An adaptive display to treat stress-related disorders: EMMA's World

ABSTRACT Most of the virtual environments currently available in the field of psychological treatments were designed to solve a specific problem. Our research group has developed a versatile virtual reality system (an adaptive display) called ‘EMMA's world’, which can address a wide range of problems. It was designed to assist in clinical situations where a person has suffered a stressful experience, for example post-traumatic stress disorder, adjustment disorder, and pathological grief. To accomplish therapeutic goals, a series of emotional virtual elements are used and personalised so that they are meaningful to the user and contain the fundamental emotional elements that the person must …

Treating cockroach phobia using a serious game on a mobile phone and augmented reality exposure: A single case study

In vivo exposure has proved its efficacy in the treatment of specific phobias; however, not all patients benefit from it. Communication and information technologies such as Virtual Reality (VR) and Augmented Reality (AR) have improved exposure treatment adherence and acceptance. Serious games (SG) could also be used in order to facilitate exposure treatment. A line of research on SG is emerging which focuses on health issues. We have developed a SG for the treatment of cockroach phobia that uses a mobile phone as the application device. This work examines results of an N = 1 study about whether the use of this mobile game can facilitate treatment of this specific phobia preparing her for th…

Brief Acceptance and Commitment Therapy for Fibromyalgia: Feasibility and Effectiveness of a Replicated Single-Case Design

Objective. Overall, the literature on the effectiveness of psychological treatments in general and those for fibromyalgia in particular has been dominated by research designs that focus on large groups and explore changes on average, so the treatment impact at the individual level remains unclear. In this quasi-experimental, replicated single-case design, we will test the feasibility and effectiveness of a brief acceptance and committed therapy intervention using ecological momentary assessment supported by technology. Methods. ,e sample comprised 7 patients (3 in the individual condition and 4 in the group condition) who received a brief, 5-week psychological treatment. Patient evolution w…

Efficacy of a Transdiagnostic internet-based treatment for emotional disorders with a specific component to address positive affect: Study protocol for a randomized controlled trial

Background Emotional disorders (ED) are among the most prevalent mental disorders. However, less than 50% of people suffering from ED receive the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which tries to address the underlying processes common to ED. Most of these programs focus primarily on down-regulating negative affectivity, rather than increasing strengths and up-regulating positive affectivity. The data suggest the existence of disturbances in positive affectivity in these disorders, and so new interventions focusing on these problems are greatly needed. It is also essential to provide assist…

Predicting response to transdiagnostic iCBT for emotional disorders from patient and therapist involvement

Background Transdiagnostic iCBT has been shown to be effective for the treatment of emotional disorders. Less is known about the optimal level of therapist and patient involvement in these interventions. Specific characteristics of Internet-delivered interventions include treatment adherence (e.g., amount of review of the materials) and guidance (e.g., amount of therapist support). Exploring the importance of these elements in treatment outcome may help to maximize the efficiency of Internet-delivered psychological interventions. Aim In this study, we aimed to analyze the relationship between patient and therapist involvement (i.e., platform usage and amount of therapist guidance) in a samp…

Efficacy of low-intensity psychological intervention applied by ICTs for the treatment of depression in primary care: a controlled trial

Background: Depression is one of the most common disorders in Psychiatric and Primary Care settings and is associated with significant disability and economic costs. Low-intensity psychological interventions applied by Information and Communication Technologies (ICTs) could be an efficacious and cost-effective therapeutic option for the treatment of depression. The aim of this study is to assess 3 low-intensity psychological interventions applied by ICTs (healthy lifestyle, positive affect and mindfulness) in Primary Care; significant efficacy for depression treatment has previously showed in specialized clinical settings by those interventions, but ICTs were not used. Method: Multicenter c…

Ecological momentary intervention to enhance emotion regulation in healthcare workers via smartphone: a randomized controlled trial protocol

Abstract Background CUIDA-TE is an APP that offers transdiagnostic cognitive behavioral therapy focused on enhancing emotion regulation. As a novelty, it incorporates ecological momentary interventions (EMI), which can provide psychological support in real time, when suffering arises. The main goal of the study is to evaluate the efficacy of CUIDA-TE to improve emotion regulation in healthcare workers, a population that has been particularly emotionally impacted by the COVID-19 pandemic. Methods In this three-arm, randomized controlled trial (RCT) the study sample will be composed of a minimum of 174 healthcare workers. They will be randomly assigned to a 2-month EMI group (CUIDA-TE APP, n …

La realidad virtual en las intervenciones psicológicas con pacientes oncológicos

El objetivo de este trabajo es presentar las principales aportaciones de la Realidad Virtual (RV) en el tratamiento psicologico con pacientes oncologicos, y describir un programa de intervencion que utiliza esta tecnologia para promover bienestar emocional en pacientes hospitalizados. La RV se presenta como una prometedora herramienta de apoyo al paciente oncologico. Diversos estudios plantean su utilidad para hacer algunos tratamientos medicos mas tolerables, para reducir los niveles de distres y dolor, asi como promover mayores niveles de emociones positivas. Se ha empleado principalmente con pacientes ambulatorios, existiendo una menor proporcion de propuestas dirigidas al periodo de hos…

Effectiveness of a transdiagnostic internet-based protocol for the treatment of emotional disorders versus treatment as usual in specialized care: study protocol for a randomized controlled trial.

