Terapia dialéctico conductual radicalmente abierta para la anorexia nerviosa

  1. de la Vega Rodríguez, Irene 1
  2. Montalvo Calahorra, Teresa 1
  1. 1 Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos. Madrid. España
Revista:
Revista de psicoterapia

ISSN: 1130-5142,  2339-7950

Año de publicación: 2020

Título del ejemplar: Complejidad de los trastornos alimentarios

Volumen: 31

Número: 115

Páginas: 147-162

Tipo: Artículo

DOI: 10.33898/RDP.V31I115.314 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Otras publicaciones en: Revista de psicoterapia

Resumen

La Terapia Dialectico Conductual “Radically Open” (RO TDC) es una terapia transdiagnótica desarrollada  para abordar el exceso de control (overcontrol) presente en trastornos graves como la Anorexia Nerviosa. El exceso de control es un modo afrontamiento desadaptativo que emerge de factores temperamentales y factores sociales y que se asocia con aislamiento social, déficit relacional, hiperperfeccionismo, rigidez, evitación del riesgo e inhibición emocional. La RO TDC tiene como objetivos la apertura a la  experiencia y al feedback negativo como oportunidad de aprendizaje, la flexibilidad para adaptarse a un entorno en permanente cambio, y el establecimiento de vínculos sociales. En el tratamiento se prioriza el placer, la relajación y la unión,  tomando como diana principal los déficit en señalización social que perpetuán el aislamiento. El objetivo de este trabajo es presentar una visión general de los principios teóricos y las estrategias terapéuticas de la RO TDC, haciendo hincapié en su aplicación y utilidad en la Anorexia Nerviosa.

