RESUMO
La desregulación emocional (de) fue identificada como uno de los principales procesos involucrados en el surgimiento y mantenimiento de los trastornos emocionales. A su vez, los trastornos emocionales son los más prevalentes mundialmente, volviendo a la deun objeto de estudio de gran relevancia. El presente trabajo consiste en la adaptación y validación de la Escala de Dificultades en la Regulación Emocional (Difficulties in Emotion Regulation Scale, ders) (Gratz & Roemer, 2004), para ser usada en población general del Área Metropolitana de Buenos Aires. Se realizó un estudio transversal con 315 participantes entre 18 y 65 años. La consistencia interna resultó adecuada (α = 0.936; ω = 0.938). Se llevó a cabo un análisis factorial confirmatorio mediante el paquete Lavaan, quedando la escala conformada por 30 ítems que se ajustan a las seis dimensiones originales. También se presenta evidencia de validez convergente y discriminante, la capacidad de discriminación de los ítems, diferencias por sexo y edad, y valores normativos para adultos del Área Metropolitana de Buenos Aires. La adaptación al español de la ders representa una herramienta válida y confiable para medir distintos aspectos del proceso de regulación emocional
Emotional dysregulation (ed) was identified as one of the main processes involved in the emergence and maintenance of emotional disorders. In turn, emotional disorders are the most prevalent worldwide, making ed an object of study of great relevance.The present study consists of the adaptation and validation of the Difficulties in Emotion Regulation Scale (ders) (Gratz & Roemer, 2004) for its use in the general population of the Buenos Aires Metropolitan Area. A cross-sectional study was conducted with 315 participants between 18 and 65 years old. Internal consistency was adequate (α = 0.936; ω = 0.938). A confirmatory factor analysis was performed using the Lavaan package, leaving the scale with 30 items which fit the six original dimensions. There is also evidence of convergent and discriminant validity, the items' discrimination ability, differences by sex and age, and normative values for adults in the Metropolitan Area of Buenos Aires. The Spanish adaptation of the ders represents a valid and reliable tool to measure different aspects of the emotional regulation process.
A desregulação emocional (de) foi identificada como um dos principais processos envolvidos no surgimento e manutenção dos transtornos emocionais. Por sua vez, os transtornos emocionais são os mais prevalentes no mundo, tornando a de um objeto de estudo de grande relevância. O presente estudo consiste na adaptação e validação da Escala de Dificuldades na Regulação Emocional (ders) (Gratz & Roemer, 2004) para sua utilização na população geral da região metropolitana de Buenos Aires. Foi realizado um estudo transver-sal com 315 participantes com idade entre 18 e 65 anos. A consistência interna foi adequada (α = 0.936; ω = 0.938). Realizou-se uma análise fatorial confirmatória utilizando o pacote Lavaan, deixando a escala com há também evidências de validade convergente e discriminante, capacidade de discriminação dos itens, diferenças por sexo e idade, e valores norma-tivos para adultos na Área Metropolitana de Buenos Aires. A adaptação espanhola do ders representa uma ferramenta válida e confiável para mensurar diferentes aspectos do processo de regulação emocional.
Assuntos
Humanos , Adulto , Argentina , Comportamento Social , Comportamento e Mecanismos Comportamentais , EmoçõesRESUMO
Resumen Los trastornos gastrointestinales funcionales (TGF) son enfermedades crónicas que configuran un problema relevante en la salud pública, asociados en investigaciones previas a una peor calidad de vida. El objetivo del presente trabajo fue estudiar la calidad de vida en pacientes que acuden a un servicio de neurogastroenterología en un hospital de Argentina y compararlo con población control. Para ello, se realizó un estudio cuantitativo y transversal incluyendo población clínica diagnosticada con algún TGF (n = 35) y una muestra control sin diagnóstico de TGF (n = 37). Se encontraron diferencias significativas entre personas con TGF y sujetos control, X 2 (1, N = 70) = 30.23,p < .001 en todas las subdimensiones de la escala de calidad de vida (MQLI), exceptuando satisfacción espiritual (PE). Similar a investigaciones previas, los resultados de este estudio sugieren que, en Argentina -al igual que en otros países-, los individuos con TGF muestran una peor percepción de calidad de vida que la población general. Estos hallazgos podrían contribuir al diseño de intervenciones que contemplen variables biopsicosociales, con el objetivo de una mejoría integral en la calidad de vida de las personas que padecen estos trastornos.