Emotional disorders (depression and anxiety disorders) are highly prevalent mental health problems. Although evidence showing the effectiveness of disorder-specific treatments exists, high comorbidity rates among emotional disorders limit the utility of these protocols. This has led some researchers to focus their interest on transdiagnostic interventions, a treatment perspective that might be more widely effective across these disorders. Also, the current way of delivering treatments makes it difficult provide assistance to all of the population in need. The use of the Internet in the delivery of evidence-based treatments may help to disseminate treatments among the population. In this stu…

Psychometric properties of the Spanish validation of the Five Facets of Mindfulness Questionnaire (FFMQ)

Background and Objectives: Mindfulness-based therapies have demonstrat- ed effectiveness in many clinical contexts. Various therapies that train mindfulness skills have proliferated in recent years. There is increasing interest in mindfulness-based thera- pies and in incorporating instruments that measure mindfulness in order to understand its role in clinical and basic research. The Five Facets of Mindfulness Questionnaire (FFMQ) is a questionnaire for measuring mindfulness; it was derived from a factor analysis of five different questionnaires that measure a trait-like general tendency to be mindful in daily life. The objective of this study is to validate the FFMQ in a Spanish sample. Me…

Efficacy of a blended low-intensity internet-delivered psychological programme in patients with multimorbidity in primary care: study protocol for a randomized controlled trial.

BackgroundThe World Health Organization (WHO) has included comorbidity between depression and a chronic disease among the 10 leading global health priorities. Although there is a high prevalence of multimorbidity, health care systems are mainly designed for the management of individual diseases. Given the difficulty in delivering face-to-face psychological treatments, alternative models of treatment delivery have been proposed, emphasizing the role of technologies such as the Internet. The aim of this study is to assess the efficacy in Primary Care (PC) of a blended low-intensity psychological intervention applied using information and communication technologies (ICTs) for the treatment of …

Negative and Positive Affect Regulation in a Transdiagnostic Internet-Based Protocol for Emotional Disorders: Randomized Controlled Trial

Background Emotional disorders (EDs) are among the most prevalent mental disorders. Existing evidence-based psychological treatments are not sufficient to reduce the disease burden of mental disorders. It is therefore essential to implement innovative solutions to achieve a successful dissemination of psychological treatment protocols, and in this regard, the use of information and communication technologies such as the internet can be very useful. Furthermore, the literature suggests that not everyone with an ED receives the appropriate treatment. This situation has led to the development of new intervention proposals based on the transdiagnostic perspective, which attempts to address the…

Blended transdiagnostic group CBT for emotional disorders: A feasibility trial protocol

Introduction Emotional disorders (anxiety and depressive disorders) are a relevant public health concern associated with high prevalence, high costs, and important disability. Therefore, research priorities include designing and testing cost-effective interventions to reach everyone in need. Internet-delivered interventions for emotional disorders are effective and can help to disseminate and implement evidence-based treatments. However, although these treatments are generally effective, not all patients benefit from this treatment format equally. Blended treatments are a new form of intervention that combines the strengths of face-to-face and Internet approaches. Nevertheless, research on …

Acceptability of virtual reality interoceptive exposure for the treatment of panic disorder with agoraphobia

Interoceptive exposure (IE) is a standard component of cognitive-behavioural therapy (CBT) for panic disorder and agoraphobia. The virtual reality (VR) program ‘Panic-Agoraphobia’ has several virtual scenarios designed for applying exposure to agoraphobic situations; it can also simulate physical sensations. This work examines patients' acceptability of the IE component as applied in two different ways: using VR versus traditional IE. Additionally, it explores the relationship between users' treatment expectations and satisfaction and clinically significant change. Results showed that VR and traditional IE were well accepted by all participants. Furthermore, treatment expectations predicted…

An Internet based intervention for improving resilience and coping strategies in university students: Study protocol for a randomized controlled trial

Background The literature shows a high prevalence of depression and anxiety in young people. The university represents a change in the lives of students, and is considered a stress factor. Therefore, it is particularly relevant to develop interventions specifically addressed to students and foster supportive environments and resilient communities. As students are “digital natives”, online interventions offer several potential advantages in doing this. This study aims to develop and evaluate the efficacy of an Internet-based intervention (CORE: Cultivating our Resilience), based on the Ryff model of well-being, to promote resilience and coping skills, decrease symptoms of depression and anxi…

Characterizing Breakthrough Cancer Pain Using Ecological Momentary Assessment with a Smartphone App: Feasibility and Clinical Findings.

Background: mobile applications (apps) facilitate cancer pain ecological momentary assessment (EMA) and provide more reliable data than retrospective monitoring. The aims of this study are (a) to describe the status of persons with cancer pain when assessed ecologically, (b) to analyze the utility of clinical alarms integrated into the app, and (c) to test the feasibility of implementing an app for daily oncological pain monitoring. Methods: in this feasibility study, 21 patients (mean age = 56.95 years, SD = 10.53, 81.0% men) responded to an app-based evaluation of physical status (baseline and breakthrough cancer pain (BTcP)) and mental health variables (fatigue, mood, and coping) daily d…

Internet-Based Intervention for Secondary and Tertiary Prevention of Depressive Symptoms

Depression is one of the most disabling psychological disorders worldwide. A very important challenge today consists on addressing the issue of depression from a preventive perspective. A growing body of research supports the efficacy of Internet-based treatments. We have developed an Internet-based program (Smiling is Fun) with the objective of helping people in prevention of depression and anxiety symptoms. It is based on classical cognitive behavioral techniques, such as behavioural activation, and also includes other positive psychological strategies to improve coping ability and positive mood. We applied this intervention program in people who had to cope at least with one stressor in …

An Internet-Based Self-Help Program for the Treatment of Fear of Public Speaking: A Case Study

ABSTRACT This article discusses the development of the first totally self-administered online CBT program for the treatment of a specific social phobia (fear of public speaking) called talk to me. The online program includes three parts. The assessment protocol gives the patient information about the problem, including impairment, severity, and the degree of fear and avoidance regarding the main feared situations. The structured treatment protocol ensures that the patient does not skip any steps in the treatment. The treatment protocol is a CBT program that provides exposure to the feared situation using videos of real audiences. Finally, the control protocol assesses treatment efficacy, no…

Virtual reality exposure-based therapy for the treatment of post-traumatic stress disorder: a review of its efficacy, the adequacy of the treatment protocol, and its acceptability

