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Treball Final de Màster Universitari en Psicologia General Sanitària. Codi: SBF018. Curs acadèmic: 2021/2022 Introducción. El deportista de alto rendimiento está permanentemente en contacto con la exigencia de lograr la perfección y perseguir los objetivos competitivos establecidos. Están expuestos a altos niveles de ansiedad y las expectativas de entrenadores o los medios de comunicación les mueven hacia unos estándares a menudo imposibles de alcanzar. El objetivo de este trabajo es poner a prueba la eficacia de la Terapia Racional Emotiva Conductual (TREC) usando un diseño de caso único con líneas bases múltiples (donde cada línea base corresponde a un componente terapéutico). Método. Para ello, se realizará una Evaluación Ecológica Momentánea con una aplicación móvil, el “Monitor de Dolor Multicéntrico”, para valorar la capacidad de la terapia para reducir los niveles basales en las tres exigencias propuestas por Albert Ellis (Éxito, Aprobación y Comodidad) en una jugadora de pádel semiprofesional. Resultados. La TREC sí fue, en general, efectiva para modificar las creencias más limitantes, reduciendo los niveles de exigencia principalmente en el componente de aprobación por los demás, así como mejorar la depresión y aumentar la exposición a juicios ajenos. Discusión. Este trabajo ha tenido tanto beneficios para la participante como para el investigador, sobre todo gracias al uso de tecnología. Por lo tanto, por su elevada aplicabilidad clínica, esta metodología puede ser una buena herramienta para futuras investigaciones que permita evaluar y guiar el tratamiento con deportistas profesionales. Introduction. High-performance athletes are constantly in contact with the demand to achieve perfection and pursue established competitive objectives. They are exposed to high levels of anxiety and the expectations of coaches or the media move them towards standards that are often impossible to achieve. The objective of this work is to test the efficacy of Rational Emotive Behavioral Therapy (REBT) using a single case design with multiple baselines (where each baseline corresponds to a therapeutic component). Method. For this, a Momentary Ecological Evaluation was implemented using a mobile application, the "Multicentric Pain Monitor", to assess the ability of the treatment to reduce the baseline levels in the three demands proposed by Albert Ellis (Success, Approval, and Comfort) in a semi-professional padel player. Results. REBT was, in general, effective in modifying the most limiting beliefs, reducing the levels of demand mainly in the component of approval by others, as well as improving depression and increasing exposure to other people's judgments. Discussion. This work has had both benefits for the participant and for the researcher, especially thanks to the use of technology. Therefore, due to its high clinical applicability, this methodology can be a good tool for future research to evaluate and guide treatment with professional athletes.

La finalidad del presente estudio fue desarrollar estrategias a nivel cognitivo, emocional y conductual en la consultante a fin de disminuir su ansiedad. La intervención se realizó a una persona de 23 años que presentaba ansiedad a raíz de una ruptura de pareja, los cuales eran acompañados de pensamientos irracionales constantes. Para tal motivo, se realizó la intervención en 18 sesiones virtuales desde la Terapia Racional Emotiva Conductual (TREC). Los resultados obtenidos indicaron que la paciente disminuyó el nivel de ansiedad a partir de la incorporación de estrategias. Así mismo, reestructuró los pensamientos irracionales por un sistema de pensamientos flexibles, adaptativos y realistas. Por último, desarrolló estrategias que le permiten solucionar los diferentes conflictos que pueda vivenciar. The purpose of the present study was to develop strategies at the cognitive, emotional and behavioral level in the consultant in order to reduce her anxiety. The intervention was carried out on a 23-year-old person who presented anxiety as a result of a couple breakup, which were accompanied by constant irrational thoughts. For this reason, the intervention was carried out in 18 virtual sessions from Rational Emotive Behavioral Therapy (REBT). The results, that we obtained, indicated that the patient decreased the level of anxiety after the incorporation of strategies. Likewise, the patient restructured irrational thoughts into a system of flexible, adaptive and realistic thoughts. Finally, she developed strategies that allow him to solve the different conflicts that he may experience.

