrés y pérdida. Estos síntomas fueron menos intensos en pacientes que utilizaban en mayor grado afrontamiento cognitivo y en menor las estrategias de bloqueo y evitación. En cuanto al cambio clínico, en el post y los seguimientos de los 3 y 12 meses los resultados del tratamiento eran independientes de los estilos de afrontamiento iniciales. No obstante, el mayor uso de apoyo social predijo una mayor mejoría en estrés y pérdida en el seguimiento de los 6 meses. Conclusiones: Los resultados subrayan el papel predictor del afrontamiento activo (cognitivo y social) en la mejoría de los síntomas relacionados con el acontecimiento estresante. Se sugiere promover el uso de estrategias de afrontamiento adaptativas durante el tratamiento de los TA. Introduction: It has been found that in the field of medical afflictions active coping is related with a better response to treatment. However, the influence of coping strategies on Adjustment Disorder (AD) has not been sufficiently analyzed. Aim: To explore the predictive value of coping styles to predict the severity of symptoms and clinical change in patients with AD. Method: The sample included 44 patients who received a 6-8 session CBT for AD. Brief COPE questionnaire (Carver, 1997) was used to measure coping strategies. Depressive and stress and loss symptoms were assessed at post-intervention and 3, 6 and 12 months follow-ups. Results: Coping strategies did not predict the severity of depressive symptoms, however, they showed significant relationship with the severity of symptoms related to stress and loss. These symptoms were less severe in patients who used more cognitive coping strategies and less blocking or avoidance strategies. Regarding to clinical change, treatment outcomes were independent of the initial coping styles at post-intervention and 3 and 12 months follow-up. Nevertheless, greater use of social support predicted a more significant improvement in stress and loss symptoms at 6 months follow-up. Conclusions: Results highlight the predictive role of active coping (cognitive and social) in the improvement of symptoms related to the stressful event. It is recommended to promote the use of adaptive coping strategies during the treatment of AD.

Adjustment disorder (AjD) is one of the most common disorders in clinical practice, and its symptoms are severe enough to cause great distress and functional impairment. The AjD CBT protocol specifically developed for this disorder has shown positive results when delivered face to face and through virtual reality. Despite existing evidence supporting the benefits of therapeutic homework as part of a psychological intervention, little is known about how to increase homework engagement in psychotherapy. This study examines the feasibility (doability, initial efficacy and acceptability) of a digital support system to deliver homework via the Internet in the treatment of AjD. Participants were randomly assigned to a traditional homework condition or a digital support system condition. Both interventions resulted in statistically significant improvements, with large effect sizes, in all the outcome measures at post-treatment, with no significant differences between groups. At 12-month follow-up, these therapeutic gains were maintained, and an improvement was even observed in both conditions, with no significant differences between groups. Additionally, treatment satisfaction predicted efficacy in both groups separately and when the whole group was considered. This is the first study to explore the feasibility an initial efficacy of delivering a therapeutic homework component for AjD through the Internet.

Adjustment Disorders (AjD) are one of the most prevalent psychological problems in primary and hospital care. It is necessary to have evidence-based instruments to help professionals diagnose and better understand this problem, which has been little studied. This study presents an adaptation of the Inventory of Complicated Grief for the assessment of AjD symptoms, referred to as the Inventory of Stress and Loss (ISL), and explores the differences in the response to stressful situations between general and clinical Spanish populations.The general sample included 208 participants, and the clinical sample 91 patients with AjD.Results showed that the ISL has high internal consistency. Confirmatory factor analysis showed one single factor, as in the original questionnaire. With respect to concurrent validity, the ISL correlated positively with the STAI-T. Finally, significant differences were found in the total score on the questionnaire between the clinical and general samples, and between men and women in the general sample.Results suggest that the ISL is a simple, useful assessment tool that exhibits good psychometric properties and makes it possible to differentiate normal reactions to a stressful situation from pathological reactions.

