Activation vs. Experiential Avoidance as a Transdiagnostic Condition of Emotional Distress: An Empirical Study.

Background: From a contextual transdiagnostic approach, this study focuses on the importance of the processes of Experiential Avoidance and Activation in explaining and treating psychological problems. There exists widespread empirical evidence to suggest that the response pattern known as Experiential Avoidance, a general unwillingness to remain in contact with particular private experiences through the use of maladaptive avoidance strategies, acts as a functional dimension in various psychological problems. Activation, that is, maintaining contact with experiences/conditions of life and consequently with associated sources of reward, is a condition present in most therapeutic processes. Although a great deal of research has analyzed the relationship of the value of reward with the etiology and maintenance of psychological problems, Activation, as a transdiagnostic factor, has been studied less. The aim of this paper is to carry out an empirical study of the relationship between Activation, EA and emotional state and analyze the capacity of these two conditions to discriminate the intensity and symptomatology type in subjects with emotional distress. Methods: The Hospital Anxiety and Depression Scale (HADS), Environmental Reward Observation Scale (EROS) and Behavioral Activation for Depression Scale (BADS) were completed by 240 health center users. Results: Of the participants, 55% showed clinically relevant emotional distress. All cases of depression showed clinical anxiety. To discriminate between subjects without (n = 109) and with emotional distress (n = 131), analyses of the ROC curves and logistic regression analysis identified the BADS-Avoidance/Rumination followed by the EROS. To discriminate between subjects with anxiety but without depression (n = 61) and with anxiety and depression (n = 70), the most efficient scales were EROS followed by BADS-Social Impairment. Conclusion: It was shown that people with no emotional complaints maintained greater contact with life experiences and with environmental sources of reward than those with emotional distress. Response patterns showing Experiential Avoidance and a reduction in Activation responses were associated with clinical distress. A reduction in Activation was the condition which distinguished those people with the greatest distress and also the greatest comorbidity of symptoms of depression and anxiety. These data support the transdiagnostic nature of Activation and suggest greater attention should be paid to this concept.

Psychological Treatments Features and Outcomes in Spanish Public Mental Health Centres

Little outcomes research has been developed at public mental health care centres up to now, where however a huge percentage of population is treated. Our purpose was to describe features and outcomes of patients attending some public psychological consultations in order to be assessed and if needed treated, in Cantabria (Spain); this should aim at improving effectiveness and efficiency of our psychological treatments. Our sample was composed by all new users coming to 3 clinical psychologists’ consultations for 3.5 years (N= 1962). We measured several clinical, sociodemographic and outcome variables at the beginning of these treatments (pretest), at its end or 1 year after the start (postest), and at 1 and 2 years follow-ups after postest; these variables were collected in clinical interviews or through a telephone survey. Postest showed that 51.4% of patients improved their state after our psychotherapies, while 31.7% did not. For the first year after postest 67.1% of them had not visited any public mental health centre in our region, and 82.4% had not done it for the second year. Previous mental health treatments, sick leaves at work, organic illnesses, applied treatments, asking for a written report, the patient’s involvement into the referral and collaboration into therapy were the main predictive variables of outcomes (AU)

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Eating habits and attitudes and their relationship with Body Mass Index (BMI)

Background and Objectives: To study the differences in eating attitudesand habits between subjects of normal weight and subjects who are overweight and to analyzein each group the relationship between these habits and attitudes and BMI, takinggender as a modulating variable.Methods: A total of 191 subjects, 117 women and 74 men, took part in this study. 102subjects made up the overweight/obesity group and 82 subjects made up the controlgroup. All of them were given a questionnaire comprising 26 items (EAT 26 Eating AttitudesTest) plus an additional group of 10 extra items.Results: The overweight group shows a significantly higher score in mood-related ingestionthan the group with normal weight. Subsequent analyses indicate that while in theoverweight/obesity group there is a positive correlation between the oral control scale andBMI, in the normal weight control group there is a negative correlation between oral controland BMI. Amongst the women in the overweight group a significant relationship wasobserved between skipping meals, oral control and BMI. 50.7% of the dieters stated thattheir attempts to lose weight had generally been followed by an even greater weight increase.Furthermore, 88.5% of the dieters stated that they had been unable to maintain theweight loss in the long term.Conclusions: The results indicate that the same restrictive practices can have differenteffects depending on the BMI and the sex of the subjects (AU)

Electrophysiological evidence for a natural/artifactual dissociation.

The aim of this work was to test whether the differences usually found between the processing of visual stimuli corresponding to natural and artifactual domains reflect the different ways in which these domains are organized in the brain or are rather due to varying tasks demands. For this purpose, we designed two tasks in which subjects had to classify a series of line drawings. In one task (semantic categorization), the subjects were asked to categorize the stimuli as corresponding either to the natural or the artifactual class, and in the other (gender decision), the subjects had to decide if the names of the stimuli corresponded to either the masculine or the feminine gender. Event-related potentials (ERPs) and reactions times (RTs) were registered during the two tasks. We found both quantitative and topographical differences between ERPs elicited by natural stimuli and those by artifactual stimuli. In the 50- to 200-ms period, ERPs were more positive for the natural stimuli in the categorization task, but more positive for the artifactual stimuli in the gender decision task. In addition, natural stimuli elicited larger P600 and were associated with shorter RTs than artifactual stimuli in the categorization task. These results likely reflect differences concerning the relative difficulty of processing the stimuli of each domain in each task. In the N400 range, in contrast, there were differences between the two domains which were independent of task. In the two tasks, natural and artifactual stimuli elicited ERPs with a different scalp distribution: ERPs were more positive at posterior (parietal and temporal) sites for the natural stimuli and in the frontal areas for the artifactual ones. This finding is consistent with the hypothesis that semantic knowledge associated with natural and artifactual domains is represented in separate subsystems with presumably different anatomical bases.