El presente trabajo evidencia la intervención desde el enfoque de la Terapia Racional Emotiva Conductual (TREC) de Ellis en una usuaria de 26 años sin autoaceptación incondicional. Se observan creencias irracionales de demanda absoluta sobre ella misma. El objetivo general de la intervención consiste en lograr la autoaceptación incondicional de la usuaria mediante la identificación y modificación de creencias irracionales a racionales de la TREC. Las técnicas de evaluación utilizadas fueron la entrevista psicológica, observación conductual y la evaluación racional emotiva. Asimismo, las técnicas de intervención fueron las técnicas TREC (ABC, debate de creencias irracionales, hechos vs. interpretaciones, demandas vs. preferencias, imperfección exitosa y entrenamiento en solución de problemas) y la inclusión de la técnica de la Terapia de Esquemas Emocionales (TEE) de Leahy (autovalidación). La intervención se realizó en 18 sesiones con una duración de cinco meses. El resultado de la intervención fue el logro de la autoaceptación incondicional de la usuaria a través del cambio de creencias irracionales a creencias racionales; lo que generó, la reducción de la intensidad de las emociones de vergüenza, tristeza, frustración, enojo y miedo y el logro de comportamientos funcionales. Por todo ello, se concluye la eficacia de la intervención TREC en la usuaria. The present work evidences the intervention from Ellis' Rational Emotive Behavioral Therapy (REBT) approach in a 26-year-old client without unconditional self-acceptance. Irrational beliefs of absolute demand about herself are observed. The general objective of the intervention is to achieve unconditional self-acceptance of the client through the identification and modification of irrational to rational beliefs of the REBT. The assessment techniques used were psychological interview, behavioral observation, and rational emotive assessment. Likewise, the intervention techniques were the REBT techniques (ABC, irrational belief debate, facts vs. interpretations, demands vs. preferences, successful imperfection, and problem-solving training) and the inclusion of Leahy's Emotional Schema Therapy (EST) technique (self-validation). The intervention was carried out in 18 sessions with a duration of five months. The result of the intervention was the achievement of unconditional self-acceptance of the user through the modification of irrational beliefs to rational beliefs, which generated the reduction of the intensity of the emotions of shame, sadness, frustration, anger and fear, and the achievement of functional behaviors. Therefore, the efficacy of the REBT intervention in the client is concluded.

Background/Objective: Environmental factors such as psychosocial stress have demonstrated to have an impact on the breast cancer (BC) course. This study aims to explore the impact of psychotherapy and stressful life events (SLE) on BC survivors’ illness trajectories. Method: 68 women with BC underwent Positive Psychotherapy or Cognitive-Behavioral Stress Management and 37 patients were included as a control group. The effects of distress reduction and SLE on their 5-year recurrence were investigated. Additional analyses examined the effect of receiving vs. not receiving psychotherapy and of the type of therapy on survival and disease-free interval, DFI. Results: A one-point decrease of the Hospital Anxiety and Depression Scale (HADS) after psychotherapy predicted a lower risk of 5-year recurrence, OR = 0.84, p = .037, 95% CI = 0.71-0.99). Also, a one point-increase in the number threatening SLE (OR = 1.92; p = .028, 95% CI = 1.07-3.43) was related to higher 5-year recurrence. Conclusions: The findings highlight the necessity of studying not only a given situation (i.e., psychotherapy, SLE) but its specific impact on individuals. Antecedentes/Objetivo: El estrés psicosocial ha demostrado tener un impacto en la evolución del cáncer de mama (CM). Este estudio tiene como objetivo explorar el impacto de la psicoterapia y de los acontecimientos vitales estresantes (AVE) en la supervivencia de pacientes con CM. Método: 113 mujeres con CM recibieron psicoterapia positiva o terapia cognitivo-conductual para manejar el estrés y 37 se incluyeron como grupo control. Se analizaron los efectos de la reducción de la Escala de Ansiedad y Depresión Hospitalaria (HADS) y de los AVE sobre la recurrencia a los cinco años, así como el efecto de recibir psicoterapia y del tipo de enfoque d esta sobre la supervivencia. Resultados: La reducción de un punto en la HADS después de recibir psicoterapia predijo un menor riesgo de recurrencia, OR = 0,84, p = 0,037, IC 95% = 0,71-0,99. Además, cada aumento en el número de AVE vividos como amenazantes (OR = 1,92; p = 0,028, 95% CI = 1,07-3,43) se relacionó con una mayor recurrencia. Conclusiones: Los resultados indican la necesidad de estudiar no solo la presencia de un evento potencialmente impactante en la conducta (psicoterapia o AVE) sino el efecto especifico que ha tenido en cada individuo.