Introduction The essential feature of post-traumatic stress disorder (PTSD) is the development of characteristic symptoms following exposure to one or more traumatic events. According to evidence-based intervention guidelines and empirical evidence, one of the most extensively researched and validated treatments for PTSD is prolonged exposure to traumatic events; however, exposure therapy can present some limitations. Virtual reality (VR) can help to improve prolonged exposure because it creates fictitious, safe, and controllable situations that can enhance emotional engagement and acceptance. Objective In addition to carrying out a review to evaluate the efficacy of VR exposure-based thera…

Dropping out of a transdiagnostic online intervention: A qualitative analysis of client's experiences

Introduction An important concern in Internet-based treatments (IBTs) for emotional disorders is the high dropout rate from these protocols. Although dropout rates are usually reported in research studies, very few studies qualitatively explore the experiences of patients who drop out of IBTs. Examining the experiences of these clients may help to find ways to tackle this problem. Method A Consensual Qualitative Research study was applied in 10 intentionally-selected patients who dropped out of a transdiagnostic IBT. Results 22 categories were identified within 6 domains. Among the clients an undeniable pattern arose regarding the insufficient support due to the absence of a therapist and t…

Efficacy and cost-effectiveness of a blended cognitive behavioral therapy for depression in Spanish primary health care:Study protocol for a randomised non-inferiority trial

Background: Data from primary health care in Spain show a high prevalence of the major depressive disorder. Blended treatment (combination of face-to-face and online components) seems to be a very promising tool for the optimization and dissemination of psychological treatments in a cost-effective form. Although there is growing data that confirm the advantages of blended therapies, few studies have analyzed their application in regular clinical practice. The objective of the present paper is to describe the protocol for a clinical study aimed at exploring the clinical and cost-effectiveness of a blended cognitive behavioral therapy (b-CBT) for depression, compared to treatment as usual (TA…

Confirmatory factor analysis and psychometric properties of the Emotion Regulation Questionnaire in participants with personality disorders

Emotional dysregulation is a key symptom in participants with personality disorders. The Emotional Regulation Questionnaire (ERQ) has been studied with nonclinical samples; however, it is necessary to confirm the factorial structure of the ERQ in participants with personality disorders. The aims of the present study were to confirm the factorial structure of the Spanish version of the ERQ and analyse its psychometric properties as well as the association between the ERQ and the Borderline Symptoms List (BSL-23) and the Difficulties in Emotion Regulation Scale (DERS). The overall sample was composed of 250 patients with personality disorders, of whom 195 met the criteria for borderline perso…

Virtual Reality, Augmented Reality, and In Vivo Exposure Therapy: A Preliminary Comparison of Treatment Efficacy in Small Animal Phobia

This study aggregated data from three randomized control trials to explore the differential efficacy of three forms of exposure therapy, namely, in vivo (iVET), virtual reality (VRET), and augmented reality (ARET), in the treatment of small animal phobia. Additionally, baseline patient characteristics were used to detect subgroups of patients who showed a differential response to certain treatment modalities. Primary measures were distance covered, anxiety during the behavioral avoidance test (BAT), and overall fear of small animals. A repeated-measures analysis of variance was used to explore the overall treatment effect across the exposure modalities. A cluster analysis and an analysis of…

Retos de la investigación psicológica en salud mental

La magnitud y el impacto que suponen los trastornos mentales no se corresponden con los recursos que se dedican a su investigación y atención. Aunque hemos avanzado notablemente en su comprensión y en la eficacia de los tratamientos psicológicos que intentan paliarlos, estamos aún lejos de la situación óptima. Este trabajo se centra en uno de los retos y una de las necesidades que consideramos fundamentales, el incremento de la investigación focalizada en psicopatología, especialmente sobre los mecanismos y procesos que explican y mantienen estos problemas, como eje básico para el desarrollo de nuevas intervenciones psicológicas, tanto para la prevención como para el tratamiento y promoción…

Design considerations of a randomized clinical trial on a cognitive behavioural intervention using communication and information technologies for managing chronic low back pain

Background Psychological treatments have been successful in treating chronic low back pain (CLBP). However, the effect sizes are still modest and there is room for improvement. A way to progress is by enhancing treatment adherence and self-management using information and communication technologies (ICTs). Therefore, the objective of this study was to design a trial investigating the short- and long-term efficacy of cognitive behavioural treatment (CBT) for CLBP using or not ICTs. A secondary objective of this trial will be to evaluate the influence of relevant variables on treatment response. Possible barriers in the implementation of CBT with and without ICT will also be investigated. Met…

An Internet-based program for depression using activity and physiological sensors: efficacy, expectations, satisfaction, and ease of use

Cristina Botella,1,2 Adriana Mira,1 Inés Moragrega,2,3 Azucena García-Palacios,1,2 Juana Bretón-López,1,2 Diana Castilla,1,2 Antonio Riera López del Amo,1 Carla Soler,1 Guadalupe Molinari,1 Soledad Quero,1,2 Verónica Guillén-Botella,2,3 Ignacio Miralles,1,2 Sara Nebot,1 Berenice Serrano,1,2 Dennis Majoe,4 Mariano Alcañiz,2,5 Rosa María Baños2,31Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume, Castellón, Spain; 2CIBER Physiopathology of Obesity and Nutrition, CIBERobn, Instituto de Salud Carlos III, Santiago de Compostela, Spain; 3Department o…

A smartphone application of “Family Connections” to increase the use of skills and improve psychological symptoms in relatives of people with borderline personality disorder: A study protocol for a randomized controlled trial

The literature reveals that borderline personality disorder (BPD) is an important public mental health problem that affects both the patients and their families. Moreover, studies indicate a high prevalence of psychological symptoms and burden in relatives of people with BPD. Therefore, it is necessary to develop useful and accessible interventions specifically addressed to the caregivers. Smartphone interventions with Ecological Momentary Assessment (EMA) and Ecological Momentary Interventions (EMI) offer several potential advantages in this regard. The aims of our study are to test the effectiveness of a combined intervention supported by a smartphone app versus the same intervention supp…

