Factors associated with prolonging psychological treatment for anxiety disorders

  1. Bernaldo de Quirós, Mónica
  2. Labrador Encinas, Francisco Javier
  3. García Fernández, Gloria 1
  4. Fernández Arias, Ignacio
  5. Estupiñá Puig, Francisco José
  6. Labrador Méndez, Marta
  1. 1 Universidad de Oviedo
    info

    Universidad de Oviedo

    Oviedo, España

    ROR https://ror.org/006gksa02

Revista:
Psicothema

ISSN: 0214-9915

Año de publicación: 2015

Volumen: 27

Número: 2

Páginas: 108-113

Tipo: Artículo

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Otras publicaciones en: Psicothema

Resumen

Antecedentes: uno de los motivos más frecuentes de atención psicológica son los trastornos de ansiedad. El objetivo de este trabajo es identificar los factores que pueden explicar una mayor duración del tratamiento psicológico en los problemas de ansiedad. Método: se analizaron los datos de 202 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense de Madrid. Resultados: el análisis de regresión multivariado mostró que los mayores predictores de la duración del tratamiento eran la presencia de un diagnóstico principal de Trastorno Obsesivo-Compulsivo y la aplicación de técnicas para el control de la activación seguidas de modelado y otras técnicas específicas. Conclusiones: se recomienda reducir en la medida de lo posible el número de técnicas aplicadas sin que se reduzca la eficacia de la intervención. En algunos trastornos que producen una mayor desestructuración puede ser conveniente intentar organizar la vida del paciente antes o durante el programa de intervención para incrementar la efectividad y reducir el número de sesiones.