Background: Adjustment Disorder (AjD) is a common and disabling mental health problem. The lack of research on this disorder has led to the absence of evidence-based interventions for its treatment Moreover, because the available data indicate that a high percentage of people with mental illness are not treated, it is necessary to develop new ways to provide psychological assistance. The present study describes a Randomized Controlled Trial (RCT) aimed at assessing the effectiveness and acceptance of a linear internet-delivered cognitive-behavioral therapy (ICBT) intervention for AjD. Methods: A two-armed RCT was designed to compare an intervention group to a waiting list control group. Participants from the intervention group will receive TAO, an internet-based program for AjD composed of seven modules. TAO combines CBT and Positive Psychology strategies in order to provide patients with complete support reducing their clinical symptoms and enhancing their capacity to overcome everyday adversity. Participants will also receive short weekly telephone support. Participants in the control group will be assessed before and after a seven-week waiting period, and then they will be offered the same intervention. Participants will be randomly assigned to one of the 2 groups. Measurements will be taken at five different moments: baseline, post-intervention, and three follow-up periods (3-, 6- and 12-month). BDI-II and BAI will be used as primary outcome measures. Secondary outcomes will be symptoms of AjD, posttraumatic growth, positive and negative affect, and quality of life. Discussion: The development of ICBT programs like TAO responds to a need for evidence-based interventions that can reach most of the people who need them, reducing the burden and cost of mental disorders. More specifically, TAO targets AjD and will entail a step forward in the treatment of this prevalent but under-researched disorder. Finally, it should be noted that this is the first RCT focusing on an internet-based intervention for AjD in the Spanish population., This study was funded by the Ministry of Economy and Competitiveness (Spain) (Plan Nacional I + D + I: PSI2013-41783-R). The funding institution had no role in the design of the study and will not have any role during its execution, analyses and interpretation of the data, or decision to submit results.

III Jornades d’Investigació per a l’Alumnat de la Facultat de Ciències de la Salut Introducción: El trastorno adaptativo (TA) es uno de los problemas psicológicos másprevalentes, pero se desconocen los factores que puedan influir en su gravedad orespuesta al tratamiento. Diferentes estudios indican que el bienestar y otras variablespositivas pueden influir en la morbilidad y cambio clínico (CC). Objetivos: Analizar lacapacidad de algunas variables psicológicas positivas (VP+) para predecir la intensidadde la sintomatología clínica en pacientes con TA, y explorar en qué medida predicenel CC tras la intervención. Método: La muestra incluyó 44 pacientes. Los cuestionariosde autoestima, refuerzos ambientales (EROS) y bienestar psicológico (BP-29)se utilizaron como medidas de VP+ antes del tratamiento psicológico. El CC en síntomasde depresión, estrés y pérdida, y afecto positivo y negativo se evaluó en el posttratamientoy seguimientos (3, 6 y 12 meses). Resultados: Un entorno reforzantepredecía la intensidad de la sintomatología clínica, siendo ésta menos grave en pacientesque lo valoraban como más reforzante. Poseer en menor medida VP+ relacionadascon autoestima, refuerzo del entorno y ciertas dimensiones de bienestar psicológico(crecimiento personal y autoaceptación), predecía mayor CC después de laintervención. Conclusiones: Los resultados apoyan la hipótesis de que las VP+, tantopersonales como del entorno, funcionan como factores protectores ante la adversidaden pacientes con TA. Sin embargo, el poseer en menor medida dichas cualidades pareceno impedir a los pacientes beneficiarse del tratamiento. Esto podría indicar quedurante la intervención los pacientes adquieren conocimientos y herramientas necesariaspara el cambio, independientemente de sus recursos iniciales. Introduction: Adjustment Disorders (AD) are one of the most prevalent psychologicalproblems, but the factors that might influence in their severity or response to treatmentare unknown. Different studies indicate that well-being and other positive variables mayinfluence morbidity and clinical change (CC). Objectives: To analyze the capacity ofsome positive psychological variables (PV+) to predict the intensity of the clinical symptomsin patients with AD, and to examine whether they predict the CC after intervention.Method: The sample consisted of 44 patients. The questionnaires of self-esteem, environmentalreinforcements (EROS) and well-being (BP-29) were used as measures ofPV+ before receiving psychological treatment. The CC in symptoms of depression,stress and loss, and positive and negative affect were assessed at post-treatment andfollow-ups (3, 6 and 12 months). Results: A reinforcing environment predicted the intensityof the clinical symptoms, being this less severe in patients who perceived it morereinforcing. Having in a lesser extent PV+ related to self-esteem, environmental reinforcementand certain dimensions of well-being (personal growth and self-acceptance)predicted greater CC after intervention. Conclusions: Results support the hypothesisthat PV+, both personal and environmental, act as protective factors against adversityin patients with AD. However, having in a lesser extent these qualities seems not toprevent patients to get benefit from treatment. This could indicate that during the treatmentpatients acquire the knowledge and tools needed for the change, regardless theirinitial resources.