Exploring the Incorporation of a Positive Psychology Component in a Cognitive Behavioral Internet-Based Program for Depressive Symptoms. Results Throughout the Intervention Process

Traditionally, evidence-based treatments for depression have focused on negative symptoms. Different authors describe the need to include positive affect as a major target of treatment. Positive psychology aims to fill this gap. Reaching everyone in need is also important, and Internet-based interventions can help in this task. The present study is a secondary analysis derived from a randomized controlled trial aimed to test the efficacy of an Internet-based intervention for patients with depressive symptoms. This intervention consisted of an 8-module Internet-based program that combined four modules based on cognitive-behavioral therapy strategies and four modules based on positive psychol…

Ecological momentary assessment for chronic pain in fibromyalgia using a smartphone: A randomized crossover study

Background Daily diaries are a useful way of measuring fluctuations in pain-related symptoms. However, traditional diaries do not assure the gathering of data in real time, not solving the problem of retrospective assessment. Ecological momentary assessment (EMA) by means of electronic diaries helps to improve repeated assessment. However, it is important to test its feasibility in specific populations in order to reach a wider number of people who could benefit from these procedures. Methods The present study compares the compliance and acceptability of an electronic diary running on a smartphone using a crossover design for a sample with a specific pain condition, fibromyalgia and low fam…

Capturing the Severity and Impairment Associated With Depression: The Overall Depression Severity and Impairment Scale (ODSIS) Validation in a Spanish Clinical Sample

Background: The Overall Depression Severity and Impairment Scale (ODSIS) is a self-report scale designed to evaluate the severity and functional impairment associated with depression. Objective: This study evaluated the psychometric properties of the online version of the ODSIS in Spanish outpatients with depression and anxiety disorders. Method: Patients with a main diagnosis of a depressive (n = 283) or anxiety disorder (n = 191) and a mean age of 38.15 (SD = 12.06) were evaluated with a clinical diagnostic interview and measures assessing depression, anxiety, positive and negative affect, and quality of life. Factorial structure, internal consistency, convergent, and discriminant validit…

Designing ICTs for Users with Mild Cognitive Impairment: A Usability Study

Background: Research has supported the cost-effectiveness of cognitive training tools enhanced by information and communication technologies (ICT) in several populations, including individuals with mild cognitive impairment (MCI) and age-related cognitive decline. The implementation of ICTs in this population, however, is sometimes challenging to their cognitive and age characteristics. Ultimately, this might compromise the effectiveness of ICT-enhanced therapies in this population. The aim of this study is to test the usability and acceptability of a European project prototype for elderly care, in an attempt to explore the ICT design needs of users with MCI. Methods: Participants were 28 i…

Upregulating Positive Affectivity in the Transdiagnostic Treatment of Emotional Disorders: A Randomized Pilot Study

Transdiagnostic cognitive-behavioral therapy for emotional disorders (ED) has proven to be effective. However, current transdiagnostic treatment protocols address only the regulation of negative affectivity, and they do not include treatment components to more directly target the regulation of positive affectivity. In this study, we propose to evaluate the preliminary efficacy and acceptability of a transdiagnostic treatment protocol for ED that includes, as an innovative feature, a specific treatment component to directly upregulate positive affectivity based on positive psychology interventions. A total of 24 participants were randomized to either a transdiagnostic treatment protocol ( n…

Treating Cockroach Phobia With Augmented Reality

In vivo exposure is the recommended treatment of choice for specific phobias; however, it demonstrates a high attrition rate and is not effective in all instances. The use of virtual reality (VR) has improved the acceptance of exposure treatments to some individuals. Augmented reality (AR) is a variation of VR wherein the user sees the real world augmented by virtual elements. The present study tests an AR system in the short (posttreatment) and long term (3, 6, and 12 months) for the treatment of cockroach phobia using a multiple baseline design across individuals (with 6 participants). The AR exposure therapy was applied using the "one-session treatment" guidelines developed by Öst, Salko…

Psychological Variables and Reality Judgment in Virtual Environments: The Roles of Absorption and Dissociation

Literature on virtual reality (VR) and psychology has focused on the influence that some basic psychological processes have on VR. Although psychological processes may be defined as common to all humans, there are individual differences that might make it difficult to provide the same VR experience for everyone. Of the several personality and psychological variables that might be relevant to the VR field, this study focuses on two: absorption and dissociation. Both psychological dimensions are deeply interrelated and might play an important role in the immersion of subjects in virtual environments and in the reality attributions they make. Thus, the purpose of this study was to ascertain pe…

Virtual Reality and Other Realities

Abstract In this chapter, we describe virtual reality and other mixed reality technological tools, highlighting the role they can play in the Clinical and Health Psychology fields: as stimulating, safe and controlled therapeutic contexts for applying psychological treatments; as ecological settings for conducting psychological assessment; and as a realistic laboratory for psychopathology to test research questions that would be very difficult or impossible to address in a traditional laboratory setting. The existing meta-analyses and systematic reviews of their efficacy are presented. The majority of studies have used virtual realities (VRs) as exposure techniques. This is not surprising, c…

Telemonitoring in chronic pain management using smartphone apps: a randomized controlled trial comparing usual assessment against app-based monitoring with and without clinical alarms

Background. The usefulness of mHealth in helping to target face-to-face interventions for chronic pain more effectively remains unclear. In the present study, we aim to test whether the Pain Monitor mobile phone application (app) is well accepted by clinicians, and can help improve existent medical treatments for patients with chronic musculoskeletal pain. Regarding this last goal, we compared three treatment conditions, namely usual treatment, usual treatment with an app without alarms and usual treatment with an app with alarms. All treatments lasted one month. The three treatments were compared for all outcomes, i.e., pain severity and interference, fatigue, depressed mood, anxiety and a…

