Does virtual reality increase the efficacy of psychotherapy for young adults with mild-to-moderate depression? A study protocol for a multicenter randomized clinical trial.

BACKGROUND: The improvement of psychological treatments for depression in young adults is a pressing issue highlighted in the literature. Its relevance is determined not only because young adults are underrepresented in research, but also to prevent chronic severe mental health disorders later in life. Engagement is considered a key factor for a good therapeutic outcome, especially among young patients. In this sense, virtual reality could be particularly suited to engage young adults in the therapy process. This project aims to improve the psychological treatment of mild-to-moderate depression in young adults by testing out the efficacy of virtual reality-enhanced personal construct therapy (PCT-VR), as compared to personal construct therapy alone (PCT) and to the reference standard cognitive behavioral therapy (CBT). In contrast to CBT, PCT neither educates patients about depression nor gives them directions on the changes to be made in their dysfunctional behaviors or cognitions. Rather, PCT explores the coherence (or conflicts) of thoughts and behaviors with respect to the person's sense of identity and focuses on meaning-making processes. METHODS: The efficacy of this innovative intervention (PCT-VR) will be compared to PCT and to CBT in a randomized clinical trial. The study includes an appraisal of therapists' adherence and independent assessments to preserve internal validity. The Beck Depression Inventory-II is the primary outcome measure for calculating both statistical and clinical significance, but other outcomes will also be assessed (e.g., functioning, well-being, anxiety, stress) at pre- and post-therapy and at 6-month follow-up. The trial will be conducted in a naturalistic context, mostly at the usual health care center of each patient. A sample of 225 participants is targeted to reach enough statistical power to accomplish the goals of the study. DISCUSSION: We expect that providing evidence for PCT-VR will widen the repertoire of evidence-based technology-based psychotherapeutic interventions for young adults and contribute to the prevention of deteriorating courses of the disorder. TRIAL REGISTRATION: ClinicalTrials.gov NCT04321525 . Registered on 18 February 2020.

Exploring identity and personal meanings in psychosis using the repertory grid technique: A systematic review.

Current research and clinical practice in person-centred approaches highlight the importance of self, identity, and personal meanings in psychosis. Previous research has focused on dimensions of self, but less attention has been paid to the personal meanings involved in identity. The personal construct theory framework and the repertory grid technique (RGT) allow the study of identity and personal meanings within person-centred approaches of psychopathology and treatment in psychosis, as suggested by studies that began more than 40 years ago. However, their contributions have not yet been reviewed. We aimed to systematically review the evidence for the role of identity and personal meanings in psychotic disorders. We performed a systematic search using personal construct and RGT terms in PsycINFO, Web of Science, PubMed, EBSCO, Scopus, and Google Scholar. After identifying 2,574 articles, 15 were included. Nine studies followed an idiographic assessment, and six were nomothetic. Patients reported their subjective experience of isolation in terms of high self-ideal discrepancy and high perceived discrepancy with their significant others, which some studies associated with a lower degree of recovery or with the way in which positive symptoms were construed. Self-fragmentation either decreased with interventions or was associated with recovery. Evidence regarding interpersonal construing was less consistent, but there was a tendency for patients to show a more rigid cognitive structure than controls. To conclude, we found some evidence that self-discrepancies, fragmentation of self, and interpersonal construing are affected in psychosis and potentially modifiable through psychotherapy.

Psychometric Properties of the Outcome Rating Scale (ORS) in a Spanish Clinical Sample.

The Outcome Rating Scale (ORS) is an ultra-brief measure of well-being designed to track outcome in psychotherapy. This research studied the psychometric properties of the ORS in a Spanish clinical sample. One-hundred and sixty-five adult participants from different primary care centers of the city of Barcelona were recruited. The psychometric properties of the ORS in the sample were explored and described, comparing them to the properties of other instruments already validated in Spain. Our results showed good reliability (α = .91 [.88, .93]; α = .96; test re-test correlations from .61 to .84), good validity (convergent validity correlations with distress and symptoms measures from -.32 to -.76), and good sensitivity to change (pre-post comparison through Wilcoxon signed-rank test, Mdnpre = 31.0, Mdnpost = 19.6, z = -7.38, p < .05, r = .42). These results are consistent with previous findings in other countries. We conclude suggesting that the instrument can be applied to monitor outcome in psychotherapy and to test the effectiveness of treatments imparted with Spanish speaking clients. However, further research with the ORS in Spanish could provide more evidence of its psychometric properties.

Psychometric properties of the outcome rating scale (ORS) in a Spanish clinical sample

The Outcome Rating Scale (ORS) is an ultra-brief measure of well-being designed to track outcome in psychotherapy. This research studied the psychometric properties of the ORS in a Spanish clinical sample. One-hundred and sixty-five adult participants from different primary care centers of the city of Barcelona were recruited. The psychometric properties of the ORS in the sample were explored and described, comparing them to the properties of other instruments already validated in Spain. Our results showed good reliability (alfa = .91 [.88, .93]; alfa = .96; test re-test correlations from .61 to .84), good validity (convergent validity correlations with distress and symptoms measures from -.32 to -.76), and good sensitivity to change (pre-post comparison through Wilcoxon signed-rank test, Mdnpre = 31.0, Mdnpost = 19.6, z = -7.38, p < .05, r = .42). These results are consistent with previous findings in other countries. We conclude suggesting that the instrument can be applied to monitor outcome in psychotherapy and to test the effectiveness of treatments imparted with Spanish speaking clients. However, further research with the ORS in Spanish could provide more evidence of its psychometric properties

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