Referencias bibliográficas

  • American Psychiatric Association (2013). The diagnostic and statistical manual of mental disorders, (5th ed.). Arlington, VA: American Psychiatric Association.
  • Boone, R. T. y Buck, R. (2003). Emotional Expressivity and Trustworthiness: The Role of Nonverbal Behavior in the Evolution of Cooperation. Journal of Nonverbal Behavior, 27(3), 163-182. https://doi.org/10.1023/A:1025341931128
  • Byrne, S., Wade, T., Hay, P., Touyz, S., Fairburn, C. G., Treasure, J., … Crosby, R. D. (2017). A randomised controlled trial of three psychological treatments for anorexia nervosa. Psychological Medicine, 47(16), 2823-2833. https://doi.org/10.1017/S0033291717001349
  • Cassin, S. y Vonranson, K. (2005). Personality and eating disorders: A decade in review. Clinical Psychology Review, 25(7), 895-916. https://doi.org/10.1016/j.cpr.2005.04.012
  • Chen, E. Y., Segal, K., Weissman, J., Zeffiro, T. A., Gallop, R., Linehan, M. M., … Lynch, T. R. (2015). Adapting dialectical behavior therapy for outpatient adult anorexia nervosa-A pilot study: Adapting DBT For Outpatent Adult Anorexia. International Journal of Eating Disorders, 48(1), 123-132. https://doi.org/10.1002/eat.22360
  • De la Vega-Rodríguez, I. y Sánchez-Quintero, S. (2013). Terapia dialéctico conductual para el trastorno de personalidad límite [Dialectical behavioral therapy in borderline personality disorder]. Acción Psicológica, 10(1), 45-55. https://doi.org/10.5944/ap.10.1.7032
  • Dejong, H., Broadbent, H. y Schmidt, U. (2012). A systematic review of dropout from treatment in outpatients with anorexia nervosa. The International Journal of Eating Disorders, 45(5), 635-647. https://doi.org/10.1002/eat.20956
  • Engel, S. G., Wittrock, D. A., Crosby, R. D., Wonderlich, S. A., Mitchell, J. E. y Kolotkin, R. L. (2006). Development and psychometric validation of an eating disorder-specific health-related quality of life instrument. The International Journal of Eating Disorders, 39(1), 62-71. https://doi.org/10.1002/eat.20200
  • Evans, C., Connell, J., Barkham, M., Margison, F., McGrath, G., Mellor-Clark, J. y Audin, K. (2002). Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE-OM. The British Journal of Psychiatry: The Journal of Mental Science, 180, 51-60. https://doi.org/10.1192/bjp.180.1.51
  • Fairburn, C. G. y Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? The International Journal of Eating Disorders, 16(4), 363-370. https://doi.org/10.1002/1098-108X(199412)16:4%3C363::AID-EAT2260160405%3E3.0.CO;2-%23
  • Fairburn, C. G. y Cooper, Z. (1993). The Eating Disorder Examination. En C. G. Fairburn y G. T. Wilson (Eds.) Binge eating: Nature, assessment, and treatment (pp. 317-360). Nueva York, NY: Guilford Press.
  • Font-Domènech, E. (2019). Trastorno Límite de la Personalidad: Revisión Sistemática de las Intervenciones. Revista de Psicoterapia, 30(113), 197-212. https://doi.org/10.33898/rdp.v30i113.274
  • Geller, J., Cockell, S. J., Hewitt, P. L., Goldner, E. M. y Flett, G. L. (2000). Inhibited expression of negative emotions and interpersonal orientation in anorexia nervosa. The International Journal of Eating Disorders, 28(1), 8-19. https://doi.org/10.1002/1098-108X(200007)28:1%3C8::AID-EAT2%3E3.0.CO;2-U
  • Gilbert, P. (2010). Compassion focused therapy: Distinctive features. Nueva York, NY: Routledge.
  • Hamatani, S., Tomotake, M., Takeda, T., Kameoka, N., Kawabata, M., Kubo, H., … Ohmori, T. (2018). Impaired central coherence in patients with anorexia nervosa. Psychiatry Research, 259, 77-80. https://doi.org/10.1016/j.psychres.2017.09.086
  • Hartmann, A., Weber, S., Herpertz, S., Zeeck, A. y German Treatment Guideline Group for Anorexia Nervosa. (2011). Psychological treatment for anorexia nervosa: A meta-analysis of standardized mean change. Psychotherapy and Psychosomatics, 80(4), 216-226. https://doi.org/10.1159/000322360
  • Hay, P. J., Claudino, A. M., Touyz, S. y Abd Elbaky, G. (2015). Individual psychological therapy in the outpatient treatment of adults with anorexia nervosa. The Cochrane Database of Systematic Reviews, 7, CD003909. https://doi.org/10.1002/14651858.CD003909.pub2
  • Hayes, S. C., Strosahl, K. D. y Wilson, K. G. (2016). Acceptance and Commitment Therapy, Second Edition: The Process and Practice of Mindful Change. Nueva York, NY: Guilford Press.
  • Haynos, A. F., Berg, K. C., Cao, L., Crosby, R. D., Lavender, J. M., Utzinger, L. M., … Crow, S. J. (2017). Trajectories of higher- and lower-order dimensions of negative and positive affect relative to restrictive eating in anorexia nervosa. Journal of Abnormal Psychology, 126(5), 495-505. https://doi.org/10.1037/abn0000202
  • Hempel, R., Vanderbleek, E. y Lynch, T. R. (2018). Radically open DBT: Targeting emotional loneliness in Anorexia Nervosa. Eating Disorders, 26(1), 92-104. https://doi.org/10.1080/10640266.2018.1418268
  • Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E., Endicott, J., McDonald-Scott, P. y Andreasen, N. C. (1987). The Longitudinal Interval Follow-up Evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44(6), 540-548. https://doi.org/10.1001/archpsyc.1987.01800180050009
  • Kochanska, G., Murray, K. T. y Harlan, E. T. (2000). Effortful control in early childhood: Continuity and change, antecedents, and implications for social development. Developmental Psychology, 36(2), 220-232. https://doi.org/10.1037/0012-1649.36.2.220
  • Linehan, M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. Nueva York, NY: Guilford Press.
  • Linehan, M. (1993b). Skills training manual for treating borderline personality disorder. Nueva York, NY: Guilford Press.
  • Lynch, T. R. (2018a). Radically open dialectical behavior therapy: Theory and practice for treating disorders of overcontrol. Oakland, CA: Context Press/New Harbinger Publications.
  • Lynch, T. R. (2018b). The skills training manual for Radically open dialectical behavior therapy: A clinician’s guide for treating disorders of overcontrol. Oakland, CA: New Harbinger Publications.
  • Lynch, T. R., Gray, K. L., Hempel, R. J., Titley, M., Chen, E. Y. y O’Mahen, H. A. (2013). Radically open-dialectical behavior therapy for adult anorexia nervosa: Feasibility and outcomes from an inpatient program. BMC Psychiatry, 13(1), 293. https://doi.org/10.1186/1471-244X-13-293
  • Lynch, T. R., Hempel, R. J. y Dunkley, C. (2015). Radically Open-Dialectical Behavior Therapy for Disorders of Over-Control: Signaling Matters. American Journal of Psychotherapy, 69(2), 141-162. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.141
  • Porges, S. W. (1995). Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A Polyvagal Theory. Psychophysiology, 32(4), 301-318. https://doi.org/10.1111/j.1469-8986.1995.tb01213.x
  • Porges, S. W. (2003). Social Engagement and Attachment. Annals of the New York Academy of Sciences, 1008(1), 31-47. https://doi.org/10.1196/annals.1301.004
  • Porges, S. W. (2009). The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic Journal of Medicine, 76(Suppl_2), 86-90. https://doi.org/10.3949/ccjm.76.s2.17
  • Schneider, K. G., Hempel, R. J. y Lynch, T. R. (2013). That “poker face” just might lose you the game! The impact of expressive suppression and mimicry on sensitivity to facial expressions of emotion. Emotion, 13(5), 852-866. https://doi.org/10.1037/a0032847
  • Soler, J., Eliges, M. y Carmona, C. (2016). Terapia Dialéctica Conductual: Aplicaciones clínicas y evidencia empírica. Análisis y Modificación de Conducta, 42(165-66). https://doi.org/10.33776/amc.v42i165-66.2793
  • Thibault, I., Pauzé, R., Lavoie, É., Mercier, M., Pesant, C., Monthuy-Blanc, J. y Gagnon-Girouard, M.-P. (2017). Identification of promising practices in the treatment of anorexia nervosa. Sante Mentale Au Quebec, 42(1), 379-390. Recuperado de: https://europepmc.org/article/med/28792578
  • Westwood, H. y Tchanturia, K. (2017). Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Current Psychiatry Reports, 19(7), 41. https://doi.org/10.1007/s11920-017-0791-9
  • Zeeck, A., Herpertz-Dahlmann, B., Friederich, H.-C., Brockmeyer, T., Resmark, G., Hagenah, U., … Hartmann, A. (2018). Psychotherapeutic Treatment for Anorexia Nervosa: A Systematic Review and Network Meta-Analysis. Frontiers in Psychiatry, 9, 158. https://doi.org/10.3389/fpsyt.2018.00158
Fuente de los datos: Dialnet