Positive mood induction procedures for virtual environments designed for elderly people

Positive emotions have a significant influence on mental and physical health. Their role in the elderly’s wellbeing has been established in numerous studies. It is therefore worthwhile to explore ways in which elderly people can increase the number of positive experiences in their daily lives. This paper describes two Virtual Environments (VEs) that were used as mood induction procedures (MIPs) for this population. In addition, the VEs’ efficacy at increasing joy and relaxation in elderly users is analyzed. The VEs contain exercises for generating positive-autobiographic memories, mindfulness and slow breathing rhythms. The total sample comprised 18 participants over 55 years old who used t…

An Internet-based program for depressive symptoms using human and automated support: a randomized controlled trial

Adriana Mira,1 Juana Bretón-López,1,2 Azucena García-Palacios,1,2 Soledad Quero,1,2 Rosa María Baños,2,3 Cristina Botella1,2 1Department of Basic, Clinical Psychology and Psychobiology, Labpsitec, Universitat Jaume I, Castellón de la Plana, Spain; 2CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Instituto de Salud Carlos III, Santiago de Compostela, Spain; 3Department of Personality, Evaluation and Psychological Treatment, Universidad de Valencia, Valencia, Spain Purpose: The purpose of this study was to analyze the efficacy of an Internet-based program for depressive symptoms using automated supp…

Improving childhood obesity treatment using new technologies: the ETIOBE System

Childhood obesity is an increasing public health problem in western culture. Sedentary lifestyles and an “obesogenic environment” are the main influences on children leading to an increase in obesity. The objective of this paper is to describe an e-health platform for the treatment and prevention of childhood obesity called ETIOBE. This e-health platform is an e-therapy system for the treatment of obesity, aimed at improving treatment adherence and promoting the mechanisms of self-control in patients, to obtain weight loss maintenance and to prevent relapse by establishing healthy lifestyle habits. ETIOBE is composed of three different applications, the Clinician Support System (CSS), the H…

Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review.

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studi…

A virtual reality system for the treatment of stress-related disorders: A preliminary analysis of efficacy compared to a standard cognitive behavioral program

This paper presents preliminary efficacy data in a controlled study of the use of a virtual reality (VR) system for treating stress-related disorders (Post-Traumatic Stress Disorder, or PTSD; Pathological Grief, or PG; and Adjustment Disorders, or AD). ''EMMA's World'' is a VR application in which patients can explore negative experiences to the degree required for their specific therapeutic needs. To accomplish therapeutic goals, a series of virtual elements is customized to be meaningful to the user; the elements contain the fundamental emotional components that the person must confront. Thirty-nine participants diagnosed with PTSD (N=10), PG (N=16), and AD (N=13) were randomly assigned t…

Cultural adaptation of the Smiling is Fun program for the treatment of depression in the Ecuadorian public health care system: A study protocol for a randomized controlled trial

Background Depression is one of the world's major health problems. Due to its high prevalence, it constitutes the first cause of disability among the Americas, where only a very low percentage of the population receives the adequate evidence-based psychological treatment. Internet-Based Interventions (IBIs) are a great alternative to reduce the treatment gap for mental disorders. Although there are several studies in low-and middle-income countries proving IBIs' feasibility and acceptability, there is still little evidence of the effectiveness in diverse social and cultural contexts such as Latin America. Methods Two studies will be described: Study 1 is focused on the cultural adaptation o…

A low-intensity internet-based intervention focused on the promotion of positive affect for the treatment of depression in Spanish primary care: Secondary analysis of a randomized controlled trial

Background: A large number of low-intensity Internet-based interventions (IBIs) for the treatment of depression have emerged in Primary Care

An adaptive display for the treatment of diverse trauma PTSD victims.

El trastorno de estrés postraumático (TEPT) puede desarrollarse después de la exposición a un evento aterrador. Las personas que sufren de trastorno de estrés postraumático presentan hiperactividad y evitación, y experimentan síntomas que provocan angustia y deterioro en áreas de vida significativas. Los programas de comportamiento cognitivo, incluida la terapia de exposición, son actualmente el tratamiento de elección para el TEPT. Aunque estos programas son eficaces, hay margen de mejora; La utilización de la terapia de exposición por los médicos es baja y las tasas de desgaste son altas. La aplicación de nuevas tecnologías, especialmente la realidad virtual (VR), podría ayudar a superar …

Additional file 1 of Positive and Negative Affect Schedule (PANAS): psychometric properties of the online Spanish version in a clinical sample with emotional disorders

Additional file 1. PANAS (Spanish version).

Psychometric properties of the General Self Efficacy-12 Scale in Spanish: general and clinical population samples.

The General Self Efficacy Scale (GSES-12) is a short version of the Sherer’s Self-Efficacy Scale, and evaluates a general dimension and three aspects of self-efficacy: initiative, persistence and effort. The aim of this study is to explore the factorial structure, reliability, and criterion validity of the Spanish adaptation of the GSES-12 in general and clinical populations. The sample was composed of 714 volunteers (332 from the clinical population). Results of the principal components analysis yielded a 3-factor structure that was later confirmed through Confirmatory Factor Analysis. Moreover, this study shows good internal consistency and testretest values, and differences in self-effic…

El Servicio de Asistencia Psicológica de la Universitat Jaume I [Psychological services at the Universitat Jaume I]

Resumen En el trabajo se analizan sucintamente las razones que hicieron surgir el Servicio de Asistencia Psicologica de la Universidad de Valencia primero y mas tarde de la Universitat Jaume I de Castellon. Dichos servicios se crearon con un objetivo doble, por una parte, servir de puente entre la sociedad y la universidad, y, por otra, facilitar el logro de las funciones generales que pretende la universidad, esto es, tareas de investigacion y formacion tanto de los estudiantes como de los profesionales. Ademas, se describe la historia del servicio, asi como las lineas de trabajo fundamentales que se siguen, su estructura y su funcionamiento. Despues de anos de andadura, es posible afirmar…