III Jornades d’Investigació per a l’Alumnat de la Facultat de Ciències de la Salut Introducción: La relación existente entre la satisfacción con la vida y la felicidad conrespecto a variables psicológicas clínicas ha sido ampliamente estudiada. Existen estudiosque muestran al afecto positivo como amortiguador del estrés y de otros síntomasclínicos, así como potenciador de comportamientos saludables y calidad de vida.Objetivo: Explorar las relaciones existentes entre las variables de satisfacción con lavida y felicidad subjetiva como factores protectores de síntomas clínicos en una muestrade pacientes diagnosticados de Trastorno Adaptativo (TA). Método: La muestraincluyó 46 participantes (media de edad= 33.2; DT= 8.47). Como medidas positivas seincluyeron las escalas de felicidad subjetiva (SHS) y satisfacción con la vida (SWLS).Las medidas clínicas fueron: depresión, síntomas de estrés y pérdida y percepción decapacidad para afrontar el problema. Resultados: Se obtuvieron correlaciones significativasen la dirección esperada entre las variables positivas y las variables clínicasde depresión y autoeficacia. Los síntomas de estrés y pérdida solamente correlacionaronsignificativamente con la felicidad. Los resultados posteriores mediante regresiónlineal reflejaron que ambas variables positivas predecían la gravedad de la sintomatologíadepresiva. Además, la satisfacción con la vida predecía el grado deautoeficacia para afrontar el problema, mientras que la felicidad subjetiva fue predictorade menos síntomas de estrés y pérdida asociados al mismo. Conclusión: Losresultados preliminares obtenidos están en la línea de los hallados en otros trabajos yreflejan la importancia de atender, en pacientes con diagnóstico de TA, a variablespsicológicas positivas como las incluidas en este estudio. Introduction: The relationship between satisfaction with life and the growing happinessof clinical psychological variables has been thoroughly studied. Some studiesshow positive affection as a shock absorber of stress and other clinical symptoms, aswell as an enhancer of healthy behaviors and quality of life. Objective: To explore therelationship between life satisfaction and subjective happiness as protective factors forclinical symptoms in a sample of patients diagnosed with Adjustment Disorder (AD).Method: The sample included 46 participants (mean age = 33.2, SD = 8.47). Positivemeasures included subjective happiness (SHS) and satisfaction with life (SWLS)scales. The clinical measures were: depression, symptoms of stress and loss, and perceptionof the ability to cope with the problem. Results: Significant correlations wereobtained in the expected direction between the positive variables and the clinical variablesof depression and self-efficacy. Symptoms of stress and loss only correlatedsignificantly with happiness. Subsequent linear regression results showed that bothpositive variables predicted the severity of depressive symptoms. In addition, satisfactionwith life predicted the degree of self-efficacy to cope with the problem, while subjectivehappiness was predictive of less symptoms of stress and loss associated with it.Conclusion: The preliminary results obtained are in line with those found in other studiesand reflect the importance of attending, in patients with a diagnosis of AD, positivepsychological variables such as those included in this study.