Objectives: Analyze the psychometric properties of a new measure for the assessment of the irrational beliefs proposed by Ellis in his model of Rational-Emotive-Behavioral Therapy (REBT): the Scale of Irrational Contents and Styles - Basics (SICS-B). The SICS-B evaluates the 'contents' of the three basic irrational beliefs (Ap: Approval, Pe: Perfectionism, and Co: Comfort) in relation to the four different 'styles' (inferences or processes of thought) in which they can be expressed (DEM: Demandingness, AWF: Awfulizing, FI: Frustration Intolerance, and CON: Condemnation). Methods: Participants: 259 respondents (79.5% women) undergraduates (63%) and (post)graduates (37%) between 18-63 years (M=26.5, SD=10.7). Procedure: A set of 72 statements were drafted (half in a rational way) using a 5-point Likert scale to cover the three areas of content and the four styles of irrational thinking (3x4 subscales), of which to choose the three items of each area with highest psychometric indices and elaborate with them the definitive scale of 36 items. Psychometric Analysis: The reliability and validity study was carried out through a comparative item analysis (average inter-item correlations, item-total correlations) and internal consistency (Ordinal α) of each subscale, and confirmatory factor analyses of several models. Results: The SICS-B presents good indices of internal consistency and content validity. Confirmatory factor analyses validate the 3x4 model in which the three specific contents of the irrational beliefs are integrated with the four main styles of irrational thinking as proposed by the REBT. Conclusions: The SICS-B is a reliable and valid short scale for the assessment of irrational beliefs.

IntroductionThe IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre–post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes.Methods and analysisParticipants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed.Ethics and disseminationThis study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities.Trial registration numberNCT04140838

To analyze the construct validity and internal consistency of a new test for the assessment of the irrational beliefs proposed by Ellis in his model of Rational Emotive Behavioral Therapy (REBT): the Scale of Irrational Contents and Styles – Basics (SICS-B). The SICS-B evaluates the "contents" of the three basic irrational beliefs (Ap: Approval, Pe: Perfectionism, and Co: Comfort) in relation to the four different "styles" (inferences or processes of thought) in which they can be expressed (DEM: Demandingness, AWF: Awfulizing, FI: Frustration Intolerance, and CON: Condemnation).

The aim of the study was to measure the effect of three cost-neutral behavioral interventions on participation compared to the standard invitation letter in a population-based colorectal cancer screening program in 2014. For that purpose, a four-arm randomized field trial was conducted among 5077 individuals aged 50 to 69 years. Over an 8-week period, each week was randomly allocated to the intervention or the control conditions. Individuals assigned to the intervention conditions additionally received a prompt to write down the date to pick up the screening test in a pharmacy. Two of the three intervention groups also included an additional paragraph in the invitation letter on either: 1) the high proportion of individuals participating regularly (social norms condition) or 2) the importance of regular participation (benefit condition). We measured screening participation before and after receiving a reminder letter six weeks after the screening invitation. An overall 8.0 percentage point increase in CRC screening was achieved as a direct result of receiving a reminder letter; however none of the intervention strategies influenced participation. The only significant difference was found for newly invited individuals. There, participation rates decreased from 34.9% to 24.2% when the invitation mailing mentioned the importance of regular participation (OR: 0.60; 95% CI: 0.38–0.95). While none of the intervention strategies improved participation rates we found that praising the benefit of regular screening may discourage individuals who have never been invited before as the continuous behavior may be perceived as a large request. Nevertheless, the reminder letter boosted participation rates independently of the intervention assigned.

La edad cronológica, variable central en la definición de diferencias generacionales en las representaciones del papel del género femenino, se ha cuestionado como resultado de la desaparición de dichas diferencias en función de la experiencia bicultural migratoria, que es compartida por madres e hijas colombianas en los Estados Unidos. Este estudio explora el nivel de generalización de este proceso de cambio a otras poblaciones hispanas, con muestras ecuatorianas residentes en Ecuador y otras en Estados Unidos. Los resultados de comparaciones post-hoc confirmaron los hallazgos previos en mujeres colombianas, en el sentido de que las diferencias entre madres e hijas parecen desaparecer en ecuatorianas residentes en los Estados Unidos, pero no en las residentes en Ecuador.