Clinical utility of cognitive-behavioural treatment for panic disorder. results obtained in different settings: a research centre and a public mental health care unit

Cognitive-Behavioural programmes have become the treatment of choice for Panic Disorder (PD). However, although its effectiveness has been widely demonstrated, there are still some limitations regarding the possibility of offering this type of treatment to all panic sufferers. Some researchers are studying ways to make these programmes more available. This study deals with the application and testing of treatment programmes for PD in sites where patients usually look for help for their psychological problems, i.e. mental health care centres. Our work follows a strategy of benchmarking, and the results obtained after applying the treatment in habitual clinical contexts are compared with the …

Enhancing in vivo exposure in the treatment of panic disorder and agoraphobia using location-based technologies: a case study

Panic disorder (PD) is quite prevalent and often appears along with agoraphobia (PD/A). The treatment of choice is cognitive behavioral therapy (CBT). Transdiagnostic intervention, an emotion-focused, cognitive behavioral intervention that has led to the Unified Protocol (UP), emphasizes the common underlying mechanisms that contribute to the development and maintenance of emotional disorders such as PD/A. A core feature of this treatment approach is in vivo exposure (IVE) to feared situations, which aims to prevent avoidance behaviors and encourages the patient to confront feared situations gradually. It is a difficult component for patients, especially when implementing the exposure on t…

Resilience as a predictor of Quality of Life in participants with borderline personality disorder before and after treatment.

Abstract Background Studies have suggested that psychotherapy improves the Quality of Life (QoL) of participants with Borderline Personality Disorder (BPD). However, there are no studies on the differential efficacy of treatments on the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between Dialectical Behavioural Therapy (DBT), Systems Training for Emotional Predictability and Problem Solving (STEPPS), or Cognitive Behavioural Therapy-Tre…

Presence and Emotions in Virtual Environments: The Influence of Stereoscopy

ABSTRACT This study investigates how stereoscopy (the illusion of depth and 3D imaging) affects the sense of presence and the intensity of the positive mood that users feel in virtual environments (VEs). A between-group design was used, and 40 volunteers were randomly assigned to one of two experimental conditions (stereoscopy vs. no stereoscopy) and to one of two emotional VEs (relaxation or joy). The participants' emotions were assessed before and after the VR experience. Presence was measured with two postexperiment questionnaires (ITC-SOPI and SUS). Results show that there were no differences between stereoscopic and monoscopic presentations in VEs (neither subjective sense of presence …

mHealth for the Monitoring of Brace Compliance and Wellbeing in Adolescents with Idiopathic Scoliosis: Study Protocol for a Feasibility Study

Escoliosis idiopática del adolescente; Aplicación móvil; Eficacia del tratamiento Escoliosi idiopàtica de l'adolescent; Aplicació mòbil; Eficàcia del tractament Adolescent idiopathic scoliosis; Mobile application; Treatment effectiveness Attempts to optimize monitoring of brace adherence prescribed to adolescents with idiopathic scoliosis (IS) have generally relied on sensors. Sensors, however, are intrusive and do not allow the assessment of psychological and physical consequences of brace use that might underlie poor adherence. Mobile applications have emerged as alternatives to monitor brace compliance. However, the feasibility and utility of these app-based systems to assess key psychol…

Retos de la investigación psicológica en salud mental

The magnitude and impact of mental disorders does not correspond to the resources devoted to research and attention. Although we have made significant progress in their understanding and the efficacy of the psychological treatments, we are still far from an optimal situation. This paper focuses on one of the major issues which we consider fundamental challenges and needs in this area, the increase in research focusing on psychopathology, especially on the mechanisms and processes that explain and maintain mental disorders, as a key point for the design and development of new psychological interventions for the prevention, treatment, and promotion of mental health. The aim is to promote disc…

Behavioral Activation through Virtual Reality for Depression: A Single Case Experimental Design with Multiple Baselines

Behavioral activation (BA) is a structured psychotherapeutic approach for the treatment of major depressive disorder (MDD), which aims at increasing the engagement in activities that might bring enjoyment and meaning to patients’ lives. Although a growing body of evidence supports the effectiveness of BA, enhancing the motivation and activity level of depressed patients is often challenging. In the present study, we explored the effectiveness of a brief BA treatment supported by virtual reality (VR) to facilitate the visualization and anticipation of four pleasurable activities that we tried to re-introduce in the patients’ daily routine. To do so, we conducted a single-case experimental de…

Opinion of the Patients About an Internet-Based Psychological Treatment Protocol

Emotional disorders (depression and anxiety disorders) are highly prevalent. Currently, there is evidence showing the efficacy of disorder-specific cognitive-behavior therapy for emotional disorders. However, high comorbidity rates among emotional disorders have led some researchers to shift the focus to treatment strategies that might be more widely effective across these diverse conditions (transdiagnostic approach). Another important line of research in the literature is Internet-based psychotherapy. An increasing number of meta-analyses have shown the efficacy and effectiveness of Internet-based cognitive-behavior treatment protocols for emotional disorders. Nevetherless, little is know…

Telepsychology and Self-help: The Treatment of Fear of Public Speaking

Abstract This work presents a self-help, Internet-based telepsychology program for the treatment of public speaking fears. The system is comprised of 3 parts: The assessment protocol gives the patient information about his or her problem (i.e., amount of interference it creates in his or her life, severity, degree of fear and avoidance). The system also includes a structured treatment protocol, organized into separate blocks, reflecting the patient’s progress. This ensures that the patient does not skip any steps in the treatment (something quite common in traditional self-help manuals), which provides more control over the process. The treatment protocol is a cognitive-behavioral program t…