Abstract Functional Gastrointestinal Disorders (FGDS) are chronic diseases that constitute a relevant public health problem, associated in previous research with a poorer quality of life. The aim of this study was to study the quality of life in patients attending a Neurogastroenterology Service at an Argentinean public hospital and compare it with a control population. A quantitative and cross-sectional study was carried out including a clinical population diagnosed with some FGD (n = 35) and a control sample without diagnosis of FGD (n = 37). Significant differences were found between people with FGD and control subjects, X 2 (1, N = 70) = 30.23, p < .001 in all sub-dimensions of the Quality of Life Index (MQLI), except Spiritual Fulfillment (SF). Similar to previous research, the results of this study suggest that individuals with FGD show a worse perception of quality of life than the general population. These findings could contribute to the design of interventions that contemplate biopsychosocial variables, with the aim of a comprehensive improvement in the quality of life of people with these disorders.
RESUMO
ABSTRACT Background: Emotions and their regulation are a phenomenon present in everyday life. Despite its relevance and growing interest, a consensual and univocal definition has not yet been reached. Objective: This paper aims to review contemporary theoretical models of emotion regulation, looking for agreements and divergences between authors. It seeks to identify the main processes considered when working with emotional dysregulation. Method: Our team conducted a systematic review in the form of a narrative synthesis following the guidelines of the PRISMA statement. The database used were SCOPUS, PUBMED, and Dialnet. We included articles published between 2018 and 2020, which have been peer-reviewed in indexed scientific journals, whose central theme was the theoretical presentation of the construct of emotional regulation. We excluded articles that conceptualized only one dimension of the construct focused on specific populations and empirical studies without a theoretical conceptualization of the construct. The information was systematized in a table identifying authors' information, country of institutional affiliation, main characteristics of the given definition of emotion regulation, regulation skills mentioned, and underlying theoretical frameworks. Results: We identified ten different theoretical frameworks that propose models of emotion regulation. The main components found in the definition were the complexity of the construct, goal orientation, intra- or interpersonal regulation, the proposal of moderators, and its voluntary character. Discussion: There is a consensus on the use of emotion regulation strategies to adapt to environmental demands, achieve goals and increase well-being. We identify that people's learning history is an important factor in the development of emotional regulation skills. In addition, context and personality traits are proposed as moderators of the therapeutic efficacy of interventions focused on emotional regulation. Further studies along these lines would favor the implementation of preventive interventions and the personalization of treatments.
RESUMEN Antecedentes: Las emociones y su regulación son un fenómeno presente en la vida cotidiana. A pesar de su relevancia y creciente interés, aún no se ha alcanzado una definición consensuada y unívoca. Objetivo: El presente trabajo pretende revisar los modelos teóricos de regulación emocional contemporáneos buscando acuerdos y divergencias entre autores. Se busca identificar los principales procesos tomados en cuenta para el trabajo con la desregulación emocional. Método: Nuestro equipo realizó una revisión sistemática en forma de síntesis narrativa siguiendo las directrices de PRISMA. Las bases de datos utilizadas fueron SCOPUS, PUBMED y Dialnet. Se incluyeron artículos publicados entre 2018 y 2020, que han sido revisados por pares en revistas científicas indexadas, cuyo tema central fuera la presentación teórica del constructo de regulación emocional. Se excluyeron artículos que conceptualizaban una sola dimensión del constructo, se enfocaban en poblaciones específicas y estudios empíricos sin una conceptualización teórica del constructo. La información fue sistematizada en una tabla identificando información de los autores, país de afiliación institucional, características principales de la definición dada de regulación emocional, habilidades de regulación mencionadas y marco teórico de base. Resultados: Se identificaron diez marcos teóricos diferentes que proponen modelos de regulación de las emociones. Los principales componentes encontrados en las definiciones fueron la complejidad del constructo, la orientación a metas, la regulación intra o interpersonal, la propuesta de moderadores y su carácter voluntario. Discusión: Existe un consenso sobre el uso de estrategias de regulación de las emociones para adaptarse a las demandas del entorno, alcanzar metas y aumentar el bienestar. Identificamos que la historia de aprendizaje de las personas es un factor importante en el desarrollo de las habilidades de regulación emocional. Además, el contexto y los rasgos de personalidad son propuestos como moderadores de la eficacia terapéutica de las intervenciones centradas en la regulación emocional. Más estudios en esta línea favorecerían la implementación de intervenciones preventivas y la personalización de los tratamientos.