Referencias bibliográficas

  • Alonso, J., Angermeyer, M.C., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H., & EsemeD/Mhedea Investigators (2004). 12-month comorbidity patterns and associated factors in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109(420), 28-37.
  • Abramowitz, J.S. (2013). The practice of exposure therapy: Relevance of cognitive-behavioral theory and extinction. Behavior Therapy, 44, 548-558.
  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders-text revision (5th ed.). Washington, DC: Author. American Psychological
  • Association Presidential Task Force on Evidence- Based Practice (2006). Evidence-based practice in psychology. American Psychologist, 61, 271- 285.Retrieved from http://www.div12. org/PsychologicalTreatments/index.html.
  • Barlow, D.H., Bullis, J.R., Comer, J.S., Ametaj, A.A., & NolenHoeksema, S. (2013). Evidence-based psychological treatments: An update and a way forward. Annual Review of Clinical Psychology, 9, 1-27.
  • Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventoryfor measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893- 897.
  • Beck, A.T., Steer, R.A., & Brown, G.K (1996). Manual for the Beck Depression Inventory - II. San Antonio, TX: Psychological Corporation.
  • Bernaldo-de-Quirós, M., Estupiñá, F., Labrador, F.J., & Fernández-Arias, I. (2013). La duración de los tratamientos psicológicos: diferencias entre casos de corta, media y larga duración. Universitas Psychologica, 12, 21-30.
  • Brown, T.A., Campbell, L.A., Lehman, C.L., Grisham, J.R., & Mancill, R.B. (2001). Current and lifetime comorbidity of the DSM-IV anxietyand mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110(4), 585-599.
  • Brown, L., Gaudiano, B.A., & Miller, I.W. (2011). Investigating the differences and similarities between second and third wave cognitive - behavioral therapies. Behavior Modification, 35(2), 187-199.
  • Carey, T.A. (2011). Exposure and reorganization: The what and how of effective psychotherapy. Clinical Psychology Review, 31, 236-248.
  • Chambless, D.L., Caputo, G.C., Jasin, S.E., Gracely, E.J., & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour Research and Therapy, 23, 35-44.
  • Clark, D. M. (2013). Developing and disseminating effective psychological treaments: Science, practice and economics. Canadian Psychology- Psychologie Canadienne, 54, 12-21.
  • Cruzado, J.A. (2008). Técnicas de modelado. En Labrador, F.J. (Ed.), Técnicas de modificación de conducta. Madrid: Pirámide.
  • Donegan, E., & Dugas, M.J. (2012). Generalized anxiety disorder: A comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation. Journal of Consulting and Clinical Psychology, 80, 490-496.
  • Deveney, C.M., & Otto, M.W. (2010). Resolving treatment complications associated with comorbid depression. In M.W. Otto & S.G. Hofmann (Eds.), Avoiding treatment failures in the anxiety disorders (pp. 231-249). New York: Springer Sciences.
  • Gaston, J.E., Abbott, M.J., Rapee, R.M., & Neary, S.A. (2006). Do empirically supported treatments generalize to private practice? A benchmark study of a cognitive-behavioural group treatment programme for social phobia. British Journal of Clinical Psychology, 45, 33-48.
  • Gyani, A., Shafran, R., Myles, P., & Rose, S. (2014). The gap between science and practice: How therapists make their clinical decisions. Behavior Therapy, 45(2), 199-211.
  • Hans, E., & Hiller, W. (2013). A meta-analysis of nonrandomized effectiveness studies on outpatient cognitive behavioral therapy for adult anxiety disorders. Clinical Psychology Review, 33, 954-964.
  • Haro, J.M., Palacín, C., Vilagut, G., Martínez, M., Bernal, M., Luque, I, & el Grupo ESEeD-España (2006). Prevalencia de los trastornos mentales y factores asociados: resultados del estudio ESEMeD-España. Medicina Clínica, 126, 445-451.
  • Herrero, M., González, E., Valverde, T., & Caballero, L. (2001). Utilización del cuestionario PRIME-MD para la detección de trastornos mentales en mujeres inmigrantes iberoamericanas e hispanohablantes [Use of the PRIME-MD questionnaire to detect mental disorders in Latin American and Spanish-speaking immigrant women]. Medicina Clínica, 117, 716-717.
  • Hodgson, R.J. (1977). Obssesive compulsive complaints. Behavior Research and Therapy, 26, 169-177.
  • Hoyer, J., Beesdo, K., Gloster, A.T., Runge, J., Höfler, M., & Becker, E.S. (2009). Worry exposure versus applied relaxation in the treatment of generalized anxiety disorder. Psychotherapy and Psychosomatics, 78, 106-115.
  • Kazdin, A.E. (2008). Evidence-based treatment and practice - New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63, 146-159.
  • Knopp, J., Kmowles, S., Bee, P., Lovell, K., & Bower, P. (2013). A systematic review of predictors and moderators of response to psychological therapies in OCD: Do we have enough empirical evidence to target treatment? Clinical Psychology Review, 33, 1067-1081.
  • Labrador, F.J., Bernaldo de Quirós, M., & Estupiñá, F.J. (2011). Por qué se alargan los tratamientos psicológicos?: predictores de una mayor duración de tratamiento y diferencias entre los casos de corta y larga duración [Why are psychological treatments prolonged? Predictors of greater treatment duration and differences between shorter and longer lasting cases]. Psicothema, 23, 573-579.
  • Lamers, F., van Oppen, P., Comijs, H.C., Smit, J.H., Spinhoven, P., van Balkom A.J.L.M, Penninx, W.J.H. (2011). Comorbidity patternsof anxiety and depressive disorders in a large cohort study: The Netherlands study of depression and anxiety (NESDA). Journal of Clinical Psychiatry, 72, 341- 348.
  • Mathews, A.M., Gelder, M., & Johnston, D.W. (1986). Agorafobia, naturaleza y tratamiento [Agoraphobia, nature and treatment]. Barcelona: Fontanella
  • McAleaveyCastonguay, L.G., & Goldfried, M.R. (2014). Clinical experiences in conducting cognitive-behavioral therapy for social phobia. Clinical experiences in conducting cognitive-behavioral therapy for social phobia. Behavior Therapy, 45, 21-35.
  • Melchior, H., Hergert, A, Hofreuter-Gaetgens, K. & Watzke, B. (2010). Predictors of treatment duration for inpatients with mental disorders - a systematic literature review. Zeitschrift fur Psychosomatische Medizin und Psychotherapie, 56, 399-418.
  • Meyer, T.J., Miller, M.L., Metzger, R.L., & Borkovec, T.D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487-495.
  • Morrison, K., Bradley, R., & Westen, D. (2003). The external validity of controlled clinical trials of psychotherapy for depression and anxiety: A naturalistic study. Psychology and Psychotherapy, 76, 109-132.
  • Muñoz, M. (2003). Manual práctico de evaluación psicológica clínica. Madrid: Síntesis.
  • Olatunji, B.O., Deacon, B.J., & Abramowitz, J.S. (2009). The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cognitive and Behavioral Practice, 16(2), 172-180.
  • Öst, L.G., Svensson, L., Hellström, K., & Lindwall, R. (2001). One-session treatment of specific phobias in youths: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 69, 814-824.
  • Rettew, D.C., Lynch, A.D., Achenbach, T.M., Dumenci, L., & Ivanova, M. (2009). Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews. International Journal of Methods in Psychiatric Research, 18, 169-184.
  • Sadock, E., Auerbach, S.M., Rybarczyk, B., & Aggarwal, A. (2014). Evaluation of integrated psychological services in a University-based primary care clinic. Journal of Clinical Psychology in Medical Settings, 21, 19-32.
  • Somers, J.M., Goldner, E.M., Waraich, P., & Hsu, L. (2006). Prevalence and incidence studies of anxiety disorders: Review of the literature. Canadian Journal of Psychiatry, 51, 100-113.
  • Stewart, R., & Chambless, D. (2009). Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 77, 595- 606.
  • Szkodny, L.E., Newman, M.G., & Goldfried, M.R. (2014). Clinical experiences in conducting empirically supported treatments for generalized anxiety disorder. Behavior Therapy, 45, 7-20.
  • Vallejo, M.A., Jordan, C.M., Díaz, M.J., Comeche, M.I., Ortega, J., Amor, P., & Zubeidat, I. (2008). Perfil sociodemográfico de los usuarios de un servicio de asistencia psicológica online [Sociodemographic profile of users of an online psychological assistance service]. Psicothema, 20, 610-615.
  • Wagner, R., Silove, D., Joukhador, J., Manicavasagar, V., Marnane, C., & Kirsten, L.T. (2005). Characteristics of the first 1000 clients attending an anxiety clinic in South West Sydney. Australian Journal of Psychology, 57, 180-185.
  • Watson, D., & Friend, R. (1969). Measurement of social-evaluative anxiety. Journal of Consulting and Clinical Psychology, 33, 448-457.
  • Westbrook, D., & Kirk, J. (2005). The clinical effectiveness of cognitive behaviour therapy: Outcome for a large sample of adults treated in routine practice. Behaviour Research and Therapy, 43, 1243-1261.
  • Wolf, A.W., & Goldfried, M.R. (2014). Clinical experiences in using cognitive-behavior therapy to treat panic disorder. Behavior Therapy, 45, 36-46.
Fuente de los datos: Dialnet