An E-Health System for Promoting Wellbeing in the Elderly

The disproportionate increase in the world’s aged population, especially in developed countries, is one of the biggest challenges for developing health and social development policies. Developed countries are starting to include e-health applications in their health policies; these are effective programs that can reach large numbers of people at a much lower economic cost. The “Butler System” is an e-health application designed specifically for older people and the health professionals who work with this population. The Butler System is a multi-user platform with various levels of action, which includes resources that enhance elderly users’ social integration, learning, socio-emotional netw…

Positive and Negative Affect Schedule (PANAS): psychometric properties of the online Spanish version in a clinical sample with emotional disorders

Abstract Background The Positive and Negative Affect Schedule (PANAS) is the most widely and frequently used scale to assess positive and negative affect. The PANAS has been validated in several languages, and it has shown excellent psychometric properties in the general population and some clinical samples, such as forensic samples, substance users, and adult women with fibromyalgia. Nevertheless, the psychometric properties of the scale have not yet been examined in clinical samples with anxiety, depressive, and adjustment disorders. In addition, the proliferation of Internet-based treatments has led to the development of a wide range of assessments conducted online with digital versions …

Treatment of flying phobia using virtual reality exposure with or without cognitive restructuring: Participant's preferences

This study analyses participants’ preferences regarding two exposure treatment modali- ties for Fear of Flying (FF): virtual reality exposure treatment (VRET) by itself or VRET plus cognitive restructuring (VRET+CR). An alternating treatment conditions design was established and a non-concurrent multiple baseline design across individuals (four participants) was used. Both conditions were equally effective and after the treatment all the participants took a flight. At the end of each session the participants were asked for their opinion on the condition they received. High mean scores were obtained in both conditions; non-significant differences between the two condi- tions were found. When…

Working Alliance Inventory for Online Interventions-Short Form (WAI-TECH-SF): The Role of the Therapeutic Alliance between Patient and Online Program in Therapeutic Outcomes.

Background: Therapeutic alliance (TA) between the patient and therapist has been related to positive therapeutic outcomes. Because Internet-based interventions are increasingly being implemented, a tool is needed to measure the TA with Internet-based self-guided programs. The Working Alliance Inventory for online interventions (WAI-TECH-SF) was adapted based on the WAI Short Form (Hatcher &amp

An Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Prolonged Grief Disorder (PGD) in adults: A multiple-baseline single-case experimental design study.

The death of a loved one has physical, psychological, and social consequences. Between 9.8 and 21.5 % of people who lose a loved one develop Prolonged Grief Disorder (PGD). Internet- and computer-based interventions (i.e., Internet-delivered Cognitive-Behavioral Therapy, iCBT) are cost-effective and scalable alternatives that make it possible to reach more people with PGD. The main goal of the present investigation was to examine the effect and feasibility (usability and satisfaction) of an iCBT (GROw program) for adults with PGD. A secondary objective was to detect adherence to the app (Emotional Monitor) used to measure daily grief symptoms. The study had a singlecase multiple-baseline AB…

Using an adaptive display for the treatment of emotional disorders

A preliminary study on the use of an adaptive display for treating emotional disorders is presented. This adaptive display (named EMMA) varies the contents that are presented depending on the emotions of the user at each moment. The application has been designed to help in the treatment of Post-Traumatic Stress Disorder (PTSD) and Adjustment Disorder (AD). The specific objective of the present work is to test the effectiveness of this adaptive display, specifically the acceptance of the treatment by patients. EMMA's tools are compared with the standard of care for PTSD and AD. Results showed differences only for the variable aversiveness. Participants in the EMMA condition evaluated the tre…

Psychological countermeasures in manned space missions: “EARTH” system for the Mars-500 project

Spaceflights missions have revealed that exist critical psychological problems. The Mars-500 project was an isolation and confinement experiment for identifying problems and solutions related to spaceflights missions. Medical countermeasures, such as physical exercise for 'bone degradation' are well recognized, but it is also important to develop psychological countermeasures for a possible 'psychological degradation'.Clinical Psychology has techniques useful for treating psychological problems, recent advances in Positive Psychology open up new possibilities for promoting resilience, and Information and Communication Technologies (ICT) have proven their utility for enhancing psychological …

Online prevention programmes for university students: stakeholder perspectives from six European countries

Abstract Background Students beginning university are at a heightened risk for developing mental health disorders. Online prevention and early intervention programmes targeting mental health have the potential to reduce this risk, however, previous research has shown uptake to be rather poor. Understanding university stakeholders’ (e.g. governing level and delivery staff [DS] and students) views and attitudes towards such online prevention programmes could help with their development, implementation and dissemination within university settings. Methods Semi-structured interviews, focus groups and online surveys were completed with staff at a governing level, university students and DS (i.e.…

The acceptability of an Internet-based self-help treatment for fear of public speaking

ABSTRACT Several randomised controlled studies have shown the efficacy of Internet-based self-help treatments. These studies have centred their attention on axis I (efficacy) of the Guidelines for Empirically Validated Treatments, although there are a few studies that also take into account axis II (effectiveness). The aim of the present work was to test the acceptability of an Internet-based self-help program for fear of public speaking and to compare its acceptability with the same treatment administered by a therapist. Fifty-two participants suffering from social phobia were randomly selected to take part in one of these treatments. All participants reported being satisfied with the trea…

Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: study protocol for a randomized controlled trial

Gambling Disorder is a prevalent non-substance use disorder, which contrasts with the low number of people requesting treatment. Information and Communication Technologies (ICT) could help to enhance the dissemination of evidence-based treatments and considerably reduce the costs. The current study seeks to assess the efficacy of an online psychological intervention for people suffering from gambling problems in Spain. The proposed study will be a two-arm, parallel-group, randomized controlled trial. A total of 134 participants (problem and pathological gamblers) will be randomly allocated to a waiting list control group (N = 67) or an intervention group (N = 67). The intervention program i…

A brief online transdiagnostic measure: Psychometric properties of the Overall Anxiety Severity and Impairment Scale (OASIS) among Spanish patients with emotional disorders.