RESUMO
Resumen El proceso de regulación emocional está siendo foco de gran cantidad de investigaciones en la actualidad. Se estima que se encuentra asociada al desarrollo y mantenimiento del 75 % de los trastornos mentales del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM, por sus siglas en inglés). En esta línea se han estado estudiando en los últimos años, a nivel global, protocolos transdiagnósticos que tienen, como foco de tratamiento, dicho proceso. El objetivo de este estudio consistió en explorar la familiaridad de los profesionales de la salud mental, de hospitales públicos del área metropolitana de Buenos Aires, con el constructo de la desregulación emocional y los protocolos diseñados para el tratamiento de pacientes con dichas características. A su vez, se buscó conocer el grado de acercamiento de los profesionales clínicos a las investigaciones sobre psicoterapias. A estos fines, se diseñó un cuestionario con 40 preguntas de respuestas abiertas y opción múltiple que fue completado por 75 profesionales (psicólogos y psiquiatras) de hospitales públicos del área metropolitana de Buenos Aires. La mayoría reportó conocer el constructo de desregulación emocional, pero al pedirles que conceptualicen un caso diseñado para este estudio muy pocos utilizaron el constructo. En cuanto a los protocolos transdiagnósticos diseñados para intervenir en la desregulación emocional, son muy poco implementados. Por su parte, menos de la mitad reportó haber leído investigaciones empíricas. Los cursos elegidos para continuar la formación son en su mayoría psicoanalíticos y la participación en congresos internacionales es escasa. Se propone la necesidad de fomentar el uso de intervenciones basadas en evidencia en hospitales públicos y la divulgación de protocolos transdiagnósticos con evidencia para la desregulación emocional.
Abstract A substantial amount of evidence regarding comorbidity among mental disorders has been accumulated during the last years. Moreover, it has been identified that there is a great variability within nosological categories. These limitations of categorical systems lead to the development of the transdiagnostic paradigm which contemplates the existence of underlying processes common to different diagnoses. The process of emotional regulation is currently the focus of many investigations. It is estimated that it is associated with the development and maintenance of 75 % of DSM mental disorders. Emotional dysregulation is being studied particularly as a common factor in depression and anxiety, the two most prevalent disorders in Argentina. Related to this, transdiagnostic protocols aiming this process have been studied in the last years at a global level. The Unified Protocol has been developed by Barlow from a transdiagnostic perspective aiming to offer an evidence-based intervention that could be faithfully used in heterogeneous groups. It was created for emotional disorders with a specific focus on emotional dysregulation, contemplating comorbidity and heterogeneity. This makes the Unified Protocol a proper and valid intervention for the most prevalent disorders in Argentina. The objective of this study was to explore the familiarity of mental health practitioners, of public hospitals in the metropolitan area of Buenos Aires, with the emotional dysregulation construct and protocols designed for the treatment of patients with these characteristics. Moreover, the degree in which clinicians approach psychotherapy research was evaluated. For this purpose, a cross-sectional descriptive study was carried on. A questionnaire was designed with 40 questions (25 with closed answer and 15 with short open answer) that investigated five thematic areas: demographic characteristics, therapeutic approach, knowledge about the emotional dysregulation construct and treatment protocols, knowledge about the transdiagnostic paradigm and approach to empirical research. The questionnaire was completed by 75 practitioners (psychologists and psychiatrists) from public hospitals of the metropolitan area of Buenos Aires. After analyzing the results, it can be said that the most prominent theoretical framework from which practitioners work in public hospitals is psychoanalysis. The most prevalent diagnoses are anxiety and depression and comorbidity is frequent (M = 2.23, SD = .707). When studying the familiarity to the construct of emotional dysregulation, it was observed that even though most of them reported knowing the emotional dysregulation construct (89.3 %), when asked to conceptualize a person with intense and long-lasting emotional distress and difficulty in controlling their behavior and recognizing their emotions, very few mentioned difficulties in the regulation of emotions (13.51 %). Individual format treatment was the most chosen by psychologists for patients with these characteristics (69 %). Psychiatrists reported pharmacotherapy as the most chosen treatment (87.5 %). Group format is not frequently used. In regards to transdiagnostic protocols designed to intervene in emotional dysregulation, they are very poorly implemented. Dialectical Behavioral Therapy was reported to be known by 80 % of the sample, but used by 33.9 %, while the Unified Protocol was referred to be known by 34.7 % and used by 7.69 % of them. On the other hand, the gap between clinical practice and research seems to be wide. Less than half of the practitioners reported reading empirical research (44 %). And the transdiagnostic paradigm is known by 46.7 % of practitioners. When asked to mention the most influential authors in their practice, Freud and Lacan (classical psychoanalytic authors) were mentioned by the majority. The courses chosen to continue their training are mostly psychoanalytic and participation in international congresses is low (10.45 %). These results show the need to look for ways to encourage the use of evidence-based interventions in public hospitals and specifically the dissemination of transdiagnostic protocols with evidence for emotional dysregulation, being emotional disorders the most prevalent.