Introducción: Tradicionalmente, los tratamientos basados en la evidencia para la depresión se han centrado en los síntomas clínicos. La combinación de estrategias de psicología positiva y los enfoques tradicionales han recibido poca atención empírica en el ámbito clínico. Objetivo: El des- arrollo e implementación de un protocolo basado en la psicología clínica positiva para síntomas depresivos. Método: El protocolo fue aplicado en 5 pacientes con síntomas depresivos. La depre- sión, la ansiedad, el afecto y la orientación al disfrute se evaluaron antes, después del tratamiento, y a los 3 meses de seguimiento. También se evaluó la opinion sobre este programa. Resultados: La intervención fue viable, no sólo para la reducción de depresión, la ansiedad y el afecto negativo, sino también en el aumento del afecto positivo y la orientación al disfrute. Conclusiones: Es impor- tante continuar con el desarrollo de intervenciones centradas tanto en los aspectos negativos como positivos del funcionamiento humano. Introduction: Traditionally, evidence-based treatments for depression have focused on clinical symptoms. The combination of positive psychological strategies and traditional approaches has re- ceived little empirical attention in clinical settings. Objective: The development and implementation of a positive clinical psychology protocol for depressive symptoms. Method: The protocol was ap- plied in five depressed patients. Depression, anxiety, affect and orientation towards enjoyment were measured at pre-, post-treatment, and at 3-month follow-up. Opinion on the program was also as- sessed. Results: The intervention was feasible, not only for reducing depression, anxiety and neg- ative affect, but also for increasing positive affect and orientation towards enjoyment. Conclusions: It is important to continue to investigate the development of interventions focusing on both negative and positive aspects of human functioning.

Introducción: En la actualidad, los trastornos adaptativos (ta) constituyen uno de los problemas psicológicos más frecuentes en atención primaria y hospitalaria. No obstante, existen pocos estudios sobre su tratamiento y las variables que influyen en la eficacia del mismo. El objetivo de este trabajo es explorar el papel de las expectativas y la satisfacción en la eficacia del tratamiento de los ta. Método: La muestra incluyó 46 participantes con ta (34 mujeres y 12 hombres). La edad media fue de 33,28 años (d. t.=8,47). Todos ellos recibieron un tratamiento cognitivo-conductual de 6-8 sesiones en 2 formatos (tradicional: n=22 y realidad virtual: n=24) y cumplimentaron las escalas de expectativas y satisfacción adaptadas de Borkovec y Nau (1972). Como medidas de eficacia se calcularon los índices de cambio fiable obtenidos tras el tratamiento y seguimiento a los 3 meses en el Inventario de Crecimiento Postraumático, el Inventario de Estrés y Pérdida (iep) y la escala de afecto negativo del panas. Resultados: En el post-tratamiento, el cambio estuvo relacionado con la satisfacción de los pacientes con el tratamiento recibido, concretamente con los aspectos relacionados con su utilidad y lógica. En el seguimiento, además de la satisfacción, las expectativas resultaron ser también una variable importante cuando se utilizó el iep como medida de cambio terapéutico. Conclusiones: Los resultados obtenidos ponen de manifiesto el papel que juegan las expectativas y satisfacción con el tratamiento en la eficacia terapéutica y, en consecuencia, la importancia de diseñar tratamientos psicológicos que sean no solamente eficaces, sino también bien aceptados por los pacientes. Introduction: Nowadays, ad are one of the most prevalent psychological problems in primary care and hospital settings. However, few studies about its treatment and the variables that influence its efficacy are available. The aim of the present work is to explore the role of expectations and satisfaction in treatment efficacy of ad. Method: The sample included 46 participants with ta (34 women and 12 men). The mean age was 33.28 years (sd = 8.47). All they received 6-8 cognitive-behavioral therapy sessions in 2 formats (traditional: n=22 and virtual reality: n=24) and filled out the expectations and satisfaction scales adapted Borkovec and Nau (1972). As measures of treatment outcome reliable change indexes were obtained after treatment and at 3-month follow-up for the Posttraumatic Growth Inventory, the Inventory of Stress and Loss (ies) and the panas negative affect scale. Results: At post-treatment, change was associated with participants’ satisfaction with the received treatment, specifically with aspects related to its utility and logic. At follow-up, in addition to satisfaction, expectations turned out to be also an important variable when the iel was used as therapeutic change measure. Conclusions: Results highlight the role of expectations and satisfaction with treatment in the therapeutic efficacy and, therefore, the importance of designing psychological treatments that are not only efficacious but also to be well accepted by patients.