The Overall Anxiety Severity and Impairment Scale (OASIS) is a self-report questionnaire designed to evaluate the severity and functional impairment associated with anxiety. Given its transdiagnostic nature, it can be used indistinctly across anxiety and depressive disorders. In this study, the psychometric properties of the online version of the OASIS were evaluated in a Spanish clinical sample with emotional disorders. Patients (n = 583) with anxiety (n = 250) and depression (n = 333) with a mean age of 37.21 (SD = 12.22), underwent a diagnostic interview and questionnaires assessing anxiety, depression, positive and negative affect, and quality of life. Factorial structure, internal cons…

Exploring the Relationship Between the Acceptability of an InternetBased Intervention for Depression in Primary Care and Clinical Outcomes: Secondary Analysis of a Randomized Controlled Trial

Background: Depression is one of the most prevalent psychological disorders worldwide. Although psychotherapy for depression is effective, there are barriers to its implementation in primary care in Spain. The use of the Internet has been shown to be a feasible solution. However, the acceptability of Internet-based interventions has not been studied sufficiently. Objective: To assess the acceptability of an Internet-based intervention (IBI) for depression in primary care, and explore the relationship between expectations and satisfaction and the improvement in the clinical variables in primary care patients receiving this intervention. Furthermore, it offers data about the effects of some s…

Efficacy of “Family Connections”, a program for relatives of people with borderline personality disorder, in the Spanish population: study protocol for a randomized controlled trial

Abstract Background Patients with borderline personality disorder (BPD) experience significant affect regulation difficulties that cause serious consequences in their work, emotional, and social environments. This dysfunctional pattern also produces great suffering and a heavy burden on their relatives. Fortunately, some studies show that treatment of relatives of people with BPD begins to be important in the patients’ recovery and in improving family dynamics. One of the treatments that has obtained the most empirical support is Family connections (FC). This 12-session program is an adaptation of different Dialectical Behavior Therapy strategies. To test the efficacy of FC, five uncontroll…

In vivo versus augmented reality exposure in the treatment of small animal phobia: A randomized controlled trial

Although in vivo exposure is the treatment of choice for specific phobias, some acceptability problems have been associated with it. Virtual Reality exposure has been shown to be as effective as in vivo exposure, and it is widely accepted for the treatment of specific phobias, but only preliminary data are available in the literature about the efficacy of Augmented Reality. The purpose of the present study was to examine the efficacy and acceptance of two treatment conditions for specific phobias in which the exposure component was applied in different ways: In vivo exposure (N = 31) versus an Augmented Reality system (N = 32) in a randomized controlled trial. “One-session treatment” guidel…

Exploring the Effectiveness of Dialectical Behavior Therapy Versus Systems Training for Emotional Predictability and Problem Solving in a Sample of Patients With Borderline Personality Disorder.

Dialectical behavior therapy (DBT) and systems training for emotional predictability and problem solving (STEPPS) are two treatment protocols for people with borderline personality disorder (BPD) that have received important empirical support. However, their possible differential effectiveness has not yet been studied. The objective of this study is to explore the effectiveness of these two treatment programs. A nonrandomized clinical trial was carried out in which both treatments were applied for six months. The sample consisted of 72 patients diagnosed with BPD. The results indicate that both groups experienced a statistically significant reduction in BPD symptom, emotional regulation, i…

Efficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial

Background: Primary care is a major access point for the initial treatment of depression, but the management of these patients is far from optimal The lack of time in primary care is one of the major difficulties for the delivery of evidence-based psychotherapy. During the last decade, research has focused on the development of brief psychotherapy and cost-effective internet-based interventions mostly based on cognitive behavioral therapy (CBT). Very little research has focused on alternative methods of treatment for depression using CBT. Thus, there is a need for research into other therapeutic approaches. Objective: This study aimed to assess the effectiveness of 3 low-intensity, internet…

How and for whom does a positive affect intervention work in fibromyalgia: An analysis of mediators and moderators.

Objectives: Psychological interventions designed to enhance positive affect are promising ways to promote adaptive functioning in people with chronic pain. However, few studies have addressed the efficacy of positive affect interventions in chronic pain populations and examined which patients can benefit more from them. The aim of the present study was to identify mediators and moderators of the best possible self intervention (BPS) in fibromyalgia patients.Methods: We used data from a previous randomized controlled trial that examined changes in pain interference, depression, self‐efficacy and quality of life after the BPS intervention.Results: Mediation analyses showed that depression med…

Treating Emotional Problems with Virtual and Augmented Reality

Virtual reality in the treatment of claustrophobic fear: A controlled, multiple-baseline design

The aim of this study was to determine the effectiveness of virtual reality (VR) exposure in the treatment of claustrophobic fear. We evaluated the intervention following a controlled, multiple-baseline design across 4 participants with claustrophobic fear who sought psychological help in our anxiety disorders clinic. The treatment consisted of 8 individual VR graded exposure sessions. Data were obtained at pretreatment, posttreatment, and 3-month follow-up on several clinical measures: Behavioral Avoidance Test, Self-Efficacy Toward Closed Spaces, Problem-Related Impairment Questionnaire, Beck Depression Inventory (Beck, 1978), and Anxiety Sensitivity Index (Peterson & Reiss, 1992). Result…

An Internet-Based Self-Help Treatment for Fear of Public Speaking: A Controlled Trial

Abstract This study offers data about the efficacy of “Talk to Me,” an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the…

Presence-inducing media for mental health applications

Presence inducing media have recently emerged as a potentially effective way to provide general and specialty mental health services, and they appear poised to enter mainstream clinical delivery. However, to ensure appropriate development and use of these technologies, clinicians must have a clear understanding of the opportunities and challenges they will provide to professional practice.